Question:
Am I taking the right type of calcium?

I have been reading about calcium citrate and how that is the type of calcium i am suppose to take. My doctor has me taking two tums a day. I this right?    — peggyp (posted on May 1, 2003)

May 1, 2003
Peggy, you are going to get TONS of replies to this question. My advice- If you doctor says to take 2 TUMS a day then that is what you should do. He is your doctor and would not tell you to do this if he did not believe in it. I was told to take 3 TUMS a day for calcium- I am following the Docs. orders and doing this. You had enough faith in the doctor to perform the surgery- now you need to believe his post op instructions are accurate. Good luck.
   — Jan S.

May 1, 2003
I'd say, do what I did. Follow instructions, get your dexascan, and then see how you're going to replace brittle bones at a very young age. (OK, young to me.) I used calciumj carbonate, 1500mg (about 8-12 Tums) faithfully, and for my trouble, have osteoporosis. I can't reverse it, only try to prevent it worsening. If I'd known THEN what I know now, I'd never let a SINGLE Tums pass these lips. I've paid the ultimate prices: crispy bones & oxalate kidney stones. Do your research, make your choice. But for me, it's calcium citrate & a lot of it.
   — vitalady

May 1, 2003
Peggy...I posted a question yesterday about calcium, iron, and multi vitamins. Michelle gave me great advice. I agree with what the first poster said about following your doctors advice. But if I were you I would take it one step further. Let me explain myself. Last week I saw my doctor and she said I should take calcium supplements twice a day. I asked her if Tums were okay. She said yes. I asked if there was anything better because I heard that when you are post-op Tums to not work very well. She said that is very true. I aksed her what the best thing to take was. She told me Citrical. Of course when I went and bought my calcium yesterday, I bought the calcium chews which are a form of calcium carbonate.... Oh well, I guess as time goes by I will figure everything out with all the supplements we need to take. Right now I am still pretty confused. There are so many different things out there. Best of Luck!!!
   — Maria S

May 1, 2003
Hi, just a short reply. I've read many testimonials all over the web and from my reading it is calcium citrate that we need to prevent osteoporosis at least 1200mg a day.I take a liquid that i get from Puritan's Pride(that is a catalog= e-mail www.puritanpride.com) so get that it is easy and safer. Jan 1yr post op and down 100lbs
   — Janet S.

May 1, 2003
Calcium carbonate requires stomach acid to be absorbed. Our stomachs are bypassed in the RNY procedure. By the time you join back up with the intestines, there is less acid present. You do the math.<p>I see this question all the time and the bottom line is this: Doctors are fallible. They are people. Sure, calcium citrate costs a little more and you don't get to eat candy when you take it. BUT what if you don't absorb the calcium--then you've got a problem that is very hard to fix and will compromise your health for the REST OF YOUR LIFE. We always have a choice. I made my choice to have this surgery to be healthy and I make my choice every day to take a type of calcium that I KNOW will be absorbed because it is just not worth it to me to take the chance. I have enough of a disadvantage from not drinking milk all my life. I am not about to compound it now by taking calcium I may or may not absorb!<p>Now if I could just talk them into making calcium citrate Viactiv . . . :)
   — ctyst

May 1, 2003
Doctors know how to cut us but they don't usually know a whole lot about vitamins and nutrition. Plus, We are all learning as we go along.This includes the docs. Some just haven't gotten that far yet and just do not know. It certainly won't hurt you to what your doc says but as the previous poster said, take it one step further and buy you some calcuim citrate.
   — Delores S.

May 1, 2003
I'm sure your doctor sincerely believes that Tums are fine. So does mine. However, some studies show that he could be sincerely wrong. Don't take the chance, take the citrate.
   — mom2jtx3

May 1, 2003
Peggy: I posted the following on the Q&A board on 4/29/03:<p>I want to share this information with all of you. I had been in contact with a researcher at the Univ. of Pittsburgh, who has been conducting a study on calcium absorption of post-op gastric bypass patients. I found the article on the UPMC website: upmc.com. It briefly stated the research being done, and stated that bone loss was at a high rate following surgery. I emailed the researcher and asked a couple questions about the study, including what type of calcium the participants took. I received the following response:<p>"Dear Ms McChesney: Thanks so much for your interest in our research. We have been recommending that people take 1000mg calcium citrate daily because we also were concerned that calcium carbonate would not be absorbed after the surgery. The calcium in Tums is calcium carbonate. Our patients were taking a variety of supplements but largely switched to calcium citrate. A very similar operation used to be done to treat stomach ulcers. The part of the stomach which produces the most acid is bypassed so stomach acid is greatly reduced. We are also strongly recommending that people maintain vitamin D intake in the form of 1-2 multivitamins daily. Most vitamin D doesn't come from food, but is made by the body during sun exposure. This obviously varies with time of year and what latitude you live on. However vitamin D deficiency has been described in people after bypass surgery who weren't taking supplements. I would also suggest to someone who has discovered low bone density after this surgery that they have their vitamin D level checked. If someone is deficient, osteoporosis therapies will not be effective. There are very high dose forms of vitamin D available as a prescription which are given over a month to build levels up fast. Vitamin D deficiency can also cause muscle aches and weakness if it is severe and longstanding. There are many other supplements including iron and B12 which also need to be taken lifelong after the operation! I hope this has been helpful Penny Coates"<p>I believe the research in this area speaks for itself. And we certainly have a lot of anecdotal evidence from members here that calcium citrate is the optimal form for WLS patients. I agree with other posters that you can have a great surgeon, but he or she may not necessarily know everything they need to about nutrition and supplementation. I'm planning to be on the safe side, and take the calcium citrate. My doctor actually recommends either one, but the information I've gotten here has shown me I need to take citrate.
   — Carlita

May 1, 2003
Simple solution: When you have a doctor or nutritionist telling you to use Tums, Viactiv, or some other form of calcium carbonate, ask them if it's okay for you to take calcium citrate instead. You won't find a doc or a nutritionist who'll say, absolutely not, don't take the citrate, it won't do you a bit of good. They may think you silly for preferring calcium citrate, but they won't tell you it's not okay to take it. That way, you're not betting your own bones on the outcome of this debate. Let the "doctor knows best" folks take their Tums and see how they're doing in five, eight, ten years, etc. Best case scenario: everybody's fine. Worst case: You're fine; some of them won't be.
   — Suzy C.

May 1, 2003
I know this question has been answered alot but just had to add my 2 cents worth. A surgeon is an expert in the field of surgery not pharmacology. Our surgeon initially was telling everyone to use Tums and Viactive too. I gathered several pages of credible research and information and gave it to his nurse practitioner who read it and then discussed it with the surgeon. Now he has all our patients doing calcium citrate. We tend to feel that our surgeons know everything about everything medical but sometimes they need a little educating. The research is clear - calcium citrate is what we need.
   — ronascott

May 1, 2003
One large support group I attend, with some members being several years post-op have told their osteo stories. They had started taking carbonate after their RNY surgeries and within 6 months had the first signs of osteoporosis. My surgeon advised his patients to take the carbonate but after speaking up time and time again in his support groups, and showing him the research and comments from others, he is now advocating either carbonate or citrate. He still thinks that we produce enough acid to have the carbonate break down, however, I am not going to chance it. I suggest that you have a dexascan right before surgery and one a year later to track whether the calcium you are supplementing is being absorbed and in the proper amounts.
   — Cindy R.

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