Calcium timing

Always take calcium with food (not before or after but during middle)
You may need additional D and K if it’s not part of your supplement.
Drink plenty of fluids like water with electrolytes. This can help reduce kidney stones that are possible. What medication for osteoporosis are you taking?
Some get a little nauseous with calcium intake to close to injection.

You might take it at night. Calcium citrate is the one calcium that you can take on an empty stomach. I have it from a notable endocrinologist that it's good to take it at night because we lose calcium all night long without replacing it. But very few of us are low on calcium.

Gently is correct…
Calcium carbonate should be taken with food to enhance absorption, while Calcium citrate can be taken with or without food. It does bother some individuals however taken on an empty stomach.
Source:
Mayo Clinic
bonehealthandosteoporosis.org

Calcium Absorption and Food
Calcium absorption can vary depending on the type of calcium supplement taken and whether it is consumed with food.

Calcium Carbonate: This type requires stomach acid for proper absorption, so it is best taken with food. The presence of food stimulates acid production, enhancing absorption.

Calcium Citrate: This form does not require stomach acid for absorption, making it effective whether taken with or without food.
For optimal absorption, it is advisable to take calcium supplements in smaller doses, ideally 500 mg or less at a time.
If you are taking other supplements or medications, consider spacing them out to avoid interactions, especially with iron-rich foods.
Source:
Mayo Clinic
Tufts University

I feel you! I am 4 months in since OP dx and finding a new routine has been the most difficult part! It is such a puzzle. So many pieces. Different “rules” to get the best outcome for each medicine and vitamin and mineral. I am working with a BoneFit PT and a dietician/nutritionist. They are really helping me figure it all out. There is no “one size fits all” here, which is what is most complicating imho. Good luck and this support group is the BEST!

Additionally here is a informative video about supplements and their effectiveness from Dr Lily Johnston Scripps San Diego

@gently but should you take your k2 and D3 with it

@vmcgrantham
Those two help “deliver” the calcium k can effect blood thinners and other drugs so check with you doctor. My doctor said to take calcium with k2 and d3. Make sure you are not taking too much for you. Get some blood work done.

@vmcgrantham, ah, controversy. K2 ad D3 rely on the same enzymes to become micelles to be absorbable from the intestine. In small doses it is fine to take them together.
They work synergistically in the bloodstream.
I never take them together partly because I take K2 early with magnesium orotate so that both are in my bloodstream when I inject Forteo. (sorry about your experience with Forteo.) I want both in my bloodstream when the blood is flooded with calcium.
Though, calcium and magnesium shouldn't be taken together, they also are synergistic in the bloodstream.

@vmcgrantham
excellent point on absorption. D3 increases absorption of calcium. K2 does not increase absorption "they" say, but both are best to have in your bloodstream when you take calcium. I take the long chain form of K2 (K2-7), so it is pretty much always there. Citrical had D3 with it, but I don't take calcium at night.
I share the cardiac-caution about calcium that Lily Johnson expresses in the video. The largest supplement I take in a day is 250mg and not everyday. I wouldn't recommend this, though, even if we could give medical advice

@osteopatient2026 thank you I am learning a lot from you all.