Are You Getting Enough Phosphorus for Healthy Bones and Teeth?

It’s an old platitude and hoary chestnut: Life is all about balance.

But sometimes we can find wisdom in even the most tired cliches. Balance is especially true in terms of managing your body’s intake of its two most abundant minerals: phosphorus and calcium.

Although they each have specific functions, they work together to build and maintain strong bones and teeth. And each mineral’s efficacy depends on the amount of the other. Too much phosphorus or not enough calcium in your diet can increase the likelihood of bone diseases like osteoporosis.

Let’s take a look at what phosphorus does, and why calcium plays an equally key role in your health.

Phosphorus is an essential mineral that plays a vital role in forming bones and teeth, creating DNA and RNA, and helping cells produce energy. It is one of the most abundant minerals in the body. Adults average about 1.5 pounds — a bit more in men, a bit less in women. Our bodies store 85 percent of its phosphorus in bones and teeth.

Besides teaming with calcium to keep bones and teeth strong, phosphorus aids the kidneys in filtering waste, helps the body store and use energy, and assists in growing and maintaining cells. Diseases associated with low phosphorus levels include diabetes, anorexia, alcoholism, Crohn disease, and celiac disease.

“Phosphorus deficiency is uncommon in the US and rarely due to diet,” says Vanessa King, a clinical nutrition manager for Queen's Health System. “Those at risk for phosphorus deficiency, called hypophosphatemia, are premature babies, individuals taking certain medications, and medical conditions such as diabetic ketoacidosis, hyperparathyroidism, and kidney tubule defects.”

Most people are far more likely to have too much phosphorus in their bodies than too little.

“A phosphorus excess may lower the level of calcium in the blood, leading to bone loss,” says King.

It can also lead to dental issues, like gingivitis or tooth decay. Adults should consume about 700 mg of phosphorus a day. Conditions associated with high phosphorus levels include advanced chronic kidney disease, hypoparathyroidism and metabolic and respiratory acidosis.

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Protein-rich foods are good sources of phosphorus, such as meat, poultry, fish, eggs, dairy products, nuts, and legumes. Other good sources include whole grains, hard potatoes, dried fruit, garlic cloves, and carbonated beverages. Here are some examples:

• Salmon (3 ounces, cooked) – 214 mg

• Chicken breast (3 ounces, roasted) – 182 mg

• Beef patty (3 ounces 90 percent lean, broiled) – 172 mg

• Bread (1 slice whole wheat) – 60 mg

• Apple (1 medium) – 20 mg

Although it’s wise to monitor your phosphorus intake from whole foods, it might be more important to look out for the mineral as an additive. People eating a Western diet can get 1,000 mg of phosphorus a day just from its use as a preservative in processed food — a growing trend.

Phosphate additives are estimated to contribute 300 to 1,000 mg to total daily phosphorus intakes or about 10 percent to 50 percent of phosphorus intakes in Western countries. Processed foods will generally list phosphorus as some form of phosphate on the nutritional value label.

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While it is important to get the recommended daily allowances of both calcium and phosphorus, it is perhaps more essential to balance them. This can be tricky, because the typical Western diet delivers roughly 2 to 4 times more phosphorus than calcium.

For example, meat and poultry contain 10 to 20 times as much phosphorus as calcium. Soda — especially darker colored carbonated beverages like colas — also contain high volumes of the mineral.

Either consuming too much phosphorus or not getting enough calcium can cause problems. When there is more phosphorus than calcium in the body, the body will use calcium stored in bones. This can cause osteoporosis (brittle bones) and lead to gum and teeth problems. A combination of a diet low in calcium and high in phosphorus presents the most risk for both bone and dental diseases.

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Most people get plenty of phosphorus in their diets. This is one mineral where more is not merrier. Boosting phosphorus without also upping calcium intake can cause health problems.

One should only consider taking phosphorus supplements if a doctor advises it. If you do take it, make sure you tell your doctor about other medications you consume, including over-the-counter drugs, since it may react badly with some antacids.

If you are instructed to supplement your phosphorus intake, make sure you stick to whatever timeline your doctor recommends and don’t go beyond that. Long-term use can lead to hypophosphatemia.

Most doctors recommend consuming both phosphorus and calcium as part of a balanced diet. The minerals tend to be taken into the cells easier that way. Supplements tend not to be as bioavailable, so it can be unclear how much of the supplement actually makes it into your body.

Although it may require a bit of work, monitoring your diet so that you get balanced amounts of calcium and phosphorus is a good strategy for not just bone health, but overall well-being.

If you are unsure of how to balance calcium and phosphorus, you might want to consult a dietician. And if you have a disease — especially a kidney-related condition — that lowers the level of the mineral in your body, it's worth having a conversation with your physician.

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Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:

• Nutrients. Importance of Dietary Phosphorus for Bone Metabolism and Healthy Aging

• U.S. Department of Health and Human Services. Phosphorus: Fact Sheet for Consumers

• Harvard School of Public Health. Phosphorus

• Wiley. Present Knowledge in Nutrition, 10th Edition

• Clinical nutrition manager for Queen's Health System. Vanessa King

• U.S. Department of Health and Human Services. Phosphorus: Fact Sheet for Health Professionals

• Advances in Human Biology. Can Excessive Dietary Phosphate Intake Influence Oral Diseases?

• Nutritional Management of Renal Disease. Phosphate Balance

Before joining Discover Magazine, Paul spent over 20 years as a science journalist, specializing in U.S. life science policy and global scientific career issues. He began his career in newspapers, but switched to scientific magazines. His work has appeared in publications including Science News, Science, Nature, and Scientific American.