9 Years Out -- Just Diagnosed With Osteoporosis

Hi All! I've been successful with my WL journey -- at 144 down from 330. I had the RNY in April of 2005. My health has been pretty good other than a few glitches: BP, cholesterol and sugar good, worst has been some digestive issues. But on Friday I was diagnosed with something with my kidney (which I am assuming has nothing to do with the RNY -- at least so far) and Osteoporosis, which the doctor says definitely could have been provoked from menopause and the surgery and weight loss. So I'm very concerned about making sure I take enough Calcium and Vitamin D3 AND absorb it. I take B12 injections. I've been taking VITAFUSION CALCIUM (as tricalcium phosphate) which also contains 1000 IU D3. Because I LOVE IT, I never forget to take it. Now my primary care doctor says to triple whatever I'm taking. She also prescribed a weekly medication, but when I went to fill it and talking to the pharmacist, the side effects made me more than hesitant to take it so fast -- I'd rather in the next two years before the next bone density test see if I can do other things nutritionally and supplement-wise without it.

My concern is: What am I absorbing REALLY after 9 years? Most of my supplements are chewable because I was told that I will absorb them better than pills. My doctor is not up on the RNY. I don't want an anecdotal answer. I really want to know the facts so I can pick what I like in that group of what would work and I'll want to take them. My friends want to get Adora Dark Chocolate Calcium -- I used to take them and I loved them, but again I don't know what they do. They are carbonate, which I know are not choice when you take them as pills, but what about when they are chewable. Any experts out there. Or should I be writing on a doctor's board? I mean absolutely no disrespect to anyone who may be reading this. I'm really sweet as pie most of the time.   I'm just trying to get best info possible as this is for life. Thank you in advance.

Marla

The osteoporosis is most likely because you've been taking tricalcium phosphate, which we don't absorb after RNY because we don't have enough stomach acid.  We need calcium citrate.  That's what the ASMBS says we need.  We absorb pills we swallow just fine, but we can't absorb tricalcium phosphate or calcium carbonate, no matter how you take it.

Thanks for your reply, Kelly -- what is ASMBS?

American Society for Metabolic and Bariatric Surgery.  Here's a link to their nutritional guidelines.  http://nutrition.otago.ac.nz/__data/assets/file/0005/4784/BariatricNutritionReading.pdf.

Thank you! I'll check it out.

In addition to the information from Kelly, you need to understand that it doesn't make any difference whether the calcium you take is in pill form or chewable.  Even in chewable form, we will not absorb the calcium carbonate or tricalcium phosphate.  

You may already know this, but I wasn't sure from your post.. It also doesn't matter how far out from surgery you are since the portion of intestine bypassed, which is the portion that primarily absorbs the vitamins, remains bypassed. Unlike the caloric malabsorption, which the body can overcome, the lack of vitamin absorption is permanent.

There are a number of chewable calcium citrate products out there: the Bariatric Advantage and Celebrate chews in raspberry, chocolate, lemon, carmel, and berry flavors; Calcet Creamy Bites in chocolate and lemon; Healthy Indulgence dark chocolate "coins"; plus the chalky lozenges (that most people don't care for).

Even with taking 1500mg of calcium citrate my DEXA scan was fine at year 4 post-op, but showed some bone loss in one hip at 6 years out. I am 51, so menopause plays into the equation for me as well.  I increased my calcium citrate I take to 2000mg per day.  It is kind of scary to know that there are multiple things working against our bones!

Lora

You also need Vit K (K2 - lots of it), magnesium and boron... boron.  All of those are very important to make sure that calcium you take and absorb get put in bones and not somewhere else.

Check the Vit K2 and bone health. 

Thanks for mentioning the K2 Just did some reading on K2. I didn't realise how important it was. I notice that centrum only has a small amount of K1 in it and no K2. Looks like I need a visit to the drug store

If you take K or K2 - they are fat soluble.  If you can't get dry - take normal K in oil together with coconut milk or coconut oil (if you had RNY or DS, VSG - it doe snotmatter - butitwould also help). Coconut oil do not need to be digested and gets absorbs almost right awaty and the body use that for energy - not fat storage.  Not only you get much better numbers with fat soluble vitamins - but you may even feel warmer.