Calcium Citrate or Calcium Carbonate

I hear so many different stories, I was curious... WHICH one (or does it matter?) should RNY patients take as a supplement?  Some people (including Wikipedia) say it has to be Carbonate, and some say it has to be Citrate. Some doctors say if you don't have one your legs will start breaking in a few years, and others say if you don't have the other the same might happen. Which is it?  I"m still pre-op and don't even know what my own Nut will say, but I was wondering if there are studies or other things I could read up on this.  I just want to be armed with the greatest amount of knowledge before I have this life-changing surgery! 

A dietician should respond but this is what my doctor's office told me.  Evidently calcium carbonate is more readily absorbed if digested with acid as in stomach acid.  If you have the RNY procedure you do not have enough stomach acid to allow for proper absorbtion of calcium carbonate.  That is why many RNY doctors now say you should have calcium citrate which absorbs without the need for stomach acid.

Great question! The information I am sharing comes from a conference I attended last year.  The speaker was  Robert Martindale PhD, MD , Professor of Surgery, Oregon Health & Science Univ. (Some of you may have been his patient - he was previously in Georgia) Normal daily needs are 1000-1200 mg/day. In RNY recs are 1500-2000 mg/day - this assumes a 30-40% malabsorption -Calcium carbonate are not as well absorbed due to decreased acid in stomach and decreased dissolution (breaking apart) in the stomach. -Calcium Citrate with vitamin D is preferred as it is better absorbed - calcium citrate should be taken between meals -Neither calcium should be taken with iron as it decreases iron absorption Then, a study was done looking at the various factors affecting calcium absorption.  It included such variables as vitamin D levels, estrogen therapy, timing of intake, gastric acidity, age, gender, drug standards of dissolution and disintegration, and bioavailability. The results: The lab data slightly favors calcium citrate Cost data favors calcium carbonate clinical result: There was an insignificant level of data to justify one over the other. There are more and more studies out there all the time. Do your research! regards, Danielle Halewijn RD eNutritioncare.com

Danielle, thank you for your response. :) Someone directed me to this forum and I can see that I will have more questions as time goes by.