Help me to have harder bones without harder poop.

June 30, 2013 10:38 PM

Friday my doctor informed me that I have osteoporosis and am at high risk for spinal fractures. I'm now taking the generic of Fosamax and my doctor has recommended that I supplement my daily diet with 1500 - 1800 mg of calcium and 2000 units of vitamin D3. While I'm not questioning the need for added calcium, I'm worried about the constipating effect it will have. I've tried taking calcium and vitamin supplements in the past (brand names like Centrum and Tums) but quickly gave them up because of problems with constipation.

I eat a healthy lowfat diet (lots of fruits & veggies, whole grains and water, no soda or red meat) but I still have bouts of constipation. I should mention that I have a history of colon cancer (10 years cancer free - yay me!) so I want to avoid aggravating my colon in any way - and in my mind, chronic constipation would be most aggravating.

I know YANMD but I'm hoping you might have recommendations for calcium and vitamin D supplements that won't make make it harder for me to poop.

posted by kbar1 to Health & Fitness (12 answers total)

Take Vitamin C, too. It helps you absorb other vitamins (or so I've often read) and at concentrations of 2,000 to 5,000 mg's, it will make you poop. Too much actually gives you temporary diarrhea, not harmful, but so you know to back off the dosage.

Easy peasy.
posted by jbenben at 10:52 PM on June 30, 2013 [2 favorites]

Best answer: I was diagnosed with osteoporosis four years ago and my doctor put me on Vit D 1,000 units. A year later it had only improved very slightly, so she upped my Vit D to 2,000 units a day. She did not recommend calcium, but I declined the Fosamax, so perhaps you need calcium if you take Fosamax, I don't know. The next year, on 2,000 units of D a day I was out of the osteoporosis box and into the osteopenia box and the year after that (last year) showed I've improved even more.

I'd check with your doctor again to see if you really do need the calcium, since calcium supplements can cause some problems of their own.
posted by aryma at 10:56 PM on June 30, 2013 [1 favorite]

You could take a calcium supplement with magnesium (with professional guidance, of course). Magnesium-based antacids are notable for getting things moving, for instance.
posted by Blazecock Pileon at 10:57 PM on June 30, 2013

Best answer: You should be taking calcium with magnesium just for proper absorption, as well as vitamin k. Yes, magnesium tends to promote looser stools. Also, avoid taking iron and calcium close together. They should be taken at least 30 minutes apart (preferably more than an hour) for maximum benefit.

My genetic disorder significantly impacts my gut. Other things I have done for constipation:

Consume aloe vera drinks. (I have had people complain to me about taste. Some of the brands actually taste good. If the taste is an issue, look for another brand.)
Take a salt water bath, especially with sea salt.
Stay hydrated.
Get enough healthy fats. Organic butter and coconut oil both helped me with this issue.
Eat lots of potato dishes, especially starchy ones (like potato soup, potato balls, & depends on the type of potato)
Avoid or limit rice. It tends to stop you up.
Limit yeast breads. They also can promote constipation.
Consume coconut water drinks or other coconut products. Coconut loosens stools and helps with hydration.
posted by Michele in California at 11:44 PM on June 30, 2013 [1 favorite]

Best answer: When I was choosing a calcium supplement and had similar concerns the pharmacist recommended calcium citrate (Citracal, though I use the store brand) over calcium carbonate. It means more tablets per day, but my gut tolerates it pretty well. My doctor told me to make sure I spaced out the doses as the body can only absorb so much calcium at a time.
posted by camyram at 3:57 AM on July 1, 2013

Talk to your doctor about this, especially given your history of colon cancer. I also agree with asking your doctor about adding K2, which has a positive track record with osteoporosis in epidemiological testing, and possibly A (which may balance D/K).

You need some fat to absorb fat soluble vitamins, so make sure any fat soluble supplements you take are oil-based.
posted by pie ninja at 4:07 AM on July 1, 2013 [1 favorite]

Weight-bearing activities will let your body use those supplements to build and strengthen your bones, otherwise they are just coming out the other end and backing you up.
posted by tenaciousmoon at 7:22 AM on July 1, 2013 [1 favorite]

Best answer: Magnesium taken with calcium and vitamin D can help the effectiveness of both with osteoporosis and has the side effect of making stools softer. Take the Magnesium at night as it can cause flushing of the face, and the calcium spread out during the day. Walking is also a good exercise to help build up your bones, and can help with constipation as well. Talk to your pharmacist, they will know the best forms of calcium to take to help with your situation and to bind you up the least, you may have to try a couple of brands before you find one that works.
posted by wwax at 9:36 AM on July 1, 2013

I take high doses of calcium citrate per doctor's orders (35 lifetime fractures! Hooray!) For each calcium tablet I also take one psyllium fiber pill. Does the trick for me.
posted by workerant at 9:40 AM on July 1, 2013

I too was going to recommend combining it with magnesium. It definitely makes the poops looser, and I seem to remember that Mg and Ca were supposed to be taken together.

And psyllium is a good buffer. Keeps things in the middle.
posted by gjc at 11:12 AM on July 1, 2013 [1 favorite]

In addition to seconding the resistance training and vitamin K2 recommendations above, I'd also note that grains can be counterproductive to bone and tooth health. Many of the minerals in them are not bioavailable due to antinutritional content. You might try adding in some extremely nutrient-dense whole foods like beef liver.
posted by Earl the Polliwog at 12:22 PM on July 1, 2013 [1 favorite]

Response by poster: Aryma - that is great news - I'll be thrilled if these supplements also help me to move out of the osteoporosis box.

It sounds like a Citracal type product with added magnesium are what I need to build my bones and keep things moving.

Thanks for the recommendations!
posted by kbar1 at 11:08 PM on July 1, 2013 [1 favorite]