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Factors That Can Help or Hinder Calcium Absorption: Getting enough calcium is only one part of the equation; some medications and conditions interfere with absorption.

Calcium plays a key role in bone strength and density. If you're a postmenopausal woman, you are at risk of osteoporosis (low bone density), so it's particularly important for you to get enough calcium. However, calcium consumption is not the only factor that needs your attention: Certain medications and medical conditions can inhibit calcium absorption or increase calcium excretion, so your bones may not be receiving as much calcium as they need to remain strong.

Conditions That Impair Absorption

Any disease or illness that affects the function of your digestive system, especially your small and large intestines, may impact how much calcium you're getting, since these are the areas where nutrients are transported out of your digestive system and into capillaries, which carry the nutrients throughout your body. "Malabsorption syndrome" is the term used for a condition that limits the absorption of nutrients.

"Many malabsorption syndromes, including inflammatory bowel disease, lactose intolerance, and celiac disease, impair the ability of the intestinal tract to absorb calcium," explains Vivian Sobel, MD, an endocrinologist at Weill Cornell Medicine.

She adds that vitamin D deficiency, which is very common, also leads to calcium malabsorption, as does a deficiency in magnesium. Even if you get enough of these nutrients from your diet, a malabsorption syndrome can cause deficiencies.

Medications

Several medications, both prescription and over-the-counter, can interfere with calcium absorption. Here are some common culprits:

Medications that treat heartburn and gastroesophageal reflux disorder (GERD), including omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium), reduce the amount of acid produced in the stomach, which can decrease absorption of calcium. Although these medications usually are recommended for shortterm use, some patients take them for many years, which increases the likelihood of inadequate calcium absorption.

Other heartburn medications called H2 blockers also decrease stomach acid production. These medications include ranitidine (Zantac), famotidine (Pepcid), and Cimetidine (Tagamet).

Long-term use of oral corticosteroid medications, such as prednisone, prednisolone, hydrocortisone, and methylprednisolone, can interfere with calcium absorption. Conditions commonly treated with a long-term course of steroids include rheumatoid arthritis, lupus, Crohn's disease, and ulcerative colitis. Your risk of reduced calcium absorption is much lower if you take corticosteroids via an inhaler or injection, or you take them for a brief period of time for inflammatory conditions such as respiratory infections and allergies.

Loop diuretics--medications commonly used to treat high blood pressure and heart failure--also can impact calcium levels. Loop diuretics include furosemide (Lasix), bumetanide (Bumex), and torsemide (Demadex).

Stimulant laxatives, including Correctol, Dulcolax, Ex-Lax, and Senokot, also may affect calcium absorption. These medications are intended for short-term use; if you have chronic constipation, discuss your treatment options, including dietary adjustments that may help, with your doctor.

Detecting a Deficiency

It's not as easy to detect a calcium deficiency as it is to detect deficiencies in some other vitamins and minerals, because your body has a complex system for regulating calcium. If you don't consume or absorb enough calcium, your body will remove some calcium from your bones in order to compensate. Your bones are constantly undergoing a process of breakdown and buildup, and there's no test that can identify how much calcium is being released from your bones at any given time.

However, Dr. Sobel says that significant calcium malabsorption can be detected by measuring calcium levels, and that more subtle calcium malabsorption can be detected by measuring intact parathyroid hormone levels.

If you have concerns about the amount of calcium you are absorbing, address them with your doctor. And, if you're 65 or older, have a bone mineral density scan to find out if your bones are healthy. If you have osteopenia or osteoporosis, talk with your doctor about steps you can take to improve your bone health and reduce your fracture risk.

WHAT YOU SHOULD KNOW

* Recommended calcium intakes are 1,000 milligrams (mg) per day for women between ages 19 and 50 and for men between ages 19 and 70, and 1,200 mg per day for women older than 50 and men older than 70.

* Less than half of the calcium you consume gets absorbed, according to the Office of Dietary Supplements at the National Institutes of Health.

* Consuming high amounts of sodium, protein, and/or caffeine may increase the amount of calcium that is eliminated from your body.

Caption: Numerous medications, including proton pump inhibitors, H2 blockers, diuretics, and steroids, can interfere with calcium absorption.
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Title Annotation:BONE HEALTH
Publication:Women's Health Advisor
Date:Jul 1, 2018
Words:728
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