There has been a lot of talk over the past decade or so of how bones need vitamin D to be strong. Doctors give out vitamin D and calcium all the time at the pharmacy and many people take them on their own because they think they need both the calcium and the D to have strong bones. While it is true that humans do require calcium and vitamin D for strong bones it’s a bit like saying that if I eat lots of protein my muscle are going to be Greek god status and awesome. While it’s true that your muscles need plenty of protein to get big and stay big, eating lots of protein in and of itself will do absolutely nothing to grow muscles. So what’s the deal with bones?
Bones are made of calcium phosphate crystals that are on a collagen matrix. Calcium is important just as phosphorus is important for the imbedding of these crystals in the matrix. Osteoblasts (bone cell builders) lay down the materials to build bone, while osteoclasts (bone cell destroyers) will break down these crystals and liberate the calcium into the blood stream. This process is happening all the time. Parathyroid (PTH) hormone is one of the hormones responsible for this process.
PTH also increases activated vitamin D production for use in the gut so more calcium is absorbed. Magnesium is needed for proper function of the cells in the bone and calcium regulation due to vitamin D. Magnesium is also needed for the conversion of active vitamin D. If a person is taking vitamin D and is already low on magnesium, the body will get it from somewhere and the muscles are likely to suffer from depletion, causing twitching, restless leg and cramping, according to Dr. Carolyn Dean. 1 She even says angina and heart attacks may be a magnesium deficiency problem, but that’s for another post. Studies looking at bone density and magnesium intake haven’t been very conclusive one way or the other however. So if we have a magnesium deficiency we potentially have a problem with vitamin D and sensitivity to PTH and responsible for bone health. 2,3
Calcium is important because that is primarily what our bones are made of, at least the inorganic part of them. Along with phosphorus, these two combine to make the crystals that form the rigidity of the bones.
Vitamin D of course is a big player in this game. D helps with calcium absorption and helps maintain a normal level of PTH indirectly. People with high levels of PTH all the time have low bone density and are at higher risk for fractures. The problem we see though is that some studies show that D alone or in conjunction w/calcium either do little or nothing depending on the study. What gives?
One study looked at several studies containing thousands of patients. The patients were primarily elderly people in institutions. Vitamin D alone didn’t seem to do much, while vitamin D and calcium did reduce the risk of hip and non-vertebral fractures, but there wasn’t any difference with vertebral fractures.3 When looking at patients who received vitamin D analogues, the risk of hypercalcaemia (too much calcium in the blood) increased.
One study from the Women’s Health Initiative looked at Vitamin D 400IU and Ca 1000mg daily. The risk of vertebral fractures went down, but the hip fractures stayed the same. 5
One problem that has been highlighted in the last couple of years is the increased risk of cardiovascular disease with the use of supplemental calcium and vitamin D. In the Women’s Health Initiative researchers found an increase risk of cardiovascular events if they weren’t taking them at the beginning of the study. Women who were already taking them didn’t seem to be at increased risk. 6
Soft tissue calcifications have also been reported with calcium supplementation. You read about those from time to time on different websites and on the news and indeed that is a problem if it is occurring. The only tissues that are supposed to be calcifying are teeth and bones. Calcifications in the arteries are indeed problematic for people because they lead to heart disease and death. I will discuss this more in Part 2, but if this is happening then it needs to be stopped because calcification of soft tissue really is a problem.
I personally don’t think supplementation with calcium is always necessary. For people that can tolerate dairy, it is a good source of calcium. Leafy greens are also an excellent source and should be part of a diet anyway. Spinach, kale and collard greens will get you there. Sardines are also a great source. People who used the buffered form of vitamin C also get some calcium from those tablets (buffered C is usually Calcium Ascorbate). A balanced and healthy diet will get you all the calcium you need.
Vitamin D is present in certain foods like milk (added) and certain fish (oysters, salmon) as well as eggs. Most of the D is made by our bodies though when our skin comes in contact with the UVB from the sun. The only problem is most of us are indoors and for only 4 months or so a year are the rays actually strong enough to create D. Cod liver oil is a great way to get both A and D and then of course there is supplementation. If that is the route you’re going, use D3 as it is the type that we produce before it’s converted to its active form.
Magnesium is also problematic because according to some research, almost 70% of Americans are magnesium deficient. 7 Magnesium can be obtained from nuts and greens. Supplements exist as well. Ionic magnesium can be purchased in water from WaterOz in Idaho. Magnesium orotate and glycinate are also very good and absorbed well. I would avoid Magnesium oxide unless you’re looking for a good laxative and nothing else. It doesn’t get absorbed well and really does have the ability to clear out your bowels. I also think taking magnesium 2-3 times a day at smaller doses is better than 1 bigger dose daily. It gives the bowel a chance to absorb smaller amounts of magnesium and doesn’t overload it to cleanse your bowel, like magnesium oxide will. I might add that I have anecdotal reports from people that say the magnesium helps them relax and sleep better.
These nutrients are essential to bone health. They are indeed part of a buffet for your bones, but they aren’t the whole story. I think many of the studies performed have not shown really good results for bone health is because the researchers are too focused on 1 or 2 things and aren’t looking at the whole picture. Again I think it’s the whole “eat lots of protein to build big muscles” analogy. It’s true you need these nutrients for bones, but there is more to it than that. We’ll explore more of this is part 2.
2. Carpenter, T. O. “Disturbances of vitamin D metabolism and action during clinical and experimental magnesium deficiency.” Magnesium research: official organ of the International Society for the Development of Research on Magnesium 1.3-4 (1988): 131
3. Zofková, I., and R. L. Kancheva. “The relationship between magnesium and calciotropic hormones.” Magnesium research: official organ of the International Society for the Development of Research on Magnesium 8.1 (1995): 77.
4. Avenell, A., et al. “Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis.” ACP J Club 144.1 (2006): 14.
5. Cauley J, et al “The Women’s Health Initiative calcium plus vitamin D supplementation trial: Health outcomes 5 years after trial completion” ASBMR 2012; Abstract 1136.
6. Bolland, Mark J., et al. “Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis.” BMJ: British Medical Journal 342 (2011).
7. “Dietary Magnesium and C-reactive Protein Levels,” Journal of the American College of Nutrition, Vol. 24, No. 3, 166-171 (2005).
Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.