Question:
Does it really matter?

I see posts that say we don't absorb calcium carbonate, only citrate, is that true? I remember in nursing school we were taught that it did not matter what kind of calcium it is a long as it has vitamin D because that is what helps you absorb it. I will ask my dietician, but I just wondered what you all thought.    — Shannon B. (posted on October 27, 2003)

October 26, 2003
What you learned in nursing school is correct for people with normal anatomies. My understanding, which my dietitian agreed with, is that calcium carbonate requires stomach acid to break it down into an absorbable form. Since we don't produce much stomach acid, and things don't stay in our pouches nearly as long as food stays in a regular stomach, there isn't enough of a breakdown to be able to absorb the carbonate well once it hits the intestines. Also, since a fair amount of our small intestines are bypassed, there is less area for the calcium to be absorbed, so it needs to in a highly absorbable form. Calcium citrate doesn't need the stomach acid to be broken down before reaching the intestine. That's why you really need to take calcium citrate now.
   — Vespa R.

October 27, 2003
I started out using Viactiv Chews and OsCal. I did not know that these was Carbonate. Eventually I began having extreme pain in my legs. Tests showed that my body was taking Calcium from my body because I was not taking in the needed calcium. I've since switched to 100% Citrate and after a couple weeks my pain got better.
   — [Deactivated Member]

October 27, 2003
Research is beginning to point to the importance of calcium citrate for post-ops. Following is some information I gathered last spring. This is also posted in my profile:<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: "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"
   — Carlita

October 28, 2003
I dont know as much about the fact that it doesnt get absorbed, but my surgeon told me that it can cause (either gall stones, or kidney stones, I cant remember which) I would rather not risk it. :-)
   — Katrina K.