If PTH is mid-normal, do I need a calcium supplement? | Masterjohn Q&A Files #71

02/26/20 • 4 min

Question: If PTH is mid-normal, do I need a calcium supplement?

I'm assuming that by midrange you mean it's 30. If you mean it's 40, then no, you're deficient or you're probably deficient. You need to test how you respond. But what I would say is, it would still be good for you to try increasing that and see if the PTH goes down anymore. Because my baseline for where I suspect that someone's PTH is maximally suppressed is 30. But the evidence that it's maximally suppressed is that it doesn't get suppressed by more calcium and vitamin D. If it goes down in response to calcium and vitamin D, then it wasn't maximally suppressed. Where you want to be is not 30 to 20. It's the point of maximal suppression.

Then the final thing is magnesium deficiency can compromise your ability to make PTH. I don't think that the average person in our society is deficient enough in magnesium for that to be relevant on the basis that population-wide most people have too much PTH. That contributes osteopenia and osteoporosis. But the big caveat here is if you are magnesium-deficient, then that might invalidate most of what I said if you're deficient enough to affect PTH. If your PTH is around 30 and not higher than that, you're probably fine. But it's good to know your magnesium status because if it's really bad, that could change that interpretation. It's also good to know if adding more calcium suppresses your PTH further, because if it does, that's probably calcium that you need.

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/30/ask-anything-nutrition-march-4-2019

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Question: If PTH is mid-normal, do I need a calcium supplement?

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/30/ask-anything-nutrition-march-4-2019

Access the show notes, transcript, and comments here.

Previous Episode

What to do about sky-high pyroglutamate? | Masterjohn Q&A Files #70

Question: What to do about sky-high pyroglutamate?

Pyroglutamate, its other name is 5-oxoproline. It is something that is primarily produced when you are synthesizing glutathione, but you do not have enough of the second step in glutathione synthesis to keep up with the first step.

Maybe you need more glycine, but your glycine isn't low enough to cause orders of magnitude higher pyroglutamate. It's almost certainly the case that you have a glutathione synthetase deficiency, unless you have extraordinary levels of oxidative stress. I think that would be easy to test for because I just can't imagine that your glutathione levels -- I guess it's not that easy to test for because if you have a glutathione synthetase defect, you're going to have bad glutathione levels. If you have a tremendous amount of oxidative stress, you're also going to have low glutathione levels. If you have low glutathione levels, that's going to cause a tremendous amount of oxidative stress. I think if it's not a glutathione synthetase defect, then it becomes a lot harder to figure out what it is because it probably means you have massive oxidative stress from somewhere and there's a lot of things that could cause that. That would be a potential Pandora's box of questions that would come out of that. But definitely the first step would be to look at glutathione synthetase. This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/30/ask-anything-nutrition-march-4-2019

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Next Episode

What does it mean when histamine intolerance and blood sugar dysregulation occur together? | Masterjohn Q&A Files #72

Question: What does it mean when histamine intolerance and blood sugar dysregulation occur together?

Well, if his blood sugar is no longer as stable and he has histamine intolerance, then that drug probably interferes with vitamin B6 metabolism. Let me try to take one minute to see if I can find quick information on this. I can't. I can't find it quickly.

My instinct is to say that the drug is affecting vitamin B6 metabolism on the basis that 80% of the vitamin B6 in the body is used for glycogen metabolism in liver, which is the thing that stabilizes your blood sugar between meals. If your blood sugar is not stable between meals any longer, then yeah, it could be a hormonal thing. What it really probably means is that there's something wrong with the liver's ability to store glycogen or to access the glycogen when it's stored because your blood sugar is stabilized between meals exclusively by the liver's glycogen metabolism.

How does that relate to histamine intolerance? They're both caused by B6 deficiency. That's my take. I'd measure his blood levels of pyridoxal 5’-phosphate. Off the top my head, I believe LabCorp has a test for that. It would be helpful to look at his excretion of xanthurenate, kynurenate, and quinolinate in organic acids test. The Genova ION has all three of those. I don't think the other one is available to have all three. But every urinary organic acids test has some of those. I would go from there.

I mean, if you want to save money, just trial a pyridoxal 5’-phosphate, which is the active form of B6. Trial a supplement of that to see if it helps. I would do that at, maybe start with 10 milligrams, but feel free to work up slowly over a few weeks to 100 milligrams. If a few weeks at 100 milligrams doesn't treat that and he's off the drug, then there's something else going on and I don't know what it is. But that would definitely be first line thinking for me. Thank you, Jennifer, for your question. I'm glad that was helpful.

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/08/ask-anything-nutrition-feb-23-2019

Access the show notes, transcript, and comments here.