Vitamin D and calcium??

[Welshnewbie]

Sorry, another question.M? Should I therefore be taking a supplement in calcium and vitamin D. My GP did not mention this.. I'm a pescatarian so just need to increase intake of sardines and salmon. I'm taking a ginger shot I make each morning, so will now alternate that with a turmeric shot. Goodness, glad I found this site! Foundation of knowledge from everyone is great!!

[Rugger]

Welcome!

Have you had a recent bone density DEXA scan? For some people, pred causes bones to become thinner. A scan will show where you are now and a daily supplement of calcium and vitamin D is advised for all. Also, a blood test for vitamin D level would be a good idea, as vitamin D deficiency can cause similar aches and pains to PMR. If you are deficient, dietary sources won't correct it. You would be given megadoses of the vitamin for a short time to top you up.

I didn't get this advice until I'd been on pred for 8 months. At that time my DEXA scan showed I have osteoporosis, so I'll never know if I had it before I started the pred.

If you do take calcium, don't take it at the same time as your pred. eg pred at breakfast and calcium with lunch and evening meal.

Best to discuss all this with your GP.

Take care.

[GerriMc in reply to Rugger]

Was never told not to take the calcium at the same time as Pred. I take Risonate once a week which is supposed to bind calcium to your bones and that has to be taken alone on an empty stomach. But I also take a Calcichew twice a day. I will move the morning one to lunchtime now. Do you know why , does it interfere with the uptake of Pred?

Thanks for the heads-up!

[Rugger in reply to GerriMc]

Sorry, GerriMc, I can't remember why pred and calcium should be separated. I wasn't told, either and only read it here. I'm sure PMRpro has explained it in the past - maybe she or someone else will again?

I also take Risedronate for the osteoporosis.

"Keep taking the tablets"!

[GerriMc in reply to Rugger]

Will do! 😁 Thanks!

[DorsetLady PMRGCAuk volunteer in reply to Rugger]

Hi,

The Pred stops the body absorping the full benefit of the Calcium if taken together. Plus, I think it says in the Adcal blurb (or whatever brand you have) if you have the calcium tablet and then eat dairy products that increases the absorption.

So Pred at breakfast, Calcium before lunch (me -cheese and biscuits very often!)

[HeronNS in reply to DorsetLady]

Read recently that yoghurt really helps with calcium absorption. Probably kefir would too, and the hard cheeses.

[DorsetLady PMRGCAuk volunteer in reply to HeronNS]

I am eating cheddar as I write, just taken Calcium!

[PMRpro Ambassador in reply to GerriMc]

Yes - pred interferes with the uptake of calcium from the gut if they are taken close together.

[Rugger in reply to PMRpro]

Should that be pred ..... calcium? I think we're losing the plit here, today!

[PMRpro Ambassador in reply to Rugger]

Don't you start...

and done!

[Hidden in reply to Rugger]

Cat...dog... whatever 😵

[Welshnewbie in reply to Rugger]

Thanks. Also started reading the Kate Gilbert book you recommended in your post so again thanks!!

[Rugger in reply to Welshnewbie]

Welshnewbie - edit your typo before this goes on all day! Now you see what we're really like - always good for a smile and a laugh! Thanks for that!

[Hidden in reply to Rugger]

🤗😉😵

[Welshnewbie in reply to Rugger]

Yup finally saw what all were on about!! Whoops! All edited! Hehe

[Hidden]

Would you like to read through your question and say if it reads ok to you. I think I've lost it again 🤔😱😉

[SheffieldJane in reply to Hidden]

😂

[Rugger]

If you click on the down arrow under your post, you can edit any spelling mistakes and re-send.

Trust Pete to spot your typo - and comment. lol!!!

[Hidden in reply to Rugger]

Ha Rugger, truth be that I wondered if it might be some magical elixir. I have been prescribed Amitriptyline which has diabolical side effects. I could quite easily describe it with the same word. Hence my careful question.

Keep smiling on this intrepid journey,

Pete

[Rugger in reply to Hidden]

"Smiling"? I'm creased up! (Must learn how to do emojis!)

[DorsetLady PMRGCAuk volunteer in reply to Rugger]

Easy if you’re on an iPad - button on keyboard.

[Rugger in reply to DorsetLady]

I'm on my 'olde worlde' PC and phone is a Nokia! "I'm just an old fashioned gal....." Sadly, I've no millionaire, either!

[PMRpro Ambassador in reply to Rugger]

Smiley: type colon, minus, close bracket with no spaces

Frown: type colon, minus, open bracket with not spaces

Wink: type semicolon, minus, close bracket with no spaces

I'm sure there are others but they escape me!

[Rugger in reply to PMRpro]

Thanks for this.

[PMRpro Ambassador in reply to Rugger]

Quick learner!!!!

Then there is this:

seniorplanet.org/more-fun-w...

and its forerunner

seniorplanet.org/how-can-i-...

[DorsetLady PMRGCAuk volunteer in reply to Rugger]

Nah...., you wouldn’t want one of them! Too much like hard work 😓 ..or so I’m led to believe.

[Hidden in reply to DorsetLady]

Ha DL, don't knock it untill you try it 😉 my wife loves it 🤗😇

I'm also known to tell a fib or two 😶

[HeronNS in reply to Hidden]

Known?

[Hidden in reply to HeronNS]

Thank you HeronNS. I'm also well KNOWN for making a mistake or two. 🤗🤡

[PMRpro Ambassador in reply to Hidden]

There are techniques using gut flora in its natural habitat - but I didn't think it included ginger...

[Hidden]

Gives a new use for the German type of 'shelf type toilet 😱😵😉

[Hidden in reply to Hidden]

Second thoughts, it's time to change the subject 🤔😱😇😵😌

[HeronNS]

And calcium also interferes with proper metabolism of pred.

[Hidden in reply to HeronNS]

Does that mean that one should not take prednisolone with a high calcium rich food 🤔such as sardines with bones, yogurt etc. ?

[HeronNS in reply to Hidden]

I don't know. Have wondered that myself. Would it be the same as the high amount in a calcium capsule? I think it's the supplements which could be a problem. Certainly many of us eat yoghurt with our pred, but a serving doesn't contain anything near 400 or 500 mg elemental calcium.... although maybe if you were eating a large helping... hmm, that's a thought. I only swallow a large tablespoon of plain yoghurt if I haven't had my breakfast yet. Maybe eating a full cup (8 oz, 250 ml) of yoghurt could be an issue.

[Hidden in reply to HeronNS]

This is looking more interesting than I first assumed. I often have a tin of sardines for my breakfast just after I have taken my pred with 2 dessert spoons of yogurt. Total calcium could be approaching 500mg. 😟

Food for thought maybe 🤔

😵😕

[HeronNS in reply to Hidden]

I wonder if anyone has done a study?

[Hidden in reply to HeronNS]

The short answer is I don't know, but returning to your original statement

"and calcium also interferes with proper metabolism of pred"

can I ask where that came from? Perhaps you are an authority on the subject. Please don't take that the wrong way. Its good to hear other people views but its even better if it can backed up with a cross reference so that idiots like me can act accordingly.

Looking through the 'Package Leaflet: Information for the user' contained in the Prednisolone Tablet box, there appears to be no mention about Calcium interfering with proper metabolism of the steroid tablet. Surely if it was a significant issue it would be mentioned.

I am completely aware that the Prednisolone leaflet cannot mention all associated shortcomings of mixing it with other drugs, but calcium isn't a drug per say, its a natural occurring mineral in food. Sardines being quite high up on the table. so either your original statement has been derived from various studies or it originated from hearsay?

If any of the more knowledgeable members of the forum read this, I am sure they will help us out.

[HeronNS in reply to Hidden]

I spent some time yesterday searching for that info, and there is something. You're right, I should have copied the link. I didn't understand the terminology well, it was something quite medical. If I can find it again I'll post. It was hard to find because Google wanted only to give me the pred interfering with calcium, but really early on I read that they did interfere with each other. Wish I'd kept that reference.

[Hidden in reply to HeronNS]

Thanks HeronNS, I think we are getting somewhere

[PMRpro Ambassador in reply to Hidden]

This

health.ny.gov/publications/...

says "Steroid medications have major effects on the metabolism of calcium, vitamin D and bone. This can lead to bone loss, osteoporosis, and broken bones. When steroid medications are used in high doses, bone loss can happen rapidly. It is important to know that not all people who take steroid medications lose bone. "

But the not taking pred and calcium supplements together is for the reason that antacids (calcium carbonate is one) reduce the absorption of cortisosteroids.

It is discussed here:

patient.info/forums/discuss...

[HeronNS in reply to PMRpro]

Yes, thanks PMRpro, that's what I found yesterday, only I think I actually stumbled over reference to the research which described the mechanism. Not spending any more time on this. Google algorithms defeat me!

[Hidden in reply to PMRpro]

Thank PMRpro, that's great!

Now it raises another question; if the calcium neutralises the acid in the stomach thereby preventing the steroid working properly? would not PPI's i.e. the drug many of us are given produce the same outcome?

[Hidden in reply to Hidden]

Sorry I think I know the answer

[PMRpro Ambassador in reply to Hidden]

Yes.