Calcium Supplements
There are many types of calcium supplements available today. The most common forms of supplemental calcium include calcium citrate, calcium carbonate, and calcium phosphate. Some food products are fortified with calcium lactate, calcium gluconate, calcium malate or calcium citrate-maleate. Although the different forms of calcium have similar names, they are not the same. Choosing a supplement can be confusing if you don't have the facts.
Solubility
Only calcium citrate and calcium citrate maleate are soluble in water. All other forms of calcium must be broken down with stomach acid before your body can make use of them — this is why it is recommended that you take other forms of calcium with meals, when stomach acid levels are high.
Citracal® is the leading brand of calcium citrate supplement.
Because Citracal is water soluble, it can be absorbed with or without a meal. Citracal can also be taken by people who are taking acid reducing agents such as proton pump inhibitors. Calcium carbonate absorption, by contrast, is reduced in individuals with low stomach acid.
Absorption
Dual Absorption of Calcium
Calcium citrate enters the blood through both intracellular and paracellular absorption.
All of the previously mentioned forms of supplemental calcium have something in common: They produce calcium ions when dissolved. Calcium citrate produces these ions when it reacts with water, and calcium carbonate gives off these ions when they react with stomach acid (hydrochloric acid). The calcium ions move into the small intestine, where they are actively absorbed into the body by passing through the cells in the intestinal wall. This is known as intracellular absorption.
Calcium citrate produces not one, but two different calcium delivery vehicles, and each of them uses a different path into the bloodstream. When dissolved, calcium citrate produces both calcium ions and a calcium citrate complex. The calcium ions are actively absorbed through the intestinal cells, and the calcium citrate complex actually passes between the cells. This is called paracellular absorption.
Calcium citrate provides both intracellular and paracellular absorption.
Citracal's high solubility and its dual absorption mechanism make it highly bioavailable.

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