New Medication is not new.

Dexascan first - do you have low bone density? Then you weigh up the situation against the options. But I don't care what they offer as "bone protection" other than calcium and vit D: you shouldn't take them until they are necessary. Only about half of patients on prednisolone develop osteoporosis - so there is no good reason for 100% of patients on pred to take anyhting more than calcium and vit D.

Polypharmacy (being given multiple drugs) is associated with all sorts of problems - avoiding taking unnecessary medications is a good start to avoiding all sorts of problems. Yes, if you are SHOWN to need risendronate (or whatever) that is fine. Otherwise, calcium and vit D are enough for many of us to avoid osteoporosis. 

PROOF first - then discuss the options.

Just a small point as an addendum to Eileen's. I you drink plenty of milk, make your own yoghurrs etc, you may be getting very adequate calcium and may only need a Vit D supplement. I say this because you can overdo the calcium and more is not necessarily better at all. You need 1,200mg daily if you are female  >50yrs. and it's better to get it from diet but, if not,  supplements are fine. You can check out various charts online ( " Am I gettting enough calcium?") and various foods are listed along their calcium amounts and you can check what your intake is.. . Now stop worrying . . . we all do - and it never helps!  Kind regards.

Thanks for advice and thoughts.  Regards to all for your input. 

Hi Juno, you are quite right, I was taking a calcium, magnesium and vit d supplement up until 4 weeks ago. My last blood test revealed that my calcium level was a little on the high side so my GP suggested I stayed off the calcium (continue with the magnesium and vit d) for a while, at least until my next blood test. Regards, christina 

I ran into problems after taking Calichew.  Pseudo-gout in knee -caused by calcium crystals.   Calcium grit in gall bladder.   Calcium dropped quickly and never took it again.  I had always eaten pure dairy products ie butter unprocessed cheese etc.  Now lack Vit D was a whole different ball game.

I suggest you all read this link https://patient.info/health/vitamin-d-deficiency-including-osteomalacia-and-rickets-leaflet

Particularly this para: What are the symptoms of vitamin D deficiency?

I starteed with aches and pains and knew it could not be PMR as I was on a high dose of pred for GCA (I never had PMR). Luckily I was listening to a GP on Radion 4 and he was talking about the rise of Rickets in the UK and Vit D Deficiency.   I came to this site, read up on it and off to GP - asked for Vit D deficiency test (and this should be done for everyone before they are diagnosed with PMR as the aches and pains are exactly the same).  Lo and behold, on the scale used by my hospital trust anything lower than 140 was deficient, I came in at 43.

40,000 units of Dekristol  per day for 10 days, followed by a blood test, still not up to scratch, so 20,000 units per day for 5 days - blood test up to scratch.  Since then I take 1,000 units per day as that is the recommended maintenance dose. 

These are all valid points - but the figures quoted for calcium requirement are for healthy people who are not taking pred. When you are on pred it makes your body lose calcium faster than usual through the kidneys - for bone health it is better to take more than not enough. 

What is important is that you have regular blood tests - about every 2 or 3 months - for the basic stuff: U&Es (urea and electrolytes: sodium, potassium, chloride and bicarbonate) calcium, magnesium, full blood count (red and white cells and haemoglobin) and a few others. These are all tests that should be done anyway, on calcium or not but I'll lay odds that most people do not have them done. Vit D is not on that list and must be requested separately but it should be done at least once as part of the differential diagnosis of PMR. If it is low it should be put right using high dose vit D and then checked once a year, in the autumn when it is at its highest or in the spring when it is at its lowest provides the most meaningful information.

These things are particularly important if you are multiple medications - they can interfere with each other and also have an effect on your body chemistry which can be serious - especially diuretics. 

And I should have also mentioned that for anyone on a PPI (omeprazole and co) the whole thing changes again: PPIs interfere with the absorption of calcium and magnesium too and are quite capable of causing osteoporosis on their own, never mind in combo with pred. That makes the supplements and blood tests story even more significant.

Thanks Tisser for your message.  I have learned so much from the good people on this site.  Like yourself, I have never had any problems with my bones and have been taking high doses of omega 3 fatty acids for years and years as well as evening primrose oil.  I don't do much diary not for any particular reason, but a wee bit of butter, some yogurt, sardines and mackeral.  Check with your dr. and let us know what she says.  Regards Pat

Eileen you're right re. the calcium amounts. Mea Culpa!  The figures (1,200 daily) that I mentioned are those recommended by the Osteoporosis Society here and they don't make any reference to those who may also be taking Pred. - and it's bone-effects.  One thing though, I was advised to try to get my daily calcium from diet rather than supplements  - because "overdoing" calcium from diet on occasions wasn't harmful but doing so from supplements may cause problems. . . Didn't put it accross very well . . . .  x

No you are absolutely right, diet is FAR better than supplements. But 3 years ago the dietician was on at me I must stop this and I must stop that - worst of all was the day-long drinking of British-style tea, With milk (which the Italians simply DON'T get) which was my primary source of calcium. I needed to improve my cholesterol and lose weight - all pred-induced. So I adjusted my diet in line with her suggestions - and brought back the food diary: Oh dear, deficient on calcium...  No s$*% Sherlock????

So I adjusted my diet MY way - no carbs! Result after 2 years: 40lbs less weight and normal cholesterol. Thank goodness for calcium supplements is all I can say! I still eat cheese but not enough by any stretch of the imagination. But you really can't have it all ways 

Hi Jane, thanks for your message.  I have nothing against anyone taking AA but at this stage It's not for me.  I wish you well.  Pat

Barbara, I, too, have a spinal problem (spondylolisthesis) but whereas I can manage a good half hour walk, I don't think my spine would ever allow me to take part in calisthenics.  It seems that my daily walk helps to keep my spine in check.

Another exercise is Nordic walking - I'm wondering whether the walking with poles would help your spine.

I also recommend a Tai Chi class - you can always then sit down between movements if your back starts to trouble you.

If you're looking for exercise other than walking, how about swimming?  One of my orthopaedic consultants told me that the best exercise I could do was to swim but only on my back.  Unfortunately, it won't offer any bone protection as it isn't weight-bearing, but it's still a very good form of exercise.

 

Hi Barbara, yes walking.  Even to have the choice would be great but at this stage it's out for me.  Pilates is good, it's a very gentle way of exercising and it's for peple 8 to 80 plus.  It elongates the muscles and is so gentle and realigns the body if it needs it.  My pilates machine is still in it's box, hopefully it will be getting put up soon.  Put pilats into a search bar and see what comes up.  Pat