What's the evidence on Calcium and Vitamin D for bone density?

@butch24350 I am a patient at Mass General Hospital in Boston. That is the where the bone density center I am going to is.
JK

Ty. Good Luck!

JK, I have posted the link to ConsumerLab.com before on this site. It is a consumer watchdog group for supplements. They test them to make sure they are what they say they are, at the strength they say they are at, and that they will open up in your body (some pills go straight through you). They found lead in AlgaeCal as well as it only have 87% of the stated amount of magnesium. There are many medical journal submissions you can read there. It isn't free - but it definitely worth it for anybody who questions the purity of the supplements they are taking. I've been a member for a very long time. I have NO immune system and I also have to be very careful what I take.

Also, doctors have HUGE case loads. It is impossible for them to keep up with all their patients' conditions as well as the latest in vitamins, minerals, other supplements, and all diseases, etc. It is hard to find a doctor that is up on everything. I only have one doctor (out of ten) that keeps up. My PCP learned to stop disputing what I said because I don't say something without a ton of research. She tried to tell me avocado was a worthless vegetable!!! That was our last dispute. Now she writes down what I say! Take the K2 article with you and share it with your doctor. Some doctors don't even know about vitamin K2 yet. It's important to know you can't get hypervitaminosis from K2. But there may be other issues of concern. Have them review it so you can be sure it is okay for you to take. I have a problem with my red blood cells, but I was cleared to take it.

Since many of us are taking supplements, I thought I would put this out there. In another group, somebody asked if it was okay to take calcium and magnesium together. The answer is that these two minerals will compete for absorption. The max absorption is about 500 mg total. I've decided to try taking half of my calcium pill that contains magnesium and space them out. This creates a headache for me - between prescription drugs and supplements - there isn't much more time. But I'd rather do that than not absorb what I am taking. You can take either 500 mg of calcium or 400-500 mg of magnesium; if they are combined, it's best to take a total of 500 mg only at one time. I believe it takes 2 hours for it to get into your bloodstream and to go where it needs to go.

@parrotqueen I appreciate how passionate you are about this, but for now I’m going to see what this doctor recommends. She is the director of the bone density center at Mass General, rated as the second best hospital in the country for endocrinology, and has had close to 30 publications.
I also have tremendous faith in my transplant surgeon and will not oppose what the transplant department feels is best for me, my surgeon did literally save my life.
I appreciate your input and concern but until I have seen the doctor tomorrow I will not try to make decisions based on much more limited knowledge than she has. At some point you have to have faith in your doctor. If you do not then it’s time to find a different doctor or just choose to do it all yourself. I do always try to have some knowledge when possible so I’m not just blindly following. I have found at Mass General, their reasons for things are generally pretty sound. It is not your average hospital. On the other hand, I’m much more skeptical about anything up here in southern NH, I do not have much confidence in most of the doctors here.
JK

JK, you make a good point. It is always advisable to talk about the supplements we take with our doctors. This is particularly important when people are also taking medications, as supplements can cause interactions or decrease the effectiveness of medication.

This is a good point to remind members of the disclaimer section of Connect's Community Guidelines, which states:
"All information shared by members on the Mayo Clinic Connect ... is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on the community."

See the complete guidelines here: https://connect.mayoclinic.org/page/about-connect/tab/community-guidelines/

It can be confusing to know what supplements are necessary and how and when to take them. Here are some articles from Mayo Clinic to help know what questions to ask your doctor:
- Magnesium Supplement https://www.mayoclinic.org/drugs-supplements/magnesium-supplement-oral-route-parenteral-route/description/drg-20070730
- I've heard that magnesium supplements have health benefits. Should I take one? https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/magnesium-supplements/faq-20466270
- Calcium and calcium supplements: Achieving the right balance https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calcium-supplements/art-20047097
- When should I take calcium supplements? Does the timing matter? https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/calcium-supplements/faq-20058238

At the end of each article is further reading, too.

This is an answer for all of you! You can make up your own mind between D2 and D3 if you just read about it online. Just put it in your browser (search engine) "Benefits of taking vitamin D" and you will begin learning. But yes, someone who specializes in osteoporosis will definitely tell you about D2 and D3. The 50,000 IU dose of D2 is partly because it is so inefficient. 2,000 IU of D3 per day will do the same thing. Everything I say should be checked and double checked with your doctor. You know your own body better than anyone. The 50,000 IU dose of D2 used to be used for people with multiple sclerosis. JK - there IS somebody out there who is testing supplements - it is http://www.ConsumerLab.com. They do laboratory tests on supplements and they post their findings. They test the purity of supplements, they test the strength, and they test to be sure they will open up in your body (some pills go straight through you!). I once soaked a turmeric pill in warm water (it was warm when I started) and it didn't come apart for days - I finally gave up on it. This is why I know AlgaeCal only has 87% of the magnesium it says it has and it also has more than the allowable amount of lead in it! You can get a membership to ConsumerLab.com and read about any supplement you decide to take because they post many articles from medical journals for you to read - but of course, you still need to run it past your transplant team. Lioness, I actually was taking collagen in just plain water there for a while. I will make myself a smoothie yet. I am on a no-sugar diet as I've said many times, and I found a good recipe for a smoothie in the book that goes with my diet, "The Candida Cure," by Ann Boroch. Lucky me, I have to get a very long MRI with and without contrast tomorrow in San Francisco, so I have to get up early (that pituitary tumor had better not be back!). So I am going to sleep early. I wish us all good luck with our bones. Keep up the good work everybody! And let us know how you are doing.

JK, I'm sorry I see your post now (I couldn't see it until after my last post) and I see that I already told you about ConsumerLab. Of course you have to do what the doctors are telling you to do. And you should always check with your doctor. My infectious disease doctor is the one that saved my life a few times - and I always listen to what she has to say - and I ALWAYS take her advice as you do with your transplant team. But I was extremely ill for a very long time before I met her, and my doctors were not listening to me. That is why I started reading everything I could get my hands on about the human body. I also had the privilege of working with scientists and doctors for many. years and the vocabulary is familiar to me. I have read medical textbooks for the past 50 years! The human body interests me almost more than anything else. I was born with a pituitary tumor in addition to everything else wrong with me. It affected almost every aspect of my life. I was diagnosed when I was 36 by a doctor who was retiring - he said "Just tell your doctor I said you have a pituitary tumor." Well my doctor didn't believe me and I was too weak to fight for myself. Nobody knew I had that tumor until I was 61 years old and I was so weak I could not get out of bed - I COULD NOT walk! I wound up on a ventilator because all the muscles wasted and I couldn't breathe on my own. So now I don't wait around. When something goes wrong, I start researching it. I also go see my doctor as soon as I can. But even though I live in a big city and my PCP doctor should know better - I find she doesn't know much about a lot of things that are important to me - but she will argue her point to the death. Just recently we got into it about avocados - she said they were worthless in food value and had no fiber (they can have 10 grams of fiber, in fact!)! She has a scribe now who looked it up on the internet while we were arguing - and my doctor had to admit she was wrong. She is considered one of the best PCP doctors in my area and I wouldn't go to anybody else. She IS a great doctor - but nobody can know everything. It takes a village! That is why I do a lot of research whenever I'm not feeling right. I think it is healthy for us to educate ourselves. But when you have a lot of medications and a lot of serious health issues, it is always best to check with the doctor and the pharmacist first. A few nights ago I started feeling very bad after I took a prescription medication - I looked it up and lo! I was having an allergic reaction - and everything that was happening to me was in the VERY SERIOUS category. My body is very sensitive to prescription medications and for that reason, my infectious disease doctor has encouraged me to use herbal supplements whenever possible. (For instance, I cannot take any antibiotics, antifungals, or antidepressants!!!). I believe my osteoporosis with a -5.7 DEXA scan reading is every bit the crisis that the pituitary tumor was - and that is why I am researching it so much. I can't find a doctor that has any good answers for what to do - I started researching it - and one by one, my doctors are now helping me to find answers. My PCP and GYN doctors are the ones that decided I should try estrogen and progesterone in small doses (I have had fractures already) - but I was the one that read that it was a good idea if you are pretty far gone with osteoporosis. After I mentioned the idea to them, they said it was a great idea and THEN they supplied me with more medical journal submissions talking about the benefits of it. So medical research has paid off well for me. But I always take it to my doctors for the final word.

Bottom line, run everything past your doctors and read as much as you can about all the things you are going through. This will help you to know when something is going wrong - it will help you to understand your medical situation - and you will have more to discuss with your doctors. If you find it isn't your cup of tea, just find the best doctors you can and do what they say. But even if it isn't your cup of tea, read a little so you will know what to watch out for.

Not one of my doctors knew about vitamin K2 - but they do now! (Doctors are very busy.)

Again, sorry for mentioning ConsumerLab so many times to you. It really is a great resource and you can find much to read there. They have a little search engine you can type in Vitamin D or Osteoporosis - and it will bring up every article they have on that topic. (No, I don't work for them.)

@parrotqueen I have been to two extremely well regarded endocrinologists, both have said that there is not a significant difference between D2 and D3.
At this point I am waiting for some test results to determine what course of action I will take.
JK

For those interested in the paper written about estrogen and progesterone on osteoporosis: Official reprint from UpToDate, http://www.uptodate.com 2018. (the date on my reprint is 11/13/2018). "Postmenopausal hormone therapy in the prevention and treatment of osteoporosis." Authors: Harold N. Rosen, MD, Marc K. Drezner, MC. Section Editors: Robert L. Barbieri, MD, William F. Crowley, Jr., MD. Deputy Editor: Jean E. Mulder, MD. The authors note that even a tiny dose of estrogen makes a big difference - and that is what my doctor prescribed in my case. You have to remember that I am already fracturing.

A note to JK: As soon as I have time to write a thesis, I will address the differences between Vitamin D2 and Vitamin D3. Take whatever your doctor is telling you to take, unless, of course, you don't want to. There is a huge difference.