Calcium Bioavailability Exceptions: What You Need to Know

Updated: August 26, 2022

Lara Pizzorno in red shirt and blazer in front of bookshelf

Lara Pizzorno is the author of “Your Bones: How You Can Prevent Osteoporosis and Have Strong Bones for Life – Naturally” and a member of the American Medical Writers Association with 29 years of experience specializing in bone health.

Recently we asked Lara if she would help us provide a series of short, ongoing videos to help you (our customers and readers) stay up to date on the latest facts and science related to bone health.

In this latest video, Lara talks about calcium bioavailability. As we learned in the last video, calcium bioavailability is virtually equal among all the forms, but there are exceptions. Watch the video below (or read the transcript provided) and let us know what you think in the comments. 🙂

Hello, I’m Lara Pizzorno the author of “Your Bones” and I’m here today to share some information with you that I hope will help you have healthier bones.

In our last video we talked about calcium bioavailability and the fact that virtually all forms of calcium are equally bioavailable for almost all of us. There are a few exceptions however and in this video clip I would like to discuss those with you. Only individuals who have had gastric bypass surgery or are taking H2 blockers or proton pump inhibitors for the treatment of GERD for example (gastroesophageal reflux disease) may be better off with calcium citrate and should be discussing this with their physicians. The reasons why with gastric bypass surgery is that gastric bypass surgery not only restricts food intake so patients consume less calcium, but in addition, food no longer passes through the duodenum – the main site in our digestive tract where we absorb calcium, this area is bypassed.

For these reasons, calcium absorption and the absorption of many nutrients is significantly impaired. Individuals that are taking proton pump inhibitors for example Prilosec or Nexium or H2 blockers like Zantac, which are two types of acid suppressing medications, produce so little stomach acid that they may have quite a difficulty solubilizing their calcium whether it’s in a food that they eat or a supplement that they take and therefore may be better off with calcium citrate.

So those who have had gastric bypass surgery or those who are taking a stomach acid suppressing medication need to discuss these issues with their doctors and get help determining which calcium supplement might be best. Remember it is really important for you to be ingesting and absorbing 1200 mg at least, of calcium every day to have healthy bones.

The most important question here though for all of us is, does absorption for elemental calcium all by itself build bone? And that’s our topic of our next video. You may be surprised at what you’ll learn. I hope you tune in and thanks for tuning in today.


Tondapu P, Provost D, Adams-Huet B, et al.  Comparison of the absorption of calcium carbonate and calcium citrate after Roux-en-Y gastric bypass. Obes Surg. 2009 Sep;19(9):1256-61. doi: 10.1007/s11695-009-9850-6. Epub 2009 May 13. PMID: 19437082

Straub DA. Calcium supplementation in clinical practice: a review of forms, doses, and indications. Nutr Clin Pract. 2007 Jun;22(3):286-96. PMID: 17507729

Reinwald S, Weaver CM, Kester JJ. The health benefits of calcium citrate malate: a review of the supporting science. Adv Food Nutr Res. 2008;54:219-346. doi: 10.1016/S1043-4526(07)00006-X. PMID: 18291308

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This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,