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Suppression of Parathyroid Hormone and Bone Resorption by Calcium Carbonate and Calcium Citrate in Postmenopausal Women

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Abstract

This study was conducted to compare the suppressive effects of calcium carbonate and calcium citrate on bone resorption in early postmenopause. Calcium citrate is thought to be better absorbed. We therefore tested the hypothesis that calcium as citrate is more effective than calcium as carbonate in suppressing parathyroid hormone (PTH) and C-terminal telopeptide. Twenty-five healthy postmenopausal women were recruited in this double blind crossover study. The subjects were randomly allocated to receive either 1,000 mg of elemental calcium as carbonate or 500 mg of calcium as citrate. They were given the alternate calcium dose 1 week later. Serum measurements of total and ionized calcium, phosphate, PTH, and CrossLaps were repeated 12 hours after each dose. Analysis of variance found no significant difference between measures for the two salts. Tests for equivalence indicated that 500 mg of calcium citrate may be superior to 1,000 mg of calcium carbonate in raising serum total and ionized calcium (P = 0.04 and 0.05, respectively). For all parameters measured, 500 mg of calcium citrate was at least as beneficial as 1,000 mg of calcium carbonate. Calcium citrate is at least as effective as calcium carbonate in suppressing PTH and C-terminal telopeptide cross-links, at half the dose. This may be because calcium as citrate is better absorbed than calcium as carbonate. If calcium citrate can be used in lower doses, it may be better tolerated than calcium carbonate.

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Acknowledgements

This trial is registered as a clinical trial in the Australian Clinical Trial Registry (ACTRN 012606000458538). This study was funded by a research grant from the Royal Adelaide Hospital and Institute of Medical and Veterinary Science Research Committee.

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Authors and Affiliations

  1. Division of Clinical Biochemistry, Institute of Medical and Veterinary Science, SA Health, Adelaide, South Australia, Australia

    Sunethra D. C. Thomas, Allan G. Need, Peter D. O’Loughlin & B. E. Christopher Nordin

  2. Division of Clinical Biochemistry, Institute of Medical and Veterinary Science, Frome Road, Adelaide, South Australia, Australia

    Allan G. Need

  3. Health Statistics Unit, Epidemiology Branch, SA Health, Adelaide, South Australia, Australia

    Graeme Tucker

  4. Department of Pharmacy, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Peter Slobodian

  5. Department of Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    B. E. Christopher Nordin

Authors
  1. Sunethra D. C. Thomas
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  2. Allan G. Need
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  3. Graeme Tucker
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  4. Peter Slobodian
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  5. Peter D. O’Loughlin
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  6. B. E. Christopher Nordin
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Corresponding author

Correspondence to Allan G. Need.

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Thomas, S.D.C., Need, A.G., Tucker, G. et al. Suppression of Parathyroid Hormone and Bone Resorption by Calcium Carbonate and Calcium Citrate in Postmenopausal Women. Calcif Tissue Int 83, 81–84 (2008). https://doi.org/10.1007/s00223-008-9148-z

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  • DOI: https://doi.org/10.1007/s00223-008-9148-z

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