Effects of three different calcium preparations on urinary calcium and hydroxyproline excretion in postmenopausal...

Some authors have claimed that 'solubilized' calcium preparations are better absorbed than calcium carbonate, while others have reported that all forms are equally well absorbed. We measured radiocalcium absorption in 35 postmenopausal osteoporotic women and then gave them on three successive evenings, in random order, three different proprietary calcium preparations (Sandocal containing 1 g of effervescent calcium, Calsup containing 1 g of calcium as the carbonate, and Caltrate containing 1.2 g of calcium as the carbonate). The daily urinary calcium excretion rose significantly and similarly on all three supplements and was greater in the high calcium absorbers than the low calcium absorbers. The fasting urinary hydroxyproline excretion was significantly decreased the morning after administration of each preparation, and one-way analysis of variance showed no significant difference between the days of administration or the type of supplement. The decrease was greater for high absorbers than for low absorbers on all three supplements but the differences did not reach statistical significance. By 36 hours after the last calcium supplement the urinary hydroxyproline had returned to baseline. The response of hydroxyproline excretion (and by implication bone resorption) appears to be rapid in onset and short lived. Strict compliance is therefore important in patients on calcium therapy.