Question:
Dietician said no diff between citrate & carbonate --Teach me
During the initial large group consult, the dietician, who seemed knowledgeable in most other areas, mentioned that we would all have to take calcium after surgery. I expected this. When I looked in her handout, I noticed she had listed some forms that were citrate and others that were carbonate. HELP! I recall that one can't be absorbed and leads to osteoporosis. I asked her about it, but she shrugged me off and replied to the group, "Oh, either's fine. Just be sure to take it." Please educate me, so that I can educate her and spare others the dangers of osteoporosis (my mother has it, so I know it's hidden and awful maladies). Thanks. — Mary Ann B. (posted on August 22, 2002)
August 22, 2002
Calcium carbonate (think of eggshells) requires hydrochloric acid (stomach
acid) to be digested and absorbed. Tums are calcium carbonate and what do
Tums do to acid?
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It really depends on the type of WLS surgery that you had as to whether the
calcium carbonate can be properly absorbed. However, keep in mind that
vitalady.com (who sells vitamins especially formulated for WLS patients)
does not offer any products which do not contain calcium citrate.
— John Rushton
August 22, 2002
I would also like to add that Michelle (vitalady) Curran and her husband
have both been diagnosed with osteoporosis because they both took calcium
carbonate. It is true that it needs acid to be broken down and be
absorbable. We don't even have the acid anymore. The citrate is a more
bioavailable form, even in regular folks. My nutritionist also had all of
the patients on Calcium carbonate until I did some research and presented
the facts to her. There is definitely a learning curve in this area and
she was very thankful that someone had taken the time to get all of the
required info to make the change. Now everyone in our group is on the
citrate. Some are just behind the times and need to be informed. Maybe
you are that person to inform her. I just felt like I had to be my own
advocate and do the research for ME. We really have to take on that
responsibility, because nobody else will. Remember to take your calcium in
500mg. increments as that is the most that can be absorbed at a time. And
for some reason our bodies do a much better job at absorbing the citrate in
the evening and night hours. But you still have to take a couple of doses
during the day. Good for you for looking into this! Do even more research
on the internet. There is lots of stuff out there.
— Cheri M.
August 22, 2002
My dietican said that since I have a history of kidney stones that I should
not take the Tums which are calcium carbonate but should take calcium
citrate. I also want to prevent osteoporosis (which my mother has) and
believe that the information provided by Michelle Curran is quite credible.
So, I am sticking with calcium citrate. Hope this helped a bit. Hugs and
Prayers.
— Kathleen K.
August 22, 2002
I have an interesting thought. If we were to take calcium carbonate with sf
lemonade (acidic) could we digest it???
— Robert L.
August 22, 2002
The acidity in citrus type foods/drinks probably doesn't even compare to
the gastric acidity level. But how much acidity is enough to absorb
carbonate? That IS an interesting question Robert.
— Cheri M.
August 23, 2002
I believe that it's the *chemical* reaction of the hydrochloric acid in the
stomach acid with the calcium carbonate. Calcium chloride, carbon dioxide
& water are the results of the reaction. Ca CO3 reacts with HCl very
easily - that's why the Tums takes care of the excess stomach acid. It's
been years since my high school chemistry, but I remember the experiments
with the marble and the dilute hydrochloric acid...
— John Rushton
August 23, 2002
Maryann, you are smart to research this topic. I, too, had a surgeon that
thought there was no difference between the two. I went to a different
support group, where hundreds attend, and they have
dieticians/nutritionists that have looked into this and calcium citrate NOT
carbonate is the way to go. This support group has some long term post-ops
in it that were initially put on carbonate and a few of them developed the
initial signs of osteoporosis within 6 months. Don't take the chance!!
— Cindy R.
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