Does what I eat affect my calcium level?
Yes. Food containing calcium does affect your level in the same way as a calcium tablet but is easier on your kidneys. Alfacalcidol, vitamin D3 and magnesium all work together to help your body to absorb calcium from your diet.
Is diet important in hypopara?
Yes, food really matters in hypopara. Along with taking your medication properly, eating regular meals with a good calcium content is the best thing you can do to help keep your calcium levels stable.. Food is a tool you can use to manage your levels better. Read more about calcium in your diet here. Eating good fresh food, avoiding processed food and keeping hydrated can make a real difference to how you feel.
How much calcium do I need?
Your daily calcium intake is made up from the food you eat and any calcium supplements you take each day. The total needs to be kept at around 1200mg – 2000mg a day maximum. This is important to help prevent kidney problems.
Should I take my medication with food?
Calcium carbonate supplements should always be taken with food. Calcium is also better absorbed if taken with vitamin C and some protein.
Should I eat regular meals?
Regular meals with a good calcium content can help to keep levels stable. If you skip meals or leave long gaps between meals your calcium levels may fall. Conversely, if you binge on cheese don’t be surprised when your levels rise.
Which foods contain calcium?
Dairy foods are high in calcium so useful in an emergency (especially plain yoghurt) but too much dairy isn’t good for your kidneys. Luckily, there are lots of other foods that contain calcium – a handful of almonds, a helping of kale or a tin of sardines are all high in calcium. You can boost your calcium level quite quickly if you need to with a glass of milk or some yoghurt. Dairy free versions with added calcium work too.
Here’s a list of foods that contain calcium:
This is a useful list of food containing calcium from the Great Western Hospitals NHS Foundation Trust which you can download and print off.
The Association of UK Dieticians provides a good calcium food list and advice here .
Does water contain calcium?
Yes. If you drink bottled water check the label – the calcium content can vary considerably. You can also call your water supplier to check the calcium content of your tap water.
Keeping hydrated is really important. Feeling thirsty is a sign that you are already dehydrated and this makes your calcium level rise. Around 8 glasses of water a day keeps you hydrated and your calcium more stable.
Are there any foods I should avoid?
Salty foods, alcohol, and to a lesser degree, caffeine and fizzy drinks can affect calcium absorption. Foods containing oxalates and phytates are best eaten away from food containing calcium as they will affect how much calcium you absorb. For example, spinach will reduce the bioavailability of cheese if eaten at the same meal. There are also other factors which can reduce or improve calcium absorption. Find out about all this in more detail here
What’s in a glass of milk?
Quite a lot, surprisingly. A 200ml glass of milk contains 250mg calcium. That’s over a third of a calcium tablet. Milk also contains phosphorous, potassium, iodine, B2, B12 and is 3.3% protein.
Because of the protein, calcium is absorbed much more effectively so milk can be quite useful in an emergency when you need a quick boost, as can plain yoghurt.
To achieve the same amount of calcium as from a 200ml glass of milk taking into account the calcium that is actually available for the body to use, we would have to consume 4 servings of broccoli or 63 brussels sprouts!’ (Dairy Council )
The body needs a small amount of protein every day. However, because the protein in dairy foods is high in fat and because failing kidneys struggle to filter protein dairy foods are best used in moderation or when quick calcium boosts are needed.
In your daily diet there are plenty of alternatives. See the chart below. Plant based milks are a good alternative. Almond milk, for example, contains just as much calcium and vitamin D as cow’s milk but about 1/4 of the protein. Most plant based milks and yoghurts (except for organic versions) contain added calcium and so do some probiotic drinks.
Do I need to be on a low phosphate diet?
If your phosphate levels are OK you only need to monitor them but mostly, in hypoparathyroidism, phosphate levels are high because of the lack of parathyroid hormone.
Because high phosphate levels (hyperphosphataemia) are part of our condition, you should try to cut down your intake but be aware of that following a strict low phosphate diet is not recommended unless you are advised to by your renal team.
However, phosphate is toxic. High levels can cause kidney and bone disease, calcifications, damage to blood vessels and it can make you very itchy too so a useful guide is this:
- Don’t try to cut out phosphate entirely but keep an eye on how much you eat at any one time. A large load of phosphate at a meal gets dumped on your kidneys causing strain. Smaller meals are better for your kidneys.
- If you do eat a large, phosphate heavy meal (dairy or meaty) you should take a calcium tablet with your food. (Calcium tablets should always be taken with food anyway.) This will help to bind the phosphate. Be careful you don’t bump up your calcium too high.
- If your phosphate level is not high you probably don’t need to take calcium tablets. Getting your calcium through food is better for your kidneys. Eating smaller meals without a heavy phosphate load will help to keep levels down.
Read more about Diet in Hypoparathyroidism Part 2 : Phosphate here
I have CKD, what should I do?
Read the article above. If you do need to change your diet, and have been advised to do so by your renal team, this helpful leaflet on diet in Chronic Kidney Disease by the Edinburgh Renal Unit here advises moderation.
Here are two food lists from NHS Hospital Trusts, also intended for renal patients, explaining how to lower or control phosphate levels by using alternative foods. Remember, that as a hypopara patient you need to watch your dairy intake!
Norfolk & Norwich University Hospitals NHS Trust
Basildon & Thurrock University Hospitals NHS Trust