Post on other forum lady had letter from GP telling her to stop taking this as proven not to do anything for bone health ???!!!!!
Anybody have any information
Calcichew: Post on other forum lady had letter from... - PMRGCAuk
Calcichew
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olive2709
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In the case of healthy people eating a healthy diet there is almost certainly no need for calcichews. However, when you are taking steroids they increase the excretion of calcium via the kidneys and it is felt that there is an advantage in having enough there to try to offset it.
In this review rheumatology.oxfordjournals...
they say:
"Calcium and vitamin D. A recent meta‐analysis concluded that calcium and vitamin D was more effective than calcium alone or no therapy in the treatment of CIOP at the lumbar spine with a 3.2% difference in BMD between treatment and control. The doses of calcium and vitamin D used in the various studies varied from 400 IU daily to 50 000 IU/week [56]. In a group of RA patients studied over 2 yr, Buckley et al. [57] found that calcium (1000 mg daily) and vitamin D3 (500 IU daily) increased lumbar spine BMD by 0.72% per year compared with a loss of 2% per year in the placebo group. There was no difference at the femoral neck."
i.e. taking a combined preparation DOES increase bone density even when taking pred.
australianprescriber.com/ma...
is another article saying much the same thing.
There are few side effects with calcium/vit D compared to the "heavier" medications and I would be most unhappy if a GP tried to stop me having it! There may be papers suggesting it doesn't help - there are also plenty that support its use.
Yes, in agreement.
Good post PMRPro.
I have been diagnosed with osteopenia and have lumbar spine problems. Am now taking two Seashell calcium and Vit. D 400 pills a day. Believe this is one of the better preventative and restorative remedies.
Whittlesey
Remarkably irresponsible advice on the part of that physician. That being said, the form of the calcium, as a chewable calcium carbonate, may not be the most readily absorbed. Chewable medications tend to contain more extraneous ingredients which themselves can be problematic for people like us whose body systems are already knocked somewhat askew by prednisone. Personally I'd prefer calcium citrate in capsule form, and vitamin D3 in an oily capsule (like vitamin E). Dietary calcium, especially from leafy greens, is also really important. Another ingredient one should make sure to get in a supplement is Vitamin K2. (K2, not K1). Olive, I think you've already heard my preaching - this is for the benefit of others who may read this post! 
Perhaps the surgery are trying to save money, !! or do you pay for prescriptions ?
My friend was told to buy her own Calcichew, or equivalent at the chemist.
Can those in the UK get non-prescription drugs through public health care system?
Calcichew, vitamins and pain killers are given free on our NHS if needed to all those over 60 years. However painkillers ie paracetamol are so cheap most people would buy them.
I'm impressed. I can't get any coverage of any kind for non-prescription items. And I had occasion to buy some shea butter from the pharmacy and she charged me a dispensing fee on top of the price!
Because of my very thin skin [ 16 years on Pred ] I also get a tub of cream for that every month, plus all my prescription pills. However my sister who lives in USA [Virginia ] reminds me that as I have paid into the NHS for 45 years [ aged 15 to 60 ] it's not entirely free !!!
I'm now 71.
The point about paying for universal social programmes through taxes is that the costs are shared amongst the whole population. Plus individuals and their families are protected against the catastrophic expenses that can bankrupt Americans.
My sister in USA also lets me know that she feels that their private health insurance is better than our NHS [ she's lived in the USA for 46 years ] I don't argue with her !!!!!!!
Private health care jolly well SHOULD be better - it's expensive enough. Public medicare fails because of human frailty and mismanagement, not because the concept is not noble or right. Millions of people in the US cannot afford private insurance and there is major push back by people who don't want "Obamacare" to be successful. They are so afraid of "socialism" in the US it would be funny were it not so tragic.
I do admit to also having a small private health insurance but that is limited, however when I have used it it's been excellent, and quick, the consultant's I have seen at the private clinic were the same ones that work for NHS hospital.
We have "universal medicare" but it doesn't cover everything, so we also have private coverage, provided through my husband's retirement benefits, a continuation of the coverage he had when he worked. Drug coverage is included in this package. There is no drug coverage in our "universal" plan so a cancer patient, for example, has their medication paid for while in hospital, but once they are home again they have to pay for their treatment. Just one of a number of egregious deficiencies in our system. I believe that the US, ironically, provides much better care to its seniors than we do. On the other hand, a pregnant woman in Canada has access to complete care from conception to birth with no charge. There is no "parallel" private system to our public one, and this is the universality we struggle to keep, as well as attempting to improve and expand the coverage we do have.
My sister tries to tell me about their health system, [ she and husband also have Medicare plus other works health insurance.] but it still seems complicated, and ours not much bette,r even on the NHS.
There was a time when we had free prescriptions, free dentist, and free eye tests. However as I'm over 60 I do get free eye tests, and prescriptions, I do pay for the dentists, a check up,clean and polish, is very cheap at just over £18
I think under 16 ? are exempt from all the above ?
I have had/have several health issues and must say I can't fault my treatment on the NHS
Wouldn't it be nice if things were made much simpler.
keep well
In UK if the drug is not approved for prescription you cannot get it on the NHS, this happened to me for eye drops. Some drugs can be both bought over the counter or on prescription eg paracetamol. If it is cheaper than the cost of a prescription people will just buy it over the counter. If they are eligible for free prescriptions they can get a prescription. There are also prescription only drugs which are not available on an NHS prescription, but can be paid for privately. eg Lodotra for PMR, although the NHS will pay if it is prescribed for rheumatoid arthritis. This area has had a lot of press recently where the NHS is refusing to pay for expensive cancer drugs, the decision seems to be based on cost, but I am sure the department of Health would disagree with me!
The NHS in it's early days was excellent, I was born in 1945 so have seen the rise and maybe the fall of it ! but I hope not.
I have read about the NHS not wanting to pay for expensive drugs, Perhaps these drug companies could charge less.
It's all above a simple soul like me, I just answered HeronNS questions re non prescription drugs.
and I like many people just buy my own painkillers, vitamins, even though I could get them free. I do feel sorry for those who have to pay for there prescriptions as they get more expensive every year, some even go without, so I suppose it's not all free is it.?
Does it make it feel different if the drug concerned MIGHT extend life in a terminal patient by less than a month on average at a cost of maybe £70,000? Many of these new "wonder" drugs are in that sort of price range and still come with side effects attached and still don't cure. "Cure" at that price means it's a no-brainer but that isn't the case.
The NHS does negotiate the price - but if you look very carefully at small print round the world you will find that the price varies from country to country. There are drugs that cost the half in other countries - because the companies will always try to charge the maximum the system will stand to get back something on the cost of development and some countries simply won't consider paying. That's why there are also periods of patent protection before other companies can make the drug as a generic without paying towards the development.
The decision is made not on the basis of cost alone - it is "cost effectiveness" which takes a lot of other things into consideration. But the pharma companies continue to push their luck. It's a difficult decision - but that all contributes to the mess the NHS is in. It was never intended to have to supply some of the things it is now expected to for the length of life we now enjoy.
I have a basically free at point of receipt service here in Italy - all I need from my GP or as an in-patient is there for no or only minimal charge. There are a lot of things we don't get here though, the list of drugs covered is very short compared to some countries but I can have a private prescription for pretty much anything and pay it myself if I wish. I pay for all blood tests and a contribution to all scans, by no means the full cost, but some, unless they are approved as related to a specific illness that qualifies for relief. But just for that, not everything else. Usually I can have them without a fight though. An ambulance is free of charge for an emergency - but if it is due to an accident the bill is sent to the responsible person's insurance. Everyone who turns up at A&E pays a small charge - imposed to dissuade the people who go to get a sticking plaster or an aspirin. It worked. You won't be turned away ever but there is a very large sign telling you that you are triaged for a reason - and if you were given a white sticker you have no business being here and the GP (maybe) or pharmacy is where you should be since this isn't an emergency.
The NHS should be saved - but the baselines need to be raised. In Germany for example you can choose to buy a top-up insurance - but we still used our basic entitlement where it was all we needed. Private was to get different, optional drugs or services - it wasn't significantly different, just the consultant shook your hand in the morning instead of just overseeing your management by the deputy consultant!
Easy for me to say at my age, but I wouldn't want to take a drug to increase my life for just a month, even if that drug was cheap, and knowing me I would get all the side effects anyway. I can understand parents with a child, who would want the treatment at any cost, as the saying goes "clutching at straws"
Very interesting re your health care in Italy, all again different, as in Germany, often wonder what it's like in Poland, Bulgaria, and Romania ?
I would have thought that as we are in the EU they [ the EU countries ] could get their heads together and make the health service the same
HOWEVER we could be out of it [ EU ] next year, but I think if there was a referendum we would vote to stay in, just my opinion.
I hope I have made sense, I'm not very good at explaining myself
When I saw a Consultant with my private health insurance he shook my hand, When I saw him in Addenbrooks. NHS no handshake.
How did we get from Calcichew to the health service,? very interesting though.
Even within Italy it is different here in the northern autonomous region of South Tirol from what the Italians further south have.
There is some thought that even with these supposed wonder drugs that many patients would actually live longer without the intervention - they would very likely have longer with a decent quality of life. Personally I'd rather have 3 months good than 6 months poor.
From what I know, some of the former east bloc countries have some strange healthcare - judging by what they expected from the NHS at least! I remember one Rumanian woman being totally huffed at not being fully investigated after a single miscarriage. I could understand expecting that after a few but not one. She alleged that it would happen at home. Maybe - but I'm sure I've been told they charge and it is certainly even more underfunded than any other European system and the system is collapsing. Poland is said to be very good - provided you are working (so insured) or family of an insured person - but they still use private cover a lot.
I think a lot of the other state systems tend to encourage a bit of self-reliance which the NHS no longer does. People don't rush to the GP after a sneeze - you turn up and wait, no appointments. People turn up to GPs for anything/ nothing - which perhaps for you and me becomes a problem. By the time I go to the doc I have exhausted my own skills and know I need their input now so I don't wish to be told to go home and wait a few days! I've already waited to see if it goes away on its own!
Ah well - I have to say we are a bit concerned about what will happen to us migrants (aka ex-pats) if Brexit comes to pass. Will I have to apply to stay here? David's OK, he's entitled to medical care in the Italian system as he has a pension here too (just a few euros but enough to go for a meal!). I worked for one year here but my clients all disappeared and it wasn't worth paying to be a business, it cost more than I earned. Will that entitle me to anything I wonder?
There are an awful lot of us over this side of the channel though! We'll all flood back to the UK - perish the thought! And that is just the weather!
Hi. My Rheumy told me to stop taking Calichew only because my blood calcium is on the high normal side. Maybe worth getting calcium and Vit d levels checked? But if they are low I believe you need the extra calcium
I do take calcium tablets, but not the high sugar ones prescribed by the doctor. I get 5hem from holland and barrett. Not sure if they help, but both doctor and rheumatologist have said to take it
I saw a post about calcium tablets on prescription causing calcification of the arteries. I asked my Dr about it and she said there used to be quite a lot about it once but now people are just told to take them. I said that one tablet was more than the daily amount needed and she agreed, so I asked if I could just take one not two a day and she said I could.
I took 2 calcichew tablets a day for many years, and my bone density scans are always satisfactory, and state "no treatment required" however my Rheumy said "that as I have been on long term Pred, to continue to take it but cut it to just 1 a day.
I have stage 3 kidney disease, and gall stones, and do wonder if I should still take it ?
Read up on the need for Vitamin K2 as the vitamin that helps calcium go into the bones, not get deposited on blood vessel walls which can happen if only on calcium and D.
Calcium supplements used in isolation by healthy people already eating a healthy diet with adequate calcium who think that "more is better" possibly do lead to deposition of calcium in artery walls. Used in combination with vit D no such effect was found.
The other concept of taking 2 tablets is that that provides an excess in the diet - which appears to help avoid the loss of bone density when you are on pred, in some people even increasing bone density despite being on pred.
It's two different things - unfortunately, however much we dislike it, we are not normal healthy people!
So if I eat a healthy diet and take one calcium tablet, I take Ad cal 1500 mg and 400 I.u. vitamin D3 tablet a day plus I take Vitamin D 1000IU, 1 tablet a day. Does this seem right? I also take an Alendronic tablet once a week.
Sounds fair enough to me! Better than I manage probably!
I find it difficult knowing what is best as Dr doesn't seem to think vitamins are necessary and rheumatologists are not a lot of help either. They just always want to stick to the plan and don't want to discuss very much.
Take your Calcium supplement at whatever level you feel you need (800-1000 IU per day?) but make sure you are also getting the things that help your body absorb that calcium - D3, K2, magnesium, etc.
You never hear K2 mentioned. I will look into it.
Of all vitamins, nearly everyone is now deficient in Vitamin K2 (not K1) as our food supply is so corrupted. We used to get it from grass fed animal products, but with nearly all our animals, including poultry, raised on grain, they can no longer manufacture K2 for us, and apparently we aren't very efficient at making it ourselves. The importance of this vitamin has only relatively recently been recognised, and as nutrition education is woefully lacking in our medics, you aren't likely to get advice to take it from your doctor. It is the vitamin that makes sure the calcium gets into your bones, rather than being deposited in less useful and possibly harmful places, like blood vessels and organs.
What can we find vitamin K 2 in if anything these days?
If you can find a source of grass-fed animals or chickens it will be in products from them - meat, dairy, eggs. There is also a Japanese fermented soy food called natto which I understand is an acquired taste, but is very high in K2. That, in fact, is what is used to make the supplements we can buy in capsule form. I wonder if it is available in other fermented foods, but I haven't found any confirmation of that.
Thanks. I am at least aware of the need for it now.
When you are healthy, vitamins per se aren't really necessary - there is no need to pop pills to top up the vitamins you get from a good healthy varied diet with plenty of fruit and veg. It's a totally different matter when you are on pred - then calcium and vit D are helpful to reduce the risk of osteoporosis and they have far fewer side effects than alendronic acid and its friends which big pharma flog as the miracle to prevent osteoporosis. If I can manage with calcichews then that is infinitely preferable to alendronic acid which that same GP probably hands out without thinking about the longer term risks that are now apparent. So far, calcium and vit D has been all I've needed.
I'd taken 1000 IU D and my doctor said I should take 2000. She was less concerned about the calcium, I think assuming I was getting enough from my diet and the supplement I was already taking (which also had a small amount of D in it). I read a day or so ago that the safe maximum daily dose of D is around 5000 IU. And at the risk of sounding like a stuck record, make sure you get Vitamin K2 (not K1, no worries about that) as nearly all of us are now deficient in that vitamin and we need it for proper absorption of calcium into the bones.
I will thanks.
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