If I'm taking Fosamax should I still be taking my K2 and Calcium?

[singingloud]

I've been on Fosamax for the past two months and I've continued to take my K2 and calcium. Is this okay or should I stop the supplement? My last bone scan showed a low score for osteopenia. Thanks

[PMRpro Ambassador]

Yes - Fosamax only works if you have enough calcium/vit D available. If you don't you are very likely to develop low blood calcium levels and that can be dangerous. I would wonder if the K2 is superfluous - the action of the Fosamax itself should direct the calcium to the bones.

[singingloud in reply to PMRpro]

Thank you. That helps me. My K-2 supplement contains 5000 iu of D3, 110 mg of calcium, 50mcg of K-2 and 84 mg of phosphorus.

I have about a month left of them.

I don’t take any other calcium but what’s in my daily food.

I think I will finish them off. When I’m done I will continue to take 300 mg of calcium. Does that sound like a sensible plan?

[PMRpro Ambassador in reply to singingloud]

Don't forget to replace the vit D though - that is a hefty dose of vit D, I take 4000 IU.

[HeronNS in reply to singingloud]

Not sure the K2 is superfluous. It should do you no harm. According to osteoporosis.ca "Bisphosphonates bind to the surfaces of the bones and slow down the bone resorping action of the osteoclasts (bone-eroding cells). This allows the osteoblasts (bone-building cells) to work more effectively."

In other words, one set of your bone-remodelling cells, the ones which take away old bone, is inhibited, to allow the other set, the bone-building ones, to be more effective. Bisphosphonates do not directly promote bone building, just inhibit half of the process. This is why it's not a good idea to take bisphosphonates for more than two or maximum three years as new bone becomes laid over an increasingly aging and consequently more fragile matrix.

[singingloud in reply to HeronNS]

Great explanations to remember.Thanks

[Janstr]

In NZ you can get Fosamax plus which contains the vit D (that’s the ‘plus’); it saves taking an extra pill. My GP had originally prescribed calcium tablets but took me off them several years ago as said there was research that they could cause heart attacks. I have noticed that a lot of people on the forum take them, so can only assume that this research has been superseded. I get my increased calcium from dietary sources

[PMRpro Ambassador in reply to Janstr]

The research he refers to came to the conclusion that it could cause problems when used by otherwise healthy young women who were on an adequate diet anyway and who weren't taking vit D concommitantly. We are not healthy (in that sense) and it is the pred that makes it a requirement.

[Janstr in reply to PMRpro]

That’s interesting. So do you think that even though I’m getting 1200 mg calcium per day in my diet, that I should take calcium supplements? If not, it would also be good on occasion to not have to pick calcium options at restaurants & maybe pop a supplement on those days.

[PMRpro Ambassador in reply to Janstr]

I have to admit that I found it quite convenient! It started because the dietician wanted me to stop all dairy - do that and calcium is a bit difficult when on pred!! I didn't do "no dairy" - I wasn't giving up English tea!

[Janstr in reply to PMRpro]

Thank you. I’ll talk to my GP about it next time I see her as it was years ago my former GP took me off them.

[HeronNS in reply to Janstr]

The cardiac issues are the result of too much calcium not being directed into the bones. This is where Vitamin K2 (and magnesium) comes into play. Vitamin D allows us to absorb the calcium, but it has no part to play in where it goes.

[Janstr in reply to HeronNS]

Is calcium from obtained from diet absorbed in a different way to calcium from tablets?

[PMRpro Ambassador in reply to Janstr]

Don't think so. But it is widely accepted there are fewer problems with interactions for some reason - maybe the form is a bit different.

[HeronNS in reply to Janstr]

I don't suppose the body knows whether you just ate a chunk of cheese or swallowed a pill, but the presence of other substances may make a difference for absorption (Vitamin D) or effectiveness (Vitamin K2). Also the body tends to prefer calcium over other substances such as certain medications (like pred), or nutrients (like iron) and will inhibit their absorption if consumed at the same time.