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Table of Contents
Introduction The Silent Killer - An Epidemic in the Making
Chapter 1 Am I Really Calcium and Mineral Deficient?
Chapter 2 Why Your Calcium Supplement is Not Building Bone
Chapter 3 AlgaeCal®, a Calcium Complex from Plant not Rock!
Chapter 4 Magnesium - the Unsung Hero
Chapter 5 New Research on Vitamin D Changes Everything
Chapter 6 A Special Vitamin from Japan supports Bone re-mineralization
Chapter 7 Strontium - A Common Mineral with Uncommon Results!
Chapter 8 A Bone Density Study with a Difference
Copyright 2008 AlgaeCal.com
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Introduction
A Direct Response to the US Surgeon General
merica‟s top doctor shocked the medical community with his 2004 Bone
Health Report. In this unprecedented work, US Surgeon General, Richard H.
Carmona warned that by the year 2020, half of all American citizens older than 50 will be at
risk of fractures from osteoporosis and low bone mass if no immediate action is taken by
individuals, doctors, health systems, and policy makers. Please notice, he did not say half
of all citizens over age 80. He said half of people over age 50 will be risking fractures!
…And he didn‟t suggest half of people over age 50 will risk osteoporosis - his warning
specifies fractures from osteoporosis. It is one thing to picture 80 year olds laid up in
hospital with a broken hip or wrist, or losing 4-5 inches of height due to the crumbling brick
vertebra, but it is quite another to think that this will begin to occur for some of us in our
40‟s so that half of the population are affected by bone fractures in our 50‟s!
How could Dr. Carmona and his elite research team come to such a dramatic conclusion?
The answer is multi-factorial, but lies mainly in our changed nutrition patterns. For
example, the Surgeon General identified that “85% of adolescent girls and 65% of boys do
not get enough calcium and bone building nutrients to support normal bone growth”, placing
“America's bone health in jeopardy.” The children of the 70‟s and subsequent decades have
largely exchanged calcium-rich milk for phosphate-laced sodas. Calcium builds bone
mineral density, and phosphates de-mineralize bones (reference) creating a double
jeopardy for bone health.
This is especially alarming when you understand that from birth to about your mid 30‟s are
your peak bone building years. You have a limited window of opportunity to build bone
mass, and then the calcium and minerals are lost at rate of almost 1% every year until
death (reference). If you live long enough, everyone will lose enough bone mineral density
to be classified as osteoporotic. In other words, it is critical to reach the maximum bone
mass possible during your building years, because each year after that you will have less
and less bone density.
The increased use of computers, television and hand-held games is having a negative
impact on the physical activity and bone health of young children, adolescents, and adults of
all ages. A spokesperson for the National Osteoporosis Society encouraged parents to
develop ways to increase their children‟s physical activity levels reporting the decline in
physical activity in young children over the last decade could have a detrimental effect on
the nation‟s bone health. The Society cited the findings on their website from a recent study
of 200 four year-olds that found the greater the four year-old child‟s physical activity level,
the stronger their bones.
The increasingly sedentary lifestyle we have adopted has another sinister side effect on our
bone health. We are not outdoors in the sunshine where vitamin D is converted from the
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sun light on bare skin. When we do venture outside, we slather on sunscreen compounding
the vitamin D deficiency. Vitamin D is also critical for calcium absorption and other aspects
of bone health, yet deficiency is rampant.
Another piece of the bone health disaster puzzle is an increased reliance on drugs, plus we
have a greater number of drugs available in America over the last few decades. Because
the FDA has ruled only drugs can treat disease, the drug companies have responded by
creating new “diseases” each year to expand their marketplace. It is almost comical to
watch television ads warning of “acid reflux disease” which we used to refer to as
indigestion. A little-publicized, but well-documented fact is that most classes of drugs have
a strong negative impact on bone density!(references).
The list includes common pain relievers, corticosteroids and other immune-suppressants,
anti-diabetic drugs, some contraceptives, cyclooxygenase inhibitors, proton pump inhibitors
(pharmaceutical anti-acids like the one advertised to treat “acid reflux disease”), total
parenteral nutrition, aromatase inhibitors, gonadotropin-releasing hormone agonists,
anticonvulsants, cytotoxic drugs, anti-depressants and more.
If lowered calcium consumption, increased soda intake, reduced exercise, increased reliance
on an increasing array of drugs, and vitamin D deficits are not enough for Dr. Carmona to
predict a bone health catastrophe, we have added an additional burden to our bones by
adopted eating habits which focus on meat and grains as our staples. Meat and grains each
form acids in our bodies which require immediate mineral transfer from bones to
counterbalance! Our agrarian-based forefathers enjoyed better quality vegetables and even
thought they were canned for winter use, the minerals were in tact. When Grandma insisted
on eating your vegetables, she was on to a good thing, because now we know the minerals
in vegetables are tremendously alkalizing and offset the acids produced by meat and grain.
Stress is also acidifying to your body, and it has been shown to reduce bone mineralization
in a similar manner to eating a diet high in protein and grain.
Taken together, this stream of individual assaults on bone health, has turned into waterfall
which America is unable to negotiate. No wonder the Surgeon General issued a “call to
action” saying “you are never too old or too young to improve your bone health”. The time
to act is now, and Dr. Carmona issued a call to action which we are responding to.
The Surgeon General’s Call to Action
His directed his call to the nutritional and healthcare industry to develop bone-health
programs that incorporate the three basic components:
1. improved nutrition
2. increased physical activity
3. improved health literacy
In response to the SG‟s guidance for products that would “improve nutrition,” scientists at
Integrative Health Technologies, Inc. in San Antonio, Texas, conducted an exhaustive
review of published studies to identify the nutrients and nutrient amounts that had the
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highest probability of enhancing bone-health. Once identified, these nutrients were then
combined with AlgaeCal International’s plant-derived calcium to create an evidence-based
bone-health supplement.
To “increase physical activity,” a practical, well researched pedometer-based behavior
modification program was incorporated into the plan.
To “improve health literacy”, a reader friendly summary of the scientific literature along with
practical steps that can be taken to improve bone health was added to the Plan. Now, we
have written this book in hopes of increasing health literacy. This book is the result of four
years of research. Please read it, benefit from it, and pass it on to people you care about!
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Chapter 1
Am I Really Calcium and Mineral Deficient?
merica‟s top doctor, the United States Surgeon General, summed it up very
well when he stated “Calcium has been singled out as a major public health
concern today because it is critically important to bone health, and the
average American consumes levels of calcium that are far below the amount
recommended for optimal bone health.”(1)
We now know that our bone health in our youth and middle years will set the stage for the
latter years, yet the Surgeon General reported a staggering 85% of adolescent girls and
65% of boys do not get enough calcium and bone building nutrients to support normal bone
growth, placing “America's bone health in jeopardy.”
Sadly, calcium deficiency is only the beginning
of nutritional shortfalls. We see our favorite
celebrities and athletes wearing a „milk
mustache‟ to stay healthy – and we are led to
believe simply drinking a glass or two of
calcium-rich milk a day, will provide all we
need for strong, healthy bones. While critical
for bone health, calcium alone is not the
antidote to bone degeneration that doctors,
osteoporosis foundations, and the media have
been promoting.
Nor is calcium combined with vitamin D the
remedy. Although this one-two punch has
more merit than calcium alone, it is still far from a complete nutritional solution for bone
health. Today‟s research, standing on the shoulders of all previous knowledge indicates that
calcium and vitamin D are essential, but so are many, many other minerals.
Bones, after all, are not composed of calcium. They are a matrix of more than 70 minerals.
By weight, calcium is certainly the largest contributor, but by function it may not be the
most important mineral in your bone tissue. Yet, when is the last time you heard the media
report on the benefits of silica to support your bone health? Has your doctor asked you to
test for zinc, manganese, or copper to improve your bone density? Which osteoporosis
foundation promotes boron or magnesium as a support for your bone health? Each of these
minerals have been shown in significant human clinical studies to play key roles in
supporting bone health. Other studies indicate you are almost certainly deficient in many
trace minerals from your diet alone!
In a two year study of 225 postmenopausal women, the group taking only calcium lost bone
mineral density, but another group taking calcium plus zinc, manganese and copper gained
bone mineral density4. Unfortunately if you are eating a typical American diet, studies show
levels of magnesium, iron, zinc, copper and manganese intake is less than 80% of the RDA,
and the RDA levels are considered low by some experts!
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Several other properly controlled studies underscore the critical need for trace minerals for
your bones, yet these “minor” minerals are not promoted because there is little financial
incentive to promote something that is unlikely to be patentable. For example, if a
company could file a patent on magnesium carbonate, it could be promoted heavily because
competition is limited for 17 years, but magnesium in this form is not new, so it is un-
patentable. With no patent protection available, companies are quite understandably
reluctant to spend advertising dollars on a product that is shared by an unlimited number of
competitors. The sad result of no mineral advertising is that calcium supplements are not
formulated with a full spectrum of trace minerals because consumers don‟t know about their
importance, and it just ends up costing the company more money to make the product with
no payoff.
But how did we get to this calcium and mineral deficient state as a nation? With the advent
of agri-business in the middle of the last century, vitamin and mineral levels in our
vegetables and meat has dropped significantly. Broccoli, one of the highest calcium
containing vegetables, has lost an amazing 50% of its calcium since the 1960‟s! (5). The
average vitamin and mineral content has fallen between 5-35% for all fruits and veggies
over the last 50 years! Farmers get paid by weight, so they‟ve been choosing the biggest
varieties of vegetables, not the most nutrient rich. The result is the fuel that our bodies
depend on has been diluted. If you have had the luxury of picking veggies from your own
organic garden, you know you can taste the mineral-rich difference between your garden
produce and the washed-out store bought vegetables! You don‟t need any research paper
to tell you the vegetables we eat are missing something!
Now I know you‟re thinking “I‟ve heard this all before. Sure my diet isn‟t ideal, but I feel
fine”. In your youth you got away with it. You stayed up all night, ate whatever came your
way, and felt reasonably fine through it all. Probably this eating pattern became the
template for your middle years with consequences that are not fully apparent. What we
don‟t think of day to day, is that your body is like a big fat bank account with too few
mineral deposits and too many withdrawals; everything is fine for years until one day your
check bounces, your credit cards are maxed out, and you are forced to face the painful life-
altering consequences of mineral bankruptcy.
Like borrowing from Peter to pay Paul, calcium and other minerals, are drawn from your
bones to neutralize the acid formed in your cells by excessive consumption of meats and
grains. If the acid is not “sponged up” with minerals from your diet immediately, you will
die, so the next step is to take the minerals from your bone to counter balance the acid. To
avoid this continual mineral deficit, it is important to eat more alkalizing vegetables and
fruits (high in minerals) and less acid forming meats and grains; and to supplement any
shortfall in your diet with calcium and trace minerals.
An excellent online tool that helps you get a picture of your dietary intake of calcium and
magnesium is found at www.algaecal.com Click on the “Bone Health Calculator” link and
enter in the foods you have eaten yesterday to get an estimate of your major mineral intake
based on USDA data. This critical tool makes clear to most that you need to supplement to
reach adequate mineral deposit levels. Be sure to average your scores over a week or more
to get a better idea of how your eating habits are measuring up compared to your calcium
and magnesium needs for your age and gender.
But, you say, “I‟m getting my calcium and minerals from my calcium supplement, am I not?
Or maybe from my multi-vitamin supplement?” Prepare to be amazed as little-known truths
about your calcium supplement are unearthed in chapter 2.
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------------------------------------------------------------------------------------------ References
Supplementing with trace minerals alongside calcium has been proven to increase bone density in post-
menopausal women more than with just calcium alone. Patrick, Lyn, N.D., Comparative Absorption of Calcium
Sources and Calcium Citrate Malate for the Prevention of Osteoporosis, Alternative Medicine Review, Vol. 4, No. 2,
1999.
While everyone is aware of the benefit calcium has on bone health, studies show that supplementing with calcium
and trace minerals together increases bone density in post-menopausal women more than calcium alone.5
Calcium alone is not enough! 5. Patrick, Lyn, N.D., Comparative Absorption of Calcium Sources and Calcium Citrate
Malate for the Prevention of Osteoporosis, Alternative Medicine Review, Vol. 4, No. 2, 1999.
1.Surgeon General Report on Bone Health: “Calcium has been singled out as a major public health concern because
it is critically important to bone health and the average American consumes levels of calcium that are far below the
amount recommended for optimal health.” US Dep’t of Health and Human Services. Bone Health and
Osteoporosis: a report of the Surgeon General (2004)
2.“roughly %85 of the female population after childhood fails to get the recommended intake of
calcium…”.Heaney Bone Health. Amer Journal of Clinical Nutrition 2007
3.‘about %30 of boys and only %10 of girls were achieving the recommended daily intake of calcium.’ Journal of
Pediatrics
(vol117pp578-585).
4. American Journal of Clinical Nutrition(1993;vol 12,No.4,pp384-389).
5.Mineral content of foods and total diets: the Selected Minerals in Foods Survey, 1982 to 1984.
7 Scientists Concerned at Plummeting Nutrient Levels, www.foodnavigator-
usa.com/news/printNewsBis.asp?id=66440, visited 3/15/2006
‘Despite the abundance of evidence supporting the positive effects of dietary Ca on bone, national surveys
indicate that Ca intakes in females of all age groups in the US are consistently lower than current
recommendations” Journal of the American College of Nutrition Vol. 19 ‘Nutrition in Bone Health Revisited’
‘National surveys consistently show low intakes of Mg among females of all age groups…’ (Ibid)
Pennington JA, Young BE, Wilson DB, Johnson RD, Vanderveen JE.
J Am Diet Assoc. 1986 Jul;86(7):876-91.
The 234 foods of the FDA's Total Diet Study were collected four times per year form mid-1982 to mid-1984 and
analyzed for 11 essential minerals. Daily intakes of the minerals were estimated for eight age-sex groups of the U.S.
population. Levels of calcium, magnesium, iron, zinc, copper, and manganese were low (less than 80% of the RDA
or below the low end of the Estimated Safe and Adequate Daily Dietary Intake range) for some or all age-sex
groups. Those most at risk of low intakes were young children, teenage girls, adult women, and older women. Non-
discretionary sodium intake exceeded the upper Estimated Safe and Adequate Daily Dietary Intake range for two
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age-sex groups, and iodine was considerably above the RDA for all age-sex groups. Levels of potassium,
phosphorus, and selenium were adequate for all groups.
‘…intestinal calcium absorption in men decreases progressively with advancing age, and this impaired absorption is
caused by a lack of vitamin D3 combined with inadequate dietary calcium intake.’ Calcified Tissue International
(1998,Vol 63).
Ca RDI is 1300/ mg day (from AlgaeCal site).
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Chapter 2
Your Calcium Supplement Is Absolutely NOT Building Bone!
s we discovered in Chapter 1, you are probably calcium and mineral
deficient with no visible warning signs. If you are reading this book,
chances are you are more educated on health matters and probably taking
a calcium supplement. Unfortunately, the benefit you are receiving from your calcium
supplement, is only a tiny fraction of what you believe it is!
Part of the problem comes from a common misunderstanding of calcium studies. A typical
double blind calcium study might organize participants into two groups. One will take the
calcium supplement and the other group will take a placebo pill which looks the same as the
calcium supplement. Neither the study participant nor the doctors knows which group is
taking the real calcium supplement. Every person over age 40 is losing bone minerals at
the rate of almost 1% per year, so we expect the placebo group to show an average loss of
bone density of about -1% in a one year study.
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The group taking the calcium and vitamin D will normally still lose bone density, but they
lose a little less than the placebo group, for example -.9%. It is normal practice for
clinicians to report a 10% gain in bone density over the placebo group from this result,
because the calcium group did outperform the placebo group by 10%. While the calcium
supplemented group has reported a gain in bone density compared to the placebo, they
have actually LOST bone density outright, and if they continue to lose at this rate, they will
eventually have osteoporosis.
Now you understand why many believe they can increase their bone density with calcium.
Marketers take data which is really reporting a slow down in bone loss, and report it as a
gain in bone density. Clinical studies involving calcium in any form, along with vitamin D do
not support an outright gain in bone density.
That is why a recent meta-study which summarized 15 clinical trials involving post-
menopausal women taking typical calcium supplements concluded that “calcium was more
effective than placebo at reducing rates of bone loss…” Notice this summary of calcium
studies does not show calcium increasing bone density – only reducing the loss of density.
This meta-study showed a combined difference of only 2.05% between the calcium group
and the placebo after two years.
Putting it in layman‟s terms, the placebo group lost the typical 1% of their bone density and
the calcium group lost darn near 1%! In other words this study shows you do benefit from
typical calcium supplements, but precious little!
Here are some reasons why your calcium supplement is NOT increasing your bone density:
You are Limited to Replacing the Losses Only
You are simply partially replacing the losses that occur through excretion of calcium in
urine, sweat and feces. There are no stimulants to tell your body to build new bone in a
calcium plus D formula. According to the leading calcium science authority in America,
Robert Heaney, you can only replace the losses of bone calcium. It is impossible to increase
bone density with a calcium supplement alone.
Mineral Imbalance From Too Much Calcium
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Large quantities of any mineral can force a deficit of another important mineral. Calcium
taken alone in amounts found in your typical supplement may drive important zinc,
magnesium, and other minerals out of your body. Magnesium and Zinc are important for
bone health and difficult to consume adequate amounts of in your diet, so you certainly
don‟t want to create imbalances with high calcium supplementation.
Missing Co-Factors to Aid Mineral Absorption
As we discussed in the previous chapter, many minerals beside calcium are needed to
support bone health, yet how many calcium supplements offer more than calcium and
maybe magnesium? To absorb minerals and place them properly in the bones, you need
co-factors like vitamin D at 1000 IU per day or more, and vitamin K2 in the MK-7 form at 80
mcg or more per day. Take a look at your calcium supplement label. Does it have these
critical co-factors? You can have all the minerals in a formula, but if it isn‟t being absorbed
due to a vitamin D shortage, you are wasting your money and giving yourself false hope.
Insoluble Tablets
Carr and Shangraw showed some calcium tablets are so closely
bound with glues that they take 4 – 6 hours to dissolve in
stomach acid conditions! Since most food passes through your
stomach in much less than 4 hours, people have actually had
calcium tablets appearing in their stool. Gelatin or vegetable
capsules are preferable to hard tablets for this reason. The
contents of gelatin capsules is a loose powder which has greater
potential to dissolve than a tightly bound tablet.
Poor Compliance
Tablets have the added disadvantage of being harder to swallow than capsules, sometimes
resulting in low patient compliance in studies. Many calcium supplement consumers are not
only having a tough time swallowing their pills, they are experiencing gas, bloating and
constipation. This all adds up to taking the pills infrequently or giving up altogether. We
have a news flash – if you don‟t take your calcium supplement, the chances of it working
are reduced significantly!
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Absorption
Calcium is notorious for having relatively low absorption, especially when taken apart from
meals. Most commercially available calcium supplements are made from rock calcium, so it
is not entirely surprising that your body may only absorb around 30%.
For now, it should be abundantly clear that your current calcium supplement is not going to
stop your bone loss, let alone help you gain any bone density! Please think about who you
know and love that is taking a calcium supplement religiously right now. Have them read
this chapter, check the research references, and see for themselves that they need to take
a different approach in order to gain bone density and excellent health.
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Chapter 3
AlgaeCal®, a Calcium Complex from Plant not Rock!
n chapter 2 we discussed the shortfalls of most calcium supplements
including the lack of trace minerals, the absence of key co-factors like
adequate vitamin‟s D and K2, the problems with solubility for some
manufactured tablets, and the constipation and other digestion challenges.
Most important, we learned that the majority of calcium supplements you find in your health
food store are made from ground up rock, and they show no clinical evidence of increasing
your bone density!
What if there was a calcium supplement that suffered from none of these problems? One
that was loaded with bone-enhancing trace minerals; one that was formulated with
adequate vitamin D3 and K2; one that was highly soluble and non-constipating? What if
there was a calcium which was sourced from a sea vegetable rather than rock?
Multiple studies on children and adults have shown direct bone health benefits from eating a
diet high in vegetables 1,2. Some of these studies have concluded that the minerals in the
vegetables are in large part responsible for alkalizing the body to prevent bone loss
(references). The trouble with most vegetable sources of calcium is they do not have
enough calcium to be useful in a supplement. You could dry broccoli and make capsules
from the powder, but you would need to eat the whole bottle each day to get your RDA of
calcium!
There is, however, an ocean algae, called AlgaeCal®, which is ideally suited to role of uber-
calcium supplement. AlgaeCal, (research name DN0361 Plant Mineral Complex) is a
patented form of marine algae called algas calcareas which is ecologically harvested by
hand off the pristine shores of remote South America.
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The algas calcareas is the size of a tennis ball. It is picked from knee-deep water, rinsed in
fresh water, dried in the sun, then milled into a powder. AlgaeCal is the world‟s only
practical pure plant-source of calcium!
The fact that AlgaeCal is a plant calcium is hugely significant once you understand that most
calcium products are made from rock. That‟s right, 90% of calcium supplements come from
limestone. Please go to your cupboard, pull out your current calcium supplement and look
at the label to see if it says “calcium carbonate”. If it does, then you have been eating
ground up rocks. If it says “calcium citrate” that is rock calcium that has been chemically
reacted with citric acid – you are still eating rocks. Most other chemical-sounding calcium
names are rock calcium which has been reacted with other chemicals to differentiate it and
give it a marketing advantage, although none exhibit any real advantage in human trials.
A Word About Other Algae Calciums
There are one or two other European marine algas available, but they far from pure
since they are vacuumed from the ocean bottom along with rocks, shells, and sand. As
the giant vacuums suck the bottom of the ocean, they create miles of silt which settles
on local flora and fauna choking it. They then process this impure product using
chemicals like hydrogen peroxide resulting in a product that is not pure, not ecologically
friendly and arguably not even natural in the end. If the bottle does not include the
research name DN0361, it is not the original.
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AlgaeCal is naturally 30% calcium, but it is much more than a calcium supplement. It is
really more like a complete multi-mineral supplement since it contains every mineral in
human milk and human plasma.
In the research world, there are 13 minerals which have been proven to support bone
health, and AlgaeCal contains each of them! AlgaeCal has surprisingly large amounts of
some of these minerals as well. For example, almost half of the normal amount of silica
found in a typical diet is in the clinical daily dose of AlgaeCal (2.4 grams). Silica is
responsible for supporting the collagen part of bone. The Magnesium naturally occurring in
AlgaeCal is at half the Dietary Reference Intake set by the US Food and Nutrition Board‟s
Institute of Medicine. Boron, strontium and vanadium are also naturally found in significant
quantities in a typical daily dose of AlgaeCal.
Calcium is the biggest part of AlgaeCal and the most prominent bone building ingredient.
So what are the steps scientists use for evaluating a new calcium form? Let‟s apply these
tests to AlgaeCal.
The Three Steps for Evaluating a Good Calcium Supplement
These three steps follow the order calcium is processed in your body. First you swallow it
and it enters your stomach where it needs to dissolve properly. If it passes the solubility
test, then it moves to the next step which is absorption (also called bio-availability) through
the intestinal tract into the bloodstream. Once adequate absorption is demonstrated,
calcium is then tested for the “holy grail” which is the human benefit of reducing fracture
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risk. Since measuring fracture risk is incredibly expensive requiring huge groups of people
and long time frames, most studies focus on bone mineral density (BMD) because high bone
mineral density is closely related to reduced fracture risk.
Let‟s evaluate AlgaeCal at each level as it passes from the mouth through to human
benefits.
1. Solubility in Stomach Acid
We know AlgaeCal has a unique porous nature, like a sponge so it has a lot more surface
area than regular calcium carbonate. More surface area means more opportunity for
stomach acid to come in contact with the calcium and dissolve it. (electron photo)
We have proven this theory is true – in a USP standard dissolution test simulating stomach
conditions, 97% of the calcium in AlgaeCal went into solution 3. In other words 97% is
available for absorption, even for elderly people if they take AlgaeCal with meals. In one
hour, 100% goes into solution, and is available for absorption through the intestinal wall.
How much goes into the bloodstream varies by 3 fold among individuals, depending on your
body‟s need for calcium, size of dose taken, etc according to Dr. Heaney. In other words
AlgaeCal does 100% of it‟s job at stomach level. Now the dissolved calcium moves to the
intestinal tract.
2. Absorption Through the Intestine
AlgaeCal absorption was tested at the famous French seaweed testing institute, CEVA,
where it was subjected to an in vitro simulation of the absorption process. As you might
expect from the world‟s only pure plant form of calcium, it performed very well surpassing
the bio-availability of common calcium containing foods including yogurt4.
3. Human Bone Health Benefits
The only reason scientists check the solubility and absorption of a calcium is to be sure that
it has a chance of benefiting human health! If it doesn‟t break down in your stomach, or
cannot be absorbed through your gut, there is no way it can enter your bloodstream for
distribution to bones and other important areas. AlgaeCal, combined with vitamin D3 and
K2, along with a strontium citrate product was the subject of a 400 person clinical trial. The
results can be summarized as follows. AlgaeCal with it‟s appropriate co-factors increased
bone density in each group of adults! This is not an increase over the placebo group as we
talked about before, but a real increase from their baseline score measured at the six month
mark. As such the AlgaeCal Bone Health Program is the only credible human calcium study
to show an increase in bone density. Exciting details are discussed in Chapter 8!
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References
1. Tucker KL, Hannan MT, Kiel DP, The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study.
Eur.J. Nutr. 2001 Oct;(5):231-7. (Pub Med)
2.Prynne CJ, Mishra GD, O’Connell MA, Laskey MA, Yan L, Prentice A, Ginty F. Fruit and Vegetable intakes and bone
mineral status: a cross sectional study in 5 age and sex cohorts. Am J Clin Nutr. 2006 Jun;83(6):1254-5.
3. JR Laboratories Analysis Certificate, Jun 29, 2005.
4. CEVA Report p.7, Feb.2007.
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Chapter 4
Magnesium - the Unsung Hero
s the fourth most abundant mineral in the body, magnesium is essential to
your good health. Approximately half of your total body magnesium is found
in your bones and the other half is distributed throughout cells of your
tissues and organs. This critical mineral is needed for more than 300
biochemical reactions! It helps maintain normal muscle and nerve function, keeps your
heart rhythm steady, supports a healthy immune system, and keeps your bones strong.
Only 1% of magnesium is found in your blood, but the body works very hard to keep blood
levels of magnesium constant 1. Magnesium also helps regulate blood sugar levels,
promotes normal blood pressure, and is known to be involved in giving energy to your cells
and making proteins.2,3 Magnesium plays a role in supporting and managing normal blood
pressure, immune function, cardiovascular health, and normalizing blood sugar, so obviously it plays a central role in your health.
You Are Probably Magnesium Deficient!
The 1999-2000 US National Health and Nutrition Examination Survey suggest that
substantial numbers of adults in the United States fail to consume recommended amounts of magnesium.
Research done throughout the world shows that the United States RDA for Magnesium is not
sufficient to make up for the amount lost in bowel movements and sweat. Aggravating
matters more, sports, physical work, mental exertion, competition or other stresses, all increase your magnesium requirements.
The shocking part is amounts actually consumed in American diets is even less than the
RDA! The amounts consumed are generally far less than enough to maintain equilibrium in
metabolic balance studies. For many people, dietary intake may not be high enough to
promote an optimal magnesium status, which may be protective against numerous disorders.5-6
According to recent USDA surveys, the average intake of magnesium by women 19 to 50
years of age was about 74 percent of the RDA. Men of the same age got about 94 percent
of the recommended amount. About 50 percent of women had intakes below 70 percent of their RDA.
These are the recommended daily requirements of magnesium:
Children
o 1-3 years old: 80 milligrams
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o 4-8 years old: 130 milligrams
o 9-13 years old: 240 milligrams
o 14-18 years old (boys): 410 milligrams
o 14-18 years old (girls): 360 milligrams
Adult females: 310 milligrams
Pregnancy: 360-400 milligrams
Breastfeeding women: 320-360 milligrams Adult males: 400 milligram
When can magnesium deficiency occur?
If your digestive system or kidney function is compromised, it can significantly influence
your magnesium status because magnesium is absorbed in the intestines and then transported through the blood to cells and tissues.
The bio-availability of Magnesium is reasonable with one-third to one-half of dietary
magnesium being absorbed into your body.7-8 Gastrointestinal disorders that impair
absorption such as Crohn's disease can limit your body's ability to absorb magnesium.
These disorders can deplete your stores of magnesium and may result in magnesium deficiency.
Chronic or excessive vomiting and diarrhea may also result in magnesium depletion.1-8 It is
interesting to note that healthy kidneys limit urinary excretion of magnesium to compensate
for low dietary intake. However, some medications cause excessive loss of magnesium in
urine as a side effect. Also, poorly-controlled diabetes and alcohol abuse causes your body to lose excessive amounts of magnesium.9-10
What is the Best Way to Get Extra Magnesium?
Eat a variety of whole grains, legumes, and vegetables (especially dark-green, leafy
vegetables with chlorophyll) to increase dietary magnesium intake. Here is a list of foods high in magnesium.
Magnesium tablets also may be recommended by your doctor, although taken alone, it can
cause diarrhea.11 A more balanced approach is to take magnesium along with your calcium
supplement as the two minerals work together in several ways to maintain balance. It is
always best to get any mineral from a food, so we recommend AlgaeCal®, a marine algae
naturally containing a balance of magnesium, calcium, trace minerals and phyto-nutrients in a whole food complex.
It is important to have the cause, severity, and consequences of low blood levels of
magnesium evaluated by your doctor. If you have kidney disease you may not be able to
excrete excess amounts of magnesium, and you should not consume magnesium supplements unless prescribed by a physician.
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Magnesium and Bone Health
Magnesium deficiency may be a risk
factor in cases of extensive bone loss12
because magnesium deficiency alters
calcium metabolism and the hormones
that regulate calcium.13 Several
human studies have suggested that
supplementing with magnesium can
improve your bone mineral density.12
In a study of older adults, a greater
magnesium intake maintained bone
mineral density to a greater degree
than a lower magnesium intake.14
Diets with recommended levels of
magnesium are beneficial for bone
health, but further investigation on the exact role of magnesium in bone metabolism is needed.
There are many health benefits of magnesium beyond bone health. According to the
National Institutes of Health, Magnesium may be Involved in supporting and protecting
several vital functions.
Magnesium and Your Blood Pressure
Magnesium may play an important role in regulating your blood pressure naturally.12 Diets
including plenty of fruits and vegetables, which are good sources of potassium and
magnesium, are consistently associated with lower blood pressure.15-17 The DASH study
suggested that high blood pressure could be significantly lowered by a diet that emphasizes
fruits, vegetables, and low fat dairy foods. This kind of diet is high in potassium, magnesium, and calcium, and low in sodium and bad fats.18-20
Foods high in magnesium are usually high in potassium and dietary fiber too. This makes it
difficult to evaluate the independent effect of magnesium on blood pressure. However,
newer scientific evidence from DASH clinical trials has made magnesium‟s independent role
in regulating blood pressure clear.21-23
Magnesium and Blood Glucose Management
Magnesium plays an important role in carbohydrate metabolism, so it influences the release
and activity of insulin, the hormone that helps control blood glucose levels.24 This low
magnesium state worsens insulin resistance, a condition that often precedes diabetes. If
you have insulin resistance, you do not use insulin efficiently and require greater amounts
of insulin to maintain blood sugar within normal levels. Your kidneys lose their ability to
retain magnesium during periods of severe hyperglycemia (elevated blood glucose). Losing
magnesium through your urine results in lower blood levels of magnesium.12 If you are an
older adult, correcting magnesium depletion may improve your insulin response and
action.25
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Wrapping Up
AlgaeCal naturally contains 7-9% magnesium, which is extremely high. That means a
typical 2.4 gram daily dose of AlgaeCal, yields 200 mg of pure magnesium in a nice body-
friendly plant form! After reading this chapter, it should be evident why AlgaeCal, with it‟s
natural magnesium was chosen for inclusion in the clinical trial that formed the response to
the Surgeon General‟s call to action!
References:
1. Rude RK. Magnesium deficiency: A cause of heterogeneous disease in humans. J Bone Miner Res 1998;13:749-58.
2.Wester PO. Magnesium. Am J Clin Nutr 1987;45:1305-12.
3.Saris NE, Mervaala E, Karppanen H, Khawaja JA, Lewenstam A. Magnesium: an update on physiological, clinical,
and analytical aspects. Clinica Chimica Acta 2000;294:1-26.
4. Aaseth J., Osteoporosis-minerals and trace substances, Department of Internal Medicine, Kongsvinger Hospital.
5.Vormann J. Magnesium: nutrition and metabolism. Molecular Aspects of Medicine 2003:24:27-37.
6.Feillet-Coudray C, Coudray C, Tressol JC, Pepin D, Mazur A, Abrams SA. Exchangeable magnesium pool masses in
healthy women: effects of magnesium supplementation. Am J Clin Nutr 2002;75:72-8.
7. Ladefoged K, Hessov I, Jarnum S. Nutrition in short-bowel syndrome. Scand J Gastroenterol Suppl 1996;216:122-
31.
8. Rude KR. Magnesium metabolism and deficiency. Endocrinol Metab Clin North Am 1993;22:377-95.
9.Kelepouris E and Agus ZS. Hypomagnesemia: Renal magnesium handling. Semin Nephrol 1998;18:58-73.
10.Abbott L, Nadler J, Rude RK. Magnesium deficiency in alcoholism: Possible contribution to osteoporosis and
cardiovascular disease in alcoholics. Alcohol Clin Exp Res 1994;18:1076-82. [PubMed abstract]
11. DePalma J. Magnesium Replacement Therapy. Am Fam Phys 1990;42:173-6.
12. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium,
Vitamin D and Fluoride. National Academy Press. Washington, DC, 1999.
13. Elisaf M, Milionis H, Siamopoulos K. Hypomagnesemic hypokalemia and hypocalcemia: Clinical and laboratory
characteristics. Mineral Electrolyte Metab 1997;23:105-12.
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14. Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP. Potassium, magnesium, and fruit and vegetable
intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 1999;69(4):727-
36.
15 .Appel LJ. Nonpharmacologic therapies that reduce blood pressure: A fresh perspective. Clin Cardiol
1999;22:1111-5.
16.Simopoulos AP. The nutritional aspects of hypertension. Compr Ther 1999;25:95-100.
17.Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser
MM, Lin PH, Karanja N. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med
1997;336:1117-24. [
18. Sacks FM, Obarzanek E, Windhauser MM, Svetkey LP, Vommer WM, McCullough M, Karanja N, Lin PH, Steele P,
Praschen MA, Evans M, Appel LJ, Bray GA, Vogt T, Moore MD for the DASH investigators. Rationale and design of
the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary
patterns to lower blood pressure. Ann Epidemiol 1995;5:108-18.
19.Sacks FM, Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Bray GA, Vogt TM, Cutler JA, Windhauser
MM, Lin PH, Karanja N. A dietary approach to prevent hypertension: A review of the Dietary Approaches to Stop
Hypertension (DASH) Study. Clin Cardiol 1999;22:6-10.
20.Svetkey LP, Simons-Morton D, Vollmer WM, Appel LJ, Conlin PR, Ryan DH, Ard J, Kennedy BM. Effects of dietary
patterns on blood pressure: Subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized
clinical trial. Arch Intern Med 1999;159:285-93.
21. National Heart, Lung, and Blood Institute. Joint National Committee on Prevention, Detection, Evaluation, and
Treatment of High Blood Pressure. The sixth report of the Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997;157:2413-46.
22.Schwartz GL and Sheps SG. A review of the sixth report of the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure. Curr Opin Cardiol 1999;14:161-8.
23.Kaplan NM. Treatment of hypertension: Insights from the JNC-VI report. Am Fam Physician 1998;58:1323-30.
24. Kobrin SM and Goldfarb S. Magnesium Deficiency. Semin Nephrol 1990;10:525-35.
25. Paolisso G, Sgambato S, Gambardella A, Pizza G, Tesauro P, Varricchio H, D'Onofrio F. Daily magnesium
supplements improve glucose handling in elderly subjects. Am J Clin Nutr 1992;55:1161-7.
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Chapter 5
Forget What You Think You Know About Vitamin D
Requirements! 2006 Research Reveals The Truth.
itamin D is unique among vitamins in that it can be provided to your body
through food, or from exposure to ultraviolet rays from the sun or a tanning
bed. Sunshine is your most important source of vitamin D because UV rays
trigger vitamin D synthesis in your skin, easily boosting your D levels, but
getting adequate vitamin D from normal diet is more difficult. If you look at the food
sources of vitamin D table at the end of this chapter, you will see it is nearly impossible to
get all of your required vitamin D from food alone.
Vitamin D functions as an important hormone by sending a message to your intestines to
increase the absorption of calcium by as much as 80%. Vitamin D is well known for
maintaining normal calcium levels(1), but new research shows it plays an important role in
strengthening your immune system, insulin secretion, blood pressure regulation, and much
more.
You Are Probably Vitamin D Deficient!
In March 2006, Mayo Clinic Proceedings printed a shocking article about the high prevalence
of vitamin D deficiency (2). The highly respected author, Michael Holick of the Boston
University School of Medicine says “Vitamin D inadequacy has been reported in
approximately 36% of otherwise healthy young adults and up to 57% of general medicine
inpatients in the United States and even higher percentages in Europe! Low sunlight
exposure, age related decreases in vitamin D synthesis in your skin, and diets low in
vitamin D contribute to the high prevalence of vitamin D inadequacy.
“Supplemental does of vitamin D and sensible sun exposure could prevent deficiency in
most of the general population,” according to Holick. In a previous published paper, he
wrote “vitamin D deficiency is now recognized as an epidemic in the United States!” After
you read the rest of this chapter, we think you will agree.
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Don’t Believe the Sunscreen Companies Propaganda
Thanks to repeated articles submitted to the press by sunscreen companies, picked up by
health organizations and presented as unbiased news, the whole nation is fearful of sun
exposure. Articles use frightening phrases like “unprotected skin”, “premature aging”, and
“UV radiation”. Let‟s not forget for 1000s of years our ancestor‟s skin was in the sun for
much of the day, and this sun exposure is fundamental to your good health. These articles
do not usually offer the balancing perspective that we absolutely need to be plugged into
the sun, or we increase our risk of breast cancer, prostate cancer, colon cancer, multiple
sclerosis, alzheimer's disease, hypertension and diabetes! For many decades researchers
have known increased sun exposure reduces cancer death rates, yet we seldom see an
article published on this topic in the mainstream press.
Of course we need to avoid sunburn, and due to ozone thinning we should spend less time
in the sun than our relatives of yesteryear. With no vested interest in presenting the flip
side of the sun protection equation, there is no balancing publicity campaign warning you of
the greater danger of avoiding all sun exposure!
How Much Sun Do You Need?
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Sunlight is the best source of vitamin D, plus it confers other health benefits that are still
poorly understood. Children and young adults who spend a short time outside two or three
times a week will generally synthesize all the vitamin D they need. If you are older, you
have diminished capacity to synthesize vitamin D from sunlight exposure and possibly use
sunscreen or protective clothing so you may consider getting extra vitamin D from food and
supplements.
The application of sunscreen with an SPF factor of 8 reduces production of vitamin D by
95%. In latitudes around 40 degrees north or 40 degrees south (as an example, Boston is
42 degrees north), there is insufficient UVB radiation available for vitamin D synthesis from
November to early March. If you live ten degrees farther north, (Edmonton, Canada) this
“vitamin D winter” extends from mid October to mid March.
As little as 5-10 minutes of sun exposure on arms and legs or face and arms three times
weekly between 11:00 am and 2:00 pm during the spring, summer, and fall at 42 degrees
latitude should provide a light-skinned individual with adequate vitamin D and allow for
storage of any excess for use during the winter with minimal risk of skin damage (35).
Notice this time frame is to provide adequate levels, but not necessarily optimal levels.
Understand too, the less skin you have exposed, the darker your skin tone, or the older you
are, the more time you need in the sun to synthesize adequate vitamin D. A good
recommendation is to cover up or put sunscreen on after you have had a reasonable time
exposed to direct sunlight. It should be noted that there may be other non-vitamin D
related benefits of sun exposure which are not within the scope of this book.
Vitamin D and Your Bones
Osteoporosis is most often associated with inadequate calcium and vitamin D intake. It is
well established that long term vitamin D inadequacy contributes to osteoporosis by
reducing calcium absorption [33]. While rickets and osteomalacia are examples of extreme
vitamin D deficiency, osteopororsis is an example of the long-term effect of vitamin D
insufficiency [34]. Unfortunately national nutritional policies such as the RDA and AI
(adequate intake) have focused primarily on short-latency deficiency diseases – that is
diseases where the results of deficiency are apparent quickly. In the case of vitamin D
deficiency over a longer period of time, osteoporosis develops, but the D amounts required
to be protective are considerably higher than the policies based on short-latency deficiency
have dictated.
New Research Proves You Need Much More Vitamin D!
In 2006, three significant research papers were published in peer-reviewed medical journals
by different respected authors, each coming to the same conclusion. You need more
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vitamin D than the recommended amount for adults of 400 IU per day – actually much
more! Most calcium supplements and multi-vitamins are formulated to this AI (Adequate
Intake) level. Listen to what the new research is showing.
Bischoff-Ferrari‟s article in The American Journal of Clinical Nutrition reviewed the current
literature and found that for bone mineral density and fracture risk reduction, lower-
extremity function, dental health, and immune system support, the best serum
concentration of 25 hydroxy vitamin D are at 90 - 100nmol/L. (Vitamin D that is
synthesized in your skin becomes 25 hydroxy vitamin D circulating in your blood stream.
This is the best measurement of the level of vitamin D you have available for use in your
various tissues). The Bischoff-Ferrari team found that healthy outdoor workers have 135 - 163 nmol/L. The first sign of D toxicity begins at 220 nmol/L.
He recommends 2000 IU/day as a new safe RDA to bring 97% of the population to 90-100
nmol/L. To bring concentrations in 50% of population up to a conservative 75nmol/L, he
recommends adult intake of 1000 IU/day. His conclusion states “a large majority of the US population could benefit from vitamin D supplementation.”
A second significant article by one of the top bone health researchers in the world, Robert
Heaney published in the Journal of Nutrition, says "Available data on metabolic utilization of
vitamin D3 indicate a total daily requirement of approximately 4000 international units or
twice the current tolerable upper intake level (UL)... Estimates of the population distribution
of serum 25 hydroxy vitamin D values, coupled with available dose-response data, indicate
that it would require input of an additional 2600 iu/d (65 microg/d) of oral vitamin D3 to
ensure that 97.5% of older women have 25 hydroxy vitamin D values at or above desirable
levels." Dr. Heaney‟s article was addressing older women, so the amounts needed for younger adults is generally less.
A third comprehensive 2006 article published in Mayo Clinic Proceedings by Michael Holick
concludes 400 IU per day should represent a minimum for vitamin D supplementation
rather than a recommended daily amount. Vitamin D toxicity has not been reported from
long-term exposure to sunlight1,4 and has only been observed from dietary intake when
daily doses exceed 10,000 IU.245,246 Doses of 4000 IU/d for 3 months and 50,000 IU/wk for
2 months have been administered without toxicity.11,247,248
Risk Factors for Vitamin D Deficiency
If you find yourself in any of the categories below, you would be well advised to see your
local physician and get a blood test to determine your circulating vitamin D levels.
Sunscreen Use
Osteomalacia, a severe bone softening disease, has been documented in women who
cover all of their skin whenever they are outside for religious or cultural reasons (26,
27). The application of sunscreen with an SPF factor of 8 or higher blocks production
of vitamin D creating a similar problem to covered skin(1). It should also be noted
that sun‟s rays going through glass acts like sunscreen producing very little vitamin
D.
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Dark Skin
People with dark skin synthesize less vitamin D on exposure to sunlight than those
with light skin (1). The risk of vitamin D deficiency is particularly high in dark-
skinned people who live far from the equator.
Breast Fed Infants
Infants who are exclusively breast fed are at high risk of vitamin D inadequacy,
particularly if they have dark skin and/or receive little sun exposure (19). Human
milk generally provides 25 IU of vitamin D per liter, which is not enough for an infant
if it is the sole source of vitamin D. Older infants and toddlers exclusively fed milk
substitutes and weaning foods that are not vitamin D fortified are also at risk of
vitamin D deficiency (18). The American Academy of Pediatrics recommends that all
infants that are not consuming at least 500 ml (16 ounces) of vitamin D fortified
formula or milk be given a vitamin D supplement of 200 IU/day (19).
Aging
The elderly have reduced capacity to synthesize vitamin D in the skin when exposed
to UVB radiation, and are more likely to stay indoors or use sunscreen.
Institutionalized adults are at extremely high risk of vitamin D deficiency without
supplementation 24, 25. A 70-year-old produces approximately 4 times less vitamin D
via cutaneous synthesis compared with a 20-year-old. If you have a parent or friend
who is in a long term care home, please be sure they are receiving adequate vitamin
D.
Inflammatory Bowel Disease
If you suffer from inflammatory bowel disease like Crohn‟s disease or irritable bowel
syndrome, you may be at increased risk of vitamin D deficiency, especially if you
have had small bowel surgery (29). You are also at risk for vitamin K2 deficiency
which further puts your bones, among other tissues, at risk. Please read our chapter
on this critically important vitamin.
Fat Malabsorption Syndromes
Cystic fibrosis and cholestatic liver disease impair the absorption of dietary vitamin D
(28).
Obesity
If you are overweight, it increases your risk of vitamin D deficiency (30). Once
vitamin D is synthesized in the skin or ingested, it is deposited in body fat stores,
making it less bio-available if you have large stores of body fat.
Vitamin D Supplements
It is not always practical to get your vitamin D from sunshine, and quite difficult to get
adequate amounts from your diet so for many people, a vitamin D supplement is a practical
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way to ensure adequate levels of this important protector are always available in your
bloodstream.
Since a large body of science shows vitamin D works closely with calcium and magnesium, it
is best to take your vitamin D in combination with calcium and magnesium to maintain a
proper balance. Most calcium supplements have too little vitamin D to be effective - and
some of them use synthetic vitamin D2. A much better form is natural vitamin D3
(cholecalciferol) which stays in your system longer and with more effect.
Food Sources of Vitamin D
In the 1930s, a vitamin D deficiency disease called rickets was a major public health
problem in the United States so a milk fortification program was implemented nearly
eliminating this disorder. Currently, about 98% of the milk supply in the US is fortified with
400 International Units (IU) of vitamin D2 per quart.
Although milk is fortified with vitamin D, dairy products made from milk, such as cheese and
ice creams, are generally not fortified. It should be noted that the less effective, synthetic
form, vitamin D2 (ergocalciferol) is used for milk and cereal fortification. Vitamin D2 is
about 70% less effective at raising serum 25 hydroxyvitamin D levels, among several other
deficiencies, compared to vitamin D3.
There are only a few foods that are good sources of vitamin D, so vitamin D3 supplements
are often recommended unless you are exposed to sunlight regularly.
Suggested dietary sources of vitamin D are listed below.
Selected food sources of vitamin D
Food International
Units(IU) per serving
Percent DV
(DailyValue)*
Pure Cod liver oil, 1 Tablespoon (Note: most cod liver oils
today have the vitamin D removed! Check your label to be
certain.)
1,360 340
Salmon, cooked, 3½ ounces 360 90
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Mackerel, cooked, 3½ ounces 345 90
Tuna fish, canned in oil, 3 ounces 200 50
Sardines, canned in oil, drained, 1¾ ounces 250 70
Milk, nonfat, reduced fat, and whole, vitamin D fortified, 1
cup 98 25
Margarine, fortified, 1 Tablespoon 60 15
Pudding, prepared from mix and made with vitamin D
fortified milk, ½ cup 50 10
Ready-to-eat cereals fortified with 10% of the DV for vitamin
D, ¾ cup to 1 cup servings (servings vary according to the
brand)
40 10
Egg, 1 whole (vitamin D is found in egg yolk) 20 6
Liver, beef, cooked, 3½ ounces 15 4
Cheese, Swiss, 1 ounce 12 4
References
1. Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and
osteoporosis. Am J Clin Nutr. 2004;79(3):362-371. (PubMed)
2. High Prevalence of vitamin D inadequacy and implications for health. Holick MF, Mayo Clin Proc.
2006;81:353-373
3. Sutton AL, MacDonald PN. Vitamin D: more than a "bone-a-fide" hormone. Mol Endocrinol.
2003;17(5):777-791. (PubMed)
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4. Guyton KZ, Kensler TW, Posner GH. Vitamin D and vitamin D analogs as cancer chemopreventive
agents. Nutr Rev. 2003;61(7):227-238. (PubMed)
5. Norman AW. Vitamin D. In: Bowman BA, Russell RM, eds. Present Knowledge in Nutrition. 8th ed.
Washington, DC: ILSI Press; 2001:146-155.
5a. DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr.
2004;80(6 Suppl):1689S-1696S. (PubMed)
6. Lin R, White JH. The pleiotropic actions of vitamin D. Bioessays. 2004;26(1):21-28. (PubMed)
7. Hayes CE, Nashold FE, Spach KM, Pedersen LB. The immunological functions of the vitamin D
endocrine system. Cell Mol Biol. 2003;49(2):277-300. (PubMed)
8. Griffin MD, Xing N, Kumar R. Vitamin D and its analogs as regulators of immune activation and
antigen presentation. Annu Rev Nutr. 2003;23:117-145. (PubMed)
9. Zeitz U, Weber K, Soegiarto DW, Wolf E, Balling R, Erben RG. Impaired insulin secretory capacity in
mice lacking a functional vitamin D receptor. FASEB J. 2003;17(3):509-511. (PubMed)
10. Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R. The effect of vitamin D3 on insulin
secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract. 2003;57(4):258-
261. (PubMed)
11. Orwoll E, Riddle M, Prince M. Effects of vitamin D on insulin and glucagon secretion in non-insulin-
dependent diabetes mellitus. Am J Clin Nutr. 1994;59(5):1083-1087. (PubMed)
12. Inomata S, Kadowaki S, Yamatani T, Fukase M, Fujita T. Effect of 1 alpha (OH)-vitamin D3 on insulin
secretion in diabetes mellitus. Bone Miner. 1986;1(3):187-192. (PubMed)
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13. Sheng H-W. Sodium, chloride and potassium. In: Stipanuk M, ed. Biochemical and Physiological
Aspects of Human Nutrition. Philadelphia: W.B. Saunders Company; 2000:686-710.
14. Sigmund CD. Regulation of renin expression and blood pressure by vitamin D(3). J Clin Invest.
2002;110(2):155-156. (PubMed)
15. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine
regulator of the renin-angiotensin system. J Clin Invest. 2002;110(2):229-238. (PubMed)
16. Heaney RP. Long-latency deficiency disease: insights from calcium and vitamin D. Am J Clin Nutr.
2003;78(5):912-919. (PubMed)
17. Zittermann A. Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr.
2003;89(5):552-572. (PubMed)
18. Wharton B, Bishop N. Rickets. Lancet. 2003;362(9393):1389-1400. (PubMed)
19. Gartner LM, Greer FR. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D
intake. Pediatrics. 2003;111(4 Pt 1):908-910. (PubMed)
20. Bringhurst FR, Demay MB, Kronenberg HM. Mineral Metabolism. In: Larson PR, Kronenberg HM,
Melmed S, Polonsky KS, eds. Larsen: Williams Textbook of Endocrinology: Elsevier; 2003:1317-1320.
21. Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent,
nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78(12):1463-1470. (PubMed)
22. Bischoff HA, Stahelin HB, Dick W, et al. Effects of vitamin D and calcium supplementation on falls: a
randomized controlled trial. J Bone Miner Res. 2003;18(2):343-351. (PubMed)
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23. Nesby-O'Dell S, Scanlon KS, Cogswell ME, et al. Hypovitaminosis D prevalence and determinants
among African American and white women of reproductive age: third National Health and Nutrition
Examination Survey, 1988-1994. Am J Clin Nutr. 2002;76(1):187-192. (PubMed)
24. Harris SS, Soteriades E, Coolidge JA, Mudgal S, Dawson-Hughes B. Vitamin D insufficiency and
hyperparathyroidism in a low income, multiracial, elderly population. J Clin Endocrinol Metab.
2000;85(11):4125-4130. (PubMed)
25. Allain TJ, Dhesi J. Hypovitaminosis D in older adults. Gerontology. 2003;49(5):273-278. (PubMed)
26. Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R. Hypovitaminosis D and vitamin D deficiency in
exclusively breast-feeding infants and their mothers in summer: a justification for vitamin D
supplementation of breast-feeding infants. J Pediatr. 2003;142(2):169-173. (PubMed)
27. Glerup H, Mikkelsen K, Poulsen L, et al. Commonly recommended daily intake of vitamin D is not
sufficient if sunlight exposure is limited. J Intern Med. 2000;247(2):260-268. (PubMed)
28. Food and Nutrition Board, Institute of Medicine. Vitamin D. Dietary Reference Intakes: Calcium,
Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington D.C.: National Academies Press;
1999:250-287. (National Academies Press)
29. Jahnsen J, Falch JA, Mowinckel P, Aadland E. Vitamin D status, parathyroid hormone and bone
mineral density in patients with inflammatory bowel disease. Scand J Gastroenterol. 2002;37(2):192-199.
(PubMed)
30. Arunabh S, Pollack S, Yeh J, Aloia JF. Body fat content and 25-hydroxyvitamin D levels in healthy
women. J Clin Endocrinol Metab. 2003;88(1):157-161. (PubMed)
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31. Malabanan A, Veronikis IE, Holick MF. Redefining vitamin D insufficiency. Lancet.
1998;351(9105):805-806.
32. Chapuy MC, Preziosi P, Maamer M, et al. Prevalence of vitamin D insufficiency in an adult normal
population. Osteoporos Int. 1997;7(5):439-443. (PubMed)
33. Thomas MK, Lloyd-Jones DM, Thadhani RI, et al. Hypovitaminosis D in medical inpatients. N Engl J
Med. 1998;338(12):777-783. (PubMed)
34. Heaney RP, Dowell MS, Hale CA, Bendich A. Calcium absorption varies within the reference range for
serum 25-hydroxyvitamin D. J Am Coll Nutr. 2003;22(2):142-146. (PubMed)
35. Holick MF. Vitamin D deficiency: what a pain it is. Mayo Clin Proc. 2003;78(12):1457-1459.
36. Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr.
1999;69(5):842-856. (PubMed)
37. Tangpricha V, Koutkia P, Rieke SM, Chen TC, Perez AA, Holick MF. Fortification of orange juice with
vitamin D: a novel approach for enhancing vitamin D nutritional health. Am J Clin Nutr. 2003;77(6):1478-
1483. (PubMed)
38. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for
bone loss and fractures and therapeutic implications. Endocr Rev. 2001;22(4):477-501. (PubMed)
39. Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a
prospective study among postmenopausal women. Am J Clin Nutr. 2003;77(2):504-511. (PubMed)
40. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE, Falconer G, Green CL. Rates of bone loss in
postmenopausal women randomly assigned to one of two dosages of vitamin D. Am J Clin Nutr.
1995;61(5):1140-1145. (PubMed)
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41. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on
bone density in men and women 65 years of age or older. N Engl J Med. 1997;337(10):670-676.
(PubMed)
42. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of withdrawal of calcium and vitamin D
supplements on bone mass in elderly men and women. Am J Clin Nutr. 2000;72(3):745-750. (PubMed)
43. Ooms ME, Roos JC, Bezemer PD, van der Vijgh WJ, Bouter LM, Lips P. Prevention of bone loss by
vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab.
1995;80(4):1052-1058. (PubMed)
44. Heikinheimo RJ, Inkovaara JA, Harju EJ, et al. Annual injection of vitamin D and fractures of aged
bones. Calcif Tissue Int. 1992;51(2):105-110. (PubMed)
45. Chapuy MC, Arlot ME, Delmas PD, Meunier PJ. Effect of calcium and cholecalciferol treatment for
three years on hip fractures in elderly women. BMJ. 1994;308(6936):1081-1082.
46. Trivedi DP, Doll R, Khaw KT. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation
on fractures and mortality in men and women living in the community: randomised double blind
controlled trial. BMJ. 2003;326(7387):469-474. (PubMed)
47. Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM. Vitamin D supplementation and fracture
incidence in elderly persons. A randomized, placebo-controlled clinical trial. Ann Intern Med.
1996;124(4):400-406. (PubMed)
48. Blutt SE, Weigel NL. Vitamin D and prostate cancer. Proc Soc Exp Biol Med. 1999;221(2):89-98.
(PubMed)
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49. Terry P, Baron JA, Bergkvist L, Holmberg L, Wolk A. Dietary calcium and vitamin D intake and risk of
colorectal cancer: a prospective cohort study in women. Nutr Cancer. 2002;43(1):39-46. (PubMed)
50. Martinez ME, Giovannucci EL, Colditz GA, et al. Calcium, vitamin D, and the occurrence of colorectal
cancer among women. J Natl Cancer Inst. 1996;88(19):1375-1382. (PubMed)
51. Kearney J, Giovannucci E, Rimm EB, et al. Calcium, vitamin D, and dairy foods and the occurrence of
colon cancer in men. Am J Epidemiol. 1996;143(9):907-917. (PubMed)
52. Bostick RM, Potter JD, Sellers TA, McKenzie DR, Kushi LH, Folsom AR. Relation of calcium, vitamin D,
and dairy food intake to incidence of colon cancer among older women. The Iowa Women's Health
Study. Am J Epidemiol. 1993;137(12):1302-1317. (PubMed)
53. McCullough ML, Robertson AS, Rodriguez C, et al. Calcium, vitamin D, dairy products, and risk of
colorectal cancer in the Cancer Prevention Study II Nutrition Cohort (United States). Cancer Causes
Control. 2003;14(1):1-12. (PubMed)
54. Peters U, McGlynn KA, Chatterjee N, et al. Vitamin D, calcium, and vitamin D receptor polymorphism
in colorectal adenomas. Cancer Epidemiol Biomarkers Prev. 2001;10(12):1267-1274. (PubMed)
55. Holt PR, Arber N, Halmos B, et al. Colonic epithelial cell proliferation decreases with increasing levels
of serum 25-hydroxy vitamin D. Cancer Epidemiol Biomarkers Prev. 2002;11(1):113-119. (PubMed)
56. Garland CF, Garland FC, Gorham ED. Calcium and vitamin D. Their potential roles in colon and breast
cancer prevention. Ann N Y Acad Sci. 1999;889:107-119. (PubMed)
57. Grant WB. An ecologic study of dietary and solar ultraviolet-B links to breast carcinoma mortality
rates. Cancer. 2002;94(1):272-281. (PubMed)
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58. John EM, Schwartz GG, Dreon DM, Koo J. Vitamin D and breast cancer risk: the NHANES I
Epidemiologic follow-up study, 1971-1975 to 1992. National Health and Nutrition Examination Survey.
Cancer Epidemiol Biomarkers Prev. 1999;8(5):399-406. (PubMed)
59. Shin MH, Holmes MD, Hankinson SE, Wu K, Colditz GA, Willett WC. Intake of dairy products, calcium,
and vitamin d and risk of breast cancer. J Natl Cancer Inst. 2002;94(17):1301-1311. (PubMed)
60. Young MV, Schwartz GG, Wang L, et al. The prostate 25-hydroxyvitamin D-1{alpha}-hydroxylase is
not influenced by parathyroid hormone and calcium: implications for prostate cancer chemoprevention
by vitamin D. Carcinogenesis. 2004 Jan 16; Epub ahead of print. (PubMed)
61. Corder EH, Guess HA, Hulka BS, et al. Vitamin D and prostate cancer: a prediagnostic study with
stored sera. Cancer Epidemiol Biomarkers Prev. 1993;2(5):467-472. (PubMed)
62. Braun MM, Helzlsouer KJ, Hollis BW, Comstock GW. Prostate cancer and prediagnostic levels of
serum vitamin D metabolites (Maryland, United States). Cancer Causes Control. 1995;6(3):235-239.
(PubMed)
63. Gann PH, Ma J, Hennekens CH, Hollis BW, Haddad JG, Stampfer MJ. Circulating vitamin D
metabolites in relation to subsequent development of prostate cancer. Cancer Epidemiol Biomarkers
Prev. 1996;5(2):121-126. (PubMed)
64. Nomura AM, Stemmermann GN, Lee J, et al. Serum vitamin D metabolite levels and the subsequent
development of prostate cancer (Hawaii, United States). Cancer Causes Control. 1998;9(4):425-432.
(PubMed)
Ahonen MH, Tenkanen L, Teppo L, Hakama M, Tuohimaa P. Prostate cancer risk and prediagnostic serum
25-hydroxyvitamin D levels 65. (Finland). Cancer Causes Control. 2000;11(9):847-852. (PubMed)
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66. Tuohimaa P, Tenkanen L, Ahonen M, et al. Both high and low levels of blood vitamin D are
associated with a higher prostate cancer risk: a longitudinal, nested case-control study in the Nordic
countries. Int J Cancer. 2004;108(1):104-108. (PubMed)
67. Deluca HF, Cantorna MT. Vitamin D: its role and uses in immunology. FASEB J. 2001;15(14):2579-
2585. (PubMed)
68. Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM. Intake of vitamin D and risk of type 1
diabetes: a birth-cohort study. Lancet. 2001;358(9292):1500-1503. (PubMed)
69. Munger KL, Zhang SM, O'Reilly E, et al. Vitamin D intake and incidence of multiple sclerosis.
Neurology. 2004;62(1):60-65. (PubMed)
70. Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, Saag KG. Vitamin D intake is inversely
associated with rheumatoid arthritis: results from the Iowa Women's Health Study. Arthritis Rheum.
2004;50(1):72-77. (PubMed)
71. Rostand SG. Ultraviolet light may contribute to geographic and racial blood pressure differences.
Hypertension. 1997;30(2 Pt 1):150-156. (PubMed)
72. Krause R, Buhring M, Hopfenmuller W, Holick MF, Sharma AM. Ultraviolet B and blood pressure.
Lancet. 1998;352(9129):709-710.
73. Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C. Effects of a short-term vitamin D(3) and
calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin
Endocrinol Metab. 2001;86(4):1633-1637. (PubMed)
74. Pan WH, Wang CY, Li LA, Kao LS, Yeh SH. No significant effect of calcium and vitamin D
supplementation on blood pressure and calcium metabolism in elderly Chinese. Chin J Physiol.
1993;36(2):85-94. (PubMed)
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75. Scragg R, Khaw KT, Murphy S. Effect of winter oral vitamin D3 supplementation on cardiovascular
risk factors in elderly adults. Eur J Clin Nutr. 1995;49(9):640-646. (PubMed)
76. Vieth R, Chan PC, MacFarlane GD. Efficacy and safety of vitamin D3 intake exceeding the lowest
observed adverse effect level. Am J Clin Nutr. 2001;73(2):288-294. (PubMed)
77. Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ. Human serum 25-hydroxycholecalciferol
response to extended oral dosing with cholecalciferol. Am J Clin Nutr. 2003;77(1):204-210. (PubMed)
78.Vitamin D. Natural Medicines Comprehensive Database [Web site]. March 1, 2004. Available at:
www.naturaldatabase.com. Accessed March 1, 2004.
79. Hendler SS, Rorvik DR, eds. PDR for Nutritional Supplements. Montvale: Medical Economics
Company, Inc; 2001.
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Chapter 6
Vitamin K2 Cleans Calcium Deposits from Your Arteries
and Moves it to Your Bones!
s we have discussed earlier, bone health is multi-factorial. Some of the
leading calcium consuming countries like the USA and Norway have the
highest incidence of osteoporosis, yet other countries who consume less
calcium, like Japan, have lower osteoporosis rates. It appears we are
missing some important nutritional element or balance of ingredients in our
typical western diet. Strong evidence is now available that vitamin K2 is
one important piece of the bone health puzzle. Japan, where most of the vitamin K2 studies
were done, is the first country to approve K2 as a treatment for osteoporosis, with several
other countries soon to follow.
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Vitamin K is the name of a group of compounds that are all related to one another. The
first one discovered was Phylloquinone or K1. In the last decade most of the research has
turned to the more effective Menaquinones, or vitamin K2. More than a dozen high quality
human studies have been done on K2 with significant findings, yet it is almost unheard of in
the western world.
Forms of Vitamin K2
Unfortunately the form found in your multi-vitamin is almost always K1 which has some
blood clotting benefits, but has shown little benefit for bone health. Vitamin K2 is further
divided into MK-4, MK-7 and several other forms. Most of the clinical studies supporting
bone growth to date have been with MK-4, and MK-7. More recently the attention of
scientists is focused on the MK-7 version which is natural and stays in the blood stream
longer than MK-4 creating benefits beyond bone health.
Vitamin K2 Sources
Vitamin K2 must come directly from your diet on a regular basis since your body is unable
to synthesize it.
When you eat vitamin K1 in your food, only 5-10% of ingested K1 is absorbed and reaches
your blood, but almost 100% of K2 is absorbed into your blood stream where it can be
distributed for beneficial use in tissues including bones and arteries.
More than 80% of the Vitamin K in western diets consists of vitamin K1. The more
beneficial form, K2, is difficult to find in your diet with the exception of the Japanese
traditional food, natto (1). Small amounts of K2 can be found in meat, fruit, fish, and dairy
products, but the dominant source, by far, is natto. Measurements in normal subjects show
the majority of the population is deficient in vitamin K2 for optimal bone health, especially
for the elderly (2).
Natto – the Food of the Samurai Warrior, Builds Your Bones
Natto, a typical breakfast food, is made from steamed and fermented soy beans. It‟s use in
Japan dates back hundreds of years to the age of Samurais who believed it increased their
strength and quickened their reflexes.
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Today about 7.5 billion packages of Natto are sold in Japan each year and Japanese health
authorities have invested resources promoting regular use of Natto, including making it an
integral part of the Japanese school breakfast programs. In the last ten years several
studies have found natto, containing the active component vitamin K2, to increase bone
mineral density and reduce bone fractures (3-6).
Also, several studies on Vitamin K2 specifically has been found to promote bone metabolism
and reduce the incidence of fracture in osteoporosis (7-13) As compared to vitamin K1,
K2 has been found to be more effective in decreasing bone turnover in vitro (14,15) and in
viv0 (16) suggesting that it offers more bone health benefits than K1.
In 2006, a British meta-study published in the Archives of Internal Medicine, found that of
13 significant human studies involving vitamin K, all but one reported a bone loss reduction
from vitamin K supplementation. Of the 7 studies which reported fracture data, all showed
a reduction in fractures from vitamin K2 supplements.
In another recent Japanese trial, osteoporotic women taking vitamin K2 supplements
sustained nearly no bone loss over two years, while cutting fracture risk by 64% as
compared with non-supplementing women.
The ability of bones to withstand fractures is not just determined by the quantity of bone
(as measured by Bone Mineral Density (BMD)), but also by the quality of bone. Evidence
suggests that vitamin K2's most important effects are on bone quality more than bone quantity.
Vitamin K2 and Your Heart
Four large scale studies have shown vitamin K2 to have a protective benefit for heart
disease, and no studies have shown the contrary.
K2 has been reported to decrease serum cholesterol and cholesterol deposits in the aorta,
contributing to the suppression of atherosclerosis (17,18). Vitamin K2 has been linked to a
reduction in coronary heart disease.i In fact one very large and significant study conducted
in the Netherlands in 2004 followed 4800 healthy men and women for ten years. It found
vitamin K2 reduced the risk of coronary heart disease mortality by 50%! (20) It is believed
that this reduction in heart disease mortality is a direct result of aortic calcification reduction
of 30-40% from K2 shown in this famous Rotterdam study. Rosenhek‟s 2000 study showed
only the extent of aortic-valve calcification was an independent predictor of cardiovascular death
in patients with aortic stenosis, whereas age, sex, and the presence or absence of coronary
artery disease, hypertension, diabetes, and even excessive cholesterol, were not. In other
words, the best way to predict heart attack is by looking the calcified plaque build up in your
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aorta. This build up has been stopped and even reversed in rat studies with administration of
vitamin K2.
Other Health Benefits Under Investigation
Arthritis
Two recent studies show an association between K status and cartilage health so it may
have a future application for osteoarthritis once further studies verify these early results.
Cancer
Several new studies suggest vitamin K may help the fight against cancer. Preliminary
research shows it has an influence on the unregulated growth of certain types of cancer
cells. Some encouraging early studies have been done involving vitamin K and leukemia,
liver, pancreatic, and ovarian cancer cells.
Anti-Aging
Vitamin K2 is a stronger antioxidant than vitamin E or coenzyme Q10, so in addition to it‟s
clearly established benefits for bone and heart health, it has a role in anti-aging.
Vitamin K2 Safety
If you take Coumadin, Heparin, or another anti-coagulant you should consult your physician
before taking vitamin K2 supplements. Vitamin K2 helps normal coagulation of blood. High
levels of K2 do not cause abnormal blood clotting. Most vitamin K2 supplements should
offer 45 – 150 micrograms per day. No tolerable upper limit has been established for
vitamin K2, but studies with very high amounts, like 45 mg per day (1000 times more than
45 micrograms) have shown no adverse effects. Adults should not be concerned about
taking levels of 45 mg/day or less, as numerous Japanese studies have shown even this
high level is safe for adults. Vitamin K in the United States has GRAS status, meaning it is
recognized by the FDA to be “Generally Regarded As Safe”.
Is Vitamin K2 safe for Pregnant Women?
Pregnant women should be especially conscious of their vitamin K intake because the
following birth defects have been linked to vitamin K deficiency:
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Cardiac dysfunction
Craniofacial abnormalities
Flat nasal bridge
Growth disorders
Learning disorders
Microcephaly
Neural tube defects
Why Have You Not Heard of This Bone and Heart Health Wonder?
It‟s almost like the old good news/bad news jokes. The good news is Vitamin K2 has been
clinically proven to provide extraordinary benefits for bone health and cardiovascular health,
plus it is a powerful anti-oxidant and some emerging science indicates it might help your
joints and intestinal health. Now for the bad news. It costs $1.5 million per kilogram so
most supplement companies find it is not cost effective to include in their formulas. As long
as we can buy a house and a Porcshe for the price of a kilo (about the size of 2 lbs of
butter) of K2, it may remain a secret that is relegated to research papers!
As interest builds in the scientific community, consumer demand increases and we predict
the price will become more reasonable with more vitamin K2 formulas available. Currently
only a few vitamin K2 supplements exist in the American marketplace.
References
1. Kaneki, M et al 2001: Japanese fermented soybean food as the major determinant of large geographic
difference in circulating levels of vitamin K2: Possible implications for hip-fracture risk. Nutrition. Vol 17, page
315-321
2. Ikeda, Y. et al 2006: Intake of fermented soybeans, Natto, is associated with reduced bone loss in post
menopausal women. J Nutr Vol 136, page 1323 - 1326
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3. Katsumaya, H. et al 2002: Usual dietary intake of fermented soybeans (Natto) is associated with bone mineral
density in premenopausal women. J Nutr Sci Vitaminol June 48(3) page 207-215
4. Katsumaya, H. et al 2004: Promotion of bone formation by fermented soybean (Natto) intake in premenopausal
women. J Nutri Sci Vitaminol Apr 50(2) page 114-120
5. Hodges, S.J et al 1991: Depressed levels of circulating menaquinones in patients with Osteoporotic fractures of
spine and femoral neck. Bone vol 12, page 387-389
6. Ikeda, Y. et al 2006: Intake of fermented soybeans, Natto, is associated with reduced bone loss in post
menopausal women: Japanese population based osteoporosis study. J Nutri Vol 136, page 1323-1328
7 Orimi et al.1992 &1998
8 Hara et al.,1995
9 Kameda et al., 1996
11 Shiraki et al., 2000
12 Vermeer, 2003b
13 Vermeer et al., 2004
14 Hara et al., 1995
15 Kameda et al., 1996
16 Vermeer, 2003b
17 Graul & Castaner, 1996
18 Spronk et al., 2003
19. Geleijnse, J.M. et al 2004: Dietary intake of menquinone (Vitamin K2) is associated with a reduced risk of
coronary heart disease: The Rotterdam Study. Am Soc Nutr Science. May 2004. Nutritional Epidemiology
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Chapter 7
Strontium – The first Bone BUILDING Supplement!
our landmark studies have been conducted in the last 5 years, uncovering
amazing increases in bone mineral density and reduced fracture risk with Strontium
supplementation.1-6 Existing drugs for osteoporosis, including calcium and vitamin D, work
by reducing bone resorption, but do not form new bone. These drugs and nutrients can add
minerals to the bone, but they simply cannot form new bone tissue. Actually, within weeks
of starting bisphosphonate drug treatment such as Fosamax, your body‟s formation of new
bone actually decreases somewhat. The result of taking Fosamax is your bone becomes
more mineralized and less prone to fracture, but certainly not the same as new bone.
Strontium is the only treatment known to increase the production of new bone without
compromising the quality of your bone. As such it is the only supplement or drug proven to build new, complete bone.
What is Strontium?
Strontium is a common element which is naturally found in your bones. Studies show
supplementation with Strontium in it‟s various forms is well tolerated and completely safe.
Strontium‟s extraordinary safety should not be surprising since it lies directly below calcium
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on the periodic table of elements so calcium, strontium and magnesium are all in the same
chemical family. They are all naturally occurring metals which easily form into stable salts
like calcium citrate, magnesium citrate and strontium citrate. They also form carbonates,
sulfates, lactates and ranelate.
As an alkaline earth element, strontium is similar to calcium in its absorption in the gut,
incorporation in bone, and elimination from the body through the kidneys. Strontium is
naturally present in trace amounts with around 100 micrograms in every gram of bone, and
one Finnish study estimated you eat about 2 mg per day in your diet normally. Strontium
use in the largest clinical trials found it most effective at 680 mg per day of strontium.
When you supplement with strontium you are making large doses of this element available for incorporation into your bone.
New Evidence Shows Amazing Results on Bone!
Post-menopausal women normally lose about 1% of their bone per year, but the strontium
ranelate studies are showing 3 year bone growth of 8.1 %! These exciting results were
published in a large phase three study that followed two other very positive multinational
strontium randomized clinical trials. In this most recent study, 1,649 postmenopausal
women were randomized to receive either strontium ranelate or placebo for three years.
Both groups also took calcium and vitamin D with the strontium to achieve these amazing results.
Several forms of strontium are available in the market, but strontium ranelate was used in
the study because it was not a common form and hence patentable. Once patents are
granted, it is protected so that it makes it worthwhile for a drug company to invest in the
above-mentioned large clinical studies. Strontium Ranelate has become a new prescription
drug called Protelos® which is approved for osteoporosis treatment in Europe and seeking
approval in the United States currently. Expect to hear more about this Strontium form in
the future.
Strontium’s Double Benefit for Your Bones
Scientists have discovered Strontium has a unique method of action which provides a dual
activity in your bones. Your bone cells are continuously growing and being re-absorbed at
the same time; bone growth drugs or calcium plus vitamin D supplements effect only one
side of the equation. Strontium inhibits bone resorption while simultaneously
stimulating bone growth, an exciting double benefit. No other natural substance or drug is known to provide this dual effect.
History of Strontium Supplementation
Strontium was studied in both animals and humans from the early 1950s to the early 1960s
and was shown to have bone health properties. For example, in 1959, Mayo Clinic
discussing a study involving another form of strontium, called strontium lactate for bone
health, reported “the therapeutic value of strontium appears to be established”. However, it
promptly fell out of favor, perhaps because atomic bomb testing converted a lot of the
natural strontium into a radioactive form called strontium-90. In spite of these encouraging early results, few studies were conducted until many years later.
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In 1981, a McGill University study involving 142 patients took strontium carbonate or
strontium gluconate in doses ranging from 100 mg to 1.5 grams per day demonstrating a dose/response relationship along with increasing bone mineral density.
In 1985, a small study pointed to a potential role for strontium in the treatment of humans.
This time strontium carbonate was used with similar positive results to the strontium
lactate used 30 years earlier. Three men and three women were each given 600 to 700
mg/day of strontium. Bone biopsies were taken in each patient at the hip bone, before and
after six months of treatment with strontium. Biopsy samples showed a 172 % increase in
the rate of bone formation after strontium therapy, with no change in bone resorption. The
patients receiving strontium remarked that the pains in their bones had diminished and their ability to move around had improved.
In the 1990‟s animal studies involving strontium ranelate were common and from 2001 to
2007 the first human studies involving strontium ranelate have been reporting extraordinary results and safety.
Effects on Joints
In one very recent study, 7 researchers hypothesized that strontium might also improve
cartilage metabolism. More studies are required on joint health to reach any conclusions.
A Few Comments Regarding the Use of Strontium
Although strontium seems to be a remarkably safe supplement, please follow these
guidelines to maximize its benefit:
1. Strontium supplements need to be taken along with adequate calcium consumption.
Animal studies suggest strontium is not effective and may even be counterproductive
if your calcium intake is not normal.
2. For best results, do not take strontium together with calcium because these two
chemically similar minerals compete at the sites of absorption. In the above noted
studies, strontium was administered first thing in the morning, half an hour to an
hour before breakfast, or three hours after the last meal of the day; they took their
calcium supplements separately, with a meal.
3. It should not be used as a treatment in children since it may alter the architecture of
rapidly growing bones. No studies have been done using high dose strontium on
children.
4. Strontium is not a “magic bullet” and a comprehensive approach to regaining bone
strength is needed. Other natural modalities of bone support include calcium, vitamin D, magnesium, vitamin K2, and weight bearing exercise.
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References
1. McCaslin FE Jr, Janes JM. The effect of strontium lactate in the treatment of osteoporosis. Proc Staff Meetings Mayo Clin. 1959;34:329-334.
2. Marie PJ, Skoryna SC, Pivon RJ, et al. Histomorphometry of bone changes in stable strontium therapy. In: Trace substances in environmental health XIX, edited by D.D. Hemphill, University of Missouri, Columbia, Missouri, 1985, 193-208.
3. Marie PJ, Hott M. Short-term effects of fluoride and strontium on bone formation and resorption in the mouse. Metabolism. 1986, 35:547-551
4. Meunier PJ, Slosman DO, Delmas PD, et al. Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis: a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab. 2002;87(5):2060-2066.
5. Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004;350:459-468.
6. Reginster JY, et al. Strontium ranelate reduces fractures in osteoporotic women. J Clin Endocrinol Metab. 2005; 90(5):2816-2822.
7. Nutr Rev 1983; 41:342–4
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Chapter 8
A Bone Density Study with a Difference!
veritable mountain of science supports calcium as a contributor to bone
health. A large body of clinical studies also supports the safety and efficacy of vitamin D3,
vitamin K2, strontium, and magnesium. And a smaller group of studies supports boron,
silica, and other trace minerals as important individual contributors to bone health. Using
the typical pharmaceutical model, most of the time each of these ingredients is tested
individually, or maybe with one other co-factor. Drug testing is normally done on a single
molecule so that any outcome is clearly attributable to the molecule. The Surgeon
General‟s call to action recommended a program rather than testing of a single component.
We kept this concept in mind as we discussed designing a trial for the new AlgaeCal
calcium. Why not put ALL the clinically supported natural ingredients into one program?
Maybe if you have 100 people losing bone density, some of them are calcium deficient,
some of them just need more vitamin D, some of them are missing one or more trace
minerals, etc. We thought with a whole program of ingredients, we can help as more
people get better results, so we did exactly that.
A clinical study with hundreds of subjects was done, with several leading University doctors
monitoring the process. The results, by anyone‟s standards, are amazing!
Rather than AlgaeCal slowing down bone loss, as other calcium supplements predictably do,
it actually helped participants grow it back! Hundreds of bone density studies have been
conducted with regular calcium supplements, all resulting in reducing the losses of bone.
The scientific outcome of increased bone density among participants of both genders and all
ages from the algaecal study is a milestone.
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The AlgaeCal® Clinical Study
Based on three components suggested by the Surgeon General in his “call to action”
(increased calcium and vitamin D3, increased physical activity and increased health
education) the bone health program was undertaken by 400 subjects aged 8-80, for a six
month period. The plan was subsequently tested by examining changes in BMD.
In the study, the subjects completed a baseline DEXA screening test to determine bone
mineral density. They were supplied with a pedometer based activity program to monitor
and encourage weight bearing exercise, as recommended by the Surgeon General, as well
as a Health Literacy Notebook to increase the chance of compliance. They were also given
680 mg of strontium to consume daily, as well one of two versions of the AlgaeCal Bone
Health dietary supplement. Although all the subjects received the same strontium citrate,
pedometer to gauge exercise, and health brochure, they were unaware that different
subjects were to consume two different AlgaeCal versions.
Two versions of AlgaeCal were used (see below) to see if the formula could be improved
upon. This was decided in light of better ingredients, and new theories on vitamin and
mineral dosages emerging.
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To ensure accuracy, compliance to the product usage was measured using the participants
daily tracking forms. For each subject, compliance was rated by the research technician on
a scale of one to five. One was considered the least compliant, and five was for the
subjects who most closely followed the plan.
274 subjects took AlgaeCal-1, and 80 took AlgaeCal-2. As to be expected with all studies, a
certain number of subjects dropped out for various reasons. In this study, 125 subjects
taking AlgaeCal-1 and 51 subjects taking AlgaeCal-2 made it to the six month finish line.
In order to facilitate ease of comparing changes in BMD during studies of different periods, a
common convention is to annualize changes in BMD to one year. Thus, a two-year study
would divide the observed changes by two, and a six-month study would double the
observed changes. This annualized convention was employed when the results of
approximately six months were compiled.
A number of studies have established normal or expected changes in BMD with age. In
general, BMD increases with age until about the mid-thirties, remains constant for a few
years and then progressively declines. The expected decline for women is about 1% per
year and is about one-half a percent for men. Since the participants in this study ranged
from 18-85 and were a mixture of males and females, norms provided by the National
Osteoporosis Foundation (www.nof.org) were used to calculate the expected decline in BMD
for each person in the study, based on their age and sex, and calculated the average for all
participants.
What Happened?
The outcome far surpassed expectations. Both groups experienced greater increases in BMD
than expected, based on age-adjusted national norms. The most amazing results happened
for the most compliant subjects taking AlgaeCal-2. They experienced a 3.7% increase in
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bone density, when calculated over the year! In an industry where slowing down the
expected bone loss from 1% to ½% is considered a victory, these rates of increase are
amazing!
Another result was that the mean increase in BMD over the expected losses in subjects
taking AlgaeCal-2 was significantly greater than the mean increase BMD over expected, in
subjects taking AlgaeCal-1 by almost 100%. This result truly validates AlgaeCal‟s research
and conviction that we need more than just calcium, magnesium and conservative amounts
of vitamin D3 for general bone health.
In both groups, subjects highly compliant to the Plan significantly out-performed those not
highly compliant to the Plan, with regard to the change in BMD. This speaks for itself, but
one can never have too much evidence to give us the motivation we need to „stick with the
program‟. Thankfully there is hope for you, if you are losing bone density. Science has
proven that you can add to your bone density at any age, naturally!
References
1,The Dietary Supplement Health and Education Act of 1994)
