Synosteo®

The absorption of calcium is reduced with age (in children, it is about 70%, and about 30% in adults), especially in women with osteoporosis.

If the needs for calcium are higher, it can be taken from the bones so that the normal values can be preserved.

However, the adding of the “borrowed“ calcium does not always lead to the quality of bone tissue. Namely, if the deficiency of calcium lasts longer, the homeostasis is disturbed and osteolysis stimulated in bones overcomes the formation of a bone and leads to a gradual decrease in bone density resulting in osteoporosis.

In perimenopause and in the early years after the menopause, the loss of oestrogen has disastrous effects on bones, and the disturbances of the level of calcium are of great importance on the occurrence of postmenopausal osteoporosis.

The deficiency of oestrogen also leads to the decrease in the production and activity of vitamin D in the intestines. This state leads to the decrease in calcium absorption in the intestines and to hypocalcemia.

So, the usage of vitamin D3 and calcium is useful during the period of postmenopause.

After the age of 40, a gradual decrease in bone density is noticeable in both genders for several reasons:

• the osteolysis phase is normal, while the phase of bone formation is a bit slower, which results in slow, but continuous decrease in bone density, which, after several years, leads to osteoporosis.
• ageing of intestinal epithelial cells results in the reduction of calcium absorption
• in older people, the kidneys do not work properly, so the reabsorption of calcium from urine is not regular and there is additional production of vitamin D which results in the reduced calcium absorption

Groups with the higher risk of inadequate homeostasis of calcium:

• women with amenorrhoea or menopause
• persons allergic to milk or lactose
• older people due to special dietary habits
• weight-losing diets and treatments for chronic obstipation contain larger quantities of fibers which can create complexes with calcium in the intestines and thus prevent its absorption
• prolonged and chronic vegetarian diet, consumption of chocolate (contains oxalate), carbonated juices, resulting in the reduced absorption of calcium from food
• people who consume larger quantities of proteins and coffee which can lead to polyuria with the increased excretion of calcium.
• increased quantities of salt in a diet lead to the elimination of calcium with urine
• excessive consumption of alcoholic drinks reduces calcium absorption

Vitamin D is a fat-soluble vitamin that regulates the absorption of calcium in the intestines and maintains the adequate serum calcium, and the concentrations of phosphorus as well, in order to ensure the normal mineralization of bones and prevent hypocalcemic tetany.

Vitamin D is considered a steroid hormone which is created in the kidneys and the role of which is the regulation of cellular growth, neuromuscular and muscular function and the reduction of inflammation.

Very little food in the nature contains vitamin D (fish, fish oil, meat, egg yolk…)
Vitamin D is also produced endogenously, under the influence of UV sun rays on the skin, as much as up to 50%.

During perimenopause and menopause, due to the deficiency of oestrogen, the production and activity of vitamin D is also reduced in the intestines, which leads to the reduced calcium absorption in the intestines and to hypocalcemia.

In older people, the production and activity of vitamin D is also reduced due to ageing of intestinal cells, the cells of skin and kidneys and due to a smaller exposing to sun. Also, the reduction of muscular mass in older people causes additional increase of risk of bone fractures.

Thus, the exogenous usage of vitamin D3 and calcium in persons in menopause and in later years is the first line of therapy.

According to scientific international guidelines, to the women after the menopause and men older than 50 who have a higher risk of fractures, the following is advised:

• daily dosage of 800 IU of vitamin D3 and
• calcium between 700 and 1200 mg a day

Vitamin K is a fat-soluble vitamin which can be in the form of K1 (phylloquinone) and K2 (menaquinone).
Vitamin K is an essential cofactor in numerous biochemical processes:

• While the role of vitamin K1 is important in the process of blood coagulation, the research has confirmed the clear role of vitamin K2 in the process of:
• deposition of calcium in the bones
• prevention of deposition of calcium in arteries

Thus it becomes clear how the two totally different diseases – osteoporosis and atherosclerosis are connected.

Another important fact was published in 2007, when it was concluded that contrary to vitamin K1, the deficiency of vitamin K2 is widely spread.

Vitamin K2-7 has a double role in the maintenance of the bone homeostasis:

• stimulates the synthesis of osteoblast and the deposition of calcium in the bones
• Reduces the resorption of bones by inhibiting the formation of osteoclast

Active osteocalcin (OC) is an essential protein for the bone formation induced by vitamin K2.

Without vitamin K2, the osteocalcin is not carboxylated and, as such, it is inactive, so it cannot connect to hydroxyapatite in the bone matrix.

The deficiency of vitamin K causes an inadequate metabolism of calcium and its usage. It is called “calcium paradox”.

This paradox suggests that the necessary calcium is not effectively used for the bone formation and other health function, simultaneously increasing its harmful levels in the vascular system and finally leading to cardiovascular diseases.  Vitamin K2 is necessary for avoiding the complications of the calcium paradox.

Among various forms of vitamin K, the length of the side chain plays an important role in the biousability:

• Menaquinone (vitamin K2) with the medium length of the side chain (MK-7) is better absorbed compared to the short (MK-4) or longer (MK-8 and MK-9) side chains
• Vitamin K2-MK7, due to its longer half-life (72 h) has more stable concentrations in the serum and tissues contrary to other forms of vitamin K (1-1.5 h)

The recommended daily dosage of vitamin K2-MK7, according to clinical studies, is 45 mcg and that dosage can be achieved exclusively by supplementation.

The latest research has concluded that the main point in the metabolism of calcium is actually the need for extra supplementation with vitamin K2-MK7 together with calcium and vitamin D3, especially in women in menopause and older people.