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PMR: Calcium and Vitamin D

Posted , 10 users are following.

Daniel1143
Daniel1143

I know we need calcium, but does it hinder absorption of prednisone? Should it be taken separately? Also, is Vitamin D particularly important, and can we get enough of it from exposure to the sun?

0 likes, 26 replies

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  • carolk
    carolk Daniel1143

    Posted

    other way around pred blocks calcium absorption therefore we need extra in the form of adcal which gives us cacium and vit d to protect our bones which are at risk with long term pred ,adcal should be taken seperate from pred time and with food carolk
    • maid_mariane
      maid_mariane carolk

      Posted

      Hi carolk

      Is adcal a prescription or over the counter and what strength do you take.

      Many thanks

    • carolk
      carolk maid_mariane

      Posted

      i am given it on perscription but you probably can buy them because they are supplements adcal-d3 1500mg/400i.u. chewable tabs calcium carbonate and vit d 3 1 tab twice a day  the doses equate to 600mg calcium and 10 micrograms vit d 3 hope this helps ,i thought all gps automatically put you on adcal with long term pred/pmr carolk
    • maid_mariane
      maid_mariane carolk

      Posted

      Brain fog plus not use to the name you used.

      I take calcium 600mg vit. D 1000UI B6 100mg and multi vitamin vit.E 400UI

      IF I've missed anything please tell me.

      Mariane

    • ptolemy
      ptolemy maid_mariane

      Posted

      Have you had any blood checks for vit D etc? Also have you had a Dexascan?
    • maid_mariane
      maid_mariane ptolemy

      Posted

      Hi there

      I knew enough to get dexascan asap within a week of on prednisone and started vitamins however rumi refuses to do any blood work other than my inflammation rates.

      I found out last week by accident my bp was180-190 and she said go to gp.

      My GP was not impressed so i will start seeing him more regularly to get blood work done which he did this week as will as my new BP pills😠

      PMR has come back in my toes, not as bad as before but walking is not great.

  • lodgerUK_NE
    lodgerUK_NE Daniel1143

    Posted

    Golden Rule, pred for breakfast and Calcium for lunch.

    Vit D -  Not unless you live in a Latitude South of Tuscany.

    Also as you get older, you have a harder time in making Vit D.

    The USA still fortifies its Flour - UK stopped late 50's early 60's.

     

  • EileenH
    EileenH Daniel1143

    Posted

    Yes, yes, yes and yes. And probably not.

    If you take pred and calcium together they can interact in the gut and reduce the calcium absorption and probably reduce the effect of the pred. So pred for breakfast, calcium for lunch and dinner (or a later meal) keeps them the necessary 2 or 3 hours apart.  And you need a small amount of fat along with the calium and vit D for transport into the cells (that's why skim milk is a bad idea).

    Vitamin D is essential for uptake of calcium but it is unlikely we get enough from the sun - although the only way to know is have a blood test to be sure you are replete.

    In the UK, or really anywhere north of about Turin in northern Italy or Boston Mass in the USA, the sun is only high enough in the sky to trigger the production of vit D in skin from May to September and between the hours of 11am and 3pm (the sun's rays have to strike the skin at above a specific angle, don't ask me what it is off the top of my head).

    So the main problems with "skin production" is that the winter can be forgotten and in the summer what are we told? Slip, slap, slop and don't go out in the midday sun. Factor 8 sunscreen reduces the amount of vit D produced by over 90% and for women most makeup is effectively Factor 15.  If you take 100% as being what you produce at age 20, by 70 we are down to 25% of potential productivity - just from aging. And we aren't so likely to be out in the sun in sleeveless tops - all you would theoretically need is 15 min at midday with no sunscreen on bare arms, shoulders and face. Doesn't happen.

    In the UK Adcal or Calceo can be had on prescription - especially if you are on pred it is normally given you automatically. They are 600mg calcium carbonate and 400IU vit D3 per tablet and you take 2 tablets, separately, the body can only absorb so much calcium at one time. That is the bare minimum of vit D3 really - you get next to none from food (under 10%) and in Europe no foods are supplemented, Orange juice and milk and cereals are in the USA - they used to be in Europe until children suffered from a mistake and it was stopped.

    If your vit D level is low, get some extra vit D3 only tablets - don't ever take more than 2 of the calcium containing tablets. It's bad for you - but I have come across doctors telling you to do it. eek   If you already eat/drink lots of calcium containing foods the you may be better with just 1 tablet of the combined version and extra vit D.

    Have I missed anything?

    • whitefishbay
      whitefishbay EileenH

      Posted

      Thanks again Eileen. You know what would help esp new PMR sufferers? A list of things to check and things to take. I have a lovely interested GP but she know didn't @ PMR and does & don't s. In the Rheumatoly Dept of St Georges Hospital Tooting, s London there are pamphlets on various forms of arthritis but nothing on PMR.
    • EileenH
      EileenH whitefishbay

      Posted

      I have written it in posts before, it almost certainly appears on the NE England support group site info for patients and in their new member - but no-one ever looks, they just ask the question on here when it comes into their head! What I've just written there is absolutely basic knowledge that ANY GP should know - OK, they don't have much time in an appointment but a practice nurse should be able to answer the questions too (hope springs eternal and I'm not holding my breath...)

      I feel that ArthritisUK and such groups tend to look down on PMR  and don't view GCA as an arthritis. And the leaflets for departments all cost money to produce. I doubt it'll change much. 

      On one of the forums we have a section that has a load of my posts under one heading. We have an FAQs on PMR page too - but the questions still come...

    • whitefishbay
      whitefishbay EileenH

      Posted

      You are so right.  Also new sufferers are so excited/relieved/comforted to find a place to vent/dump/ask questions to a living community that is so supportive and helps them in real time which is why the PMR forum is a living breathing forum sometimes going round in circles. 

      ​Enjoy the bank holiday weekend. Was even sunny all morning.

    • EileenH
      EileenH whitefishbay

      Posted

      I'm in Italy - it happens to be a public holiday (May 1st, all over Europe except the UK) but it is a Sunday so just means the shops that would normally be open (supermarkets) will be shut. If you don't normally work on Sundays, no extra day off! The forecast makes a normal UK Bank Holiday look pleasant - rain all day and barely into double figures which suggests it may snow yet again...

      I still have my winter tyres on - no-one else does though!

    • faye______00403
      faye______00403 EileenH

      Posted

      I know Tums are pure calcium of some kind but have no

      idea if it is the right one or how many you need to chew.

      Any idea?

       

    • lodgerUK_NE
      lodgerUK_NE EileenH

      Posted

      Eileen

      ARC don't recognise it as an arthritis.  Historically they were the only people who had piece in an arthitis pamphlet on both PMR and GCA.

      It is not surprising as GCA is arteritis and part of the vasculitis family, as you well know and now PMR is finally being recognised as being in the same family.

      If we had loads of money, instead of being tiny and running on a shoestring, we would happily produce leaflets for depts, particularly as both PMR & GCA are now being recognised more and more and more people are being diagnosed.   But like you, I am not holding my breath.

      From no charities to three in 8 years is not bad and all run by volunteers.

      Maybe someone with energy will do a 'crowdfunding' for us and then we can do a pamphlet.  One fine day...........................  I live in hope.

       

    • EileenH
      EileenH faye______00403

      Posted

      Tums are calcium carbonate yes. They quote 2500 - 7500 mg/day in 2-4 divided doses for osteoporosis but that seems an extremely high dose to me compared with what I gave above. It is something that should be checked with a pharmacist and your blood calcium also needs to be checked periodically.

      However - they do not contain any vit D and vit D is very important in the absorption of calcium into bone.

    • ptolemy
      ptolemy lodgerUK_NE

      Posted

      I was a trustee of Arthritis Care in the dim distant past and we sort of gave lip service to it. The main type of arthritis that seemed to be concentrated on was rheumatoid. I think this was because the people were young, aggressive and very vocal. Many had had juvenile arthritis and had been at the Canadian Red Cross hospital at Taplow with the world renowned arthritis and rheumatism specialist Dr Barbara Ansell, who also pushed for them. They really did seem to me to have an effect on awareness and I felt the amount of research done. The older people who had osteo had trouble having a look in sometimes. I did learn that if you want to make yourself heard you have to shout very loud! 
    • lodgerUK_NE
      lodgerUK_NE ptolemy

      Posted

      Nearly 9 years ago, I was so grateful that Arthritis Care did publish the one and only two pamphlets in the UK.

      We did try and get under the umbrella of that organisation at that time, but well understood that they did not want to branch out into an entirely different field. 

      http://www.patient.co.uk/forums/discuss/pmr-gca-website-addresses-and-resources-35316

      The above link takes you to a different part of this site and you can see how progress has been made.  Very useful.

       

    • ptolemy
      ptolemy lodgerUK_NE

      Posted

      Arthritis Care was a fantastic charity, I joined as a volunteer in 1980, more recently they had a lot of politics going on and that was the main reason I parted company with them. We had a chief executive who believed that we should not have high reserves, so spent the money on ridiculous things including his salary. It seemed to me his main aim was to get a gong, ideally a knighthood, in the New Years honours, so he spent a lot of time with politicians. I must admit he was amazingly good at fund raising though.

      Thanks for the link. In fact I had set up the discussion board for Canada which is included. 

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