Vit D deficiency and rib pain

Hi all,

Just to say - if you're struggling with asthma or are coming out of a bad patch and have been given pred and your ribs still hurt - don't assume it's 'just' costochondritis (even though this is ouch ouch ouch and also needs sorting if possible) as you *might* - obviously not definitely - have Vit D deficiency.

I got rib pain during/after last pred course, thought it was costochondritis as I had that last year. I mentioned it in an appt (almost as an afterthought as I wasn't sure it was necessarily relevant or something they could do anything about) and the dr asked if I'd been taking anything for my bones while on pred. I said no, had no idea I needed that if not on it all the time and he said actually bones have a lot of the significant loss early on with steroids. So he tested me for Vit D: finally got results back and turns out yes, I am definitely deficient (sheet gives ranges for deficient, insufficient, adequate and optimal).

So worth considering though I know everyone is different and you'd need to discuss it with GP/cons etc.

(Am slightly puzzled though as results were attached to clinic letter with no discussion or indication of what they're planning to do about it - would kind of assume they would give supplements or something but not sure - emailed CNS to say 'umm, should I do something about this?')

[Hidden]

Thanks for this info, very useful!!

I have adcal tablets daily which have calcium and vitamin d plus a once a week tablet of alendronic acid.

BTW if you are given alendronic acid follow the instructions on taking them to the letter or you can feel quite sick and definitely follow the instructions re the full glass of water.

X

[Hidden]

P.s. Hope it isn't too painful Eloise and that ant treatment makes it better for you.

X

[Hidden]

Thanks Angelica, will remember that tip though not sure what I'll be getting. Got a call from the dr at RBH just after 6 this evening, saying first letter was returned to them hence why I'd only just heard, and yes it was low so either they could give me supplements or I could get my GP to which might be easier as I don't live in London. Appreciate him ringing me to let me know, even asked how I was and how work's going!

It's not too painful generally thanks, but from what I've read it does seem like it's because of that and it's not too hard to fix so hopefully the supplements will work (he did say can't guarantee it but it should help).

[Hidden]

Mmmm, very interesting. I get painful ribs often and just assume it's because of how hard it is to breathe or from coughing a lot.

[Hidden]

Well it might be - I *think* that was what I had it from last year, though this feels fairly similar. Was puzzled though because lungs doing a lot better so couldn't work out why ribs were misbehaving. Worth asking about maybe? My legs also hurt sometimes (more in last few days for some reason) though it's mostly ribs.

[Hidden]

Just thought I'd update as saw GP and now a bit confused. I think he was pissed off at having to work on Xmas Eve tbh - it wasn't an emergency appt, I'd never have made one just for this but figured as he had a slot today then not for a bit...

He's generally v good and listens, and was asking me whether I agreed with the RBH's assessment of how I was doing, and how I was getting on. But he started off with 'everyone is low on Vit D at this time of year, you weren't on steroids that long and they don't reduce Vit D plus deficiency doesn't cause bone pain anyway, maybe the breathing exercises are making your ribs hurt because you're getting used to a different way of breathing' (may have a point, will ask physio next time).

Not really what the RBH said (I was surprised at needing bone protection too if not on them long-term but they said the bone loss can happen fairly quickly so it does still help even if just on them for a month), also not what I'd read on (reputable) sites (yes I know, not good to trust the internet over an actual doctor but I was being careful to look at proper sites and reports of actual studies, plus it fitted with what RBH were saying).

He did actually prescribe calcichew anyway (looked at actual numbers on report and said 'oh yes, it is quite low, you'll need a good strong dose). But really hopelessly confused me and I thought I'd update here as there's clearly more to it than I thought!

(Oh, and it turns out the standard 'electrolyte' blood test doesn't measure calcium, because while it is technically an electrolyte it's not a concern in acute medicine whereas sodium and potassium levels are, so when they say 'measure electrolytes' those two are what they mean).

[Hidden]

I'd say go.with what RBH are saying philomela.

My gp is very good at admitting that some aspects of my treatment are out of his field of expertise but I've.come.across others who won't admit this and end up messing things up treatment wise.

X

[Hidden]

Thanks Angelica - I'm definitely going to, was anyway but was just a bit surprised and confused by GP as he's normally so good and was just a bit...odd and confusing this time, but as I said maybe he's just a bit knackered and didn't appreciate having to work round Christmas!

He seemed a bit sceptical about the breathing exercises as well esp when I said I did a lot of singing ('but you must know how to breathe properly already then!' - nice to have vote of confidence there and it was v helpful in the past!) - but it is v subtle apparently and I suspect it may be one of those things that physios are better at because it's their focus - particularly an RBH physio. I did say I thought the exercises weren't the only thing having a good effect as I think the pred did too ugh.