Alendronic substitutes: I want to come off... - PMRGCAuk

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Alendronic substitutes

Trulyscrumpious profile image
31 Replies

I want to come off Alendronic acid. I remember

PROpmr suggesting Magnesium. Which one? There is Mag Phos and Mag citrate. Will either do and what is the difference? I will also take Vit D, as I understand that is good too. I’ve just had a bone density done which is within normal limits. Have had PMR for 4 years and on AA all that time . Now down to 4 mg Pred.

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Trulyscrumpious profile image
Trulyscrumpious
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31 Replies
PMRpro profile image
PMRproAmbassador

Magnesium is not a substitute for alendronic acid - is that what you mean? Magnesium is usually discussed for muscle cramps.

I have no idea what sort of magnesium salt is best - I just buy what is available and it seems to work!

Trulyscrumpious profile image
Trulyscrumpious in reply to PMRpro

I didn’t really mean a substitute but something to prevent osteoporosis, and to take instead of AA as I have learnt on this forum that AA has nasty long term side effects. I do take Mag phos when I get night cramps but not as a daily dose. What do you recommend I take now I have decided to stop AA. I tried to find the

previous series of postings when this was raised but don’t know how to retrieve it. I think it suggested Vit D and magnesium but I may be wrong.

piglette profile image
piglette in reply to Trulyscrumpious

It is vit D and calcium you want. Everyone with PMR / GCA taking pred should really be prescribed it. I have Accrete-D3, but there are several others that people take too.

Slosh profile image
Slosh in reply to piglette

Please just make sure you are having enough magnesium too as well as loads of greens for vitamin K

piglette profile image
piglette in reply to Slosh

Did you mean this post for trulyscrumptious?

Trulyscrumpious profile image
Trulyscrumpious in reply to Slosh

Thanks, will do.

Trulyscrumpious profile image
Trulyscrumpious in reply to piglette

I have been taking Adcal for 4 years and have only just noticed that it contains Vit 4, as well as the calcium! So that seems to already cover it so thanks for good advice.

PMRpro profile image
PMRproAmbassador in reply to Trulyscrumpious

You do need some magnesium but it is calcium and vit D you use for bone protection at the stage before you get to bisphosphonates. For 7 years I used just calcium and vit D with occasional magnesium when I had muscle cramps and have never taken vit K2 and my bone density was almost unchanged despite pred.

Trulyscrumpious profile image
Trulyscrumpious in reply to PMRpro

Thanks. I’ll carry on with the Mag for cramp then.

Bobbury profile image
Bobbury in reply to PMRpro

Hello, Ive been reading all the post re AA. I've been taking calcium instead of AA.

Wasn't aware of the vit D. Is Vit D a daily dose as well?

PMRpro profile image
PMRproAmbassador in reply to Bobbury

Yes. You should also get your blood vit D level checked to see if your level is good. If it is, you just need a maintenance dose. If it is low - you need a high dose boost first.

And even if you were to decide to take AA - you still need the calcium and vit D supplements as otherwise the AA won't work effectively.

Bobbury profile image
Bobbury in reply to PMRpro

Many thanks for that, much appreciated.

Trulyscrumpious profile image
Trulyscrumpious in reply to Bobbury

You can be prescribed Ad Cal(calcium) + Vit D in the tablet. 2 per day.

SheffieldJane profile image
SheffieldJane

You ought to be able to obtain Calcium and vit D on prescription. Vit K2 also assists absorption of Calcium.

If I remember correctly the Magnesium we take is Magnesium phosphate.

Glad you got a good Dexa, glad you’re done With AA, glad you’re down to 4 mgs Pred. Things are looking rosy 🌹.

Trulyscrumpious profile image
Trulyscrumpious in reply to SheffieldJane

I do get Calcium and Vit D on prescription. I love your optimistic ending- i’ll Try and adopt it!

SnazzyD profile image
SnazzyD

Hello. Glad your scan was normal! Nothing is a substitute for AA that artificially disrupts the bone manufacturing/destruction process. No one nutrient does the trick; it’s a holistic approach which can be as involved as you want to get. I recommend a book Your Bones by Lara Pizzorno published by Prakticos Books. You can search this topic on this forum too as it comes up a lot. I take magnesium oxide by the way.

Blearyeyed profile image
Blearyeyed

If you are interested in getting more information on improving your bone health the suggested book is good .

You may also appreciate reading some of the posts and going to the links from forum member Heron , who has worked successfully on improving her bone health and scan figures.

Blackcat1M profile image
Blackcat1M

my rhymi wants me to go on AA, but after reading some of the side effects, and the NHS website I have indicates you cannot take magnesium with it, but I need it for cramps. l am waiting for a dexa scan, but today my doctor rang to say your AA prescription is ready to pick up, but I am not going to take it till I get the results, my OH also agrees with me.

DId you have many side effects?

PMRpro profile image
PMRproAmbassador in reply to Blackcat1M

It is perfectly OK to take AA and magnesium - you must just take the AA at least half and hour before taking the magnesium or the magnesium interferes with the uptake of AA. But you are supposed to take AA 45-60 mins before ANY other substance.

NICE says: "Oral magnesium decreases the absorption of alendronic acid. Manufacturer advises alendronic acid should be taken at least 30 minutes before magnesium (all salts)"

Blackcat1M profile image
Blackcat1M in reply to PMRpro

Thank you, is it best then to wait two hours before taking pred as well. I need more hours in my day to fit every thing in.

PMRpro profile image
PMRproAmbassador in reply to Blackcat1M

You only take AA once a week at the most, some forms are monthly I believe, and it is to be taken on an empty stomach, first thing in the morning.

You have the entire rest of the day to take magnesium if you need it and 45mins is fine to wait to take your pred that morning.

Blackcat1M profile image
Blackcat1M in reply to PMRpro

Once many thanks for your help.

Thelmarina profile image
Thelmarina in reply to Blackcat1M

I take Ibandronic acid once a month first thing in the morning, one hour before breakfast and Pred.

MhairiP profile image
MhairiP

Can I ask... if your bone density scan is within normal limits, why are you taking AA?

Blackcat1M profile image
Blackcat1M in reply to MhairiP

I don't know what the result is yet, as I have not had my scan till July.that is why I won't take it till I find out the result

MhairiP profile image
MhairiP in reply to Blackcat1M

Sorry - I thought I was replying to the original poster - this forum is tricky!

Blackcat1M profile image
Blackcat1M in reply to MhairiP

No I think I mistook it to be that you were replying to my message, sorry

PMRpro profile image
PMRproAmbassador in reply to MhairiP

You did - your reply doesn't have any other directive - when you reply within a nested comment it says who it is for.

Libra-girl profile image
Libra-girl in reply to MhairiP

My GP insisted on prescribing AA even though I have not had a dexa scan. She said that it is recommended, good practice to anyone on long term pred as a precaution against the potential bone loss caused by the preds. When I requested a dexa scan she said that regardless of the results AA is still the standard practice so even if my bone health was excellent AA would still be prescribed. My request for dexa scan was denied.

PMRpro profile image
PMRproAmbassador in reply to Libra-girl

I suppose it deoends what you call good practice. Good practice changes with time - and using it as a preventative is not recommended. She is wrong I fear.

Trulyscrumpious profile image
Trulyscrumpious in reply to Libra-girl

It’s gd to have that confirmed again. I shall certainly try and stay off AA and resist being put back on. My GP agreed to me ‘having a break’. She also failed to offer a dexa scan until I asked for one after 4 years. It is ok which is why I want to stop AA for good. Do you feel you can be assertive with your GP? Difficult I know, but good luck.

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