Killed by calcium


I’m not much of a pill popper, preferring to suffer a bit rather than give in to some miracle relief tablet.

But I am trying to be more conscientious about taking vitamin supplements and I often have a problem with choking. Anyone else have this problem?

I take a monster calcium pill every night and it gets stuck nine times out of 10.

While choking, I usually end up jumping up and down on the bed to try to coax it on down. I keep thinking how embarrassing it

will be when my obit reveals I was killed by calcium.

Apparently this is a problem for many people. Pills can get stuck when swallowed and cause significant problems through mechanisms that are not entirely understood. Some compounds, including medications that treat osteoporosis (Fosamax [alendronate], for example) are very irritating to the esophagus, and people taking these drugs are always instructed to sit upright for at least 30 minutes after taking the dose. This is because the medication can cause a problem known as esophagitis — inflammation of the esophagus that can lead to serious complications, including pain and bleeding.

This problem requires two factors: a pill or capsule getting lodged in the esophagus, leading to a prolonged period of contact, and a compound that is either too acidic or basic for the esophagus. Other medications that can cause direct irritation to the esophagus include anti-inflammatory agents such as ibuprofen, tetracycline antibiotics, iron, and potassium. Whew – no mention of calcium.

To avoid the problem of pills getting stuck, prevention is clearly key. Follow these steps:

  • Never take a medication when you are lying down; instead, sit or stand when swallowing a pill.
  • Remain upright for at least 30 minutes afterward if possible.
  • Drink enough liquid — usually a minimum of eight ounces — when taking pills so that the pill is “chased” down.

If you feel the sensation of a pill being stuck, drinking fluids and eating small amounts of food such as bread may be helpful, if the medication can be taken with food. Call your doctor if the feeling persists despite these steps or if you feel pain. Treatment may include localized measures to decrease the inflammation, pills to decrease acid production if reflux is believed to be worsening the symptoms, or an upper GI endoscopy in rare cases.

5 thoughts on “Killed by calcium

  1. Emily—–I have taken calcium pills for years————and, my solution is to wet the pill first (I just dip it in my glass of water)——put it in my mouth and down it goes with a swallow of water. In fact, I do all of my pills that way——even the capsules which are normally easy to swallow. But, it takes just one frightening incident to make you take all precautions!

  2. Hi Emily,

    BlueBonnet makes a liquid Calcium/Magnesium combination this is the easiest to swallow, and the Magnesium helps prevent constipation.]

    This company also makes an Iron Free Multi Minerals Plus Boron in Vcaps.
    It takes 4 of them/day to make a serving 1000 mg Calcium and 500 mg of Magnesium — the other contents you’ll have to read on the bottle. I do seem to notice a tendency to move toward…er ah..not moving with this, but don’t remember that with the liquid form above. For that reason, I’ve not been able to get up to four of these a day, but may MOVE toward just taking one capsule of the latter, and making up the difference with the liquid Ca/Mg caps.

    I also take the Bluebonnet Vitamin D3 Vcaps which come in 1000 units each (that is when I remember to take anything!!)

    For my vitamin B’s which I test low for, I use a different brand — B-Right, from the Jarrow Formulas company. They have a nice combination of alot of B vitamins to make the stuff work better. I further supplement with METHYLcobalamine (B-12 sublingual) from a subsidiary called Biochem of the Country Life company. This helped to move my low B-12 from malabsorption into mid-range of the normal reference points listed on the lab results sheets which incidentally, are usually 200 too low on the low end. The lowest should never be less than 400 to avoid neurological symptoms. After a while, these 3000 mcg tablets just needed to be taken every few days.

    To get enough Folic Acid, I’m supposed to take an 800 mcg tablet of Country Life’s product “vegetarian Folic Acid” each day.

    I probably should be taking some other supplements, but I have just concerned myself with these due to my lab results and osteoporosis from maladbsorption related to some small bowel damage I HAD secondary to gluten intolerance.

    I came upon this information after being diagnosed with microscopic colitis a few years ago — 2002, and most docs in the USA don’t know, even now, that M.C. in the colon is related to (usually undetectable by pathology) damaged villi in the small bowel with this form of colitis, but I was fortunate in finding a support group (see the bottom of Perksy Farms’ business site, –scroll down) who had already discovered the gluten connection to M.C., and then, as a group, we teased out the other common allergens/delayed sensitivities to foods that put a stop to my having any symptoms from the M.C. I had NO life before that, and was miserable — couldn’t work or anything.

    Now, I just have the residual damage of not being able to absorb enough vitamins from foods from all those years of damage to the gut — thus the supplementation. Besides the quality of these brands and products, I also can use them because they are free of the major allergens (see information on the bottle if you have specific allergens/foods to avoid).

    There are some tests from a company that does tests that show whether or not certain vitamins are getting into the cell (as opposed to just being in the blood stream as the usual lab tests do). One of these days I’m going to find a way to take some tests there relevant to my malabsorption issues. I can’t recommend any labs at this point, however. I just like the idea of testing to make sure I’m really not absorbing something before I go spending $$$ on vitamins I probably don’t need.

    While I’m at it, if you have a colonoscopy coming up, be SURE that the doc doing it(Gastroenterologist) ALWAYS does routine biopsies throughout the colon. This condition HAS to be diagnosed by the pathologist — the doc doing the colonoscopy, won’t be able to diagnose this with his eyes looking through the scope, but during that test, he’ll take representative samplings of tissue along the length of the colon, and send them to the pathology lab. The path report comes back in a few days, after the pathologist as had a chance to look at the slides, and results should be back within a week, and sent to the GI to report back to you.

    Anyone given a diagnosis of “IBS” should seriously consider that they might actually have Microscopic Colitis (LC or CC form) and get a doc with a number of diagnoses of M.C. under his belt before letting him perform the colonoscopy in the first place. Ask him about how many he thinks he’s diagnosed. Never, never consider letting anyone scope you WITHOUT taking an adequate sampling of biopsies to be sent to the pathology lab.

    Then, even if he’s cooperative in getting you the M.C. diagnosis, he won’t know about the gluten connection because he’ll say M.C. isn’t related to what you eat. Balony!! In our group, we seldom have anyone come back from small bowel endosopy with the totally flat villi that it has historically taken to get a diagnosis of celiac disease.

    Unfortunately, most docs still think that gluten sensitivity and celiac disease are mutually interchangeable which they are not, but then, it’s only since the big prevalence study at U.Of Maryland a few years ago that GI’s even looked for celiac disase in the first place, so most simply went undiagnosed for years and years. What you don’t look for, you won’t find!!

    Gluten sensitivity tends to go along with other (thought to be) autoimmune disorders, some of which are very serious, so it’s a good idea to find out if you are sensitive to gluten, and with M.C., often several other foods can be problematic. It would be nice if the new and improved blood tests for classic celiac were sensitive enough, but unfortunately, they are not for M.C. and milder versions of small bowel disease undetected by the usual “gold standard” tests for celiac disease. Continuing to eat gluten is a dangerous thing and potentially life threatening.

    After years of suffering, I found out by totally eliminating gluten, that after three days, most of my suffering, though not all “inconvenient” symptoms (use your imagination on this one) pretty much left in three days!! I was able to return to normal BM’s gradually by eliminating the others — the dairy protein casein, dietary yeast (brewer’s/baker’s species), eggs (particularly ovalbumin in the whites), and soy protein.

    Many people do not have this many, but gluten (wheat, rye, barley, oats, spelt) tend to be the Mother of all Food Sensitivities! Start by eliminating those to test for relief of IBS, if, in fact, your colon biopsies show M.C. (LL or CC forms).

    Insist on the GI doing biopsies or get another GI who does them and let him/her do your tests! Then, go to the M.C. support group at the bottom of Persky Farms website’s home page (click at the bottom) for tons of good information.

    By the way, if your doc is going to evaluate you for celiac disease (small bowel studies or just the blood work for starters) then wait to initiate the gluten free diet until after those tests. Otherwise, if you have celiac disease, your small bowel lining will begin to heal up so fast that even a person with totally flat villi will be undiagnoseable after just a few days on the gf diet. It can be dangerous to reinstate eating gluten, and you’d have to eat it long enough to make yourself as sick as you were before to assure getting a diagnosis of celiac disease. Mostly, when that happens, the GI will get a person back on gluten (a so-called “gluten challenge”) for not long enough to get their villi flat, so what you end up with is subclinical disease and still a missed diagnosis.

    One advantage to going ahead with small bowel endoscopy is that while in there, the GI can look for other problems like cancer, etc., that could co-exist with celiac disase. Talk to your doc about doing that before trying the diet, but don’t rule it out with a negative small bowel diagnosis IF you are really committed to staying on it for life. Believe me, the sicker you are, the easier it is to maintain on the diet. Mine is lots stricter than most celiacs who are only off of gluten (wheat, barley, oats, rye, spelt).

    I just thought this might be a good place to let the readers know a particular condition which is more common than alot of people think, that can result in osteoporosis and low vitamin levels with the neurological and other problems that brings up. For some reason which we don’t absolutely understand, food sensitivities and other true allergies (immediate reactions to things) are on the rise recently, including studies on the prevalence of celiac disease.

    By the way, I found all of my vitamins at Whole Foods, but I should think a good healthfood store would carry some of them. Someone in my group found the B-Right online for a very good price. I need to try to get the moderator of that site to pull up that threat and entry.

    Good luck to all, and hope none of you have to experience any of this, but suspect malabsorption if you have any autoimmune conditions or idiopathic neuropathy, osteoporosis, etc., even in the absence of GI symptoms. Check your B-12 level if you have neurological symptoms for which there is no diagnosis, and start to supplement that right away. After 6 months, it can be periment.

    This was way too long, and a bit off course, but just look for classic celiac disease if you have anemia, for sure. GI’s and even good old primary care docs will often begin to try to rule out celiac given a person whose blood shows they are anemic — iron deficiency.

    Just get on the internet and look for all the symptoms one can have with celiac disease, and that will tell you you need to check for celiac disease the usual way as well as look for M.C., and if M.C. do a trial diet without ANY gluten. Check the celiac sites first for how to eliminate everything, but start with what you know and keep learning til you figure out how to eliminate all versions and quantities of gluten.

    Nuf said on this one.


  3. I’ve decided it is better to crunch the calcium pill and swallow the bits rather than have that awful stuck in the throat panic, choke, panic, cough syndrome
    Its like eating a piece of blackboard chalk – not pleasant but bearable with great gulps of liquid to help it down.

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