Once and for all, let's clarify: calcium with/without food!?

[Marquis Mark]

Been getting lots of mixed info and can't get a definitive answer.

Here is my background:

1. D level is 35. I had gotten it up to 48 by taking 200,000 iu day, but I wanted it higher. Had the D shot at Dr. K's. He said I could stop taking the pills. Unfortunately, three months later, my D had dropped to 35. Just got another shot and have resumed 200,000/day. Dr. K said my D needs to "stabilize." I'm not sure what that means in this context of it actually dropping.

2. My last PTH is 78, which is why I'm trying to up the D. 78 is a bit higher than my post DS average. It was about 58 pre DS.

3. My last calcium was 8.9. It has dropped a bit from my historical post DS average of about 9.2. Pre DS it was 9.4.

4. While I've been lucky enough to avoid kidney stones, my oxalates are through the roof.

5. I used to take 3,000 calcium/day but it was brutal vis a vis constipation. And my 24 hour urine showed I was peeing out a way above normal amount of calcium. So I dropped it to 1,600/day (plus lots of dairy). It has helped the constipation a lot and I now pee out a high-normal amount, but my calcium blood level did drop a tiny fraction and the PTH went up a tiny bit, too (see above). But that may be more related to the D.

OK, now my questions:

A: I know to avoid oxalates I need to take calcium with food, but does taking all my calcium with food decrease it's effectiveness at lowering my PTH?

B: Should I increase my calcium from 1,500? I'd really like to avoid this, if possible, due to constipation and apparently peeing out the excess as noted above, but will do it, if necessary. How much role does calcium play in lowering the PTH vs. Vitamin D?

BTW, I take about 1,300 Cal citrate and 300 Jarrow. I tried taking all Jarrow and it didn't do much for the constipation.

 

[DianaCox]

If you are peeing out excess calcium, it seems to me you might be taking TOO MUCH calcium, because you are apparently absorbing it very well, and you don't want to require your kidneys to process so much calcium. Are you taking magnesium? Are you taking K2? You need that to USE the calcium you are absorbing.

Note too that in the first year or so post-DS, your bones are INTENTIONALLY losing calcium, because you don't NEED as much bone to support your much lighter body. So PTH can be a bit misleading in the beginning, because your body is INTENTIONALLY redistributing/modifying the amount of calcium in your bones.

Perhaps you could either substitute or add calcium carbonate, which should serve to bind to the oxalates in your gut to remove them before they are absorbed into your bloodstream, while the excess calcium itself is not as easily absorbed into your bloodstream.

 

[Marquis Mark]

If you are peeing out excess calcium, it seems to me you might be taking TOO MUCH calcium, because you are apparently absorbing it very well, and you don't want to require your kidneys to process so much calcium. Are you taking magnesium? Are you taking K2? You need that to USE the calcium you are absorbing.

Note too that in the first year or so post-DS, your bones are INTENTIONALLY losing calcium, because you don't NEED as much bone to support your much lighter body. So PTH can be a bit misleading in the beginning, because your body is INTENTIONALLY redistributing/modifying the amount of calcium in your bones.

Perhaps you could either substitute or add calcium carbonate, which should serve to bind to the oxalates in your gut to remove them before they are absorbed into your bloodstream, while the excess calcium itself is not as easily absorbed into your bloodstream.

Yes, I'm taking about 800 mag glycanate and 200 k2 mk7 a day.

Doesn't the cal citrate I take work to bind to the oxalates?

 

[swimbikerun]

Have you seen a nephrologist or any one else? Can they maybe shed light on this?

 

[Marquis Mark]

Have you seen a nephrologist or any one else? Can they maybe shed light on this?

My kidney and liver tests have been good. Really just trying to figure out how much calcium to take and, given my oxalate level, whether I should take it all with food, or some with food and some without, or? And, of course, I'd like to understand the rationale for the recommendation.

 

[DianaCox]

Since the calcium citrate or calcium carbonate has to dissociate from the anion (citrate/carbonate) to bind to oxalate, my first guess would be that the citrate (which dissociates at neutral pH) would be better, but since the oxalates bind throughout the gut, and the citrate needs to dissolve near the receptors higher up the alimentary tract, I think it doesn't matter, and carbonate is cheaper.

But here is some research/opinion for you: http://kidneystones.uchicago.edu/calcium-binding-by-citrate/

 

[Marquis Mark]

Since the calcium citrate or calcium carbonate has to dissociate from the anion (citrate/carbonate) to bind to oxalate, my first guess would be that the citrate (which dissociates at neutral pH) would be better, but since the oxalates bind throughout the gut, and the citrate needs to dissolve near the receptors higher up the alimentary tract, I think it doesn't matter, and carbonate is cheaper.

But here is some research/opinion for you: http://kidneystones.uchicago.edu/calcium-binding-by-citrate/

Thank you. Tried reading that. Honestly, reading research for me is like reading Beawolf translated into Yiddish then Icelandic and back to old English again, which I never understood to begin with. And that one seemed almost folksy compared to some of the stuff I've looked at.

I'm just really trying to find out if Calcium loses it's effectiveness at lowering PTH whether it's taken with or without food. BTW, my urine PH is 5.2, a bit under range. Not sure if that's relevant to this.