Atrophic Gastritis and Calcium Deficiency

Mechanism of Calcium Malabsorption

Atrophic gastritis destroys parietal cells, leading to hypochlorhydria or achlorhydria, which markedly impairs the dissolution and ionization of dietary calcium salts, according to the American Gastroenterological Association 2

Multiple micronutrient deficiencies are common in patients with atrophic gastritis, with older persons having increased risk due to reduced nutrient bioavailability, specifically affecting vitamin B12, calcium, and iron absorption, as reported by the Clinical Nutrition society 1
Iron deficiency occurs in up to 50% of patients with corpus-predominant atrophic gastritis, typically presenting earlier than vitamin B12 deficiency, based on guidelines from the European Society of Gastroenterology 3

All patients with atrophic gastritis should be evaluated for calcium status along with other micronutrient deficiencies, including vitamin D, iron studies, and vitamin B12, particularly those with corpus-predominant disease, as recommended by the American College of Gastroenterology 1, 3
Calcium supplementation should be considered in patients with documented deficiency, and these deficiencies should be corrected by supplementation, according to the National Institutes of Health 1