Looking for some advice on taking the right dose of Calcium and Vit D3.

[Pr0jection]

I've just had a dexa scan. I had my last one in May 2020 (before diagnosis) which showed mild to moderate osteopenia. Since August 2020 I've been on prednisolone and a Calcium and Vit D supplement (as well as magnesium, biotin, Vit B complex) so I wanted to see whether or not my osteopenia had become worse. In fact there is a increase of the bone density of the lumber spine by +2,3 but a decrease of the measurement of the femoral neck by -4,2%. To get to my question - I'm currently taking Caltrate 600+D (Calcium 600mg and D3 200IU). Is this a fairly reasonable amount to take on 7.5mg? Or should I up my dose? I'm 77 years old. Thanks in advance.

[PMRpro Ambassador]

Are you taking 2 tablets of the Caltrate? That is the usual dose and plenty of calcium. Personally I take more vit D - during the winter I take 4000 IU although I don;t take the calcium/vit D combination. I always did take about 2000 IU.

[Pr0jection in reply to PMRpro]

As always, thanks for your reply. I took two tablets yesterday, one after lunch and another after the evening meal. This morning, for the first time since being diagnosed, I had blurred vision and when I sat down at the laptop to type an email I couldn't form the words to do so, i.e. my brain wouldn't function properly and it took me half an hour to complete the 6 line email. It was a weird experience, never happened before, and maybe nothing to do with taking the Caltrate but I think I'll stick to taking one tablet today and see how I fare. My blood pressure was a little on the high side but nothing alarming.

[PMRpro Ambassador in reply to Pr0jection]

One is probably plenty of calcium - not so good for vit D.

[Pr0jection in reply to PMRpro]

Thanks, I'll probably increase my Vit D intake only.

[Amkoffee]

I think your dosage is a question you need to get from your doctor and not from us. That would be akin to prescribing it for you. That being said my rheumatologist recommended 1200 a day of the calcium but I have significant osteoporosis. Something else that I recently learned is that there is a difference between calcium carbonate and calcium citrate. The difference is how the body absorbs the calcium. For example if you are on a proton pump inhibitor which is a drug used to treat gerds or other stomach problems you need to take calcium citrate. If you don't have anything wrong with your tummy you should be fine with calcium carbonate which is much easier to find in dose size that you need. Good luck!

[Pr0jection in reply to Amkoffee]

Thank you for taking the rime to reply. My rheumatologist just said to make sure I take Calcium and Vit D supplements but doesn't appear to be that interested in how much is taken. However, I must be doing something right with the bone density increasing in the lumber region (if not in the femoral neck) since taking the supplement. I take my current dose after food and not close to the time when I take my prednisolone. I also eat a lot of diary and have Greek yoghurt every day, leafy veg, etc, as well as walking, doing weight bearing exercises. My mother had PMR, was yo yo'ing on steroids for a long time and developed bad osteoporosis which is why I'm being cautious. Thanks again.

[HeronNS]

600 mg calcium really is the very maximum one should take in a single dose, somewhat less may be better as the body can only absorb just so much at one time. Dietary calcium is very good and generally better absorbed. You can get it not just from dairy but also from a lot of our leafy greens and broccoli, as well as eating the bones in tinned salmon or sardines. If you add Vitamin K2 (not K1) the calcium will be sent to the bones where you want it, and it will lower the risk of calcium from supplements settling where it can cause harm, as onto the walls of blood vessels or into organs.

Is the D3 dose 2000IU or 200IU as you typed? Can you have your D level checked?

A couple of years ago someone posted about a study which showed we absorbed calcium better if we took our supplements with a little yoghurt. Probably other fermented dairy (kefir, some cheeses) would have a similar effect.

You probably already know that weightbearing exercise (yes, walking will do it!) is beneficial for maintaining and building bone density.

[Pr0jection in reply to HeronNS]

Thanks for the reply. Yes, the D3 dose of 200IUis the one I'm taking. I'm taking goat's kefir each day as well as Greek yoghurt, lots of dairy and leafy veg. Sadly I can't eat fish. I'm walking each day, doing weight bearing exercises. I'll look into the K2 supplement. Thanks again

[readingbooks in reply to Pr0jection]

I take a combination capsule of K2 and D3 with my calcium.

[Pr0jection in reply to readingbooks]

Thank you. I'm going to speak with my pharmacist tomorrow.

[readingbooks in reply to Pr0jection]

This is an OTC supplement, PrOjection. But it never hurts to ask a Pharmacist !!

[Pr0jection in reply to readingbooks]

Our pharmacists here in Cyprus are almost doctors so by and large they give very good advice. Thanks.

[Sophiestree in reply to Pr0jection]

I would get a separate supplement of Vit D and increase that. I take 4000iU like PMRPro and have done for several years. It is really important in bone health. I do have pretty poor osteoporosis hence the consultant suggesting this high dose. I have never gone lower.

[Pr0jection in reply to Sophiestree]

Thanks, that's good advice.

[PMRpro Ambassador in reply to Pr0jection]

Just to add you should NEVER increase a combined supplement to get more vit D, always buy it separately or you run the risk of over-dosing on calcium