Friday, March 21, 2008

The Calcium I Take

EDITED TO ADD: I've written an extensive list of available Calcium Citrate brands including chewable calcium, liquid calcium and pill-form calcium. You can view it here: My Calcium Recommendations.

It's VERY important that after RNY that we take calcium citrate.

This form of calcium is the most soluble in a non-acid environment. After surgery there is no longer any gastric acid in our pouches - or very little, and what is there is often suppressed with acid blockers for the first year after surgery. (I'm taking Prevacid per my surgeon's orders.) The cheaper and more readily available form of calcium - which is carbonate - requires gastric acid to be broken down within the stomach and absorbed by the intestines.

There's a medical condition called Achlorhydria - which is when a patient has no stomach acid (hydrocloric acid). By studying this condition we can learn a lot about how we as post-RNY patients should be treated by our doctors and which medications and supplements we need to choose.

In a study published in the New England Journal of Medicine by R.R. Rekker the calcium absorption rate of achlorhydria patients was studied. After giving test subjects a dose of calcium, the bioavailability (absorption of the dose) was measured. His finding were:

Calcium Carbonate Absorption = 4%
Calcium Citrate Absorption = 45%

So it's clear that after gastric bypass surgery we MUST take calcium citrate in order to have a chance at having healthy bones and teeth.

So here's what I take - yes, I really do use all these forms of calcium. I take 4 doses per day, so I like variety and choices. 

UpCal-D ---- this is a powdered calcium citrate with Vitamin D3. In each tiny scoop I get a dose of 500mg of calcium citrate and 250IU of Vitamin D3. I mix it with my protein shake, plain water, food or whatever - it's tasteless and dissolves very easily with anything. I've even started to just pour the dose on my tongue and take a swallow of water - kind of like a Pixie Stix. It has a slightly sweet taste, not yucky or medicine-y at all.

Bariatric Advantage Calcium Chews -- When you want your calcium to taste like dessert! These little two-bite candies might taste sinful or naughty, but they contain 500mg calcium citrate, just what we need.  You can get them in chocolate, lemon, raspberry.

Bariatric Advantage Calcium Lozenges -- These wafer-type chewable calcium citrate pills are great for getting your calcium. They've recently redesigned the formula, so each pill has 500mg. They are chewable and the Wild Cherry tastes like a sweet tart. I'm not sure where the term "lozenge" came from, because that word seems to imply a hard-candy like thing you'd suck on. But these aren't hard candy at all, it's a chewable sweet tart like consistancy. I love the Wild Cherry flavor but there is also chocolatecinnamon

Citrical Regular Calcium Citrate -- with 630mg per dose (2 pills) these are an economical and easy way to get my calcium. You can buy the Citrical Petites - they are a smaller sized pill for easier swallowing but each pill has less calcium per dose, so check the label and adjust accordingly. 

The ASMBS recommends RNY patients get 1500-2000mg calcium citrate per day, in addition to any calcium we get from our diet.

Because I'm on a form of birth control that tends to leach calcium from bone (Depo Provera), my GYN has recommended that I increase my calcium intake above the normal range because Depo Provera tends to leach calcium from the body. So opt to dose at the top end of the recommendation scale and I take 2000mg per day.

Here's my calcium schedule:

Pre-Breakfast Protein Shake --- 500mg
After Lunch -- 500mg
After 4:30 Snack -- 500mg
After Dinner -- 500mg

It's best to take calcium with food because it will absorb better. However, if your meal is very high in iron (green leafy veggies or beef) then you might want to avoid a dose of calcium after that meal and find a different time to take it. Iron interferes with the absorption of calcium. That's why I take my multi-vitamins at different times than I take my calcium because my vitamins have iron in them.

If you have any questions about calcium, feel free to ask. I'll do what I can to shed some light.


1 comment:

  1. The information here is great. I will invite my friends here.



Related Posts

Related Posts with Thumbnails