Question about calcium supplements

[Anniegal]

I have PMR-GCA dx. Also heart condition. My question is about calcium. If my blood labs show I am receiving sufficient calcium from diet, do I need to supplement as well? My cardiac calcium score is high and trying to prevent further cardiac issues while avoiding osteoporosis. I take D3 and some K2 - on anticoagulant so have to be careful not to take too much of latter.Thanks for any information you can share. Trying to avoid bone strengthening drugs.

[Joydeck]

Here's my understanding of current research. Avoid vitamin D supplements unless you are deficient and get calcium safely from food sources. Supplements do little for osteoporosis. I have K2 but have yet to decide to take it. Jolting exercise (like tennis) seems to work.

[PMRpro Ambassador in reply to Joydeck]

This applies for otherwise HEALTHY populations. Being on pred means we excrete more calcium and vit D is suppressed - it is a different situation and studies in the past showed that calcium and vit D supplements DID protect agains loss of bone density while on long term pred.

[Joydeck in reply to PMRpro]

I did not know about prednisolone mediated excretion of calcium and vit D. Very interesting and, perhaps, explains my marginally low serum vit D despite a year on 2000 iu D3, taken twice a week.

[jinasc]

I can only tell you, that I took the Calichew (amongst the add-ons they give you when you know nothing) and ran into pseudo gout very quickly......turned out the last thing I needed was more calcium. I dumped all add-ons saying, if I run into a problem, we deal with that problem. Needless to say, both medics were surprised, but complied.

Dexa scans every two years whilst on pred, bones never moved from 97% and I had GCA which = high doses for quite some time.

[PMRpro Ambassador]

What anticoagulant are you on?

[Anniegal in reply to PMRpro]

Plavix 75 mg and aspirin 81mg

[PMRpro Ambassador in reply to Anniegal]

If you were on Warfarin or the like then vit K is significant. Plavix is a platelet inhibitor and so vit K has no role to play, The same applies to the new generation direct acting anticoagulants:

"Does vitamin K2 interfere with blood thinners such as clopidogrel (Plavix)? I have read that K2 will interfere with warfarin (Coumadin) but not with Plavix. Is this correct?

Your statement is correct. Vitamin K is an essential cofactor for the synthesis of clotting factors. The effect of anticoagulants (blood thinners) like Coumadin is inhibited by intake or supplementation of vitamin K. Plavix, on the other hand, is a compound that inhibits platelet function. Plavix has no known interactions with vitamin K."

cardiosmart.org/Heart-Basic...

[Anniegal in reply to PMRpro]

Thanks for this! Very reassuring.

[HeronNS]

It is suggested that we get as much of our calcium from diet as possible but as PMRpro says we are in a population which needs some supplementation. Best way to supplement calcium? Do not take it at same time as pred. Take it with food, apparently foods like yoghurt help us to absorb the supplement better. Also take moderate Vitamin supplementation, unless you are already deficient. A few people will have high vitamin D level - I'm in that category as I have otherwise non-symptomatic sarcoidosis which can cause too much D to be activated. This is one reason people should have a D level test. I followed doctors instructions and took more D, certainly not a megdose though, and ended up with too high a level - easily sorted by dropping to the dose I'd taken for years long before diagnosis with any chronic disease requiring medication. The other key ingredients to make sure calcium actually goes into the bones rather than being deposited where you don't want it and where it can do harm - make sure you also have a good intake of magnesium. If you may be deficient in magnesium take it separately from your calcium supplement (and the pred of course) or get it through the skin either through a spray or through Epsom salts soaks. And the biggie, which most of us need to supplement, Vitamin K2 (not K1) although be cautious if you are on a warfarin type blood thinner.

healthline.com/nutrition/vi... (as an introduction)

And just as important as nutrition - appropriate exercise.

[Anniegal in reply to HeronNS]

Thanks for your replies. I do take two doses of magnesium citrate 200 mg each separate from prednisone and other supplements. l need Vitamin D3 due to other health issues and try and get everything else from food. Adding exercise as able. My D level measures at 50.

[Daylily2000 in reply to HeronNS]

I take calcium citrate at the same time I take pred. What is the reasoning for not doing this?

[PMRpro Ambassador in reply to Daylily2000]

If I remember rightly the calcium coats the pred tablets so it isn't absorbed well. But they certainly interfere with each other in some way. Two hours separation is thought to be enough although some say 4 hours - realistically you end up with a full timetable!!!!

[Daylily2000 in reply to PMRpro]

Thanks!

[Anniegal in reply to PMRpro]

For those of us who are on thyroid meds the recommendation is also 4 hours of separation between thyroid and calcium. I wonder if this is true for food sources as well?

[Lee1945 in reply to Anniegal]

Food sources are difested and absorbed more quickly than those awful calcium carbonate pills which can collect in the arteries and cause heart attacks!

[Hidden in reply to Daylily2000]

Hi Daylily

This is a much discussed topic, l’ll see if l can find previous links to it. There is an understanding that calcium can interfere with the absorption of Pred so it’s best to leave four hours between.

The levels of debate have been quite intense & rather than take a risk most people take their Calcium later in the day.

I was advised by my first consultant to do this & l have always done so.

Kind Regards

MrsN

[Daylily2000 in reply to Hidden]

Thanks! I will separate them.

[HeronNS in reply to Daylily2000]

Calcium is a problem with a number of things. I can't take my iron with calcium either (although I can with pred), so PMRpro is right, you do end up with a full timetable. Calcium speeds up the elimination of pred from the body, and prednisone actually interferes with calcium metaboism so it is definitely best to take them at separate times to give the body the best chance to utilize the calcium, as well as allowing the pred to do its good work.

[Daylily2000 in reply to HeronNS]

Will do this! Thanks.

[Lee1945 in reply to HeronNS]

It is important to get our Calcium from our food and NOT Calcium Carbonate tablets which block tge arteries and cause heart attacks.

We then need a chelated Magnesium to help get the Calcium from our blood into our bones. I take

[Lee1945 in reply to Lee1945]

I take a chelated Magnesium- Magnesium Glycinate

[HeronNS in reply to Lee1945]

Wow, this is an old thread!

I use calcium citrate and calcium hydroxyapatite.

[Lee1945 in reply to HeronNS]

I was advised by a nutritionist to avoid anything 'citrate'. He also advised me against taking calcium tablets

[Janstr]

I have osteoporosis ( diagnosed many years pre pred) & took calcium supplements until my GP said there was research that they can cause heart attacks. Instead I changed by diet so that I now get the required amount from food

[Anniegal in reply to Janstr]

Yes, that is my approach as well. Fairly early on my prednisone journey (6 months) and keeping my fingers crossed that l dodge most of the worrisome side effects. Adding back K2 (100 mg daily). I am on rx for potassium. Eating carefully.

[Lee1945 in reply to Janstr]

Apparently Calcium Carbonate and anything else .......carbonate should be avoided. Try natural Calcium from food.

[Lee1945 in reply to Janstr]

I was told the same thing so maybe there is truth in this information

[Hidden in reply to Lee1945]

This is an old thread.

[Lee1945 in reply to Janstr]

That is best and we have so many sources of calcium in our diets

[cranberryt]

My dr. said no calcium before menopause. And after only if it tests low. She said on a multi vitamin and two servings of dairy I am getting plenty of calcium. I am taking D3 though.

[PMRpro Ambassador in reply to cranberryt]

But if you are including the multivitamin - that is a supplement. I take an AdCal clone - but no multivitamin.

[cranberryt in reply to PMRpro]

true

[Lee1945 in reply to cranberryt]

Are you taking a chelated Magnesium like Magnesium Glycinate to help get the Calcium from the blood into the bones??

[Hidden in reply to Lee1945]

We usually recommend taking Vitk2 which is to protect the heart when taking calcium, letting calcci be directed to bones and not cvs.

[Lee1945 in reply to Hidden]

What is cvs?

[PMRpro Ambassador in reply to Lee1945]

The cardiovascular system

[Lee1945 in reply to PMRpro]

Thanks

[Hidden in reply to Lee1945]

Cardio vascular system.

[Anniegal in reply to Lee1945]

I just added mag glycinate yesterday in the advice of my doctor.

[Hidden in reply to Lee1945]

No. I may have missed this. That's why I was asking if you could post your evidence for taking MG. I like to know the ins and outs.

[Lee1945]

I have been advised to get all my Calcium through diet. Calcium Carbonate is known to cause heart attacks as it clogs the veins and arteries.

There are so many foods that provide natural Calcium. It is ESSENTIAL though to take a chelated Magnesium to help fry the Calcium from the blood into the bones. I take Magnesium Glycinate.

[Hidden in reply to Lee1945]

Some people dont take dietarrycalcium if vegan/or lactose intolerant etc. Can you provide the links where you are findintjis info so we can read and add to group knowledge based on evidence and research.

[Lee1945 in reply to Hidden]

I will see if and when I have the time. One source I have is from a nutritionist.

[PMRpro Ambassador in reply to Lee1945]

I think this may be overstating the value and you shoud always check with your doctor or pharmacist as to whether it is safe for you personally to take chelated magnesium with any other supplements or prescription medications you may be taking.

drugs.com/mtm/chelated-magn...

[Lee1945 in reply to PMRpro]

Sadly my GP simply wants me to have Prolia injections and made NO mention of dietary needs!

[Hidden in reply to PMRpro]

Yes and reading your link would make me think twice about taking it as someone with diabetes. Thanks pp.