Calcium Against Syndrome X Diseases & More
"Of course, all of these diseases may have many
causes, but they also all have one thing in common - calcium
deficiency." - Robert Heaney, M.D.
In this section, we present some remarkable research
about calcium and disease. This research demonstrates
that the lack of calcium and magnesium (and vitamin K
and sunshine) may contribute to a large number of illnesses.
We will discuss the work of Dr. Lawrence Resnick, one
of the most prominent modern researchers in the field.
But let's start by looking at the work of a pioneer who
developed an entire theory of disease based on calcium:
Dr. Carl Reich, M.D.
Probing the Mystery of Disease
In the early 1950's, Dr. Carl Reich, during his post-graduate
studies, began to suspect that a number of imba lances
and diseases could be traced to deficiencies in certain
vitamins and minerals, particularly calcium.
In 1954, he began treating his patients with nutritional
supplements. Patients with a variety of symptoms such
as chronic asthma, constipation, leg cramps and sinusitis
experienced rapid relief when treated with elevated calcium
and vitamin D, as well as a full spectrum of basic nutrients.
Encouraged, Reich began to treat more patients with
his nutritional therapy. A whole host of symptoms such
as indigestion, headaches, muscle pain, constipation and
migraines were successfully treated with calcium and other
nutrients. He also came to believe that a number of diseases
as diverse as chronic arthritis, rheumatoid arthritis,
ileitis and colitis, asthma, hypertension, heart spasms,
diabetes, Alzheimer's disease, Parkinson's disease, Lou
Gehrig's disease, and even cancer, were all in some way
related to calcium deficiency.
The connection, according to Reich, was in an individual's
response to physical or emotional stress. When the body
is under stress, the autonomic nervous system sends out
various messages to internal organs; for example, the
blood vessels can be stimulated to dilate or constrict,
the heart can beat faster, and the digestive system can
slow down. Reich reasoned that many diseases were due
to an imba lanced stimulation of the internal organs by
the nervous system. And the roots of this imba lanced
response, he believed, were deficiencies in certain key
nutrients, especially calcium and, secondarily, vitamin
Individual response to stress is a complex topic. Some
people take all kinds of stress in stride - even seem
to thrive on it - while others react badly, often developing
debilitating symptoms or, over the long term, serious
diseases. Reich's theory may partly explain why people
respond to stress so differently.
Reich theorized that a lack of dietary calcium would
lead to an over-constrictive response to stress in specific
tissues. For example, an over-constrictive response in
muscles surrounding blood vessels would lead to hypertension
or migraines; constriction of muscles in the lungs would
cause asthma. Reich believed angina was related to constriction
of the coronary arteries, while ileitis and colitis meant
there was a constriction of the gastrointestinal tract.
Obviously, this is an oversimplification of complex physiology,
but Dr. Reich's treatments became widely known, suggesting
some validity of his approach.
Dr. Reich's Special Advantage
Dr. Reich had a special advantage over the scientific
and medical communities: he got to test his theories with
real people for many years. Regularly, he saw proof that
calcium, magnesium and vitamin D were very often the key
factors in disease.
Reich also used substantial doses of vitamin D. Reasoning
that mankind's consumption of calcium and other minerals,
as well as exposure to the sun, has decreased with evolution.
His treatment program also included the use of other vitamins
Reich perceived, and further research confirms, that
the lack of vitamin D is one of the major nutritional
deficiencies of our time. This deficiency, estimated at
40 to 50 percent of the U.S. population ( New England
Journal of Medicine, 1998), dramatically compounds the
already existing deficiency in calcium. Without vitamin
D, calcium cannot be absorbed into the body or perform
its tasks properly in the bloodstream. This deficiency,
combined with a low calcium intake, contributes to a lot
of very disturbing statistics: a very high osteoporosis
rate, hip fracture rate, and a skyrocketing onset of Syndrome
X diseases, as well as an increase in other disease patterns
discussed by Dr. Reich.
Calcium Takes Center Stage
Building on the pioneering work of Dr. Reich, in 1999,
in his published work The cellular ionic basis of hypertension
and allied clinical conditions (Prog Cardiovasc Dis. 1999
Jul-Aug;42(1):1-22), Dr. Lawrence Resnick proposed a unifying
hypothesis with calcium at center stage. His work goes
back almost a decade, and is well represented in the medical
literature and is often cited by his peers.
Resnick's hypothesis states that when the level of calcium
inside the cells becomes elevated, combined with a decrease
in intracellular magnesium, cellular functioning is impaired
and the cell is likely to become diseased. The hypothesis
goes on to state that Syndrome X diseases are closely
related to this impairment in cellular functioning.
Simply stated, too much calcium inside the cells is
a disaster in the making. Calcium is normally supposed
to be at very low levels inside the cells: 10,000 times
less than the levels of calcium in the fluid surrounding
the cells. The body uses the difference between the concentration
of calcium in the cell and the calcium in the bloodstream
as a signaling mechanism among the cells. When the difference
in concentration is correct, proper signaling between
cells can occur.
If the intracellular calcium level (calcium inside the
cells) is too high, however, the signaling response is
blunted. As a result, the cells can no longer regulate
themselves, grow less responsive to stimuli, become calcified
and begin the dying process. And this deterioration of
the cells can lead to a host of serious diseases. Resnick
L. The cellular ionic basis of hypertension and allied
clinical conditions. Prog Cardiovasc Dis. 1999 Jul-Aug;42(1):1-22.
These metabolic alterations of cellular calcium and
magnesium alter and damage the function of the body tissues.
In certain diseases, there is incontrovertible evidence
that intracellular calcium is elevated and intracellular
magnesium is deficient. These include Type II diabetes,
hypertension, cardiac hypertrophy, insulin resistance,
and hyperinsulinemia. These conditions represent the infamous "Syndrome
X." Obesity is also considered one of the Syndrome
X diseases. Researchers propose that adequate dietary
calcium and magnesium, by preventing high levels of intracellular
calcium, may be protective for a whole host of obesity
Dr. Resnick and other researchers, including the Zemel
Group, have discovered that all the conditions in Syndrome
X are characterized by an underlying impairment of intracellular
calcium. In addition, they found that when excessive amounts
of intracellular calcium were lowered, there was a clinical
improvement in blood pressure, insulin resistance, platelet
aggregation and left ventricular hypertrophy. Resnick
L. The cellular ionic basis of hypertension and allied
clinical conditions. Prog Cardiovasc Dis. 1999 Jul-Aug;42(1):1-22.
What Causes the Syndrome X Diseases?
The critical role of calcium in regulation of cellular
actions needs to be ba lanced with magnesium. Magnesium
provides the balancing and relaxation effects that offset
the constrictive effect of calcium. Reduced intracellular
magnesium leads to an excess of intracellular calcium
and exaggerates calcium-induced stimulation. The elevated
intracellular calcium sends out a message to "tighten
up," and the message goes to the contractile apparatus
of cells, causing them to constrict.
As an example, these messages lead to alterations in
the smooth muscles surrounding blood vessels. This in
turn leads the blood vessels to constrict, causing restriction
of blood flow. This can ultimately result in arterial
stiffness and/or hypertension.
In the heart, these mineral metabolic imbalances lead
to overwork and exhaustion of the heart muscle, as the
heart must work harder to pump the blood throughout the
body. This is called "cardiac hypertrophy." In
the blood platelets, whose function is to regulate the
clotting of blood when necessary, these same metabolic
imba lances lead to increased blood "stickiness" and
the potential for deadly blood clots. The stickiness of
blood also impedes circulation and reduces oxygen and
nutrient availability to the cells all over the body.
In larger, active muscle tissues, the calcium/magnesium
imba lances can lead to insulin resistance, a common condition
associated with diabetes. In the beta-cells of the pancreas,
where insulin is produced, these mineral deficiency symptoms
can lead to insulin abnormalities and diabetes.
In other endocrine tissues, where hormones are generated,
these same metabolic alterations can lead to associated
hormone problems. In certain nerve cells that respond
to stress, called sympathetic nerve cells, it can lead
to stress diseases and increased nervous activity, as
well as a hyper-responsiveness to stimuli and anxiety
Resnick's simple hypothesis explains how a broad range
of diseases are associated at a fundamental cellular level,
through imba lances of calcium and its companion nutrients.
"All together, whichever aspect of hypertensive
disease that was assessed, the higher the intracellular
calcium, and the lower the intracellular magnesium, the
more severe the clinical manifestation of each individual
tissue abnormality measured; the level of blood pressure,
cardiac mass (enlargement of the heart), arterial stiffness,
abdominal visceral fat ("beer belly"), hyperinsulinemia,
and even fasting and chronic average level of blood glucose." -
Dr. Lawrence Resnick
GLOSSARY OF TERMS
Intracellular: inside the cell.
Extracellular: outside the cell (in the fluid
surrounding the cells).
Type II Diabetes: The most common form of diabetes.
In Type II diabetes, either the body does not produce
enough insulin or the cells have become desensitized to
Hypertension: Excessively high blood pressure,
especially arterial blood pressure.
Cardiac Hypertrophy: Overwork and exhaustion
of the heart muscle.
Insulin Resistance: When the body does not respond
adequately to insulin (insulin is the blood sugar hormone
produced by the pancreas).
Hyperinsulinemia: Too much insulin in the bloodstream.
Blood Platelets: Also known as thrombocytes,
are large cells found in the bone marrow. They are the
key clotting mechanism for an injury.
Platelet Aggregation: The tendency of blood platelets
to form clots in the blood vessels. This can lead to blockage
of the vessel resulting in stroke.
Triglycerides: The chemical form in which most
fat exists in food as well as in the body. They are also
present in blood plasma.
Resnick's Cellular Mineral Hypothesis Is Similar to
It is interesting to note the similarities between Dr.
Resnick's mineral hypothesis of diseases with that of
Dr. Carl Reich. It turns out that Reich died before Resnick
published his research, but he had already figured out
that calcium and magnesium deficiency was at center stage
in a number illnesses, and he presented a hypothesis remarkably
similar to Resnick's.
Like Reich, Resnick also prescribed high doses of calcium
and vitamin D, and used a full range of vitamins and minerals,
including of course, magnesium, and told his patients
to spend time in the sun.
What causes cells to become overloaded with calcium?
A lack of dietary magnesium, vitamin D, vitamins K1 and
K2 and calcium are only part of the answer. When there
is insufficient calcium in the diet, the body responds
by withdrawing calcium from the bones (bone resorption).
The bones act as kind of a "bank" for calcium.
At the time when Reich was doing his research, scientists
believed that calcium deficiency could be fully and completely
compensated by bone resorption, and that the bone-supplied
calcium would fill all the needs of the body's metabolic
Of course, without new deposits, the body cannot continue
to withdraw from any bank without consequences: In this
case, the consequence is osteoporosis. Reich however,
believed that there were immediate medical effects of
calcium deficiency that went far beyond the risk of osteoporosis.
His theory was that when the body was forced to take calcium
from the bones, the metabolic processes suffered. This
conceptual leap was obvious to Reich because he saw his
patients dramatically responding to calcium and vitamin
D therapy (along with magnesium and other nutrients) on
a daily basis. And the responses were immediate, as it
often is with buffered vitamin C.
These concepts are only now becoming more obvious to
scientists and doctors. New research demonstrates that
dietary calcium can protect against certain types of hypertension,
colon cancer, the absorption of cadmium and lead and certain
other toxic metals. In addition, of course, calcium can
provide long-term protection against osteoporosis. Higher
calcium and vitamin K1 and K2 also prevent calcium from
being deposited in the wrong places such as soft tissues
and joints (tissue calcification). Diseases in which calcification
occurs include arthritis, rheumatism, sclerosis, periodontal
disease, and Alzheimer's disease.
The Calcium Paradox Appears to Explain Calcification
Parathyroid hormone or PTH, is a hormone produced by
the parathyroid gland. PTH works to maintain adequate
blood levels of calcium at all times. Any decrease in
blood calcium levels will stimulate the parathyroid gland
to secrete PTH, which then removes calcium from the bones
and delivers it to the blood to maintain critical levels.
PTH thereby facilitates such critical metabolic functions
as the activity of the heart and brain. However, PTH can
be inefficient in its action and often floods the blood
with too much calcium. Excess blood calcium is excreted
by the body through the urine, and is also deposited into
soft tissues, where it contributes to tissue damage.
The "calcium paradox" refers to the observation
that excess blood calcium via PTH, may lead to a number
of unwanted health conditions such as calcification of
joints, cartilage, and other tissues, bone spurs, plaque
in the blood vessels, obesity, the Syndrome X diseases,
colon cancer, gingivitis and even Alzheimer's disease
- all of which can result from an overactive PTH mechanism.
These conditions represent the body's maladaptive coping
mechanisms that are activated by dietary calcium deficiency.
It is our contention, as Resnick stated, and based on
the research we quote here, that the diseases that result
from this faulty bodily response can either be prevented
or greatly reduced by simply maintaining a higher dietary
intake of calcium, combined with the optimum amounts of
vitamin D, magnesium and vitamin K.
The Role of Calcium and Associated Nutrients in Disease
If we add other related Syndrome X diseases, we will
have covered an overwhelming percentage of the illness
that occurs in the U.S. Obesity, of course contributes
to many illnesses, including all the Syndrome X diseases,
which are all related to each other. But obesity also
relates to cancer, especially to hormone-sensitive cancers.
Clearly, we are looking at a broad range of conditions
which cause much of the morbidity and mortality in the
IMPORTANT SAFETY CAUTION ABOUT CALCIUM & SODIUM
Generally, all of the health conditions we have discussed,
except for a certain rare type of high blood pressure
called sodium insensitive (high rennin) high blood pressure,
can probably be helped with calcium and magnesium therapy.
In salt-sensitive hypertension, sodium is worsening the
calcium entry into the cell and the elevated blood pressure
may be reduced with supplemental calcium. However, in
salt-insensitive hypertension, there are compensatory
membrane phenomena that reverse this, and extra calcium
may need to be restricted. Too much calcium can worsen
this type of hypertension and cause a blood pressure crisis.
If you have been diagnosed with hypertension, it is important
that you consult with your doctor about supplemental calcium.
(See Editor's Note citing the work of Hans.)
Editor's Note on Calcium Supplementation
Of all the ideological conflicts in nutritional medicine,
one area where there is huge disagreement is whether to
supplement with calcium or not.
Leaders and opinion makers I respect have criticized
supplementation of additional calcium despite increasing
RDA's and dozens of studies showing benefits for osteoporosis
prevention. Evidence exists that higher intakes of calcium
minimize expression of such conditions as cancer of the
colon and breast, and hypertension and obesity, all of
which are multifactorial in causation and have a calcium
deficiency component. The higher RDA's are a result of
studies showing that higher levels are required to maintain
calcium ba lance. J. Nutrition. 133: 249S-251S 2003
If we go back to the very basic issues, calcium deficiency
is firmly established, as summarized from Kelley's Textbook
of Internal Medicine (Fourth Edition, Chapter 470, pg.
3111, 2000) as presented on page 8. We are a population
deficient in calcium, as defined by federal based requirements.
It is one of the most significant nutritional deficiencies
that exist. Other paramount nutritional deficiencies that
are talked about here include vitamin D, magnesium and
vitamin K, especially vitamin K2. Since all of these nutrients
work together to optimize calcium biochemistry, and since
calcium is such a critical structural and regulatory molecule,
functional problems associated with deficiencies are likely
be much greater, as clinical effects are compounded by
multiple deficiencies of these related nutrients. The
odds are that most of us are deficient in one or more
of these nutrients.
Why do we need so much calcium when other cultures don't?
There are some other cultures that exhibit much lower
calcium consumption and lower osteoporosis? Our culture
wastes calcium via high protein, high phosphorus and acidifying
diets. These are big factors and cannot be overlooked.
Jaffe R, Brown S. Acid-Alkaline ba lance and its effect
on bone health. Intl J Integrative Med, 2001; 4 (6): 7-18.
Also, our consumption of pasteurized milk, being our
major food source of calcium, may exaggerate magnesium
deficiency because the ratio of calcium to magnesium is
so high at 9:1. As I will show, magnesium deficiency compromises
some of calcium's function, so milk may be worsening both
calcium and magnesium deficiency in some patients. There
are also recent findings that suggest that milk may not
be the best source of calcium for healthy bones, as seen
in the Nurse's Study done at Harvard, although numerous
other studies show benefit for bones.
So why are leading orthomolecular doctors, who are opinion
leaders, and internationally-known authoritative figures,
anti-calcium or let's say, calcium antagonists? Because
these doctors are concerned about calcium accumulation
in the vascular system and in soft tissues over many years,
and they blame dietary calcium. Also, these doctors are
well aware of the vast magnesium deficiencies that exist
and are afraid that supplemental calcium will compete
with magnesium for absorption.
I will quote from the very prestigious textbook Modern
Nutrition in Health and Disease (9th Edition, edited by
Maurice Shils, James Olson, Moshe Shike, Catherine Ross.
1999, Lippincott Williams & Wilkins). (All quoted
text is italicized.)
With advancing age, humans commonly accumulate calcium
deposits in various damaged tissues, such as atherosclerotic
plaques in arteries, healed granulomas, and other scars
left by disease or injury, and often in the rib cartilages
as well. These deposits are called dystrophic calcifications
and rarely amount to more than a few grams of calcium.
These deposits are not caused by dietary calcium, but
by local injury, coupled with widespread tendency of proteins
to bind to calcium.
Our opinion is that higher dietary calcium, via the
calcium paradox, and magnesium and other minerals such
as boron, and especially vitamin K, will prevent much
of the dystrophic calcification.
Calcification, which usually occurs intracellularly
in tissues other than bones and teeth is generally a sign
of tissue damage, cell aging and cell death. As cells
lose control of calcium regulation and are unable to maintain
low intracellular calcium, cellular function must degenerate.
It is worth explaining that calcium binds to a large
number of cell proteins, which result in the activation
of their function. By binding with oxygen atoms of glutamic
acid and aspartic acid residues projecting from the peptide
backbone, calcium stiffens the protein molecule and fixes
its tertiary structure. Hence the cell keeps cytoplasmic
concentration very low, and when it wants to activate
these calcium-associated enzymes, it allows calcium to
enter and uses calcium in a regulatory manner. When calcium
generally "leaks" into cells it means the cells
are sick and failing to regulate calcium and this will
initiate a further loss of function of the cell.
These calcium-associated proteins range from those involved
in cell movement and muscle contraction to nerve transmission,
glandular secretion, and even cell division. In most of
these situations calcium acts as both a signal transmitter
from the outside of the cell to the inside, and an activator
of the functional proteins involved. In fact, ionized
calcium is the most common signal transmitter in all of
biology. It operates from bacterial cells all the way
up to cells of highly specialized tissues in higher mammals.
There is concern that high calcium intake would produce
relative magnesium deficiency, and this has been observed
in rats but not humans. Calcium intake does not affect
magnesium retention in humans. However the reverse, hypocalcemia,
can occur as a result of magnesium deficiency. (Summarized
in Shils, et al., Modern Nutrition in Health and Disease,
Hypercalcemia refers to an elevation of calcium in blood
and is generally reported wherein there is large consumption
of calcium to raise the pH in peptic ulcer disease, but
not for the normal diet. In Africa , the nomadic pastoral
Masai tribe diet consists mostly of milk from the herds
and flocks, and they consume 5000 mg of calcium per day
or more, which is 5 or more times what the industrial
population consumes. The Masai tribe are not known to
have unusually high incidence of hypercalcemia or kidney
stones. (Shils, et al., Modern Nutrition). They probably
have another good source of magnesium.
The theory presented by Heaney and others that prehistoric
man consumed a lot of calcium is also presented in the
Shils text and referenced to in Eaton's New England Journal
of medicine article. (Eaton SB, Konner M. N. England J.
Med. 1985:312 283-289) Therein it is stated that:
Early man derived calcium from roots, tubers, nuts,
and beans in quantities believed to exceed 1500 mg per
day, and perhaps twice this amount when consuming food
to meet the caloric demands of a hunter/gatherer of contemporary
Such a well-known text and nutritional source as Modern
Nutrition presents generally accepted nutritional concepts
which must be accepted by a wide range of experts. So
their opinions represent a consensus of academic thinking.
In these cases, the concepts generally agree with the
citations from Dr. Westin Price's work, the Okinawa program
by Willcox B, Willcox C, and Suzuki M., and the theoretical
and research conclusions from a host of other researchers
presented in this newsletter.
The health benefits of pasteurized milk have become
highly questioned due to significant research correlations
with cardiovascular risk, prostate cancer, MS, bovine
leukemia virus and more. The exact cause is still uncertain,
but proteins altered by the heat of pasteurization and
other potential causes are cited. Raw milk and yogurts
are probably better choices. It is interesting to note
that much of civilization grew up surrounded by flocks
of goats and other milk-bearing animals. Such animals
have fed hungry families for millennium, and our genetic
constitution must have adjusted to some degree. (The Untold
Story of Milk, Ron Schmid, N.D., 2003, NewTrends Publishing).
Calcium critics should probably direct their concerns
towards commercial milk and milk products rather than
the calcium they contain.
Responses to Common Criticisms of
Criticism: None of the studies strongly support
calcium supplements as contributing to weight loss. They
do support dairy calcium, meaning calcium found in non-fat
Response: The original study was made when yogurt
was added to the diet of hypertensive patients with no
other dietary changes. On average, over 10 lbs was lost
by participants in one year. These results lead to an
interest in calcium and weight loss. Shortly afterwards,
animal studies in which calcium was increased from .1%
to 2% resulted in a reduced weight gain in both lean and
overweight Zucker rats. Extensive biochemistry studies
followed to delineate the mechanism involved. Both calcium
from milk products and calcium salts were used (summarized
in Calcium Intake and Reduction in Weight or Fat Mass,
Mass J. Nutr. 33: 249S-251S 2003). In a two year study,
mineral bone mass was tested. 54 women completed a two
year trial. Calcium intakes were low, 781+- 212 mg per
day, compared to dietary reference of 1000 mg per day.
The primary calcium source was dietary calcium from dairy
(67%). Dietary calcium ratio to energy (calories) negatively
predicted changes in body weight and body fat, but not
for lean mass. This means the more calcium, the less fat
accumulated without reductions in protein levels. Dairy
calcium predicted the changes as well as did non-dairy
calcium; the research on fat storing enzymes and alterations
in body temperature by calcium works independent of the
source of calcium.
Another very important point is that this relationship
of lowered body weight to calcium intake occurs in low,
but not high calorie diets.
"Calcium intake did not predict
changes in weight or fat mass in the group with calorie
intakes above the mean. On the other hand calcium, but
not calories, negatively predicted changes in weight
and fat mass in calorie intakes below the mean."
So you can't stuff yourself and expect calcium to protect
you. This indicates that one should be moderate in food
consumption in order to get calcium to work for your biochemistry.
"Clearly if dairy products are
added to a diet without compensation for energy intake,
one is likely to gain weight."
We would like to emphasize that this is not a magic
bullet for immediate weight loss, but a long term solution
which may generally aid patients to gain advantage over
the slow weight gain that accompanies aging. Calcium could
turn around that increase in girth, when consumed with
a moderate diet, and even turn that to a slight weight
loss, according to the researchers we cite.
However, aggressive interventions as described on page
1 might be tried under medical supervision, and may produce
dramatic results as the study cited, with a milk diet.
Also, notable benefit may follow the use of a highly
buffered form of calcium, magnesium and potassium formula
in relationship to food cravings.
Criticism: The low incidence of obesity in ancient
people and underdeveloped countries is directly proportional
to activity levels and lack of food or lack of refined
Response: There are obviously many factors and
exercise is certainly got to be a big one. The calcium
effect is a statistical factor. We have tried to emphasize
that by relying on some of the analysis in the abstracts.
Not everyone will respond and this is a long term potential
solution of potentially great magnitude. Also, one might
appreciate OUR model that winter brings hibernation in
hibernating animals. I suspect that we (humans) also have
some of those hibernation characteristics. Perhaps because
not enough vegetables and other rich sources of dietary
calcium are being consumed, and less time is spent in
the sun, humans may have retained the ability to conserve
reserves by reducing fat burning, thereby conserving energy
in the form of fat "for a sunny day" or for
the spring and summer season. Just as the old adage goes,
normally we save our resources "for a rainy day" and
the body does the same by conserving fat and reducing
fat burning when sunshine and calcium (a marker for vegetable
consumption) are in short supply. There is data that vitamin
D also has an inverse relationship to obesity. Hence,
lack of vegetables (high in calcium) and sunshine would
signal the body to go into a modified hibernation mode,
slowing down metabolism for the winter season. So that's
our hibernation theory.
We have presented expert "textbook" opinions
on the safety of calcium supplementation, along with the
probable explanation of the calcium paradox and clinical
benefits from higher levels. However, more needs to be
said on safety.
Certain medical conditions might be related to or worsened
by increased dietary calcium, but this is not clear from
the literature from what we have seen. It is plausible
that in patients with renal failure there could be preferential
mineralization in vascular tissue instead of bone. Kidney
failure, as with other serious illness may require special
consideration on a case by case basis. In other disease
states, abnormal calcification of vessels and tissues
as described in complex animal studies by Hans Selye (
Calciphylaxis, 1962, The University of Chicago Press)
may occur, but again we think the weight of the evidence
by far, suggests safety and benefit for RDA, and even
somewhat higher levels for the general population.
Since we have presented statistical findings, we cannot
appropriately determine which patients will respond. It
is likely that a portion will not respond and this may
well be related to metabolic type. Since some significant
groups may not respond, the data for those that do respond
would thus be understated, because it would represent
average numbers (per individual). Hence a more profound
response might be expected from responders.