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High calcium causing heart attacks? Vitamin K to the rescue!

You’ve likely heard the media furor around a recent finding that use of calcium supplements is associated with a higher risk of heart attack, based on a study published in the British Medical Journal a month or so ago. Many people I’ve heard from are surprised and alarmed by this news — but unfortunately, it’s not news to me. In my 2000 book, Better Bones, Better Body, on p. 248, I wrote, “Over and over we are told to consume adequate calcium. What we are not told, however, is that we also need… other bone building nutrients. They also forget to tell us that it can actually be harmful to consume high levels of calcium without its companion nutrients.”

Calcium doesn’t magically travel straight from your yogurt to your bones, as some advertisers would have you believe (I discuss this in my article The calcium myth). Instead, it needs companion nutrients that help with absorption, utilization, and regulation of calcium in not only the bones, but also the blood, organs, and other tissues. The fact that vitamin D is crucial for calcium absorption is becoming better recognized by researchers and the public alike thanks to an avalanche of research on vitamin D, but another vitamin — vitamin K — is, in my opinion, the “next big breakthrough” for bone (and overall) health. You see, vitamin K (specifically K2 in the form of MK-7) has a very critical role to play in binding calcium to the tissues that need it, particularly the bones. And if vitamin K is present and doing its job, calcium meant for the bones and teeth doesn’t wind up being calcified in the arteries, setting the stage for heart disease.

But heart disease is not the only health problem that arises with excess calcium — it’s just the most frightening possibility out there. High calcium intake interferes with the absorption or utilization of other nutrients, including manganese, magnesium, iron, zinc, and phosphorus (most of which, by no coincidence, are key minerals involved in keeping bone strong and flexible). And calcium and magnesium work in concert so that increasing your calcium levels without simultaneously increasing magnesium can promote calcium deposits in the joints or kidneys, leading to arthritis and kidney stones! In a nutshell, supplementing with high levels of calcium alone tips the scales not toward better, healthier bones and bodies, but away from them.

Fortunately, rebalancing those scales is easy! We need to recognize, first of all, that we don’t really need  the very high  calcium intakes that we’re constantly told will strengthen our bones, and second, that we’d fare better with a comprehensive nutritional approach to osteoporosis and overall health that includes, at the very minimum, vitamin D, magnesium, and above all vitamin K2 to balance the body’s absorption, metabolism, and utilization of calcium.

Also, there is a large body of scientific research on vitamin K and the prevention of arterial calcification.Should you be interested in knowing more, take a look at my article, “Vitamin K: the overlooked bone builder and heart protector.”

References
Bolland, M.J., Avenell, A., Baron, J.A., et al. 2010. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: Meta-analysis. BMJ;341:c3691.

Cleland, J.G.F., Witte, K., Steel, S. 2010. Calcium supplements in people with osteoporosis. BMJ;341:c3856.

We created the Osteo Blast blog as our forum to express opinions and educate the public about natural means of supporting and improving bone health and overall wellness. As part of this forum, we sometimes discuss medical issues and medications, and their effects on bone health in general. However, we cannot advise readers about specific medical issues in this forum. If you wish to obtain advice from Susan E. Brown, PhD, about your specific bone health and nutritional concerns, please visit our Consultations page. Other specific medical questions should be referred to your healthcare provider.

Comments

August 20. 2010 23:07

Vitamin K is produced by intestinal bacteria. I don't understand why supplements are touted.

eileen

August 22. 2010 11:21

Eileen,
The situation with vitamin K is much like that with vitamin D,we have set the mark for adequacy at the lowest level to prevent the most obvious deficiency disease.  As it appears most folks, except those whose intestinal flora has been depleted thru antibiotic use, have enough gut bacteria to produce enough vitamin K to provide for proper clotting.  There are other important roles for vitamin K, however, like providing for the carboxylation of the bone protein, osteocalcim, and assisting in the prevention of arterial calcification, which only occur if we have a higher level of available vitamin K.

Susan Brown

August 23. 2010 09:38

Hello Dr. Brown,

I noticed that your Basics contains EPA and DHA (both of which are Omega-3 Fatty Acids), but not ALA, which is also an omega 3...Can you please tell me why they do not include ALA? (or am I misreading the labels?)

Should I be getting ALA from another source? Also, is there a reason why the supplements do not include omega 6 or omega 9?  Should I be getting ALA, omega 6 and omega 9 from another source?

Thank you,
MaryLee

MaryLee

August 24. 2010 00:42

Would love to find out what amounts of K, D, Calcium create the right balance. I understand K1 can be toxic.

Lana

August 24. 2010 08:46

@Lana, Your understanding is not quite correct. There are various forms of vitamin K, and according to the Merck Manual, "Vitamin K1 (phylloquinone) is not toxic when consumed orally, even in large amounts. However, menadione (a synthetic, water-soluble vitamin K precursor) can cause toxicity and should not be used to treat vitamin K deficiency." Something to keep in mind when choosing a vitamin K supplement.

Managing Editor

August 24. 2010 11:42

@MaryLee, ALA, or alpha linolenic acid, is indeed a polyunsaturated n-3 (omega-3) fatty acid and an "essential" fatty acid -- in that the body does not produce it on its own and it must be acquired through the diet -- but people today rarely lack adequate dietary ALA. Sources rich in ALA include canola, soybeans, walnuts, and flaxseed.

The omega-3 fatty acids featured in our Better Bones programs -- DHA and EPA -- are synthesized within the human body from alpha linolenic acid, but with a very limited efficiency. Because of this extremely restricted conversion cascade, the myriad crucial roles DHA and EPA play throughout the body, and our limited consumption of foods that are rich in EPA and DHA, supplementing daily a high-quality fish oil product is a very good idea for anyone interested in preventive health maintenance.

To answer the second part of your question, neither omega-6's nor omega-9's are lacking in most women's diets today, either. But to gain a better understanding of why, please see the following articles on our partner's web site (particularly the first):

1) What's the difference between omega-3's, 6's and 9's?: http://www.womentowomen.com/healthynutrition/differencebetweenomega369.aspx
2) Omega-3’s, phytonutrients, and the Mediterranean diet: http://www.womentowomen.com/healthynutrition/mediterraneandiet.aspx
3) Guidelines on omega-3's for vegans and vegetarians: http://www.womentowomen.com/healthynutrition/veganepadha.aspx
4) Benefits of omega-3 fatty acids: http://www.womentowomen.com/healthynutrition/omega3benefits.aspx

Managing Editor

August 24. 2010 21:32

I have heard that the vitamin K is substantially reduced by freezing vegetables.   We purchase fresh vegetables but are only two people and cannot eat all the vegetables immediately.  Is it okay to steam them and freeze the left overs?

Carol

August 28. 2010 08:59

I have a question in regards to your reply to Lana's question:  You mention that Vitamin K (medadione form) can be toxic.  Can vitamin K2 as Menaquinone-7 be toxic?

Thanks,
MaryLee

MaryLee

August 28. 2010 21:37

I have an extensive medical history; most recently severe osteosporosis, rheumatoid arthritis, no energy, chronic fatigue,
lost all teeth after Reclast; worsening kidney stones & balance problems in one remaining kidney; throat and swallowing, heart murmur; not complaints, just the truth of a 72 yr. old woman, fibromyalglia...............very much depressed and ashamed and sorry I can not do more here at home or for family or others.  Thanks for listening (reading) is anyone does......May God Bless you for the good work I have heard you do.

Mary Forster

August 31. 2010 09:57

Dear MaryLee,
Natural vitamin K as MK-7 is very safe and non-toxic, as is K1 from plants.  MK-7, however, is more potent and longer lasting that K1 and has been found to help reverse arterial calcification, while K1 has not.  Japanese who consume fermented soy cheese known as "natto" consume about 360 mcg of MK-7 a day and they have less fracture and less heart disease. There is also about 50 mcg in a serving of true aged cheese. Mk-7 is healthful and safe.  Be well, Susan

Susan Brown

August 31. 2010 10:08

Dear Mary Forster,
Thanks for the note.  I encourage you to keep your spirits up, and keep looking for a health care professional who might take a second look at your entire picture.  For the bone health issues it is always good to get a full medical osteoporosis work-up which I discuss on this website at http://www.betterbones.com/bonehealth/medicaltestingforosteoporosis.aspx. For example, kidney stones and osteoporosis can be related to a loss of calcium in the urine, and testing for vitamin D adequacy is always important. In the meantime,keep up simple acivities like walking, eating more vegetables and fruits and drinking adequate pure water-and never be ashamed of illness.  I send you my best wishes, Susan Brown

Susan Brown

September 7. 2010 09:58

I noticed your recommended range for blood calcium is between 4 and 5, so why do the labs state the normal range between about 8 and 10? My calcium is always between 9.4 and 9.8 and I'm concerned because my 62 yr old mom has SEVERE osteoporosis, had tumors on her parathyroid. Both of our alkiline phosphastase numbers are abnormally low (leading me to believe that is genetic). Please tell me what the appropriate calcium bumbers should be.
thank you,
shelley

shelley harrison

September 7. 2010 16:26

Dear Shelley,
I think there is some confusion. But no need to worry, the laboratory that tests your calcium level will give the acceptable range for the test they do. Calcium can be measured as total serum calcium with a normal range of 8.8 to 10.4 mg/dL (or 2.2 to 2.6 mmol/L)per the Merck Index.  Sounds like your doctors were measuring your serum calcium.  There is another blood calcium test called "ionized calcium" and that range is 4.8 and 5.2 mg/dL (or between 1.2 and 1.3 mmol/L)according to the Merck Index.  So there are two different test for two types of blood calcium measures, and the ranges can vary a bit by laboratory.  If you have any questions about your particular calcium test, just ask you health practitioner.

Susan Brown

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