Question:
Tums as a calcium supplement after surgery??????

I have read many post from post-ops stating that they take Tums with calcium as a supplement, but I was reading the bottle and it contains calcium carbonate not calcium citrate. So my question is isn't that like taking no calcium supplement at all? or can we absorb some calcium in that form? I was under the impression that we can't.    — jerzeygirl71 (posted on July 7, 2002)

July 7, 2002
Our nutritionist says that the calcium has to be in the form of calcium citrate (and they also recommended it only for the women having WLS). There are chewable forms of calcium citrate out there - put "calcium citrate" & chewable into your search engine of choice and you should see lots of sites.
   — John Rushton

July 7, 2002
First of all, it depends on what type of surgery you had. If you had the bpd/ds (Duodenal Switch), you can take calcium carbonate because you still have stomach acid which is required to absorb it. The stomach of a DS patient is fully functional, just smaller than it was before.<p>If you're a RNY patient, then you've had the lower portion of your stomach (where the acid is produced) separated from the top portion which is now a "pouch" and no longer used to begin digestion. <p>Also, regarding the RNY, there are also two schools of thought that are prevalent at this site. Many believe that if your surgeon has prescribed it, it's beneficial. I am one who has a hard time believing that surgeons don't know what's good and what's bad in regard to supplementation, and I doubt that it would be such a popular calcium supplement by surgeons if it truly was of no benefit to the RNY patient. <p>The other school of thought is that RNY patients need calcium citrate because surgeons don't really know the facts. These folks may in fact be right. Who knows? You have a choice to make. Are you going to believe what you read by people who may or may not have something to gain financially, i.e., distributors of calcium citrate, which is not backed up by scientific data most of the time? Or are you going to take your surgeon's word for it? Ultimately, it is up to each individual here to do their own research and decide for themselves. Read the clinical studies and find the data that will answer your question. I, for one, would really like to see some place on this site a list of clinical studies either proving or disproving the calicum citrate/carbonate theories.
   — artistmama

July 7, 2002
Hi. Let me start out by saying that I am very opinionated on this issue. And Brenda, I'm not being critical of your trust in your surgeon. It's just that I've worked with enough physicians to know that they don't know everything. Dietitians, too, for that matter. Here's the deal: surgeons cut. Yes, they SHOULD know what is best post-op for those whom they've cut. But often, they don't. Especially in the area of supplementation. They get very little nutritional training in med school to begin with; whatever additional knowledge they may gain along the way becomes outdated rather quickly as things change. Here's my point: Never blindly accept what your MD or dietitian tells you, just because they SHOULD know, or because they have initials after their name. Do your own research, ask questions, insist on rationales for WHY you're told do do or not do something. Now, I'm not saying to take a lay person's advice over your physician's... just that these professionals (nurses, too!) don't know (CAN'T know) everything. We must be ultimately responsible for our health. We exercise that responsiblity through education. OK, I'm getting off of my soapbox now... With Aloha, JK, RN
   — Joya K.

July 7, 2002
Tammy, At my support group meeting, run by nutritionists, there are several women who had RNY surgery several years ago and initially were put on calcium carbonate-a few of them now have osteoporosis, and a few have suffered noticeable bone loss (found on a dexascan). The nutritionists and these women swear that if they had taken the citrate and not the carbonate, they would have better absorbed the calcium and not be in the fix they are in today. I'm a believer as I know many post-ops a year or so out who use citrate and have not had bone loss problems. Its especially critical for those that are post menopausal.
   — Cindy R.

July 7, 2002
Well, you pretty much said it with your last statement. Except that with Tums, you're also building kidney stones. There is an article in the Feb 2002 Beyond Change that talks about our high risk for kidney stones. Carbonate appears to keep blood levels looking good for quite awhile, and yet the general (intact) public who've used it for their calcium still show bone loss. I'm one who thought just taking more carbonate would solve the problem. That's sorta like putting more lotion outside my shirt to smooth my rough elbows, huh?
   — vitalady

July 7, 2002
I too was told by m,y doctor to take Tums. I chose to go a step beyond and take Calcuim Citrate, pill form from GNC. I want to be on the safe side.
   — Candi B.

July 7, 2002
I will have to agree with Joya. I have worked with so many physicians that are a bunch of idiots. Yes, I have worked with brilliant ones, they are not all idiots, but those that are, really stick out in my mind. How they get through school is beyond me. So I don't trust any doctor 100%. I do my own research and do what is best for me. My surgeon isn't as concerned with my health as I am. My surgeon and his nutritionist were recommending the tums when I had my surgery 8 months ago. I disagreed with the tums and took it upon myself to do the research, and present it to my nutritionist. They have since switched all patients to the citrate. She said that she just didn't have all that time to do the research required and was very appreciative of my efforts. I even took in copies of websites where they sold different forms of citrate that she could recommend to the other patients. I say NEVER trust that the doctors know everything! They don't, nobody does.
   — Cheri M.