This is more common than you might think, and "yes" there is a way to take your PPI's and address your osteopenia. For some background, (in case others reading this have same question) Calcium, unlike almost all other vitamin/nutrients requires a high acidic environment in the gut for absorption. When taking PPI's you are obviously creating a low acidic environment so your uptake of calcium drops to minimal amounts. So what if you need to continue taking PPI's?... here is what I have had patients do with clinical success: First find a high quality chelated calcium and magnesium (1000 mg/400 mg), then take it after the last bite of your largest meal of the day. Why? because after the end of the largest meal you will have the highest acidic level of the day giving you the best possible uptake. This plan combined with the chelated form of both calcium and magnesium will drastically improve total absorption. This approach showed marked improvement on Dexa-scans given at the next year point.