Ask the Nurse

I am age 62 and had triple negative breast cancer 11 years ago. I was treated aggressively, which put me into menopause instantly. I enjoyed eating yogurt and calcium rich foods until this past year when I developed a serious case of intolerance to dairy products - lactose intolerance. I cannot seem to tolerate even lactose-free dairy. I know that I have osteopenia. What does a person like me do to get adequate calcium daily? I also am recovering from a total hip replacement that has slowed down my exercising for the past year. The only exercise that I can do is walk. How I can get enough calcium in my diet since I cannot tolerate any real dairy products?

For women with bone thinning it is very important to get adequate dietary calcium and to take at least 2000iu of Vitamin D3 supplementation per day to keep your 25-OH vitamin D level between 40-60.

Low vitamin D3 levels and low estrogen levels (which sounds like you have the latter) can limit the amount of calcium that is absorbed through the intestines. The current recommendations for postmenopausal women is 1000mg to 1200mg of calcium in the diet per day in divided doses.

While you may not be able to tolerate any dairy options in your diet, I would suggest adding non-dairy calcium rich foods like:

  • almond “milk”
  • flax milk
  • almond milk
  • leafy green vegetables : spinach, broccoli, and bok-choy

Additionally, you may need to be on calcium supplementation. It can even be as easy as taking a TUMS after meals! If you are on acid blockers or have had kidney stones, your best bet would be to add calcium citrate to your diet, and this would best be done twice a day once in the morning and once at night as this can be absorbed with or without stomach acid.

Be sure to follow up with your women’s health physician to discuss this further and to get a formal workup to rule out any malabsorptive disorders. You may also need to undergo a 24 hour urine collection for calcium and may need a GI evaluation at least lactase enzymes to digest any lactose that may be in your diet.

Calcium, vitamin D and exercise are necessary but not always sufficient for bone health, and are not specific bone treatments for osteoporosis.

Be sure to get a follow up bone density within 2 years of your last one.

All My Best,
Speaking of Women’s Health Nurse

April 17, 2018 at 8:56am