What are the symptoms of bad bones? How do different groups of people supplement calcium? Huaxi doctors explain it clearly in 10 answers!

Last time I told you how bones become soft after the age of 35, and someone sighed: The world is so big, I haven’t even seen it yet, and I can hardly walk?

Even the editor's colleague went for a bone density test after reading it, and came back with a few cans of milk powder. He wanted to hold on to the last few years and save more "bone capital"!

You can see how common osteoporosis is. There are so many of them. Just go to a family group and find any aunt or uncle, and he or she may be a candidate for osteoporosis.

" So how do you assess whether you have osteoporosis?

Does prevention mean calcium supplementation?

How should calcium be supplemented?

What should I pay attention to?

"There are too many questions. The editor has selected the ten most concerned ones and invited Dr. Wang Qin from the Department of Endocrinology and Metabolism of West China Hospital of Sichuan University to answer them for you! Remember to like and collect them!

ask

My knees hurt for a moment when I climb a hill, but then they are fine again. What's going on? Is it osteoporosis?

answer

The symptom described may be a manifestation of osteoarthritis for the elderly. The knee joints have many inflammatory diseases, autoimmune diseases, etc. Just like osteoporosis, the bones and joints will age. The aging of the joints is called osteoarthritis, also known as degenerative osteoarthritis .

In daily life, if you find that your knee joints are rubbing, feeling uncomfortable, painful, or making crackling sounds when you are climbing, descending a mountain, or squatting, it may be that your joints are sending you a distress signal.

ask

What are the symptoms of osteoporosis? Who are the high-risk groups for osteoporosis?

answer

Osteoporosis can be seen as an inevitable step in bone aging, and it will definitely lead to this step.

Symptoms such as these may indicate osteoporosis:

① Back pain and discomfort after walking or moving, especially after walking or standing for a long time or bending over for a period of time;

② The height has decreased by more than 3-4 cm compared to when you were young, or there is a hunchback or decreased mobility, such as feeling weak in the legs and being unable to climb stairs;

③ Fracture caused by any reason occurred in patients over 50 years old.

It is recommended that women over 65 and men over 70 have a bone density test.

Postmenopausal women under the age of 50 and men over 50, those who have a low-calcium diet, have related underlying diseases and take medications are all at high risk of osteoporosis and should undergo bone density tests in a timely manner. If they have osteoporosis, they must seek timely treatment.

ask

Can taking calcium tablets cure osteoporosis? How much calcium should I take?

answer

It should be noted that calcium is not a medicine , but a trace element we need to maintain body functions, just like eating food and vegetables.

If you are already a patient with osteoporosis, it is unlikely to cure osteoporosis by taking calcium alone. You still need to see a doctor for treatment, and generally anti-osteoporosis drugs are required.

As for calcium supplementation, the amount of elemental calcium required by the elderly or patients with osteoporosis per day is about 1,000 to 1,200 mg. However, this includes all calcium including dietary calcium. It does not mean that you have to take 1,000 to 1,200 mg calcium tablets.

In our daily life, there is calcium in the food we eat, but the calcium intake of many Chinese people is insufficient. The average level is about 300-400 mg (drinking milk can reach 500-600 mg, and some people who don’t drink milk may only have 200-300). Therefore, there is a gap of about 500-600 mg/day . At this time, you just need to choose the corresponding dosage when choosing calcium tablets.

Special attention should be paid to special periods such as adolescent growth and development, children's growth and development stage, women's pregnancy and lactation period, and after menopause. The minimum recommended daily intake is 1,000 mg for supplementation.

ask

Can I take calcium supplements during pregnancy/lactation, taking Euthyrox, or if I have kidney stones? What kind of calcium should I take?

answer

During pregnancy and lactation, you must pay attention to calcium supplementation, and the required amount is even greater, for example, about 1200 mg/day. If you still experience cramps after taking two calcium tablets (500 mg/tablet), it means that your calcium intake is insufficient and you can add a little more appropriately.

In clinical practice, it is not considered that one should eat more calcium just because one is taking Euthyrox. For patients with ordinary hypothyroidism, Euthyrox is enough to supplement the physiological needs and there is no need for additional calcium supplementation.

The reason why you need to consider increasing calcium supplementation is that after the thyroid gland is removed for thyroid cancer, you need to use Euthyrox for TSH (thyroid stimulating hormone) suppression therapy. At this time, the amount of Euthyrox is usually greater than the body's needs, which may increase bone loss and make osteoporosis more likely.

Therefore, many thyroid surgery teachers will ask patients to take calcium supplements, but calcium is not the same as taking more. The specific dosage depends on how the doctor recommends it.

For patients with kidney stones who need calcium supplements (osteoporosis), it is recommended to go to the hospital for a 24-hour urine calcium test, which means collecting urine for 24 hours to measure the calcium level in it;

After professional evaluation and confirmation that urinary calcium excretion is normal , calcium citrate, also known as calcium citrate, is recommended as a calcium tablet. (See next item 👇)

ask

What is the difference between calcium citrate and calcium carbonate? How should we take them?

answer

In terms of calcium content, calcium carbonate is slightly higher, but calcium citrate has an advantage in that its absorption does not require the participation of stomach acid , while the absorption of calcium carbonate does require the participation of stomach acid.

Therefore, when taking calcium carbonate, such as the common Calcium carbonate, Diqiao, Caseli D, and Landi, it is best to take it immediately after a meal, because it requires the participation of gastric acid to be absorbed; while calcium citrate does not matter whether it is taken before, during, or after a meal, and it can be taken on an empty stomach.

Note that patients with atrophic gastritis or those taking acid-suppressing drugs (such as esomeprazole, famotidine, etc.) have insufficient gastric acid secretion. In this case, calcium carbonate should not be chosen; calcium citrate is a better choice.

ask

What should I do if I take too many calcium tablets and get constipated? How should I choose different types of calcium?

answer

It doesn't mean that you will get constipated if you take too many calcium tablets. There are different types of calcium tablets, and each person's stomach can accept them to different degrees. Based on existing experience, many people do get constipated when taking calcium carbonate.

If you have constipation after taking calcium carbonate, you can improve it in the following ways:

① Change the dosage form . Calcium carbonate has different dosage forms, such as calcium carbonate tablets. A large tablet is swallowed with water. From experience, it is more likely to cause constipation. At this time, you can choose to chew it and then swallow it, or directly buy calcium carbonate chewable tablets, which can relieve constipation;

② You can choose liquid calcium . Liquid calcium is a capsule. It is actually calcium carbonate, but in liquid form.

③ You can choose other types of calcium , such as calcium citrate, but you must pay attention to the calcium content of the calcium tablets and make sure to get enough.

When choosing calcium supplements, the first thing to consider is the long-term economic investment. Calcium carbonate tablets are generally recommended because they are the cheapest and most cost-effective, and they also contain a relatively higher amount of calcium. Of course, choosing a calcium supplement that the body can accept is still the most important thing.

ask

Does taking vitamin D also provide calcium supplement?

answer

No. The complete process of calcium supplementation is eating calcium - stomach - blood - bones. How can the calcium eaten enter the blood from the intestines? Vitamin D plays a role in this process. It is a very important nutrient that promotes calcium absorption.

If vitamin D levels are deficient, the calcium you eat will be poorly absorbed and will not be able to enter the blood.

In addition to enhancing calcium absorption, vitamin D can also promote muscle function, improve balance, and ensure adequate bone mineralization, that is, make bones harden. Severe vitamin D deficiency may lead to osteomalacia .

ask

Milk powder, yogurt, and milk from different animals, which one is better for calcium supplementation? How to choose?

answer

I have a simple method for everyone. Learn to read the food ingredient label. Behind each package of milk, there are numbers of milligrams of calcium per 100 ml. It is clear and concise. Just make your choice based on this.

If you are lactose intolerant (diarrhea after drinking milk), you can choose milk powder;

Yogurt is concentrated and fermented milk, and it contains very little lactose, so it is not likely to cause digestive discomfort after drinking it. You just need to pay attention to the sugar content , because many yogurts on the market contain a lot of sugar to improve the taste. People with diabetes or abnormal sugar metabolism should choose with caution, or choose sugar-free yogurt.

As for the milk from different animals, there is actually not much difference (but the price is very different). Drink according to your ability, the nutrition is similar (far less than the difference in price).

ask

Can I take calcium supplements all the time? What should I pay attention to?

answer

As mentioned above, calcium supplementation is the same as eating vegetables and meat. It is a daily need of the body. Unless there are special circumstances , such as finding that blood calcium levels are high after regular calcium supplementation (this is very rare), adjustments need to be made. For most people, there is no problem with continuing to supplement.

There are several things to note:

① Never take calcium tablets with dairy products!

Including milk, yogurt, cheese sticks and any dairy products, because these are milk calcium, and milk calcium is absorbed super well, killing all calcium tablets in seconds; as long as you drink milk, you should wait at least 4 hours before taking calcium tablets;

② If the elderly have cramps, you can observe the time period when the cramps occur . For example, if they occur in the middle of the night, it is recommended to take calcium tablets before going to bed, which will have a better effect.

③ The total daily calcium intake should not exceed 1,500 mg . Exceeding 1,500 mg may increase the risk of kidney stones, and exceeding 2,000 mg may even increase the risk of cardiovascular events. Therefore, for patients with kidney stones , the safest way is to supplement calcium through diet (such as dairy products).

ask

Why is osteoporosis under the jurisdiction of the Department of Endocrinology and Metabolism? Isn't it the Department of Orthopedics?

answer

This is a question that many people find strange, so here I will give you a detailed introduction.

Endocrine mainly refers to classic endocrine diseases, including diseases of the thyroid gland and adrenal pituitary gland ; metabolism is something that everyone is very familiar with, including diabetes, lipid metabolism disorders, glucose and lipid metabolism, and bone metabolism;

Therefore, metabolic diseases of the bones are under the jurisdiction of the endocrinology and metabolism department. Osteoporosis is the most common metabolic bone disease. The diagnosis and treatment of other metabolic bone diseases are all performed by specialists in the endocrinology and metabolism department.

Orthopedics is the department that repairs fractures when osteoporosis is severe and fractures occur . If you need differential diagnosis and drug intervention, such as what calcium tablets to take, how to take them, how to supplement vitamin D, and how to use osteoporosis drugs, these are actually the subspecialties of osteoporosis and metabolic bone disease in the Department of Endocrinology and Metabolism. Now you know how to register.

This article contains a lot of content, but it’s all valuable information!

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