Chewable Calcium Citrate
Bariatric University - Bariatric Coach
Unlike deficiencies of vitamin B12, iron, and folate, for which periodic blood testing is a sensitive indicator of status, calcium deficiency is more difficult to detect. Only 1% of the body’s calcium is in the blood stream, the rest being in bones, teeth and marrow. When blood stream calcium is low, the body regularly borrows calcium from bones and marrow. Consequently, blood stream calcium is seldom low even when the body intake is insufficient. The blood stream calcium may be adequate, but the bone calcium level has been depleted. Hence, a blood test for calcium will not register a bone calcium deficiency. A bone density scan is required to do this. Once ingested, calcium normally is absorbed in the duodenum and proximal jejunum by an active saturable process that is assisted by vitamin D. The surgical exclusion of these intestinal segments from digestive system acts to diminish net calcium absorption.
A second factor affecting calcium absorption is the form of the calcium. Calcium is most commonly available as calcium carbonate and calcium citrate. Calcium carbonate, table chalk, has a higher concentration of calcium and is less expensive. However, calcium carbonate is not absorbed well in a non-acidic environment. Calcium citrate has a much higher bioavailability rate than calcium carbonate, particularly for gastric bypass patients who have little if any stomach acid available to assist in absorption. Viactive is calcium carbonate, so it is not absorbed as well as calcium citrate, such as Centrum Creamy Bites.