Calcium, Afib and Osteoporosis

George,

This sentence in a recent post of yours really caught my attention:

Then about a year of poorer control, most likely caused by an excess of calcium, many more episodes most lasting an hour or two. Subsequent to limiting Ca intake, my control is back to what it was for the 7 1/2 years.

I know that Jackie has often warned against excessive calcium intake and LAF Survey III (June 2001) found a highly significant correlation between calcium intake and longer episodes in vagal afibbers – a correlation that became increasingly significant with higher intakes (p=0.001). Calcium, of course, is also an excitatory ion and is intimately involved in the control of heart rhythm.

Your experience with reducing your afib frequency by cutting back on calcium raises some obvious questions:

How much (approximately) is your daily calcium intake (from food and supplements) when your afib is under control? How much was it when you noticed the increase in episode frequency?

Do you supplement with calcium at all or is your entire intake from food?

Which particular foods did you eliminate in order to reduce your calcium intake?

There is substantial evidence that calcium (in combination with vitamin D) is needed to ensure adequate bone mass and prevent osteoporosis [www.yourhealthbase.com]. An adequate calcium intake is particularly important in the case of high-protein diets. The RDA for calcium is 1200 mg/day. This brings up the question: How do you prevent osteoporosis and its forerunner osteopenia if you severely limit calcium intake?

I am sure your answers to these questions as well as Jackie’s comments on the subject would be of great interest to many afibbers.

Hans

PS to George. In discussing ketosis you may wish to point to the discussion in Conference Room Session 73 [www.afibbers.org]

Hans,

A quick summary - as I've posted before <[www.afibbers.org] , I had very good afib remission for 7 1/2 years. Then my stress level increased dramatically because of the ending of my long term marriage. My afib became more frequent. I attributed this to the divorce stress. Then it became very frequent - at one point I was getting it every night and terminating with PIP flec. At this point I got a prescription for propantheline bromide to be used as a vagolytic and was thinking of scheduling an ablation with the Bordeaux team or Dr. Natale. I never did use the PB as it does cause photosensitivity as a side effect. Instead, I started taking flec pre bed as a preventative (initially 300 mg). At about the same time, i started using Ginger as per your suggestions (reported here: <[www.afibbers.org] <[www.afibbers.org] <[www.afibbers.org] ). I quickly started weaning myself off the flec and titrating down. Over six weeks or so, I titrated the flec to zero. The ginger by itself worked for a couple of month, then I would notice breakthroughs, especially in the vagal aftermath of sex. This was annoying, to say the least. PIP flec continued to work to terminate the episodes.

When I analyzed this, I noticed that the afib got more frequent as my perceived stress level decreased. I was fortunate to have an amicable divorce and was in a terrific new relationship. This inverse correlation puzzled me, if the cause of the afib increase was truly stress. I rationalized it that the afib had progressed because of the stress and there was no going back, even though the stress had diminished markedly.

I started looking at my lifestyle, and remembered that I'd added in a lot of cheese to my diet. I could easily eat a round or two of Brie a day - stress eating due to the divorce. From my early days on this board, nine years ago, I remembered Jackie's admonition about calcium not being a good actor for afib. So I decided to completely quit the Brie. It was also common for me to eat some Greek yogurt and I'd throw in some whey protein powder. I also quit this stuff, too.

The USDA says a round of Brie (1/2 pound) has 417mg Ca+
The yogurt has 450 mg Ca+ in 8 oz.
The whey protein has 125 mg Ca+ per serving

This was the INCREASE in Ca in my diet and I could easily eat 2x of Brie plus yogurt. So someplace between 400-1500 mg/day, depending on the day. I purposely have never taken Ca supplements.

I've not done an analysis to see what is in the rest of my diet, but I just did and it looks like maybe 300 mg Ca+/day (by the way, this kind of intake is common in countries with little or no osteoporosis).

I'm sure eating this much of these kinds of foods would be uncommon for others, but getting the Ca+ might not, especially with supplements. By the way I'm not fat - my BMI is 23.7.

"There is substantial evidence that calcium (in combination with vitamin D) is needed to ensure adequate bone mass and prevent osteoporosis [www.yourhealthbase.com]. An adequate calcium intake is particularly important in the case of high-protein diets. The RDA for calcium is 1200 mg/day. This brings up the question: How do you prevent osteoporosis and its forerunner osteopenia if you severely limit calcium intake? "

Hans, my sense is that magnesium is a much bigger actor in the osteoporosis issue than calcium and I obviously take a lot of magnesium. The other issue is not so much intake, but excretion. My diet isn't particularly high in protein. I eat around 85-100 grams/day. My dietitian friend said her standard was around 1gm protein/kg body weight. As my weight is about 80kg, my intake is in the ball park. To help with excretion, I consume 200-400 ml of Waller Water concentrate (magnesium bicarbonate)/day (1.5-3 grams of bicarbonate) and 2 grams of potassium as potassium bicarbonate/day(3.3 grams bicarb). The bicarbonates should help to keep the body from pulling Ca+ from the bones to neutralize acid. I do take 5-6,000 IU of vitamin D3/day as well as 50 mcg of vitamin K-2 as Menaquinone-7.

I've not had a bone density scan, though I frequently take some pretty hard falls associated with my outdoor avocations (like off a slack line yesterday and a crash at 55 MPH skiing in the winter) and have never broken a bone.

Hope this helps.

George

George,
Thank you for the reply. I absolutely agree with you on the importance of magnesium for bone health. Actually there are abstracts in the IHN database attesting to that. I had just forgotten about them <[www.yourhealthbase.com];. So really, there should be no reason to supplement with calcium if one is eating a standard diet and getting enough magnesium through diet and supplements. Is that your "take" as well?

Hans

Hans/George,

The Book "Vitamin K2 and the Calcium Paradox " by Dr Kate Rheaume-Bleue is a great resource on this issue. I've increased by K2 intake of MK7 to 270mg/day. Also eating butter from grass fed cows and organic grass fed beef . Hopefullly, that will direct all my calcium to the bones where it belongs.

John

Hans,

I agree.

George

John,

I'll look into it.

Thanks!

George

I have several comments and will post soon; hopefully, yet today.

Jackie.

Agree with the comments about magnesiums paramount importance in the mineral family over extra calcium intake for osteopenia / osteoporosis prevention.

Almost no one needs to take extra supplemental calcium unless suffering from a relatively rare form of hypercalcimia.

But another important factor for most everyone over 50 in the whole bone loss equation is to insure repletion of normal healthy levels of our anabolic hormone levels which almost invariably are significantly in decline by then ... Not coincidentally at a time when we also discover nutritional assimilation issues starting to occur as well as being a time when other metabolic signs and symptoms of aging start to increase noticeably ... Alas, also along with the appearance so often of our old companion AFIB in this time frame from the mid to late 40s and onward.

Getting a better restoration of the anabolic/ catabolic hormonal symphony in and of itself can go a long way toward restoring a healthier normal level of calcium balance just for food and with the help from insuring we are getting enough IC mag as well as Vitamin K an D both of which have pro-hormone like function and are not just a simple vitamin. I went from low serum calcium in my mid 40s to taking some supplemental calcium and getting too high of levels up to 12 but now with a much better overall anabolic/catabolic hormonal balance my serum calcium maintains itself at an optimal range around 9.1 or so with no supplemental calcium but a heathy level of D3 and K2 ( though I had to lower my K2 during my last Coumadin year ... One of the things I so look forward to doing is taking bigger doses of Vitamin K2 the day Dr N gives me the green light to ditch the Coumadin for good ... Hopefully on Sept 24 after my Laiart confirmation TEE the day before on Monday the 23rd.

In any event, you can get good results just with the right vitamin and mineral restoration, but it all works much better when you can tweak your hormones as well into a healthier range.

All of these things tie together and no doubt lay much closer to a deeper understanding of the core metabolic issues driving AFIB to begin with, though we are still a good way from truly understanding the whole dance.

Shannon

Sorry for the delay.

I find most often people are only aware of what’s emphasized in the news or at the doctor’s office …calcium as it relates to osteoporosis. So far, arrhythmias aren’t commonly mentioned but there’s no shortage of bone spurs and hypertension. Afibbers are obviously more concerned about mineral intake and imbalances.

No commentary on health by optimizing nutrition is complete without the reminder that in order for nutrients from any source… food, supplements, infusions or injections… the integrity and function of all cellular membranes must be healthy, intact and functional. If not, then nothing else works as expected. This is basic, fundamental science. If the nutrients we consume can’t make it to the cell wall and be transported inside the cell, then no matter what we take or eat, we can’t benefit, be healthy or thrive. Prior to nutrients arriving at the cell’s outer membrane, if there are if there are interferences in the gut wall where most nutrients are transferred through the intestinal mucosa (at the lumen) to the bloodstream, then that’s another road-block. Just because we consume something… doesn’t guarantee it reaches the target. There can many interferences along the way and if the cell membrane is damaged, then nutrients that do manage to access the cell’s interior, quickly leak out. That’s often why so many people claim that nutritional supplements don’t help.


On the topic of calcium, I am not anti-calcium but I am educated to be cautious in terms of thinking that everyone needs to supplement with calcium because they are worried about bone health. This is especially true for new afibbers who are most likely 99.9% sure to be found magnesium deficient and adding calcium in the presence of magnesium deficiency practically guarantees an event. It’s definitely easier to get dietary calcium from food than it is magnesium; yet, most people are unaware of that fact or the fact that magnesium deficiency can result in so many other related ailments because the popular press always focuses on Bone Health and Calcium.

That said, calcium is an essential nutrient and has an important role to play in our body’s ‘symphony of life’ especially bone health and muscle and nerve function. But, it should be viewed with cautionary respect just we should view sodium. Both can cause trouble if imbalances are present.

Often not emphasized in discussions of bone health and supplementation are these points.
1. The ratio of Calcium/Magnesium intake should be at minimum 1:1. Better higher in magnesium than calcium.

2. Calcium alone doesn’t contribute to strong bones or prevent osteoporosis. It’s the adjunctive nutrients that combine to ensure a healthy bone making process… magnesium/calcium/phosphorous/strontium/boron plus vitamin D3 and vitamin K2 in the form of Menaquinone 7. The latter two help direct the minerals inside the cells where they form the bone cell structure called osteoblasts.

3. An alkaline-ash producing diet ensures bone health by lessening the pulling out of minerals stored in bone cells to buffer an acid ash dietary intake…especially sugars, proteins, grains and phosphoric acid from soft drinks such as cola beverages.

4. Weight-bearing exercise.


My personal Calcium Experience goes back to my initial onset of AF 18 years ago. I had dutifully joined the popular Calcium Supplement Band Wagon for bone health…as many women still are doing today. I’d have periodic DEXA scans and my bone levels were always above average for my age and I wanted to keep it that way… thus the added calcium began around age 55. Age 59 – first AF event. When the AF happened, it was always about an hour or two after the Ca dose. It took about 3 AF recurrences to put 2 and 2 together.

What I didn’t know at the time was I also had intestinal dysbiosis…mostly Candida albicans (yeast) and leaky gut syndrome… so with the yeast voraciously consuming all my minerals rapidly, not only was I deficient from that but undoubtedly deficient in overall magnesium and potassium as well… knowing what I do now about lifestyle, food intake and mineral depletion unless there is a concerted effort to focus on repletion.

Once I became deeply entrenched in arrhythmia research, I found plenty of evidence as to why calcium supplements can contribute to AF in those who are low in magnesium. In others, it may manifest as hypertension; in still others, it may build stealth atherosclerosis.

Calcium is an essential nutrient. As has been reported for years, health advice news clips over-emphasize the role of calcium intake as it relates to preventing or treating bone loss yet only tells part of the story because calcium alone doesn’t make bones strong or prevent osteoporosis. As with everything else, it’s systemic in nature and not just one linear factor. Unfortunately, linear is the way most doctors think and this spills over to the public at large.

Researchers who look at “systems” approach to health and healing rather than specific elements…ie, osteoporosis, emphasize that while calcium is a large part of the bone structure, it isn’t the only element. There has been a good deal of information from researchers and advanced medicine practitioners explaining that just adding supplemental calcium for bone health can contribute to calcifications of soft tissues such as heart valves, arteries, aortas, smaller blood vessels and cause kidney stones and bone spurs; yet doesn’t correct or halt osteoporosis. This is not new news.

Afibbers are reminded that they need magnesium to balance out calcium to keep heart cells from becoming overly excited or stimulated. Afibbers who used Coumadin…or others who have mechanical heart valves and have used Coumadin for years have experienced profound arterial/aortic calcifications and osteoporosis because in years passed, the importance of also adding in magnesium, vitamin D3, Vitamin K2 MK7 (menaquinone 7) and other trace minerals was not emphasized. Today we know that the K2 MK7 and D3 are vital to help direct serum calcium into bone cells where it functions rather than soft tissues where it causes harm.

The late Mildred S. Seelig MD, MPH, is recognized as the world’s foremost magnesium researcher. Her early work many years ago warned about the problems when calcium overshadows magnesium. We have discussed her findings vigorously over the years in many posts and we know her science proves that magnesium is in higher demand in the body than calcium… (not to diminishes the importance of calcium), but that when calcium overpowers magnesium, nothing good comes of that imbalance. AF is just one consequence of many ailments.

In various publications, she offered nuggets useful for this thread…

• Optimal Mg intakes are amounts that maintain normal functioning of the body and prevent disorders treatable with Mg supplements.

• No one can afford to lose more Mg than is provided by the diet. When that happens, the person is in negative Mg balance. This means that in order to maintain normal vital function, the Mg that is already in the body that is serving to activate enzymes, to maintain energy and normal electrolyte levels in the cells, as well as to form healthy structures, is drawn upon, with the result that some tissues are broken down to meet the demands of organs needed to sustain life.

There are published studies showing that some areas of the US and also some countries are more prone to cardiovascular, renal and bone diseases and they often note a relationship to magnesium deficiency. Dr. Seeling notes that hard water containing predominantly magnesium is protective. Southeastern United States has water that is soft and low in magnesium and is known as “the heart disease and kidney stone belt.” She says, “in contrast, the north Midwestern states have water rich in Mg and have fewer cases of heart disease.” She notes that studies from Finland where Ca intake is high and Mg intake is low, both osteoporosis and cardiovascular disease are serious problems and that studies from Finland indicate a Ca/Mg ratio of 4:1 and a very high death rate of middle-aged men from coronary heart disease.

Life Extension’s August 2012 issue featured an editorial “Potential Dangers of Calcium Supplements” and also balances out that news with the risks of too little calcium intake: weak bones, osteoporosis and life-ending fractures.
[www.lef.org]

Soon, the new book by Cardiologist, Thomas E. Levy, MD, JD, will be available title: Death by Calcium – The Toxic Supplement. Dr. Levy joins other savvy researchers and practitioners who have found that we are overdosing on calcium driven by the ‘bone health scare’ and the prevalence of osteoporosis. You can read some of his thoughts which undoubtedly be in the book…here: [www.naturalhealth365.com]

In one of his talks on Atherosclerosis, Dr. Levy emphasizes that this ‘overkill’ with calcium supplements is hardening tissues and arteries. He also advises not to take vitamin C in the form of calcium ascorbate for that reason as well.

This segues into the last segment which is about linear thinking versus systems management.

The emphasis on supplemental intake of bone health minerals is still linear thinking in that it leaves out the importance of physical exercise and dietary influences to promote bone health. These are systemic functions… the buffering system and the bone remodeling system.

Bone loss obviously occurs when the raw materials or building blocks are either not available due to dietary choices or are pulled from the bone storage because of the body’s innate protective mechanism to buffer acidic blood to prevent kidney damage. Diets high in acid-ash producing foods, acidic cola and soda beverages, proteins, grains, sugar, alcohol, all require buffering or changing from acidic to alkaline so the acid doesn’t ‘fry’ the delicate kidney mechanism…it’s the body’s innate protective mechanism. A system.

When we are already deficient in essential minerals, in order to buffer acid, buffering agents (which are minerals such as calcium and magnesium) are pulled from storage – bone is the major warehouse – and if not replaced, weak bones result. The bone matrix structure becomes ‘lacey’ rather a dense structure.

In a normal, healthy body where diet is meeting all the nutritional needs of every system, enhancing the system with physical exercise daily is not an option…it’s a requirement. For bone, this means weight-bearing exercise where muscles flex and relax from weight and tension. Muscles attach to bones by ligaments and tendons at insertion points. In those insertion areas, the tugging and pulling stimulates the bone remodeling process (a system) by stimulating production of new bone cells (osteoblasts) and calling out osteoclasts to resorb bone in the natural cycle of bone remodeling. You can’t have bone health without out that process. Swimming is often thought to be a good exercise and it is but not for bones because there is no weight-bearing stimulating. Weightlessness in space flight is of huge concern to astronauts because of the rapid tendency for bone loss. Couch potatoes and people who sit at desks all day are especially at risk of developing osteoporosis and obviously, much more.

Over-exercise, however, has some negative aspects since over-exercise is recognized in the body as stress and the disadvantage of that includes magnesium loss plus the effects of that stress on other systems including adrenals from the stress hormones involved. That balancing act can be tricky to avoid the downside of Type A characteristics. There are healthy and unhealthy stress levels; finding the balance for your body is the challenge.

The dietary intake of foods that metabolize to acid-ash are damaging on many levels and for that reason, we have emphasized the use of the home formula for magnesium water by Erling Waller to help keep from pulling the essential minerals we need for all of our systems, but for this topic… heart and bone health. It’s quick, easy and economical insurance.

Awareness of all the factors in a systems approach keeps us healthy. Especially noteworthy is being aware of low magnesium intake and excess calcium intake no matter where you live or whether or not you have Afib.

Jackie