Friday, March 12, 2010

A Hearty Dose of Calcium???

March 12, 2010

Institute For Medical Wellness Healthy Living Report

A Hearty Dose of Calcium???

Everyone always asks, Hey Doc, What type of calcium supplement should I take? You know, I don't want to have weak bones or Osteoporosis.

But does calcium supplementation help you or hurt you?

To answer this question we need to go back to a term mentioned a while back in an older, more ancient newsletter. The term or concept is called NNT, or number needed to treat. This is, to me, a very valuable statistic. It tells me how many people we need to treat to help or to hurt one person? I then convert that number into a percentage to see the actual percentage of people helped, or hurt, by a treatment.

Here is an example:

If 11 people have strep throat, and I give an antibiotic to all 11, on average, 10 people will be cured and 1 will not. The NNT is 10/11, or a 91% success rate. In healthcare, that is pretty good odds, especially for a treatment that is very safe.

Before I get to calcium, let me provide another NNT, this time for one of my favorites, the cholesterol drug Lipitor. Lipitor has an NNT of 100 to prevent one cardiovascular event. So it helps 1 out of every 100 people who take it, or 1%. I'll bet that is not what you see or hear on the television advertisements.

Now let us look at NNT for calcium supplementation in a few different ways.

Over five years,to prevent one symptomatic fracture in one person, we need to give calcium supplementation to 50 people. That is an NNT of 50, which means 1 out of 50 or 2% of people may benefit. That also means 98% do not!

Now, can calcium cause any problems?

In the above population, the NNT of individuals who took calcium supplementation over 5 years and went on to have a heart attack, otherwise known as an MI, or myocardial infarction, a coronary, or acute coronary syndrome, or coronary thrombosis .............

Sorry bout that! I sometimes get carried away!

The NNT of individuals who took calcium supplementation and went on to have a heart attack was 44. This means that 1 out of 44 individuals or 2.3% went on to have heart attacks. Here is another study on Vitamin D, calcium and prevention of cardiovascular events.

Things that make me go Hmmm!!!

2% of people benefit from calcium by not developing a symptomatic fracture, while 2.3% had a heart attack. More had heart attacks than prevention of fractures.

I do not exactly like those odds ; (

So the benefit of calcium supplementation appears to be overblown!

But I can still take one of those Osteoporosis drugs to prevent my bones from weakening. They will help because I trust Sally Fields!!! Sally would not lie to me!!

Full disclosure time: The only movie I ever liked with Sally Fields was Smokey and the Bandit. But that was a long, long time ago!!!

Below are the NNT's for prevention of hip fractures over 3 years for 3 common Osteoporosis drugs, as well as for low dose Vitamin D supplementation and hormone replacement therapy.

1. Risedronate (Actonel): 77
2. Alendronate (Fosamax): 91
3. Zoledronic Acid (Reclast): 91
4. Vitamin D 800 IU daily: 45
5. Hormone Replacement Therapy: 385

The lower the number, the better.

It appears that low dose Vitamin D was twice as effective as Fosamax or Reclast.

My suggestion.

Eat a well balanced diet, low in processed carbohydrates, with an abundance of colorful vegetables, meats, chicken, fish and eggs. Throw in some nuts, butter and olive oil. Get some summer sunshine for Vitamin D, or take a Vitamin D supplement.

And "just say No", to calcium supplements and Osteoporosis drugs!

To Good Health!

Steven Horvitz, D.O,
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

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