Calcium Carbonate vs Citrate

I know I shared some of this with Dan last week but I wanted to share it with everyone but this is the first time Ive had time to really do it. I know my drs office when I had surgery suggested the soft chew in the purple container for us to use as a Calcium supplement. However I had heard from a medical bypass group I belong to that bypass patients shouldnt use those so I had bought some but didnt use them....gave them to my mom. Well when I went for my one week post op check up I found out that even the baratic center at St V has now changed their recommendations for calcium..... Here is some interesting reading if any of u would like to look into this further. I know for us women its very important we get our calcium/mag/vitD. Calcium Citrate (w/Magnesium and Vitamin D) We get a lot of e-mails about calcium and which are recommended for WLS patients. Here's a great explanation from US Pharmacists Journal on why it is recommended we use calcium citrate instead of calcium carbonate: "Calcium is predominantly absorbed into the body by the duodenum, which is bypassed in gastric bypass surgery. As a result, calcium deficiency can be a common occurrence in patients if appropriate life-long supplementation is not initiated. Additionally, the solubility and amount of elemental calcium provided vary greatly among the various calcium salts and thus should be considered when a product is recommended. This is particularly important in bypass patients who do not have stomach acid present in the new stomach pouch to aid in absorption. As a result, the absorption of less soluble calcium salts (calcium carbonate) that require stomach acid for absorption is lower, and the absorption of more soluble calcium salts (calcium citrate) that do not require stomach acid for absorption is higher. RYGB patients are also more susceptible to lactose intolerance, as the lactase enzyme that breaks down milk sugars is secreted at the distal bypassed portion of the stomach. This may result in decreased intake of dairy products, further worsening deficiency.7,12,16-30 Of particular concern regarding calcium supplementation is the number of providers who still recommend calcium carbonate­ containing products to WLS patients, even in the face of the achlorhydric environment that the new stomach pouch creates. Calcium carbonate products are often recommended despite their relatively insoluble nature due to the larger degree of elemental calcium they provide in comparison to other salt forms (carbonate provides 40% elemental calcium, vs. citrate which provides 21%). To overcome the solubility issue, many providers advise that patients take their carbonate products with food to enhance absorption. It has been proposed that after food intake, the acid-producing parietal cells (located in the body of the stomach) become stimulated to produce more acid, thus improving absorption. This mechanism does not apply to WLS patients, however, as the bottom portion of the stomach is entirely bypassed after surgery and the acid-secreting parietal cells will never again be stimulated by food intake. Absorption of carbonate-containing products will therefore not be enhanced by this means. This is the perfect reason for pharmacists to come into play and to recommend more soluble salt forms such as citrate or microcrystalline hydroxyapatite concentrate (MCHC), which are the most absorbable forms for WLS patients"

Hi Mariah, I heard the same thing- we need to take the Calcium Citrate. I found Citracal Creamy Bites- in chocolate fudge. Kind of like a "mini" brownie in taste. Not a chewy as the Viactive, but better for us. As a side note- I also haven't experienced as much GAS since starting it. What a blessing! Thanks for sharing this, Ellen

Mariah, I have heard this subject before but I want to talk to my Dr. and nutritionist first. I had a wellness day at work with all types of bloodwork done and my calcium showed up in the high level. I have been taking the viavtiv chews, 2 daily and will see what Dr. says next week about changing. Thanks for keeping us informed. I wish there was some type of monthly newsletter put out by St. V's for those of us who had our surgery there about any new changes they have found for us. I see Dr this week for my 6 month check up.....my 6 months is the 3rd of August and my goal was to be down 100 pounds.....I am hanging tight at 98.......I think I am at a plateau....It is not that I mind the plateau but it sure would be nice if our bodies could tell us that we are still doing the right stuff only it is reorganizing I hate this wondering ...am I eating and drinking the right things?? Too much?? Too Little??? Then I comfort myself that I thought I was all done losing when I hit 70 pounds....lol I guess we just have to keep the faith! Hugs! Marianne

I agree....however if u call the bariatric center at St. V's Im sure they would mail u out the new requirements if u asked. St v did change their recommendations on what to take this month. I got the new printout when I was there for my drain to be pulled. Mariah

Hi ya sexy lady!!! Long time since I been around here Just a side note....blood levels of calcium can be normal to high....however, it isn't being absorbed into the bones where it is needed and long term results of low bone absorption is brittle bones wayyyyyyyyy before your time to have brittle bones. At St Francis....they had us taking calcium citrate from the beginning....I am so glad to hear St Vincents has finally gotten into the groove of things Ya looking good sweety!!!!!!!!!!! Keep up the good work!!!!