Are your calcium supplements actually useless?

August 25, 2010 by  

Many of us swallow vitamin supplement pills each day, including calcium for bone health. Clinical guidelines on osteoporosis recommend supplementation with calcium especially for those who are at high risk for bone loss and fractures.

But the truth is, the benefits of calcium supplements are rather unclear, not to mention contradictory. Previous studies have shown that:

  • Calcium can protect against vascular disease.
  • Calcium can cause vascular disease by hastening vascular calcification.

So what now?

A group of researchers at the University of Auckland in New Zealand conducted a systematic search of electronic databases and conducted a meta-analysis of randomized clinical trials of calcium supplements compared to placebo. The results of the meta-analysis might have answered the calcium supplement question once and for all and can be summarized below:

  • Calcium supplements were associated with a significant increase (about 30%) in incidence of heart attacks.
  • Calcium supplements were also associated with trend of increased risk of stroke and mortality, although the increase is much smaller and not statistically significant.

These findings were consistent in all 5 trials included in the analysis and the increase of MI risk due to the supplements also increased with higher dietary calcium intake. Age, gender and type of supplement did not influence the results.

What is even more disappointing is the finding that calcium supplements have very little benefits when it comes to preventing fractures.

How reliable are the current results?

Some experts speculate that misdiagnosis of heart burns caused by the supplements as cardiac chest pains may have given erroneous results. This is based on the fact that many of the heart attack reported occurred within an average of 3.6 years after calcium supplementation was started. However, calcification of the blood vessels should take longer than that.

In addition, the studies analyzed were only those that did not include vitamin supplementation. It is common clinical practice, however, that calcium and vitamin D supplements are coadministered for osteoporosis. It is not clear whether vitamin D, which supposedly has cardiovascular protective properties, combined with calcium would give the same results.

However, the majority of experts agree is the fact that calcium supplements do not seem to prevent fracture indicates it is practically useless to take them even if the supplements as such are safe and do not cause heart problems.

According to senior author Dr Ian R Reid:

“Clinicians should tell their patients that, for most older people, the risks of calcium supplements outweigh the benefits. Changing to calcium-rich foods may be appropriate.”

According to independent expert Dr John Schindler (University of Pittsburgh Medical Center in Pennsylvania:

“I think the safest thing to tell your patients right now is if you can get your dietary calcium from good dietary sources, such as yogurt, sardines, and skim milk, that potentially might be all you need to ward off the risk of osteoporosis. Then we don’t have to deal with this increased cardiovascular risk.”

Vitamin D and rheumatoid arthritis

June 22, 2010 by  
Filed under ARTHRITIS

Vitamin D deficiency has been linked to a wide range on health conditions, including rheumatic diseases. Three European studies looked into the relationship between rheumatism and vitamin D levels as well as the effect of vitamin D supplementation.

Study  1:

An Italian study followed up 1191 patients with rheumatoid arthritis. The results showed that vitamin D levels in the blood were lower in these patients compared to the normal levels of at least 50 nmol/L . Furthermore,  supplementation does not always help. Only 40% of these patients who are take vitamin D daily supplementation of 800IU or more reach the normal values. The vitamin D levels in the blood in 60% of patients are still below normal. Measures of disease activity using questionnaires show that low vitamin D levels are correlated to increased disability, decreased  mobility, and more swollen joints.

According to  Dr. L. Idolazzi of the Rheumatology Unit, University of Verona, Italy:

“We have seen in studies that vitamin D deficiency is common in patients with a range of rheumatic diseases, and our results have confirmed this using several clinically accepted measures of disease activity. What we need to see now is a range of long term studies, which examine the clinical response of patients to vitamin D supplementation.”

Study 2:

In another Italian study, the effect of vitamin D supplementation on inflammatory autoimmune diseases was investigated. In this group of 43 patients, only 29% achieved normal vitamin D levels following supplementation.

Study 3:

A third study conducted in the UK involved 90 patients with rheumatoid arthritis, osteoporosis or unexplained muscle pain. These patients, too, had below than normal levels of vitamin D.

About vitamin D:

Vitamin D is also called the sunshine vitamin as it can only be synthesized by the body when exposed to sunlight. Unfortunately, vitamin D is not available in sufficient amounts in the food that we eat. Although vitamin D is available through sun exposure, the risk for skin cancer than the sun rays bring has led many health experts to discourage this practice.

In recent years, there has been a big debate about the necessity of vitamin D supplementation. In many countries, including the US, milk is supplemented with vitamin D. In addition, doctors often recommend vitamin D supplementation to their patients, especially little babies who are being breastfed. The American Academy of Pediatrics recommends routine vitamin D supplementation for children and updated its guidelines on Vitamin D intake last 2008. The new guidelines increased the recommended dose from 200 IU to 400 IU per day.

Vitamin D and calcium do not prevent breast cancer

March 3, 2009 by  
Filed under CANCER

Here is another study from the Women’s Health Initiative that gives disappointing results. At least disappointing for those who are big fans of vitamins and other dietary supplements.

Previous studies suggested that vitamin D supplements may lead to a reduction in breast cancer risk. The current research by UCLA researchers looked at 36,282 postmenopausal women who were randomly assigned to two groups. One group took a pill containing 1,000 mg of calcium plus 400 IU of vitamin D every day while the other group took placebo which was identical in appearance to the vitamin pill. This way, the participants were not aware which drug they were taking. The study was originally designed to study the effects of supplements, especially calcium on the incidence of hip fractures. Fractures due to osteoporosis are quite common among women of postmenopausal age and calcium supplements are prescribed as primary care preventive measure. Vitamin D is also known to contribute to bone health and prevent rickets.

Unfortunately, the main findings of the study say

Calcium and vitamin D supplementation did not reduce invasive breast cancer incidence in postmenopausal women. In addition, 25-hydroxyvitamin D levels were not associated with subsequent breast cancer risk. These findings do not support a relationship between total vitamin D intake and 25-hydroxyvitamin D levels with breast cancer risk.

This wasn’t the first disappointing news regarding vitamin supplementation and cancer. Late last year, the National Cancer Institute prematurely stopped the SELECT trial which investigated the efficacy of selenium and Vitamin E in preventing prostate cancer – with negative results.

There have been many reports that vitamins and other nutritional supplements do not necessarily give us health benefits. Many health experts discourage the use of supplements with the exception perhaps of vitamin D. The American Academy of Pediatrics, for example, revised its guidelines last year to double the dose of vitamin D supplements for children to prevent vitamin D deficiency and rickets. This is in addition to the fact that baby formula and milk products in the US are fortified with vitamin D.

Recent research studies are putting a question mark on the benefits of vitamin supplementation and the current study also puts to doubt the necessity of vitamin D supplements, which taken in excessive amounts, can actually be toxic.

The Consumer Healthcare Products Association (CHPA) has compiled some facts and figures on supplementation, as given below:

What the Cows Know…

August 31, 2008 by  
Filed under DIABETES

The dairy cow knows the value of Vitamin D.

And now so do researchers.

Study participants were given Vitamin D supplements (typical infant multivitamins) from birth on and after a tracking period of 15 to 30 years it was found that they were 29% less likely to develop type 1 diabetes than those infants who did not receive the supplemental Vitamin D. (Archives of Disease in Childhood) You can read the entire story here.

Low levels of Vitamin D apparently leads to insulin resistance.

Sources of Vitamin D:

  • Vitamin D is synthesized in the human skin when it is exposed to ultraviolet light
  • Fortified milk
  • Swiss Cheese
  • Beef Liver
  • Fish (mackerel, tuna, sardines)
  • Eggs
  • Cod liver oil

And according to this associated article from USA Today News: June 14, 2008, Vitamin D Tests Soar As Deficiency, Diseases Linked—more doctors are testing for Vitamin D deficiency related diseases than ever before as more than 35% of adult Americans are found to have low levels.

How Much Vitamin D Do We Need?

Per the Mayo Clinic:

“You’re unlikely to get too much vitamin D from the food you eat, and prolonged sun exposure doesn’t seem to cause vitamin D toxicity. Over time, however, megadoses of vitamin D supplements can cause

nausea, vomiting, poor appetite, constipation, weakness and weight loss. More seriously, excessive doses of vitamin D can raise the level of calcium in your blood — which can cause confusion and changes in heart rhythm. Generally, the upper limit for vitamin D is 2,000 IU a day.”

Read more

Grapefruit Pulp For Bone Health

July 23, 2008 by  
Filed under ARTHRITIS

The bone health ‘industry’ is dominated by Calcium and Vitamin D, as many people already know. I know this is an arthritis blog but for now I want to talk about our bone health. For somebody who has never been a religious milk drinker, I wanna take this opportunity to remind myself of the importance of starting early on milk. While I cannot take back  or even make up for the years lost of not drinking milk (I’m a true-blue coffeeholic!), I remain a work in progress in putting milk into my diet. (The time I was pregnant and breastfeeding and of course when I was a kid was the only times in my life I was on milk!)

There is always the option of taking the supplemental Calcium with Vitamin D. I was on this too when I got pregnant and even afterwards. However, I have always believed that taking the dietary sources are a lot better than taking the supplements. That’s why I have always resorted to other dairy products ( and other food sources rich in calcium) such as cheese and fruit yoghurt (yikes, i never thought the day would come I’d be brave enough to try yoghurt!). Just think non-fat dairy folks, that’s arthritis-friendly.

Speaking of grapefruit. Who likes it? It isn’t one of the nicest citrus fruits to eat but it has become popular in lose-weight fad diets. One time I bought grapefruit juice and was repulsed by the taste. Really. That time I thought maybe that’s why people lose weight with grapefruit because after eating (or drinking the juice) you feel horrible in the stomach and the mouth and then you can’t eat anything else anymore.

Now results of  Texas AMU research showed that red grapefruit pulp may compete with Calcium and Vitamin D for bone health, at least in their study using male rats:

The pulp of grapefruit may improve bone health and reduce the risk of developing osteoporosis, according to a new study with male rats.

Consumption of the red grapefruit pulp led to a slow down in bone resorption, and an increase in bone mineral build-up and calcium absorption, according to researchers from Texas A&M University.

If the results can be repeated in humans, grapefruit pulp may offer a new ingredient to the growing bone health market dominated by calcium and vitamin D.

Well…if grapefruit pulp later becomes a supplement, I guess I can take it better than eating fresh grapefruits! But then that’s just me. Other people may disagree and find grapefruit appealing to their taste buds.

So there, I’m just saying there goes maybe another option in the future for people who can’t drink milk. There are always substitute, even for people with cow’s milk allergy and even for the lactose-intolerant. Really I should be thankful because I only cannot take the smell and taste of fresh milk that’s why I have turned creative and put them in my fruit shake. Yum!

What about you, I want to here how you take care of your bones. And joints too!

Is there a link between peripheral arterial disease and vitamin D?

June 13, 2008 by  

Peripheral arterial disease (PAD) is a medical condition wherein arteries in the lower extremities – the legs – become narrow or clogged up with fatty deposits. This results in reduced flow to the legs.

A recent study by researchers at the Albert Einstein College of Medicine in New York City on 4839 American adults show that people with higher levels of vitamin D are less likely to have PAD than those with lower levels of the vitamin

According to head researcher Dr. Michal Melamed

“After adjusting for age, sex, race and co-existing health problems, we found adults in the lowest vitamin D group had a 64 percent higher prevalence of PAD compared to those with the highest vitamin D levels”. “For each 10 ng/mL lower vitamin D level, there was a 29 percent higher risk of peripheral arterial disease.”

It is not clear whether vitamin D has protective properties against PAD. The researchers emphasize that further studies are needed to investigate the mechanisms behind the link between Vitamin D and PAD.

More on PAD

According to the American Heart Association’s (AHA) Heart Disease and Stroke Statistics – 2008 Update, PAD affects about 8 million Americans and is associated with a significant number of cases of disability and death. Risk factors for PAD include high cholesterol levels, diabetes, and high blood pressure and inflammatory markers such as C-reactive protein.

More on Vitamin D

Vitamin D is also known as the sunshine vitamin. It is synthesized by our body when our skin is exposed to the sun. It is therefore surprising that vitamin D deficiency is becoming a global problem and has been linked to many diseases including Alzheimer’s disease, multiple sclerosis, and osteoporosis.

Although Vitamin D supplements are available over-the-counter, AHA doesn’t recommend taking them. Vitamin supplements in general have become popular in recent years. However, they may actually be linked to health risks, according to recent studies. Our nutritional requirements are best met by natural sources – fresh fruit, vegetables, cereals, nuts, fish, and other fresh food products.

The best and the cheapest source of vitamin D is still the sun. It can also be found in natural food such as salmon, sardines, and cod liver oil. Milk in the US is fortified with vitamin D but not in most European countries.

The study concludes:

Photo credit

Sun Exposure and Arthritis

April 30, 2008 by  
Filed under ARTHRITIS

We’ve always been told to lessen our exposure to the sun in order to lower our risk of developing skin cancer.

However, according to The Arthritic Association, avoiding the sun totally can lead to arthritis.

That makes sense became sunshine is necessary for the body to produce Vitamin D. Vitamin D is then necessary for the absorption of calcium for general bone health.

Which reminds me to take my calcium supplements and spend sometime in the sun each morning! It’s summer around here and most days are sunshiny.

The national arthritis charity warns that sunshine is crucial for the body to produce vitamin D which is required to ward off degenerative conditions such as arthritis and osteoporosis.

Earlier this year, James E Dowd, an American rheumatologist, published details of his use of vitamin D in treating arthritic patients. However, The Arthritic Association states that supplementation alone is not the answer.

“The body needs sunshine in order to synthesise the vitamin D required for optimum health,” explains The Arthritic Association’s John Wedlake-Griffiths. “Although you could take a vitamin D supplement, it’s easy to overdose, and that can be counter-productive. So moderate exposure to sunlight is better – for example, earlier or later in the day, for short periods of time.”

I really think that it won’t be difficult to get enough exposure to the sun, enough against arthritis and not too much as to risk skin cancer. Morning persons won’t have a problem at all as it is best to catch the sun early in the morning.

Of course, we have to remember the supplementation of Vitamin D-Calcium combo will always be not enough. We gotta drag ourselves out of bed early and catch some some good sunlight. Yeah, right. I am definitely speaking for myself. Ha ha!

Source: Nursing in Practice

The Arthritis Association, is by the way UK’s organization promoting natural arthritis treatment and remedies.

The Arthritic Association aims to relieve the suffering and pain of arthritis by natural methods.

Our Home Treatment Programme, developed by Charles de Coti-Marsh, is a natural, drug free way to treat arthritis, based on a 3-stage recovery process.

The Programme offers an easy to follow holistic approach to managing your own health. A lessening of arthritic symptoms can be realistically achieved within 4 months.

Believed to be an effective natural treatment for most forms of arthritis, the Home Treatment is essentially a self-care programme: the patient’s motivation, pro-activity and willingness to investigate every aspect of the treatment are crucial.

Visit The Arthritic Association for more information on natural arthritis treatments.

Major Clinical Trial For Children’s Arthritis

April 18, 2008 by  
Filed under ARTHRITIS

In Northern Ireland, a major clinical trial will focus on children suffering from arthritis — not only for the betterment of its treatment but also to reduce brittle bones (osteopenia) in this children as a result of steroid treatments.

The said clinical trial – funded by the Arthritis Research Campaign and is being lead by Consultant Rheumatologist Dr Madeleine Rooney – aims to recruit about 40 local youngsters aged between four and 18 and is being conducted at the Belfast’s Musgrave Park Hospital.

Many children develop osteopenia as a result of taking steroids to treat their diseases.

The team hope their research will lead to new guidelines on the treatment of steroid-induced osteopenia, which could improve the lives of the tens of thousands of children with arthritis who are affected throughout the world.

Also, later in the progress of the said clinical trial, it hopes to extend the study to 230 children and young people from throughout the UK — making this the first multi-centre trial involving children to be led from Northern Ireland.

More than 12,000 children and teenagers in the UK have childhood arthritis, known as juvenile idiopathic arthritis (JIV). Around 400 of them live in Northern Ireland.

Steroids are widely used in the treatment of childhood arthritis and other related conditions, such as lupus, juvenile dermatomyositis or vasculitis.

But the down side of these drugs is that they cause thinning of the bones. More than 50% of children who take steroids develop osteopenia within a year.

The said clinical trial will compare the effectiveness of risedronate (a bisphosphonate drug which protects against bone loss) against 1-Alpha (a more potent form of Vitamin D) on the bone density of the children over a year.

It becomes troubling that young children suffers from arthritis. Whoever said that arthritis is age related?! There are even more concern when children have arthritis because they are still growing.

As Dr. Rooney puts it:

“As a result of early onset arthritis, children develop growth abnormalities, joint damage and osteopenia.

This means they are at greater risk of developing osteoporosis in later life and are at increased risk of fractures, particularly vertebral collapse.

There are currently many studies showing the effectiveness of bisphosphonates in the treatment of osteoporosis in adults – including a significant reduction in fractures, and there are now clear guidelines on how it should be diagnosed and treated.”

But she said, there are no available data to support the effectiveness of bisphosphonates in children. At least now, that’s gonna be looked into, especially these days that early onset or juvenile arthritis has gotten rampant.

Find more details on this at Belfast Telegraph.

Book Recommendation: The Vitamin D Cure

January 17, 2008 by  
Filed under ARTHRITIS

The Vitamin D Cure is a controversial new book written by American doctor, Dr. James Dowd.

Working at the Arthritis Institute of Michigan, Dr James Dowd has been prescribing vitamin D to people suffering from chronic disorders such as arthritis, back pain and headaches.

Dr. Dowd claims that the result is a huge improvement in their symptoms.

As written in the UK Daily Mail:

In his book, The Vitamin D Cure, Dr Dowd describes a number of success stories using this approach. One of his patients, Barbara, for instance, was obese, and suffered from arthritis in one leg as well as high blood pressure.

As Dowd explains: “In the past I would have given her anti-inflammatory drugs, pain medication, a pill to lose weight and drug treatment for hypertension.”

But several years earlier he himself began to suffer symptoms of joint pain and fatigue and after researching other treatments, devised a very different “and much more effective approach”.

He believes that he, like Barbara and millions of others in America and Europe, was seriously deficient in vitamin D and was eating foods that were making his condition worse.

He devised the ‘Vitamin D Cure’ which he used on himself, and patients such as Barbara.
Dr Dowd says: “Within six weeks she told us that she could hardly believe how much better she felt.”

The cure involves a high dose supplement of vitamin D and simple dietary changes, including cutting out wheat and cheese and encouraging a greater variety of fruit, vegetables and protein. It also involves a certain amount of exercise.

“It sounds almost magical,” Dowd admits, “but in fact it’s just common-sense medicine based on good science; the sort that has eluded many physicians for decades.”

Dr Dowd says his approach works for patients complaining of a wide range of symptoms.
“Many of them are obese and have been diagnosed with high blood pressure, diabetes, osteoarthritis, osteoporosis and autoimmune diseases.

“Usually they believe their problems are down to their genes or just because they are getting older. In most cases this is selfdefeating nonsense.”

Vitamin D is essential for good bone health, but as research now suggests, it is also important in chronic conditions such as cardiovascular disease and cancer.

Known as the sunshine vitamin, Vitamin D is also available as oral supplements.

Usually for bone health, calcium supplements comes with Vitamin D.

However, please consult your doctor before taking Vitamin D supplements.

Vitamin D Against Rheumatoid Arthritis?

January 12, 2008 by  
Filed under ARTHRITIS

Vitamin D is already known as good for our bones but may also have good effects on our immune system.

Now, it has been found that women with highest levels of vitamin D intake are about one third less likely to develop rheumatoid arthritis (RA).

Such were the findings reported by senior author Dr. Kenneth G. Saag (from the University of Alabama at Birmingham) and colleagues in the medical journal Arthritis and Rheumatism.

To determine the effect of vitamin D intake on rheumatoid arthritis risk, Saag’s team analyzed data from nearly 30,000 women, between 55 and 69 years of age, who participated in the Iowa Women’s Health Study. All of the women were rheumatoid arthritis-free at study entry in 1986, and vitamin D intake was ascertained through food frequency questionnaires.

During the 11-year follow-up period, 152 confirmed cases of rheumatoid arthritis were identified, the investigators report.

Both dietary and supplemental vitamin D intake were inversely linked with rheumatoid arthritis risk, the authors found. High dietary (at least 290 IU/day) and supplemental (at least 400 IU/day) intake were associated with 28 percent and 34 percent reductions, respectively, in the risk of rheumatoid arthritis.

However, only the association between vitamin D supplement intake and rheumatoid arthritis risk was statistically significant.

No single food item high in vitamin D or calcium was strongly linked to rheumatoid arthritis risk, the researchers point out. However, there was a trend toward a lower rheumatoid arthritis risk with greater intake of milk products.

Rheumatoid arthritis is an autoimmune disease. Therefore, like this study suggests, if our immune system is improved by Vitamin C, our risk of developing rheumatoid arthritis is lessen. Besides, a direct effect is not yet known.

Let’s see…what are the sources of Vitamin D, aside from sunlight and the supplemental form?

Food sources of Vitamin D are milk products and some ready-to-eat cereal breakfast that are fortified with Vitamin D.

About 98% to 99% of the milk supply in the U.S. is fortified with 10 micrograms (ìg) (equal to 400 International Units or IU) of vitamin D per quart.

One cup of vitamin D fortified milk supplies one-half of the recommended daily intake for adults between the ages of 19 and 50, one-fourth of the recommended daily intake for adults between the ages of 51 and 70, and approximately 15% of the recommended daily intake for adults age 71 and over.

Read this fact sheet for the enumerated natural food sources of vitamin D and everything there is to know about this vitamin.

Find more details from Online News.

Vitamin D Deficiency, Worsens Osteoarthritis of the Knee

November 21, 2007 by  
Filed under ARTHRITIS

According to a new study from Tufts New England Medical Center, low vitamin D levels may cause greater knee pain and difficulty walking in patients with knee osteoarthritis.

Knee osteoarthritis is caused by cartilage breakdown in the knee joint. Factors that increase the risk of knee osteoarthritis include being overweight, age, injury or stress to the joints, and family history can increase the risk of knee osteoarthritis.

In recent studies, it has already been found that vitamin D influences both musculoskeletal and neuromuscular function – so that this new study took a closer look on this in two-year trial of vitamin D supplements on knee osteoarthritis progression.

The researchers tested whether vitamin D deficiency at study entry is associated with pain and physical function in OA patients.

Vitamin D promotes the absorption of calcium and phosphorus needed for bone mineralization, growth and repair.

Sources of vitamin D are available to a lesser extent from dietary sources typically found in fortified margarine, oily fish, liver, fortified breakfast cereals and dairy products. Sun exposure helps vitamin D to become active.

Absorption of vitamin D from food and conversion of it to the active form is less efficient in elderly persons. For this reason, vitamin D supplements of 400-800 and calcium doses of 1,200 to 1,500 mg a day are recommended to prevent osteoporosis.

The results of this study suggest that Vitamin D supplements may also help in arthritis treatment.

Around here, (except on gloomy, rainy days like the past week) we have ample amount of healthy sunlight on a regular basis. But then in places that are deprived of warm sunlight especially at this time of year, there are always dietary and supplemental sources of Vitamin D.

Of the 100 participants, 47 percent were vitamin D deficient, with vitamin D levels below 30 ng/ml. This deficiency contributed to increased pain and difficulty walking among the participants. However, the deficiency did not affect time need to stand and sit repeatedly.

According to Tim McAlindon, MD, MPH; associate professor of medicine, division of rheumatology, Tufts New England Medical Center; and an investigator in the study:

“These preliminary results suggest that, among people with knee osteoarthritis, having a low vitamin D level is associated with more knee pan and greater functional limitation.

Future results from this ongoing randomized, double-blinded, placebo-controlled clinical trial of vitamin D will help determine whether vitamin D is an effective disease-modifying intervention for knee osteoarthritis.”

Yes, we do need Vitamin D – if you haven’t realized it yet. 😉

Find more details from Science Daily.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.