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Calcium: The Good, the bad, and the ugly
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Calcium is the stuff we use to generate your heart scan score.
The less we have, the better.

But that’s not true everywhere in the body. In bones, the less calcium, the worse
the osteoporosis and the greater the risk for dangerous fractures. All the while,
calcium in blood and other tissues remains tightly regulated.

Why this calcium disconnect in different places?
Does taking calcium have any effect?
Is there anything we can do about it?

Calcium in bones allows us to stand upright. In teeth, calcium allows us to chew food. It occurs as calcium hydroxyapatite, identical to that found in rocks and confers rigidity to teeth and bone, harder than even platinum and iron.

Calcium is the most plentiful mineral in the body. Take away the body’s water, and the bulk of remaining material consists of calcium, along with some protein. Without calcium, we’d be amorphous blobs of protoplasm like a jellyfish.

Calcium also plays an indispensable role in transmission of cellular signals in the body. In the heart, for example, too little calcium in the blood (hypocalcemia) results in random mis-firing of cellular signals and permits dangerous heart rhythms to develop. Too much calcium (hypercalcemia) can be equally dangerous and, in fact, is a frequent cause of death in people with advanced cancer. Because veering just a little from a narrow range of safety poses dire consequences, blood calcium is normally maintained under extremely fine control.

But calcium is also an ingredient in several abnormal conditions, like kidney stones (calcium oxalate). Deposition of calcium can occur in artery walls as part of the atherosclerotic plaque process, thus our heart scan scores. Calcium can also accumulate on heart valves, causing abnormal stiffness (aortic stenosis and mitral anular calcification).

So, is calcium good, or is calcium bad? Do we add to the dangers by taking calcium supplements?

The answer is that calcium can be both good and bad. Just as too little blood sugar causes you to lose consciousness, too much and you are diabetic, both too little or too much calcium can likewise wreak havoc with health.

If calcium taken by mouth were left to randomly distribute throughout the body, then we’d have a mess on our hands: soft bones and teeth, chaotic cellular signaling and heart rhythms, kidney stones, etc. Nor can we simply rely on oral intake to regulate this fine-tuned system, else a brief lapse in intake or a modest excess could yield disaster.

That’s why calcium is tightly controlled by a variety of mechanisms, all designed to direct calcium to where it’s needed and in just the right amount. Calcium metabolism is regulated by several systemic hormones, like parathyroid hormone and calcitonin, local hormones like osteoprotogerin and nuclear factor-kappaB, is subject to pH shifts, various enzymes, and several vitamins. In other words, it is the fine orchestration of myriad players that keeps calcium in check, safely doing its job.

Then why does calcium play a role in disease?

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