There's More to the Story: Calcium Edition

 By: Nick Sienkiewicz, DPT, CSCS

 There are some conversations that pop up more frequently than others with patients and clients. I suggested this phenomenon in my newsletters regarding cholesterol. Like with cholesterol, when discussing these common themes in the world of health and fitness, there is typically more to the story. This is part of the reason these conversations are recurring in our industry. Unfortunately, we are at a time where there are too many disconnects between modern “healthcare” and authentic health. So let’s commence a little series, “There’s More to the Story,” here to unravel some of these concepts. This could begin with a variety of topics, but one is fresh in my mind following a recent conversation with a client. I’m going to start this series discussing calcium. So many individuals are prescribed supplemental calcium, and this recommendation is typically made in the presence of low bone density scores. Yes, calcium deficiency is more common nowadays, and this is largely due to modern food being more mineral-depleted than ever before. Even though calcium levels across the board are lower than our ancestors, the research on calcium supplementation is rather inconclusive. Some studies show a small improvement in bone mineral density and a subsequent slight reduction in osteoporotic fracture, while other studies show no effects at all (Check out here if interested). Furthermore, lower income countries who have lower calcium intakes and levels overall actually tend to present with less incidence of osteoporosis-related fractures compared to countries, like the US, who have one of the highest rates of calcium supplementation yet higher rates of such fractures (Confusing right?!?). Before I peel back the curtain on this, I must clarify that some individuals do really well with calcium supplementation. This is by no means a knock on that if you are currently supplementing calcium. Like the purpose of this entire newsletter, It is more about digging deeper and thinking more holistically about everything related to health. Before taking a calcium supplement, get tested to make sure you’re truly deficient in the first place. Then, if you are taking a calcium supplement, you cannot expect that it is just going to magically correct the issue. We have to get to the root cause of why you calcium is low in the first place. Take it for a while and see if things change. If no alterations or benefits occur, then continuing to blindly take the supplement without any positive changes is, quite frankly, silly. In that instance, THERE HAS TO BE MORE TO THE STORY!!

Let’s break down the story behind calcium that isn’t being told:

Calcium requires an acidic environment for adequate absorption: 

The human stomach is supposed to have an acidic pH. America is one of the largest consumers of proton-pump inhibitors and other acid-blocking medications. I’ve discussed this concept before: Most people are being told they have too much stomach acid when in reality they likely possess too little acidity in the stomach. You can test this with a simple at-home test using baking soda. Put 1/4 tsp of baking soda in 4-6 oz of water. Drink it (ideally on an empty stomach) and assess what ensues. You should burp within 5 minutes. If this is the case, you likely have adequate stomach acid. However, if it takes longer than 5 minutes to burp or you don’t burp at all, it is an indication that you may have low stomach acid. This test is by no means perfect or diagnostic, but it is super simple and almost free as baking soda is cheap. If you present with the signs of low stomach acid, then your body will have difficulty accessing and absorbing the calcium from your food and/or supplementation. Therefore, continuing to supplement without addressing your insufficient stomach acid is a great way to render your supplement useless.

Calcium needs to be in balance with vitamin D: 

Vitamin D is another common deficiency in our world today. Vitamin D is also required for calcium absorption in the gut. If you supplement with calcium, but have low vitamin D levels and do not address that in conjunction, this will also hinder the effectiveness of your calcium supplement. Some data suggests that a balanced state of calcium and vitamin D is more important than their respective absolute levels. This means that even if your calcium is technically low, your risk of osteoporosis and subsequent fractures is still reduced as long as the ratio of calcium to vitamin D is still in a good limit. This would imply vitamin D would be low too, so this is absolutely not a recommendation to just aim for low levels on both, as that would correlate with deficits in other bodily aspects. This is just another way to exemplify that the ratio of calcium and vitamin D is just as important as their individual levels.

Calcium requires essential fatty acids for absorption and utilization within the body:

Yet another common deficiency in our modern world. This is one of the many reasons people will often experience profound benefits from fish oil and other essential fatty acid supplements. The ratio with respect to omega 3s to omega 6s is extremely important in this regard too. In the US, most have no problem getting sufficient amounts of omega 6 fatty acids, but many struggle to consume adequate omega 3s. This modern presentation is a big reason why I believe calcium supplementation has diminished effects overall in today’s world. Basically, calcium-rich foods, like dairy products and bone marrow, provide calcium in conjunction with a variety of other compounds and cofactors. This is how it is found in nature, and thus, is more effectively and efficiently acquired by the human body in these forms. Supplementation can be beneficial in many cases, but will always have a hard time matching the innate sources of calcium provided by the planet.

EMF (electromagnetic field) radiation alters calcium status at the cellular level:

An important mechanism for the balance between intracellular (inside the cell) and extracellular (outside the cell) calcium is voltage-gated calcium channels. These are proteins within the cellular membranes that open and close in response to certain electrical charges and frequencies. EMF from devices, like cell phones and microwaves, has been shown to disrupt these voltage-gated calcium channels (One example here). Therefore, excessive EMF exposure and/or EMF sensitivity play significant roles in our body’s calcium status. This is a pertinent consideration as it relates to possible calcium supplementation. If our calcium levels are being altered by the EMF in our immediate environment, we have to ask ourselves how we can mitigate and modify this load on the body in order to get a more accurate measurement of internal calcium.

Lead is a heavy metal that preferentially displaces calcium: 

If someone is supplementing with calcium to no avail, I would look into toxic load and potential lead exposure. Our culture as a whole is well aware that lead is noxious to humans. As a society, we’ve removed lead from contaminated things, like paints and building materials. However, lead and other heavy metals are very resistant to degradation and are ubiquitous in our environment. One of the huge modern exposures to lead is tap water. When someone cannot seem to increase their bodily calcium levels, I would first intervene with water filtration and purification if possible. Secondly, investigating other potential exposures to lead, such as in the home or office, would be warranted. Another typical exposure is non-stick pots and pans. On the flip side, if you find you do have excessive lead buildup, then calcium supplementation would be a potential option for helping to cleanse it from the body.

Calcium is a mineral that tends to bind and clump together: 

This is pertinent in the case of calcium supplementation, especially if over-consuming calcium and causing excess stores in the body. Due to its clingy nature, calcium in excess will bind to other minerals and compounds, potentially leading to blockages within the body. Two of the most prevalent examples of this are kidney stones and arterial calcification. Kidney stones are typically formed by calcium-oxalate crystals, which accumulate within the small tubules of the kidneys resulting in pain and difficulty urinating. As it relates to heart health, a Coronary Artery Calcium (CAC) score is one of the best measurements indicating risk for a cardiovascular event. This score is an indication of the amount of calcium that has built up within the coronary arteries. Ideally, this score is a zero, yet modern medicine will often report a score is normal if under 100. Is it truly normal to have mild to moderate calcium buildup in your coronary arteries, or have we just become indoctrinated to believe this to be true due to decades of misunderstanding calcium as it relates to our health?!? The answer is likely nuanced, but worthwhile to question based on the ambiguous research around calcium and subsequent supplementation. This binding tendency of calcium must also be considered if someone deals with constipation issues.

I hope this helps provide a little more clarity on the story of calcium. Ultimately, calcium is a pivotal mineral that our body needs for a variety of functions. Like all minerals, adequate amounts are required and it needs to be balanced with other compounds in the body. Certain substrates are also necessary for appropriate absorption and utilization of calcium. Problems can arise when levels are deficient, elevated, or imbalanced. Issues can stem from dysfunction in calcium’s cofactors as well. Learning and understanding there is more to this story is massively beneficial when making health decisions.

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 Let's thrive together,

Nick

*Disclaimer: This is not medical advice. The information is meant to be educational in nature. It is not intended to diagnose, treat, prevent and/or cure any disease or health condition. Simultaneously, the information is not stating that any supplements or methods mentioned can replace medications or any interventions prescribed by your healthcare provider. Please speak with your own healthcare provider before beginning any new supplements or making changes that may affect your health. By utilizing any of this information, you are assuming responsibility for your own health decisions and actions.