Kern et al. reported calcium supplementation may increase the risk of dementia in elderly women with cerebrovascular disease. [1] Among the possible mechanisms that could explain this association, the authors mentioned "the steep increase in serum calcium levels caused by the supplements." [1] This statement was referenced to a previous publication, [2] which described the supplement-induced increase in serum calcium as "modest" based on the results of an earlier study in young healthy subjects. [3] A more recent study in overweight but otherwise healthy post-menopausal women administered a single dose of 500 mg elemental calcium supplement after pre-treatment with 10 micrograms 25(OH)D3 and found that the maximal increase in serum level of ionized calcium post-dosing was in the vicinity of 0.3 mg/dL (i.e. approximately only 5% of the upper limit of this ion's normal serum concentration); this change peaked 3 to 5 hours after the supplement's ingestion. [4] Such a small increase over several hours can hardly be termed "steep." The mechanism, if any, linking the increased dementia risk with calcium supplementation should probably be looked for outside the realm of calcium's pharmacokinetics.
1. Kern J, Kern S, Blennow K, et al. Calcium supplementation and risk of dementia in women with cerebrovascular disease. Neurology Epub 2016 Aug 17.
2. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691.
3. Reid IR, Schooler BA, Hannan SF, Ibbertson HK. The acute biochemical effects of four proprietary calcium preparations. Aust N Z J Med 1986;16:193-197.
4. Heaney RP, Dowell MS, Bierman J, Hale CA, Bendich A. Absorbability and cost effectiveness in calcium supplementation. J Am Coll Nutr 2001;20:239-246.
For disclosures, please contact the editorial office at journal@neurology.org.
Kern et al. reported calcium supplementation may increase the risk of dementia in elderly women with cerebrovascular disease. [1] Among the possible mechanisms that could explain this association, the authors mentioned "the steep increase in serum calcium levels caused by the supplements." [1] This statement was referenced to a previous publication, [2] which described the supplement-induced increase in serum calcium as "modest" based on the results of an earlier study in young healthy subjects. [3] A more recent study in overweight but otherwise healthy post-menopausal women administered a single dose of 500 mg elemental calcium supplement after pre-treatment with 10 micrograms 25(OH)D3 and found that the maximal increase in serum level of ionized calcium post-dosing was in the vicinity of 0.3 mg/dL (i.e. approximately only 5% of the upper limit of this ion's normal serum concentration); this change peaked 3 to 5 hours after the supplement's ingestion. [4] Such a small increase over several hours can hardly be termed "steep." The mechanism, if any, linking the increased dementia risk with calcium supplementation should probably be looked for outside the realm of calcium's pharmacokinetics.
1. Kern J, Kern S, Blennow K, et al. Calcium supplementation and risk of dementia in women with cerebrovascular disease. Neurology Epub 2016 Aug 17.
2. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691.
3. Reid IR, Schooler BA, Hannan SF, Ibbertson HK. The acute biochemical effects of four proprietary calcium preparations. Aust N Z J Med 1986;16:193-197.
4. Heaney RP, Dowell MS, Bierman J, Hale CA, Bendich A. Absorbability and cost effectiveness in calcium supplementation. J Am Coll Nutr 2001;20:239-246.
For disclosures, please contact the editorial office at journal@neurology.org.