Gary Krieger says, "Would a seasonally low vitamin D level," he lives in northern Michigan,
"combined with a high calcium intake, 1,500 to 2,000 milligrams, 500 milligrams from supplements,
1,500 from diet, 500 milligrams from supplements, would this increase the risk for soft tissue
calcification?
Vitamin A, K2, magnesium levels are adequate.
Will the calcium simply be excreted due to low vitamin D levels?"
I'll take the first stab with this one.
Carrie: I was like, "That's a lot of question for you, Chris."
This is a Chris question.
Chris: Okay.
The seasonally low vitamin D level, despite high calcium, would that increase with the
-- Gary, if you can follow up.
I'm not sure if you're asking would the low vitamin D level increase the soft tissue calcification
or would the high calcium do so.
Carrie: Or both, you could answer either way.
Chris: Yeah, okay.
The end of this question is would the calcium simply be excreted due to the low vitamin
D levels.
Your vitamin D level being low, the first thing that's going to do and the major thing
that's going to do is it's going to lower your calcium absorption.
You would have more calcium excreted in the feces as a result of not absorbing it if your
vitamin D level is low.
However, a high enough calcium intake is going to more than compensate for that.
It depends how low it is.
If you live in northern Michigan and you're not supplementing with vitamin D in the winter,
but you're outdoors a lot, your vitamin D is probably not going like rickets level low.
It's probably dipping a bit.
A calcium intake of 2,000 milligrams is so high that you're probably absorbing at least
enough calcium.
Then once the calcium is in your system, one of the problems with low vitamin D is that
it's going to take more calcium to suppress your parathyroid hormone and you want your
parathyroid hormone maximally suppressed for the sake of your bone health.
But again, a high calcium intake like that may well completely compensate for that.
Now, the soft tissue calcification is going to be driven by, on the one side, you could
view it as like a calcium in, calcium out.
You could view it as a pro-calcification, anti-calcification equation.
The calcium phosphate product which is the concentration of calcium in your blood times
the concentration of phosphorus in your blood is going to be the pro-calcification side
of that equation.
The protective factors like the proteins that are made by A, D and activated by K2, the
magnesium and a couple other things are going to be defending the soft tissues against calcification.
The low vitamin D is probably not going to change your calcium phosphate product that
much.
The calcium intake, 2,000 milligrams I think is pushing the safe limit of calcium.
It's not necessarily harmful.
Calcium doesn't have a huge window.
I think 1,000 or 2,000 milligrams is probably the safe window for calcium.
It depends how low the vitamin D levels are.
If it's going down to 20 or 25 nanograms per milliliter, it's probably not going to interfere
that much with the ability of the other things to defend you against soft tissue calcification.
But below that, it might.
If it's dipping from 60 to 40 nanograms per milliliter, it's probably just that.
Vitamin D has a U-shaped curve with calcification so you don't want to be deficient.
But when you get up into 50, 60 nanograms per milliliter, you're not asking the question
of whether you need more vitamin D to protect against soft tissue calcification.
You're asking whether you might have too much.
If it's going down to 30, no issue at all.
If it's going down to like 20 or 25, you might want to measure your vitamin D levels, your
parathyroid hormone levels, and use a little bit of extra vitamin D if you need to to normalize
those levels.
Bring 25(OH)D up to 30-ish or a little higher.
Bring PTH to 30-ish or lower.
That's my thought.
Do you have anything to add, Carrie?
Carrie: Nope.
I like it.