Calcium Tablets

Bitpo · 10-01-2012, 04:54 AM

Is it nice for a person dong CISC like me to consume calcium tablets? Actually i don't want but my mum asks me to because she bought calcium tablets. She likes nagging.
I once had renal stones. Before i did operation in Jan 2010, i had recurrent UTI and urosepsis. I had recurrent fever. Nightmares....

gjnl · 10-01-2012, 01:29 PM

Excerpts from two papers.

http://intl-ncp.sagepub.com/content/22/3/286.full
Renal Calculi
Calcium once was thought to play a role in the formation of kidney stones, and patients with stones often began receiving a low-calcium diet. More recent studies now suggest that a low-calcium diet may actually increase the risk of developing kidney stones.44 In a 5-year randomized trial, 120 men with recurrent calcium oxalate stones began receiving either a low-calcium diet (10 mmol/d) or a normal-calcium (30 mmol/d), low-sodium, low-animal-protein diet. Urinary oxalate excretion increased in the men receiving the calcium-restricted diet but decreased in the men consuming the normal-calcium, low-animal-protein (52 g/d), low-sodium diet (50 mmol/d sodium chloride). The risk of stone recurrence was decreased by 50% in the men receiving the normal calcium diet compared with those receiving the low-calcium diet. It is thought that dietary calcium binds oxalates in the gut, preventing absorption.

Dietary calcium intake was also inversely associated with the risk of kidney stones in the Health Professionals Follow-up Study.42 A cohort of 45,619 men from 40 to 75 years of age, with no history of kidney stones, was followed for 4 years. No significant risk was associated between the risk of kidney stones and calcium supplementation. Additionally, in a study of 56 postmenopausal women, calcium carbonate supplementation with a meal or combined calcium supplementation with estrogen therapy did not increase urinary calcium oxalate excretion.43 Conversely, results of the WHI raised some concerns regarding whether calcium and vitamin D supplementation together increases the risk of renal stones.26 Women in the group randomly assigned to receive 1000 mg/d calcium and 400 IU/d of vitamin D3 experienced a significant 17% increase in risk of renal stones compared with the placebo group. However, apparently the women in the supplemented group were also using self-selected supplements, which resulted in a calcium intake close to 2000 mg/d. Thus, further studies are needed to clarify this issue.

To reduce the risk for calcium oxalate stones, calcium supplements should be taken with food to allow calcium to bind with oxalates in the gut, and the UL should not be exceeded.

http://www.ncbi.nlm.nih.gov/pubmed/11271790
J Clin Pathol. 2001 Jan;54(1):54-62.
Why oral calcium supplements may reduce renal stone disease: report of a clinical pilot study.
Williams CP, Child DF, Hudson PR, Davies GK, Davies MG, John R, Anandaram PS, De Bolla AR.
Source

Department of Medical Biochemistry, Wrexham Maelor Hospital NHS Trust, Wrexham LL13 7TD, UK. clive.williams@new-tr.wales.nhs.uk
Abstract
AIMS:
To investigate whether increasing the daily baseline of gut calcium can cause a gradual down regulation of the active intestinal transport of calcium via reduced parathyroid hormone (PTH) mediated activation of vitamin D, and to discuss why such a mechanism might prevent calcium oxalate rich stones. To demonstrate the importance of seasonal effects upon the evaluation of such data.
METHODS:
Within an intensive 24 hour urine collection regimen, daily calcium supplementation (500 mg) was given to five stone formers for a 10 week period during a six month crossover study. In a further population of patients on follow up for previous renal stone disease, observations were made on 1066 24 hour urine samples collected over five years in respect of seasonal effects relevant to the interpretation of the study.
RESULTS:
In the group of patients on calcium supplements the following results were found. During calcium supplementation, the proportion of urine calcium to oxalate was higher (increased calcium to oxalate molar ratio), the 24 hour urine product of calcium and oxalate did not rise, and urine oxalate was lower during the first six weeks of supplementation. Twenty four hour urine calcium was 10.2% higher than baseline in the final four weeks of the 10 weeks of supplementation. Twenty four hour urine phosphate was 11.4% lower during the first six weeks of supplementation, but then rose while the patients were still on supplementation; renal tubular reabsorption of phosphate (TmP/GFR) mirrored the urine phosphate changes inversely. PTH was higher after stopping supplementation, but 1,25-(OH)2-cholecalciferol changes were not detected. In the 1066 urine samples collected over five years the following results were found. Calcium and oxalate excretion correlated positively and not inversely. Urine calcium and phosphate excretion were 5.5% and 2.5% higher, respectively, in "light" months of the year compared with "dark" months. A post summer decline in both urine calcium and urine phosphate was relevant to the interpretation of the study.
CONCLUSIONS:
Regular calcium supplementation does not raise the product of calcium and oxalate in urine and the proportion of oxalate to calcium is reduced. The underlying mechanisms of the changes seen in phosphate, calcium, and PTH and the observations on 1,25-(OH)2-cholecalciferol are not clear. Observed changes in phosphate could possibly be part of a calcium regulating feedback loop operating over a period of weeks. In evaluating these mechanisms background seasonal effects are important. It is possible that "programming" of the gut mucosa in terms of calcium transport is a major determinant of the relation between calcium and oxalate concentrations in urine and their relative abundance. Increased oral calcium, in association with a reduction of the relative proportion absorbed, may be pertinent to the prevention of calcium oxalate rich stones.

It might be a good idea to run this by your urologist before starting a calcium supplementation regime.
Key points of discussion:
---How much calcium should you take per day?
---When should you take calcium supplements? Once a day? Twice a day? With meals?
---Should you be taking Vit. D with calcium?

All the best,
GJ

SCI-Nurse · 10-01-2012, 05:06 PM

I would definitely ask your physician before starting the calcium. And I would ask the questions listed above.
CKF

gjnl · 10-01-2012, 10:20 PM

You may want to talk to your doctor about a blood chemistry panel, if you haven't had one recently. The blood calcium portion of this panel can give your doctor some insight if your body is still leaching calcium as a result of your injury. This insight may make a difference in you doctor's recommendation to take calcium supplements or not.

All the best,
GJ

10-01-2012, 04:54 AM	#1
Bitpo Senior Member Join Date: Mar 2012 Posts: 126	Calcium Tablets Is it nice for a person dong CISC like me to consume calcium tablets? Actually i don't want but my mum asks me to because she bought calcium tablets. She likes nagging. I once had renal stones. Before i did operation in Jan 2010, i had recurrent UTI and urosepsis. I had recurrent fever. Nightmares....

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10-01-2012, 01:29 PM	#2
gjnl Senior Member Join Date: Jun 2005 Posts: 5,057	Excerpts from two papers. http://intl-ncp.sagepub.com/content/22/3/286.full Renal Calculi Calcium once was thought to play a role in the formation of kidney stones, and patients with stones often began receiving a low-calcium diet. More recent studies now suggest that a low-calcium diet may actually increase the risk of developing kidney stones.44 In a 5-year randomized trial, 120 men with recurrent calcium oxalate stones began receiving either a low-calcium diet (10 mmol/d) or a normal-calcium (30 mmol/d), low-sodium, low-animal-protein diet. Urinary oxalate excretion increased in the men receiving the calcium-restricted diet but decreased in the men consuming the normal-calcium, low-animal-protein (52 g/d), low-sodium diet (50 mmol/d sodium chloride). The risk of stone recurrence was decreased by 50% in the men receiving the normal calcium diet compared with those receiving the low-calcium diet. It is thought that dietary calcium binds oxalates in the gut, preventing absorption. Dietary calcium intake was also inversely associated with the risk of kidney stones in the Health Professionals Follow-up Study.42 A cohort of 45,619 men from 40 to 75 years of age, with no history of kidney stones, was followed for 4 years. No significant risk was associated between the risk of kidney stones and calcium supplementation. Additionally, in a study of 56 postmenopausal women, calcium carbonate supplementation with a meal or combined calcium supplementation with estrogen therapy did not increase urinary calcium oxalate excretion.43 Conversely, results of the WHI raised some concerns regarding whether calcium and vitamin D supplementation together increases the risk of renal stones.26 Women in the group randomly assigned to receive 1000 mg/d calcium and 400 IU/d of vitamin D3 experienced a significant 17% increase in risk of renal stones compared with the placebo group. However, apparently the women in the supplemented group were also using self-selected supplements, which resulted in a calcium intake close to 2000 mg/d. Thus, further studies are needed to clarify this issue. To reduce the risk for calcium oxalate stones, calcium supplements should be taken with food to allow calcium to bind with oxalates in the gut, and the UL should not be exceeded. http://www.ncbi.nlm.nih.gov/pubmed/11271790 J Clin Pathol. 2001 Jan;54(1):54-62. Why oral calcium supplements may reduce renal stone disease: report of a clinical pilot study. Williams CP, Child DF, Hudson PR, Davies GK, Davies MG, John R, Anandaram PS, De Bolla AR. Source Department of Medical Biochemistry, Wrexham Maelor Hospital NHS Trust, Wrexham LL13 7TD, UK. clive.williams@new-tr.wales.nhs.uk Abstract AIMS: To investigate whether increasing the daily baseline of gut calcium can cause a gradual down regulation of the active intestinal transport of calcium via reduced parathyroid hormone (PTH) mediated activation of vitamin D, and to discuss why such a mechanism might prevent calcium oxalate rich stones. To demonstrate the importance of seasonal effects upon the evaluation of such data. METHODS: Within an intensive 24 hour urine collection regimen, daily calcium supplementation (500 mg) was given to five stone formers for a 10 week period during a six month crossover study. In a further population of patients on follow up for previous renal stone disease, observations were made on 1066 24 hour urine samples collected over five years in respect of seasonal effects relevant to the interpretation of the study. RESULTS: In the group of patients on calcium supplements the following results were found. During calcium supplementation, the proportion of urine calcium to oxalate was higher (increased calcium to oxalate molar ratio), the 24 hour urine product of calcium and oxalate did not rise, and urine oxalate was lower during the first six weeks of supplementation. Twenty four hour urine calcium was 10.2% higher than baseline in the final four weeks of the 10 weeks of supplementation. Twenty four hour urine phosphate was 11.4% lower during the first six weeks of supplementation, but then rose while the patients were still on supplementation; renal tubular reabsorption of phosphate (TmP/GFR) mirrored the urine phosphate changes inversely. PTH was higher after stopping supplementation, but 1,25-(OH)2-cholecalciferol changes were not detected. In the 1066 urine samples collected over five years the following results were found. Calcium and oxalate excretion correlated positively and not inversely. Urine calcium and phosphate excretion were 5.5% and 2.5% higher, respectively, in "light" months of the year compared with "dark" months. A post summer decline in both urine calcium and urine phosphate was relevant to the interpretation of the study. CONCLUSIONS: Regular calcium supplementation does not raise the product of calcium and oxalate in urine and the proportion of oxalate to calcium is reduced. The underlying mechanisms of the changes seen in phosphate, calcium, and PTH and the observations on 1,25-(OH)2-cholecalciferol are not clear. Observed changes in phosphate could possibly be part of a calcium regulating feedback loop operating over a period of weeks. In evaluating these mechanisms background seasonal effects are important. It is possible that "programming" of the gut mucosa in terms of calcium transport is a major determinant of the relation between calcium and oxalate concentrations in urine and their relative abundance. Increased oral calcium, in association with a reduction of the relative proportion absorbed, may be pertinent to the prevention of calcium oxalate rich stones. It might be a good idea to run this by your urologist before starting a calcium supplementation regime. Key points of discussion: ---How much calcium should you take per day? ---When should you take calcium supplements? Once a day? Twice a day? With meals? ---Should you be taking Vit. D with calcium? All the best, GJ

10-01-2012, 05:06 PM	#3
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,367	I would definitely ask your physician before starting the calcium. And I would ask the questions listed above. CKF

10-01-2012, 10:20 PM	#4
gjnl Senior Member Join Date: Jun 2005 Posts: 5,057	You may want to talk to your doctor about a blood chemistry panel, if you haven't had one recently. The blood calcium portion of this panel can give your doctor some insight if your body is still leaching calcium as a result of your injury. This insight may make a difference in you doctor's recommendation to take calcium supplements or not. All the best, GJ