Does anyone know if there's blood test than can tell if the calcium supplements are in fact going to the right place ( the bones) and not being absorbed into the bloodstream, if so what's it called?
I have been diagnosed, via the DEXA scan, with severe osteoporosis, but I don't understand the explanation for my calcium level being shown in the blood test as 'normal' .
My doctor insist that I take calcium supplements, which I have been taking, but how can we know if they are actually working?
The explanation I was given was that the body adjusts the level of calcium. I read that some people on this forum, have low levels of calcium so I am more confused than ever.
I've just started treatment with bisphonates and would like to know how to monitor the effectiveness.
I also noticed some black spots in my stools since taking calcium supplements. Is that common?
Another thing that has worried me lately, my blood pressure has shot up since taking alendronic acid. I wondered if there was a link. Is that a common side effect? My GP didn't think so, said it was 'an age' thing.
I have an appointment with the specialist on Friday, and in order to make the most of this precious time, I would like to go armed with as much information as possible so that I can ask the right questions.
I would be really grateful if anyone could shed some light on this and help my frazzled brain to understand.
Thanks in advance.
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Cheerleader123
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The most important thing to ensure with calcium is that it is going to your bones and not being leaked into your bloodstream. As simple blood test can check your PTH level - that is to say your parathyroid glands (nothing at all to do with thyroid) are working properly. If the level of calcium in your blood is raised, even slightly, it can be an indication of hyperparathyroidism and no supplements or medication will do any good until the offending gland/s is removed. As soon as osteoporosis is diagnosed this should be checked for but it often isn’t. I was lucky enough for an astute GP to notice this in a routine blood test and I had a parathyroidectomy in due course. Have a read of this. I hope it helps.
Thank you so much for taking the time to reply to my question. I'm glad your GP was on the ball and that you received the correct treatment. I will read the article now.
I had the PTH blood test before starting calcium supplements and bisphonate treatment and it showed a 'normal' reading. It will be interesting to see the results now that I've started the treatment.
So have I understood correctly, the test to see if calcium is being absorbed into the bones is called PTH?
As I understand it the test for PTH is to show that the parathyroid glands are not overactive, i.e. producing too much hormone which would lead to raised calcium levels in your blood in turn causing thinning bones.
Ah I see. Yes, apparently they are miraculously working ok, as my calcium levels were deemed normal and the PTH levels were also normal, even though I've had a lobectomy (10 years ago)
I am trying to find out how we can monitor where the calcium is going. To be sure, if that's possible, that the calcium is being absorbed by the bones.
I've had all the tests to show calcium, Vitamin D, parathyroid etc, but I have never had the one for bone turnover markers. This I will ask for when I see the specialist.
I'm reluctantly taking the supplements and the treatment, but want to be sure they are really working. I'd much rather a holistic approach to treating this.
I hope you can get an answer to your query. After much deliberation I decided against bisphosphonates of any sort and opted for supplements, calcium in my diet and HRT as I have to take a daily PPI.
For the moment, I'm taking alendronate weekly tablets, as I am still trying to find out more about the benefits and risks of having a yearly infusion.
Personally, the injection seemed the most scary, but I do know someone who had this treatment (Prolia) for a few years, followed by a few months of bisphonates to counter balance the rebound effect of stopping the Prolia.
Although,I'm still not convinced, I am very happy someone has had such good results and no badside effects with it!
None of those, I have been offered Zolendronic infusions, but I haven’t started yet because I am still talking to the hospital. I was asked if I wanted infusions injections or tablets, not having any information previously I thought it would be easier to have a once yearly infusion , since investigating I am having second thoughts as it’s once a year, and if problems arise I would not be able to change it. So I am booking a telephone appointment to discuss the possibility of injection myself as that could be stopped. Dentists are reluctant to treat patients on zolendronic infusions even though they say my teeth are ok! and I’m worried about if anything else might need attention during the year it’s current. I’m still not sure about any of them being needed as I have a-3 in my upper left arm, presumably dr has had a second thought about the omprazol I’ve been taking for a long time without it being questioned! Appreciate help from health unlocked members making me question Drs decisions!
My dr wasreluctant tostart yearly infusions before testing the weekly tablets. If any side effects during weekly tablets, this canbe stopped. whereas with the yearly dose, there's nothing you can do.
We don't have any option to administer the IV at home here. I would question that with your doctor.
I'm by no means an expert, but the only injection I've heard of that can be done at home is with another treatment.
No I would have to go to hospital for the infusion, originally I hadn’t any information on my first visit, now I’ve found out more I definitely don’t like the idea of having a whole year , so you have a very good doctor. I’m still investigating and in discussions with hospital and doctor. But will probably discuss the self injection option.
One-Blue-Lady, I hope I'm not confusing you, but I thought I should clarify that
the Zolendronic acid comes under different brand names.
Reclast is a brand name for Zolendronic acid and Zometa is another one that I've heard of.
The only one I've been told about that is used to treat Osteoporosis is the Reclast infusion yearly dose administered by medical staff.
I believe that the Zometa brand is also administered by medical staff, weekly or monthly doses, but it's used to treat other illnesses.
I've not heard of any other zolendronic acid injections that can be admisinstered at home by the patient themselves.
I've been taking the tablets now for 6 weeks and I haven't noticed anything bad apart from slightly higher blood pressure, which has settled down now and my doctor believes is unrelated.
I don't see why you'd want to start with a yearly dose.
I dothink you are right to ask your doctor and (or) the hospital for an explanation for the pros and cons of each type of treatment for you, to help you make your decision.
There is nothing wrong with calcium in your bloodstream. It is quite necessary for it to be absorbed there from the digestive tract. It can also be released from the bones into the blood. The dynamics of the systems involved in maintaining/modulating your serum (blood) calcium levels and bone density are complex. There is no one test. A picture emerges from looking at serum calcium, DEXA, parathyroid, vitamin D, bone turnover markers, etc.
It is the perfect subject to discuss with your specialist. If you want to do your homework in advance of your appointment, I would advise calling the office and asking for prepatory reading material based on this question. That material should fit the way that particular specialist thinks about and explains it to patients, which should put you a step ahead in any in-person dialogue.
Hi - you may want to look into Vitamin K2 also. There are articles out there that suggest it helps direct the calcium supplements towards the bones. Also I believe it’s ideal to take calcium supplement with vitamin d to help with the absorption. I try and get as much calcium as I can via diet (including a drink of kale/cucumber/celery/apple/beetroot juice & water - tastes better than it sounds !) plus Viridian calcium and Vit D supplement plus K2. Appreciate everyone is different though. Hope this helps & good luck with your consultant.
Will measure how much I put in over the next couple of days and let you have it. - re the vitamin K - there is K1 and K2 and it’s the K2 that helps direct the calcium to the bones. Think K1 is involved in blood thinning. It’s worth reading up on.
Hi - sorry to be so long in coming back to you - do hope you’ve been able to get more answers…the rough proportions of the juice I make gives 3 glasses (3 of us) including a bit of pulp/fibre. So it’s roughly: Cucumber 120g, celery 200g, Kale leaves (small bit of stalk also) 180g, Apple 200g, Beetroot juice (I use James white organic) 70ml and top it up with water about 350ml totaling 420ml. I don’t weigh regularly - just go by eye & try to use organic where possible. It tastes better than it looks (but my mother adds a bit of honey to sweeten it) - extra apples will do that ! All is chopped before mashed & apples are cored. Good luck with it…. Do hope you like it & it’s useful. All the best
PTH is made by four tiny parathyroid glands in your neck. These glands control calcium levels in your blood. When calcium levels are too low, the glands release PTH to bring the calcium levels back up into a normal range. When your calcium levels rise, the glands stop releasing PTH. Measuring PTH can help explain the reason for abnormal calcium levels. PTH blood test can help your doctor figure out whether your abnormal calcium levels are caused by your parathyroid glands. If your test shows that your PTH level is appropriate for your calcium level, then there is some other cause of high or low calcium levels. Your doctor may recommend this blood test if you’re showing symptoms of hypercalcemia (too much calcium in your blood) or hypocalcemia (too little calcium in your blood). This is not a test for how much calcium is getting to the correct places in your body, including your bones. Bones are the largest "storage" of calcium in the body...but calcium is also important for blood clotting, cardiac function, muscle contraction, improving cholesterol levels, and preventing preeclampsia in pregnancy.
How can you find out if your bones are getting enough calcium? To my knowledge, there is no specific test available.
Vital is to obtain enough but not too much organic calcium through foods, Vit D3, Vit K2 and Magnesium. Vit D3 is most important in the interactions, but K2 puts it in the right places. Calcium can be dangerous if you are taking the "rock" inorganic type...Tums is an example....organic such as algae calcium is safer...but many doctors are lowering calcium or stopping the supplementation, especially if you have cardiac problems. Ask your doctor specifically if the type you take is safe.
I've had numerous surgeries in the last two years, 12...had pre-op testing, and the last one was reviewed as clean, clear arteries, "no seen" heart disease, which was the same as the last MRI and CT scan. Vit K2 is vital for those "clean" arteries as well. I learned this from my mother's cardiologist years ago...he didn't get her to stop taking the Tums 3x a day...he tried, but she was stuck with bad info from years back...She only started K2 the year she died, with 600 blocks in her 100 lb body...not enough time to work.
Thank you so much for taking the time to reply to my query. My PTH levels were ok apparently as was the calcium levels. This caused my confusion as to why I had to take the supplemts. I will bring this up with my consultant tomorrow. I'm taking calcium carbonate and I've tried asking for a different one from GP, without success. I also include enough calcium through my diet and this was another concern that I make have too much calcium now. I haven't had a blood test since taking the supplemts or treatment so will discuss this also during my appointment. Glad you've got the all 'clean' and I'm so sorry to hear about your mum.
I just started taking Vitamin K2 along with my calcium and magnesium (all at different times). Would you mind sharing the dosage of the K2, D, magnesium, and calcium that you are taking? Sorry about the loss of your mum.
Remembering we are all different...I have my Vit D3 checked twice a year, and live in a very sunny area. Vit D3 I take in the morning, 5000 iu. Levels stay at 60. I have autoimmune, so I need it higher as we don't convert from the sun well. Calcium supplements I do not take at all, my calcium is monitored 4 times a year, and because I take Tymlos, calcium levels stay at 9.8 to 10.0, and the "line is 10.0" for blood calcium to be safe...per the doctors at Tampa FL who took out my parathyroid tumor...Norman Parathyroid Center. Lab level values are not accurate and allow a higher number due to children being included in the numbers...children can be higher, not folks over 35. But when I was taking a supplement, it was True Osteo, which has a great combo product. Vit K2 , MK7 I take in the morning, it's 180 mcg. In the evening I take MK4, 400 mcg. Magnesium I take the glycinate form 3x a day, 400 mg per dose. I take this amount to help with autoimmune conditions, it helps with over 300 processes in the body...the standard amounts are in most cases far too low. If I'm having tons of muscle spasms, I'll add an extra dose. My last scan (for pre-op) showed zero heart issues, zero blocks, the radiologist asked what I was doing to keep them all so clean. Vit K2!!! Two other supplements I use are BioGaia Osfortis, which is a probiotic for women for their bones; and Lactoferrin, which comes from mother's milk and helps bone growth, both have clinical research for good outcomes.
Who supplies your Lactofetrin and BioGiaOsfortis is it a private company or prescription. Presumably you are in USA so that’s not going to help me in uk! Interesting though, thanks.
I get both from Amazon, but the brand is BioGia products, it may be elsewhere. The lactoferrin is Jarrow Formulas, one of two brands in the clinical trials showing benefit to the bones. I think both can be purchased from many websites.
I believe that the protocol for prescribing bisphosphonates is that calcium+vitD3 supplements must be prescribed alongside. That is because bisphosphonates can cause calcium depletion in the body (due to the slowing down of bone resorption). It's in GPs' instructions to prescribe them together.
Regarding your GP's rather dismissive response to your report of a sudden increase in your blood pressure, I don't think that age-related increase would be a sudden event. In my opinion (I should add, I am not medically trained) it would seem far more likely that any sudden change experienced shortly after starting a new drug would be very likely related to the effects of that drug.
Thank you for replying to my query and for the clarification regarding the supplemets. That makes sense now. Just need to get to the bottom of these new symptoms and armed with this new information, plus all the replies above, I now feel confident about what I need to ask.
It’s not an easy decision to reject medication is it? Mine was prescribed over the phone by a nurse who knew nothing about me reporting the results of a DEXA scan I was sent for because I had broken my wrist. She simply told me I had osteoporosis and I would have to take Alendronic Acid. At the time I was being treated for MALT lymphoma of the stomach - can you imagine what an oral bisphosphonate would have done to me? Around the same time an astute GP noticed the calcium level in my blood was raised and referred my to an endocrinologist in case I had hyperparathyroidism which it turned out I did. AA would not have had any effect whatsoever until the offending gland was removed but despite this the consultant pushed me to take it and actually threatened me with what would happen if I didn’t. The gland was subsequently removed and I like to think that because of this surgery there was some improvement in my bone readings, Some months later I started treatment with an osteopath who asked how long I had had scoliosis - I didn’t even know I had it or for how long, it could have been decades! .This should have been pointed out to me at my DEXA as this reduces the accuracy of the scan quite considerably. It wasn’t. Good old NHS again. Fortunately I have a great GP who, being aware of my ongoing concerns about taking a PPI for my stomach issues, suggested HRT patches and I am only too happy to keep on with these and yes I am aware of the risks. I think considering the fact that I have taken a PPI for more years than I care to remember and suffered from hyperparathyroidism for heavens knows how long before it was detected the HRT I took for many years in my 40s and 50s may well saved my poor bones from being very much worse! I now refuse DEXA scans, they are of no use to me. If my osteoporosis is stable that’s fine, if it’s deteriorating then I’d rather not know as I am doing all I possibly can to control it and can do no more.
Hello, I've asked for the bone marker blood test (P1NBP) from 3 different doctors.
My GP, an Endocrinologist and an osteoporosis 'specialist' who turned out to be a rhumatologist.
The endocrinolgist thought it would be interesting to have this done, but preferred to wait to hear what the 'specialist' decided, the GP said it was only used if the other blood tests (CTX) flagged up anything abnormal and would only routinely order this test if I was taking a different medication, or had a specific illness.
The 'specialist' reiterated what the GP stated, that this blood test (P1NP) wasn't necessary as a measure for osteoporosis and said that crosslaps (CTX) were the tests routinely used to measure the bone turnover.
The factsheet from the ROS website has some good information about the different tests.
My last blood tests were done over a year ago (March 2023) which included the parathyroide (PTH) blood test and the crosslaps CTX, plus a whole plethora of tests to check liver, kidney function etc. and all showed a normal reading apart from low vitamin D.
I had a Dexa scan in Novemeber 2023 and was diagnosed with severe osteoporosis so based on this scan I have been advised to take alendronate for 2 years and have blood checked again in 6 months time and have a follow up DEXA scan in 2 years!
I wrongly thought the specialist would be able to at least recommend a nutritionist, physiotherapists (with osteoporosis knowledge / experience)- nada!
I also raised the question re: HRT and was told that this wouldn't be an adequate treatment for me.
As I am taking extra calcium supplements with vitamin D3, and I am worried that I'm taking too much calcium (because I already consume a lot of calcium in my diet), so the specialist agreed to have this checked and has ordered a 24 hour urine test to check my calcium levels.
My scoliosis would undoubtedly have affected the DEXA results, it would have been good to have been informed of that at the time as well as being tested for hyperparathyroidism. More failures on the part of our wonderful NHS! My osteopath, whom I rate very highly, is of the opinion that as all women lose bone density as they age too much emphasis is placed on diagnoses of osteoporosis especially as the drugs used for treating it often do more harm than good. Perhaps she has a valid point so maybe France has got it right.
Hi everyone, It's fantastic to see so many of you supporting Cheerleader123 with their question. Here is some additional information and support available from our theros.org.uk/ website for some of the topics raised in the thread.
Vibration Therapy - strwebprdmedia.blob.core.wi... (The current up to date expert-view, based on the research evidence is that exercise and physical activity is the best way to work your bones to keep them strong. You may, of course, choose to take use or buy a vibration therapy machine. But our expert advisers tells us research hasn’t yet proven that this is useful. The best evidence is for Whole Body Vibration reducing your risk of falling. Research shows it is generally safe. Research has not proven that Low Intensity Vibration therapy is better or safer than Whole Body Vibration at strengthening bones)
DXA Scans – strwebprdmedia.blob.core.wi... (We’ve noticed you sharing your questions and concerns about DXA bone density scanning. We fully understand you want to know all about ways to measure your bone strength. We encourage you to read more about this on our website. The important thing to grasp is that DXA scanning doesn’t provide a perfect measure of bone strength. This doesn’t mean results are ‘fake’ but DXA shouldn’t be used on it’s own to make drug treatment decisions. Results have to be combined with other ‘risk factors’. Some of these, such as older age, mean that bone strength is affected other ways not shown on the scan such as reduced bone quality - when the structure inside bone has ’broken down’. It doesn’t mean that DXA is wrong, but we may have an unrealistic expectation of what the scan can show us.)
Hello all. I want to share with you a podcast with Margie Bissinger called “Happy Bones Happy Life”. Margie is a PT and an integrative health coach. Her podcasts are full of useful information about osteoporosis. One in particular is #186. It’s an interview with Dr Kieth McCormick who explains all of the medications to treat osteoporosis and side effects etc. He also explains all of the bone marker tests.
There are many other informative discussions in Margie’s podcasts and ways to increase bone health without medication.
They have been very helpful for me. Knowledge is our greatest asset to help us through this process. Please give a listen!
Thank you Garden-wise for sharing this interesting information about Margie's fantastic podcasts!
The interview with Dr Kieth Mc Cormick gave a very balanced view with regards to taking the medication and understanding the process of bone cell renewal and the connection with immune system and inflammation.
As I have already started treatment with medication, I found it reassuring and encouraging to hear his calming point of view.
This forum is a truly wonderful source of knowledge, information and incredible support!
Have been put on 6 monthly subcutaneous injections of denosumab for the osteoporosis. Am still on mtx, have the usual 3 monthly blood tests and they have now included a test for calcium. I also had a blood test exactly 19 days after the first jab, the nurse emphasised the necessity of the length of time. Good luck.
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