Calcium Citrate vs. Carbonate

[more2adore]

So I know from what I've read here over and over and over again that Calcium needs to be Citrate form, not Carbonate form. But I can't find the "why" of it other than off-handed references to absorption. Somebody knock me over the head if I'm being obtuse! I did search the forum and couldn't find anything on this.

I can't handle the ginormous Calcium Citrate tabs right now. All my other vits I manage, but the Calcium Citrate just will NOT go down without serious pain. I've tried crushing it, but with the timing of my other vits and meds and the timing of my meals right now it's impossible to time it to take it with food... I have tried to find a way, and there just isn't one. I've even tried crushing it and mixing it with water but it won't mix well. I've tried crushing it and putting it directly on my tongue... yuck!

I finally caved and bought chewables, but the only chewables available over here are Carbonate. Is it going to be a serious problem for me (remember, I'm just a VSGer!) to spend a few months on chewable carbonate before I try going back to those giant honking Citrate tablets? The ones I got yesterday are 1250mg of Calcium Carbonate (providing 500mg of elemental calcium) and I take two.

From what I can tell, Calcium is not normally absorbed in the stomach, so I shouldn't be malabsorbing it much if at all.

Thanks!

 

[DianaCox]

Stomach acid - you don't have enough to dissociate sufficient calcium carbonate (which requires acid to dissociate to calcium ions and carbonate ions).

http://www.webmd.com/osteoporosis/features/calcium-supplements-pills

What kind of calcium supplement should you take?

"I tell my patients to take the kind that they tolerate best and is least expensive," Bolster says. She says she recommends calcium carbonate because "it's inexpensive, won't cause discomfort, and is a good source of calcium."

Some people's bodies may have problems making enough stomach acid, or may be taking medications that suppress acid production. Forthem, says J. Edward Puzas, MD, a calcium citrate supplement might be better because it "dissolves a little better than calcium carbonate for these people."

http://bariatricfacts.org/threads/calcium-carbonate-transformed-to-calcium-citrate.889/

 

[more2adore]

Ah, I see! Thanks Diana! Though the "a little better" makes me think it might not be a big problem doing it for just a few months. And with the acid issues I am having right now... hahaha. Hard to see how "too little acid" would be a problem, lol. Twice what the maximum dose of my PPI is supposed to be for reflux, OTC Gaviscon and OTC Zantac and I'm still having breakthrough acid issues while I sleep right now.

 

[newanatomy]

As a VSG'r, can you take a normie dose of calcium anyway? I would not panic until you can get them down. You are not very far out yet.

 

[Larra]

You may not have as much stomach acid as you feel like you have. Remember, with most of your stomach gone, you no longer have a big reservoir for the acid to pool in. It has to go somewhere, and for now, that somewhere is up into your esophagus. So even a relatively low amount of acid feels like a lot. In other words, when Diana tells you that you may not have the stomach acid you need to dissociate the calcium carbonate, she's probably right (she usually is).
I totally understand about those ginormous calcium citrate pills. I have trouble with them as well. Since you aren't here in the USA where it's easy to get other products, I would recommend a pill cutter. They are cheap and readily available at any drugstore. Even if the pills aren't scored you can still cut them with a pill cutter. If two pieces are still too large for you, cut them into 4 pieces. Do whatever you need to do. It's so important, and while I never tried crushing them, I think it would be easier and much less unpleasant to swallow a bunch of little pieces of calcium citrate than to crush them and then try to swallow something disgusting.

 

[Purple Frog]

As a VSG'r, can you take a normie dose of calcium anyway? I would not panic until you can get them down. You are not very far out yet.

Yup, I started taking them at 8 days out.
I'm amazed they go down.

@more2adore, I like @Larra's suggesting of getting a pill cutter.
There are also "petites" (I don't know if they are available where you are), but you'd have to take an extra to get the right dosage.

 

[more2adore]

Oh, believe me, I HAVE a pill cutter - I tried that before I tried crushing them (should have mentioned that!). Even cut in half they are PAINFUL! When I tried cutting them where they weren't scored, they crumbled into a zillion pieces and I had the same issues as when I crushed them.

@newanatomy I am trying to take a normie does, lol. But the pills for even that are ginormous.

@Purple Frog No petites that I've found here so far! It's frustrating living somewhere with so many fewer choices than you guys have in the States sometimes. I think when we live in the US we really take the availability of a lot of things for granted!

I'll figure something out. It shouldn't be an issue TOO much longer.

 

[GirlFriday]

I am 42 hours away from surgery.
I got the chewable calcium citrate. Did you try the chewable kind? I ordered mine off of Amazon.
I got a 60 day suppy for $12.00.

 

[Larra]

@GirlFriday be sure to check the dose on each of the chewables. Some contain 500 mg of calcium citrate, some only 250. A "dose" is 500 mg, and you will need at least 4 doses/day, at least 2 hours apart.
the good news is that you don't need to worry about this until you are a bit recovered from your surgery. Don't torture yourself trying to take pills or even chewables right away. Your sleeve will rebel. Give yourself time to heal first.
Also, be sure to read the label on those chewables to see whether or not they contain sugar alcohols. A couple grams here or there will probably be ok. A whole lot of sugar alcohols and your colon will be very unhappy, and so will you.

 

[marissamast]

My calcium citrate is in capsules. Hope you feel better soon.

 

[southernlady]

Also, be sure to read the label on those chewables to see whether or not they contain sugar alcohols. A couple grams here or there will probably be ok. A whole lot of sugar alcohols and your colon will be very unhappy, and so will you.

Yeah, I simply can not do sugar alcohols...my DAILY limit is 4 grams or I pay for it.

 

[more2adore]

I am 42 hours away from surgery.
I got the chewable calcium citrate. Did you try the chewable kind? I ordered mine off of Amazon.
I got a 60 day suppy for $12.00.

Thanks, girlie, but Amazon won't ship those here to Australia. I checked. Unfortunately we're very limited in what we can get here. Hugs. You'll do great. You're preparing very well.

 

[Munchkin]

If you can't find citrate, look for apatite or bone meal too. I know it's easier to find these in Europe than citrate.

 

[Larra]

Would Bariatric Advantage ship to Australia? If so, you could order their lozenges and/or chewables.

 

[more2adore]

I think we may have located somewhere here that has citrate chewables... fingers crossed! I'll post where it is once I get them so anyone else that ends up posting here from Aus can find them!