Vit D and Calcium

[Suzan62]

Hi there, I have PMR and although my Vit D levels were fine, I was prescribed Vit D and Calcium tablets which I’ve been taking twice a day since June this year. I was just wondering if this is ok or too much? I have the start of a waterworks problem I think which has made me question this. Possibly no connection but just thought I’d ask the experts 🙂vv

[Celtic PMRGCAuk volunteer]

Hello Suzan

Calcium plus Vit D taken twice daily (lunch and evening meal times) is the usual practice whilst taking steroids. No doubt you will be seeing your GP regarding the UTI, with a specimen being sent off to the Lab for analysis to ensure you are prescribed the right antibiotic for whichever bacteria is found. At the same time, do ask your GP to arrange for your calcium levels to be checked - too much calcium can lead to problems such as calcium grit forming - unusual but not unknown. Good luck, especially with the UTI - the bane of my life this past year! As a point of interest, I was never prescribed the recommended Calcium plus Vit D due to an oversight on the part of both my GP and Rheumy - luckily, my bones remained fine throughout my years on steroids starting at 40mg.

[borednow in reply to Celtic]

Intrigued by the words "calcium grit", I looked it up on t'internet. Came up as something for poultry and especially suitable for small birds. So that rules me out .............

[Celtic PMRGCAuk volunteer in reply to borednow]

Thank you for a good Monday morning giggle and something I’m sure to giggle about again when I’m enjoying the Christmas turkey!

[PMRpro Ambassador]

Pred makes your body lose more calcium than usual through the urine - and a study some time ago found that giving calcium and vit D supplements protected patients from loss of bone density (vit D is essential for the uptake of calcium). IMHO it is preferable to being handed a bisphosphonate. I had been on pred for over 7 years at the last dexascan and my bone density has only changed minimally in that time - all I have been on is calcium and vit D.

Is it a UTI (i.e. an infection) or is it just cystitis - the symptoms of irritation of the bladder/urethra (the tube between the bladder and the outside) which can be due to a lot of different things. One can be the calcium - and the most likely problem is getting dehydrated for some reason so the urine is more concentrated and the calcium forms grit. That is what happens to me - especially if I am travelling and am not drinking enough! PMR and/or pred can also led to developing irritable bladder syndrome. So do make sure your doctor sends a urine sample for culture rather than just doing a "dip" and making the assumption.

And if you do get given an antibiotic, make sure it isn't one of the quinolones - ciprofloxacin for example (the names end -oxacin) as they should not be mixed with steroids as that can lead to achilles tendonitis (been there, done that, spent 9 months on crutches!).

[HeronNS]

One thing which seems to help with the problem of too much calcium being in parts of the body where not wanted, is to take a Vitamin K2 supplement. This vitamin specifically directs calcium into the bones, Vitamin D can't do that. The other thing to consider is your magnesium level as taking extra calcium without also making sure magnesium intake is adequate can cause an imbalance. You could consider taking a magnesium supplement from time to time, not necessarily every day, or having an occasional bath or footbath soak with Epsom salts (your body will absorb magnesium through the skin). Normally we get a lot of magnesium in the diet because it is to plants what iron is to animals, but sometimes we need to give Nature a bit of help.

Don't take your calcium supplement at the same time as you take your pred. They interfere with each other!

[Zofitmogelijk in reply to HeronNS]

Hi Heron, since you know so much about minerals and vitamins ( and no doubt a lot of other things as well ) I like to know your opinion on the following ; I red somewhere - sorry don’t remember more, that magnesium comes mostly from plants growing deep in the ocean, eventually it turns up in the clouds and falls on the soil, and that is the reason to avoid veggies from the greenhouse. Since I have one myself, the answer will be much appreciate and perhaps for others interesting too 🌾aletta

[HeronNS in reply to Zofitmogelijk]

I guess just as we are what we eat, so plants are what they absorb. And if the minerals aren't in their environment they can't absorb them and pass them on to us. I happen to have a couple of different bottles of magnesium supplements which turned out to be intolerable to me so we've been dissolving them and feeding them to our garden! I have no idea if this will help or not, but I must say our kale looks a bit more vigorous this year than it did the first time we grew it, last year. I'll ask my daughter if she knows anything about this, being both a dietitian and a foodie.

[Zofitmogelijk in reply to HeronNS]

Thanks Heron, in Holland we say the Apple does not fall far from the tree, so Mother so daughter and is it not rewarding

Having inspired your child. I’ll wait for the answer and perhaps it is more flowers and less vegs in the greenhouse.

[HeronNS in reply to Zofitmogelijk]

Ha ha. My kids have all learned to cook out of self defense, not through any inspiration on my part.

[karools16 in reply to Zofitmogelijk]

Zofitmogwlijk, we also use that saying in S.Africa.I haven't heard it here, in England.

Gosh, I would've thought greenhouse veg were fine? Just goes to show. Never too old to learn.

[Zofitmogelijk in reply to karools16]

Hi Karools I am not sure about that, was just thinking perhaps one could collect rainwater instead of tap water for the seedlings and plants growing inside?

[PMRpro Ambassador in reply to karools16]

I was going to say it is used in the UK - then realised I probably know it from German too so I'm not sure now!

This discusses it:

english.stackexchange.com/q...

This says it is of eastern origin

phrases.org.uk/bulletin_boa...

but on reflection - yes, I think it is used on some regions in the UK.

[Zofitmogelijk in reply to PMRpro]

How interesting, where does eastern begin, in Germany already, or in the middle east? To us Germany is the neighbour.

[PMRpro Ambassador in reply to Zofitmogelijk]

Possibly but it also seems to stem from Russia. I'd say "eastern" would be sort of the other side of the Austro-Hungarian border. It never ceases to amaze me how far east that is! I think they mean Eastern-European really.

[karools16 in reply to PMRpro]

That's a lovely website...the first 1. I love sayings, and there are plenty of them, here, in Norfolk, esp. rural norfolk, where I spent my first 6 years, in Burnham Thorpe, when I came to England, 17 years ago. I had to listen long and hard, to make out what they were saying!

[PMRpro Ambassador in reply to karools16]

There are a lot of British who'd struggle too!

[HeronNS in reply to Zofitmogelijk]

I thought about this today and remembered that we used to say the acorn, or, humorously, the nut, doesn't fall far from the tree.

[PMRpro Ambassador in reply to Zofitmogelijk]

If plants in the greenhouse are magnesium deficient they will lose their bright green colour and become much paler as the chlorophyll is broken down. It depends more on the type of soil - acidic, light, sandy soils lose magnesium fastest which is one of the reasons gardeners add rich organic compost to light soils as that fulfils several needs.

gardeningknowhow.com/garden...

[Zofitmogelijk in reply to PMRpro]

PMRpro, you seem to always succeed in finding the Good articles. I do have the sandy soil and I do ad potassium, so learned again. Thank you, aletta

[PMRpro Ambassador in reply to Zofitmogelijk]

It's all about knowing the right words to search for! Plus I grew up on a farm and did biology. Glad it helped.

[HeronNS in reply to Zofitmogelijk]

My daughter doesn't know about minerals in rainwater. She says there is some evidence that much of our food is less nutritious than it used to be, but we don't really know why, there are several possible reasons. This is what she said: "I do think there's been some evidence that our produce is less nutrient-rich than it used to be. I don't think they're sure why though. It could be due to the varieties chosen, soil, methods of growing... I don't know about anything grown under glass. Do you mean greenhouses? I'm not sure how much nutrition plants really get from the rain besides water. I think the nutrients in the soil and derived from the sunlight would be the main nutrient sources."

[Zofitmogelijk in reply to HeronNS]

Thank you for the answer, it is worth more study I think . A Dutch study pointed out there was a 45% decrease in minerals in vegs.in 50 years The reason you must eat lots of vegs nowadays. ☹️

[PMRpro Ambassador in reply to HeronNS]

I suspect some of it is due to overinflated balloons that some veggies are nowadays - albeit filled with water not air! Organic stuff here is totally different in texture, more concentrated it feels. I bought an organic non-plastic wrapped cucumber the other day - it crunched all the way through!

[Footfairy-1 in reply to HeronNS]

Hi Heron, can you tell me how the calcium supplement and Pred interfere with each other please? I have always taken them together so this is news to me.

[PMRpro Ambassador in reply to Footfairy-1]

"Pharmacologic doses of corticosteroids impair intestinal calcium absorption and contribute to negative calcium balance."

Which is a fancy way of saying that pred stops you absorbing calcium as well as you should. All you have to do is take pred for breakfast, calcium for lunch and tea/dinner. You should also not take the entire 1200mg of calcium/day all at once, the body can only deal with about 600mg at a time so by splitting the dose you will also absorb more.

[HeronNS in reply to Footfairy-1]

And there is something that calcium does to pred, probably stops us from absorbing it as effectively, calcium interferes with a number of things. Once upon a time I knew the details but have forgotten them. 🤔

[Footfairy-1 in reply to HeronNS]

Thanks for the info. My vit D3 contains Cholecalciferol. I presume this is calcium.

I'll start to take it at a different time to the Pred.👍

[PMRpro Ambassador in reply to Footfairy-1]

Cholecalciferol is vit D3 - it is better absorbed than vit D2 which they used to use.

[SheffieldJane]

I think there is a connection between taking Calcium and urinary irritation. Hence the trooping off to the GP with supposed cystitis or infection and everything being clear. I wish I knew the solution. I still take the supplement because of the effect of Pred on the bones. I discovered this by process of deduction. I think I am better taking the dose with food and we’ll spaced.

[PMRpro Ambassador in reply to SheffieldJane]

With food and drinking plenty seems to work for me.

[HeronNS in reply to SheffieldJane]

I need to take mine with food as well, and agree with PMRpro about the need to keep well hydrated.

[HeronNS in reply to SheffieldJane]

Take Vitamin K2. Then the calcium will go to the bones where you want it.

[Suzan62]

Well I’m on my second lot of antibiotics. Doc sent sample off and first ones weren’t suitable. Day 3 of taking them and still feeling really ropey. Taking paracetamol too. How long does it take for them to work??

[PMRpro Ambassador in reply to Suzan62]

Depends - for me it often works in hours but mostly it takes a couple of days. It does help to have the right abx of course...

[Suzan62 in reply to PMRpro]

Doctor said these were the right abx for this bacteria but I just don’t feel right. Taken 4 so far.

[PMRpro Ambassador in reply to Suzan62]

Maybe it is the abx that are making you feel rubbish?

[Suzan62 in reply to PMRpro]

True could be.