Calcium and Osteoporosis

By Julio C. Gonzalez, MD

The Importance of Calcium

Calcium is extremely important for the maintenance of skeletal metabolism, muscle function and cell activity. Around 40% of body calcium is bound to proteins, such as calcium phosphate, calcium citrate and calcium sulfate. For the rest of the body, calcium is outside the cells and is highly regulated by hormones, such as the parathyroid hormone.

Humans consume around 1,000 milligrams of calcium daily and from that amount, around 300 milligrams are absorbed by the gut with the help of vitamin D. The rest are either excreted in urine and feces or reabsorbed by the kidneys and bones.

There are several cases of alteration of the calcium body pools. Calcium can be deficient or excessive leading to certain diseases.

When a doctor finds unusual increased values of calcium, the first concern is the existence of excessive parathyroid hormone, which can be suspected if the patient complains of fatigue, weakness, thirst, frequent urination, calcium kidney stones, bloody urines and bone loss (osteoporosis), joint pain, bone pain, loss of appetite, peptic ulcers, lack of mental concentration, forgetfulness and depression.

Sometimes the problem is low calcium values, known as hypocalcemia. Some of the symptoms include tingling sensation, numbness, muscle cramps, sustained rigidity, even seizures.

In cases when the parathyroid hormone is also low, the symptoms may include hair loss, grooved finger nails, cataracts, brain calcifications, mental depression, chronic anxiety and delusions. Low calcium may also be accompanied with low vitamin D. Prolonged calcium deficiency leads to osteoporosis or poor bone calcium mass.

About Osteoporosis

Osteoporosis may arise from some of the following conditions poor nutrition, poor gut absorption, lack of sun light exposure, lack of physical activity, bone cancers, breast cancer, lung cancer, prostate cancer, multiple myeloma and sometimes from the long standing use of steroid medications.

Osteoporosis is mostly silent, presenting itself frequently with spontaneous or traumatic bone fractures.

Osteoporosis is treatable by replacing calcium, vitamin D, increasing physical activity and exposure to sunlight, treating an underlying disease, and good nutrition.

Fortunately, numerous modern preparations are on the market in the US to treat osteoporosis

Actonel It is given once a week, until the bones return to normal.
Evista This product not only replaces calcium but also helps prevent the risk of breast cancer. It is given once a day.
Reclast This product is given by IV injection once a year.
Forteo This is also given by injection. It is the only product approved by the FDA to increase bone formation, bone turnover, and skeletal strength.
Prolia It was approved in 2010 by the FDA. It is given by injection once every six months. It works by reducing the destruction of bones and by increasing bone mass.
Boniva It is given orally once a month.
Fosama It is given once a week.

There are numerous other products, some of which, are combined with Vitamin D.