The calcium pills we want you to use are Citracal + D. We have lots more information on the type of calcium in the “Before Your Operation” section of the app and in the “After Your Operation” section of the app.
Yes, calcium pills tend to be pretty big, and yes you can break them in half. It is also OK to crush the calcium pills and put into a cup of water, or put into apple sauce or yogurt. We put you on a high dose of calcium for the first two weeks after your operation, but after that, we don’t really care what type of calcium you take. But you should still take at least 1000 mg of calcium per day to help your bones recover some density and strength.
Citracal has “petite” pills which are smaller than the regular ones, but they have less calcium in each pill. You need to take 3 petite pills for every 2 regular pills you take. Read the dosage on the bottle. We talk about this in other parts of this app.
Yes, you can crush or break your calcium pills. You can take them with or without food. You can take them with or without your other medicines. You can take them with our without your thyroid pills for the first two weeks, but long term it is best to take the calcium at a different time than your thyroid pills (like Synthroid).
If you really can’t stand the Citracal Maximum
There are other options. We like calcium CITRATE because it tends to be well tolerated. Most of the chewable calcium tabs out there contain calcium CARBONATE, a different form of calcium that often causes constipation if you take lots of it (which you need to do after parathyroid surgery).
Most forms of calcium CITRATE are in hard pill form, like Citracal Maximum.
There is a chewable form of calcium citrate: Solaray Calcium Citrate Chewable. You can buy it online, at Whole Foods, or in vitamin stores. It’s not as common as Citracal Maximum, so you usually cannot find it at the big-name pharmacies. Note that it does not contain Vitamin D, so you will need to also buy a separate Vitamin D pill. Vitamin D pills tend to be tiny, and some of them will dissolve in your mouth. Take any over-the-counter Vitamin D3, 1000 units daily. If you have significant bone loss, we may tell you to increase this. Note that you don’t have to take Vitamin D with every dose of calcium to get the benefit of Vitamin D. You can take the Vitamin D just once a day, but you should spread out the calcium.
Each pill of Solaray calcium citrate chewable has 250 mg of calcium, so if you are replacing the Citracal with this, you should start with 6 pills per day, then taper (6 per day for a week, then 4 per day for a week, then 2 per day).