Adcal-D3

[chatshy]

Just been prescribed this today . Is this a good thing or a bad thing . I take 35mg prednosolone daily . I know it is to protect the bones but nothing else . I am also reducing my steroids 5mg weekly after 5weeks at 40mg , since reducing I have really bad cramp in my feet could it be due to the reducing of steroids .

[PMRpro Ambassador]

Yes, calcium supplements are a good thing. It has been noticed that people on pred and calcium supplements have less bone density loss because the calcium seems to inhibit something in the removal of calcium from the bones. Anyone on pred needs a dexascan and then bone protection medication according the result of that scan. The starting one is calcium/vit D supplements and many of us have been on that for our entire pred journey and have had no real change in bone density.

If you are already osteoporitic you would need different medication - but they shouldn't really be used prophylactically (to prevent something that hasn't yet happened) although the manufacturers have marketed them in that way as being totally safe and a miracle. They aren't 100% innocent in the long term and can have nasty side effects - wait until it is obvious they are needed.

Pred can change the way your body stores magnesium and lower the levels - and that can cause cramps. The standard advice in all of mainland Europe if you go to the doctor with muscles cramps is to ask if you have tried taking magnesium tablets so that is a good place to start - ask at the chemist or H&B for plain magnesium tablets, not multi-supplement tablets where the magnesium level is low and you will get a lot of other things you don't need. I take 200mg/day magnesium when I need it. My husband does too and when he's not bothered for a few months - back come the night cramps!

[chatshy in reply to PMRpro]

Thank you for replying . Learnt so much from here . Waiting on an appointment for a dexi scan . I have had a lot of lectures from the GPS about the side effects of prednosolone but not a lot of understanding about the difference they have made to mine and my families life in fact they have given me my life back . It was a consultant at the local hospital that diagnosed me and prescribed prednosolone . Thank you once again .

[michaelegan]

5mg weekly reduction is too fast. Every 14 days would be better until you reach 10mg. Then 1mg a month. Drink some tonic water to reduce the cramps. Your Doctor should be linking your dose level of steroids to your symptoms and your blood picture.

Adcal will help to reduce the likelihood of a reduction in bone density as long term use of steroids can bring on Osteoporosis.

Good luck!

[piglette]

The local pharmacist said I should take vit D and calcium all the time I am on steroids. The rheumatologist had forgotten to tell me that! One thing though don't take them at the same time as the pred, leave at least two hours if not more inbetween, as the vit D can stop the pred being absorbed properly.

[paddyfields in reply to piglette]

My own experience is that use of steroids at a lower dose and over a lesser period than previously thought can accelerate bone density loss. My osteopath confirmed that he was a course where they also said that this is now accepted. Despite doubling my exercise following a dx of Parkinsons 5 years ago , my bone density relative to my peers (75 years old) has lost ground so that I now have osteopenia and the only factor that I can think of is the periodic use of steroid tabs or injections for hip problems in the last five years.. I now take a once a month pill but am not entirely sure about this sure and will certainly stop it as soon as I get off the prednisone which will be in February if all goes well with the PMR only recently confirmed as a typical symptoms. Any further observations about these anti osteoporosis pills would be welcomed

[PMRpro Ambassador in reply to paddyfields]

If you have falling bone density then taking one of the bone protection medications is reasonable enough - but only if the problem is proven by a dexascan. Some people find a lot of difficulty taking the bisphosphonates, they tend to come as once weekly or once monthly tablets, and if they do then there are other substances available. Bisphosphonates should not be taken by anyone with a history of gastric problems (reflux, hiatus hernia and so on).

Um - if you have only recently been diagnosed with PMR then it is very unlikely you will be off pred by February. A much more likely scenario is that you will be on pred for up to a couple of years if all goes smoothly - but I have had PMR for 10 years and am only now down to a very low dose. The reduction scheme is to find the lowest dose of pred that manages the symptoms, not to get to zero straight off. PMR is the symptoms of an underlying autoimmune disorder. As long as that is active you will need some pred though hopefully at a relatively low dose. Reducing too fast and too far is a certain way to develop a flare in the symptoms and there are a couple of very slow reduction schemes doing the rounds which seem to be allowing people to reduce further than before with fewer flares or problems with steroid withdrawal pain.

[chatshy]

Thank you everyone x

[paddyfields]

The PMR was only recently diagnosed since I first saw a rheumatologist last February. Before that I had been trying to reduce the pred .from 15 mg as per GP's regime but had not been able to go lower 8 mg before the hips ached again and the generally ill/fluey whole body aching returned and sometimes my hips seized up til I could hardly walk with no relation to what exercise I might or might not have been doing . I have had symptoms on and off and periodic courses of steroids and/or injections for bursitis in the past five years. MRI showed little or no arthritis but tendon inflammation was apparent and bursitis both sides. My osteopenia was picked up 18 months because I have had dexa scans from time to time over the last fifteen years and whereas I had better bone density than my peers, the last scan showed a relatively accelerated decrease in spite of increased weight bearing exercise. I have been winding down from 15 mg since last February, at the moment 1 mg a month and should be almost off by February, at least sufficient to let the rheumatologist see how I am without the pred. . The arms have also been involved slightly in the last few months but my white bloodcell count has been normal - hence the rheumy's reluctance initially to dx PMR. It was a locum that put PMR in his ltr to the GP and I'm not sure he was supposed to. It must be obvious hat I have not been as ill as some people on here. But the near miraculous change in 24 hrs from hobbling in pain with a stick to running up the stairs does point to PMR. "If it looks like a duck......"

as the saying goes.