Excess calcium during pregnancy-Calcium Needs During Pregnancy

Stronger bones, better teeth -- your parents probably gave you plenty of reasons to drink up. But now that you're a parent yourself, it may have been a while since you drank the white stuff beyond maybe dumping some in your coffee. Here's what you need to know. A pregnant woman's need for calcium goes up in the third trimester, when the baby's skeleton is rapidly developing. It helps your baby grow and fortifies your breast milk.

Excess calcium during pregnancy

Excess calcium during pregnancy

Relationship of estrogen and pregnancy to calcium homeostasis in pseudohypoparathyroidism. Oral phosphates or phosphate enema are modestly effective in reducing calcium levels. In addition, it may minimize the absorption of biphosphonates that treat durnig, the fluoroquinolone and tetracycline classes of antibiotics, levothyroxines that treat hypothyroidism, Excess calcium during pregnancy anticonvulsant phenytoin, and pregnajcy disodium that treats Paget's disease. Further, protein energy malnutrition calcium and vitamin D deficiency are commonly encountered in this age group [ 18 ]. Khovidhunkit W, Epstein S.

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An overdose of calcium supplements may make certain medical conditions worse, such as diarrhea, Excess calcium during pregnancy problems, heart conditions and kidney disease. Calcium can be naturally consumed through yogurt, sardines, cheese and even tofu. After that, checkups every year or every other Excess calcium during pregnancy are fine. Read Rhonda lee female bodybuilder porn next. Complications are possible as a result of both too little and too much Excess calcium during pregnancy. Dried Fruit. Show sources Gynecologists. Summary Dairy products, especially yogurt, are a great choice for pregnant women. Two servings fulfill your calcium needs for a full day. Lisa Watson. As an estimate, you suring be drinking about 34—68 ounces 1—2 liters each day. Stronger bones, better teeth -- your parents probably gave you plenty of reasons to drink up. These include fiber, vitamin C, caalcium K, vitamin A, calcium, iron, folate and potassium. The first few weeks after labor require lots of extra TLC, and this self-care package of products will ensure new moms are getting what they really….

Significant transplacental calcium transfer occurs during pregnancy, especially during the last trimester, to meet the demands of the rapidly mineralizing fetal skeleton.

  • Needs vary by age and too much and too little calcium can cause complications.
  • When you're pregnant, your developing baby needs calcium to build strong bones and teeth.
  • During this time, your body needs additional nutrients, vitamins and minerals 1.

Maternal and newborn health and nutrition status are the significant indicators of the burden of any disease. Calcium in extracellular fluid maintains its physiologic equilibrium is in three forms namely ionic, protein bound and complexed.

During the course of pregnancy, a remarkable series of physiologic changes occur, aimed at preserving maternal homeostasis while at the same time providing for fetal growth and development. These changes which have direct implications on calcium metabolism include falling albumin level, expansion of extracellular fluid volume, increase in renal function and placental calcium transfer. Calcium homeostasis is a complex process involving calcium and three calcitropic hormones—parathyroid hormone, calcitonin and 1,dihydroxyvitamin D 3 1, 25 OH 2D.

Total serum concentrations fall during pregnancy due to hemodilution. This fall mainly occurs in albumin bound fraction of the total calcium and due to fall in serum albumin. Ionized calcium levels do not differ from that in non-pregnant women. However, constant blood levels of calcium are maintained by homeostatic control mechanism. Calcium homeostatic response during pregnancy includes increase in intestinal calcium absorption, increase in urinary excretion of calcium and increase bone turnover.

The bulk of fetal skeletal growth takes place from midpregnancy onward, with maximal calcium accretion occurring during the third trimester. The increase in calcium absorption is directly related to maternal calcium intake.

Ritchie et al. The mechanism of calcium absorption involves binding of calcium to a specific protein calcium-binding protein whose synthesis is stimulated by active forms of vitamin D 1,dihydroxyvitamin D. Maternal serum 1, 25 OH 2D levels increase twofold during pregnancy, allowing the intestinal absorption of calcium also to double.

Serum hydroxy vitamin D inactive form of vitamin D levels do not change during pregnancy, but an increase in 1-a-hydroxylase and additional synthesis in the placenta allows for an increase in the conversion of hydroxy vitamin D to 1, 25 OH 2D [ 3 ].

Other calcitropic hormones affecting maternal calcium metabolism is parathyroid hormone PTH. During the first trimester, parathyroid hormone PTH levels in women consuming adequate amounts of calcium decrease to low-normal levels and then increase to the higher end of normal in the third trimester, reflecting the increase in calcium transfer from mother to fetus. Although PTH levels typically do not increase above normal during pregnancy, levels of a prohormone, parathyroid hormone receptor protein PTHrP do increase in maternal circulation.

This prohormone is produced by mammary and fetal tissues to stimulate placental calcium transport to the fetus. PTHrP may also protect the maternal skeleton from bone resorption by increasing both calcium absorption in the small intestine and tubular resorption in the kidney.

Thus, the principal maternal adjustment during pregnancy is increasing parathyroid hormone and PTHrP secretion which maintains the serum ionic calcium level within its characteristically narrow physiologic range in the face of extracellular fluid volume expansion, renal function increase and placental calcium transfer. Maternal calcitonin levels have been reported to be increased in early pregnancy.

Physiological hypercalciuria occurs during pregnancy as a result of increased maternal calcium absorption. Interestingly, urinary calcium is within normal limits during fasting but increases postprandially, indicating that elevated excretion is related to the increase in calcium absorption.

Although urinary calcium excretion increases during pregnancy, the increase in intestinal calcium absorption is not ameliorated, and net maternal calcium retention is positive [ 3 , 4 ]. The cardinal feature of calcium metabolism in the fetus is the active placental transport of large quantities of calcium, whereas PTH and calcitonin do not cross the placenta.

The resultant fetal hypercalcemia suppresses the fetal parathyroid and stimulates fetal calcitonin release. Calcium supplementation in pregnancy has the potential to reduce adverse gestational outcomes, in particular by decreasing the risk of developing hypertensive disorders during pregnancy, which are associated with a significant number of maternal deaths and considerable risk of preterm birth, the leading cause of early neonatal and infant mortality.

An inverse relationship between calcium intake and hypertensive disorders of pregnancy was first described in [ 5 ]. This was based on the observation that Mayan Indians in Guatemala, who traditionally soak their corn in lime before cooking, had a high calcium intake and a low incidence of preeclampsia and eclampsia.

A very low prevalence of preeclampsia had been reported from Ethiopia where the diet contains high levels of calcium [ 6 ]. This group of women had a low mean baseline calcium intake A Cochrane review of 13 trials involving 15, pregnant women reported that the average risk of preeclampsia was reduced in those receiving calcium supplements compared to placebo [relative risk RR 0.

Imdad et al. There was no effect on incidence of eclampsia RR 0. These physiological changes can lead to the development of preeclampsia. WHO recommends an intake of 1. Target group includes all pregnant women, particularly those at higher risk of gestational hypertension and in areas with low calcium intake [ 10 ].

In our study, biochemical markers of bone turnover are found to be greater in preeclampsia compared with normal pregnancy [ 11 ]. This may be due to the multisystem involvement of the disease that occurs in response to circulating factors released during the development of preeclampsia. Increased levels of proinflammatory cytokines and occurrence of endothelial dysfunction in preeclampsia have been implicated in stimulating osteoclast activity and hence increased bone resorption.

This further necessitates the supplementation of elemental calcium during pregnancies complicated with preeclampsia, for preservation of maternal skeleton. Calcium supplementation has shown effectiveness in reducing the risk of preterm delivery in women with low calcium intakes.

A possible mode of action of calcium is that it reduces parathyroid release and intracellular calcium and so reduces smooth muscle contractility. By this mechanism, calcium supplementation reduces uterine smooth muscle contractility and prevents preterm labor and delivery. A study done on North Indian primigravidas with low mean daily calcium intake showed a significant reduction in risk of preterm births following calcium supplementation in pregnancy.

A review of 11 randomized trials by Imdad et al. However, the latest Cochrane review reports that there are no clear additional benefits to calcium supplementation in prevention of preterm birth [ 12 ]. Abalos et al. The first-line agent used in the prevention and treatment of PPH is oxytocin, which acts by binding with the oxytocin receptor found on myometrial cells to cause uterine contraction. It does this by increasing levels of calcium within the myometrial cell, which promotes contraction.

Following prolonged exposure to oxytocin, there is desensitization of the myometrium resulting in a significant reduction in contractility upon delivery of further oxytocin.

Calcium is an important messenger required within the uterine muscle cell to result in muscle contraction following administration of oxytocin. A physiological level of calcium is known to provide optimal contractility to normal myometrium. Characterization of low, normal or high calcium levels in a setting of prolonged exogenous oxytocin administration may provide guidance for the use of exogenous calcium as a uterotonic adjunct. In a study done on 36 women, Talati et al. Changes in skeletal calcium content have been assessed through the use of sequential bone density studies during pregnancy.

Due to concerns about fetal radiation exposure, few such studies have been done. Such studies are confounded by the changes in body composition and weight during normal pregnancy, which can lead to artifactual changes in the bone density reading obtained. Three recent studies have used dual-energy X-ray absorptiometry DXA before conception and after delivery to assess bone mineral density.

In two of the studies, maternal lumbar spine bone density had dropped 4. Significant transplacental calcium transfer occurs during pregnancy, especially during the last trimester, to meet the demands of the rapidly mineralizing fetal skeleton.

Similarly, there is an obligate loss of calcium in the breast milk during lactation. Both these result in considerable stress on the bone mineral homeostasis in the mother.

In India, a significant proportion of pregnancies occur in the early twenties when peak bone mass is not yet achieved [ 17 , 18 ]. Further, protein energy malnutrition calcium and vitamin D deficiency are commonly encountered in this age group [ 18 ]. Poor prepregnancy bone mineral density, low calcium and vitamin D intake during pregnancy and poor socioeconomic status puts these women on increased risk of low bone mass and later developing osteoporosis.

Interpreting the effect of maternal calcium intake during pregnancy on infant bone density measured during the postpartum period is challenging.

In a clinical trial conducted by Koo et al. Dual-energy X-ray absorptiometry measurements of the whole body and lumbar spine of the neonates were performed within the first week of life. The total body bone mineral content was significantly greater in infants born to calcium-supplemented mothers Diets were typically cereal based with a very low intake of protective foods such as milk and milk products, flesh foods, fish, fruits and vegetables.

Animal sources of protein were consumed irregularly [ 18 ]. If diet does not provide enough calcium, then body steals it from the bones.

Dietary calcium intake has a negative correlation with bone resorption markers. High calcium intake is associated with improved calcium balance, perhaps providing a protective effect against bone loss during pregnancy.

Zeni et al. This increase in calcium absorption decreased markers of bone resorption. This suggests that an increase in 1,25 OH 2D may allow the maternal skeleton to store calcium in advance of peak fetal demands later in pregnancy. However, no relationship was reported between the daily intake of calcium and the occurrence of hypocalcaemia, attributing the same to faulty dietary habits and vitamin D deficiency [ 22 ].

The part of the dietary calcium coming from plant sources is known to have low bioavailability. Also, the inhibitors of calcium absorption such as phytates and oxalates are abundant in the vegetarian diet and retard the absorption of dietary calcium.

Oxalates form insoluble salts with dietary calcium, which are eventually excreted in the feces [ 23 ]. Women with severe deficiency of vitamin D had low mean serum calcium levels of 7. Thus, in a population with widespread prevalence of vitamin D deficiency with low dietary calcium intake, the problem is likely to worsen during pregnancy because of the active transplacental transport of calcium to the developing fetus.

Women with lactose intolerance need careful assessment of their calcium intake because they tend to drink little milk and to have relatively low calcium intakes [ 25 ]. Women should also get adequate sunlight exposure and increase their intake of vitamin D supplements. We have also reported that various demographic factors like socioeconomic status and educational status affect calcium intake.

With improved educational level and per capita income, they have better living conditions and better nutritional intake [ 26 ] and better bone mineral density [ 18 ]. Hypercalcemia is rarely encountered in pregnancy.

The commonest cause of hypercalcemia in pregnancy is hyperparathyroidism. Adverse fetal outcomes include increased rate of abortions, severe intrauterine growth retardation and still birth.

PTH levels are low to mid-normal in pregnancy and higher than normal values in the background of high calcium may point to the diagnosis of primary hyperparathyroidism [ 17 ].

As a result of the hypercalciuria that occurs naturally during pregnancy, pregnant women are at an increased risk for developing kidney stones [ 3 ]. The mineral demands of the growing fetus are largely met by increased intestinal calcium absorption. The daily calcium intake of pregnant women has been reported to be low. Calcium supplementation during pregnancy for women with deficient dietary calcium intake offers modest benefit in terms of preventing preeclampsia and preterm births and improving maternal and infant bone health.

He has a special interest in maternal health and has published research papers on thyroid hormonal changes during pregnancy, calcium supplementation during pregnancy for preventing hypertensive disorders included in a Cochrane review, , hepatitis E reviewed in Obstetrics and Gynecology Survey and C during pregnancy, latent celiac disease in reproductive performance, dydrogesterone in recurrent pregnancy loss included in the European Progestin Club guidelines, and preeclampsia.

Vincent University. Lisa Watson Dr. Avocados are an unusual fruit because they contain a lot of monounsaturated fatty acids. Eating foods that are rich in vitamin C, such as oranges or bell peppers, may also help increase absorption of iron from meals. Maintaining a healthy diet during pregnancy is very important. It also contributes to healthy skin and hair, and boosts your immunity.

Excess calcium during pregnancy

Excess calcium during pregnancy

Excess calcium during pregnancy

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Needs vary by age and too much and too little calcium can cause complications. The American College of Obstetricians and Gynecologists ACOG recommends that pregnant and breastfeeding moms age 19 and over consume mg of calcium each day. They need enough to maintain their bones and the stores of calcium in their own bodies while supporting the growth of their baby. Therefore, experts recommend that pregnant teens age 18 and under get at least mg of calcium each day. Calcium is an important nutrient for the body.

Your developing baby needs calcium to form bones and teeth. They're building an entire skeleton, after all. Calcium is also an important nutrient for your baby's heart, muscles, nerves, and hormones. If you don't get enough, you could run into some complications.

Regardless of whether or not you take in enough, your body will still give calcium to your baby. So, if you are not replacing what you're giving away, you could end up with weakened bones and a greater risk of osteoporosis later in life.

Complications are possible as a result of both too little and too much calcium. Luckily, they're easily preventable. In severe and rare cases, too little calcium could lead to death. While, understandably, many of these complications are a cause for worry, remember that you are likely to get some calcium without even trying, and you should have enough stored in your bones to give to your child.

It is rare to get too much calcium from the foods that you eat. You may be getting extra without even knowing it. Your body does not make calcium, so you have to get it from food, fortified products, or supplements.

Four servings of fortified milk or other fortified dairy products will fulfill your daily calcium requirement by giving you about mg approximately mg per serving. A glass of fortified orange juice has the same amount at about mg per serving. Other foods such as greens, nuts, and beans have a little less about mg per serving.

Make sure the dairy products you eat are pasteurized and talk to your doctor about the type of milk and dairy products that are best. Low-fat and non-fat milk contains all the calcium and nutrients of whole milk without the extra fat and calories. Vegetarian and vegan diets are often very healthy. There are different types of vegetarian diets. How much calcium you get and how much of it you absorb depends on what you eat.

If you follow a lacto-ova vegetarian diet, you can have eggs, milk, and cheese. So, on this plan, you should be able to get enough calcium each day.

On a vegan diet, you do not consume any milk or dairy products. Plus, some plants interfere with how well your body absorbs calcium. It just means you have to know the right foods to choose from. If you are having trouble getting the calcium you need through your diet alone, you should talk to your doctor about a vegetarian or vegan calcium supplement. You can also enjoy vegan-friendly sources of calcium. You may need to take a supplement. Prenatal vitamins, along with other vitamin and mineral supplements that your doctor recommends, are a great way to fill in any nutrition gaps.

Be sure to talk to your doctor before starting anything on your own. Let your doctor know if you are already taking an over-the-counter prenatal vitamin, calcium supplement, or antacid. Your doctor will advise you about the safest supplements or provide you with a prescription for what you need. Outside of the potential complications caused by too much calcium, in general, taking calcium supplements may cause you to experience gas, bloating, and constipation.

If you do have these side effects, it may be worth trying a different brand, tweaking your diet to reduce gas-causing foods, or finding methods that can ease these side effects. Vitamin D is an essential vitamin for many reasons. One of the things that it does is help your body absorb calcium.

Vitamin D and calcium work hand-in-hand to promote strong bones. During pregnancy, experts recommend that you get IU of vitamin D each day. Your body uses sunlight to make vitamin D naturally. But, you can also get vitamin D from some foods or a supplement. An increase in urination can cause some calcium to leave your body through the urine. However, if you drink a lot of coffee, tea, and soda, then it can affect the amount of calcium in your body.

Not only does it cause you to lose calcium through the urine, but these drinks can take the place of other calcium-rich beverages such as milk or fortified orange juice that you could be drinking instead. Do your best to be mindful of the types of liquids you're consuming. A balanced diet will keep you healthy during your pregnancy, provide your baby with what she needs to grow and develop, give you strength and energy for childbirth , and encourage successful milk production once your child is born.

When you see a doctor at your prenatal appointments, talk about your diet and your concerns. Your doctor can advise you on the best way to meet your daily needs. Get expert tips to help your kids stay healthy and happy. Dietary reference intakes for calcium and vitamin D. National Academies Press; Apr Fong J, Khan A. Hypocalcemia: updates in diagnosis and management for primary care. Canadian family physician. Nutrition as prevention and treatment of osteoporosis.

Physiol Res. Demographic, dietary, and urinary factors and h urinary calcium excretion. Clinical Journal of the American Society of Nephrology. World Health Organization.

Guideline: calcium supplementation in pregnant women. World Health Organization; Daily Requirements. Vegetarian and Vegan Diets. Lactose Intolerance. View All. Calcium needs vary by age. For Your Baby. Too Little Calcium. Too little calcium can lead to:. High blood pressure during pregnancy Premature birth Low birth weight Numbness and tingling in the fingers Slow growth of the baby The baby not getting enough calcium in the bones Heart problems Muscle and leg cramps A poor appetite Higher risk of breaking bones later in life.

Too Much Calcium. Too much calcium can cause:. Dairy products that are a great source of calcium include:. Other foods rich in calcium include:. Calcium-fortified products include:. Supplements with calcium include:. Prenatal vitamins Calcium citrate Calcium carbonate. Here are a few easy options to help you get what you need. Have cereal in the morning. Enjoying a bowl of cold cereal and milk or even hot cereal or oatmeal made with milk is a great way to start the day. Make it a latte. Add a little extra milk into your morning coffee or tea.

Top it with cheese. Add a little bit of cheese to your salads, soups, and other dishes. Make it creamy. Add some milk or evaporated milk to your recipes and make creamy soups, sauces, casseroles, mashed potatoes, mac and cheese, and other delicious dishes. Substitute some dairy in your cooking. Use milk instead of water to cook noodles, pasta, rice, oatmeal, or other foods.

Change your regular order. Have a glass of milk or chocolate milk with lunch or dinner instead of a soda or another beverage. In colder weather, enjoy a hot chocolate made with milk instead of water. Add it as a snack. Have a treat. Enjoy a bowl of ice cream or frozen yogurt, an ice cream shake, yogurt and fruit smoothie, or some pudding for dessert.

Excess calcium during pregnancy