Are there any studies that confirm effective calcium absorption when the patient is taking long-term proton pump inhibitors (PPIs) along with oral calcium? These patients should be on calcium citrate — not calcium carbonate — but my supervisor says there are no data to support this. — Jo Killenbeck, APRN, Billings, Mont.

The results of a recent small study showed impaired absorption of calcium carbonate but normal absorption of calcium citrate in achlor­hydric subjects who were in a fasting state (J Bone Miner Res. 2010;25:2786-2795). In an older study, researchers found that the absorption from calcium carbonate was impaired in achlorhydria under fasting conditions, while absorption from calcium citrate in those with achlorhydria was higher (New Engl J Med. 1985;313: 70-73). — Eileen F. Campbell, MSN, CRNP (160-2)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have something you would like to share, send us an email.

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