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Minerals and Bone Health

Minerals and Bone Health

Many people tend to think of bones as just tubes made of calcium. The role of calcium in bone health has been stressed to the exclusion of the other components of bone. Bone is living tissue. It is a protein matrix that is reinforced with calcium and other minerals. Many minerals other than calcium are important to bone health.

Magnesium, manganese, folic acid, boron, vitamin B6, vitamin B12 and even strontium are necessary for healthy bones. Exercise, digestion, and hormonal balance also play a role in bone health.

Antacids Shouldn’t Replace Calcium Supplements

Many practitioners recommend calcium supplements. The primary reason for this recommendation is the reduced risk of osteoporosis derived from long‐term intake of calcium. Some healthcare professionals have recommended antacids as a good source of supplemental calcium. Although antacids have their place, they should not be relied on as a source of calcium.

What do antacids contain? Antacids contain calcium as one of the main alkalizing agents. In addition to calcium, many antacids also contain the following ingredients:

Sodium: Many antacids contain as much as 53 mg of sodium. Sodium can be particularly troublesome for those with high blood pressure.
Aluminum: Aluminum compounds—such as magnesium aluminum silicate and dihydroxyaluminum found in antacids—are believed to be harmful by many nutritional oriented practitioners.

Food Preservatives: Methylparaben, propylparaben and polyethylene glycol, three widely used food preservatives, are often present in antacids.
Mineral oil: This can coat the digestive tract and impair absorption of fat‐soluble nutrients, such as vitamin D and vitamin E.

Flavorings: These are not always listed individually, which means that they could include synthetic chemical compounds.
Sucrose: This is table sugar; which can be detrimental to those with diabetes or hypoglycemia. Corn starch and corn syrup: These could be a problem for individuals with allergies to corn.

FD&C Red #3: This could trigger problems for those who are chemically sensitive.

What about the calcium in antacids? The calcium carbonate contained in antacid tablets ranges from 317 mg to 500 mg per tablet. Unfortunately, calcium carbonate is only 40% calcium; the other 60% is the carbonate carrier. Therefore, the actual calcium content only ranges from 127 mg to 200 mg per tablet.

The conservative adult recommended allowance for calcium is 1,000 mg. It would require between five and eight antacid tablets per day to meet this recommendation using antacids as the calcium source. The per tablet cost of antacids is much higher than regular calcium supplements. Average costs for five to eight antacid tablets is up to ten times more than a comparable amount of calcium supplied by calcium supplements.

Aside from cost, calcium supplements are a better choice since they are less likely to contain chemical additives. In addition, calcium supplements usually contain other key minerals needed for bone health, such as magnesium and zinc.

If an antacid were available that contained no potentially harmful chemicals and was comparable in price to a calcium supplement would it be a good source of supplemental calcium? Unfortunately, the answer is still “no.” Here’s why:

First, aluminum compounds have received a great deal of publicity in recent years due to the association of aluminum in the brain and Alzheimer’s disease. It has been shown that the aluminum in antacids is absorbed by the intestine. Furthermore, aluminum‐containing antacids interfere with normal mineral metabolism.

Prolonged use of aluminum containing antacids has been linked with severe bone pain and fractures. In fact, some practitioners have gone so far as to suggest that such antacids cause bone loss and their use should be considered one of the causative factors in bone diseases of unknown origin.1

Second, a key factor in protein digestion and some mineral absorption (including calcium absorption) is an adequate supply of hydrochloric acid (HCl) in the stomach.2 Since the function of antacid tablets is to reduce stomach acidity, antacids can theoretically reduce, rather than increase, calcium absorption.

The relationship between antacids and stomach acid: When stomach HCl is in short supply, heartburn can develop. With low HCl, people often cannot tolerate fried or spicy foods. Some cannot even handle eggs, butter, milk, meat, or cheese. These are the same symptoms that antacids are prescribed for. Other symptoms include a feeling of fullness after eating, belching, constipation, diarrhea, and flatulence.3

If HCl is low, the stomach holds the food longer. (This is why one symptom of low HCl is a feeling of fullness after a meal.) The small amount of HCl available, mixes with the food, but instead of emptying its contents into the small intestine, the stomach churns and regurgitates some of this mixture into the esophagus. Since the throat is not protected against acid with the same mucosal barrier of the stomach, the throat feels “burned” by the heartburn. By treating this heartburn with antacids, the burning stops—but all the problems described above can occur. A better solution would be to increase the stomach’s HCl levels.

References:

  1. Spencer and L Kramer. Antacid‐induced calcium loss. Arch Intern Med 1983,143(4):657‐9.
  2. Turek L. Orthopaedics: Principles and Their Application. 1977, JB Lippincott, pages 189‐90.
  3. Rappaport M. Achlorhydria: Associated symptoms and response to hydrochloric acid. NEJM, 1955,

    252(19):802‐5.

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