Calcium Supplements: Are you taking the right one?

After a sleeve gastrectomy, there are several supplements you need to take each day. One of the most commonly forgotten is calcium. Taking a calcium supplement is essential as it is very difficult to get enough in the portion sizes eaten after surgery. But are you taking the right one?

The recommended daily intake for calcium is 1000-1300mg depending on your age. The ASMBS who write the guidelines for nutrition after weight loss surgery recommend that the daily calcium intake from diet and supplements for those with a sleeve should be even higher than the regular person at around 1200-1500mg/day.

1200-1500mg calcium equates to 4-5 serves of dairy which is near impossible to eat after surgery without compromising other food groups. This is where supplements come in.

What happens if I don’t take a supplement?

The body regulates the amount of calcium we have in our blood as it’s involved in muscle contractions. When you don’t eat enough calcium in your diet, to keep this blood level stable, your body starts to take calcium out of your bones (the biggest store of calcium in the body!).

Taking calcium from the bones can lead to osteopenia and osteoporosis in the long term. Other serious consequences inadequate calcium intake include muscle twitching and cramps, headaches, low blood pressure, brittle nails, skin problems, depression, vision problems and even fainting and heart issues. All very good reasons to make sure you are taking calcium supplements daily!

Don’t rely on a blood test

Often when I ask if a client is taking their calcium supplements, I get a “No, but my calcium was fine on my blood test” in response. The problem is, because your body needs calcium in your blood to be consistent, it’s impossible for a blood test to show if that calcium in your blood is coming from your diet or your bones. Until it’s too late, that is. So, don’t rely on your blood tests – you need to be taking a calcium supplement daily anyway!

What supplement should I take?

There are two different types of calcium in calcium supplements: calcium carbonate (most common) and calcium citrate. Unfortunately, although the most common, calcium carbonate supplements are not well absorbed after a sleeve as you have less stomach acid for the supplement to interact with.

Calcium citrate is the type of supplement recommended for those who have had a sleeve as it is better absorbed (up to 2.5 times more than calcium carbonate!). The only problem is, there aren’t many on the market.

To make the most of your money, and do the best for your bones, look for one of these supplements:

• Citracal + D. This is usually easy to find in pharmacies (not so easily found in supermarkets). It is quite big though so you might need to cut it to make it easier to swallow
• Swisse Ultiboost Calcium and Vitamin D. This one is also quite large so you may need to cut it. Also found quite easily in pharmacies
• BN Cal. This one is specifically designed for use after weight loss surgery. It’s a little more expensive, but it’s easier to take as it’s chewable (and chocolate flavoured as a bonus!). Visit the BN Multi store to purchase.

How much should I take?

You should be aiming for 1200-1500mg calcium per day from diet and supplements. So for example, if you have milk and yoghurt on your cereal in the morning and a milk coffee during the day you could be up to around 600mg so would still need 600-900mg in supplements (usually 2-3 tablets).

To maximise absorption the ASMBS recommends:

• Calcium should be given in divided doses throughout the day. For example, taking one mid-morning, one mid-afternoon and one after dinner.
• If you do use calcium carbonate – take it with meals, then when you run out, but a calcium citrate supplement instead. Calcium citrate may be taken with or without meals.

All of the above is a general rule, so make sure you discuss what is best for you with your dietitian and adjust accordingly. You can also download my guide to supplements below.