Friday 3 July 2020

Make no BONE about CALCIUM


Bones form our body frame or musco-skeletal system to support the various organs. Imagine without which how our body endures vicious injury and shock?


Major functions of bones
  • Provide structural support for the body
  • Provide protection of vital organs
  • Provide an environment for marrow (where blood cells are produced)
  • Act as a storage area for minerals (such as calcium)



















Components of bone


Bones are essentially made of calcium and protein. Cells called osteoblasts combine protein, calcium and phosphate to harden into bone. When required, small amounts of bone tissue are dissolved by these cells to convert into calcium. The outer crust, including collagen is protein-based. A substance inside the bone known as hydroxyapatite stores mainly calcium. In the centre of the bone is the marrow where specialised cells are in charge of producing blood cells. (red and white)

Importance of calcium


Our bones are constantly restoring themselves. Bone itself undergoes continuous remodeling, with constant reabsorption and deposition of calcium into new bone. The balance between bone reabsorption and deposition changes with age.


Bone formation exceeds reabsorption in growing ages:
-  Babies lacking in calcium tend to have late teeth formation and feet with O and X shape;
-  Kids must take adequate calcium to develop elongated and dense bones.


Bone formation and reabsorption process are relatively equal in early and middle adulthood. However, anyone with a diet high in protein, fat, caffeine and sugar should note that the calcium uptake is reduced and should increase its intake.


In aging adults, particularly among postmenopausal women due to decreasing amounts of estrogen, bone breakdown exceeds formation, resulting in bone loss that increases the risk of osteoporosis over time. Coupled with low calcium intake and lower absorption rate (higher dosage required)compromise the density of the bones. You may not detect the problem until bone breaks due to a minor fall. Osteoporosis is often associated with fractures of the hip, vertebrae, wrist, pelvis, ribs and bones. For them, a lack of calcium intake can also cause postmenopausal symptoms like hot flush, nerve twitching and emotional imbalance. 


*  A bone spur is a bony growth formed on normal bone when the body tries to repair itself in response to continual pressure, abrasion or stress over a prolonged period. For instance, there is an injury to an ankle joint and calcium is withdrawn from bones to heal the injury to the affected bone. The body may over-compensate and in the process causes calcium build-up which forms an outgrowth or bone spur.

Functions of calcium 


Primarily for bone metabolism, a mere 1% of calcium is required for normal biological functions like protein absorption, fat transfer, muscle contraction, heartbeat regulation, blood vessel expansion and contraction, blood clotting, secretion of hormones and enzymes, control of blood acid-alkaline balance and transmission of nerve impulses. When your body is forced to prioritize its use of available calcium, it uses it for nerve and muscle functions, rather than for supporting your bones. As such, the calcium in the blood is constantly replenished from the stores in bones and teeth when the need arises.


Sources of calcium


+  Incorporate in our daily diet calcium-rich foods like anchovies, dairy products, tofu and dark leafy vegetables. Other rich sources are jackfruit, kiwifruit and beans. By combining the multiple forms of calcium in the form of gluconate, citrate, lactate and carbonate we can see desirable results in the shortest possible time.  (see below for details)


+  Calcium carbonate from coral, shellfish, unrefined oyster shell and dolomite are generally known as non-food source of calcium due their low bioavailability and poor assimilation in the body, making digestion and absorption difficult that can lead to the formation of gallstone and kidney stones. Such calcium supplements may contain significant amounts of lead and other toxic metals harmful to the body. For information, lead content per 800 mg calcium is only 0.92 ug in refined calcium carbonate as compared to 11.33 ug in bone meal.


+ Traditionally, bone broths have become the nourishing recipes amongst older Chinese, believing that animal bones contain high level of calcium. In fact, the amount of calcium content is generally low, with less than 50 mg derived. Even adding few drops of vinegar does not yield much more – opposed to what most believe in. 


How much calcium to take? 


How much calcium intake is determined by many factors, of which the most important are child-bearing, puberty and old age period of one's lifetime. During childhood, more bones are added than removed, tend to grow bigger and denser. From adolescence onwards, our bones stop growing but continue to become denser till around 30. Come 35, more bones are lost than replaced with average loss of between 0.3-0.5% yearly.


Broadly, the three main causes are:

(A) Hormonal changes (for both menopause/andropause)

For women, the bone mass decline accelerates after menopause losing about 1.5 inch for every 10 years if calcium intake is found lacking. As such, they are the most vulnerable with estimates put at 1 in 3 women older than 50 will suffer a fracture bone in their lifetime. Note that men suffer the same fate mostly in their 70s.

(B) Dietary deficiency especially calcium, magnesium and vitamin D.

- A traditional Chinese diet tends to be low in calcium. Average calcium intake is further reduced as most Asians are lactose-intolerance (unable to digest milk) as compared to the Westerners. Postmenopausal women should get 1300 mg of calcium each day.

- Magnesium increases the uptake of calcium and aids in nervous reaction and muscle contraction.

- Vitamin D aids in calcium absorption and thus proper bone development and maintenance. A daily dosage of 600 IU is recommended for adults aged up to 70 and 80 for older people. Avoiding sun exposure amongst Asian women is another reason for the lack of Vitamin D essential to improve calcium absorption.

(C) Drug-induced medications such as chemotherapy drugs, thyroid hormone, cortiocosteroids and anticonvulsants unrelated to this illness.


Recommended Intakes


Intake recommendations for calcium and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies (formerly National Academy of Sciences). DRI is the general term for a set of reference values used for planning and assessing the nutrient intakes of healthy people.


Table 1: Adequate Intakes (AIs) for Calcium


AgeMaleFemalePregnantLactating
Birth to 6 months210 mg210 mg
7-12 months270 mg270 mg
1-3 years500 mg500 mg
4-8 years800 mg800 mg
9-13 years1,300 mg1,300 mg
14-18 years1,300 mg1,300 mg1,300 mg1,300 mg
19-50 years1,000 mg1,000 mg1,000 mg1,000 mg
50+ years1,200 mg1,200 mg


+ The two main forms of calcium in supplements are carbonate and citrate. Calcium carbonate is more commonly available and is both inexpensive and convenient.  Although both the carbonate and citrate forms are similarly well absorbed, individuals with reduced levels of stomach acid can absorb calcium citrate more easily. It is commonly found in some fortified juices. The body absorbs calcium carbonate most efficiently when the supplement is consumed with food, whereas the body can absorb calcium citrate equally effectively when the supplement is taken with or without food. Other calcium forms in supplements or fortified foods include gluconate, lactate and phosphate.

+ Calcium supplements contain varying amounts of elemental calcium. For example, calcium carbonate is 40% calcium by weight, whereas calcium citrate is 21% calcium. The percentage of calcium absorbed depends on the total amount of elemental calcium consumed at one time – as the amount increases, the percentage absorption decreases. Absorption is highest in doses ≤500 mg at one go. So, split 1,000 mg/day of calcium supplements into 500 mg each and allow 4 to 6 hours between doses.

+ Some individuals who take calcium supplements might experience gas, bloating, constipation or a combination of these symptoms. Such symptoms can often be resolved by spreading out the calcium dose throughout the day, taking the supplement with meals, or changing the brand of supplement used. Mild constipation may occur especially when taken with another supplement or medication that binds the stool.

The calcium you consume from your diet or as a supplement is absorbed by the body in the small intestine. Not all the calcium taken is absorbed, with residue passing through the body and be excreted as waste. How much calcium is absorbed by the body depends on the type of calcium you consume, how well the calcium dissolves in the intestines and the existing amount of calcium in your body.


Other useful guides -


+ Take vitamin C like an orange together with a calcium supplement for better absorption of calcium. Calcium carbonate is usually added to vitamin C supplement to reduce its acidity on the stomach especially for those with gastric disorder.

+ Foods high in the amino acid lysine include eggs, fish, lima beans and soy products aid calcium absorption.

+ Take a sunbath without sunscreen for 15 minutes, three times a week. Sunshine is the easiest way to get vitamin D, which is essential for proper absorption of calcium. Stay out of the sun when the rays are strongest, between 10 a.m. and 2 p.m.

+ As minerals represent about 4-5% of body weight and calcium should be about half, watch other macro-minerals that can be present. For examples -

- Combine calcium with magnesium in a 2-1 ratio. A calcium with magnesium supplement is better because magnesium oxalate is 567 times more soluble than calcium oxalate and a million times more soluble than mercury oxalate.
- Taking iron and calcium together reduce the efficacy of both minerals. Highly insoluble iron oxalate plays a major contributory role in gout. It usually appears after age 40, when ferritin levels in blood exceed 100 ng/dl. A warning here – beer is rich in oxalate and iron, and ethanol increases iron absorption and magnesium elimination, so beer intake greatly increases the risk of a gout attack.
- Avoid taking large doses of zinc with calcium. At high doses, zinc can interfere with calcium absorption.
- Avoid soft drinks as they are high in phosphorus that can lead to calcium excretion in your urine.

+ High intake of animal-based proteins causes increased amounts of calcium to be excreted in your urine due to the high acidity. Worst if such proteins are combined with another culprit - sodium as in bacon.

+ Junk foods, alcohol, caffeine and white flour lead to an excessive loss of calcium from your body and a decreased rate of absorption.

+ Excessive amounts of wheat bran can interfere with calcium absorption.

+ Certain prescription medications such as glucocorticoids can interfere with calcium absorption.


Symptoms of calcium deficiency


Overweight people tend to be less bone porous as more calcium is conserved to support the additional weight.


Some visible signs of calcium deficiency are:
+  Insomnia
+  Muscle cramps
+  Loosened or decaying teeth due to lack of calcium or lead deposited in the bones
+  Back pain (mostly due to spine out of alignment)
+  Elevated blood cholesterol, heart palpitations, hypertension, nervousness, numbness in the arms/legs, depression
+  Brittle nails
+  Eczema
+  Rheumatoid arthritis


How calcium deficit can worsen conditions -

+ wrong posture = scoliosis
+ sports injury/lifting heavy objects = bone spurs
+ pregnancy = tooth loss, back pain, leg cramps, high blood pressure
+ fall/collision = bone fracture
+ taking excessive caffeine/carbonated drinks/meats = calcium leach
+ menstruation = menstrual pain
+ others such as insomnia, hunchback, backache, muscle cramps, eyelid twitches

Excessive calcium causes kidney stones?


Oxalic acid interferes with calcium absorption and can be found in foods like almonds, beet greens, cashews, chard, kale, rhubarb and spinach. It combines with divalent metallic cations such as calcium and iron to form minute crystals which are then excreted in urine. However, these oxalates can form larger kidney stones that can obstruct the kidney tubules which account for 80% of kidney stones formed from calcium oxalate. As such, patients with kidney disorders, gout and rheumatoid arthritis are thus advised to avoid foods high in oxalic acid. Studies done on rats showed that right calcium supplements given along with foods high in oxalic acid can cause calcium oxalate to precipitate out in the gut and reduce the levels of oxalate absorbed by the body (by as much as 97% in some cases).


Also calcium carbonate and calcium acetate are being used to reduce phosphate levels in people with kidney disease as well.

However, choice of calcium is important. Calcium from non-food source not dissolved can turn into calcium stones too. Plant-based sources of calcium are generally more absorbable than non-food sources because they are more easily broken and utilised. For this reason, vegetarians are seen to retain more calcium from foods than non-vegetarians. Generally, a person on vegetarian diet high in minerals (such as calcium, magnesium, and potassium) and fiber, and low in fat tend to have lower blood pressure.

What should we do?

1. Taking calcium is not enough. The correct balance of magnesium, boron, potassium, folic acid and Vitamins C, D, E and K all play vital roles in battling osteoporosis, as does protein. The above elements help in calcium absorption and build bone mass. Some research showed that high intake of animal protein may cause an acid imbalance (high in phosphorus), which the body tries to counteract by releasing minerals from the bones, including calcium. On the other hand, not getting enough protein is associated with loss of bone mineral density in the hips and spines of old people. Vitamin C deficiency affects the synthesis of collagen and if inferior quality can cause bones to become brittle and new bones cannot properly formed.

2. When the body gets regular weight-bearing exercise (including walking), there is more deposition of minerals in the bones, especially the weak points hips, spine and legs. Exercise has been shown to boost bone density by 1-2% in randomised trials though its main benefit lies in increasing muscle mass and the resulting improvement in balance and strength - both help in preventing falls and fractures.

3. Cut down on smoking and drinking as they suppress the absorption of calcium and Vitamin D.

4. Cut back on caffeine as it results in calcium leeching from the bones.

5. Soft drinks contain high phosphorous content. The ratio to maintain for calcium/phosphorus is 2:1. To correct this imbalance, calcium is leaked from the bones.


6. Eat plenty of foods high in calcium and vitamin D. Otherwise take a good supplement. Consume whole grains and calcium foods at different times because the former prevents the uptake of calcium. Best to take calcium during bedtime when is best absorbed and aids in sleeping.

7. For menopausal or postmenopausal women with osteoporosis, take more soy products as it contains phytoestrogens, a substitute for the body's own estrogen running at low level. Those on thyroid drug should increase the amount of calcium by 25-50%.

People prone to Osteoporosis

+ Small, thin frame (risk of malnutrition and loss of oestrogen)

+ Advanced age

+ Family history

+ Early menopause (before 40) or abnormal absence of menstrual periods and for men, low testosterone levels (calcium leaking in the urine)

+ Eating disorders

+ Low calcium intake

+ Smoker, drinker and steroid and drug users

Other comments

In extreme cases, Miacalcic nasal spray is recommended for postmenopausal women with osteoporosis suffering from severe spinal fracture. This substance contains the active ingredient salmon calcitonin which is a synthetic form of the natural hormone calcitonin produced by the thyroid gland cells responsible for controlling the amount of calcium in the body, by regulating the formation and breakdown of bone. The synthetic form has the same effects as the natural human hormone in inhibiting the action of the osteoclasts. This slows the increased breakdown of bone in osteoporosis, and thus helps keep the bones strong.

When administered Miacalcic nasal spray into the nose, the calcitonin is rapidly absorbed through the lining of the nose into the bloodstream. Watch out for possible side effects that can affect some people such as nasal irritation, inflammation of the lining of the nose causing a blocked or runny nose, sneezing, dry nose, nasal swelling, nose ulcers, nausea, nosebleeds, inflammation of the sinuses and throat, flushing, dizziness, headache, diarrhoea, musculoskeletal pain, face swelling, hypertension and abdominal pain.

Intensive research by the European Medicines Agency (EMA) has established that long-term use of calcitonin is associated with a small increased risk of cancer of various types. It has concluded that due to this, the benefits of calcitonin no longer outweigh its risks in the long-term treatment of osteoporosis.


Other comments  


High quality calcium-rich foods helps to guard the calcium reservoir and prevent bone loss. If we can keep to a constant replenishment of calcium, magnesium and vitamin D as well as regular exercise (both aerobic and resistance) there should be lesser fear of breaking bones throughout our life cycle.

Do not wait till old age to top up calcium level as the absorption rate is on decreasing scale.


VIVA corner


Other viva products to aid in strengthen the musco-skeletal system are:


VIVA Flexiguard provides nutritional support for forming and strengthening joints, ligaments and tendons. The sulphur content helps to reduce inflammation and for joint and tissue repair. VIVA Vivaguard offers protection to fluid in the joints from destruction by free radicals and speeds up recovery.


VIVA Omega3 supplies essential fatty acids that increase production and activity of anti-inflammatory prostaglandins.


VIVA CAL-MAGNESIUM & D is a special formulation that contains calcium gluconate, calcium lactate, calcium carbonate and calcium citrate that are extracted from plants and thus easily absorbed by the body. Most importantly, both vitamin D3 (absorbable form) and magnesium are added to further enhance the calcium absorption. Zinc is also added as epidemiological studies showed that those who with osteoporosis are often zinc deficient. This synergistic formulation helps to promote calcium absorption for a healthy cardiovascular and musco-skeletal system.


Finger Injury (testimony)  


A year ago I had a terrible fall that almost took away my left index finger….

One evening I went down flat on my wet kitchen floor. Instinctively my left hand tried to brake when my body was falling backward.  Before I realised it the entire body was landing on my palm heavily.  I felt a sharp pain and noticed that the index finger was bloated rapidly. The next morning it turned purpish and swelled to double the size.

An x-ray was performed and showed the tiny bones inside were fragmented.  The clinic helped me to embalm and pre-arranged for orthopedic treatment in a private hospital for necessary treatment the following day.

That night I took high dosage of VIVA OMEGA 3, VIVA FLEXIGUARD, VIVA CALCIUM-MAGNESIUM and VIVAGUARD hoping to improve the condition.


When the orthopedic removed the dressing, it was not purplish anymore but pinkish. However, he recommended immediate surgery which I was not in favor.  He was not too pleased but I prefer to let my finger heals the natural way. A metal support was placed on the finger so it would not fall off.  I continued taking the above products in large dosage daily.


After 2 weeks another X-ray examination was carried out and showed the bones are forming up well.  The hospital was surprised with the good result.  The orthopedic took the metal support away and placed a band to bind with the 4th finger for support and capped the injured finger to prevent further damage. 


Another X-ray examination was arranged 2 weeks later.  This time the finger showed almost full recovery but stiff having been wrapped up for too long. Few sessions of physiotherapy treatments helped to regain flexibility. 


My little finger was saved with timely medical attention and most importantly those wonderful VIVA products I have been taking consistently are working again!


Leonard (Administrator)

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Administrator
Leonard