My calcium level appears low within bone profile blood tests. Are these an accurate representation I wonder?

[Alternatively]

Diagnosed with osteopenia after having Dexa scans in 2016 and 2023 and breaking wrist and arm in separate incidents of slipping on ice. My concern is that when my calcium is tested via bloods, it comes back as being borderline low even though I’m taking 900mg calcium citrate per day and ingest another 800mg via dairy products every day. So at 1700mg per day I would expect blood test results to be in the very good range. I also take vitamin D 400mg and 300mg vit k2, and 600mg magnesium at a separate time from the calcium. My Parathyroid and all other bone profile test results say ok. Confused. . Need your thoughts please? Is there a reason why my blood tests are not reflecting the amount of calcium I ingest?

Can I get private urine testing done somewhere? Is this more accurate than a blood test?

[FrogLeg]

Serum calcium homeostasis is extraordinarily complex, involving the interaction of a variety of hormones, minerals, organ functions, etc. I could write a litany of influences, but that would be irresponsible, as you might limit your thoughts to what I choose to mention. I cannot emphasize enough how critical it is that you seek advice from a medical provider. If you have done so already, please share their assessment of your situation in detail. We can help you with followup questions to potentially ask. You cannot simply compare urine to serum calcium levels. I would not take more than 1200mg of calcium daily without a clear explanation from a physician. This isn’t something you just take more calcium to get your numbers up. It is much more complex and sophisticated. And too much calcium can be harmful.

[Alternatively in reply to FrogLeg]

Thankyou for your reply Frogleg.

I’ve spoken to 2 GP’s at my practice about this and they can’t offer me any suggestions.

Interesting that you say you can’t just take more calcium to get your numbers up as that is exactly what I’ve been trying to do. And my gp’s know this.

I’m happy to go and see a Consultant privately but I don’t know which specialty would be able to help me best with calcium levels ….. Haematologist or an Orthapedic Consultant or someone else?

Can you recommend some websites where I can get some more information?

As from today I will keep my calcium intake to 1200mg, good advice.

I’m fit and healthy in all other aspects apart from I take Levothyroxine daily for an under active Thyroid.

[FrogLeg in reply to Alternatively]

You should see an endocrinologist. I would not make any adjustments to your intake of calcium based on my comments, especially if your GPs are aware that you take this level of supplementation. BUT I would speak to an endocrinologist. They can explain how blood calcium levels are managed and talk about when to be concerned and what steps to take, if any.

[FrogLeg in reply to Alternatively]

I am sending you a private message. Please look for it.

[Met00]

Could you confirm how much vitamin D you're taking, as it's usually measured in MCG (not mg) or iu. Would you also be willing to share your vitamin D, calcium and parathyroid blood levels, together with the normal ranges for each. That might help to give a clearer picture.

[Alternatively in reply to Met00]

Apologies I got that wrong, I’m actually taking 4000iu vitamin D

I will get that information together and post my blood levels and ranges to you tomorrow.

Thankyou for asking.

[Anonimoveneziano]

Are you on regular osteoporosis medication? And with regards to supplements beyond calcium, have you been advised on the dosage each of them particularly D3 and K2. D3 dosage/strength is usually shown in IU rather than mg. The action in the body of these 2 are closely linked. D3 helps with absorbsion of calcium in the gut, while K2 action is to transport the calcium in the blood to end up where we want it to go, in our bones, by preventing the calcium from depositing in our veins. Both supplements are fat soluble so need to be taken say with a small piece of bread and a little olive oil. Of course you will need water, but the fat component is needed. So a correct dosage of K2 may be important. The 2 of them can be taken with magnesium. I take similar supplements myself. If you are on prescription medication you may want to discuss your concerns with your GP or Endocrinologist.

[Alternatively in reply to Anonimoveneziano]

Hello, many thanks for responding to me.

No I’m not on any medication for osteoporosis as I only have osteopenia.

I should have said that I’m taking 4000iu vitamin D combined with 200 ug vitamin k2 in an oil based capsule…. Brand is Aava Labs from Amazon. I take this in the evening with omega 3 oil capsules

In the morning I then take an extra 100ug vitamin K2 capsule with omega 3 oil capsules. And selinium and MSM .

3 times a week I take a vitamin B complex

I wonder if the oil from the supplements is enough to aid the absorption?

I also take 300mg Magnesium Glycinate with zinc 4 hours away from taking my calcium

My B12 and vitamin D were both at the higher end of the range in all my blood tests and there were no flags for iron etc

It’s just the calcium results that are a mystery. And 2 of my GP’s couldn’t offer me any information or solutions when I told them the amount of supplements I’m taking daily plus the dairy I’m consuming in an effort to bring the numbers up at my next blood test

Would appreciate your thoughts.

[Anonimoveneziano in reply to Alternatively]

I am not a physician, was diagnosed with osteoporosis later 2007 at 50, most probably genetic but made worse by living in the UK with low levels of sunshine vitamin, D3. I read a lot about it but only from reliable sources like clinical studies/white papers. I find getting a good GPs in UK hard work and to be honest anything to do with bone metabolism or any concerns should be dealt by an endocronologist sodcialised in bone metabolism/osteoporosis. All my blood tests seem to be ok on the whole however, I eat healthy, and take all the supplements you are taking and my femoral neck readings have not improved for nearly 3 yrs despite taking Denosumab. My knowledge is that this monoclonal medication can interfere with low levels of calcium in the blood especially during the first few months from the injection. But you are not on medications.

As for me DXA scan are only as good as the operators with the possibly variable results depending even from the correct adjustments of the hips on the table of the scan.

I am seriously thinking to have a private REMS as it may well tell a different story about my bones but in addition you get a projection on the quality of the bone and more accurate incidence of possible fractures which is as important if not more important than density in some cases.

REMS does not give radiations, it is an ultrasound basically.

If there is a medical reason for the osteopenia, I would personally want to be referred to a consultant. Wishing all the best.

[Alternatively in reply to Anonimoveneziano]

That’s all really interesting, thankyou for sharing.

I will look into having a private REMS and will look for an Endocrinologist too.

I think the reason for my osteopenia was having an early menopause in my 40’s and having no hormone replacement therapy.

Wishing you all the best too.

[Anonimoveneziano]

Hi again,

Re: urine test, not sure which one you are referring too. NHS does not usually perform bone markers tests from urine in my 10 years experience.

In Italy they take regularly tests of collection of 24 hrs urine to check the amount of calcium the body expels during a typical day. It gives an indication of how much calcium is lost despite meds and diet.

I know there is N-telopeptide (NTX) .

I only get P1NP (blood) (new bone formation markers) every 2 years, however a CTX (bone reabsorption markers) also should be taken for a more comprehensive view of bone metabolism. In USA it is more likely to be performed regularly for osteoporosis/osteopenia (private/insurance) every 6/12 months.

Regarding Calcium in the blood depending how low is on the scale, if below the scale, is the job of the consultant to advise. All I know is that it is important that calcium in the blood needs to be within the parameters and it is very important to ensure all is good.

You may have come across this link before.

There are lots of useful video on you tube and it is possible to interact with this very knowledgeable lady. She has written some useful books on exercise for low bone dentity available on Amazon.

melioguide.com/

You can also subscribe to her email.

She has just recently moved from Canada to Portugal. Good for her.

Also look out for the Merodyne LV plate. It has been approved in Europe to increase bone density.

Not cheap, so sitting on the fence atm.

She has at least a video about it and several mentions on the benefits of using it regularly.

With regards to the endo, make sure he is had a strong interest and expertise in bone metabolism.

Anyone mentioning medications, make sure you research properly on symptoms and especially in case of coming off the treatment like in the case of denosumab. I was prescribed it for the wrong reason, a small stress fracture in my foot, when it should be prescribed for more serious fractures like spine fractures and now I cannot come off it without the serious rebound effect that can result in multiple fracture of the spine.

I would have been better with Zolandronade for 3 yrs instead.

There are several white papers mostly dated around 2018. The first was written by Dr Lamy about the rebound. The clinical trials only lasted 3 yrs and coming off the treatment was not included in the trial at the time. FDA approved the drug in 2011 I believe.

[Alternatively in reply to Anonimoveneziano]

I’m really sorry to hear about the medication you were given. Thankyou for your advice to research it myself thoroughly before accepting.

Currently I’m not at the stage of needing osteoporosis medication.

I’ve clicked into the link you sent me, looks very helpful, thankyou!!