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Calcium

Posted , 11 users are following.

floramac
floramac

Hi, reading through the forums, I note that you should not take calcium

at the same time as steroids.

What is the best time to take them?

What are the general thoughts on Supplements?

Thanks

0 likes, 24 replies

24 Replies

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  • Dave-California
    Dave-California floramac

    Posted

    Hi,

    Yes, both my reumatologist and my GP  recommended that I take 500mg Calcium and 1800 IU of Vitamin D3 for daily maintenance, but not to take it at the same time as prednisone and methotrexate. So, it was recomended that I take it after supper - at least 6 hours 'after' morning pred and at least 6 hours 'before' the morning pred dose.

    Dave

  • Nefret
    Nefret floramac

    Posted

    We usually say Pred for breakfast and Calcium & Vit D for lunch and tea/dinner/supper whatever your last meal of the day is.

    Supplements?  There are one or two which I believe benefit me, but on the whole I avoid them.

  • EileenH
    EileenH floramac

    Posted

    Our standard advice has been pred for breakfast, calcium for lunch and dinner. The whole dose of pred should be taken as early as you can for best effect. Something with some fat in helps absorb the calcium and vit D.

    Supplements besides calcium and vit aren't generally necessary if you eat a decent diet. Though for bone health vit K2 and magnesium are probably not a bad idea - Anhaga will say more about that. Magnesium is also useful if you find you get muscle cramps.

    But otherwise? Probably a waste of money!

  • Anhaga
    Anhaga floramac

    Posted

    Don't take more than 400-500 mg calcium in a single dose, which is why people are suggesting calcium for lunch and dinner.  Because I also have to take iron twice a day I actually take pred and iron at breakfast, iron at lunch, calcium at supper and near bedtime with a snack.  When I was trying to take calcium three times a day as my particular supplement suggests it was pretty ridiculous fitting everything in!  Yes, as Eileen suggests, make sure you are also getting Vitamin K2 (K1 is in our leafy greens, K2 is often lacking in the modern diet and will need to be supplemented).  Also when we are on extra calcium the calcium/magnesium balance in the body can be upset so it may be a good idea to take a bit more magnesium.  If it has already been supplied in your calcium supplement no worries as that will have been maintaining the balance.  Otherwise, for a separate magnesium supplement, take it at a different time than calcium.  I've kind of given up fitting in magnesium as a pill supplement and every once in a while I just have a nice soak in a tub with Epsom salts, as magnesium is absorbed through the skin.  Over on the arthritis forum you sometimes read about people trying to figure out how much boron or zinc or copper etc., they should be taking in supplement form.  When it gets to that level I think, why not just eat food? idea

     

    • mimi1950
      mimi1950 Anhaga

      Posted

      What is a safe dose of calcium supplements if you have a calcium rich diet? I take vitamin D3, K2 and magnesium but In sort of afraid to over do it. For most of my life, Vitamin D was the"dangerous" one while with calcium there was no problem...I used to give it to my young kids as candy, almost, and used to take Tums without counting how many I was chewing up!

    • Anhaga
      Anhaga mimi1950

      Posted

      My understanding is that we don't really need much in the way of supplements if diet is satisfactory.  The reason we're recommended to consume D3, K2 and magnesium in particular (the others are micronutrients we should be getting enough of in a balanced diet high in plants)  is to make sure calcium is absorbed into the bones and not deposited in organs or onto the walls of blood vessels.  Vitamin D alone does not perform this function, Vitamin K2 is really important and often lacking in modern diets, and I believe magnesium is also important for healthy bone remodelling.  

      What do you mean by D being "dangerous"?

    • nick67069
      nick67069 Anhaga

      Posted

      I read somewhere that pred impairs calcium absorption and digestion, by changing acidity of the stomach.  I would imagine that it could also do the same for iron. Because of that I think it is better to take any of the supplements 4-6 hours before or after pred.
    • mimi1950
      mimi1950 Anhaga

      Posted

      Well, I know this will sound pretty crazy but before they were able to measure Vitamin D in blood, it was thought that what is now considered a normal dose, was a highly toxic one .My husband who went to medical school in the 60s was taught that, and still to this day, even after showing him all the up to date information, is still afraid of vitamin D overdose.Im sure he has seen a few overdoses along his long career and it must be hard to accept how he was taught to believe something and then find out it wasnt so...Y guess as we get older we all have those moments ..

      Thank you , Anhaga, for the information...I did read something related to PMR that had a list of calcium rich foods withb amount of calcium they have in them and think I get enough from food but as I have been diagnosed with osteopenia recently, and am taking Prednisone, I just wanted to make sure.

    • EileenH
      EileenH mimi1950

      Posted

      I have to say, I think it is pretty unlikely he's seen many vit D overdoses - unless Spaniards are in the habit of taking massive doses of supplements. The body switches off making vit D in the sun after 20,000 IU or so and there is so little in most diets you won't overdose. Unless you are Inuit and eating blubber and tons of liver!

      The main reason for taking the supplements it to ensure and excess of calcium is present in the gut since pred makes the body lose calcium via the kidneys. You should be able to work out how much calcium you eat and adjust the supplementary calcium to give about 3-400 mg more than the recommended RDA for other people.

      I had the bisphosphonates and calcium discussion with a new rheumy I had to see last week (I'll forgive her, her myofascial release techniques are awesome!). Five years ago I was told in the same hospital to cut dairy (I did temporarily until it was obvious it made no difference) and couldn't eat excessive amount of leafy greens (warfarin) - last week she was encouraging me to change my dietary habits yet again and eat tons of dairy! "Then you won't need to take the supplement". I will, I'm not going to get enough vit D otherwise, we have seen that, but sorry, no I'm not going to change my diet yet again having found one that keeps my weight at least stable.

      Nick - I don't think pred alters the gastric milieu of the stomach - it is the PPIs we are given to "protect" our stomachs that do that. They are able to cause osteoporosis all on their own!

    • Anhaga
      Anhaga nick67069

      Posted

      I checked for pred interactions with iron, and apparently there are none.  I take my iron when I first get up, on an empty stomach, and it's usually well over an hour before I get to breakfast and pred.  And the second iron is well away from anything else, except lunch.  Calcium is what interferes with iron. frown

    • Anhaga
      Anhaga nick67069

      Posted

      I think pred actually has an effect on calcium metabolism and the function of the bone-building cells.  That's why it can continue to have an effect on our bones even when taken in very small doses.  Why some people are more susceptible than others I have no idea.

    • Anhaga
      Anhaga

      Posted

      But I was royally ticked when I realized pred had been interfering with my calcium absorption during the very time the dose was at its highest and my bones were therefore most vulnerable.  
    • mimi1950
      mimi1950 EileenH

      Posted

      I agree, but he insists that one of the symptoms of overdose is intracraneal pressure and he has seen some cases....There are no Vitamin D enriched foods here, either..So who knows how they these Spaniards overdosed...Whatever it is, it is definitely not an excuse to cling to the old paradigms!

      So I should be taking some amount of calcium in a supplement? just to make sure im getting enough?

    • mimi1950
      mimi1950 EileenH

      Posted

      Wow. Before the PMR, I didn't take any meds at all and now im taking more than I can manage...all of a sudden...One warrants another, and another and so on....I'll be happy when Im in the single digits of pred..Just dying to get off of some of the others at least. Before the Prednisone, no specialist I went to for my other conditions ever told me to take Vitamin D even when my levels showed zero, now, anything that is a bit off, and whatever it is, it's the prednisone.

      The Prednisone gives immediate satisfaction so I trust my need for it, when just one milligram makes a noticeable difference, it seems ok, whereas taking stuff just because some doctor tells you to and there is no real consensus on here about it, I really have a hard time complying.

    • EileenH
      EileenH mimi1950

      Posted

      Depends on your diet - work it out, there are lists on the internet with amounts. You can see if you are eating enough of those sorts of foods. I know I don't on a regular basis so I'm quite happy to take a supplement.

      Doctors who insist everything is due to pred are showing their ignorance! A lot can be due to PMR - but again, not all. Handing out a pill to cope with side effects is just silly - and the doctors who do it are often lazy. There are non-pharmacological ways of dealing with some.

      It becomes particularly worrying when you look at hospital occupancy and death rates which relate to poly-pharma. It isn't too bad when a doctor keeps a close overview - but when patients are under different doctors who aren't totally au fait with a patients entire clinical history it can lead to trouble.

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