adcal calcium

[Radars]

My gp has prescribed adcal lemon chews for my severe osteoporosis, I already take vit d3 1000iu and k2 mk-7, is it ok to take them at the same time, adcal is 2 a day.

[Met00]

Vitamin D3 and K2 both need fat for absorption, so need to be taken with a meal. In order to ensure there's enough fat for each of them, it may be better to take them at different mealtimes. Taking your existing D3 supplement as well as Adcal is probably OK, but you really need to know your blood D level in order to know how much Vit D supplement you need. I assume there's 800iu in 2 Adcal tablets, so that would give you a total of 1800iu daily, which is safe for almost everyone. If you already get a lot of calcium from your diet, there's a slight risk that taking a high dose calcium supplement (I think Adcal has 600mg per tablet) could be too much. We only need a calcium intake of 700mg - 1200mg per day, so those 2 tablets alone would be giving you your daily allowance, without accounting for any that you get through food. If you drink milk (or fortified milk subsitute) and eat cheese and yoghourt regularly, you'll already be getting a lot of calcium that way, as well as other food sources.

[Radars in reply to Met00]

I take my d3 1000iu and k2 and krill oil with a meal so there's good fat with them, I use alpro milk and yogurt both fortified, when I go for my blood work on Monday how will I know where my calcium levels are, and why has my gp prescribed adcal.

[Met00 in reply to Radars]

It's very common for GPs to prescribe a combined Vitamin D/calcium supplement for osteoporosis, because that used to be recommended. They don't seem to have caught up with the change in the guidelines. I was prescribed Adcal, but once I read up on it, I went back to my GP and asked to drop the calcium as I get plenty in my diet and was concerned about potential and unnecessary side effects from taking a supplement. It's something you can discuss with your GP. As you're taking a PPI he/she may recommend a calcium supplement in addition to dietary calcium, but if it wasn't recommended before, I would question why that has now changed.

[56jennywren in reply to Met00]

Hi Met00,

Can you direct me to the change in the prescribing guidelines for calcium /vitamin D please?

[Met00 in reply to 56jennywren]

See bnf.nice.org.uk/treatment-s.... It says "Patients at risk of osteoporosis should also ensure an adequate intake of calcium and vitamin D. Calcium should preferably be obtained through increasing dietary intake; supplements may be used if necessary." And here: cks.nice.org.uk/topics/oste..., where it says "If the person's calcium intake is adequate (700 mg/day), prescribe 10 micrograms (400 international units) of vitamin D (without calcium)". (The Vitamin D recommendation is ridiculously low for most of us!!!).

[56jennywren in reply to Met00]

Thank you, just what I need!

[Radars in reply to Met00]

I will stop the 1000iu of d3 I take and just take adcal chews along with k2 mk-7

[Met00 in reply to Radars]

It's worth getting your blood D tested. Many of us need 2000iu of D3 daily, some need even more. Aim for a blood level of at least 75 nmol/litre (for those in the US, that's 30ng/ml).

[Radars in reply to Met00]

on my blood form it says (bone profile)(crp),u&e(with egfr)(ue)vitamin d(vitd)vit d=prior to bisphosphonate/denosumab. will that be ok.

[Met00 in reply to Radars]

Yes, they'll test it then. Ask for a copy of your results afterwards, or at least ask them to let you know the actual results rather than just telling you "normal".

[Radars in reply to Met00]

it will be about a week or 2 before I get results

[fraid]

I cannot seem to find out if Adcal,just that, has Vit D3 included or if AdcalD3 is a separate med? Even chemist didn’t help.🤷‍♀️

[Met00 in reply to fraid]

I'm fairly sure it includes D3, which is essential to take if we have osteoporosis. I can't imagine a doctor would prescribe just calcium.

[fraid in reply to Met00]

thanks but it just says Adcal, when I look it up they all show/talk about Adcal D3 ,wonder if I’m getting just calcium not D3 too. Have tried to find out but get blanks,guess I’ll have to ask again? 🤔🙃

[Radars in reply to fraid]

2 tablets 600mg calcium and 400iu d3

[Met00 in reply to fraid]

If you have the supplement, it will say in the box and leaflet what's in it.

[fraid in reply to Met00]

Oddly, there is never a leaflet in the box nor does it say on the box,just ADCAL. When I googly it ALL the boxes say ADCAL D3. Hence my query, surgery didn’t know, chemist said think so but it doesn’t mention D3 on box.🤷‍♀️🤔

[Radars in reply to fraid]

adcal is 2 chew tablets 600mg of calcium carbonate and 400iu d3

[Met00 in reply to fraid]

Doesn't it list all the ingredients on the back of the box? I'm fairly sure that's a legal requirement, together with a patient information leaflet enclosed. Did you get it on prescription?

[fraid in reply to Met00]

yep, prescription, says 1500mg calcium carbonate ( equivalent to 600mg calcium) on back of box. No mention of owt else,so just calcium. Shall tackle doc re D3 if can every get hold of him. Thanks for your help & interest.

Back of box

[Met00 in reply to fraid]

It sounds like your doctor prescribed the wrong supplement! Calcium should be from diet for most of us (NICE guidelines) but we do almost always need to take a Vitamin D supplement. Has your doctor done. Vit D, calcium and parathyroid blood test (all 3 at the same time)?

[fraid in reply to Met00]

just had another bt, re low potassium re oedema lower legs, had pot tabs 5 days didn’t make much difference. Which came first oedema, diuretics ,low potassium, seems circle as each can cause each other! 🤷‍♀️Shall phone this week re D3 and results. Thanks for your interest and help.X

[Radars in reply to Met00]

I take vit d3 1000iu and k2 mk-7, I am not taking the adcal because I have hiatus hernia, I take lansoprazole 30mgs every morning, I am going for a blood test tomorrow, for bone profile, and vit d.

[ChristineK in reply to Met00]

Is it necessary to have all three bloods taken at the same time? The reason I ask is that I was worried about hyperparathoidism and so requested a test for this from the endocrinology department and they did this text on it's own.

[Met00 in reply to ChristineK]

Yes, they should be done together, because the three interact with each other. If, for example, high Vitamin D means more calcium is being absorbed, the parathyroid glands will work to keep calcium blood levels low, so the blood parathyroid level should be low. It's the combination of high blood calcium (or sometimes normal blood calcium), normal Vitamin D and high parathyroid that can indicate a problem.

[Radars in reply to Met00]

I have just received my blood test results, calcium in normal range, vit d65.normal,I refused adcal so gp said continue vit d3 400-800iu,so my lansoprazole 30mgs is not stopping me from absorbing calcium and vit d.

[Met00 in reply to Radars]

That's reassuring. I would expect calcium to be in the normal range, because if everything is working as it should, blood calcium gets priority over the bones. It's important to make sure you get plenty of calcium in your diet (with taking lansoprazole, I would aim for at least 1000mg daily) and personally I'd want to increase my blood D to at least 75nmol/litre. You said you've been taking 1000iu Vitamin D daily, so if it were me, I would increase that to at least 1500iu daily (you could do that by alternating between 1 tablet one day and two tablets the next). If you took 2000iu daily, that would probably increase your blood D to about 90nmol/litre. I certainly would not reduce to 400iu daily, as that would likely drop your blood D to about 50nmol/litre, which is the bottom of the normal range and not considered nearly high enough by many experts. In the US they expect blood D to be at least 75nmol/litre (30ng/ml by US measurements) to be considered normal. I would also take vitamin K2 to help direct the calcium to your bones.

[Radars in reply to Met00]

I said to gp that I won't take adcal as it's full of sugar and because I have prostate cancer, she said ok but keep vit d3 between 400iu 800iu, I will use up my 1000iu first, if calcium levels in my blood test are normal why add adcal.

[Met00 in reply to Radars]

I agree that adcal isn't the answer (you need to get your calcium from diet), but please don't reduce your Vitamin D intake, as you'll end up with low blood D and probably less calcium being absorbed. My daughter lives in the US and was told her blood D was deficient because it was under 75nmol/litre (30ng/ml), so if you lived in the US, you would be considered deficient and told to take more Vitamin D, not less! There are many doctors here in the UK who also say blood D should be 75nmol/litre, particularly if you have osteoporosis, but unfortunately too many GPs just don't know enough about it.

[Radars in reply to Met00]

yeah I will keep my 1000iu d3. also k2 mk-7 I take them together, I have just started boron 3mg which I take earlier. I am waiting to start zoledronic acid after I have had dental work, I have been referred urgent to endocrine team because I get a bit breathless after just starting my daily walk,

[wellness1 in reply to Radars]

In addition to K2, magnesium (Mg) is another important co-factor of vitamin D. Ideally we get enough from our diets, but many people don't and take supplements. Mg comes in different forms and all are not created equal. A good all-rounder is magnesium glycinate. Some who suffer from constipation prefer magnesium citrate. There are claims Mg helps with bones and has other health benefits, as well. More info in this link if you are interested. I include it because of the relationship of vitamin D, calcium, and magnesiun.

medicalnewstoday.com/articl...

I'm sorry you are dealing with so much Radars. Glad you have received an urgent referral and hope it goes well for you.

[Radars in reply to wellness1]

thanks, I have read not to take boron with magnesium

[wellness1 in reply to Radars]

That's interesting. I know boron is involved with calcium and magnesium metabolism and important to have adequate amounts of all. Maybe the concern is that you could end up with too much if boron reduced urinary excretion levels. I'll have to do some reading.

[ChristineK in reply to Met00]

Thank you. You are so knowledgeable. It's unbelievable that they would be so incompetent at the hospital. I will get on to them again, although I am sure they will not be happy. I hold my hands up in dismay at the way these people work.

[Met00 in reply to ChristineK]

From what I've read on other groups, doctors' knowledge about hyperparathyroidism is often quite limited! I only know what I do from extensive reading! If anyone claims anything specific, I always check it out for myself rather than just taking it at face value, as there's an awful lot of rubbish being spouted too!

[ChristineK in reply to Met00]

All they told me about the blood test at the hospital was that it MUST be in th lab within 30 minutes?

[Met00 in reply to ChristineK]

That surprises me, as if it's done at a GP surgery there's no way it will get to the lab that fast!

[ChristineK in reply to Met00]

I had to go to hospital for that reason. and not all hospitals in our area can supply a quick service, only certain ones. I was told that it MUST be in the lab within 30 minutes. The lab actually refused it because the guy who took the bloods put the wrong colour on the phial and they pboned me to go back and have the bloods done again. It's a good thing I had not left the hospital. (I was n the coffee shop). Beurocracy in It's fullest form!

[Met00 in reply to ChristineK]

I just found this, which makes it clear calcium should be tested at the same time, with instructions for the correct tubes and order! gloshospitals.nhs.uk/our-se...

[ChristineK in reply to Met00]

Thank you. It seems you learn something new every day. As I recall, person taking the blood should have used the purple tube, but used a grey one instead.

[walk21 in reply to fraid]

Try emailing the makers if you can find an address in packet

[strongmouse in reply to fraid]

Patient information leaflets available online. Here is the one for Adcal chewable - medicines.org.uk/emc/produc...

[fraid in reply to strongmouse]

Thanks but that’s for Adcal D3, like I said mine is Adcal ,calcium only. Shall ask for D3 too.

[Neonleon]

I take a bone support supplement which includes calcium, magnesium, bit D, Vit K2. I read on the ADcal notes that it is not to be taken long term as it can cause tooth decay. I had to start taking it 30 years ago and my dentist recommended another calcium product.

[Radars in reply to Neonleon]

is adcal ok for stomach because I have a hiatus hernia, I have got severe osteoporosis so I will have to take adcal, I am going for blood work on Monday so I will wait and see what that says before starting adcal.

[fraid]

Thanks for your replies.I will have to phone doc again re D3 thing & also check ok to be on Adcal long term. HAPPY NEW YEAR ! 🥳🤗

[fraid]

Aha! After Met00 pointing out leaflet should be in box having never found one before,I had another look & there it was hiding at the bottom! Duh! So thanks for that.It just days contains calcium, no mention of D3, so shall ask doc.X