Phosphate

Overview

Excess dietary phosphate is a central driver of aging, and keeping it under control relative to calcium is one of the most important things a person can do for their long-term health. Phosphate is essential but causes problems in excess: most people eat roughly five, six, or seven times as much phosphate as calcium, when the ratio should be close to one to one. An excess of phosphate binds calcium and damages cells, keeps cells in a pro-excitatory state that pushes them toward inefficient glycolytic metabolism, and drives the calcification process in which calcium phosphate deposits in arteries, kidneys, and soft tissues while leaching out of the bones where it belongs. The discovery of the Klotho protein, an anti-aging protein that is mainly a calcium phosphate regulator, made it clear that managing phosphate is central to slowing the degenerative process. The practical answer to the excess phosphate problem is a high-calcium, lower-phosphate diet built on milk, cheese, and leaves rather than meat, grains, beans, and nuts.

Key Points

• Excess dietary phosphate is one of the basic factors in aging across many organs. A mutant mouse named Klotho, after a Greek Fate, was found to age very rapidly and developed most of the features of human aging: decreased lung function, respiratory failure, hardening of the arteries, osteoporosis, and wrinkled skin. The defect involved calcification, the deposition of calcium phosphate where it should not be while taking it out of the bones where it should be. Excess phosphate is involved in the aging of many different organs and disease processes, and a lack of nutrients like niacin that help excrete it makes the problem worse.

• The Klotho anti-aging protein is mainly a calcium phosphate regulator. The accumulation of phosphate with aging is what has made the Klotho gene so interesting over the last ten to fifteen years. The protein works to prevent the pro-aging effects of too much phosphate, and experiments increasing its production in mice make them live around 30 percent longer. Because Klotho's main job is regulating calcium and phosphate, many of the same protective effects can be achieved through diet using things like milk, fructose, niacinamide, and baking soda.

• Phosphate keeps cells in a pro-excitatory state. An excess of phosphate has a calcium-binding effect and causes cell damage, but it also has a tendency to keep the cell in an excited state. It is pro-excitatory which burdens the cell and makes it tend toward inefficient, ultimately glycolyzing metabolism. The good thing that parathyroid hormone does is help to excrete phosphate, keeping it under control.

• A high-phosphate, low-calcium diet acts on the body exactly like a vitamin D deficiency. The excess phosphate and the reaction of the parathyroid hormone to high phosphate intake is the same as a deficiency of vitamin D. Too much phosphate combined with too little vitamin D produces what amounts to an early stage of chronic kidney degeneration. Parathyroid hormone and phosphate are called uremic toxins, the markers of late-stage kidney disease.

• The phosphate-to-calcium ratio should not exceed about two to one. Many people habitually eat a ratio of roughly five, six, or seven times as much phosphate as calcium. Milk and cheese run about 1.3 to 1 (calcium to phosphorus), so a mostly milk-and-cheese protein source keeps a person close to a one-to-one ratio. Meat is a high phosphate source with very low calcium (as high as 10 to 1 phosphate over calcium).

• Meat, grains, beans, nuts, and seeds are the main high-phosphate foods. The germ of a grain contains most of the phosphate, so whole wheat is much higher in phosphate than refined white flour, and brown rice is higher than white polished rice. White rice and white bread therefore have a nutritional advantage on this measure, and they also lack the polyunsaturated fatty acids. Grass-fed meat and milk have lower phosphate than grain-fed, because grains are very high in phosphate and slightly poison the animal that eats them.

• Inorganic phosphate added to processed meat is a separate, industrial source of excess. When the government began regulating the adulteration of meat in the 1960s, inorganic phosphate became widely used to make meat hold water and bulk up. This is distinct from the phosphate that occurs naturally in grains and meat. One article linked increased inorganic phosphate consumption to lung cancer, and even when recommendations come out to reduce it as an additive, the industry tends to find another way to make meat hold water, such as gluing fragments together with carrageenan, alginate, or protein-bonding enzymes.

• Sugar and fructose lower phosphate and help explain how sugar can substitute for vitamin D in building bone. In a 1930s fat-free diet study, William Brown lived for six months on sugar and milk, and sugar was found to lower phosphate. In an animal experiment 35 years ago, a sugar-based diet built strong bones despite a vitamin D deficiency, while the starchy diet produced weak atrophied bones, and the sugar's lowering of phosphate accounted for it. Fructose increases the resistance of the intestine to taking up phosphate while promoting phosphate loss through the kidneys, acting as a phosphate blocker in the gut and a phosphate-loss promoter in the kidneys.

• High phosphate raises parathyroid hormone, and parathyroid hormone is bad news across the board. Elevated parathyroid hormone drives immediate bone resorption, raises prolactin, slows the metabolism and produces insulin resistance. Parathyroid hormone raises bone resorption specifically by raising prolactin and serotonin, and serotonin in turn raises cortisol, so the whole catabolic cascade is downstream of letting phosphate run high.

• Elevated parathyroid hormone is directly causative of diabetes, both type 1 and type 2. This is not a loose association. Animals that have had the parathyroid gland removed do not develop diabetes no matter what diet they are fed. Since dietary phosphate is one of the main drivers of parathyroid hormone, keeping phosphate in check and calcium adequate is a direct lever on diabetic risk.

• High dietary phosphate has been associated with virtually every type of cancer. The more phosphate you take in through food, the higher the risk of developing some form of cancer. Part of this runs through parathyroid hormone and the prolactin it raises (prolactin is itself strongly tied to a range of cancers), but the phosphate association shows up broadly enough that it is worth treating dietary phosphate load as a real consideration rather than an afterthought.

Notable Quotes

"A lot of people habitually eat a ratio of roughly five, six, or seven times as much phosphate as calcium. We probably shouldn't exceed about two parts of phosphate for each calcium."

[Ray Peat — Phosphate and Calcium Metabolism]

"The anti-aging protein (klotho) is mainly a calcium phosphate regulator preventing those pro-aging effects of too much phosphate."

[Ray Peat — CO2 and Mineral Balance, Thyroid, Magnesium, Calcium in Health and Disease]

"An excess of phosphate has not only the calcium binding and cell damage effects, but it has a tendency to keep the cell in the excited state. In itself, it is pro-excitatory."

[Ray Peat — CO2 and Mineral Balance, Thyroid, Magnesium, Calcium in Health and Disease]

"So too much phosphate, too little vitamin D, and you get what amounts to an early stage of chronic kidney degeneration."

[Ray Peat — Phosphate and Calcium Metabolism]

"High phosphate is not just bad because it promotes parathyroid hormone, it's bad because it also has been associated with virtually every type of cancer."

[Georgi Dinkov, A Bioenergetic View of Weight Loss [Generative Energy #9]]

"Animals with the parathyroid gland removed, they do not develop diabetes no matter what diet you feed them."

— [Georgi Dinkov, A Bioenergetic View of Weight Loss [Generative Energy #9]]

Important Things To Consider

The fix for excess phosphate is more calcium. Doctors have long recommended cutting calcium to avoid calcification, but this is backwards: a calcium-deficient diet raises parathyroid hormone, which pulls calcium from the bones and deposits it in arteries, kidneys, and other soft tissues. Aiming for around 2,000 milligrams of calcium a day, from milk, cheese, eggshell powder, or boiled greens, suppresses parathyroid hormone and protects against calcification.

Vitamin D and calcium together raise Klotho, while activated vitamin D does the opposite. There is massive confusion in the literature between 25-hydroxycholecalciferol and the activated 1,25-dihydroxy form. The 25-hydroxy form supports Klotho, but the activated 1,25-dihydroxy knocks down Klotho and raises parathyroid hormone and angiotensin. The activated form is a marker of extreme stress and sickness, and in end-stage kidney disease its activation runs wild and can kill a person. Consuming calcium and vitamin D lowers parathyroid hormone and largely turns off that dangerous activation.

Niacinamide, baking soda, and vitamin K all help the body excrete phosphate. Baking soda acts the same way as vitamin K or niacinamide, helping the kidneys excrete unneeded phosphate and deposit calcium and phosphate in bones rather than arteries. Anything that raises carbon dioxide helps excrete phosphate, and salt and calcium stimulate carbon dioxide production. Food sources of niacinamide include liver, milk, cheese, eggs, and dark roast coffee, which can supply close to 40 milligrams a day across several cups.

Vitamin K dosing for bones and arteries runs from one to ten or fifteen milligrams a day. A high-potency mixture of K1 and K2 at one to ten milligrams per day is in the safe range and probably therapeutic for bones and arteries. Ray recommended Thorne Research liquid vitamin K, where one drop is one milligram. Liver and kale are the famously rich food sources. Japanese animal studies used very high doses of vitamin K2 (MK4) to rebuild osteoporotic bones while taking calcium out of arteries.

Baking soda is generally safe and improves endurance. People who regularly take one or two teaspoons of baking soda with or after meals report increased endurance and energy and reduced fatigue, and as much as a tablespoon at the start of a race has been tested on athletes for performance. The usual amount taken for stomach acidity is a good amount. Baking soda baths combined with epsom salts are also fine, with the baking soda aiding magnesium absorption.

Calcium phosphate is a bad form of calcium supplement. Some calcium supplements contain so much phosphate as a co-factor that the phosphate itself raises stress hormones and activates the breakdown of the bones, defeating the purpose. The main things that pull calcium out of the bones, besides excess phosphate, are cortisol, prolactin, and serotonin, all of which trigger parathyroid hormone.

Calcium does more than balance phosphate, it directly raises the metabolic rate. Calcium raises body temperature and improves the function of the Krebs cycle. Ray Peat consumed 3000mg (3 grams) per day.

Pairing sugar with high-phosphate foods blunts phosphate absorption. Whenever you eat high-phosphate foods like meat or nuts, having some sugar alongside increases the intestine's resistance to taking up phosphate. Fresh ripe fruit, honey, sugar, and the lactose in milk all work this way. This parallels using coffee at a meal to protect against meat's high iron, adding sugar to that coffee protects against the phosphate too.