Effect of Estrogen Treatment and Vitamin D Status on Differing Bioavailabilities of Calcium Carbonate and Calcium Citrate

The authors hypothesized that estrogen treatment or vitamin D status may affect the bioavailability of two common calcium supplements differently. Using data derived from a recent trial in 25 postmenopausal women, the authors found that AAUC of serum calcium after subtraction of placebo was significantly higher after calcium citrate (median, 0.85; 25th to 75th percentile, 0.70 to 3.15) than after calcium carbonate (0.25; −0.58 to 1.00) in non‐estrogen‐treated patients. There was no difference in the bioavailability of calcium between the two calcium formulations in estrogen‐treated patients. Bioavailability was also significantly higher with the citrate salt for the subgroups with lower serum 25‐hydroxyvitamin D and higher serum 1,25‐dihydroxyvitamin D concentrations. In summary, bioavailability of calcium from the calcium carbonate product was more dependent on estrogen treatment and vitamin D status than that of calcium citrate. This may explain the variable results of reported calcium supplementation studies.

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