Osteoporosis and coronary calcium

Several studies over the years have demonstrated a curious paradox:

People with more osteoporosis (thin bones) tend to be more likely to have coronary disease (heart attacks). They also tend to have higher heart scan scores (more coronary calcification as an index of atherosclerotic plaque).

People with more coronary disease and higher heart scan scores tend to have more osteoporosis.



In other words, regardless of which way you tackle the question--osteoporosis first or heart disease first--it leads to the same conclusion: Both conditions are somehow related.

I realize I harp an awful lot on this whole vitamin D issue. But, even after correcting the vitamin D blood levels of many hundreds of people, I remain enthusiastic as ever about the untapped potential of this fascinating factor.

So I couldn't resist showing this amazing comparison of how the long-term effect can be quite graphic.

The first scan is from a 46-year old man and shows normal coronary arteries without calcium and normal density of the vertebra (a common and reliable place to measure bone density).

























The second image is from a 79-year old man with both severe coronary calcification (and therefore severe coronary disease) and severe osteoporosis.
























It makes you wonder if the disordered metabolism of calcium through vitamin D deficiency allows transport of calcium away from bone and into coronaries. This has, however, been shown to not be the case. Instead, they are separate processes, each under local control, but sharing a common pathophysiology (causative factors).

An intriguing question: Would the 79-year old still look like the 46-year old had he begun increasing his vitamin D intake at, say, age 30?

Comments (9) -

  • Anne

    3/4/2008 10:50:00 AM |

    Dear Dr Davis,

    Just this weekend I found this article on the web from a research scientist about vascular calcification and "osteoblast phenotype": http://www.medicine.manchester.ac.uk/postgraduate/research/studentships/nonfunded/yalexander2

    I contacted her and she told me that "resorption of bone in the skeleton co-exists with the deposition of bone in the vasculature" and sent me a diagram explaining it. She also told me that the medication I take for osteoporosis, Strontium Ranelate, which stimulates formation of osteoblasts and prevents resorption by osteoclasts, would help with vascular calcification.

    That photo of the man's osteoporosis is scary. Here's a link to one of the scans in the CT angiogram I had and now I can see the degeneration in my spine :-( And even in my sternum :-( I have been diagnosed with osteoporosis and I'm only 54 :-(

    http://i228.photobucket.com/albums/ee253/clermont_photo/ln019.jpg

    I have no calcification in my coronary arteries but there is some on my bicuspid aortic valve...I don't think you can't see it because of all that contrast media.

    Anne

  • Anonymous

    3/4/2008 1:29:00 PM |

    Perhaps it is Vitamin K (particularly K2) that is playing the role of 'traffic cop' for calcium, directing it TO bone while diverting it FROM arteries.

  • Olga

    3/4/2008 4:50:00 PM |

    Hi Dr. Davis:

    This comment is about an unrelated subject.  A well intentioned friend who is worried about my low carb life style sent me this article from the Canadian Broadcasting Corp. (CBC) website:

    http://www.cbc.ca/health/story/2008/03/03/heartdisease-study.html

    The article states that "Low-fat beats low-carb in diets to reduce heart disease" as if it were a done deal.
    I was wondering what is the relevance of reduced blood flow in the arms with respect to heart disease, and if this is the only parameter they measured, as they don't supply a link to the research article.  I find it hard to believe it holds as much weight as the huge drop in triglycerides and reduction of small dense LDL particles associated with low carb vs. high carb diets.  Just curious if you had seen this article.  

    Olga

  • mike V

    3/6/2008 4:05:00 AM |

    Re: Earlier post on Vitamin K


    See: "Vitamin K - Keeping Calcium in Your Bones and Out of Your Blood Vessels"

    http://blogs.webmd.com/integrative-medicine-wellness/2007/11/vitamin-k-keeping-calcium-in-your-bones.html
      
    From: WebMD
    MikeV

  • Stephan

    3/6/2008 8:53:00 PM |

    Hi Olga,

      I just reviewed this article on my blog.  It clearly shows LC is healthier than LF, but their interpretation of the data is WAY off base.  And interestingly, I have access to the full-length article so I saw some of the other things they measured.  Even though vascular reactivity went down in LC, vascular diameter went up.  So maybe it was just dilating less because it was already more dilated than in the LF group.

    Whole Health Source blog

  • Stan

    3/8/2008 2:54:00 AM |

    I noticed on various webmd and other fora that quite a number of long term vegetarians in their 50-ties and 60-ties seem to report osteoporosis (and coronary disease).  Q for Dr. Davis:

    - did you look at the dietary  connection among your patients, between being long term vegetarian and having higher or lower chance of osteoporosis than non-vegetarians?
    ,
    Stan (Heretic)

  • mike V

    3/10/2008 2:43:00 PM |

    stan
    It doesn't exactly answer your question, but did you read Dr D's post:

    "Should you become a vegetarian?"
    (Saturday, February 24, 2007")
    mikeV

  • buy jeans

    11/3/2010 2:39:23 PM |

    I realize I harp an awful lot on this whole vitamin D issue. But, even after correcting the vitamin D blood levels of many hundreds of people, I remain enthusiastic as ever about the untapped potential of this fascinating factor.

  • sinus surgery Los Angeles

    12/21/2010 3:27:01 PM |

    It is often said that the intake of milk ensures inflow of calcium into the body.But I have noticed that even those consuming milk in heavy doses do suffer from this problem...could you explain as to what could be the other reasons to it?

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Life Extension article on iodine

Life Extension article on iodine

Here's a link to my recent article in Life Extension Magazine on iodine:

Halt on Salt Sparks Iodine Deficiency

Iodized salt, a concept introduced into the U.S. by the FDA in 1924, slowly eliminated goiter (enlarged thyroid glands), along with an enormous amount of thyroid disease, heart attack, mental impairment, and death. The simple addition of iodine to salt ensured that salt-using Americans obtained enough iodine sufficient to not have a goiter.

Now that the FDA, goiters long forgotten from their memories, urges Americans to reduce salt, what has happened to our iodine?

I talk at length about this issue in the Life Extension article.

Comments (25) -

  • Michael

    11/17/2009 1:08:06 PM |

    The link provided is based on the Life Extension search tool and seems broken.  This link works Halt on Salt, Oct 2009.

  • Terry H

    11/17/2009 1:20:13 PM |

    Dr D,

    The link does not work for me. Sends me to a www page that appears unrelated to your post and certainly not the the article you recommend.

  • Jim Purdy

    11/17/2009 1:22:21 PM |

    I don't think that link goes to the magazine article. It seems to go to a product advertisement instead. Did I do something wrong?

  • Daniel

    11/17/2009 3:28:09 PM |

    LE must have changed the link - it sends me to a page where I can purchase pure IGF, which, by the way, I'm surprised people want to take.

  • Anonymous

    11/17/2009 3:29:06 PM |

    I think you want this link

    http://www.lef.org/magazine/mag2009/oct2009_Halt-on-Salt-Sparks-Iodine-Deficiency_01.htm

  • ciphen

    11/17/2009 4:06:49 PM |

    The link you posted doesn't go to your article. Might want to update that.

    Question: what is the best way to test for Iodine levels? I've been taking 400mg kelp iodine for a while, and want to make sure I'm not overdoing it (I'm 28).

  • Sara

    11/17/2009 4:15:05 PM |

    Dr. Davis,

    Clicking the link in the article takes me to the page to buy iodine supplements, not the article itself; I had to search to find the actual article. I think it's because you're linking to search results, and when someone else puts in the same URL without having given it the same inputs, it hiccups. This link should be to the actual article: http://www.lef.org/magazine/mag2009/oct2009_Halt-on-Salt-Sparks-Iodine-Deficiency_01.htm

  • Anonymous

    11/17/2009 4:31:03 PM |

    http://www.lef.org/magazine/mag2009/oct2009_Halt-on-Salt-Sparks-Iodine-Deficiency_01.htm

  • Anonymous

    11/17/2009 4:49:33 PM |

    The article appears to be at this link:

    http://www.lef.org/magazine/mag2009/oct2009_Halt-on-Salt-Sparks-Iodine-Deficiency_01.htm

    Tom

  • Catherine

    11/17/2009 5:59:27 PM |

    Dr. Davis,
    Great article on Iodine (had to use LEF search to get it--link doesn't work).
    I am the perfect example of the healthy-diet person who developed thyroid disease and fibrocystic breasts due to salt and dairy food avoidance.
    I also have that abnormal reaction to iodine now. Iodine causes a hashi flare-up, and as you've stated I have become hyper-sensitive to it now.  But you also stated that in your experience it is a "temporary" reaction which makes me want to try it again--maybe more slowly, very low doses at first?
    Any tips from your experience with this hyper-sensitivity?
    Thanks for addressing this iodine problem with thyroid---many thyroid books and articles say if you have Hashimoto's to just avoid iodine completely so as not to create a flare-up, but that is not healthy for the rest of the body either.
    Warm regards,  
    Catherine

  • jack

    11/17/2009 6:03:53 PM |

    Hi -

    The link to the LEF article pulls up an
    ad for one of their Human Growth Factor
    pills.

    Punching Iodine into their search engine
    did'nt find it - Perhaps I missed it...

  • Jack

    11/17/2009 6:08:15 PM |

    Here it is...

    http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=1490&query=iodine%20deficiency%20salt&hiword=DEFICIENCIES%20DEFICIENCYIN%20DEFICIENCYIS%20DEFICIENCYS%20DEFICIENT%20IODINATION%20IODINES%20SALTED%20SALTER%20SALTI%20SALTIN%20SALTING%20SALTMAN%20SALTO%20SALTS%20SALTY%20deficiency%20iodine%20salt%20

  • Anonymous

    11/17/2009 6:40:31 PM |

    It is rather interesting for me to read that post. Thanx for it. I like such themes and anything connected to them. I would like to read a bit more soon.

  • Anonymous

    11/17/2009 7:01:46 PM |

    Good point. I'll make sure to eat spoonfuls of salt Wink But seriously, very important point and people should take their supplements.

    Off-topic: Can you share your thoughts on the virtually zero-fat diet described in the book by Dr. Esselstyn. Thanks.

  • Kevin

    11/17/2009 10:54:45 PM |

    My blood pressure is lower than the average so I ingest a lot of iodized salt.  Also I run a lot of marathons during the summer.  When I need more salt during races I can pour it in my mouth.  If I'm low on sodium it tastes great.  If I'm not in need of salt it just about makes vomit.  

    kevin

  • Dr. William Davis

    11/17/2009 11:14:48 PM |

    Thanks, all, for noting the broken link. I'm not sure what happened.

    It should be corrected.

  • Electronic Medical Records

    11/18/2009 2:58:10 AM |

    I completely agree to the post.Sea salt or rock salt is very good for health but definitely in measures.

  • Future Primitive

    11/18/2009 6:15:12 AM |

    I'm trying to understand what an appropriate dose is.  It seems like iodine dosage in relation to TSH follows a "U" shaped response, where too little iodine results in high TSH and too much iodine can likewise result in high TSH.  There's evidently a sweet spot, BUT it also seems to depend very much on whatever the thyroid is adapted to in terms of the ambient, dietary iodine intake prior to the beginning of supplementation.  That is, a mid-Westerner with a chronically low iodine intake is going to respond quite differently to a 1000 mcg iodine dose than, say, a person who grew up on the Northern coast of Japan... On an immediately related topic, I'm curious to know more about the apparent adaptive down-regulation of T3 in response to caloric restriction and likewise (similarly, it would seem), carbohydrate restriction.  Any thoughts?

  • Runner2009

    11/18/2009 5:42:23 PM |

    Dr Davis:

    My question is on a bit of a tangent to this topic, but on the related issue of what seems to be a situation where maintaining what was considered a "healthy" level now is possibly dangerous:

    "Low triglycerides are risk factor for hemorrhagic stroke"

    http://www.lipidsonline.org/news/article.cfm?aid=8578

    Do you have any insight into this study ? I have been diligently keeping my lipid levels in check .I lowered my triglycerides from a fairly low level of 75mg/dL down to 50 mg/dL. Now I am concerned. (My LDL is 95 mg/dL and HDL is 64 mg/dL). I don't take any drugs , just lots of exercise and diet (Krill oil, almonds, Beta Glucan fiber)

    Thanks

    Thanks

  • Runner2009

    11/18/2009 5:44:22 PM |

    Sorry, forgot the link:

    http://www.lipidsonline.org/news/article.cfm?aid=8578

  • Dr. William Davis

    11/18/2009 10:55:25 PM |

    Hi, Future--

    That is the frustration with iodine: insufficient data on what represents an ideal level of intake. And it may vary from region to region, individual to individual.

    The T3 issue is indeed fascinating, a topic that will be explored more fully in the blog and in the Track Your Plaque website.

  • Dr. William Davis

    11/18/2009 11:18:27 PM |

    Hi, Runner--

    I'm skeptical that this is an important effect that warrants action.

    Primitive cultures typically have triglycerides in very low ranges, since they avoid processed foods. I'd be shocked if achieving physiologic normal levels is the sole explanation behind increased stroke.

  • Anonymous

    12/12/2009 1:29:24 AM |

    mm... good  post

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