Vitamins and minerals

[Carrollee]

Hi everyone hope life is being kind today.

Does anyone know for sure of any vitamins and minerals we should absolutely avoid on steroids? Am taking the usual vit c, omega 3,   Garlic. Also take MSM, rose hip and collagen for joints etc and multi b complex. Started taking a good quality probiotic and D3 as soon as put on pred. Have hit a bit of a brick wall health wise after a nasty sickness bug don't seem to be getting over it and doubting everything. I was coping with steroids and side affects until started reducing and just got lower and lower in mood. I know some people get depression going on them but it seems I am getting it coming off. Oh found blood in urine over weekend was given three days anti biotics. used to be someone who could see funny side of things not sure where it's gone! 🤓 Sorry to be a misery. Lv cc

[Runrig01]

Prior to pmr I never took any supplements, and wound pick up infections really easily. I was concerned when starting steroids that the number of infections I would get would increase. 

My GP told me to take Magnesium when I first started getting muscle pains. When my rheumatologist started Prednisolone she recommended Vit C for reducing infection, and Vit B complex to help the tiredness.  I have lactose intolerance do don't eat much dairy, so I started taking a supplement with pre and probiotics. I know it advises caution with pre & probiotics in immunocompromised people, as it can cause bowel infection, my Drs are aware I take this and I monitor closely. All I know is since starting Pred over 3 yr ago, I have only had 2 infections, which is a miracle for me. I have added turmeric to my supplements for their anti- inflammatory properties. 

Supplements which stimulate the immune system, such as Echinacea, are not advised. Vitamin A apparently might reverse the benefit of steroids. Hope this helps

[Carrollee in reply to Runrig01]

Thank you. Glad to hear your improved on the infection front. didnt catch much before being on steroids. Had heard about vit A have never taken it. I have ME as well so it may all just be crashing back although it was well under control before getting pmr and GCA. Thanks for your time. Take care cc

[PMRpro Ambassador]

To be honest, if you are eating a decent diet you probably don't need much beyond the calcium/vit D supplements that help protect your bones - and which have been all I have taken the entire time and hadhad no change in bone density after 4 years on pred.

Vitamins and minerals in general probably don't interact with pred much but other supplements may and you should always check with a pharmacist or have a really careful google. Licorice, for example, isn't recommended alongside pred, nor echinacea, and I'm sure there are others. Pred makes you excrete more calcium and magnesium than normal - we should be given the calcium/vit D pretty much automatically, but as runrig says, magnesium can be useful if you develop muscle cramps. And don't fall into the trap of thinking "more is better" - too much calcium in supplement form is bad for you in various ways and too much magnesium will give you the runs...

[HeronNS]

To add to what has already been said - you may be, as most people in the Western world are, deficient in Vitamin K2.  (Not K1 which you'll get from a balanced diet.)  It's important because it's essential for guiding calcium into the bones which otherwise tends to do nasty things like collect in organs or on the walls of blood vessels where it becomes a hazard to our health. We used to get K2 mostly from products of grass-fed animals (meat, dairy, eggs) but now that most animals are grain fed they are not producing Vitamin K2 for us to take in.  It's available in a limited number of foods, notably a Japanese product called natto which I understand is an acquired taste, and is the source for the supplements you can buy.  We may also be able to obtain a limited amount from fermented foods like sauerkraut and its relatives, certain aged cheeses, etc.,  although the best bet still appears to be finding a source of grassfed animals....