Aliva

Dr. Mohamed Taha

Sales & Marketing Director
Calcium
• is an essential nutrient found in many foods, such
as dairy products.
• About 99% of the body’s calcium is stored in the
bones, but cells (particularly muscle cells) and
blood also contain calcium. Calcium is essential
for the following:
• Formation of bone and teeth
• Muscle contraction
• Normal functioning of many enzymes
• Blood clotting
• Normal heart rhythm
• The body controls the amount of calcium in cells and
blood.
• The body moves calcium out of bones into blood as
needed to maintain a steady level of calcium in the
blood.
• If people do not consume enough calcium, too
much calcium is mobilized from the bones, weakening
them and osteoporosis can result.
• To maintain a normal level of calcium in blood without
weakening the bones, people need to consume at least
1,000 to 1,500 milligrams of calcium a day.
• The normal level of calcium in the blood is about 10
mg/dL
• The level of calcium in blood is regulated
primarily by two hormones:

Parathyroid hormone
• is produced by the four parathyroid glands,
located around the thyroid gland in the neck.
• When the calcium level in blood decreases,
the parathyroid glands produce
more parathyroid hormone.
• When the calcium level in blood increases, the
parathyroid glands produce less hormone.
 Parathyroid hormone does the following:
• Stimulates bones to release calcium into blood
• Causes the kidneys to excrete less calcium in urine
• Stimulates the digestive tract to absorb
more calcium
• Causes the kidneys to activate vitamin D, which
enables the digestive tract to absorb more calcium
Calcitonin
• is produced by cells of the thyroid gland.
• It lowers the calcium level in blood.
• Too little calcium in the blood is called hypocalcemia.
• Too much calcium in the blood is called hypercalcemia

Hypocalcemia
• condition characterized by abnormal low levels of
calcium.
• can have an adverse effect on a number of different
body systems including circulation, muscles, nerves, and
bone.
• Without adequate calcium, blood has difficulty
coagulating, the heart may skip beats or stop beating,
muscles may have difficulty contracting, nerves may
have difficulty functioning, and bones may become
brittle.
Causes of Hypocalcemia

• A low level of parathyroid hormone (hypoparathyroidism),

• Lack of response to a normal level of parathyroid
hormone (pseudohypoparathyroidism)
• No parathyroid glands at birth
• A low level of magnesium (hypomagnesemia), which
reduces the activity of parathyroid hormone
• Vitamin D deficiency (due to inadequate consumption or
inadequate exposure to sunlight)
• Kidney dysfunction, which results in
more calcium excreted in urine and makes the kidneys less
able to activate vitamin D
• Inadequate consumption of calcium
• Disorders that decrease calcium absorption
Symptoms of Hypocalcemia

• The calcium level in blood can be moderately low without

causing any symptoms.
• If levels of calcium are low for long periods, people may
develop:
• dry scaly skin
• brittle nails, and coarse hair.
• Muscle cramps involving the back and legs are common.
• Over time, hypocalcemia can affect the brain and cause
neurologic or psychologic symptoms, such as confusion, memory
loss, delirium, depression, and hallucinations.
• These symptoms disappear if the calcium level is restored.
• An extremely low calcium level may cause tingling (often in the
lips, tongue, fingers, and feet), muscle aches, spasms of the
muscles in the throat (leading to difficulty breathing), stiffening
and spasms of muscles (tetany).
 hypercalcemia
• condition characterized by abnormal high
levels of calcium
• The nervous system is underactive, which
results in lethargy, sluggish reflexes,
constipation and loss of appetite, confusion,
and in severe cases, coma.
What Calcium Does

Skeletal Strength
• Bones and teeth are where 99% of the body’s
calcium can be found .
• Bones are continually remodeling, whether being
broken down and going through resorption with
deposits of calcium .
• The bones also serve as the body’s calcium
reservoir.
• Most people have reached their bone mass peak
by age 30, after that there is slightly more bone
lost than gained during the remodeling process .
Nerve and Muscle Function
• Calcium’s positive molecule is important to
the transmission of nerve impulses to
the muscle fiber via its neurotransmitter
triggering release at the junction between the
nerves .
• Inside the muscle, calcium facilitates the
interaction between actin and myosin during
contractions .
Blood Clotting
• Without calcium blood would not clot.
• Calcium needs to be present in the blood for the
formation of fibrin, an insoluble protein that
forms a fibrous network for the blood clot’s
framework .
• And a few more…
• Calcium also plays an important role in blood
pressure regulation, heart rhythm, cellular
metabolism, water balance and immune function,
energy and fat metabolism.
Calcium supplements come in two forms: carbonate and citrate.
Calcium carbonate
• is less expensive and works best if you take it with food.
Calcium citrate
• works just as well with food or on an empty stomach.
• Many calcium supplements also contain vitamin D, which
helps your body absorb calcium.
• Limit to 500 mg at a time. To make sure your body absorbs
the most calcium possible, take only 500 mg of calcium at a
time.
• For example, this might mean taking a 500 mg supplement
with breakfast and another with dinner.
Effective for
Indigestion (dyspepsia).
• Taking calcium carbonate by mouth as an antacid is
effective for treating indigestion.
• High levels of potassium in the blood
(hyperkalemia). Giving calcium gluconate by IV can
reverse heart problems caused by high potassium
levels.
Kidney failure.
• Taking calcium carbonate or calcium acetate by
mouth is effective for controlling high phosphate
levels in the blood in people with kidney failure.
Bone loss in people taking corticosteroids.
• Taking calcium and vitamin D by mouth seems
to reduce bone density loss in people using
corticosteroid drugs long-term.
Overactive parathyroid (hyperparathyroidism).
• Taking calcium by mouth reduces parathyroid
hormone levels in people with kidney failure
and parathyroid hormone levels that are too
high.
Weak and brittle bones (osteoporosis).
• Consuming adequate amounts of calcium, both from
the diet and supplements, is effective for preventing
bone loss and treat osteoporosis.
• Taking calcium by mouth, alone or with vitamin D, also
helps prevent fractures in people with osteoporosis.
Premenstrual syndrome (PMS).
• Consuming adequate amounts of calcium, both from
the diet and supplements, seems to significantly
reduce mood swings, bloating, food cravings, and pain.
Colon cancer, rectal cancer.
• Taking calcium supplements by mouth or
increasing intake from the diet seems to
reduces the risk of colorectal cancer.
Increasing bone strength in the unborn baby.
• Taking calcium supplements by mouth during
pregnancy increases the bone mineral density
of the baby when calcium intake from the diet is
low.
High blood pressure.
• Taking calcium supplements by mouth seems to
reduce blood pressure by a small amount in
Softening of the bones (osteomalacia).
• Taking calcium by mouth seems to help
reverse softening of the bones caused by very
low calcium intake.
pre-eclampsia
• pregnancy complication marked by high blood
pressure and protein in the urine.
• Taking 1-2 grams of calcium by mouth daily
seems to reduce the risk of pregnancy-related
high blood pressure. It seems to be most
helpful in those who are high risk and have
low calcium levels.
Breastfeeding
• Needs more calcium.
• We need to continue calcium supplements while
you're breastfeeding
• Research shows you may lose 3% to 5% of your bone mass when
you nurse because you lose some of your calcium
through breast milk.
Rickets
• Softening of bones in children, often due to vitamin D deficiency.
• Taking calcium by mouth seems to help reverse softening of the
bones in children with very low calcium intake.
Preventing tooth loss (tooth retention)
• Taking calcium and vitamin D by mouth appears to help prevent
tooth loss in older people.
Possibly Ineffective
Breast cancer.
• Taking calcium by mouth doesn't reduce the risk
for breast cancer.
Heart attack.
• Taking calcium supplements by mouth doesn't
seem to help prevent a heart attack.
Obesity.
• Taking calcium by mouth doesn't seem to help with
weight loss.
Death from any cause.
• Taking calcium supplements by mouth doesn't
seem to reduce the overall risk of death.
Side effects
When taken by mouth:
• Calcium is safe when used in recommended amounts
of about 1000-1200 mg daily.
• Calcium can cause some minor side effects such as
belching or gas.
• But calcium is possibly unsafe when taken in doses
above the daily tolerable upper intake level (UL).
• The UL is 1000 mg for those 0-6 months old, 1500 mg
for those 6-12 months old, 2500 mg for those 1-8
years old, and 3000 mg for those 9-18 years , 2500
mg for adults ages 19-50 years and 2000 mg for
adults over 50 years.
Special Precautions & Warnings
Pregnancy and breast-feeding
• Calcium is likely safe when taken by mouth in
recommended amounts.

Children
• Calcium is likely safe when taken by mouth in
recommended amounts. But calcium is possibly unsafe
when taken by mouth in doses above the daily tolerable
upper intake level (UL).
Low acid levels in the stomach (achlorhydria)
• People with low levels of gastric acid absorb
less calcium if calcium is taken on an empty
stomach.
• People with low acid levels should take calcium
supplements with meals.
Too much calcium in the blood (as in parathyroid
gland disorders)
• Calcium should be avoided if you have a
condition that causes high calcium levels.
Kidney disorders
• In people with kidney disorders, taking calcium
supplements can increase calcium levels too much.

Smoking
• People who smoke absorb less calcium from the stomach
and might require calcium supplements.

Stroke
• Taking calcium supplements for 5 or more years might
increase the chance of developing dementia in people who
have had a stroke. More research is needed to know if
calcium supplements should be avoided after a stroke.
Major Interaction

• Do not take this combination

Ceftriaxone (Rocephin) interacts with CALCIUM
• Administering intravenous ceftriaxone and
calcium together can result in life-threatening
damage to the lungs and kidneys.
• Calcium should not be administered
intravenously within 48 hours of intravenous
ceftriaxone. This interaction is not a concern
when calcium is taken by mouth.
Moderate Interaction
Antibiotics (Quinolone antibiotics) interacts with
CALCIUM
• Calcium might decrease some antibiotics work.
In the gut, calcium binds to antibiotics known as
"quinolones."
• This can decrease the amount of these drugs
that the body absorbs.
• To avoid this interaction, take these drugs at
least 2 hours before or 4 to 6 hours after
calcium.
Antibiotics (Tetracycline antibiotics) interacts with CALCIUM
• Calcium might decrease some antibiotics work.
• In the gut, calcium binds to antibiotics known as
"tetracyclines." This can decrease the amount of these drugs
that the body absorbs.
• To avoid this interaction, take these drugs at least 2 hours
before or 4 to 6 hours after calcium.
Bisphosphonates interacts with CALCIUM
• Calcium can decrease how much bisphosphonate the body
absorbs, which can decrease the effects of bisphosphonates.
• To avoid this interaction, take bisphosphonates at least 30
minutes before calcium or at a different time of day.
Minor Interaction

Medications for high blood pressure (Calcium

channel blockers) interacts with CALCIUM
• Calcium channel blockers are a type of
medicine used for high blood pressure.
• Calcium may decrease the effects of calcium
channel blockers when given by IV.
• But taking calcium supplements by mouth or
consuming foods containing calcium does not
seem to have this effect.
Dosing
• For all adults 19-50 years of age and for males 51-
70 years of age, the RDA is 1000 mg.
• For females 51 years and older, the RDA is 1200
mg.
• pregnant and breast-feeding, the RDA is 1300 mg
for those under 19 years of age and 1000 mg for
those 19 years and older. In children, the RDA
depends on age.
• In supplements, calcium has most often been
used by adults in doses of 500-1500 mg by mouth
daily
• There are plenty of calcium-rich foods for you to choose
from.

• 415 mg: Yogurt,

• 375 mg: Orange juice
• 325 mg: Sardines,
• 307 mg: Cheddar cheese,
• 299 mg: Milk,
• 181 mg: Salmon,
• 100 to 1,000 mg: Cereal,
• 94 mg: cabbage,
• 80 to 500 mg: Soy beverage,
• If you're allergic to milk, are lactose intolerant, or are vegan,
getting enough calcium from food can be difficult you should
take a calcium supplement.
Potential side effects
• Supplements may make you feel bloated,
gassy, or constipated If they do, try taking the
calcium supplement with food.
• Too much calcium may cause kidney
stones and prevent your body from absorbing
zinc and iron, which you need to stay healthy.
• Osteoporosis is when there is a decrease in
bone mass and density, and the bones become
porous and fragile .
• This has a higher incidence in post menopausal
women when estrogen and progesterone
production declines, but can also be caused by
low calcium and vitamin D intake, eating
disorders, smoking, too much alcohol, and a
lack of physical activity (or bed-rest) .
• Developing and maintaining peak bone mass is
key in preventing osteoporosis.
 Why do we need magnesium?
• Magnesium is an important mineral, playing a
role in over 300 enzyme reactions in the
human body.
• Its many functions include helping with
muscle and nerve function, regulating blood
pressure, and supporting the immune system.
• An adult body contains around 25 gm of
magnesium, 50–60% of which the skeletal
system stores. The rest is present in muscle,
soft tissues, and bodily fluids.
Benefits
• Magnesium is one of seven essential macrominerals.
• These macrominerals are minerals that people need to
consume in relatively large amounts — at least 100
milligrams (mg) per day.
• Microminerals, such as iron and zinc, are just as
important, though people need them in smaller amounts.
• Magnesium is vital for many bodily functions.
• Getting enough of this mineral can help prevent or treat
chronic diseases, including Alzheimer’s disease, type 2
diabetes, cardiovascular disease, and migraine.
1. Bone health
• magnesium is essential for healthy bone formation.
• Research from 2013 has linked adequate
magnesium intake with higher bone density,
improved bone crystal formation, and a lower risk
of osteoporosis in females after menopause.
• Magnesium may improve bone health both directly
and indirectly,
• it helps to regulate calcium and vitamin D levels,
which are two other nutrients vital for bone health.
2. Diabetes
• Research has linked high magnesium diets with a lower
risk of type 2 diabetes. This may be because magnesium
plays an important role in glucose control
and insulin metabolism.
• A 2015 review in the World Journal of Diabetes reports
that most, but not all, people with diabetes have low
magnesium and that magnesium may play a role in
diabetes management.
• A magnesium deficiency may worsen insulin resistance,
which is a condition that often develops before type 2
diabetes.
• On the other hand, insulin resistance may cause low
magnesium levels.
3. Cardiovascular health
• The body needs magnesium to maintain the health of muscles,
including the heart. Research has found that magnesium plays an
important role in heart health.
• A 2018 review reports that magnesium deficiency can increase a
person’s risk of cardiovascular problems.
• This is partly due to its roles on a cellular level. The authors
observe that magnesium deficiency is common in people with
congestive heart failure and can worsen their clinical outcomes.
• People who receive magnesium soon after a heart attack have a
lower risk of mortality. Doctors sometimes use magnesium
during treatment for congestive heart failure (CHF) to reduce the
risk of arrhythmia, or abnormal heart rhythm.
• According to a 2019 meta-analysis, increasing magnesium intake
may lower a person’s risk of stroke. They report that for each 100
mg per day increase in magnesium, the risk of stroke reduced by
2%.
4. Migraine headaches
• Magnesium therapy may help prevent or relieve headaches.
• This is because a magnesium deficiency can affect
neurotransmitters and restrict blood vessel constriction,
which are factors doctors link to migraine.
• People who experience migraines may have lower levels of
magnesium in their blood and body tissues compared with
others. Magnesium levels in a person’s brain may be low
during a migraine.
• A systematic review from 2017states that magnesium
therapy may be useful for preventing migraine.
• The American Migraine Foundation report that people
frequently use doses of 400–500 mg per day for migraine
prevention.
5. Premenstrual syndrome
• Magnesium may also play a role in premenstrual
syndrome (PMS).
• The American College of Obstetricians and
Gynecologists suggest that taking magnesium supplements
could help to reduce bloating, mood symptoms, and breast
tenderness in PMS.
6. Anxiety
• Magnesium levels may play a role in mood disorders,
including depression and anxiety.
• According to a systematic review from 2017, low magnesium
levels may have links with higher levels of anxiety.
• This is partly due to activity in the hypothalamic-pituitary-
adrenal (HPA) axis, which is a set of three glands that control a
person’s reaction to stress.
Recommended dietary allowance
Age Male Female

1–3 years 80 mg 80 mg

4–8 years 130 mg 130 mg

9–13 years 240 mg 240 mg

14–18 years 410 mg 360 mg

19–30 years 400 mg 310 mg

31–50 years 420 mg 320 mg

51+ years 420 mg 320 mg

Magnesium deficiency

• Magnesium deficiency is known as hypomagnesemia.

• Magnesium deficiency can result from
• excess consumption of alcohol
• a side effect of certain medications
• some health conditions, including gastrointestinal
disorder and diabetes.
• Deficiency is more common in older adults.
Symptoms of magnesium deficiency include:
• a loss of appetite
• nausea or vomiting
• fatigue or weakness
Symptoms of more advanced magnesium deficiency
include:
• muscle cramps
• numbness
• tingling
• seizures
• personality changes
• heart rhythm changes or spasms
• Research has linked magnesium deficiency with a range
of health conditions, Alzheimer’s disease, type 2
diabetes, cardiovascular disease, and migraine.
Risks of too much magnesium
• An overdose of magnesium through dietary sources is unlikely because the
body will eliminate any excess magnesium from food through urine.
• However, a high intake of magnesium from supplements can lead to
gastrointestinal problems, such as diarrhea, nausea, or cramping.
Drug interactions
• Magnesium supplementation may also give rise to some drug interactions.
Medications that may interact with magnesium supplements or affect
magnesium levels include:
• oral bisphosphonates that treat osteoporosis, such as alendronate
(Fosamax)
• tetracycline antibiotics, including doxycycline (Vibramycin) and
demeclocycline (Declomycin)
• quinolone antibiotics, including levofloxacin (Levaquin) and ciprofloxacin
(Cipro)
• diuretics, such as furosemide (Lasix)
• prescription proton pump inhibitors, including esomeprazole magnesium
(Nexium)
Vitamin D

• A human body produces vitamin D as a

response to sun exposure. A person can also
boost their vitamin D intake through certain
foods or supplements.
• Vitamin D is essential for several reasons,
including
• maintaining healthy bones and teeth.
• protect against a range of diseases and
conditions, such as type 1 diabetes.
• Despite its name, vitamin D is not a vitamin,
but a prohormone, or precursor of a hormone.
• Vitamin D has multiple roles in the body. It assists in:
• promoting healthy bones and teeth
• supporting immune, brain, and nervous system
health
• regulating insulin levels
• supporting diabetes management
• supporting lung function and cardiovascular health
• influencing the expression of genes involved
in cancer development
1. Healthy bones

• Vitamin D plays a significant role in the regulation

of calcium and maintenance of phosphorus levels in the
blood. These factors are vital for maintaining healthy bones.
• People need vitamin D to allow the intestines to stimulate
and absorb calcium and reclaim calcium that the kidneys
would otherwise excrete.
• Vitamin D deficiency in children can cause rickets, which
leads to a severely bowlegged appearance due to the
softening of the bones.
• Similarly, in adults, vitamin D deficiency manifests as
osteomalacia, or softening of the bones.
• Osteomalacia results in poor bone density and muscular
weakness.
• A vitamin D deficiency can also present as osteoporosis
2. Reduced risk of flu
• A 2018 review of existing research suggested that some
studies had found that vitamin D had a protective effect
against the influenza virus.
3. Healthy infants
• Vitamin D deficiency has links to high blood pressure in
children.
• One 2018 study found a possible connection between
low vitamin D levels and stiffness in the arterial walls of
children.
• The American Academy of Allergy Asthma and
Immunology (AAAAI) suggest that evidence points to a
connection between low vitamin D exposure and an
increased risk of allergic sensitization
4. Healthy pregnancy
• A 2019 review suggests that pregnant women
who are deficient in vitamin D may have a
greater risk of developing preeclampsia and
giving birth preterm.
• Doctors also associate poor vitamin D status
with gestational diabetes and bacterial
vaginosis in pregnant women.
Deficiency
• Although the body can create vitamin D, a deficiency can occur
for many reasons.
Causes
Skin type:
• Darker skin, for example reduce the body’s ability to absorb
the ultraviolet radiation B (UVB) rays from the sun.
• Absorbing sunlight is essential for the skin to produce vitamin
D.
Sunscreen:
• A sunscreen with a sun protection factor (SPF) of 30 can
reduce the body’s ability to synthesize the vitamin by 95% or
more.
• Covering the skin with clothing can inhibit vitamin D
production also.
Geographical location:
• People who live in northern latitudes , work night
shifts, or are homebound should aim to consume
vitamin D from food sources whenever possible.
Breastfeeding:
• Infants who exclusively breastfeed need a vitamin
D supplement, especially if they have dark skin or
have minimal sun exposure. The American
Academy of Pediatrics recommend that all
breastfed infants receive 400 international units
Symptoms

• regular sickness or infection

• fatigue
• bone and back pain
• low mood
• impaired wound healing
• hair loss
• muscle pain
• If Vitamin D deficiency continues for long periods, it may result
in complications, such as:
• cardiovascular conditions
• autoimmune problems
• neurological diseases
• infections
• pregnancy complications
• certain cancers, especially breast, prostate, and colon.
Sources of vitamin D

• Getting sufficient sunlight is the best way to help the body produce
enough vitamin D. Plentiful food sources of vitamin D include:
• fatty fish, such as salmon, mackerel, and tuna
• egg yolks , cheese
• beef liver , mushrooms
• milk ,cereals and juices
• Dosage
• People can measure vitamin D intake in micrograms (mcg) or
international units (IU).
• The recommended daily intakes of vitamin D are as follows:
• Infants 0–12 months: 400 IU (10 mcg).
• Children 1–18 years: 600 IU (15 mcg).
• Adults up to 70 years: 600 IU (15 mcg).
• Adults over 70 years: 800 IU (20 mcg).
• Pregnant or lactating women: 600 IU (15 mcg).
Risks

• The upper limit that healthcare professionals recommend for

vitamin D is 4,000 IU per day for an adult.
• Excessive consumption of vitamin D can lead to over calcification
of bones and the hardening of blood vessels, kidney, lung, and
heart tissues.
• The most common symptoms of excessive vitamin D
include headache and nausea.
• However, too much vitamin D can also lead to the following:
• loss of appetite
• dry mouth
• metallic taste
• vomiting
• constipation
• diarrhea
 Aliva
Composed of :
• Calcium citrate 500mg
• Mg citrate 200 mg
• Vit. D3 400 IU
Dose:
1-3 times daily.
Price:
Jar contain 30 tab \ 65 L.E
Aliva
Indications:
the prevention and treatment of mineral
deficiency for oral administration.