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Want to know why you need Calcium Citrate and NOT carbonate

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Started by Tiffykins, Jan 10, 2011 1:14 AM
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    Tiffykins

    Believes in the Sleeve

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Posted January 10, 2011 - 1:14 AM

#1
One of my biggest pet peeves is when I see people taking Tums for calcium. Calcium carbonate is much cheaper, and it's not readily absorbed in a neutral pH tummy. This happens when we are on proton pump inhibitors such as Nexium, Prilosec, Prevacid, Protonix and some H2 blockers such as Pepcid/Zantac.

Here's a great article that explains it: Please consider getting on a good quality Calcium Citrate supplement to prevent bone density loss, fractures and osteoporosis. Of course, please discuss this with your specific medical professionals, but next to taking kid's vitamins that are formulated for children bodies, people being told that Tums is sufficient just irks me to NO end.

http://www.healthcen...492/medications

Calcium is an essential mineral in the human body. It is needed for the proper formation of bones and teeth and is also found in the blood and other cells where it regulates metabolic functions. When previous headlines blared about the increased risk of hip fractures with PPI use many AR patients began to worry. I have also had many parents ask me how these medications will affect their child's bone development.



The bottom line is that the research to date is not perfect and does not provide us with all of the answers we need to these questions. According to some commentaries on the PPI and hip fracture research there may be several variables that were not taken into account. Some of those include additional medications those study participants were taking that also have the potential to increase fractures.



A huge issue that was also not addressed was nutritional intake. In an older population with acid reflux it is possible that dietary consumption of calcium is also inadequate. This could be due to a number of factors including palatability issues. It would be interesting to see if the fracture results would be duplicated with the above factors taken into consideration.



By now you are probably wondering where this leaves you, the AR patient, currently taking a PPI. While I would never presume to give you medical advice I can tell you what I have chosen to do:



  • I try to use the lowest dose of my PPI medication that affectively controls my AR and work with my daughter's doctors to do the same for her as well. For children on PPIs it is important to discuss a timeline for weaning from them if (and/or when) they are no longer needed. By no means is this a suggestion that anyone decrease their medications. Improper control of AR can cause a whole host of other problems (See my post on Listen to your Dentist for my hard learned lesson).
  • I include calcium rich foods that are readily absorbed in our diets every day! Some good sources of bioavailable calcium include: yogurt, milk, cheese, fortified OJ, fortified soy, some greens, cabbage and tofu. It is important to note that some foods that seem to have high calcium content are also not readily absorbed. So while they look good on paper, less than 5% of that calcium may actually make it into the body.
  • I take a calcium supplement derived from calcium citrate. While calcium carbonate is cheaper it becomes relatively insoluble in neutral pH and requires stomach acid to be utilized. Calcium citrate on the other hand is much more soluble and does not require stomach acid to be absorbed. If it causes stomach upset you can try taking it with meals. Many experts also recommend including vitamin D and magnesium to this regimen.
  • I participate in weight bearing exercise at least 5 days per week. If you can't make it five days per week start out smaller and work your way up. Some examples include: walking, low impact aerobics or any exercise where your bones are supporting your body weight. (Yes mom, gardening counts!). Things like swimming, which does not require your bones to support your weight, does not have the same positive affect on bone density.
  • Last but NOT least: Discuss your concerns with your doctor!! Please do not make any changes to your current treatment plan, supplements or exercise regimen with out your doctor's consent.




    Shan

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Posted January 10, 2011 - 2:30 AM

#2
I don't take Tums, I take Viactiv which is also calcium carbonate. My Dr. never prescribed a PPI and I've never taken one. I've never felt overly hungry or that gnawing feeling that some people say is acid mistaken for hunger. Is there any reason that I wouldn't want to take a calcium carbonate in my situation? I know I've heard several people mention taking Viactiv in my patient support groups and the Dr. has never said that this is not reccomended.


    M2G

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Posted January 10, 2011 - 7:12 AM

#3
Everyone at my surgeon's office, from the nurses, to the NUTs all tell us all the time Calcium Citrate, NOT carbonate is what ALL WLS patients want (maybe with the exception of the bandsters). It IS much harder to find calicum citrate in chewable form, so I order mine online. It doesn't bother me, I was told up front that I needed chewable calcium citrate.


    Tiffykins

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Posted January 10, 2011 - 9:21 AM

#4

I don't take Tums, I take Viactiv which is also calcium carbonate. My Dr. never prescribed a PPI and I've never taken one. I've never felt overly hungry or that gnawing feeling that some people say is acid mistaken for hunger. Is there any reason that I wouldn't want to take a calcium carbonate in my situation? I know I've heard several people mention taking Viactiv in my patient support groups and the Dr. has never said that this is not reccomended.


It's still not the "best" option, it's less expensive quality, and not as readily absorbed without an acidic environment. My PCM refuses to even suggest to people without WLS to take calcium carbonate. Carbonate needs an acidic environment to break down and be absorbed properly.

If you read the information on carbonate vs. citrate, it's really a better option to take the "best" option even without altered internal organs. I've heard several patients say their surgeons are "happy" with them taking some form of vitamins that something is better than nothing. It's just my opinion that if we're going to take additional supplements, we need to take good quality, adult supplement/vitamins that give us our best chances of not having deficiencies. And blood levels for calcium will not necessarily guarantee that you aren't deficient in calcium. A bone density scan is really the only way to determine how our bones are "aging".

I am not trying to discourage anyone from doing what their surgeons recommend, but I do not believe surgeons are gods, and I want to take care of my body the best I can after going through with VSG. My band surgeon would tell people that Flintstones are just fine, but admitted the reason he said that is because most adults gripe and complain about vitamins so Flintstones taste good, and people will take them.


    Shan

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Posted January 10, 2011 - 1:47 PM

#5
Damn! Those viactivs are darn tasty, too! I guess since I have a full bottle of pineapple flavored liquid calcium citrate in my cupboard I should go ahead and start taking it. I find it repulsive, but I'd find osteoporosis a far sight more repulsive. Next time I'll go for those chewables!


    LilmissDiva Irene

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Posted January 10, 2011 - 2:38 PM

#6

It's still not the "best" option, it's less expensive quality, and not as readily absorbed without an acidic environment. My PCM refuses to even suggest to people without WLS to take calcium carbonate. Carbonate needs an acidic environment to break down and be absorbed properly.

If you read the information on carbonate vs. citrate, it's really a better option to take the "best" option even without altered internal organs. I've heard several patients say their surgeons are "happy" with them taking some form of vitamins that something is better than nothing. It's just my opinion that if we're going to take additional supplements, we need to take good quality, adult supplement/vitamins that give us our best chances of not having deficiencies. And blood levels for calcium will not necessarily guarantee that you aren't deficient in calcium. A bone density scan is really the only way to determine how our bones are "aging".

I am not trying to discourage anyone from doing what their surgeons recommend, but I do not believe surgeons are gods, and I want to take care of my body the best I can after going through with VSG. My band surgeon would tell people that Flintstones are just fine, but admitted the reason he said that is because most adults gripe and complain about vitamins so Flintstones taste good, and people will take them.


I completely agree with you Tiffy, 100%!! I've never spent so much time reading and purchasing all the best types and forms of supplements in my life. However, with the time left over from not eating and money left over from less food and less prescriptions - I can do this for myself. I hope everyone takes this information and really does this for themselves.

Also, I wanted to touch on our Surgeons not knowing everything. How true this is!! My band surgeon was the worst on this. He called the sleeve "Total Bullsh!t"!! Just like that, well I'm here to tell him he was "Oh so wrong". ;)

Anyway, that is why there are Surgeons and there are also Registered Dieticians and Nutritionists.

Good luck everyone!



    SFOTraveler

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Posted January 11, 2011 - 3:27 AM

#7
I was told to take Tums while my stomach heals and then about a month out to switch to Calcium Citrate. No need to get worked up, maybe just explain why a certain type of calcium is best.


    NtvTxn

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Posted January 12, 2011 - 2:18 PM

#8
Get the chocolate chewable calcium citrate from Bariatric Advantage (on line, google it) - they're like Tootsie Rolls!! Better than Viactiv!!! No shipping if you are on the auto shipping plan!! There are other flavors, some people LOVE the lemon, but not me, the chocolate rules!!! :)


Damn! Those viactivs are darn tasty, too! I guess since I have a full bottle of pineapple flavored liquid calcium citrate in my cupboard I should go ahead and start taking it. I find it repulsive, but I'd find osteoporosis a far sight more repulsive. Next time I'll go for those chewables!




    Shan

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Posted January 12, 2011 - 3:09 PM

#9

Get the chocolate chewable calcium citrate from Bariatric Advantage (on line, google it) - they're like Tootsie Rolls!! Better than Viactiv!!! No shipping if you are on the auto shipping plan!! There are other flavors, some people LOVE the lemon, but not me, the chocolate rules!!! :)




Thank you, Thank you!! I'll definitely give them a whirl!


    Tiffykins

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Posted January 13, 2011 - 7:19 PM

#10

I was told to take Tums while my stomach heals and then about a month out to switch to Calcium Citrate. No need to get worked up, maybe just explain why a certain type of calcium is best.


I don't see anyone getting worked up.

People can take what they choose. I happen to choose what is scientifically proven to be the very best option for my needs. If other people choose to take something else, that's on them. I simply shared information that might help someone if they are self-pay, have little to zero nutritional support, or are in the research phase.


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