Is there a limit to how much calcium we can absorb?

[Marquis Mark]

While trying to wrap my head around my rapidly advancing osteoporosis, I went through some of my medical records:

About 6 months into my DS, I was taking about 2,500 mg/day of calcium. The endo gave me a 24 hour urine kidney stone test. Turns out I was peeing out 370 of calcium (they consider normal to be 250 or below) so he told me to cut back to 1500.

Does that mean that no matter how much calcium I take, I will just pee it out, so no use in increasing it? If so, what do I do to fight off the osteoporosis (other than taking drugs)?

 

[southernlady]

It’s not JUST calcium involved in osteoporosis. What was your D and PTH?

 

[hilary1617]

What's your schedule? Are you splitting up the calcium doses and taking with D but at a different time than iron?

 

[Marquis Mark]

I take 200,00/ day of D and I've had some injections. The best I ever got was an 80, but more often it's around 50.

The lowest PTH I ever got was 61. More often it's about 75. Prior to surgery it was 59.

Don't take oral iron due to constipation. I get infusions.

Calcium doses are divided throughout the day and taken away from other supplements.

 

[southernlady]

Try separating your D doses as well.

 

[Marquis Mark]

Try separating your D doses as well.

I do that. I take it 4 times a day.

Regarding the original question, does anyone know if I will just pee out all the calcium, no matter how much I take?

 

[southernlady]

I do that. I take it 4 times a day.

Regarding the original question, does anyone know if I will just pee out all the calcium, no matter how much I take?

DianaCox Larra ????

 

[Munchkin]

Everyone only has X receptors in their gut. When calcium is there, each receptor grabs a molecule and gets to work. If there is more calcium available than receptors available the excess is waste. Works the same for everyone. We just have fewer receptors. Many people who take Ca have it in their urine.

 

[Marquis Mark]

Everyone only has X receptors in their gut. When calcium is there, each receptor grabs a molecule and gets to work. If there is more calcium available than receptors available the excess is waste. Works the same for everyone. We just have fewer receptors. Many people who take Ca have it in their urine.

Then there is a real possibility that I have to get my DS reversed because I'm peeing out excess at even 1500 mg of calcium which means I don't have enough receptors to get enough calcium to keep my bones from rapidly deteriorating. I can put up with vitamins, gas, etc, but not a potentially lethal hip fracture before I even retire.

This sucks.

 

[southernlady]

Then there is a real possibility that I have to get my DS reversed because I'm peeing out excess at even 1500 mg of calcium which means I don't have enough receptors to get enough calcium to keep my bones from rapidly deteriorating. I can put up with vitamins, gas, etc, but not a potentially lethal hip fracture before I even retire.

This sucks.

Or you could get an infusion like I did of Reclast or similar but I was already in osteoporosis not osteopenia. There is also Prolia (shots every six months).

 

[Munchkin]

Then there is a real possibility that I have to get my DS reversed because I'm peeing out excess at even 1500 mg of calcium which means I don't have enough receptors to get enough calcium to keep my bones from rapidly deteriorating. I can put up with vitamins, gas, etc, but not a potentially lethal hip fracture before I even retire.

This sucks.

Don't be basing decisions on lab work that's about 3 years old. Remember what Diana told you about losing bone density because you no longer NEED enough bone to support a 350lb man? It's true.

 

[Marquis Mark]

Don't be basing decisions on lab work that's about 3 years old. Remember what Diana told you about losing bone density because you no longer NEED enough bone to support a 350lb man? It's true.

I'm mostly basing it on the rapid decent of my DXA and the fact that I may not be able to stop the decent. Even with 200,00k of D, injections and taking 2500 calcium, K2, etc I have never gotten my PTH to normal, except once when it was 61.

The unloading of weight Diana speaks of is certainly a factor, but not the only one. There are hormones, bone homeostasis, etc. that are affected by the DS. Otherwise, I don't think you would see so many DSers with great PTH, calcium and D levels who end up with osteoporosis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467779/

Sorry to seem pessimistic, but I can't let myself get to -4 or -5 on the DXA. There would be no fixing that. If I have another drop like this on my next DXA, I may waive the white flag. The osteo meds seem to have limited long-term effectiveness and a lot of bad side effects.

I don't know...

 

[DianaCox]

When you take calcium, it first had to get from the gut into the bloodstream, and then (assuming you need to be building bones) into the bones. If you’re peeing out an excess of calcium, you’re absorbing more than enough, but not utilizing it for some reason. You might need to speak to an endocrinologist - but beware - while it’s not impossible, endos who don’t understand the DS sometimes leap to the conclusion of primary hyperparathyroidism and want to remove the parathyroids. Most of the time, that’s not appropriate - it is getting the body to respond to the PTH by putting calcium back. It may have to do with other micronutrients like boron or magnesium or K2. Find a bone/bariatric expert. Ask Belzberg.

 

[Marquis Mark]

When you take calcium, it first had to get from the gut into the bloodstream, and then (assuming you need to be building bones) into the bones. If you’re peeing out an excess of calcium, you’re absorbing more than enough, but not utilizing it for some reason. You might need to speak to an endocrinologist - but beware - while it’s not impossible, endos who don’t understand the DS sometimes leap to the conclusion of primary hyperparathyroidism and want to remove the parathyroids. Most of the time, that’s not appropriate - it is getting the body to respond to the PTH by putting calcium back. It may have to do with other micronutrients like boron or magnesium or K2. Find a bone/bariatric expert. Ask Belzberg.

Thanks, Diana. I always like to hear from you as I know you have not only the science background but the DS life experience.

The Kaiser endo tested me for Parathyroid issues. First via ultrasound and then confirmed with a Sestamibi. She said I'm good.

After my last DXA, I upped calcium to 5 x day (combo of citrate, hydroxapetite and even one slow-release carbonate) with Magnesium and boron citrates in each batch. I also started 680 Strontium in the morning, away from calcium. I'm now taking a total of 2,600 calcium, 1,200 magnesium and 15 boron. And I upped my K2 MK7 to 400 mcg. I've cut caffeine and will add the elliptical and other hip exercises to my walking routine. In six months I'll ask for another DXA to see if I have slowed down or, hopefully, arrested the DXA slide.

My hope is that I'm doing better at absorbing the calcium now than during the first urine test when I was only 8 months out. Although I did have one as recently as March of this year when I was only taking about 1,500 calcium and it was still 306 (250 normal high).

Doubt there's a bone/bariatric expert, per se at Kaiser, but I'll found out. Yes, I may speak with Belzberg if just to see if he knows someone who can figure this out. I think he's a very dedicated and talented surgeon, but I don't think he delves too much into DS issues once he's done his job. It's kind of like a baton pass at Kaiser, as you know.

 

[Marquis Mark]

Just got of the phone with endo. She handles most of the bariatric patients. Here's what she said (I think):

1. It is almost inevitable that all malabsorptive WLS will eventually get osteo issues due to unloading, metabolic and hormonal changes. It may be worse for some than others, but it's definitely something to watch out for. (she ordered me some bone turnover tests - C-Teleopeptide, Bone specific Alkaline, Osteocalcin, Alk. Phosphotase)

2. There is no specific test to see how well we're utilizing the calcium we absorb. The 24 hour urine only tells how much we're excreting, not how much is being used, or how well it's being used for bone building.

3. Calcium infusions are useless as they have a very short half-life.