What role calcium supplements?

A frequent question in the Track Your Plaque program is whether taking calcium supplements to reduce risk for osteoporosis adds to calcium in arteries and raises CT heart scan scores.

No, calcium supplementation does not add to coronary calcium. Thankfully, there is some wisdom to calcium metabolism. Calcium deposition or resorption is under independent local control in bone, as it is in the artery wall. Taking calcium has no effect on calcium deposition in your coronary arteries.

However, there's a lot more to it. Taking calcium has only a modest effect on bone health. Most women can only hope to slow or stop calcium loss from bone by taking calcium supplements. Calcium supplements do not increase bone calcium. The reason why calcium supplementation works at all is, when calcium is absorbed into the blood, it provides a feedback signal to the parathyroid gland to shut down parathyroid hormone production, the hormone responsible for extracting calcium from bone. But the calcium itself does not end up deposited in bone.

Likewise, calcium supplements have essentially no effect on the artery wall. But vitamin D controls calcium absorption and, curiously, appears to exert a dramatic effect on calcium depostion in coronary arteries. In fact, I would credit vitamin D as among the most important factors in regulating arterial health that I've encountered in a long time.

Thus, bone health and arterial health do indeed intersect via calcium, but not through calcium supplements. Instead, the control exerted by vitamin D connects the seemingly unconnected processes.

Vitamin K2 provides another unexpected juxtaposition of the two processes. Deficiency of K2, which is proving to be a lot more common than previously thought, permits an enzyme in bone to exert unrestrained calcium extraction. Deficiency of K2 in artery walls allow another enzyme to deposit calcium and grow plaque without restraint. Yet another intersection between bone health and coronary health that involves calcium, but as a passive participant.

Stay tuned for a comprehensive Track Your Plaque Special Report on these topics coming in the next couple of weeks. I'm very excited about the emerging appreciation of calcium as an active ingredient in plaque, not a dumb, passive marker as previously thought. Vitamins D3 and K2 are among the keys to this phenomenon.

Comments (8) -

  • JT

    7/22/2007 12:34:00 PM |

    I'm probably living proof that eating or taking calcium does not cause a high heart scan score.  

    For around 18 years I suffered from a crippling gut problem.  During that time I was advised to avoid milk products along with high fiber.  Milk was avoided because of lactose intolerance and another effect I noticed it had on the gut.   Calcium rich vegetables were not eaten in much quantity due to fiber causing my gut problem to become worse and more painful.  Early on I tried taking calcium tablets but they caused a great deal of gut problems too so that was stopped.  

    Basically my body was calcium deficient for close to 2 decades.        

    It was only after I figured out my gut problem was food related - a food allergy - that I began eating fiber calcium rich foods along with cheese again.  It was also around this time that I had a heart scan.  My score is in the top 90% for my age.  From blood testing it appears my plaque build up came from eating a sugar rich / low fiber diet and not eating too much calcium.

  • Anne

    7/22/2007 5:38:00 PM |

    Is there a test for K2 deficiency?

    What is the best source of K2?

  • Dr. Davis

    7/23/2007 12:00:00 AM |

    To my knowledge, no clinically available measure of K2 adequacy is yet available. The best source is arguable, but we're gravitating towards supplements that supply the MK-7 form until the data clarify.

  • DrSwanson.com

    1/8/2010 9:21:38 PM |

    Dr Davis,
    Thank you for your comments. You state that supplemental calcium does not cause artery calcification, explaining there are different mechanisms in bone vs. arteries, etc. This may not be the case however.  A recent study has shown that calcium supplementation might very well increase vascular events (e.g. heart attack or stroke) in elderly women. According to the studies lead author the findings were surprising and robust.
    ref:
    1. Bollard MJ, et al. Vascular events in healthy older women receiving calcium supplementation: randomized controlled trial.
    2. Medscape CME/CE 1/24/08
    ref: British Med. J. 1/15/2008

    These calcium concerns can be added to other studies linking excess calcium (esp. calcium citrate) to small vessel calcification in the brain, and others showing increased aluminum levels when co-ingested with sources of aluminum hydroxide, such as antacids. Also noted here is calcium citrate is up to .25 to 2.5 times more absorbed and bioavailable than calcium carbonate. Then a more prudent dose recommendation becomes necessary. Ours is to limit the dosage below the daily value (DV) for most post-menopausal women. The DV is based mostly from lessor absorbed (esp. on an empty stomach) calcium carbonate studies.  
      In our clinic, the following calcium (citrate, or citrate/malate) supplementation guideline is given to postmenopausal women, and especially important for over age 65.
    1. Do not take calcium without vitamin D3 and vitamin K2 (MK-7), unless K is contraindicated because of warfarin / coumadin.
    2. Limit dosage to 600 mg per day, as unopposed with or without vitamin D. (e.g. a cal+D supplement)
    3. Limit dosage to maximum 1200 mg / day with the co-administration of vitamin D (dosage based on 25(OH)D testing) and vitamin K2 (MK-7a) 50-100 mcg /day.  
    4. Limit calcium (citrate)intake to 600-1000 mg / day (even with D+K) if known coronary artery disease is present or coronary calcium score elevated, or smoking.  
    5. If elevated coronary calcium score is elevated and the risk for CHD is high, individualize the vitamin K2 (MK7) dose upward as high as 300 mcg/day to attempt to reverse the calcification.
    6. Do not take aluminum hydroxide antacids, or any other sources of
    AH.
    7.Related "bone up" caveats: Recognize that bone loss and CHD often co-exist in the same patient. Hip fracture risk is greatly increased with proton pump inhibitors (e.g. reflux meds). Consider natural alternatives to bisphosphonates and calcium+D only supplements.  e.g. The FOOT Plan (Fully Optimized Osteoporosis Therapy) using strontium citrate, potassium (citrate) alkalization,  vitamin D3/K2, omega-3 EPA/DHA, melatonin, and calcium /magnesium citrate. Far greater and faster bone density results occur in both spine and hip, with healthier bone architecture and geometry. And much healthier for the heart too!  

    Mark Swanson, ND
    drswanson@drswanson.com

  • Jackie

    3/11/2010 9:23:28 PM |

    Hello,

    I was diagnosed with stage III-C uterine cancer about 4 years ago. A recent CT scan of the abdomen and pelvis revealed atherosclerotic disease. However, the same day I took the scan, I also took a Calcium Scoring test which revealed a good score of zero concerning the heart arteries.

    I ordered k2 supplements, but I am leery as to whether it would increase estrogen in my body because K2 is generally derived from fermented soy beans. When I was first diagnosed, one oncologist felt soy was ok, another oncologist plus my gynecologist suggested I steer clear of it. I just wonder what your opinion is on this matter. Also, would the fact the scan picked up atherosclerotic disease indicate it is in an advanced stage? Thank you.

    Jackie

  • buy jeans

    11/2/2010 9:17:33 PM |

    Thus, bone health and arterial health do indeed intersect via calcium, but not through calcium supplements. Instead, the control exerted by vitamin D connects the seemingly unconnected processes

  • Jack

    3/9/2011 3:43:19 PM |

    Chances are the calcium supplement you are taking now is a rock source of calcium. The label will say "calcium carbonate", which is nothing more than limestone. AlgaeCal Plus contains an organic, plant-sourced calcium form derived from a unique South American marine algae called Algas Calcareasâ„¢.

  • paul

    4/29/2011 6:25:25 AM |

    Calcium supplements helps strengthen your bones. You should always take them to maintain your strong bones.

    Lorna Vanderhaeghe products

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"Instant" reversal with fasting?

"Instant" reversal with fasting?

Here's a fascinating e-mail we received recently. It came from a man in Hawaii who dropped his heart scan score a modest amount, but did it in two months using fasting. He also has the advantage of access to the Holistica Hawaii scan center with our friend, Dr. Roger White. His experience is so fascinating that we asked for his permission to reprint his story which he did enthusiastically.

So here is Don's story:


I am a 61 year old male with a history of heart disease in my family. My maternal grandfather, for instance, died at age 39 of a
heart attack and my mother died of a stroke. There are other instances in my family as well.

I, personally, before going to Holistica had had three heart procedures; one radio catheter ablation for WPW Syndrome, and two radio catheter ablations for atrial fibrilations. After suffering with WPW for over 30 years and A-Fibs for about a year, those issues seem to be behind me fortunately.

Three or four months back, however, I was suffering from shortness of breath and slight chest pains when doing the uphill part of a 5 mile walk that I do almost every day. My wife had had a coronary heart scan several years back at Holistica so that's how I knew about it.

I had a scan done on October 4th this year. The scan did show fairly
advanced plaque build up; my total coronary plague burden was
312.9. The day following the scan I felt absolutely terrible; lightheaded, weak, much like feeling you were at death's door.

I had read a book a number of years back about therapeutic fasting
(water only) called "Fasting and Eating for Health" by Dr. Joel
Furhman.


According to his book, one on the areas where he consistently has dramatic and quick results with fasting is with reducing arterial plaque. Based on how badly I was feeling at the time, I decided to start an immediate fast. Within just the first 24 hours, the relief was dramatic and amazing. I continued the water only fast for 3 weeks.

Yesterday, December 1st I went in for another cardio scan instead of the coronary angiogram that I had previously been scheduled for. I could tell they were a little confused why I was doing that but went ahead and did another coronary EBT scan.

When I went in for the doctor consultation, Dr. McGriff said, "OK, exactly what is it you've done since last time." In less than two months, my coronary plaque burden had dropped to 296.2. That's a 6% reduction in less than 2 months. Had I gone back in for the second scan right after my 3 week fast then it probably would have a 6%
reduction in less than a month.

Frankly, based on how good I've been feeling (I'm even thinking of
getting back into jogging instead of walking), I was surprised it was
only 6%. Based on the common experience, however, that it sometimes
takes a year or two to just stabilize your plaque increase, much less
actually start losing it, the doctor was truly startled and
surprised. He said he had never seen such a sudden reduction as that
before!

We are still going to proceed with the coronary angiogram and I
intend to apply what I find in your book but I thought you might be interested in these results since I've never heard or read of anyone actually measuring the effectiveness of a fast with before and after EBT Scans.

I admire your direction and work focusing on prevention instead of catastrophic management like most doctors. Dr. Fuhrman is very much the same with the greatest attention on prevention so if you haven't heard of his book you might be interested. Especially interesting regarding this particular issue is Chapter 5 entitled, "The Road Back to a Healthy Heart-the Natural Way."

I can personally verify everything he has said about the fasting procedure itself from start to finish. I consider his book the Bible about fasting. As I mentioned, given your similar direction in medicine, I thought I would bring my personal experience on the matter to your attention for your consideration. Maybe in a future edition of your book, you might want to include some information on fasting.

Anyhow, I hope you will find this helpful. Any other questions,
don't hesitate to e-mail back. Please keep up your good work and
thanks for what your doing!

Yours truly,

Don P.
Honolulu, Hawaii



Isn't that great?

Now, in all honesty, a change of 6% could conceivably be within the margin of error for heart scanning. (Although several studies from a number of years ago suggested that variation in heart scan scoring was about 10%, sometimes more, in my experience, on EBT devices like the one Don used, variation is <5% at this score range.) Genuine regression would probably be better documented by yet another scan down the road. If the trend is consistent, then it is probably real.

Nonetheless, Don's story may support we've been saying for some time: Fasting is a rapid method to gain control over plaque--but I didn't know it might be that quick! Perhaps Don is a living example of what I've called "instant" heart disease reversal.

Don is potentially off to a good start. But, unless he can periodically repeat his fast, he will still have to engage in a program that allows continuing control over coronary plaque in between fasts. Also, fasting cannot address issues like vitamin D deficiency, lipoprotein(a), and any residual lipid/lipoprotein issues. But I am continually impressed with the power of fasting to "jump start" a program of heart disease reversal.

It would be a fascinating study to perform, with serial heart scans within brief periods of weeks or months to gauge rapid response. However, we need to keep in mind that as wonderful as heart scans are, they do involve modest radiation exposure.

It might be interesting in future to add a fasting "arm" to the virtual clinical trial. That might yield some great insights.


Copyright 2007 William Davis,MD

Comments (17) -

  • Stan

    12/4/2007 4:10:00 AM |

    Re: "It might be interesting in future to add a fasting "arm" to the virtual clinical trial. That might yield some great insights."

    Yes I am sure it might. Let me think, fasting = burning one's body fat (and a little bit of  muscles) = ketogenic metabolism.

    Hmm, what is that other method of inducing a ketogenic metabolism?

    Ragrds,
    Stan (Heretic)

  • chickadeenorth

    12/4/2007 4:47:00 AM |

    hmm.so if a diabetic did this after so many hrs if bg fell low wouldn't you liver start spewin some glycogen, then bg would rise,making you hungry, but only water,man would you lose weight, would this be ok for a diabetic, ????
    GoodonyaDon, did the hunger bother you or did it stop after few days???

  • jpatti

    12/4/2007 4:52:00 AM |

    How long a fast do you feel is necessary to be beneficial?  

    Do you think the whole intermittent fasting thing (fasting 24 hours on /24 hours off) is useful?  How about just a one-day a week fast?

  • Anonymous

    12/4/2007 10:18:00 AM |

    How long would a fast need to be to get results? It's rare I can go even eight waking hours without getting the shakes (I've been this way since my teens).

    S

  • Dr. Davis

    12/4/2007 12:46:00 PM |

    Interesting thought.

    But I do think that fasting provides a unique phenomenon, unlike that of a low-carbohydrate, ketogenic diet. I can only speculate why. But the physical and emotional perceptions  experienced during fasting are a world apart from low-carb eating.

  • Dr. Davis

    12/4/2007 12:53:00 PM |

    Jpatti--

    Nobody knows. You will find discussions about length of fast and various patterns of fasting to achieve weight loss, regression of various disease states, but no real data on regression of coronary plaque by heart scans. The Track Your Plaque experience is informal and has not been subjected to formal examination. But it sure is fascinating, particularly when you hear about experiences like Don's and the stories articulated by Dr. Fuhrman. (I'm going to ask Dr. Fuhrman for an interview for Track Your Plaque.)

    Please see the Track Your Plaque in-depth Special Report, Fasting: Fast track to coronary plaque control at http://trackyourplaque.com/library/fl_04-012fasting.asp

  • Dr. Davis

    12/4/2007 12:55:00 PM |

    S-

    This is a very common phenomenon in the carbohydrate/wheat addicted. (I assume you are not diabetic.)

    I know of no way to get beyond it except to get beyond it. Also, you will need to work with your doctor if you are taking medications, particularly blood pressure meds, etc.

  • kdhartt

    12/4/2007 2:28:00 PM |

    I read in the TYP report of optionally discontinuing supplements during a fast, what about my statin?

  • wccaguy

    12/4/2007 4:30:00 PM |

    What is the best approach to supplements during a fast?

    Keep taking all supplements including TYP program supplements?  or not?

    Thanks!

  • Anonymous

    12/4/2007 11:51:00 PM |

    Dr. Davis

    I am possibly in the beginning stages of diabetes: FBS good, but a1c a bit high. I had been drinking a lot of koolaid (with sugar), and doing a lot of processed grains, and also starches when the a1c test was taken.

    I haven't gone into my new GP with the a1c results yet (my ob/gyn caught the a1c), since I have a colonoscopy scheduled next week. I'll go to the GP after I receive my colonoscopy results to see what they want to do about the a1c.

    Instead of koolaid, I now drink tea with 1 tsp of sugar in 2 quarts, the rest sweetened by stevia. I eat about 3 pieces of bread a week now, and no potatoes, rice either. I've been using cellophane/glass noodles instead of regular pasta.

    So we'll see if those changes made enough of a difference to bring the a1c down.

    Back to fasting: I wonder if reducing high glycemic carbs, especially wheat, will eventually enable me to fast longer periods? I should start a food/carb journal, makring what/how much I ate, and how long I can go before the shakes set in.

    Thanks,
    S

  • Dr. Davis

    12/5/2007 1:26:00 AM |

    Though clearly an improvement, the amount of carbohydrate intake you are describing would make me either very hyperglycemic (high blood sugar) or diabetic.

    I find completely divorcing yourself from these sugars and sugar equivalents easier than cutting back, since continued inclusion of sugars and wheats maintain a craving.

  • jpatti

    12/5/2007 4:48:00 AM |

    anonymous, it sounds like you have reactive hypoglycemia.  This means you have a slow phase 1 insulin response, so when you eat, your bg goes really high, then your pancreas overreacts and splurts out too much insulin and you go low.  Most people with reactive hypoglycemia progress to diabetes if they don't get it under control because it's a disorder of insulin production.

    You really need to get a bg meter and begin testing how specific foods effect you.  You can't rely on the glycemic index, because we're all different - the GI is an average.  The diet you described *may* be fine for you; it would massively spike my bg though.  You have to find out what really works for *you* and the only way to do that is to test.

    There's good advice about testing at these links:

    http://www.alt-support-diabetes.org/NewlyDiagnosed.htm
    http://loraldiabetes.blogspot.com/2006/11/when-to-test-one-hour-or-two-hour.html
    http://loraldiabetes.blogspot.com/2007/04/teting-on-budget.html

    Meters are often given away by the companies for free, or free if you buy 100 strips or such.  The biggest cost is in strips, so you want a meter with cheap strips unless you can get a doctor to prescribe it and insurance to cover it.  Both Walmart and Walgreens have cheap generic meters with inexpensive strips.

    If the bg targets at the links I provided make you feel hypo, it's cause you've gotten used to high bg feeling normal.  Just aim at higher targets for a few weeks while you adjust before going lower.  

    I hope you follow this advice and find out what you need to do to avoid diabetes; I'm a member of the club and we don't want new members!    ;)

    Good luck.

  • Anonymous

    12/8/2007 9:41:00 AM |

    Thanks Dr. Davis and jpatti,

    Now that my procedure is out of the way, I'm cutting all sugar, bread/grains, and starches, and have started a food journal at http://www.myfitnesspal.com and I'm going to leave the times the meals were eaten in the food notes so I can monitor how I can go before the shakes/light-headedness sets in.

    As soon as my procedure results come back, I'll make an appointment with my new GP to see what they want to do about my a1c being 6.3 five weeks ago. Maybe they'll retest, or start me with a glucose monitor. If it's the glucose monitor, then I'll be able to do the PP tests to see which foods do me in on my blood sugars. But if I have to test, maybe they'll be better numbers with my stopping sugars, grains, and starches.

    S

  • Dr. Davis

    12/8/2007 1:28:00 PM |

    S--

    Let us know how it goes.

  • chickadeenorth

    12/11/2007 3:12:00 PM |

    STAN,in Canada an A1C over 6.1 is considered diabetic, may want to have a 2 hr GTT as well for firmer diagnosis as some docs don't treat it aggressively and it does damages minutely everytime your bg is over 140, from what I have read. I'd buy my own meter and work aggressively to stop it in your tracks as it contributes greatly to calcium score as well. If I could do it all over again and had a mentor that knew what I know now I may be healthier and as patti says this isnt a fun club.... you shouldn't even peek into the doorway of, so jump start it now .You may find it helpful to read Dr Bernstein's Diabetic Soltuion, new editon Oct 2007.Its very similar program to TYP except for few diff to keep bg low. Of course he is not the guru of calcium score etc so the 2 work well together, goodonya for paying attention to it SmileGood Luck.

  • Anonymous

    12/15/2007 12:08:00 PM |

    S's progress in stretching out hypoglycemic events by cutting out quick carbs:

    Although I haven't cut out quick carbs 100% in these last few weeks (small burger at drive through once, with a frozen hotpocket later that day -- I was run down and wasn't up to cooking, and used flavored creamer in coffee twice), I've been able to go 9 hours before feeling the beginning stages of hypoglycemia today:

    0530 Woke up
    1000 Kefir (whole milk) w/ wheat germ*
    1730 Baked chicken thigh, beans, greens, 1/2 tomato, 1/2 cucumber, 1 tbsp ranch

    *I've been using wheat germ in my kefir to increase fiber. Since cutting out most wheat products, except my puny day, my gastro problems haven't bothered me. But the day after I ate that burger and hotpocket, my gastro problems returned for most of the next day.

    I don't have other signs of gluten allergies, but I wonder if I might be sensitive to gluten or wheat. I'll bring it up to my gastro dr when I go in for my follow up. I already know there's no CA or polyps, and from my pics there doesn't seem to be any diverticulits pockets, or raw Crohns area, but I am not a gastro, and I'm basing that guess on only a few pics.

    But between battling against hypoglycemia and probable beginning diabetes, and also gastric problems, I am definitely stopping wheat (and also continuing with the slow-carbs only). I still have to make an appt with my new GP regarding my a1c of 6.3 a few months ago when I was a glutton with sugar, wheat and other starches.

    I don't know how much weight I've lost since I don't have a working scale yet, but my face has thinned and almost no double chin (now it's only noticeable when my face is towards my neck), and my waist has started to indent again.

    I'll check back in when I've found out if my dietary changes helped my a1c, or when I can fast all day.

  • Dr. Davis

    12/15/2007 2:24:00 PM |

    Have you tried ground flaxseed in place of wheat germ?

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