calcium debate

I received an email from someone on the main message board telling me that I am wasting my time taking Tums. I need to take Calcium Citrate. The paper I received from PMRI says Calcium Carbonate. Any suggestions?

I heard at the Dec meeting some controversy over it. Apparently the calcium citrate is better for us, but calcium carbonate "will do". Kathy posted about this one time with a lot of detail recently. Hope this helps, others know more... After that meeting and the info that Kathy shared, I decided I would get calcium citrate for myself. Dianne

Hey Debbie, I asked Brett about calcium and he says that Tums is fine. It seems that one of the vitamin companies is trying to suggest that the material in Tums counteract the calcium but not really sure this is accurate. Call Brett or anyone at Dr. Irgaau's office to confirm. Rob

I didn't hear anything about Tums specifically. What the "controversy" is about is that Tums - as well as Rolaids with calcium and many chewable and pills contain Calcium Carbonate. Supposedly it is easier to take because it comes in things like Tums. However, because we have absorption issues, the concern is that the carbonate types of calcium are not absorbed well and therefore you are not really getting the full calcium benefit. - any type of carbonate not just the Tums that Chrias and PMRI recommend. Calcium Citrate is the type of calcium that is absorbed more readily by bodies and therefore given our situations - a lot of people say we should take the citrate over the carbonate. Many doctors, including ours are not really on the citrate is better then carbonate train. They say the carbonate is more tolerable and therefore some form of calcium is better then nothing. Others disagree and say that you may as well be taking nothing because the carbonate is just not absorbed adequately. I spoke with my nutritionist at PMRI on the subject as there seems to be so much debate. She looked into it and said yes, calcium citrate is absorbed better then calcium carbonate - however - they do not feel there have been substantial studies to prove that citrate is the only way to go for WLS patients. They Tums for example are in a chewable form and because our instructions are to take chewable the first month - Tums seems the likely choice. So, here in lays the controversy about what to take. My personal opinion is this... if I can tolerate the citrate (I take Citracal - it is easy & pretty cheap at Wal-Mart) then why not take it if there is a possibility that the carbonate is not really getting absorbed. For my 1st month, I took Rolaids with calcium (I don't personally like the taste of Tums) after the 1st month when I could swallow pills I began to search for a citrate form that I could use. That is when I found the Citrical at Wal-Mart. I have to take 3 per day to get the 1200 mgs but they are small in comparison to even my multi-vitamins. Hope this helps some.. bottom line is even though our doctors and PMRO say to take the Tums - you have a choice and you can take Calcium citrate if you want just in case. If you ask them, they won't tell you not to take the citrate - just that the carbonate is okay too. Hopefully there will be more formal studies done in the future for not only the best calcium for WLS patients to take - but something for all vitamins to help us see what can actually get absorbed. As Gastric Bypass Surgeries continue to grow in numbers, we can probably expect such studies to happen. In the mean time, you have to just choose what you think is best for you.

I didn't hear anything about Tums specifically. What the "controversy" is about is that Tums - as well as Rolaids with calcium and many chewable and pills contain Calcium Carbonate. Supposedly it is easier to take because it comes in things like Tums. However, because we have absorption issues, the concern is that the carbonate types of calcium are not absorbed well and therefore you are not really getting the full calcium benefit. - any type of carbonate not just the Tums that Chrias and PMRI recommend. Calcium Citrate is the type of calcium that is absorbed more readily by bodies and therefore given our situations - a lot of people say we should take the citrate over the carbonate. Many doctors, including ours are not really on the citrate is better then carbonate train. They say the carbonate is more tolerable and therefore some form of calcium is better then nothing. Others disagree and say that you may as well be taking nothing because the carbonate is just not absorbed adequately. I spoke with my nutritionist at PMRI on the subject as there seems to be so much debate. She looked into it and said yes, calcium citrate is absorbed better then calcium carbonate - however - they do not feel there have been substantial studies to prove that citrate is the only way to go for WLS patients. They Tums for example are in a chewable form and because our instructions are to take chewable the first month - Tums seems the likely choice. So, here in lays the controversy about what to take. My personal opinion is this... if I can tolerate the citrate (I take Citracal - it is easy & pretty cheap at Wal-Mart) then why not take it if there is a possibility that the carbonate is not really getting absorbed. For my 1st month, I took Rolaids with calcium (I don't personally like the taste of Tums) after the 1st month when I could swallow pills I began to search for a citrate form that I could use. That is when I found the Citrical at Wal-Mart. I have to take 3 per day to get the 1200 mgs but they are small in comparison to even my multi-vitamins. Hope this helps some.. bottom line is even though our doctors and PMRO say to take the Tums - you have a choice and you can take Calcium citrate if you want just in case. If you ask them, they won't tell you not to take the citrate - just that the carbonate is okay too. Hopefully there will be more formal studies done in the future for not only the best calcium for WLS patients to take - but something for all vitamins to help us see what can actually get absorbed. As Gastric Bypass Surgeries continue to grow in numbers, we can probably expect such studies to happen. In the mean time, you have to just choose what you think is best for you.

I echo everything Kathy said (although she already echoed it once herself...lol). I asked Dr. Wynn about it and she said that I can take the citrate if that was what I was more comfortable with. So, coupled with that and the other reports...that's what I'm doing. (Only my calcium is a little bigger because it has the extra Vit D and magnesium in it.) Just do what is best for you! (((hugs))) -Karen

Debbie, Here I am to echo again ... ECHO *grin* This really kinda threw me for a loop in the beginning also. Then I heard what Kathy and Karen found ... plus I asked ... same answer of course. but it kinda weired me out at first cause here I was thinking that perhaps I knew something that my docs should know but did not? Then I came to realize that they KNEW ... and they had good reasons for what they suggested. They suggest tums in the beginning because it is an easily attained and the calcium carbonate is easier on the tummy. After the first month or so they said that I could do what I felt was best for me. Calcium Citrate is a little more expensive but there are some reports that perhaps it is better absorbed. But if you find it caused tummy distress make sure you at least take the carbonate. I personally am on the citrate, better safer than sorry even if costs just a little more. Another thing I heard was that by the time a calcium deficiency shows up on your labs there is already damage that can not be reversed. So what I reading is to be sure to get a baseline bone density test. Then follow up with them to keep track of the bone density. I am going to ask the doc about his thoughts on this at my next appointment. Best wishes with whatever you decide. Just make sure you are taking something ... and be SURE to get in that vit b-12!!! Hugs, Tammy