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Bone Health
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Calcium and supplements

Hello

When I was diagnosed last July I only received my dexa and letter through the post. ‘Lifestyle recommendations ‘ - none. Just offered AA, which, so far, I have refused. Not offered calcium or Vit d.

In April I had had a Vit D test, among many blood tests, as I had cancer treatment in 2016. My Vit D levels were 99 nmol. Just noticed my Calcium levels 2.45, adjusted calcium 2.44 nmol.

I do, however. Take Vit d3, 1000iu, sometimes 2000iu, as I’m not sure on maintenance and would prefer to be over 100 nmol.

Now, after speaking to a nurse on helpline, it was mentioned that if the body doesn’t get enough calcium intake, it is leeched from the bones. I then became anxious that my dietary intake could be insufficient. I started to measure my intake. But I drink calcium fortified soya or almond, and noticed this was calcium carbonate. I was re-assured this was ok - past week hitting over 1000 mg of calcium - but not easy. I’m going to start taking a back up supplement, maybe 200 or 500 mg, but worried re calcium carbonate.

Anyone else get calcium from soya or almond milk? I also take kale, almonds, sesame seeds, apricots , figs. yogurt. Just started prunes and back on shop bought kefir as my efforts to make this didn’t work!

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Hello Justme13. Sorry to hear about your osteoporosis diagnosis and the way you found out through the post. The same thing happened to me too, which I was quite shocked at, especially as the DEXA report told my GP she should discuss the options with me!!!

The "normal" range for serum (adjusted) calcium is 2-25-2.65, so yours is bang in the middle of this, which sounds very good to me. If you do want to take a supplement, it's possible to buy calcium citrate (said to be more easily absorbed) instead of calcium carbonate (I get mine from Amazon), either as a powder (which can be mixed with juice) or a tablet, though the tablets tend to be very big. Your Vit D level is excellent too! I have heard there may be benefits to having your Vit D level above 100nmol, but I think the jury is out over this, with some studies suggesting there may be risks in having levels this high. Both Vit D and chewable Calcium Carbonate tablets (usually combined as Adcal) are available on prescription to those with osteoporosis, although if you pay for your prescription it may cost more than over-the-counter - you'd need to check that out! Assuming you're in the UK, your GP should have offered you Vit D and Calcium along with the Alendronic Acid.

Have you been able to get lifestyle advice since receiving your DEXA result? My GP (I made an appointment to see her, I wasn't happy to just accept a prescription through the post) was very vague, which probabaly isn't surprising as I think most GPs only have a limited knowledge of osteoporosis and just hand out prescriptions in line with the NICE guidelines. There are lots of practical suggestions on this forum about exercise, diet and supplements, and the NOS have a series of very useful leaflets, which you can view on their website.

Best wishes.

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Hi Met00

Thanks for your help. Yes, saw Gp, but I think as my Vit D was fine, wasn’t offered it. As I didn’t want AA, she said she would be happy to refer me to Endricinologist, if I wanted, but would probably be offered the drug. I re-started Vit D myself, but thought Vit C was ok, but now worried. On noticing Soya and almond milk use calcium carbonate, have I damaged myself? Used calcium enriched soya for many years. Will now buy calcium citrate.

Will also buy Vit K2 today. Go to the gym 3 times a week, walk a lot, re-started Vitality classes, do Physio exercises, and waiting to start Physio gym.

Can’t believe letter said no lifestyle recommendations!

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When I went to a workshop our hospital presents a couple of times a year for people diagnosed with osteoporosis we were actually reassured that most people get enough calcium from their diet, and Vitamin D intake was more important. It is generally accepted that for the supplements calcium citrate is more easily absorbed. I've also read that having something like citrus fruit when taking the calcium supplement, like calcium carbonate, is helpful, but you might want to double check this as information seems to change all the time.... If you do decide to take a calcium supplement it's best to take a couple of smaller doses every day rather than one large dose. Probably 300 to 500 mg per dose is best. So avoid the supplements which are as large as 1000 mg as the body simply can't absorb that much at one time. To avoid possible problems with calcium supplements, such as calcium deposits where you don't want them, make sure you are also getting enough magnesium, readily available in a diet including lots of leafy greens as yours does, or through the occasional soak in an Epsom salts bath. A vitamin K2 supplement is also essential as this is the vitamin which makes calcium go into the bones, Vitamin D can't do that, and Vitamin K2 is deficient in most Western diets now.

Are you doing as much weightbearing exercise as you can reasonably manage? Simply walking is great!

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Hi HeronNS

Thanks so much for your advice. I’m thinking perhaps the calcium wasn’t getting into my bones. I had held back on Vit k2 as website said something about studies inconclusive, but I saw it in Health shop and I’m going to buy it today. Also, If calcium in soya and nut drinks is carbonate....will need to switch back to milk.....and buy citrate. At the moment, will try and get magnesium from diet. Also, think I read somewhere that the test for calcium in the blood isn’t very reliable? So, it’s possible to have calcium in blood but not in bones...?..?

Yes, I’ve been going to the gym, and although always a walker, have increased this. I had cancer treatment in 2016, fairly inactive as a result, and the steroids for anti sickness seem to have caused problems for my bones.

Just hope I’m doing enough.

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The Japanese have done research and they are convinced it's effective. I think a problem with earlier Western studies was they weren't distinguishing between K1 and K2. A rheumatologist at a bones clinic I went to dismissed K2 saying there had been four studies which disproved its effectiveness, but I looked it up and found her four studies, and then added Japan to the search terms, because I had heard otherwise, and they have indeed published positive research. The K2 in supplements comes from a fermented Japanese soy called natto.

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Hi HeronNS

Thanks a lot for that info. I bought K2 yesterday but still to check correct dosage. Source of Life Vit k2, organic, 120 ug, mcg?, 160% RI. One a day. Could consider Life Extension Super K, Vit k1 1500 mcg. Vit k2 menaquinine 4, 1000 mcg , Vit k2 menaquinine 7. 200 mcg. 3375% daily value. Thought this might be a bit high, but if not, would be more cost effective. Don’t think I need Vit k1 supplement though.

Will check the NOS website on the correct dosage. Difficult to know how much to take.

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I bought a vitamin K2 supplement, no other things in it, and just follow the dosage suggestion on the bottle. I think it's 100 mcg per day. I read somewhere that unlike the other fat soluble vitamins it's hard to overdose on it.

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Thanks HeronNS. I think I may be ok with Source of Life 160 mcg. Life extension is only 200 mcg Mk7, plus other Ks. So, I understand Vit K2. Mk7 is the most important.

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Hello, I only occasionally take calcium supplements and try to get my intake from my diet. I also drink Soya and Almond milk rather than Cows milk, and thought this was better for you, is this not the case?

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Hi Kaz1607

I have still to buy calcium supplements. I only just found out that calcium can be leeched from bones if intake is insufficient. I started to measure how much almond and soya milk I was taking, then noticed it was fortified with calcium carbonate. I always thought it was better than cows’ milk. Just that I read on here that calcium carbonate supplements are not the best. I can’t remember the name of the preferred calcium. Maybe someone else will advise? Does it make a difference what type of calcium is added to soya almond etc?

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