Calcium is a MUST with Respen-A

Calcium Supplementation is a MUST with Respen™

 Many patients have verbalized some concern with the need to take 2,000mg of elemental calcium while using Respen™.  The rationale for the increased need of calcium is explained below.

 The active ingredient in Respen™ is reserpine.  Research has shown that reserpine increases monoamine oxidase-A (MAO-A) activity 2-fold.  MAO-A is the mitochondria enzyme involved in metabolizing histamine, serotonin and norepinephrine into their active aldehyde metabolites.  Histamine is metabolized by MAO-A into tele methylimidazoleacetaldehyde, which stimulates the H2 receptors in the brain and body.

 H2 receptor stimulation results in:

  • Increased gastric acid production
  • Increased digestive enzyme production and intrinsic factor for the absorption of Vitamin B12
  • Thyroid stimulation
  • Vasodilation of small arterioles
  • Pineal gland activation
  • Production of melatonin
  • Production of cyclic AMP
  • Major neurotransmitter in the hypothalamus
  • Dilation of the bronchioles
  • Stress regulation
  • Immune system regulation
  • Heat stress regulator for the brain and body

 Reserpine’s activation of MAO-A results in increased H2 receptor stimulation, which results in increased production of calcitonin by the thyroid gland.  Calcitonin pushes calcium from the blood into the bones.  H2 receptor stimulation also causes calcium from the blood to be excreted in the urine.  This results in decreased levels of calcium, which is a benefit of reserpine in that free unbound calcium can be too high in autistic children resulting in inflammation and excitatory cell destruction.  But reserpine lowers the blood calcium so much; 2,000 mg of elemental calcium is required to keep the blood calcium levels in the normal range. 

 It is recommended that the entire 2,000mg of calcium be taken all at once with breakfast because only 4-15% of the calcium supplemented is absorbed and it should be taken with adequate saturated fat and protein such as butter, whole milk, eggs or coconut butter if your child is on a casein free diet.  Saturated fat and protein is needed to adequately absorb calcium.  If calcium is taken later in the day, it can inhibit the parathyroid which can result in low blood calcium levels despite the calcium supplementation, thus it is recommended to take the calcium supplement all at once with breakfast. 

 Whenever hypercalciuria (calcium excreted in the urine) is initiated, magnesium becomes a blocker of calcium absorption from the intestine.  Thus, it is recommended a 4:1 or 5:1 ratio of calcium to magnesium when using Respen™.

 Symptoms of aggressiveness and irritability occur if the calcium intake is inadequate or poor absorption of the form of calcium being taken.  Most people report the best results with a calcium carbonate rather than a calcium citrate.  We recommend no vitamin D in the calcium supplement.  Below is a list of various calcium supplements that have been used with success:

  1. Calcium Carbonate powder from PCCA available only from the pharmacy where you get the Respen™.
    1. This powder goes into suspension easily in water or juice or can be mixed in applesauce, yogurt, etc and it has no taste.
    2. Requires frequent shaking if mixed in water or juice to keep it in a suspension while drinking.
    3. Requires a separate magnesium supplement to be taken i.e. magnesium oxide 500 mg a day.
    4. Certificate of Analysis states contains less than or equal to 3 ppm of lead
  2. Calcium Carbonate/magnesium oxide capsules available from the pharmacy where you get the Respen™.
    1. The capsules can be opened and the powder can be mixed with food or liquid. 
    2. 6 capsules are required to get 2,000 mg of elemental calcium
    3. Certificate of Analysis states contains 0.58 ppm of lead
  3. Calcium Carbonate liquid from Roxane laboratories available from the pharmacy or online.
    1. 1 teaspoon (5 ml) contains 500 mg of elemental calcium so 4 teaspoons (20 ml) are required to get 2,000 mg of elemental calcium
    2. Spearmint flavor
    3. Requires a separate magnesium supplement to be taken i.e. magnesium oxide 500 mg a day.
  4. TUMS Ultra 1,000
    1. Online information states that TUMS contain less than 3 ppm of lead.
    2. One tablet contains 400 mg of elemental calcium so 5 tablets would be required to get 2,000 mg of elemental calcium.
    3. Requires a separate magnesium supplement to be taken i.e. magnesium oxide 500 mg a day.
  5.  Calcium Carbonate Powder by NOW Nutritionals
    1. Less than 0.3ppm  of lead
    2. This calcium comes from limestone
    3. Requires a separate magnesium supplement to be taken i.e. magnesium     oxide 500 mg a day.

  If you experience increased aggressiveness or irritability using a Calcium Carbonate supplement, the following may be an alternative form of calcium supplementation:

  1.  Calcium Lactate Powder from Standard Process Product No. 1925
    1. 1 level tablespoon equals 800 mg of elemental calcium so 2.5 level tablespoons are required to get 2,000 mg of elemental calcium
    2. Contains magnesium so supplemental magnesium would probably not be required.  The calcium to magnesium ratio is 5:1 so if constipation occurs may need to supplement with separate magnesium. 
    3. Has been reported to dissolve well in hot slightly acidic liquids like warm apple juice.
  2. Calcium Lactate tablets from NutritionGeeks.com
    1. 1 tablet contains 255 mg of calcium so 8 tablets would be required to get 2,000 mg of elemental calcium
    2. Requires a separate magnesium supplement to be taken i.e. magnesium oxide 500 mg a day.

      3.   Calcium Citrate available in powder or tablet from various suppliers. 

  1. May require a separate magnesium supplement to be taken i.e. magnesium oxide 250-500 mg a day
Advertisements