Dear Dr. Roach: I was diagnosed with atherosclerosis two years ago. I also had calcium in my carotid artery. I feel like a walking time bomb. When I found out, I stopped my calcium supplement completely. I didn’t even ask my doctor — he was the one who had me take them for years. Did I do the right thing? Why would a doctor put you on a calcium regimen knowing that you have this condition? Doesn’t calcium supplementation make atherosclerosis worse?
L.J.
Atherosclerosis remains the leading cause of death in industrialized societies. This disease is the progressive blockage of arteries with plaque that’s made up of cholesterol, other fatty materials and fibrin (a blood-clotting protein). Calcium is usually associated with plaque. People who do not have calcified plaque are at a lower risk for a heart attack.
There is mixed evidence about whether calcium supplements increase the risk of heart attack. Some studies seem to show a significant risk, including two large studies that suggested calcium supplements increased heart attack risk by about 25%. Other large studies did not show an increased risk. In contrast, high calcium intake from diet has consistently shown to have no harm, and sometimes shows a decrease in the risk of heart attack.
Based on the data, I recommend dietary calcium as the primary way for people to get enough calcium in their diet whenever possible. In addition to milk, cheese, yogurt from dairy, there are nondairy sources. This includes seeds; small fish with edible bones, such as sardines; legumes; leafy green vegetables; fortified drinks such as soy and nut milks; and calcium-enriched fruit juices. Most people can get adequate calcium through diet, but there are still people who cannot. And if the condition is serious (for instance, people with osteoporosis), it may call for supplemental calcium. The physician needs to consider both the benefits and potential harms, so you should certainly discuss stopping your calcium with your doctor.
Most people with blockages in large arteries, such as the carotid, aorta or coronary vessels, should be on medication to reduce heart disease risk.
Dear Dr. Roach: A friend gave me a brochure for a company that claims full-body light therapy (red and near-infrared light) has multiple physical benefits, including improvement in bone density, among other things. I am a 70-year-old female and lung transplant recipient with a history of osteoporosis. I receive semi-annual Prolia injections. I have never heard of this osteogenesis treatment, and I’m highly skeptical. What is your opinion on this?
L.K.
I reviewed the data provided by the manufacturer, which showed promising short-term results in rats and mice. I read a doctoral thesis using a cell culture model, suggesting that the mechanism of the light therapy might transmit through the same pathway as the denosumab (Prolia) injections you are taking.
However promising, these are preclinical studies. Many treatments that are promising in animal models fail in humans. Until there is solid data in human studies showing improvement in bone density or, better yet, reduction in fracture risk, I cannot recommend this expensive treatment.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
