Calcium citrate vs carbonate (long)

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To: Graduate-OSSG

OK, I do not want to start a war here. But I am looking for an

article, written by a reputable source, that talks abut the benefit

of calcium citrate over calcium carbonate. IF you have any, would

you please e-mail to me the site?? Thanks.

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Here is some info I copied into my database. Hope you find what you're

looking for.

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From: dr4kids2@... (Carolyn)

As both a physician and a bypass patient, I find both of these sources

medically sound and useful. I hope you do as well.

From Source 1: " Let's look at the different calcium combinations:

--- calcium carbonate: The cheapest supplement, is also the highest in

elemental clcium: 40 percent. This is the form of calcium found in Tums and

many generic versions. It has one big drawback: It dissolves slowly in your

stomach, so you may not get the full benefit of all the calcium.

---calcium phosphate ( also called tribasic calcium phosphate): 39 percent

elemental calcium, but you don't need the extra phosphorus that comes with

these tablets-skip them.

--- calcium citrate: This is the form that many doctors and nutritionists

recommend. Only 21 percent elemental calcium, and relatively expensive. On

the big plus side, it dissolves easily even if you don't have much stomach

acid, so you're more likely to absorb all the calcium before the pill passes

out of your stomach. Many people naturally produce less acid as they age, so

this is a good choice for older adults. It's also good for people on acid

blocking drugs.

---calcium lactate: found in many generic calcium supplements. only 13

percent elemental calcium and relatively expensive. on the other hand, it

dissolves easily even in low stomach acid; it is a good choice for older

adults and those who take acid blocking drugs.

---calcium gluconate: also found in many generics, but has only 9 percent

elemental calcium. not a very good choice.

--- calcium glubionate: This is a concentrated syrup form that contains 6.5

percent elemental calcium. You'd need to take 12 teaspoons a day to get 1,000

mg of calcium. this is on the expensive side. take it only if your doctor

suggests it.

Adding to all the calcium confusion are three forms you should not take, no

matter how large the word " natural " is on the label.

---Bone meal: A powder made from the ground bones of cattle, bone meal

has over 1,500 mg of calcium in a 5-gm serving, along with other minerals

such as phosphorus and zinc. The FDA warns that bone meal may contain

dangerously high amounts of lead.

--- Dolomite: This is a mineral also known as calcium magnesium

carbonate. It contains calcium, and also magnesium, which you may not want or

shouldn't take. The FDA warns that dolomite may contain dangerously high

amounts of lead.

---Oyster-shell calcium: this is actually a type of calcium carbonate,

but its made from ground up oyster shells. It may also contain too much lead

and sometimes other contaminants such as mercury and cadmium. Do not use

this if you are allergic to shellfish. "

::::Source 2 ::::

" Several studies indicate some calcium supplements may contain substantial

amounts of lead. Lead is a toxic metal that primarily affects the brain,

kidney, and red blood cell manufacture. Lead toxicity is a significant

problem in industrialized countries like the US. The level of lead in the

body is directly linked to IQ....

" In 1981, the FDA cautioned the public to limit its intake of calcium

supplements derived from dolomite or bone meal because of the potentially

high lead levels in these calcium supplements. However recent studies show

that other calcium sources, such as carbonate and various chelates, may also

contain high amounts of lead.

" To determine the extent of the lead problem in calcium supplements,

researchers measured the lead level in 70 brands of calcium supplements. The

results indicated lead content is still a major concern in some calcium

supplement forms. They divided 70 brands into 5 categories:

1. Refined calcium carbonate produced in a lab (n=17)

2. Unrefined calcium carbonate derived from limestone or oyster shell (n=25)

3. Calcium bound to chelates (citrate, gluconate, lactate, etc) (n=13)

4. Dolomite (n=9)

5 Bone meal (n=6)

Here are the results- (amount of lead in micrograms of lead per 800

milligrams of calcium)

The recommended level is less than or equal to 1 microgram of lead/800mg or

calcium.

1. Refined calcium carbonate, 0.92

3. Calcium chelate, 1.64

4. Dolomite, 4.17

2. Unrefined calcium carbonate, 6.05

5. Bone meal, 11.33

None of the dolomite (9 products) and bone meal (6 products), and only 3 out

of 25 un refined calcium carbonate products ahd lead levels below the

recommended lead level.

" Because of the total tolerable daily lead intake for children 6 years and

under is less than 6 micrograms, young children should use refined calcium

carbonate or chelated calcium products for supplementation. Chelated calcium,

especially calcium citrate is better absorbed than calcium carbonate;

therefore, products that feature a calcium bond to citrate, gluconate, or

some other organic molecule are best. The smae is true for older children and

adults as well.

" Avoid natural oyster shell calcium, dolomite, and bone meal products unless

the manufacturer provides reasonable assurance that lead levels are

negligible. Although refined calcium carbonate has the lowest lead content

the body absorbs calcium chelates more efficiently.

" The absorption of calcium depends somewhat on the calcium becoming ionized

in the intestines. Calcium ionization is a major problem with calcium

carbonate, the most widely used calcium supplement. In order for calcium

carbonate to be absorbed it must first be solubilized and ionized by stomach

acid.

" Studies with postmenopausal women show that about 40 % of the women studied

are severely deficient in stomach acid. Patients with insufficient stomach

acid output can only absorb about 4 % of a calcium carbonate oral dose, but a

person with normal stomach acid can absorb about 22 %. Patients with low

stomach acid secretion need a form of calcium already in a soluble and

ionized state, like calcium citrate, calcium lactate, or calcium gluconate.

Patients with reduced stomach acid absorb about 45 % of the calcium form

calcium citrate compared to 4 % absorption for calcium carbonate.

" This difference in absorption clearly demonstrates that ionized soluble

calcium in more beneficial than insoluble calcium salts like calcium

carbonate in patients with reduced stomach acid secretion. Calcium is also

more bioavailable from calcium citrate than form calcium carbonate in normal

subjects. Calcium citrate and other soluble forms (lactate, aspartate,

orotate, etc) are the best supplements availalble for optimal absorption. "

The article goes on further to discuss how calcium citrate provides a

protective effect against the formation of calcium oxalate kidney stones that

other forms of calcium supplementation cannot provide.

Sources:

1. Pressman, DC, PhD, Alan H and Buff, Sheila; Vitamins and Minerals; alpha

books; 2000

2. Murray, ND, T; Encyclopedia of Nutritional Supplements; Prima

Health Publishing 1996

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from The Natural Pharmacy (in ass'n w/ Health Notes online, © 1998, by 2 MD's

and 2 ND's: (this book is a bit simplistic; mentions studies but doesn't cite

which ones they are)

p.145

A greater percentage of elemental calcium = fewer tabs need 2b taken for

desired intake. Calcium citrate/malate (CCM) has higher absorption rate than

cal carbonate, per research.

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From: sallycpt@...

You are supposed to get at least 1500 mg of ELEMENTAL calcium, over 2500 mg

can be toxic. If you are in doubt about the product, call the manufacturer.

They are all good about giving a speedy response, just contact customer

service. Twin Labs and Citracal are elemental so their labels are exactly as

stated. Calcium citrate reduces risk of kidney stones over carbonate which

is just another bonus.

Sally Myers, RD, CPT

BTW, there is one absorption study on the BPD that states patients are only

absorbing 25% of their calcium. Go read it on the duodenalswitch site.

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There is also an article in the March 2002 issue of Dr. Weil's

" Self-Healing " that says calcium citrate is better absorbed than calcium

carbonate. I don't have the article in my database. You'd have to get it from

a library or maybe his website.

Carol A