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Calcium and Vitamin D After your Parathyroid Operation HF#7330

This handout explains how to meet your daily calcium and vitamin D needs after your parathyroid operation, once your calcium level (blood test) has returned to the normal range. 


Calcium is important for people of all ages for good health.  Calcium is a mineral that helps form and maintain healthy bones and teeth. It is needed throughout your life. Most of your bone mass is built when you are a child or young adult. After the bone building period ends, bone mass must be maintained. The main way to build and maintain bone mass is to have a diet rich in calcium. Calcium is needed to keep bones strong and healthy and to reduce the risk of osteoporosis. It also helps maintain healthy teeth, normal blood clotting, and makes your heart and muscles work as they should. 

  
The body does not use calcium well if you do not get enough Vitamin D.  Vitamin D also decreases bone loss and lowers your fracture risk.


Calcium needs are based on the amount of bone and tissue growth during phases of the life cycle.  The calcium and vitamin D needs advised by the Food and Nutrition Board, Institute of Medicine, and the National Institute of Health are shown below. 

 

Life Stage                                Age                                      Recommended Dietary Allowance
                                                                                              Calcium(mg)        Vitamin D(IU)


Children                                1 – 3 years                                 700                          600

                                              4 – 8 years                               1000                          600

 


Adolescents                         9 – 18 years                             1300                         600


 

Adults: Men and Women     19-50 years                              1000                         600
                                              51-69 years
                                              70 years and older                   1200                         600


Pregnant /Nursing Women   Less than 18 years                  1300                         600
                                               19-50 years                            1000                          600
 

 

Foods That Are Good Sources of Calcium

 

250-300 mg of Calcium
1 slice Wonder® calcium-enriched bread
2 pieces cheese pizza (1/4 of 14” pie)
8 oz. milk (whole, 2%, 1%, skim, chocolate or other flavor, dry milk).
6 oz. yogurt
8 oz. calcium-fortified orange juice
1 oz. cheese (195-335 mg of calcium.  Hard cheese has more calcium
3 oz. sardines, canned, drained, including bones
1 cup macaroni and cheese, homemade
1 cup cocoa made with milk
1/6 of 9” quiche
1/3 cup non-fat dry milk powder
1 cup malted milk
½ cup tofu with calcium (435 mg of calcium)
8 oz. calcium-fortified juice or drink*
8 oz. calcium-fortified soy milk

 

200-250 mg of Calcium
1 cup macaroni and cheese, packaged
1 cup cheese soufflé

150-200 mg of Calcium
½ cup cottage cheese
½ cup ice cream or frozen yogurt
½ cup au gratin potatoes
1 cup cream soup made with milk
3 oz. salmon, canned with bones
½ cup bread pudding made with milk
1 taco with beef and cheese


100-150 mg of Calcium
1 cup broccoli
½ cup kale
½ cup oysters
½ cup custard
1 cup sherbet
½ cup bok choy, cooked
½ cup turnip greens, cooked
¾ cup mustard greens, cooked
3 oz. herring, canned
¾ cup soybeans, cooked
2 pancakes (4” diameter)
1 waffle (7” diameter)
1 tbsp. blackstrap molasses

 

50-100 mg of Calcium
½ cup cooked beans
½ cup cooking dark leafy green vegetables (50-135 mg of calcium)
24 whole almonds
1 medium orange

 

Foods That Are Good Sources of Vitamin D       International units per serving
1 tbsp. cod liver oil                                                               1360
3 oz. cooked sockeye salmon                                                 794
3 oz. cooked mackerel                                                             388
3 oz. canned in water tuna fish                                                154
1 cup milk                                                                                 100
1 cup orange juice fortified with vitamin D                              100
6 oz. yogurt fortified with vitamin D                                           80
2 sardines (canned in oil)                                                           46
¾-1 cup Ready-to-eat cereal fortified with vitamin D              40
1 whole egg                                                                                 25

 

Be sure to check the nutrition label because calcium and vitamin D content varies by brand.

 

Calcium Supplements
If you’re not meeting your daily calcium needs through your diet, you should think about adding calcium tablets. Calcium tablets take the form of calcium carbonate, calcium citrate, calcium gluconate, or calcium lactate. The table below compares calcium carbonate and calcium citrate supplements and the best time to take them. Calcium gluconate and calcium lactate cost more and contain less calcium per pill so you’d have to take more pills to get the same amount of calcium.


Note:  if you are taking medicine to decrease stomach acid (acid blockers) or use antacids on a daily basis, calcium citrate is advised instead of calcium carbonate.

 

        Calcium Citrate

              (Citracal)

                                   Calcium Carbonate

               (Tums, Oscal, Caltrate, Viactive, CalBurst)

Can be taken any time during the day. Must be taken with meals or snacks to be absorbed best.
Does not require stomach acid to be absorbed. Stomach acid is needed for it to absorb.  Do not take with antacids.
Gentle on the stomach. May cause gas, constipation and bloating.
Look for "USP" on label or box (confirms pill will dissolve in normal amount of stomach acid.)


 Calcium and Vitamin D content per pill

 

Supplement Calcium (mg) Vitamin D (IU) Comment
Caltrate 600 600 0 Carbonate
Caltrate 600 + D 600 200 Carbonate
Caltrate 600 plus chewables 600 400 Carbonate
Citracal + D 315 200 Citrate
Citracal Ultradense Petites 200 200 Citrate
Citracal 250 + D 250 200 Citrate
One-a-Day Women's or 50 + Advantage for Women 500 800  
One-a-Day Men's 210 600  
One-a-day 50 + Advantage for Men 250 600  
OsCal 500 500 0 Carbonate
OsCal 500 + D 500 200 Carbonate
OsCal 500 + Extra D 500 400 Carbonate
Oscal Ultra 600 200 Carbonate
Tums 500 0 Carbonate
Tums EX 750 0 Carbonate
Tums Ultra 1000 0 Carbonate
Viactiv plus D + K 500 500 Carbonate
Calcium gummy bears 200 0 Phosphate

 

 

What about other medicines?

 
Calcium (supplements) may not mix well with other medicines. Make sure to tell your health care practitioner that you are taking calcium so they can help you determine the best time of the day to take your calcium.

 

How do I take my calcium?
Calcium is best absorbed if taken with meals and in smaller doses.  Avoid taking more than 600 mg of calcium at one time so your dose should be split and taken throughout the day with 8 oz. of water. Chewable forms of calcium should be chewed well.

 

Are there any side effects?
Side effects with the proper use of calcium are rare.  Constipation and gas can also be problems with calcium use. Make sure you drink plenty of fluids and eat fiber to avoid these problems. If these measures are not helpful, try switching to a different form of calcium.



The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 03/23/2012

Copyright © 03/23/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7330

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