1

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Just Went to the Doc Who Said I Need to Eat More Dairy For Calcium & Vit D...

Answered on August 19, 2014
Created January 14, 2013 at 11:25 PM

So I had a doctor's appointment today; my last appointment was in October, before I went completely Paleo in November. When she asked about my diet and how my weight loss was coming along, I told her I had lost a solid 12 pounds since November, by eliminating gluten, legumes, refined sugar, processed foods, and 95% of dairy (I still eat cheese every so often). I did not once say I was on the Paleo diet.

She reacted very positively to my weight loss and was happy with my "constraints." She is well aware my goal is to lose another 50-60 pounds.

However, she advised she was concerned about the lack of dairy in my diet, more specifically the lack of yogurt and milk. She thinks I may lack Calcium and Vitamin D. As we continued to discuss the dairy topic, she then said that if I wanted to continue not eating dairy for weight loss I can, but once I reach my goal weight we would test for any deficiencies and begin implementing dairy products back into my diet. This then led to her discussing implementing a little toast and such back into my diet after the weight loss.

From there, I told her that I was happy with the way I feel, and have no plans to begin eating those foods once again. She does in fact want to keep track of my weight loss and my diet, so she wants to see me again three months from now, and six months from now.

Anyways, sorry for the book, I just thought I'd share my experience today, which then leads to my questions. (Take into account I am a Newbie)

  1. Should I be concerned about a Calcium or Vitamin D deficiency? I do take Cal Mag and Vitamin D supplements a couple times a week.

  2. When she asks me about my diet again during my next follow-up visits, what would you suggest is the best way to counter her recommendations politely?

ADDED INFORMATION: Just thought I should add that I posted my blood test results on Paleohacks a few days ago. Here is the link to my results. She also raised a bit of concern over my Cholesterol, but she agree with my assertion that the more I exercise, the higher the HDL count will gradually raise. http://paleohacks.com/questions/172792/newbie-please-hack-my-blood-results#axzz2I49nKpK6

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 07:10 PM

My doctor won't do it unless it was needed, and based on our conversation yesterday, she would not find a reason for me to need it.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 07:09 PM

Thank you Amy! You have been a wealth of information for me this week!

32652cb696b75182cb121009ee4edea3

(5802)

on January 15, 2013
at 06:42 PM

I eat kale for breakfast almost every morning. Sauteed in a little bacon grease, with a dash of red pepper flakes and salt. Yummy.

Ae8946707ddebf0f0bfbcfc63276d823

(9402)

on January 15, 2013
at 06:40 PM

I just went to a nearby university to get mine. It was $40 ($30 for students). The primary purpose is often to get a very accurate measure of BF %, but it also tells you your bone mineral density. You should be able to use google to find somewhere nearby that offers it. I'm guessing your doctor wouldn't do it.

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 15, 2013
at 06:31 PM

Think of all the women downing calcium supplements like crazy but still with osteoporosis. Why? Not enough K2, magnesium, D3, and possibly overall protein. (Bones are made of lots of stuff besides calcium. Think about it -- pure calcium carbonate is chalk -- drop a piece on the ground and it shatters. Not what we want with our bones! Add all those other good vits & mins and our bones are strong and somewhat flexible, the way we want them.)

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 15, 2013
at 06:30 PM

But honestly, as important as your calcium intake are D, magnesium, and especially K2 (found exclusively in good animal fats and organ meats). Actually, the best source, as far as I know, is dairy fats from grass-fed ruminant animals, but if you've cut out dairy, you can still get it from meats & non-dairy animal fats. (Also natto, but I don't know anyone who's eating that in the U.S.) The K2 is important for *directing* calcium into the right places -- keeps it in our bones & teeth and out of the soft tissues (like kidney stones or calcification of the arteries and joints).

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 15, 2013
at 06:27 PM

D - most doctors (should) know about the basic vitamin D test...ask for the 25-hydroxy-vitamin D test. (Or 25-OH-D.) I think it's pretty much the standard.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 06:14 PM

Haha.. If she does that I will laugh and think back to your post. I'm thinking of bringing the flyer RK linked me to, and from there highlight the foods I eat on a normal basis to show her I am getting enough calcium.

089dd41b18fbb95ebb5347cded708d98

(5635)

on January 15, 2013
at 05:37 PM

yeah, that's what i was thinking, too. i've noticed most doctors are so set in their ways that even if you said a "no dairy diet" was giving you adequate calcium, she'd say it's the small amount of cheese that's saving you.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:28 PM

Chris - I don't know if this will help your assessment, but I did post my blood test results on Hacks this week. She had me get blood work for our appointment. http://paleohacks.com/questions/172792/newbie-please-hack-my-blood-results#axzz2I49nKpK6

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:22 PM

joanna - Even if I tried to prove her wrong, I doubt it would ever work. Most believe what they've been taught, regardless of what their patients say. Just as Matt said above, the best way to prove what I am doing is ok, is to continue to lose weight, and show her that it works.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:20 PM

Anastasia - Do you just blend the kale in with the applejuice?

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:19 PM

Mike T - Is a DEXA scan something my doctor would do? Or is there somewhere else I can go to get it done?

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:18 PM

blueballoon - I have never had my vitamin D levels checked. Is there a specific name for the test? Is this something I can do from home or do I need to have my doctor do it?

2fd93e91bb14e641a2bac9c6033e84e2

(1614)

on January 15, 2013
at 05:18 PM

Basically, you maybe should be concerned about Vit. D deficiency, and possibly about calciumm deficiency. Her concern would definitely not be enough to persuade me to add back drinking milk, though. For #2, know your facts. Be ready to talk about your dietary and supplemental sources of Vit. D. and calcium, why you feel they're adequate, and specific physiological reasons for not wanting to drink milk. If you are prepared, listen to her reasoning, and then are polite but firm in your responses, you should have no problem. marksdailyapple is a great place to start researching. Good luck!

2fd93e91bb14e641a2bac9c6033e84e2

(1614)

on January 15, 2013
at 05:14 PM

If it were me, I would do some basic research on what dairy, particularly milk, does once you've ingested, particularly in regard to insulin reaction. I would also do some research on the role of magnesium and potassium in bone health, and how the ratio of those minerals in relation to the amount of calcium you're getting is important. Then consider some food-tracking to make sure you ARE getting mag, D, potassium, and calcium from your diet. Online trackers won't be perfect, as mineral content does vary by origin, type of soil food is grown in, how long you boiled your bone broth. etc.. TBC

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:10 PM

Chris - She never actually said why. She simply stated she was concerned about my calcium and vitamin D intake because I cut out about 98% of dairy from my diet (I only eat cheese every so often). And when I think back to our conversation she sounded really concerned that I wasn't drinking milk anymore.

2fd93e91bb14e641a2bac9c6033e84e2

(1614)

on January 15, 2013
at 04:44 PM

Did she says why she was concerned about vitamin D and calcium specifically? I'm assuming for bone health, but I thought I'd clarify...

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on January 15, 2013
at 12:16 AM

+1. D3 sufficiency also helps with fat loss. Make sure to get enough A& K2 for optimal D3 utilization.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on January 14, 2013
at 11:49 PM

Best way to counter her recommendations is to beat them. If you meet her expectations without dairy, she's got no leg to stand on.

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10 Answers

best answer

4
32652cb696b75182cb121009ee4edea3

(5802)

on January 15, 2013
at 12:46 AM

Here is a great chart of calcium sources:

http://www.eat-real-food-paleodietitian.com/support-files/calciumpaleo.pdf

And some good info from Loren Cordain (scroll down to the calcium question - he addresses the inflow versus outflow of calcium idea):

http://thepaleodiet.com/paleo-diet-faq/

Personally, when I speak to conventional docs I do two things. One is to bring in relevant resources to show them (just a few, that are really necessary). The second is to listen politely to their recommendations and say, "thank you for those ideas; I will keep them in mind." And smile. That's all. You don't have to justify every detail. :)

3
E36cb992cf0a5eba8b97a359c15f38b3

on January 14, 2013
at 11:47 PM

There are plenty of non-dairy calcium sources. (Broccoli, some seafood, etc.)

Have you had your vit D levels checked? I do have to take vit D for deficiency. I actually was deficient even when I ate dairy regularly, so the concern about vit D via dairy I think is a bit silly. (Dairy is fortified with D anyway.) You want to look for vit D3, not D2, as the former is more bioavailable as I understand it. But do get your levels checked. Vitamin D is pretty important. If you're low, you may end up on megadoses once a week for a while or on a slightly lower dosage of a regular supplement.

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 15, 2013
at 06:27 PM

D - most doctors (should) know about the basic vitamin D test...ask for the 25-hydroxy-vitamin D test. (Or 25-OH-D.) I think it's pretty much the standard.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on January 15, 2013
at 12:16 AM

+1. D3 sufficiency also helps with fat loss. Make sure to get enough A& K2 for optimal D3 utilization.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:18 PM

blueballoon - I have never had my vitamin D levels checked. Is there a specific name for the test? Is this something I can do from home or do I need to have my doctor do it?

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 15, 2013
at 06:30 PM

But honestly, as important as your calcium intake are D, magnesium, and especially K2 (found exclusively in good animal fats and organ meats). Actually, the best source, as far as I know, is dairy fats from grass-fed ruminant animals, but if you've cut out dairy, you can still get it from meats & non-dairy animal fats. (Also natto, but I don't know anyone who's eating that in the U.S.) The K2 is important for *directing* calcium into the right places -- keeps it in our bones & teeth and out of the soft tissues (like kidney stones or calcification of the arteries and joints).

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 07:09 PM

Thank you Amy! You have been a wealth of information for me this week!

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 15, 2013
at 06:31 PM

Think of all the women downing calcium supplements like crazy but still with osteoporosis. Why? Not enough K2, magnesium, D3, and possibly overall protein. (Bones are made of lots of stuff besides calcium. Think about it -- pure calcium carbonate is chalk -- drop a piece on the ground and it shatters. Not what we want with our bones! Add all those other good vits & mins and our bones are strong and somewhat flexible, the way we want them.)

3
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on January 14, 2013
at 11:47 PM

Considering she was willing to work with you and do a test for diffencies rather than prescribe something, I'd say she is pretty reasonable. She has concerns, but she is willing to work with you.

2
Ae8946707ddebf0f0bfbcfc63276d823

(9402)

on January 15, 2013
at 01:00 AM

Go get a DEXA scan. I just got my first one and it showed that my bone mineral density was excellent even though I don't eat much if any dairy. I'm not sure how long it takes a calcium deficiency to affect your bone mineral density, but you could get an annual DEXA scan and just ignore your doctor until you see bone mineral density going down more than would be expected of someone your age. I doubt it will go down at all.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:19 PM

Mike T - Is a DEXA scan something my doctor would do? Or is there somewhere else I can go to get it done?

Ae8946707ddebf0f0bfbcfc63276d823

(9402)

on January 15, 2013
at 06:40 PM

I just went to a nearby university to get mine. It was $40 ($30 for students). The primary purpose is often to get a very accurate measure of BF %, but it also tells you your bone mineral density. You should be able to use google to find somewhere nearby that offers it. I'm guessing your doctor wouldn't do it.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 07:10 PM

My doctor won't do it unless it was needed, and based on our conversation yesterday, she would not find a reason for me to need it.

1
089dd41b18fbb95ebb5347cded708d98

(5635)

on January 15, 2013
at 04:52 PM

i never listen to any nutrition advice from my doctor. what they say kind of makes me chuckle anyway. i'd just nod your head and keep doing what you're doing. no point in trying to prove her wrong. what does that do anyway?

089dd41b18fbb95ebb5347cded708d98

(5635)

on January 15, 2013
at 05:37 PM

yeah, that's what i was thinking, too. i've noticed most doctors are so set in their ways that even if you said a "no dairy diet" was giving you adequate calcium, she'd say it's the small amount of cheese that's saving you.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 06:14 PM

Haha.. If she does that I will laugh and think back to your post. I'm thinking of bringing the flyer RK linked me to, and from there highlight the foods I eat on a normal basis to show her I am getting enough calcium.

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:22 PM

joanna - Even if I tried to prove her wrong, I doubt it would ever work. Most believe what they've been taught, regardless of what their patients say. Just as Matt said above, the best way to prove what I am doing is ok, is to continue to lose weight, and show her that it works.

1
A048b66e08306d405986b6c04bf5e8e4

on January 15, 2013
at 12:30 AM

Spend time out in the sun for Vit. D, and try vegetable juices and chia seeds for calcium. IF still in doubt, you can always take a suppliment

1
532cfd279d793e8fcc23b9f6d91dde5c

(1981)

on January 14, 2013
at 11:40 PM

Look up the calcium content of your diet: dried herbs, green leafy vegetables, brazil nuts are all high in calcium. So are broccoli and oranges. Lots of foods other than dairy contain calcium. And fish like herring and salmon are high in vitamin d, also oysters, eggs and mushrooms. Remind your doctor that dairy is not the only source for these nutrients.

0
1f9e10beade2f9ee60890d7cbb7718c5

on January 15, 2013
at 04:35 PM

you could ALWAYS take suppliments, that weeds out actual consumtion

ALSO KALE for calcium. and probiotics come in pill form.

KALE GREEN LEMONADE!!! love love or kale apple juice :)

97d98cdf2f18fa2c0bd8567ea1159609

(1047)

on January 15, 2013
at 05:20 PM

Anastasia - Do you just blend the kale in with the applejuice?

32652cb696b75182cb121009ee4edea3

(5802)

on January 15, 2013
at 06:42 PM

I eat kale for breakfast almost every morning. Sauteed in a little bacon grease, with a dash of red pepper flakes and salt. Yummy.

0
B4e1fa6a8cf43d2b69d97a99dfca262c

(10255)

on January 15, 2013
at 03:25 PM

your doctor's recommendations are base only on what she believes is right. as mentioned above, get your density checked now so that you have something real to compare your post goal level to.

-1
383127951e2e17f23b584cd3842bb796

(835)

on January 15, 2013
at 12:57 AM

milk is delicious. drink some

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