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Many of us don’t realize that calcium is vital to our entire body, not just our bones. It is the most common mineral in the body and is required for proper function of our brain, our heart, and many other organs. Priority is given to the body’s organs. Not eating enough calcium-rich foods can cause the body to pull the needed calcium out of our bones, causing them to become weak and sponge-like. This condition is called Osteoporosis and can cause bones to fracture during every day activities.

The easiest and least expensive ways to protect your bones are through your food and lifestyle choices. What you put in your mouth will affect your total health in the long run! Some of basic suggestions for strong, healthy bones are as follows:

Make sure you get 1200-1500mg of calcium per day, divided into 3 doses
Vitamin D is necessary for your body to absorb the calcium-drink fortified milk, take a supplement, or get some sun!
Maintain a moderate intake of phosphorus-too little and your body can’t form bones and teeth-too much and it will upset the calcium balance in your body. Carbonated beverages and too much protein in your diet will give you too much phosphorus
Get enough fiber for proper function of the digestive tract, but not so much that it decreases the absorption of calcium. Up to 35 gm per day should be enough
Lighten up on caffeine! Not only does it cause sleep issues, but more than 3 cups of caffeinated beverages per day can cause a loss of calcium in your body
Alcohol has a toxic effect on the formation of bone cells, save your drinks for special occasions, not every day
Cigarette smoking has been shown to increase bone loss and decrease estrogen levels (estrogen protects your bones). Quitting smoking is not only good for your lungs!
Regular weight-bearing exercise helps prevent bone loss. Try adding a few extra steps everywhere you go by parking further away from your destination, using the stairs instead of the elevator, etc. Every little bit helps!
Make sure your estrogen levels in your blood are high enough to protect your bones-a decrease in estrogen with menopause corresponds directly to an increase in bone loss. Menopause is a time when women are especially vulnerable to bone loss.
Check out your diet for simple ways to increase calcium intake-dairy products, dark green leafy vegetables, tofu, fish and whole grains are good sources of calcium. Some juices, grains and dairy products are fortified with calcium as well.

If you and your physician have decided you should take a calcium supplement, how do you know which one is best? Generally Calcium Carbonate is recommended because it has the highest amount of absorbable calcium. Less effective are Calcium Citrate, Calcium Lactate and Calcium Gluconate. Bone meal and dolomite are not recommended because they may contain toxic substances such as lead, arsenic and mercury. Chelated Calcium is expensive and generally no better than any other form of calcium. Make sure you take no more than 2000mg of calcium per day, as long term use of large doses can cause unhealthy side effects. Your physician can help you determine the correct dose for you as an individual.
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The usual recommendations are that women over 40 years old get a mammogram every year. While this is a valuable screening tool, it’s not at all comfortable and the image obtained can be hard to read. Advances in mammography technology are changing all that. Many sites are now offering digital mammography. The images are much clearer, often making additional views unnecessary. Along with the digital mammography service, many sites are trying to make the process more comfortable as well. Breast pads are now being offered so you feel less compression and no cold metal plates! The facilities themselves are undergoing change, becoming more like a day spa with artistic interiors and little “goodie bags” being given to patients. One local company is leading the way towards a more comfortable, accurate mammogram experience. The Imaging Center of Idaho offers a friendly and professional staff, the latest technology, a comfortable interior and soft padding on their mammography plates. I had my screening mammogram there recently and did not feel any embarrassment or discomfort at all. I came away with a clean bill of health, my dignity intact and a “goodie bag” filled with breast health information, mints and a pair of pink gardening gloves. It’s time that medical professionals realize that it’s not enough to follow the latest studies and buy the latest equipment. I applaud the movement towards personalizing treatment-Do I feel cared about? Is the staff knowledgeable and concerned with my emotional well-being as well as my physical care? Can the facility get accurate test results the first time and explain them to me? Even though mammograms are not my favorite way to pass the time, do I feel comfortable going back next year? After my experience with digital mammography and with the Imaging Center of Idaho this year, I can answer “yes” to all these questions. I encourage all women to consider digital mammography for their yearly screenings and ask your doctor who they recommend. Facilities are upgrading all over the country and your mammogram doesn’t have to be a horrible experience anymore.

Traditionally, your doctor would run through several risk factors to determine if you were at risk for cardiovascular disease:

Are you a smoker?
Do you have high blood pressure?
Do you have high cholesterol?
Are you overweight?
Do you have Diabetes Mellitus?
Are you sedentary?
Do you drink excessive amounts of alcohol?
How do you deal with stress?
Are you male?
Do you have a family history of cardiovascular disease?
Are you over 65?
Are you Hispanic, American Indian, or Native Hawaiian?

All of these factors could put you at higher risk for cardiovascular disease. If you have 2 or more risk factors, there is a new test your doctor should consider. The PLAC test is a blood test that measures the level of Lp-Pla2 present in your system. This enzyme is produced by plaque in the body and indicates inflammation and the formation of rupture-prone plaque. It is the only blood test approved by the FDA to aid in assessing risk of coronary heart disease and ischemic stroke from atherosclerosis. If your Lp-Pla2 levels are elevated, your doctor may want to pursue more aggressive therapy to lower your risk. If your levels come back normal, published data suggests you are at lower risk and can take a more conservative approach.

The PLAQ test is a simple, yet thorough test; you don’t have to be fasting, you can continue to take medications uninterrupted, and the results are not falsely elevated from infections, obesity or rheumatologic disorders like the CRP (C-Reactive Protein, another common screening test for determining inflammation).

Half of all heart attacks occur in people with low to moderate cholesterol levels. One third of all strokes occur in people 45-65 years of age with all levels of cholesterol. Cholesterol levels are not a reliable predictor of heart attack or stroke- the PLAQ test is. Often the PLAQ test is not covered by insurance as it is considered preventative. But, at under $100 it may be worth paying out of pocket for if you have risk factors. Ask your doctor for more information on the PLAQ test.

Several studies have recently shown that women that are deficient in Vitamin D are more likely to develop breast cancer. The lower the level of Vitamin D in their blood, the higher the grade of cancer they develop and the higher the risk of mortality. In these studies, the association between Vitamin D levels and disease free survival were not related to age, BMI (body mass index), insulin level, and tumor stage/grade, estrogen-receptor status, chemotherapy or tamoxifen use. This implies that adequate levels of Vitamin D in your blood could protect you from breast cancer. If you do end up with breast cancer, maintaining adequate Vitamin D levels along with your treatment may prevent death and increase your chance of disease free survival.

Vitamin D deficiency can also harm your bones. Your body requires Vitamin D to absorb Calcium and make it available for use. If you don’t have enough Vitamin D, Calcium is not absorbed and your bones become weak, leading to rickets in children and osteoporosis in adults.

If you and your doctor decide that you would benefit from supplementation, your serum 25 hydroxyvitamin D levels must be measured before and during treatment. High levels in your blood could lead to the permanent deposit of minerals in the heart, lungs, and kidneys. Symptoms of toxicity are nausea, vomiting, pain in joints, and lack of interest in eating food. Continuing at toxic levels can result in death.

If you have any questions about your Vitamin D levels, talk to your doctor. Open communication with your doctor is one of the most important tools you have in the pursuit of good health.

September 2008

Protect Your Bones

Digital Mammography

Assessing Cardiovascular Risk

Vitamin D and Breast Cancer Risk

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