I love Dr Greger, if you don't know of him, he's a nutrition version of PMR Pro.. 
If anyone's taking calcium supplements, you might want to start eating yer greens after reading this article..!
Calcium supplements: The evidence for and against - PMRGCAuk
Calcium supplements: The evidence for and against
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Funky-Butt
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But maybe different if you are on steroids which are known to deplete the calcium level as I have been told ?
I found it an interesting article but he didn't once mention steroids and their effects on the bones.
PMRproAmbassador
Fair enough - except the gentleman doesn't mention the reason for us to be taking calcium supplements: we are taking corticosteroids which make us lose more calcium through the kidneys. Taking more means there is a better chance of it getting where it ought to be and a study showed that taking calcium/vit D supplements in moderation along with pred reduced the rate of fractures and prevented loss of bone density.
No, healthy people with a decent diet probably don't need calcium. We probably do. And I definitely need vit D since when I cut that back my blood level falls - despite spending a lot of time outdoors without sunscreen all year round (and I live about the latitude of Turin so should be making vit D all year. But I don't.
How much and what form of calcium is recommended for those on steroids?
I was never prescribed calcium.
I was prescribed the Adcal before the Prednisolone..........these GPs vary so much!
In the UK the usual is AdCal or Calceos - they are all basically the same:
Totally agree with you as usual.
The calcium is a must with the steroids , although not usually good for healthy people over a certain age.
It is especially important if you are having to take Vitamin D supplements because of deficiencies too.
According to a medical study I read , taking calcium with your Vitamin D supplements prevents the possibility of rising and high cholesterol that can happen on Vitamin D.
Plus, I don't fancy having the possibility of bone related issues in the future.
I think people who make these nutritional videos should state ( or have one of those on screen disclaimers) that they are giving information for people without complex medical issues and that people with illnesses or diseases should check with their GP or specialist before following the advice in the film.
It would have been nice if he had told us where he got his findings from.
If you click.on words in blue takes you to the reports.
I didn't read them as too much to take in so early in the morning.
All the articles provided by Dr Greger on the website are based on an analysis of ALL the available research. On the About page it explains: "..individuals who want to make the correct dietary choices for themselves and their families are faced with a deluge of confusing and conflicting nutritional advice. The goal of this website is to present you and your doctor with the results of the latest in peer-reviewed nutrition and health research, presented in a way that is easy to understand."
After my OH had a heart attack, and experienced terrible side effects from all the medication that docs prescribed, I was looking to find some objective nutrition advice, and I got it here.
I am not sure that the articles are based on all the available research, that would be pretty hefty. His about page seems to be a blog again written by him. I am sure he is terrific but I just felt that some links to research papers would be helpful.
I had osteoporosis for several years pre prednisone, & was originally prescribed calcium supplements. My GP took me off them a few years ago for similar reasons in your article, & said that I need to get at least 1200mg per day calcium from my diet. I changed my diet totally to achieve this.
Which is the point of the supplements - I'd really struggle to get the amount, I eat loads of green veg but not a lot of dairy. And if I did eat the stuff that is supposed to up dietary calcium I'd weigh a lot more than I already do.
• in reply toPMRpro
Neither doctor or Rhuemy have mentioned
taking calcium supplements but I was given a leaflet on what to eat for healthy bones, something I knew already anyway. I take an over the counter supplement called Osteocare, contains magnesium vitamin D and zinc plus I drink milk and eat a lot of home made yogurt. Do you think this is enough or should I ask for Adcal?
No idea - can you work out about how much it is? Dieticians can - maybe ask for an appointment? Or is that pie in the sky?
Janstr• in reply to
It depends how much you drink. Milk has 115 Gm calcium per 100ml of milk; I can't remember the content of yoghurt as need to replenish supplies ( the calcium content is on the packets). I was told that I need a minimum of 1200 mg per day.
I too was worried about weight & although I do eat cheese, looked at alternatives to dairy sources of calcium. I eat a lot of tofu & quinoa both of which are high in calcium, but not excessive in calories. Black strap molasses is also good, which I have very occasionally now due the diabetes risk with steroids, but if you are using sugar, it's a good calcium rich alternative.
I use no sugar - haven't bought sugar for about 15-20 years.And I have already been there with the weight thing, I lost 35 lbs by cutting carbs and have no intention of going back. I eat dairy - just not a lot. But then, I don;t eat a lot of anything except veggies...
Great food ideas.
I think we would all prefer to be able to get our calcium and other nutrients from diet alone , especially as there is alot of research like that shown in the article.
Alot of us have struggled over the years to do just that.
Unfortunately, sometimes though, especially if you have more than one medical disease or multi system diseases, no matter how much you try to get all your nutritional needs from food and the sun alone, your system doesn't allow it.
I like PMR pro have Vitamin D deficiency , which does not improve with food alone, Calcium supplements in this case are useful in preventing a rise in bad cholesterols, which can cause heart issues too.
There are plenty of people who cannot eat enough because of health issues or the level of their vitamin deficiencies to be able to get all they need from food, especially if they are vegan , dairy free or also have pancreatic or IBS related illnesses. Without taking the supplements the risk of bone related diseases , heart issues and flare ups in existing symptoms far outweigh the risks in the study.
Plus most people who have to take supplements consistently , especially Calcium , after the age of 50 are ( or should be ) regularly monitored for signs of cardio, liver and heart related symptoms .
I know I am packing my diet with Vitamin D , as a nature artist I am out in the sun , and I am on supplements and still have vitamin deficiency. My first month of the supplement was done without calcium and my cholesterol did rise . I am now on Calcium to reduce it. Both of these nutrients I could not consume in a high enough quantity at the moment without making myself ill and aggravating abdominal issues.
We are a world of wonderful variety and each of us needs to find our way to health in the way that best suits our individual needs.
No solution is totally right, no solution fits all and no solution is quick.
Unfortunately, both good health pronouncing websites and the conventional medical system all need to start recognizing that if we are all going to get better.
Your comments about calcium supplements helping to reduce cholesterol are interesting as my cholesterol has gone up since being on pred. I had assumed it was due to a huge decrease in my level of exercise due to PMR.
Lots of things affect your cholesterol.
Not being able to exercise as much as we want is part of it.
Our diet , even if filled with healthy foods can do it, if our metabolism has slowed down , or other health issues or deficiencies in certain chemicals within our bodies , means we are not processing our foods or cholesterol levels properly.
Even hydration and salt levels make a difference to our ability to remove bad cholesterols in our systems.
Obviously , in my own case , and in the case of some people who need Vitamin D supplements , cholesterol levels can increase with the Vitamin D and Calcium is advised as an extra supplement to counteract this , but I will stress it isn't the same for everyone .
It is all a very fine balance .
I always try and adjust my diet , try and exercise as much as I can , and keep well hydrated and see how that works before I try certain supplements , unless I have been told I have a deficiency that needs addressing that will help.
Cholesterol levels can take a while to respond to to new regimes too. My friend had an issue with it a number of years ago and was told it can take upto 6 months for your levels to drop back to a healthy level , depending on what level of mobility or health issues you have. As long as you keep it monitored each month, that it doesn't have a steep rise , or it slowly begins to decrease , you are doing well.
Certain types of oils , like coconut , although having lots of health benefits can make it spike up.
One supplement a have taken for years is garlic, until my present flare up, I have felt the benefit on my circulation and it can help to balance cholesterol.
I also drink alot of green, white and good Chinese black tea which are beneficial to heart health, keep you hydrated, help digestion and are good for oral health too.
So here is what I have learned about calcium, vitamin D & Vitamin K2 over the last few days:
Calcium needs Vitamin D to be absorbed, and Vitamin K2 to direct it to the bones and away from the arteries.
I havent found any reported health risks with taking vit D supplements, in fact
both Dr Greger and Public Health England recommend taking vitamin D supplements at least part of the year, and for some people all the time, as its difficult to get the 10mcg needed from food and/or when you can't get enough sun. See here:
gov.uk/government/news/phe-...
Vitamin K2 is found in Kale, cheese & eggs among other things. Its easy to get enough from food.
My conclusion is that its important to get enough of all three!
I use a fab online nutrition monitor cronometer.com/ which is worth a look. Its complicated to start with but brilliant if you can get the hang of it.
All vitamins and minerals taken in too high a quantity can cause you toxicity and other issues.
Vitamin D toxicity can cause to much Calcium in the bloodstream and a illness called hypercalcaemia.
Too much Calcium we have discussed alot on the post.
Too much Vitamin K can cause clotting issues , and is bad for people on dialysis and with liver disease .
You are right it is important for us all to get enough of all three.
It is also right for all of us to make sure we don't get too much of all three.
And we all have to find various ways that works for our age, health , health issues, sex, ethnicity , and mobility to get that right balance.
Vitamin K2 is not easy to get from modern foods. If your animals are raised only on grass and never grain, yes, but most of us don't have that source any more, or not reliably. Vitamin K1, on the other hand, is very available in leafy greens for example. Although we can convert Vitamin K1 to K2 apparently we are not very efficient and are unlikely to be able to provide ourselves with enough. That's why the animal sources used to be so important before we corrupted our food supply. The animals converted the vitamin for us. So, eat natto or take a supplement which is likely to be derived from natto. Try to get a supplement from a natural source, as so much soy is now genetically modified.
I think it’s a balance as always in life. I recently found out about ‘calcification of the arteries’ (my elderly father had a angiogram and was told one of his grafts from previous heart bypass surgeries was blocked due to calcification) and it got me thinking about my calcium supplementation. Am I preventing risk of a bone fracture at the expense of increasing a risk of narrowing my arteries?
By the way I an not on steroids.
I would love to see reply’s to your post, is there another calcium other than Adcal that won’t leave deposits in your arteries. I had a bypass on 1999 and have had osteoporosis I was put on adcal but I am worried that this will block my arteries. Any information about other calcium that won’t block will be gratefuly recieved. Thank you
I also read about the calcification of arteries, after looking into the effects of the supplement, when I was put on Calceous and I started to feel pains inside??!! my leg bones, and found the supplement can cause pain. So stopped and pain has gone. After reading about all the people on here who do take it due to steroids affecting calcium absorption, I started on Calceous again, pain came back, so have stopped.
Now, I have no proof it was the tablets, but I do eat a lot of kale, love it, and other greens, so think I will stick to green fibre and eggs. though I and will take Vit.D .
No tests were suggested by Doc for osteoporosis just automatically prescribed calcium as he said all older women should take it.
of course, he didn't think to mention the effect Pred. has on the body's ability to absorb calcium. Too technical/medical. Still he does trust me to manage the Pred. So don't want to rock the boat by telling him I have stopped the calcium.
Sorry not much help in recommending another brand, surely it is the calcium itself causing the deposits regardless of maker.
I do believe there are other forms of calcium (seaweed perhaps?). There are various books such as Osteoporofis by Dr Marilyn Glenville and Your Bones by Lara Pizzorno which you may find useful. Bones need other micro nutrients other than just calcium and vitamin D (which is what Adcal is) to form and repair. I therefore used to supplement with a preparation containing the micronutrients such as vitamin K2, vitamin C, magnesium, strontium, zinc etc called osteo-vi-min. Best source of calcium as with all other nutrients is naturally occurring in foods such as greens. Hope this helps
I think we need to know how much calcium someone taking steroids requires. But if it can be obtained through food it is surely better than a supplement that carries risks. If Janstr's doc recommended 1200mg and half a cup of Kale provides 500mg, I'd have a cup of kale everyday in a green smoothie and call it my medicine! As always, its a personal choice. But good to be able to make an informed choice.
No wait! I just looked back, and I've mis-quoted.. half a cup of kale provides 500mcg of K2, not 500mg calcium!
There's 120mg of calcium in 80g of cooked kale. Here's a list of where to get your calcium from: webmd.com/food-recipes/guid...
Are you sure it's K2? Can you give us the reference?
healthline.com/nutrition/vi...
Hi Heron, it wasnt one particular article, it was several, as I came across conflicting advice, so decided to try to find out as much as I could from various places.
There's a good discussion following the NutritionFacts.org article on the best sources of Vitamin K here: nutritionfacts.org/question...
Its a long read though!
The problem is that Vitamin K1 and Vitamin K2 are NOT the same. I find it so frustrating to read these articles where it's blithely stated that we can get plenty of Vitamin K2 from kale. Well, maybe, if our own gut was good at making the conversion. The human body is not very efficient at converting K1 to K2, which is why through history we've relied on our animal sources to do that for us. Yes, eating fermented vegetables can help. Yes, we get small amounts from certain cheeses, like Brie. Yes we can convert a small amount in our gut. But as someone who was given a diagnosis of osteoporosis (thankfully wrong, it was really "low bone mass" which is called osteopenia) I will never feel confident relying on food sources. I think our food supply is simply too degraded these days, no matter how well we shop and try to eat. This is one nutrient I'm happy to supplement. Vitamin D3 is another.
That's really interesting, thank you. I'm learning so much! I've been looking at the research on Vit D, and it would appear we get nowhere near enough from food, so supplements especially for those at risk of osteoporosis is necessary. Not quite sure about the difference between D2 and D3 though?
We make D3 in our skin.
healthline.com/nutrition/vi...
Really clear article, thanks. I'll need to take D3 supplements then as I don't eat animal products.
This is a very interesting article,l was given Adcal by my doctor when l was given the steroids.l managed to take them while on a high dose of Pred.,but always found that they caused dreadful bloating,so l have stopped taking them now that l am on a low Pred., dose.l often have to take over the counter indigestion tablets,which are calcium carbonate,and l hope that this will help replace the Adcal .l try to get vitamin D through my diet etc.My doctor did say that it was OK to not take the Adcal on a low 3 mg dose of Pred.,then he later suggested l take l tablet every other day.l have had to increase my dose of Pred.,to 5 mg .,the last month because of a PMR flare,and am rather confused now .l do not take any other vitamins as my doctor always said that a good diet should be enough ,it can be harmful to take too many vitamins.l shall have to eat more greens !
I read quite a lot about VitK2 guiding the calcium to the bones and not to the arteries and so I have been taking this for the last year or so. I know that I have Ostepoenia and a bit of Osteoporosis so I felt that the calcium supplements were necessary and if combined with K2 and a diet very high in dark leafy greens etc much preferable to Alendronic Acid.
Very interesting, I'm going to cut my Ad-Cal back. It seems to strengthen my nails though.
Some people say prednisone gives them stronger nails. Can't say I've noticed that effect.
I have definitely got stronger nails from something, could be the vit D and calcium, could be the pred. The only trouble is because they are now so tough they can break at the side fairly far down.
Hi piglette. I was not consistent with taking my AdCal and would notice my nails crumbling which would remind me to take it. Also I think the vit K2 has strengthened them since I started it.
I think it probably is the Vit D and calcium in my case.
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