Why does our body need calcium?
Calcium is one of the most abundant minerals in the body and does a lot more than strengthening our bones and teeth. Hence the deficiency of calcium can affect many of our body functions.
Though 99% of the calcium in our body is stored in the bones, other tissues like muscles and blood also contain calcium.
The primary reason for the high availability of calcium in the human body is its need.
Calcium is necessary for many important processes like:
- Formation and strengthening of bones and teeth
- Muscle contractions
- Clotting of blood
- Maintaining a normal heart rhythm
- Normal enzyme functioning
The body continuously regulates the calcium present in the blood as well as the cells by moving it in and out of the bones as and when there is calcium deficiency.
When the intake of calcium is less or when there is calcium deficiency, the body maintains its levels in the blood and cells by mobilizing them from the bones, thereby weakening them.
Quick Fact: Calcium, an essential mineral, plays a vital role in many physiological processes. Less calcium intake is counterbalanced in the body by mobilizing it from the bones.
How much calcium do you need?
Calcium is obtained from the foods we eat.
There are many foods that are naturally rich in calcium and one needs to consume them during each meal.
Some calcium-rich foods that one must include in their diet are:
- Soya beans
- Dairy products like milk, yogurt, cheese
The amount of calcium required by an individual depends upon their age, gender and other factors like underlying health conditions and overall health.
The normally followed dietary recommendations for calcium are:
- Women(50+): 1200mg per day
- Women(<50 years): 1000 mg per day
- Men(71+): 1200 mg per day
- Men(<71 years): 1000mg per day
Quick Fact: The dietary intake of calcium differs based on factors such as age, gender, and medical conditions. In general, women over 50 years and men over 71 years require more calcium than optimum range.
How do your genes influence your calcium requirements?
CASR or Calcium-Sensing Receptor is an extracellular G-protein that plays a vital role in calcium homeostasis.
This gene is usually expressed at very high levels in the parathyroid glands, thyroid, intestine, and kidneys.
This gene forms a stable homodimeric cell membrane complex that signals upon binding extracellular calcium ions.
This results in the downregulation of the gene expression of the short-term regulator of calcium homeostasis in the parathyroid whereas. At the same time, there is an upregulation in renal calcium and downregulation sodium chloride excretion.
Also, the binding of calcium to the CASR gene is very expected within the normal physiological limits of the calcium ions. This leads to a steep dose-response curve and results in tight control of calcium levels in the blood.
A986S(rs1801725) located on exon 7 is an extensively studied and researched SNP in the CASR gene.
This polymorphism indicates a mutation from G to T which changes the activity of the CASR gene.
This might further alter the parathormone secretion, increase calcium clearance and thereby, affects calcium homeostasis.
Quick Fact: Calcium homeostasis in the body is maintained by CASR gene, and polymorphisms in the gene can alter the calcium levels.
The CYP24A1 gene is located on chromosome 20 and provides the instructions required for the production of the enzyme 24-hydroxylase.
This enzyme is responsible for controlling the amount of active vitamin D available in the body.
When this gene is active, vitamin D helps to maintain an optimum balance of the various minerals in the body, including bones and teeth.
Vitamin D is absolutely essential for the proper absorption of calcium from the intestines and is also necessary for various processes required for bone and tooth formation.
There are many mutations that are found associated with this gene and are known to cause idiopathic infantile hypercalcemia 1.
Quick Fact: The enzyme encoded by CYP24A1 gene regulates vitamin D levels, which is essential for calcium absorption. There is an association between mutant variants of this gene and idiopathic infantile hypercalcemia1 condition.
GATA3 or GATA binding protein 3 is a gene that is located on chromosome 10 and belongs to the GATA family of transcription factors.
Any defects in this gene result in hypoparathyroidism along with sensorineural deafness and renal dysplasia.
Hypothyroidism also means a reduction in the calcium levels in blood i.e hypocalcemia.
Quick Fact: GATA3 gene belongs to the GATA family of transcriptional factors, and any defect in this gene results in conditions such as hypoparathyroidism, renal dysplasia and sensorineural deafness.
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Calcium deficiency – Hypocalcemia
The condition when the calcium levels in the blood are low is called hypocalcemia.
This condition is more common in women, and also more so as people age.
Calcium deficiency – Causes
- Hormonal changes in women
- Poor intake of calcium
- Dietary intolerance to foods containing calcium
- Medications that affect calcium absorption
- Genetic factors
Some other causes that can lead to hypocalcemia include:
- Low levels of vitamin D (therefore, reduced calcium absorption)
- Chemotherapy drugs
- Hypophosphatemia(decreased phosphate levels) and hypomagnesemia(decreased magnesium levels)
- Removal of the parathyroid gland as a part of thyroid gland tissue during surgery
Quick Fact: Hypocalcemia, a condition of low blood calcium levels is more prevalent among women and aged people. The most common causes are usage of certain medications and genetics
Calcium deficiency – Symptoms
Early-stage hypocalcemia does not show any symptoms, which only appear when the disease progresses.
Some symptoms of hypocalcemia include:
- Muscle problems such as aches, spasms, cramps
- Increased numbness and tingling in the arms, legs, hands, and feet
- Severe fatigue, lack of energy
- Dry skin
- Weak and brittle nails
- Osteoporosis that increases the chances of breaking or brittle bones
- Dental problems like poor oral health, week roots of teeth, brittle teeth, gum irritation, increased cavities
Untreated hypocalcemia can be life-threatening.
Quick Fact: As the disease progresses, hypocalcemia encompasses symptoms ranging from muscle spasms to hallucinations and can be life-threatening if left untreated.
Treatment for calcium deficiency
It is advisable to not self-treat calcium deficiency by taking OTC calcium supplements as it can negatively impact one’s health by interacting with any other medications one may be taking.
Based on the calcium levels, your physician will provide you with the right calcium supplement and ask you to increase your dietary intake.
Commonly advised calcium supplements are:
Including calcium-rich foods in each of the meals is also helps treating the deficiency.
Quick Fact: While self-treatment for calcium deficiency is not recommended, it is advised to take calcium-rich foods as it aids in increasing their levels.
More about calcium supplements
Who should consider calcium supplements?
The following groups of people may be at a risk for calcium deficiency and can consider taking prescribed supplements:
- Individuals with lactose intolerance
- People with osteoporosis
- Individuals who consume excess proteins or sodium (as these minerals cause increased excretion of calcium)
- People undergoing long-term corticosteroid treatment
- Individuals who are unable to absorb enough calcium due to digestive issues like celiac disease, IBD, etc.
- People with health conditions like Crohn’s that limit the body’s ability to absorb calcium
Quick Fact: Individuals with medical conditions, lactose intolerance are advised to consume prescribed calcium supplements to overcome the deficiency.
Types of calcium supplements
Calcium supplements are primarily of two types: Calcium carbonate-based and calcium citrate-based.
Among the various calcium supplements, each contains a different calcium salt and different amounts of elemental calcium.
The supplements that are calcium carbonate-based are cheaper and therefore, more popular. They contain 40% elemental calcium.
About 21% of elemental calcium is present in calcium citrate-based supplements.
Other calcium supplements contain salts like calcium lactate (containing 13% elemental calcium) and calcium gluconate (9% elemental calcium).
Combining calcium supplements with vitamin D intake can help increase the absorption of calcium. Magnesium is also a good substitute for vitamin D.
Due to these specifications, it is best when the physician advises what is best for the individual.
Quick Fact: In general, each calcium supplement varies in their salt composition and consulting physicians before consumption is recommended. Usage of vitamin D increases calcium absorption.
Side effects of calcium supplements
Calcium can cause calcification of blood vessels and thus, the usage of calcium supplements raise some serious cardiac concerns. However, no study has shown a solid proof of calcium supplements posing a threat to the heart health.
There has also been no conclusive proof to show that the intake of calcium supplements indeed helps in preventing diseases like osteoporosis.
Quick Fact: There are no established research studies that have neither proven the relevance of calcium supplements with cardiac diseases in the elderly nor as a medication for osteoporosis.
Calcium supplements and kidney stone
According to a 2015 study, calcium supplements increase the risk of kidney stone recurrence.
Although there are some claims that state that dietary intake of calcium is good for those suffering from kidney stones, these supplements have also shown to increase the rate of growth of kidney stones in those who are prone to it.
Quick fact: Although dietary calcium intake on a daily basis is recommended, a research study has proven the association of calcium supplements with kidney stones development. Hence, it is necessary to keep track of how much you cosume.
Calcium supplements and heart disease
There is a split in the medical world about their opinion over whether calcium supplements cause heart disease or not.
While some say these calcium supplements do not precipitate heart disease, others say that the calcium from the supplements can harden or calcify the existing plaque in the blood vessels.
However, resrarch suggests the following about the relationship between calcium supplements and heart disease:
- The supplements that most doctors are concerned about are those which contain only calcium
- There is no proof of the effect of calcium supplements with vitamin D to cause heart disease
- Calcium that we get from dietary sources such as leafy greens and dairy products is not a cause of worry
Quick Fact: The link between the intake of calcium supplements and heart disease has raised concerns in the medical community. A hypothesis suggests that calcium from leafy vegetables is safe, but by far, there has been no research to substantiate this claim.
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What is hypercalcemia?
When the calcium level in the blood is over 10.3mg/L, it is termed as hypercalcemia.
Excessive calcium in your blood can be harmful to your bones, kidneys, and also affect the way the other organs in your bodywork.
Hypercalcemia is usually the effect of overactive parathyroid glands that result in an increase in the blood calcium levels.
Other causes of hypercalcemia include:
- Cancers, especially lung and breast cancer
- Certain medications
- Taking excess calcium or vitamin D supplements
- Renal disorders
Quick Facts: Hypercalcemia is a condition in which blood calcium levels are above 10.3mg/L. The etiology is multifactorial but does not pertain to overactive parathyroid glands, cancer, renal disorder.
Symptoms of hypercalcemia
The symptoms of hypercalcemia affect different organs differently.
- Kidneys: Excessive calcium in your means that your kidneys need to work harder to filter it. This causes increased thirst and frequent urination.
- Digestive system: Excessive calcium can cause nausea, vomiting, stomach upset, and in some cases, constipation
- Bones: In cases where hyperparathyroidism results in hypercalcemia, the calcium from the bones is leached out into the blood due to parathormone. This causes bone pain and weakens them.
- Muscles: Hypercalcaemia can cause muscle weakness and spasms.
- Heart: Though it has not been proven yet, severe hypocalcemia might interfere with the proper functioning of the heart. It can cause palpitations, arrhythmias and other cardiac problems.
- Brain: Hypercalcaemia can cause lethargy, confusion, fatigue and even depression.
Quick Facts: In hypercalcemia, depending on the organ affected the symptoms are showcased accordingly. It affects a wide range of organs including but not limited to kidneys, heart, brain.
Treatment and prevention of hypercalcemia
In individuals with mild hypercalcemia, the calcium levels return to normal over time and do not need any treatment.
The individual’s physician may continue to monitor the calcium levels and the health of the kidneys while the calcium levels return to normal.
However, in individuals whose calcium levels do not return to normalcy on their own, the doctor will recommend further testing to determine the underlying cause of high calcium levels.
Possible treatments to reduce calcium levels include IV fluids and medications like calcitonin and bisphosphonates.
If hypercalcemia is due to excessive vitamin D, hyperactive parathyroid glands or any other underlying condition, the doctor will focus on removing or treating this cause.
One of the basic things to do to keep your calcium levels in check is maintaining a healthy and balanced lifestyle.
- Drink lots of water: Helps you stay hydrates, reduces calcium levels, and also prevents the formation of kidney stones
- Quit smoking: Having an imbalance in calcium levels can negatively impact one’s bone health. Smoking accentuates bone loss, and thus, it is best to quit smoking in order to keep calcium levels in check.
- Regular exercise routine: This helps keeps your bones and muscles healthy and strong
- Follow prescriptions: Always stick to prescriptions when taking calcium or vitamin D supplements. Excessive consumptions of these supplements can have negative health effects.
Quick Facts: The treatment for hypercalcemia depends on the time it takes for calcium to come down to the normal levels. If the calcium levels continue to be in the higher levels, modifying lifestyle and dietary habits could help.
One of the best ways to ensure healthy and optimum calcium levels is by sufficient dietary intake of the mineral. Some foods that are exceptionally high in calcium are:
- Seeds: Many seeds such as sesame seeds, poppy seeds, and chia seeds are rich in calcium
- Dairy products: Milk and other dairy products such as yogurt and cheese are storehouses of calcium and are, therefore, important for young kids and older adults.
- Greens: Vegetables including the leafy greens such as broccoli, spinach, kale, Brussel sprouts, etc., are particularly rich in calcium and magnesium.
- Beans and Lentils
- Fortified foods: A large number of foods are fortified to make them healthier. They are fortified to improve their nutritional value.
- Soya and Soya products like tofu, tempeh, and edamame are also rich in calcium.
Quick Fact: Optimum calcium levels can be met on a daily basis by consuming calcium-rich foods such as greens, almonds, and dairy.
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