Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

Email Dr. Alice

    follow me on Twitter
    This page is powered by Blogger. Isn't yours?
    Monday, October 27, 2003
    The Mystery of the Disappearing Calcium

    Sorry, again; busy again. I spent the weekend studying and freaking out about the fires, the Boards, then the fires, then the Boards... ad infinitum. I actually was looking forward to Monday and the discipline of work, hoping it would get my mind back on its tracks.

    We shall see.

    Presented here is a post from Paula, an internist like myself; it's all about her experience of acute hypocalcemia and tetany during a colonoscopy. It's very well written and I'd like to take this opportunity to recommend her blog in toto, but the other reason I'm linking to it is that thanks to this post I finally understand calcium metabolism.

    Briefly, Paula is a vegan (at least, she was for a while. I don't know if she still is after this experience) who went for a colonoscopy as a regular screening procedure. Prior to this sort of test, you must ingest a "colon cleanser" (read: extremely powerful laxative) so that the MD can see what he/she is doing and whether there are any lesions in the colon. Most colon cleansers are heavy on the phosphate. Phosphate binds with calcium and precipitates it out of the bloodstream. If you have normal calcium levels, this is not a problem - but if you are vegan, meaning you don't eat dairy, and you work from dawn to dusk and never see the sun (and therefore don't have any Vitamin D in your system), you wind up with osteomalacia or "adult rickets." And then, after ingesting lots of phosphate in the colon cleanser, your calcium goes into the basement and you get tetany or cramps and spasms all over your body.

    Thanks, Paula. I get it now.



    Post a Comment