Taking Supplements with Your Diet

The very-low-protein diet requires not only supplements of essential amino acids (or their keto-analogues, which are converted in the body into the essential amino acids) but also supplemental vitamins and cal cium, because very-low-protein diets usually contain inadequate amounts of these substances. Almost any multivitamin suffices, unless it contains added phosphate. However, vitamin requirements for those with advanced kidney failure are different. Specially formulated multivitamin preparations are available. (See Appendix 1.)

Calcium is best provided as calcium carbonate (CaCO3), because other calcium salts, such as calcium lactate, contain substantially less calcium by weight. In other words, you need to take considerably larger doses to get the same amount of calcium. Calcium carbonate contains 40 percent calcium by weight, so to get 1,000 mg extra calcium daily, you would have to take 2,500 mg (2.5 g) of calcium carbonate. One easy way to achieve this is to take six Tums a day. To get the same amount of calcium as calcium lactate, for example, you would have to consume 5.5 g a day.

You may need extra zinc, too, because high-protein foods are the major source of zinc intake. Zinc gluconate is available in a 50 mg tablet, without a prescription.

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