Which Calcium do I take after Bariatric Surgery?** Increased Risk for Bone Fractures**

Are you getting enough calcium in your diet after bariatric surgery? No. As a bariatric patient you need to take calcium supplements to maintain bone health. The Obesity Action Coalition reports that doctors from the Mayo clinic looked at 97 bariatric surgery patients from the past 20 years and found that 21 had suffered a total of 31 fractures. This is more than twice the fracture risk of the general population Most fractures occurred an average of seven years after weight loss surgery surgery, primarily in the hands and feet. Other fracture sites were the hip, spine and upper arm.

Calcium is one of the most common supplements taken after weight loss surgery, along with vitamin B12, iron, and a multivitamin. If you are like me, your individual needs may require more beyond these fundamental supplements.

**Calcium Intake after Bariatric Surgery  **

With regard to calcium, what caused me the most confusion was which formulation to take for my RNY gastric bypass. My bariatric surgeon simply had told me "calcium." But I soon learned that calcium is formulated as calcium, calcium citrate, calcium carbonate, coral calcium, calcium plus magnesium, calcium plus vitamin D, and so on.

The main form of calcium supplements are calcium carbonate or calcium citrate. Both are well-absorbed by bariatric surgery patients, although those with decreased stomach acid will absorb calcium citrate more comfortably. Calcium citrate dissolves a little better than calcium carbonate.

It’s a good idea to call or email your bariatric surgeon’s office to find out what the current recommendations are based on the type of surgery you had. Medical knowledge changes and, as such, so might the recommendations that we were given when we first had our bariatric surgery. The Obesity Action Coalition lists the current recommendations from the American Society for Metabolic and Bariatric Surgery for calcium intake after bariatric surgery as follows:

â–ª Adjustable Gastric Band: 1500mg elemental calcium

â–ª Gastric Bypass: 1500 to 1800mg elemental calcium as calcium citrate

â–ª Duodenal Switch: 1800 to 2400mg elemental calcium as calcium citrate

Calcium intake for the vertical sleeve gastrectomy is not provided but may be inferred from the recommendations above as a starting point.

Calcium Absorption

Be mindful of the milligrams and "serving size" on the calcium supplement label. The body only can absorb 500-600mg of calcium at a time. So split your intake into three or more doses of 500-600mg spaced evenly throughout the day, and taken with food to aid absorption.

Do not combine calcium with iron-containing supplements. Separate calcium and iron-containing supplements by at least two-hours to maximize iron absorption and minimize gastrointestinal intolerance.

Vitamin D, magnesium and zinc aid calcium absorption. You need a minimum of 800IU of Vitamin D3 and 400mg of Magnesium. I find it easiest to take these as individual supplements at the same time with my calcium citrate. Yes, that’s a lot of pills but I have not found a compound formulation that provides the ideal amounts of each supplement. Please let me know if you find one!

More information can be found in my article: Calcium After Gastric Bypass Surgery

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References

ObesityAction.org