Dear Dr. Roach: I'm a healthy female in my mid-70s. I've taken the recommended calcium citrate with vitamin D for years, until about three months ago, when test results showed I have slightly higher than normal calcium levels. I stopped the calcium, but testing results were the same three months later. Since women have been advised to take calcium, especially as we age, this is quite a surprise.

A: Most of the calcium in the body is locked away in the bones. The body has several systems to carefully regulate the calcium level in the blood. The two most powerful of these are vitamin D and parathyroid hormone. Abnormalities in either of these can cause problems in blood calcium levels, which is very dangerous, because it can affect the muscles. A very low blood calcium level causes tetany, severe cramping and inability to move muscles normally (tetanus is an infectious disease that causes muscle cramps via an entirely different pathway).

With low calcium intake, blood calcium remains normal or near normal, but the calcium in the bones is depleted. That's why adequate calcium intake is important in the prevention and treatment of osteoporosis. Calcium through the diet is preferred to calcium via supplements, because supplements increase the risk of kidney stones and may increase the risk of heart disease.

High levels of blood calcium are more likely to be due to excess parathyroid hormone than high vitamin D (which is very uncommon). With the body systems working normally, excess dietary calcium is simply excreted by the kidneys.

Since the most likely cause for high calcium is an excess of parathyroid hormone, often made by a benign tumor of the parathyroid gland, your doctor should test your parathyroid hormone level.

The osteoporosis pamphlet furnishes details on calcium intake and how it affects bones. Readers can obtain a copy by writing: Dr. Roach, Book No. 1104, 628 Virginia Dr., Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 with the recipient's printed name address. Please allow four weeks for delivery.

Dear Dr. Roach:I read your recent column regarding Fosamax. I'm 55, female and recently have been diagnosed with osteoporosis. My left hip was at the -2.5 threshold for the diagnosis. My primary-care physician and gynecologist both are recommending Fosamax. With so much confusing information about this drug, I am questioning taking it. What is the alternative to taking Fosamax? Is there anything else I can do to increase my bone mass? Would you advise one of your family members to take Fosamax?

A:If there are no other treatable causes, such as low vitamin D or high parathyroid hormone levels, then I think Fosamax or another bisphosphonate is a good choice. There are others, but Fosamax has been well-studied. The recent critical column I wrote was about atypical femur fractures in women taking Fosamax and other similar medications for longer than three to five years without any re-evaluation of whether it is still needed.

Go here to read the rest:
Dear Dr. Roach: Elevated calcium level may signal excess hormone - Herald & Review

Comments are closed.