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Ask Dr. Mike: Health Benefits from Coffee & Chocolate, Managing Your Calcium Levels & More

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans. Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

Should I include dietary and supplementary sources in calculating my total calcium intake?

Typically, integrative medicine doctors recommend postmenopausal women should be getting anywhere between 1,000-1,500 milligrams of calcium a day. Women who are still menstruating should be taking a little less.

Each nutrient is a little different when considering dietary or supplementary sources. For calcium, Dr. Mike wants you to be taking a total (from both sources) around 1,500 milligrams a day if you're not menstruating anymore. You may also want to consider checking the amount of calcium in your foods as well so you're not consuming too much.

What's the difference between red blood cell magnesium and cerium magnesium level? My cerium magnesium level is normal, but my red blood cell magnesium level is low.

If your red magnesium level is low, that's the one doctors pay attention to. Red blood cell magnesium levels are what doctors look at to measure your overall true magnesium status.

The amount of a mineral or any nutrient in your blood is very transient. It's very hard for doctors and patients to have confidence in that number. There's only a low percentage of magnesium that's in your blood at any given time, most of it is in your muscle, bone or or red blood cells.

Because of this, doctors look at specific targets like your red blood cell magnesium level. If your red blood cell magnesium level is low, don't worry about what your cerium level said.

Are there any health benefits to coffee and chocolate?

The simple answer is yes, there are benefits to both. However, Dr. Mike isn't talking about the chocolate found in candy bars. Cocoa that's found in dark chocolate has been shown to help your cardiovascular system, blood pressure, and is packed with powerful antioxidants.

Coffee has been shown to reduce certain cancer risks like prostate and skin, as well as reduce your risk for type-2 diabetes.

If you have a health question or concern, Dr. Mike encourages you to write him at This email address is being protected from spambots. You need JavaScript enabled to view it. or call in, toll-free, to the LIVE radio show (1.877.711.5211) so he can provide you with support and helpful advice.

RadioMD Presents: Healthy Talk | Original Air Date: March 6, 2015
Host: Michael Smith, MD

RadioMD. It's time to Ask Dr. Mike. Do you have a question about your health? Dr. Mike can answer your questions Just email: This email address is being protected from spambots. You need JavaScript enabled to view it. or call now: 877-711-5211. The lines are open.

So, my first question today is about calcium.
"Should I include dietary and supplement sources in calculating my total calcium intake?"

So, we have more integrative doctors. You know, doctors who integrate West and East. Whatever modality is necessary. We've been talking about anywhere between 1000 mg to even upwards of 1500 mg a day of calcium for post-menopausal women. For women who are menstruating, maybe a little less, but not too much less--maybe 750-1000 mg.

So, I think people are starting to question a little bit about that much calcium given the fact that there have been some negative studies relating supplement calcium intake to heart disease in women.

Of course, I've talked about those studies before. I'm not going to go into that again. Those studies were just poorly designed. They didn't look at other nutrients that are important to help manage calcium, like Vitamin D, Vitamin K2. We've talked about that before. But, I still think this is a good question. I think sometimes when we talk about a certain amount of a nutrient we want you to get every day, I don't think we're always clear about is that dietary plus supplement or just supplement? It's really an individual case. Each nutrient is a little bit different. But, in the case of calcium, I want you to calculate your total intake of calcium from both sources, right? And it needs to come out to probably around 1500 mg a day if you're not menstruating any more.

So, that's a good question. I like to look at both of those. So, you need to look at the foods you're eating. Now, I guess that's not always easy to do, but thank God for Google. You can just go online and just put in "the amount of calcium in kale", "the amount of calcium in spinach". You know, whatever it is you're eating. There are all kinds of charts like that on websites and stuff, so it's not as hard as it used to be to do that. So, yes. You do want to look at both supplement and dietary sources and we're still shooting for about 1500 mg of calcium a day. Yes, take your other nutrients like Vitamin D and Vitamin K2. That's critical for calcium management.

Okay. The next question has to do with magnesium.

"What's the difference between red blood cell magnesium and serum magnesium? My serum magnesium level is normal, but my red blood cell level is low."

Well, let me just start off answering that by saying, if your red blood cell magnesium level is low, that's the one you look at. Red blood cell magnesium gives us a better measurement of your overall true magnesium status, okay? So, if you get a red blood cell magnesium, don't even look at the serum one.

But, this is a good question. I think more and more, we're going to be seeing tests looking at these minerals within certain cells. So, there's already like a red blood cell folate cell test out there. As I just said here, there's a red blood cell magnesium test.

So, what's the difference between those standard ones you've been getting and a red blood cell measurement? Well, it turns out that the amount of a mineral, or any nutrient really, in the blood at any given time, is so transient it's just hard to really have a lot of confidence in that number. We also know that magnesium, for instance, at any given time only about—and I don't remember the exact percentages—but, maybe 5%, 10% of your total magnesium is in the blood at any given time. Most of it's in other places: muscle, bone and red blood cells.

So, looking at a specific target like a red blood cell gives us more confidence in the number we're actually looking at. So, a red blood cell folate level. A red blood cell magnesium level. And probably soon, in the future, all of these nutrient profiles are going to be looking at the specific targets like that for certain cells. Far better than just a serum check, a blood check. Okay.
So, if your red blood cell magnesium level was low, it's low. Don't worry about what the serum level said. I think the normal red blood cell magnesium level is like 5 or 6.

Again, I think the conventional labs will list a broader range, like 2-6. I think that's way too broad of a range. I think it's more like 5-6. So, if you're less than 5, then you have a magnesium deficiency. We need to improve that and remember, magnesium deficiencies are associated with blood pressure, muscle issues, brain issues, heart issues. I mean, magnesium is important for, I think the number I always see is, like 300 biochemical reactions. It's a lot. It's important. It's interesting that a lot of the age-related diseases and symptoms we see in aging Americans in this country mimic or match what you'll read just on Google about magnesium deficiency. Look at the average symptoms that people complain about, that they go into their doctor's office with: sleep issues, muscle issues, headaches, blood pressure--all of these things. Just look at that. They rank those things all of the time.

"Here are the top 5 symptoms people go see their doctor about." Then, compare that to just a list of symptoms from low magnesium. It's an eye-opener. They match. I'm not saying that a low magnesium or magnesium deficiency is causing all those things but it's interesting that they match. Maybe it is. I don't know. So, yes, take more magnesium. If you want to know if you really need it, do the red blood cell magnesium level, shooting for a 5-6 milligrams per deciliter in your blood. I just looked the units up here. Again, thank God for Google. Okay.

Let's move on to some more questions here. I think I'm okay on time. A couple of minutes left. Okay.

"Are there any health benefits to coffee and chocolate?"

Coffee and chocolate. Well, let's talk about both of those separately. Well, the simple answer is, yes, there are benefits to coffee and chocolate. Let me talk about the chocolate first. So, I'm not talking about candy bars. A lot of people just went "aw". No. I mean, yes, chocolate itself—especially the dark chocolate, the cocoa butter—has some good antioxidants.

Dark chocolate has been shown to improve the health of the cardiovascular system. What's really interesting about dark chocolate antioxidants is that they seem to improve the health of the cells that line the inside of the arteries. Those are called "endothelial cells". And, when you improve the health of the endothelial cell, you're improving the health of the overall cardiovascular system. We can measure that by the production of nitric oxide, which is the chemical compound that allows arteries to dilate and relax. Dilate and relax.

You know, with the heart: dum dum dum. Nitric oxide at the artery level is what's running that and that comes from the endothelial cells. So, endothelial cells that are able to produce more and more nitric oxide, we believe that's a healthier endothelial cell. Well, dark chocolate antioxidants improve nitric oxide production. There's also some evidence that dark chocolate can improve blood pressure. Yes. So, that's good. But, not the candy bar. That has sugar and added fat and gunk in it. Dark chocolate. If you want to enjoy a little bit of dark chocolate, maybe try a bar that's like 75% dark cocoa. That's what you want to shoot for. It's a little bit bitter, but it's better.

Coffee, yes. Coffee has chlorogenic acid in it which is helpful in managing sugar and insulin. We just talked about that. Chlorogenic acid. So, a coffee a day. As a matter of fact, coffee has also been shown to reduce the risk of certain cancers like prostate and breast. I did a blog on coffee and cancer, if you go to the website. So, there you go. Yes, they are good for you.

This is Healthy Talk on RadioMD. I'm Dr. Mike. Stay well.