Nowadays, "calcium" can be considered a trendy term. Everyone knows that calcium deficiency in children can lead to slow growth and development, while calcium deficiency in middle-aged and elderly people can cause osteoporosis. When it comes to treatment, how should we go about it? Is calcium supplementation effective for osteoporosis? Can taking calcium supplements alone treat osteoporosis? Let's see what three renowned medical experts in China have to say about these questions.
1: Hormone reduction is the main culprit
The information describes osteoporosis as a systemic bone metabolism disorder characterized by damaged microstructure of bone tissue, continuous reduction of bone mineral and bone matrix in proportion, thinning of bone, reduction of trabecular number, increased bone fragility, and increased risk of fractures. Osteoporosis is generally divided into primary and secondary types, with senile and postmenopausal osteoporosis being the most common. The incidence rate in elderly men is about 60%, while in women it is over 90%. Osteoporosis can easily lead to fractures, especially femoral neck fractures in the elderly, posing a significant threat to their health.
Why do people develop osteoporosis? The medical community believes that as age increases, various hormone secretions decrease, which is one of the important reasons for osteoporosis. For example, after menopause, estrogen levels in women decrease, leading to increased bone resorption. Imbalances in the secretion of calcium-regulating hormones in the elderly also disrupt bone metabolism. The decline in absorption function and reduced outdoor activities in the elderly are also important factors contributing to osteoporosis. As for the relationship between vitamin D receptor gene polymorphisms and osteoporosis, this has been an area of research in molecular biology in recent years.
2: Calcium supplementation is not a simple issue
In recent years, some institutions in China have claimed that "osteoporosis is caused by calcium deficiency, and calcium supplementation is the treatment for osteoporosis," which has caught the attention of Professor Meng Xunwu, an endocrinologist at Peking Union Medical College Hospital.
She said that calcium supplementation can indeed reduce postmenopausal bone loss and reduce the risk of fractures, but overemphasizing the role of calcium supplements while neglecting other factors such as exercise is not beneficial for preventing and treating osteoporosis. Calcium needs to be correctly positioned, and it should be recognized that calcium supplementation is an important measure for preventing and treating osteoporosis, but it should be done in moderation as simply taking calcium supplements alone cannot prevent osteoporosis.
Professor Meng also reminded that when taking calcium supplements, it is important to note that dividing the dosage into multiple doses has a higher absorption rate than taking it all at once. For people with low stomach acid, taking calcium supplements immediately after meals can improve absorption. Adequate vitamin D can promote calcium absorption in the intestine, and taking it before bed can reduce nocturnal calcium loss.
Professor Huang Gongyi, a professor of orthopedics at Peking Union Medical College, expressed his disagreement with the advertising claims of some businesses: "Many advertisements claim that taking their calcium supplements can prevent osteoporosis, but there are many factors that affect the effectiveness of calcium supplementation." He said that calcium is an essential element for bone formation, but its effectiveness is influenced by many factors. Many people who blindly supplement calcium do not consider whether their bodies can absorb it and whether their bodies can fully utilize it. In addition, animal experimental results do not necessarily have the same effect on humans because the absorption rate of calcium differs between animals and humans. Animals can have a maximum absorption rate of about 90%, while even in a "calcium-starved" state, humans can only achieve an absorption rate of about 34%. Therefore, for severe osteoporosis, active treatment is necessary in addition to calcium supplementation.
3: Not everyone is at risk
When it comes to preventing osteoporosis, some people immediately start "first-level maintenance" by drinking milk and taking calcium tablets every day, keeping themselves busy. Several experts unanimously pointed out that calcium supplementation is only one aspect of prevention, and not everyone needs to be overly concerned. Generally, there are several groups of people who need to be particularly cautious: those who have already been diagnosed with osteoporosis, those without a diagnosis but with a clear family history or a history of long-term use of corticosteroid drugs, those with various unhealthy lifestyle habits such as long-term alcohol consumption, smoking, and excessive coffee drinking, and women who experience early menopause. For these groups, prevention, treatment, and protection should be carried out simultaneously to effectively reduce the risk of fractures caused by osteoporosis.
How should we view the role of calcium in osteoporosis? Professor Xu, a gynecologist at Peking Union Medical College Hospital, suggests that calcium should be used in combination with other medications, as it can affect calcium absorption. Currently, bisphosphonates have been unanimously recognized by many experts for their effects on osteoporosis, and they have shown good results in both treatment and prevention.
Bone tissue consists of osteoclasts and osteoblasts, which attach to the surface of bones, consuming old bone and promoting the growth of new bone. Generally, there is a balance between bone resorption and bone formation. However, in old age, the function of osteoclasts is enhanced, far surpassing the rate at which osteoblasts fill in, leading to gradual bone destruction. Bisphosphonates can attach to the bone surface, inhibit osteoclasts, increase bone density, and reduce the incidence of fractures, thus treating osteoporosis. Clinical trials have shown significant effects, whether in reducing vertebral fractures or hip fractures, and the once-weekly administration of bisphosphonates not only has clear therapeutic effects but also provides convenience for patients.
4: Give bone density the same attention as blood lipids
Not having the above high-risk factors does not mean that you can stay away from osteoporosis. Many people have no knowledge of their bone health, and even in orthopedic clinics, only about 100% of patients undergo bone density testing.
Experts suggest that the public should pay as much attention to bone density as they do to blood lipids, especially high-risk groups for osteoporosis, who should go to regular hospitals for orthopedic department examinations as early as possible. The whole process of bone density testing takes only a few minutes, and the amount of X-rays received by the body is only one-third of that of a chest X-ray, with a cost of only a few hundred yuan.
