The question whether calcium supplements are good or bad for you, and how much you should take, is very controversial. That is because it is the wrong question. The answer is “it depends”. We spent an hour at ASBMR going over many studies and analyses.
Total calcium intake is what matters. That means that how much calcium supplement you need today depends on how much calcium is in your diet. Unless you eat the same thing every day (boring!), your need for calcium supplement at each meal will vary. And it is more tricky than that.
The American Society for Bone & Mineral Research 35th Annual Meeting has just concluded. Of the roughly 2000 attendees, nearly half were form other countries. Most are PhD researchers dealing in basic science issues and then moving toward answers to human maladies. Two totally new types of osteoporosis medications are in phase 3 human trials. They look promising.
Those of us who treat human patients use meetings to trade information. My poster about using Vertebral Fracture Assessment to improve the accuracy of DXA was well received. Many academic osteoporosis centers routinely use VFA, but have not yet analyzed and reported their results. I learned a lot from other attendees, much of which will help me help my patients.
If you screen by DXA alone you fail to identify most of the individuals who will fracture. Over 80% of fracture patients over age 50 have “osteopenia” or “normal” as their Bone Mineral Density (BMD) test result on DXA. Wow! DXA is a terrible stand-alone test.
Previous fractures are a much more reliable screen. Any previous fracture predicts future fractures. The best predictors of fracture risk are Vertebral (spine) fractures, but there is a problem. Most vertebral “crumble” or even “crunch” fractures are not identified as fractures until you look for them. You must do Vertebral Fracture Assessment (VFA) to identify those persons who are at increased risk of fracture because they already have fractured.
A Hip Fracture over age 70 is Very Bad. About 20% of women and over 30% of men die from their hip fracture. Some consider these to be the lucky ones. Nearly half of those who survive a hip fracture spend the rest of their lives in a nursing home.
Many hip fractures should be preventable. There were warnings! Half of the people who break a hip had another Fragility Fracture a few months or years before. Most warnings go unheeded. Hip Fractures that could have been prevented destroy quality of life for too many individuals.