cinwa

Are you sure you're getting all the calcium you think you are?

116 posts in this topic

We all know that we should be taking calcium citrate and not carbonate, right?

This has probably been posted before but with all the newbies, it's definately worth mentioning again.

Did you know that the amount of calcium citrate shown on the label isn't necessarily the amount of elemental calcium you think you're getting. And more to the point, it isn't the amount you need for bone health.

If the label says (and I use 500mg as an example):

"500mg calcium as calcium citrate" - you get 500mg elemental calcium.

"500mg calcium from calcium citrate" - you get 500 mg elemental calcium.

"500mg calcium (calcium citrate)" - you get 500mg elemental calcium.

"500mg calcium citrate" - you get about 125 elemental calcium.

"500mg calcium" - who knows! Chuck it away.

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Oh!! I can add to this one...

We buy Calcium Citrate that is labeled as 600 MG. We're supposed to take 1200 MG a day, so we have been taking two a day. We're good...right? Wrong!

Jane noticed a little while back when reading the label that the serving size is 2 pills! That means that the pills are only 300 MG each, so we need to take 4 to get the 1200 requirement.

I've never seen a vitamin labeled this way before and we did not notice it for almost a year.

-Mike-

msde83 likes this

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Corrine, I've posted this same information before but it is something that is worth repeating. It actually should be made a sticky. I don't think most people are aware of the difference of the labels and how 500mg Calcium Citrate isn't actually 500mg Elemental Calcium Citrate. Why do they have to make is so hard to understand? It really is kinda frustrating!!

Thank you for re-educating us. You are such a wonderful resource when it comes to vitamins.

Now to get John to make this a sticky! :D

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For the 2nd time in a year I have been found to be Vitamin D deficient and have to take a HUGE pill once a week or 6 months.

Make sure your surgeons are testing for this with your other labs. You need the Vit. D to absorb that calcium!!

MaggyMay likes this

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For the 2nd time in a year I have been found to be Vitamin D deficient and have to take a HUGE pill once a week or 6 months.

Make sure your surgeons are testing for this with your other labs. You need the Vit. D to absorb that calcium!!

AND IT SHOULD BE VITAMIN D3 (cholecalciferol)!

Duckie - I had the same problem.

The prescription for 50,000IU Vitamin D turned out to be D2 (ergocalciferol) and not the dry form D3 (cholecalciferol) - this is worth reading from the American Journal of Clinical Nutrition The case against ergocalciferol (vitamin D2) as a vitamin supplement -- Houghton and Vieth 84 (4): 694 -- American Journal of Clinical Nutrition "vitamin D2, or ergocalciferol, should not be regarded as a nutrient suitable for supplementation or fortification."

And this is short and sweet from Bariatric Advantage:

How is D3 different from D2?

Vitamin D2 (ergocalciferol) is differenet from vitamin D3 (cholecalciferol). D2 is the most common commercial form because it can be readily prepared from plant materials that contain the compound ergosterol. Vitamin D3, cholecalciferol, is the form that animals (including humans) synthesize from cholesterol, and is considered to be the natural form of the vitamin. D3 is estimated to be 3 times more potent than vitamin D2

You can get 50,000IU D3 (dry form) online - the cheapest I've come across is from vitalady.com - $22.55/100 caps (they're tiny).

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THanks for the info!!

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I'm not sure I see the difference in line 3 and line 4 - (other than what I assume is 375mg difference)

Corrine - I'm sure you've answered this several times before - but what brand of Ca do you take?

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I'm not sure I see the difference in line 3 and line 4 - (other than what I assume is 375mg difference)

Corrine - I'm sure you've answered this several times before - but what brand of Ca do you take?

3. calcium (calcium citrate)

4. calcium citrate

Basically, if it just says "XXmg calcium citrate" then you're getting calcium salts too and that makes up approximately 75% of your dose, the other 25% being elemental calcium that we need. In a nutshell, you have to take 4 times as much.

What calcium citrate do I use? - the cheapest as long as I get all the elemental calcium I need in one dose.

I'm far enough out to use tablets. These are usually the most costs effective and even though they're pretty big, if you can't swallow them as is (or cut in half), they're soft enough to chew up a bit and wash them down with a bit of water. They're just a little chalky.

If you're still a little confused, go for Citracal (all the range comes with the necessary vitamin D3 too).

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ok...am i goona catch flak for this?

I take calcium carbonate. I KNOW it requires acid to absorb so I chew it up with orange juce. Above that, I drink between 3/4- 1 liter (3/4-1 qt) milk a day.

My dietician says this is ok.

Anyone have some feedback on this?

Princesse

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ok...am i goona catch flak for this?

I take calcium carbonate. I KNOW it requires acid to absorb so I chew it up with orange juce. Above that, I drink between 3/4- 1 liter (3/4-1 qt) milk a day.

My dietician says this is ok.

Anyone have some feedback on this?

Princesse

Princess,

It's doubtful that citric acid in orange juice can come anywhere near to performing the function that hydrochloric acid in the stomach would.

Bloodwork merely measures the amount of calcium in your blood and your blood does a really good job of taking calcium from your bones as and when it needs it. Although we think of calcium in terms of bones and teeth, we also need it for our muscles, blood clotting, nerve transmission, cell membrane maintenance etc. etc.

Anyways, he only accurate way of determining that you have sufficient calcium stores is to have a densitometry or DEXA scan done on a regular basis. And unless you're doing that, there is no way of knowing whether your intake of calcium cabonate (and milk) is sufficient for your needs.

Calcium in your bones is like a savings bank and your blood is constantly making withdrawals. If you're not depositing enough to keep the calcium levels up in your bones, ultimately you're going to be overdrawn and that could lead to osteoporosis. And the worst is, you won't know that's happening until it's too late.

What form of calcium you take is your choice but at 42, now might be the time to do some serious research into this.

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Calcium Question, figured I'd put it here.

My protein shake says that it gives 100% of daily calcium in each 11oz serving. Does anyone else factor in their shakes into their calcium totals for the day? I'm still struggling to find the calcium for me, but if i'm drinking 2 shakes a day that say they give me 100% each, how much more calcium should I be taking?

Thought?

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I don't factor in any of the calcium I get in from food etc. I drink at least 24oz of milk plus cheese plus yogurt.

The normal additional requirement is between 1,500 and 2,000mg of calcium citrate per day.

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I don't factor in any of the calcium I get in from food etc. I drink at least 24oz of milk plus cheese plus yogurt.

The normal additional requirement is between 1,500 and 2,000mg of calcium citrate per day.

May I ask why you don't factor these things in? I know that as a post-op patient, we need more than the average person, but do we really need upwards of 350% of the daily requirement?

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If we got our calcium from our food we wouldn't have to take extra vitamins. Our bodies don't absorb it due to our "re-routing" therefore we need the supplements.

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Just an FYI - You can take as much Calcium as you want as your body will not absorb more than it needs (water based). However, vitamin D is oil based and you can overdose on this. I did.

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Just an FYI - You can take as much Calcium as you want as your body will not absorb more than it needs (water based). However, vitamin D is oil based and you can overdose on this. I did.

Although there is no clear information as to how much a WLS patient malabsorbs, there is clear evidence that you can overdose on calcium supplements:

Dietary Supplement Fact Sheet: Calcium

While low intakes of calcium can result in deficiency and undesirable health conditions, excessively high intakes of calcium can also have adverse effects. Adverse conditions associated with high calcium intakes are hypercalcemia (elevated levels of calcium in the blood), impaired kidney function and decreased absorption of other minerals ... (high calcium intakes is the potential for calcium to interfere with the absorption of other minerals, iron, zinc, magnesium, and phosphorus)....

Additionally, men who ingested more than 2,000mg of calcium/day were nearly double at risk of developing protate cancer (but this was a study done by the American Asociation for Cancer Research on non-WLS patients). Linus Pauling Institute at Oregon State University

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Although there is no clear information as to how much a WLS patient malabsorbs, there is clear evidence that you can overdose on calcium supplements:

Dietary Supplement Fact Sheet: Calcium

Additionally, men who ingested more than 2,000mg of calcium/day were nearly double at risk of developing protate cancer (but this was a study done by the American Asociation for Cancer Research on non-WLS patients). Linus Pauling Institute at Oregon State University

I can only attest to my own experience with not regulating my vitamins properly. But at one point I was passing kidney stones on average of 1 or 2 a month (I wish that was an exaggeration). I also had what is called Ossification of a Mid-line Incision. Basically, I had a bony mass that was growing along my RNY scar just below my sternum. By the time it was removed (when I had my hernia repair) the mass had grown to the size of a lemon.

To be fair, I did have kidney stones pre-op at a rate of about 1 a year. Since getting on my current vitamin regiment I have not had serious (take me to the ER) kidney stone in over a year now.

One other note - The vitamin D overdose is cumulative. I am guessing that I was overdosing at least a year before something showed up in my blood work (alkaline phosphatase levels out of normal range).

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I can only attest to my own experience with not regulating my vitamins properly. But at one point I was passing kidney stones on average of 1 or 2 a month (I wish that was an exaggeration). I also had what is called Ossification of a Mid-line Incision. Basically, I had a bony mass that was growing along my RNY scar just below my sternum. By the time it was removed (when I had my hernia repair) the mass had grown to the size of a lemon.

To be fair, I did have kidney stones pre-op at a rate of about 1 a year. Since getting on my current vitamin regiment I have not had serious (take me to the ER) kidney stone in over a year now.

One other note - The vitamin D overdose is cumulative. I am guessing that I was overdosing at least a year before something showed up in my blood work (alkaline phosphatase levels out of normal range).

In fairness, I should ask exactly how much calcium you take on a daily basis.

The currently recommendation is between 1,500 and 2,000mg/day broken into 500mg doses.

For anyone else, before you decide to increase the WLS recommended doses of vitamins or supplements, run it by your doc/surgeon/NUT first.

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In fairness, I should ask exactly how much calcium you take on a daily basis.

The currently recommendation is between 1,500 and 2,000mg/day broken into 500mg doses.

For anyone else, before you decide to increase the WLS recommended doses of vitamins or supplements, run it by your doc/surgeon/NUT first.

I am taking 1500 mg daily. The problem (as I see it) was that this included 3x of the RDA of vitamin D, and I am already getting 2x with my multivitamin. I am guessing that I had been dosing 5x the RDA of vitamin D every day for over a year. And this is not accounting for the vitamin D I get from sunlight (and I live in Florida). Anyway, I'm not sure if we have any malabsorptive issues for vitamin D, but as my blood work indicated that I was getting more than I needed, I've cut out the "Plus D" vitamins.

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I am taking 1500 mg daily. The problem (as I see it) was that this included 3x of the RDA of vitamin D, and I am already getting 2x with my multivitamin. I am guessing that I had been dosing 5x the RDA of vitamin D every day for over a year. And this is not accounting for the vitamin D I get from sunlight (and I live in Florida). Anyway, I'm not sure if we have any malabsorptive issues for vitamin D, but as my blood work indicated that I was getting more than I needed, I've cut out the "Plus D" vitamins.

Having read your posts again, I think your message relates more to the matter of vitamin D rather than calcium. And is probably worthy of an entirely new thread.

But to get back to calcium.

The current RDA for calcium (elemental) is 1,000mg/day (19-50yrs) and 1,200mg/day (51yrs and over).

The Upper Intake Level is 2,500mg/day.

But that is for people with intact stomachs.

The latest recommendation for WLS patients (ABMBS Guidelines released March 2008) is: http://www.asbs.org/Newsite07/resources/bgs_final.pdf

RNY: 1,500-2,000mg/day elemental calcium

BPD/DS: 1,800-2,400mg/day elemental calcium

Your 1,500mg/day is well within those guidelines.

But again, to bring this thread back on track, I'll repost the original message because it is important:

We all know that we should be taking calcium citrate and not carbonate, right?

This has probably been posted before but with all the newbies, it's definately worth mentioning again.

Did you know that the amount of calcium citrate shown on the label isn't necessarily the amount of elemental calcium you think you're getting. And more to the point, it isn't the amount you need for bone health.

If the label says (and I use 500mg as an example):

Please start a new thread about your experiences with vitamin D. Overdoing any vitamin/mineral has consequences which is important to share.

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I use the chewable Celebrate Bariatric Supplements for Calcium. A serving size is 4 tabs, I take 2 at noon and 2 at suppler (I take iron at breakfast time). They have Calcium (as calcium citrate) and the cholecalciferol Vitamin D, 200 IU per tab.

Rose

Lap RNY 05/08/08

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Having read your posts again, I think your message relates more to the matter of vitamin D rather than calcium. And is probably worthy of an entirely new thread.
I only bring it up as most of the brands of calcium citrate now include vitamin D. The last time I went to purchase vitamins (local CVS) I actually found myself having to search for calcium citrate that did not have vitamin D. I think that this germane to the discussion, but it's your thread.

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I only bring it up as most of the brands of calcium citrate now include vitamin D. The last time I went to purchase vitamins (local CVS) I actually found myself having to search for calcium citrate that did not have vitamin D. I think that this germane to the discussion, but it's your thread.

Vitamin toxicity is too important to bury in a thread about deciphering calcium labels.

Again, I think you should start a new thread about this.

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Why is this all so confusing?!?! Argh!!! It is very confusing, but very good to know. I am less than 2 weeks away from surgery and trying to make a daily 'what I need' just so that my MIL and husband as well as I will know what I need to be taking in.

I knew about the Vitamin D aiding in the absorption of Calcium Citrate. And thank you Corrine for all of that info. Thank the Lord I am already taking the correct one. It actually says Calcium (elemental) right on the serving sugg., so good. But, like others, I've only been taking one serving of two tablets where I should be taking 2 servings.

The other thing that was not mentioned on here that I thought is pretty important is that you should not be taking your calcium at the same time as your multivitamin. The iron blocks the absorption of calcuim. Maybe this is common knowledge to everyone, but hopefully this info might help someone. It's a lot to deal with. I am definitely taking another look at all my vitamins and making sure I'm gonna get what I need after surgery, just glad I'm doing it now.

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ok.... so what is everyone's FAVORITE Calcium Citrate??? I need help w/this. I don't like a taste of "earth", you know those vitamins/supplements I'm talking about! yuck!!! I wouldn't mind a chewable if its not orange flavored. I wouldn't mind a tylenol sized COATED capsul/tablet. Any ideas???

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