My GP as recently prescribed me "ADCAL Calcium tablets I have been on preds for 12 months now down to 5mg

[JOHNONE28]

Are the calcium tablets really necessary on such a low dose

[PMRpro Ambassador]

Has he really only recently decided to give them to you? He's a bit late catching up with recommendations! What else are you on? Calcium plus vit D should be the second prescription given to you after the pred. Only if that isn't adequate according to a dexa scan should they go on to any other bone protection medication.

Taking pred alters the way the body processes calcium and makes new bone. It is known that taking extra calcium and vit D seems to help avoid loss of bone density. I know the effect of the pred is still there at 10mg, I don't know about at 5mg but I imagine there is still some. Taking the calcium tablets has never bothered me and I'm still taking them at 5mg on the basis they certainly aren't doing any harm and I almost certainly also need the vit D!

If you are concerned about the stuff last year in the media about taking calcium being bad for you, that isn't an issue. It was only in otherwise healthy people taking excessive supplements that were only calcium, as long as vit D was included there was no adverse effect. It was merely a case of more isn't always better!

[PMRpro Ambassador]

I have now looked it up. There is a not inconsiderable extra risk of fractures in patients taking steroids. Overall, iIt is more than doubled (x2.27) at doses of over 7.5mg/day and at 2.5-5mg/day the risk is not quite doubled (x1.77). These figures are based on a population of about 500,000, half taking pred, half not.

If you are used to reading medical/scientific technical stuff this explains it quite well (the figures aren't quite the same as I took them from another source):

australianprescriber.com/ma...

[Annodomini]

I am still taking Adcal. Now on 5mg of pred, tho was down to 1.5 until I had a flare. I think I still need the calcium because my nails are in a terrible state which is most unusual for me.

[jinasc]

Hope you were told - Pred at breakfast and Calcium at Lunch. If you take them together, you might as well take smarties and not the calcium.

[Hidden]

My doctor told me there was no truth in that! Can you explain please quite confused

[Celtic PMRGCAuk volunteer]

Susie - best advice from sambucca! Calcium taken at the same time as Pred can reduce the effect. If taking calcium twice a day, lunch and dinnertime is best.

[yevrah]

oh my goodness i cant even get as far as seeing a rheumy, but i have learnt such a lot on here, thank u all. i put myself on calcuim and d, my doctor only has phone appts with me now. have been dropped from 15mg to 12.5 and over last ten days have been in pain down my left hand side neck to knee, have now started doing 15mg one day 12.5 mg next since last thursday and still in pain, have phone appt booked but i think its time my doctor and i haad a meet, surely i should not be in pain, having to take regular pain killers but still end up with a dull ache. have to say feeling very down at the moment with this condition

[daveD in reply to yevrah]

evening yevrah. my heart goes out to you.I took advice from PMRpro?. I tend to use the Drs. for Blood test&prescriptions.I get all my info from these Forums. At the moment i am slowly going from 15mg to 12.5mg.if need B. i will go to the Drs. Try to be Firm but Calm at Drs.Take care. Dave.

[yevrah]

thanx daveD. drs havent done my bloods for ages, think i am an easy patient in there eyes, phone me, encourage me, pacify me and tell me they sure that i know what i am doing. its nice to have this site to talk with people otherwise i think we would all be lost in the dark. i hope your process from 15 to 12.5 goes smoothly. kind regards yevrah