Question:
How many post-ops have take their calcium but still have developed osteoporosis?

I was just at the website for the International Size Acceptance Association (which is VERY anti-WLS) and there is a claim made that one of the originators of the procedure (Dr. Mason) no longer supports the surgery since the malabsoption of calcium causes the leeching of calcium from the bones since calcium is absorbed in the part of the small gut that is bypassed. I have read other articles re. the issue of how even calcium supplements have not prevented post-ops from developing painful and debilitating osteoporosis. Okay, my surgery is 4/29/03 and this now officially has me freaked out. I was fine until just about 30 minutes ago.    — snohflake (posted on April 24, 2003)

April 24, 2003
MANY of us developed (or had, who knows?) britle bones. HOWEVER, not many of us were taking calcium CITRATE. And then, even so, how much is "enough"? That's the question. I wouldn't have lived long enough to complain about bones, so I do not regret my surgery. I wish I'd had a full dexascan before surgery, as many, many, many of us already HAVE damage going in. But the usual doc wil say, "WEll, fat folks have dense bones". And much to our surprise, that isn't any more true than most other myths about us. Thing is, get a scan now (not ankle or wrist), take plenty of calcium citrate, with D, with magnesium. Check your own labs so you can watch your levels, including the D. Get a scan annually. Then, if there's any fluctuation, you'll know right away. You'll note most post-op plans include milk and/or Tums for calcium. And THAT is why the osteoporosis is so prevalent among us. Those forms are not accessible to us.
   — vitalady

April 24, 2003
Michelle is an expert on the issue of RNYers who don't absorb calcium carbonate sufficiently (if at all), but I'll add the following thoughts: Some folks, WLS veterans or not, simply do not absorb calcium carbonate as well as they absorb calcium citrate. In other words, there are studies that have found calcium carbonate is not well absorbed even by some (not all) folks with *normal* stomachs. Here's a link to an article about some studies on normal folks concluding that, "[C]alcium citrate was absorbed 22-27% better than calcium carbonate when taken either on an empty stomach or with meals":<BR> http://www.wcanews.com/archives/2000/Jan/jan00b.htm<BR>When you add in the fact that our stomachs are no longer normal, there's additional cause for concern about how useful calcium carbonate supplements actually are.<P>Also, in addition to anecdotal evidence of WLSers who faithfully took calcium carbonate but still got brittle bones (like Michelle's experience), I've noticed similar anecdotal stories from people who have parathyroidism. If you lose your parathyroid glands, you have a tough time absorbing calcium -- and I've seen several people in my thyroid support group, who have normal tummies, report they got no relief from their critical calcium deficiency problems until they switched from calcium carbonate to calcium citrate. Sometimes the same debate breas out over there that we get over here, between folks who are sure calcium carbonate is just fine because it worked for them, and those who found that calcium citrate worked better. The endocronologists who monitor parathyroidism seem to be just as uninformed in that context as many of our bariatric surgeons are here in the WLS context. Interesting.<P>You will find the landscape here full of patients whose docs tell them to take "Tums" or "Viactiv" (both calcium carbonate) and let it go at that. Mine used to say that, and I'm glad I didn't listen to him (and I'm glad he has since changed his mind and now recommends calcium citrate). Some patients may appear to be getting by with calcium carbonate supps. (or none at all) because they haven't been "out" long enough from surgery to become aware that calcium is being leached out of their bones. As Michelle says, only tracking your bone density with a good bone density scan will tell you how you're doing there (not the bloodwork we get every few months). Caveat emptor.<P>For more on the citrate verus carbonate debate (ad nauseum!), check out the AMOS library.
   — Suzy C.

April 24, 2003
Here is a link to a brief article on the UPMC website: http://www.upmc.com/NewsStories/2003/BoneLoss0415.htm. The article DOES NOT state what form of calcium the study participants were using. I have attempted to contact the researcher in charge of this study to find this out, but have gotten no response so far. If and when I find out I will post the answer both here and on the message board. You are right to be concerned about this very perplexing problem. Hopefully, the doctors and researchers will begin to supply some better answers for WLS patients.
   — Carlita

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