I discussed in my recent blog post, What You Need to Know About Bone Health, why your skeleton is SO important. Your skeleton is your core. You need to keep it strong and healthy to allow you to gracefully move through life. There are many reasons why vitamin and mineral supplementation may be needed to help you in this quest. Today we'll talk about what to consider when choosing supplements to support your bone health!
Let's face it. You can't eat perfectly every day. A combination of diet challenges along with other risk factors like a history of certain medications (steroids) or digestive disorders like celiac or Crohn's disease can wreak havoc on your bones and make supplemention a logical choice. My goal is to recognize my patient's risk factors ahead of time and address their nutrition needs in order to prevent their bones from ever being impacted!
A bone density test is the only way to know for sure whether you have osteoporosis or osteopenia (early stages of osteoporosis). A DEXA scan can provide the information you need. This is an easy x-ray that is typcially done on the spine and hips to measure bone loss.
Your blood levels of certain nutrients like calcium, vitamin D, and vitamin K2 can also provide valuable insight. Your unique needs for dietary changes or supplementation can then be evaluated to support your bone health. Nutrition Dynamix can help you order a micro nutrient blood panel to evaluate these key nutrients and others.
Supplementation is never an excuse to eat a poor diet! It's rather a supportive measure to ensure adequate nutrients.— Melissa Karch, RDN
3 Key Nutrients to Consider Supplementing for your Bone Health
More than 99% of the body's calcium is in your bones and your teeth. We want that calcium to stay in these two areas, NOT be elevated in your blood. High levels of calcium in your blood can create calcium plaque in your arteries and can lead to heart disease over time.
How much Calcium should be supplemented?
Good question! This all depends on your current diet. Calcium needs usually range from 1000-1300mg per day depending on your age. I like to first estimate the average amount of calcium in your daily diet and try to maximize this amount (see list of high calcium foods). I recommend that you supplement only as much calcium as is absolutely necessary. Small amounts of calcium should be taken since your body can only absorb a maximum of 500mg at one time. If higher amounts of supplementation are needed, they should be spread out at different times of the day. You also need to be cautious to not combine your calcium supplement with a multiple vitamin or other supplements such as iron because this can interfere with absorption.
What kind of calcium is best? This is crucial.
There are at least 10 different types of calcium on the market! Most are derived from rocks in one form or another, but there are some algae based sources. Each source has a different level of "elemental calcium" (absorbable amount) ranging from 10-40%.
Calcium carbonate is the most common type of calcium found on your supermarket shelves. It is usually the least expensive. It requires that you have adequate stomach acid to be absorbed so it MUST be taken with food. Unfortunately, stomach acid usually decreases with age. There are also a large number of people who are on acid reducing medications (Omeprazole, Prilosec, Zantac). In addition, too much unabsorbed calcium in your intestines can also cause constipation. This can make calcium carbonate a poor choice unless you are strategic about taking it with the right amount and types of food at the right time of day.
Calcium citrate/malate is usually my recommended type of calcium for most people. It can be taken with or without food since it already has an acid component.
#2 Vitamin D
Vitamin D is essential to help your body deliver calcium to your bone. Low blood vitamin D is much more common then we previously realized. It is now more common for doctors to check vitamin D blood levels on their patients. If your vitamin D is deficient (generally less than 30) or on the lower end of normal, supplementation is indicated.
Although the RDA for vitamin D is only 400-800 IU per day, research supports the benefit of much higher amounts and more is definitely needed if you are deficient. I have my deficient patients take a higher dose of approximately 5000 IU per day to replenish vitamin D stores. After 4-6 months, I typically have them drop down to a maintence dose that can be found in most multiple vitamins or calcium supplements. Vitamin D is a fat soluble vitamin, so it can be taken in a larger dose once per week instead of every day if desired. It is best absorbed when eaten with a foods that contains fat.
#3 Vitamin K2 (Menaquinone)
There are two forms of Vitamin K. Vitamin K1 (phylloquinone) is well studied for it's role in blood clotting. Vitamin K2 (menaquinone) however, has only recently been getting the attention it deserves for it's role in bone health. In fact, it wasn’t until 2006 that the USDA even began differentiating between food sources of the two!
Vitamin K2 is essential to binding calcium to the bone. Without enough vitamin K2, calcium may not make it to the bone! This is especially true if you are supplementing calcium while your vitamin K2 blood level is low. If the calcium isn't getting to your bones, it may be depositing in your arteries to create calcium plaque. This increases your risk for heart disease!
In a meta-analysis of randomized controlled trials looking at vitamin K2 and prevention of fractures, it showed that supplementation of vitamin K2 prevented bone loss and incidents of fractures in 12 of 13 studies.
Vitamin K2 supplementation is recommended to those at risk in the amount of 200-320 mcg per day. The MK-7 form is preferred for most people. I prefer the capsule form for most supplements and not a hard tablet. Capsules are easiest to break down and enter your blood stream faster.
You need all 3 of these essential bone nutrients to work together for ideal bone health. If you lack vitamin D or vitamin K2 and you are only supplementing calcium, this could actually be causing more harm than good! Please reach out to a professional for assistance to individualize your supplement needs and remember that supplements are NEVER an excuse for a poor diet!
Nutrition Dynamix is here to help you maximize your health. Did you know your health insurance may cover visits at little or no charge to you? Schedule your appointment today!
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