Calcium Risks | Hair Loss | The Oscars | Chicken Wrap

For decades, women over 50 have been told the same thing: take your calcium supplement. It's good for your bones. Your doctor recommended it, the pharmacy shelves are full of it, and it feels like responsible, proactive health behavior.

I'm here to clarify that narrative.

The science on supplemental calcium has quietly shifted over the last fifteen years, and I think a lot of women — and frankly, a lot of physicians — haven't caught up with it yet. A landmark 2010 study published in the BMJ by Bolland and colleagues found that calcium supplements, taken without vitamin D, were associated with a significantly increased risk of myocardial infarction (i.e., heart attacks). A follow-up meta-analysis in 2011 extended those findings and suggested the risk persisted even when vitamin D was added. We're not talking about small signals. We're talking about data that should have changed the conversation.

The working theory is this: when you swallow a calcium supplement, you get a sharp spike in serum calcium levels. Your body isn't built to handle that kind of bolus delivery. That spike may promote arterial calcification, stiffen blood vessels, and increase the risk of clotting. The result, in vulnerable women, can be cardiovascular.

Whole food calcium doesn't behave the same way. When you get calcium from food, it enters your system slowly, in doses your body recognizes and can actually use. The cardiovascular signal we see with supplements? It largely disappears with food sources, and this distinction matters enormously.

Here's what hitting 1,200mg of calcium actually looks like on a plate: 

With intention, it’s entirely doable to get there without opening a single pill bottle.

I can hear you asking, “So what about AlgaeCal”, the plant-based calcium supplement derived from South American algae that's been heavily marketed as a safer alternative?

The honest answer is: maybe, but the evidence is thin. The existing studies are small, industry-funded, and not yet independently replicated at scale. I'm not dismissing it, but I wouldn't call it proven, and so, until data consistently looks at plant-based calcium supplements and heart attack risks specifically, it is prudent to err on the side of caution and assume that the risks may be the same.

In addition, emerging data suggest that Vitamin K2 can help direct calcium into bones rather than into blood vessels. K2 may improve bone mineralization and may reduce some fracture risk (but this has been inconsistently shown in large studies), but broad clinical guidelines on its use have not yet been developed. I would, therefore, put K2 in the category of: maybe helpful, but not yet definitive data for or against.

My clinical recommendation, and what I personally do: aim for 1,200mg daily from food first.

If you genuinely cannot hit that target through diet, have a real conversation with your doctor about whether supplementation makes sense for you, at what dose, and what your individual cardiovascular risk profile looks like.

Bone health matters, but so does the heart that keeps those bones moving. Know what you’re talking about and have the data to make informed decisions. 

If you've found yourself angling your phone camera slightly higher lately, or parting your hair differently than you did five years ago, you're not imagining things. And you're not alone. I am living the thin-hair journey myself and have been for the past 5 years!

Hair thinning along the frontal hairline and crown is one of the most common and least discussed changes women experience after 50. It has a name: female pattern hair loss, or androgenetic alopecia. And the reason it tends to accelerate after menopause is straightforward. Estrogen and progesterone help keep hair in its growth phase longer. When those hormones decline, the growth phase shortens, the resting phase extends, and hair follicles miniaturize over time. What you're left with is hair that grows back finer, shorter, and less dense than before. This is biology, not neglect.

The other thing worth knowing: the frontal hairline is particularly vulnerable because follicles in that region tend to be more sensitive to androgens, specifically DHT, the testosterone derivative that shrinks follicles over time. After menopause, with estrogen's protective effect reduced, DHT has more room to operate.

So what actually works?

Topical minoxidil remains the most evidence-backed option we have. But there's a newer conversation happening around topical retinol, and the science is genuinely interesting. A study published in the Journal of the American Academy of Dermatology found that tretinoin, a prescription-strength retinoid, enhanced minoxidil absorption and improved hair regrowth outcomes when the two were used together. The theory is that retinoids upregulate growth factors in the scalp and improve cellular turnover around the follicle, creating a more receptive environment for regrowth.

At-home retinol use:
If you want to try topical retinol at home, start low and go slow. A 0.025% to 0.05% retinol applied to the scalp two to three nights per week is a reasonable starting point.

How to do it:
Apply it to a dry scalp, use sparingly along the hairline, and expect some initial dryness or irritation. Give it at least three to four months before drawing conclusions.

Other options:
Beyond retinol, the options worth discussing with your dermatologist include low-level laser therapy (LLT), which has solid trial data behind it, platelet-rich plasma injections, which are promising but still evolving, and oral minoxidil at low doses, which is gaining traction as an option for women who don't respond to topical treatment. (Note: I’m doing a deeper dive into red light therapy for thinning hair in an upcoming issue. Stay tuned!) 

One thing I want to be direct about: hair loss in this population is under-treated because it's under-reported. Women don't mention it at appointments because they assume it's just aging. And physicians don't ask because it's not on the acute problem list. Bring it up, it's worth the conversation.

I watched the Oscars this year the way I imagine a lot of you did: appreciating the fashion, admiring the talent, and then finding myself stopped cold by something harder to name. It wasn't envy. It wasn't admiration; it was concern.

The ultra-thin silhouette was back on that red carpet in a way we haven't seen since the early 2000s. And this time, we know what's likely behind it.

I want to be careful here, because this topic deserves it. I am not commenting on any individual's body, their personal choices, or their medical history. I don't know what any specific person is taking, struggling with, or navigating privately. What I am commenting on is the collective image that got beamed into millions of homes that night, and what it communicates to women, particularly women over 50, who are already fighting hard enough against a culture that makes them feel invisible.

GLP-1 medications are genuinely remarkable. I've written about this before, and I'll say it again: for the right person, they are a serious and legitimate medical tool. But a medication designed to treat obesity and metabolic disease (and possibly even provide some healthspan long-term benefits that are independent of weight loss for people without overweight/obesity) is increasingly being used as an aesthetic accelerant by people who were never candidates for it clinically. The result, on a stage as visible as the Oscars, is a beauty standard quietly recalibrated in a way that concerns me deeply as a physician.

Here is the medical reality that often gets lost in the cultural conversation: being significantly underweight carries serious health risks of its own. 

Let me be clear: after 50, when we are already fighting to preserve muscle mass and bone integrity, excessive thinness isn't a health achievement; it's a liability. It actually INCREASES the risk of all-cause mortality, death from everything and anything.

The research is consistent on this. Mortality risk follows a U-shaped curve: it rises at both extremes. We talk constantly about the dangers of obesity, as we should. We almost never talk about the other end of that curve with equal seriousness.

Every woman gets to decide what she does with her own body. Full stop. That is not a negotiable principle for me.

But individual choices, when amplified on a platform that size, stop being purely individual. They become a signal. And the signal this sent, intentionally or not, was that smaller is better, that visible is desirable, that a body that takes up less space is a body worth celebrating.

For women over 50 who are already navigating menopause, body composition changes, and a culture that has never been particularly kind to aging female bodies, that signal lands hard. It lands in the way that makes someone skip a meal, reconsider their medication, or look in the mirror with a new and unnecessary hostility.

We can hold two things at once: We can support access to GLP-1 medications for their plethora of benefits and still ask hard questions about what happens when powerful tools migrate from medicine into aesthetics or are overdone/used to an extreme. This is where one of my favorite lines about health and wellness raises its hand: most things in MODERATION.

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In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

^{This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.}

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