In people with anorexia nervosa, where individuals lose large amounts of weight, the bone density actually plummets to extremely low levels, and may never recover. We must keep in mind, however, that if we ignore the admonition to limit our fat intake, we will increase our risk of premature heart disease and never get the opportunity to enjoy the good bone health that we were planning for our later years. Calcium supplements vary in size, shape, content and availability to the body. It has little effect for people on antacids or many other medicines used for gastritis or ulcer disease and has limited effect in older individuals who have age-related decreases in stomach acid. Since calcium carbonate is best absorbed when taken with meals, when there is a greater concentration of acid, its absorption may be impaired by minerals and protein also contained in the meal.
Calcium carbonate is also notorious for creating gas, bloating and constipation.
All other calcium preparations contain a much lower percentage yield of elemental calcium, so more tablets must be consumed. The highest yield of calcium absorption is seen with calcium citrate, which has minimal gastrointestinal side-effects and may be taken on a empty stomach. In the setting of good nutrition, weight-bearing exercise will help to strengthen bone and the improved muscle tone will help to prevent injury. Hormone replacement therapy is the primary treatment option for postmenopausal women or for men with low hormone levels. Estrogen therapy in women, in addition to improving the bones, also reduces the risk of heart disease, urinary tract infections, cancer of the ovaries and perhaps stroke.