I was prescribed Adcal D3 750 Mg caplets three years ago after a Dexa scan result showed osteopenia. The GP label directions on the box were for one caplet twice a day. The actual box contains a paper information list of details however that show adults and children over 12 to take two caplets twice a day. Has anyone else received the same GP instructions of one twice a day as I have? Just wondering, as my latest Dexa scan seem to be worse than 3 years ago. Should my GP, three years ago, have told me to take 2 caplets twice a day? Thanks for any feedback. Jackie
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stillmovin
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In fact the dosage in a single caplet is even more than the recommended single dose, which should be in the region of 400-500 mg. The body can't absorb too much at a time. Too much calcium supplement is what leads to some of the problems with calcium.
Were you checked for secondary causes of osteoporosis?
Do you take Vitamin D3 and Vitamin K2 supplements, which are needed for good calcium absorption? K2 (not K1) can eliminate most of the problems of extra calcium as it directs calcium into the bones. Magnesium also important and when we take extra calcium the balance can get upset and we need extra magnesium as well - which should be taken at a separate time from calcium, or obtained in another way, for example an Epsoms salts bath or footbath. Magnesium is present in diet as it is to plants what iron is to animals, so eat your leafy greens!
I take k2 with one Adcal caplet after dinner at 6.30 pm. I also take one d3 25 UG gel capsule in the morning.
I have been taking epilepsy meds for a long time which cause osteoporosis. Can’t reduce or change those so I have to take extra supplements.
My problem is I don’t know the recommended doses of vit d3, magnesium and calcium for a person with osteopenia or borderline osteoporosis. Can anyone give me a good guide as there are varying bits of advice.
Can anyone give advice on doses for calcium. Vit d3 and for magnesium?
I have a cupboard full of these supplements and it’s becoming confusing.
Please add Vitamin K2 to that regimen. You don't need more calcium. The recommendation, as I said, is to take about 400 mg, no more than 500 in one dose. For some time now I have taken three doses of calcium a day, and each dose is about 350 mg. I take them at lunch, supper and before bed with a small snack as I take another med at breakfast which shouldn't be taken with calcium.
It's hard to recommend dosage for magnesium. It can cause loose bowels and some people are more susceptible than others. This is why I suggested the Epsom salts idea as the skin will absorb magnesium quite readily. I believe there are also sprays available which you apply to the skin.
It doesn't hurt to get a Vitamin D test to find out your level. It's now thought that current recommendations have been too low so the trend is to encourage people to aim for the higher end of the "normal" range and not accept a reading in the lower range as adequate. Only by finding out your level will you know whether your supplement is sufficient or whether you should consider taking more.
Some interesting reading for you:
Kate Rheaume-Bleue. Vitamin K2 and the Calcium Paradox
Carolyn Dean. The Magnesium Miracle.
You should be able to find these at the library, obtainable through inter-library loan, or for purchase as books or e-books.
Thanks for that advice. I am confused about the Adcal calcium amounts. The bottle states that each caplet contains 750 mg calcium carbonate equivalent to 300 mg calcium. What does that mean? Is it 750 mg calcium or 300 mg calcium? If my epilepsy meds stop adequate calcium absorption in my body, shouldn’t I therefore take two of these caplets in a day rather than just one? That is where I am baffled as my Dexa Reading has worsened after three years of one caplet of Adcal d3, a k7 tablet and an extra d3 supplement table.
I do have a bad acid reflux problem and have problems taking dairy food and milk so I realise I have missed out a lot on these sources of calcium and I think I need supplements but I am frustrated about the dosages. I mean my understanding of the dosages. Thanks.
You know, that's a very interesting question. I think you'd have to ask your pharmacist unless we can find the info on line. I take both calcium citrate and calcium hydroxyapatite, not calcium carbonate, and neither bottle gives me two measurements.
I do believe you're right, though. If you are getting 300 mg per dose then you'd think you should probably be taking one dose three times a day. But if it's 750, then certainly not.
There is some interesting info about "serving size" (i.e. dose) down this page:
Thank you for that. I now understand that Adcal d3 contains 750 mg calcium carbonate and 40% of that (300 mg) is elemental calcium or the calcium that is absorbed into the bones. Calcium citrate seems to be the one to take if you have low stomach acid and is easier to be absorbed. Sounds interesting to me.
I think my anti-epilepsy medications, which have kept me seizure-free for many years, are a worry now. This is something for me to discuss with my consultant however.
Thank you for that advice. I am trying to work out when to take my Adcal D3 and K2 tablets. In your opinion, is it a good idea to take Adcal D3 together with K2 100 ug in the morning ( 2 hrs after breakfast) and then the second caplet of Adcal with another vit d3 25 ug tablet at about 10 pm? I have a box of K2 natto 100ug but you can only take one of those a day so I’m working out the best routine to follow. I have to keep the Adcal away from the time of the epilepsy medication and between meals as I eat spinach, porridge etc and these apparently interfere with calcium. It seems a headache working it all out. Thanks.
I keep hearing different things about when to take the Vitamin K2. I honestly don't know if it makes a difference. I take all my supplements together, twice a day: calcium in a formula including other bone-healthy things, Vitamin K2, Vitamin D3 (once a day - mornings - in my case as my D actually was a bit high), glucosamine (for osteoarthritis), and alternating evenings a complete B vitamin supplement or mixed tocopherol Vitamin E, and my third dose of calcium, or sometimes magnesium instead, near bedtime usually with kefir or yoghurt). It's only prednisone I take separately, and when I sporadically take iron I can take that at the same time as pred, not with calcium and its cohort! All I can tell you is that whatever I've done appears to have worked as I did improve my bone density, although it's been several years since that second DXA scan so I hope things have either stayed the same or continued to improve.
Good advice and best to post blood tests results with such a question but Adcal D3 alone is not all the body needs for good bone health. Need adjusted calcium, and Vitamin 25-OH blood test results. Absorption is absolutely key and medical professionals don't take much notice of this nor the other nutrients required for healthy bones. In the winter months, in the UK, 200IU of Vitamin D does not "maintain" levels. Sadly after years of doing as they say I am now taking the advice of people who are trained in nutrition who take a look at the "wider" picture and the very important matter of absorption and the other nutrents needed. I'm on Zoledronic Acid infusions annually.
The problem is that doctors simply haven't had the training in proper nutrition. We are what we eat. And it is true that we know our own bodies best. My doctor would have liked me to go on alendronic acid. Instead I did my own research, got advice from friends, read books, and ultimately saved my bones without using any of the OP drugs. My doctor, when she saw the results of my second DXA scan, asked me how I did it! And has never mentioned AA since. Her only other recommendation had been to take calcium (which I'd been doing for about twenty years already) and double my Vitamin D3 (which made my D level go a bit too high). She said nothing at all about Vitamin K2. The only rheumatologist I've had the (mis)fortune to encounter had eyes only for bone meds, didn't believe in calcium supplements, and said Vitamin K2 didn't work, completely ignoring extensive Japanes research.
Hello again. I came back to you today as I looked back to some advice I received three years ago from this site following my first DEXA scan and it was largely from yourself! Thanks for sharing all that and patiently offering your help from your own level of experience. I looked back on my queries then and saw that I was confused about deciding how much to take of what supplement and when it should be taken, fitting it all in around the anti-convulsant medications that I have to take for life. So, you can tell I am still wandering around in a maze. But I understand that we are all trying to find what is best for our own circumstances. At the end of the day, if we manage to get those T scores to improve or even stay as they were before, then we have done something correctly. Well done for working hard to improve your bone density.
Having osteoporosis for quite some time now and been throught the "to supplement or not to supplement" medical professionals, my understanding is that calcium is best obtained from diet for absorption purposes or calcium Citrate as supplement and you need Cholcalciferol (D3) with Magnesium, Boron and Vit K and Vitamin C. Vit E is also key for healthy bones. If I had my time again being caught between medical professionals who aren't trained in nutrition I would definately get myself an excellent nutritionist as I have now. Too late but better late than never. In your case I wonder whether you know what your blood results were as they would be a factor in what I took. One Adcal from the patient leaflet says Vit D 200 IU which will not maintain levels through the winter months. Personally I don't like taking supplements fot too much calcium, a small top up to help on those days when I might miss something but otherwise most of my calcium I want from diet. Doing your best to ensure the calcium you have gets to where you want it to be is the key, is my understanding.
Thanks for this input and I intend to ask for blood tests when I get my official dexa results from the GP. My main problem seems to be the anti convulsants meds, which are very effective, have side effects of interfering with vit d and calcium. I can’t change those so I must rely on supplementing calcium and vit d. I don’t want to take bisphonates. I know I will have to work hard at this but I am concerned as I thought I had been doing that since the last dexa scan 3 years ago but obviously not. I haven’t yet had the exact dexa scan results from this week’s scan but the radiologist told me my hip showed osteopenia and my spine was osteopenia and borderline osteoporotic. Those were his words. My first scan previously only showed osteopenia in the spine and the hip was ok.
I wonder is there anyone who can relate to the situation I am in where other tablets they have to take for life for another chronic condition are interfering with their absorption of calcium and vit d?
I have always had a very low BMI and am naturally slim build and small bones so that doesn’t help.
Some people are built like that. I have recently had a bad lung infection as I have bronchiectasis and I was on a long bout of penicillin v and then doxycycline antibiotics in Jan and early Feb. I wonder does this reflect in my bone mass results too?
I am giving a lot of information here but perhaps someone out there can relate to this?
Yes, I agree that a nutritionist would be helpful. It’s finding a good one locally that is the challenge.
I can relate to you totally. I have a number of conditions too and for now have decided against any medication that would otherwise affect my bones. Many nutritionists will help you remotely. I went to London to see mine at a Clinic that specialises in women's health in 2012. Since then she now works alone and at some specialist clinics in London. I'm happy to share her details via PM with you if you'd like them. You can read about her first on her website. She's not expensive and is excellent. she has just done a new plan for me and assessment this week. Just a thought, have you checked the nutrients your medication depletes? As you may need to supplement for those too. Google your medication name and put Medication Induced Nutrient Depletion and you will be able to look on various tables. Best wishes
Are you also short? Asking as it is known that smaller people (have seen it referred to as snack size 😀) often have worse dexa readings. This is because we are being compared to the average sized 30yr old and anyone of around 5’ and smaller are not part of the average population. Also was your scan on the same machine?
Hi. I’m not short. Unfortunately in this case I am average 1 m 62 or 5’4’’ . I don’t remember if it was the same machine s and I’m not sure how to check that really.
The reports should say if they were done on a hologic machine or the other one, unhelpfully I can’t remember the name of the other type. But the two types produce different types of pictures and graphs from each other. Your scan prints from your scans should look the same meaning they were done on the same type. The print out will give you the model of the machine.
Compare the pictures very carefully to make sure they look identical that, if they are not it can have an effect on the numbers. I hope that makes some sense!
I didn’t get a copy of my first scan and was just told the figures by my GP. I will ask this time for a copy of the recent scan and see if I can have the older scan report too. Don’t know why we find out these things through talking to others on these helpful forums and not from our GP at the start. I am learning all the time. Thanks for the advice.
I have realised, very late in the day, that usually GPs are general (the clue is in the name) not specialists and I do not mean that in any derogatory way. How can they know everything about everything? A lot depends on how good their training is. It is only in fairly recent times that it has come to light the importance of diet and the woeful lack of teaching student doctors get on the subject in the whole of their training. Luckily this is beginning to change.
This is why we need to be proactive in our own care and seek out/share what we can - and then make up our own minds.
I hope you find the answers to your original question.
I do see your point but GPS treat a wide range of conditions and have a certain responsibility in getting important information across to the patient. As far as I know, they spend many years studying for their degrees, get paid well (as indeed they should) and yet some of us end up going online to help ourselves. That’s fine if you are a reasonably bright and discriminatory person but some people can risk getting it dangerously wrong if they go their own way and don’t follow their doctor’s advice. I am simply saying that a GP does have the means at their hands to offer some extra information on test results, treatments, etc. And some do. I suppose you really have to know what questions to ask in the first place yourself. I didn’t know anything about results varying from one Dexa scanner to another, for example. I have to ask the right questions and do my research.
Thank you and of course you may PM as I am interested in what you say about nutrition.
I've been taking these for 6 years, and was always told 2 a day. I take one in the morning and the second in the afternoon. I was first prescribed it after cancer treatment as I was on steroids and aromatase inhibitors during and after chemo. Since then I was diagnosed with Vasculitis which was treated with very high doses of steroids.
I too am on Adcal D3 caplets (was on the chewable disgusting ones yuk). I changed to the caplets over a yearago and just took one in the morning and one in the afternoon/night. I only recently looked at the pharmacy label and it actually says take two twice a day.
I hadn't realised. So it is very apt your query as I too am wondering should I now up my dose.
I will raise this with my GP next I see her/him...as don't really want to take lots of calcuim.
If possible, and there are no contraindications, get as much calcium from your diet as you can! Much better for you. The experts say 700-1250mg of calcium is needed daily, I personally aim for the higher figure and rarely need to top up with tablets. The body can only absorb so much in one go , the perceived wisdom is in quotes below
“Calcium absorption is best when a person consumes no more than 500 mg at one time. So a person who takes 1,000 mg/day of calcium from supplements, for example, should split the dose rather than take it all at once. Calcium supplements may cause gas, bloating, and constipation in some people.6 Dec 2019”
Do you/can you also take vitamin k2 as this is supposed to be helpful in directing calcium away from the soft tissues and to the bones. This is also another job for vit d3.
The Vitamin K2 and the Calcium Paradox by Kate Rheaume-Blueu is worth a read but I have found the link below giving a general outline.
Good idea! I will do that myself. I am taking note of what I have now learned on this forum however, that it’s best not to take too much calcium via supplements and get more through diet. Let me know what you hear from your doctor. Take care.
Ad Cald3 is a complete waste of time . I took it for Some 15 or 20 years and still slipped into osteoporosis. Gave up and now on a vitamin D regime. Try the Facebook group ... vitamin D and Cofactors - Discussion, and use the protocol there. 5000iu vitamin D, 500 of K2 - mk7, 500 magnesium and 3 mg boron. You do not need calcium supplements unless you are calcium deficient. The vit D3 will activate the calcium in your diet and make it much more available to the body.
Did you take any medication for another condition that was preventing you from absorbing vit d or calcium? I can’t see how a calcium supplement such as Adcal d3 can be a waste of time if your body isn’t absorbing calcium or vit d3 properly. Did you have vit d and calcium level blood tests before the regime you are on? Has the vit d program you are now on helped improve the t scores for you? Thanks for info.
It’s to early go tall about my t scores - not had another dexa scan since I came off sodium risedronate. . The amount of D3 in those tablets I was taking was minute and wouldn’t raise levels. I am slowly getting up to 120nmol/L which is recommended as optimal unless you have an autoimmune disease. I get my levels tested through Better You who use a NHS lab in Birmingham. If you take decent levels of D3 and all the co factors, you have the best chance of producing enough calcium and it being directed to your bones and muscles where it should be. You don’t want calcium floating around in your body and calcifying your soft tissues. Sadly doctors have very little training in vitamins and minerals. They are geared to Big Pharma, except in very rare cases.
Hi stillmovin. I was prescribed 'the i-cal D3' after radiotherapy and the oestrogen lowering drug Letrozole following breast cancer surgery. A scan showed I was osteopaenic too. My calcium supplement is a chewy tablet (I call them my Refreshers, as they taste a bit like them, if you're old enough to remember those sweets!) Mine are 1000mg/880 IU Calcium/Colecalciferol and I take one a day before lunch. I don't take them with breakfast as I usually have branflakes. High Fibre foods inhibit absorption of calcium apparently. Hope that helps.
Thanks jools I am careful not to take Adcal d3 with All bran as I learned it stops absorbtion of calcium. I am going to ask the GP to do blood tests of my calcium and vit d levels before upping my vit d3 supplement. I already take 25 mg (1000 iu) of d3 in addition to the daily 400 iu contained in Adcal.
It seems to me that we all have different requirements and a lot depends on our build, our diet, exercise, other medications taken and many other factors. That’s what I’m learning from this forum. I would like to have a dexa scan every year but it seems we can only have one every 3 years in the U.K. I don’t know where I could have a private scan near me.
Hmm Stillmovin'...it might be worth your while to ask your GP/Practice Nurse to refer you for a Dexa scan before the 3 years are up, as I was told I was to have one every 2 years. My GP said after reviewing the results of my first scan "We should call you for a referral to hospital for your next one in 2 years, but this probably won't happen so ring and ask for one!" It might be different where you live, but worth a try.
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Her only other recommendation had been to take calcium (which I'd been doing for about twenty years already) and double my Vitamin D3 (which made my D level go a bit too high). She said nothing at all about Vitamin K2. The only rheumatologist I've had the (mis)fortune to encounter had eyes only for bone meds, didn't believe in calcium supplements, and said Vitamin K2 didn't work, completely ignoring extensive Japanes research. 
How much is too much D3 
DEXA results worse, trialling HRT
Osteopenia ,can it be halted 
