Should I be taking Prednisolone and Calcium at the same time?

[pal-o-mine]

Hi all - quick question, if anyone can advise me?

I've read somewhere that you should not take prednisolone (currently I'm on 10mg) at the same time as calcium tablets (Evacal D3 1500 mg/400iu - two tablets a day).

Anyone know if that's true, and if so how much of a time gap should be left between them. I have, from 6/8/2021 until now, been taking both the Pred and one Calcium just after breakfast - following a 30 minute wait for the Omeprazole to go down. The other calcium tablet I take in the evening

BTW, just started on K2 Mk7 this evening - they suggest taking it with a meal in the evening so I'm wondering if I could take both the K2 and both calcium tablets together. Sorry, started out a quick question and it just grew :0

[PMRpro Ambassador]

The calcium tablets have been found to coat the pred tablets and impair their absorption from the stomach. Conversely, pred impairs the uptake of calcium further down the gut. 2 hours is enough to reduce the problem so we say pred for breakfast, calcium/vit D for lunch and tea - it is best to take calcium and vit D together with some fat to improve absorption. It is better to take the calcium in two smaller doses - the body only absorbs about 500mg at a time, if you take a larger dose all at once, the excess is just excreted so a bit of a waste. As far as I know, the K2 doesn't cause problems taken with anything else but HeronNS is your lady about K2 questions

[pal-o-mine in reply to PMRpro]

Thanks PMRpro. I guess I'll have to re-think my routine as it's seems to be a bit of a logistical nightmare and I want to get it right, otherwise what's the point. Always so reassuring having someone so knowledgable to call on in times of uncertainty.

[HeronNS in reply to pal-o-mine]

I've read conflicting statements about K2, whether it should be taken with D or not. At a certain point, in the absence of definitive information, I threw up my hands and now just take my Vitamin K2 at the same convenient times as my other supplements. - always avoiding taking calcium with anything else!

There must be some evolutionary reason why the body seems to prefer calcium over and above any other nutritional supplement. I suppose because our skeleton is the basis on which everything else depends, and for billions of years has been unique in providing the sttructure, framework, for both endo- and exoskeleton of animals..

[pal-o-mine in reply to HeronNS]

Thanks Heron. You've managed to confuse me even more. I thought it was OK to take calcium with other vits or meds - just not Pred? So now I'm wondering why they make Calcium tablets with Vit D combined.

[HeronNS in reply to pal-o-mine]

Oh that's just me being super cautious. My calcium supplement actually contains a whole lot of things! I did question at first why it includes so little magnesium, but now I know it's because the body "prefers" calcium and when we are taking a calcium supplement it's wise to have a magnesium supplement separately to help maintain the proper balance. I think the major issue is with some meds, like pred, and with other elements, like iron amd magnesium, both of which are supplements many of us will benefit from taking so we might as well get the best out of them. I think we need a biochemistry class to work all this out! Logically, of course, because we get most of our nutrition from food, it makes sense that we should be able to take supplements with any other nutrient. But I think it's probably the quantity found in a supplement which makes a difference. After all, leafy greens are an excellent source of magnesium, and some are also excellent sources of calcium.

[pal-o-mine in reply to HeronNS]

I knew there was a reason I should have stayed on at school longer - it was so I could go on and get a degree on how to take medicines and vitamins the right way. Oh well, I'm doing my lessons now instead I guess - thanks to everyone here for being so helpful

[Harbel in reply to pal-o-mine]

😁

[Nagswoman in reply to PMRpro]

Thank you PMRpro. I was Googling this very thing this morning and didn't really find an answer. I hate taking the calcium dinner plates, which they are nagging at me to start taking again, at night time as they taste like neat icing sugar and give me a sugar high just before bed. I got sick of taking pills to counteract pills and went on a pill strike for a few months. Yes, I know! Dividing them into two will be done in future - that was never suggested by the GP. Thank you pal-o-mine for asking the question and I hope you are well.

[pal-o-mine in reply to Nagswoman]

Hi Nagswoman, That's the great thing about this forum - you can ask as many questions as you like and always get an intelligent response. Don't think I could remain so calm if I had to ask all my questions to my doctor (good as he is). He would probably throw his hands up in despair. I am doing well thanks and hope you are too.

[DorsetLady PMRGCAuk volunteer]

Even though I’m no longer in Pred, I do still take a VitD/Calcium supplement - also take VitK2. So one dose of VitD/Calcium with breakfast , one with evening meal, and VitK2 before bed.

[pal-o-mine in reply to DorsetLady]

Thanks for your reply. I guess it's a lifelong thing now, all these tablets.

🤔

[DorsetLady PMRGCAuk volunteer in reply to pal-o-mine]

Not necessarily…..certainly not the Pred if most people’s experience is anything to go by.

I take meds for high blood pressure….and the Adcal-D3 on prescription…but do add in a few supplements…so what?

We are living a lot longer, so if we need a few meds to make life easier then so be it!

My view is just be grateful the meds are available - as are other procedures - late hubby had triple bypass heart op. which gave him 18 more years, I’ve had 3 joints replaced, and intend to make the most of them, and the money spent on me doing them! Be rude not to. 😉

Enjoy age

[Nextoneplease in reply to DorsetLady]

Couldn’t agree more DL 👍😊xx

[pal-o-mine in reply to DorsetLady]

Totally agree. I'm finally getting back some of the money I gave to the government when I was working!

😜

[pal-o-mine in reply to DorsetLady]

Thanks DL. I'm looking forward to the day I no longer have to worry about the Pred, but I suspect it's going to be quite a while as I've only just started on my journey.

[cycli in reply to pal-o-mine]

with you there

[arvine in reply to DorsetLady]

I have only seen K2 and VitD3 combined in my drugstore, so they do have just K2 by itself then, I haven,t been taking that, and dr,s etc never put too much interest into your vitamins, but think I should be taking it then, also wondered about the calcium, I take 650 units a day currently, and also bought some magnesium, again, my dr just poo poos, vitamins, what is the consensus on taking magnesium for our body health , thank you

[DorsetLady PMRGCAuk volunteer in reply to arvine]

Lots of doctors think that way….and yes K2 does come on it’s own, preferably K2 mk7 apparently.

Magnesium is often recommended for muscle cramps on here, have taken it for that, but taken too often can cause gastrointestinal problems - depends how much you get naturally through food…like most vitamins.

[valb232 in reply to DorsetLady]

Most of you likely are fortunate if you don't have chronic kidney disease. I have stage 4 CKD, andy calves have been cramping when I walk at all. I, too, thought maybe my magnesium was low. I asked my nephrologist about it; he checked my level and it was normal. Bit my nephrologist told me not to take magnesium, as it could harm my kidneys. I'm at the dialysis/transplant point, so I obviously do what he tells me! I'm only saying this because all of you should have your kidney function checked just to be sure they're OK. When you have CKD, you have to be very careful about what supplements (and drugs) you take, and in what dose. Sorry to be so verbose but wanted to be sure everyone is careful. 😁

[DorsetLady PMRGCAuk volunteer in reply to valb232]

Good point, and we do usually recommend ppl check with GP/pharmacist before taking an off the shelf supplement.

[PMRpro Ambassador in reply to valb232]

You are quite right - but one point: just because your BLOOD magnesium is OK doesn't mean your MUSCLE magnesium is. The blood scavenges magnesium from muscles to keep the blood level up.

I DO appreciate that for you, magnesium supplements may not be appropriate. But that isn't the only cause of cramps in calves - peripheral vascular disease can lead to it too.

[cycli in reply to PMRpro]

thanks for the clarity in this distinction PMRpro. I will have to consider both of these.

[LindaB-66 in reply to DorsetLady]

Hi Dorset Lady - as you now seem to be off Preds can I ask if you had any problems with your adrenal glands kicking back in (so the speak). I’m down to 3.5mgs and wondered if you had any problems getting off them completely. Thanks

[DorsetLady PMRGCAuk volunteer in reply to LindaB-66]

No issue getting off the steroids, but did have random bouts of fatigue (nothing worse) whilst I was reducing from 6mg down to 3mg despite going very slowly - took about 8 months.

Once I got to about 1mg woke up one day and really felt back to normal…whether that was GCA finally gone into remission, or adrenals back on form or combination of both never been 100% sure…but certainly was a step-change.

But even when completely off steroids, it can take up to a year for your whole system to return to normal.

[LindaB-66 in reply to DorsetLady]

Thanks for this. Keeping fingers crossed I’ll achieve my goal this time to get off them for good using the DSNS method! Ta

[GpaJ in reply to DorsetLady]

So interesting to read all the remarks and comments regarding Pred and Calcium. I have been taking both now for quite a long time. After my Omeprazole at 07:00, one hour later I take my pred, along with several other meds, at breakfast . I then take my first Calceos tab, on its own, at lunch time. My second Calceos tab is taken at bedtime with a Rosuvastatin tab. Reading that Calcium tabs should be taken on their own, should I perhaps take the statin tab with my supper meds which are Warfarin and Entresto. That would then mean that both Calcium tabs are taken on their own. I would be very grateful for some advice. PS the Upper Stour is flowing well!!

[DorsetLady PMRGCAuk volunteer in reply to GpaJ]

It’s a bit of a conundrum isn’t what to take with what, or not!

Although Pred is no longer a consideration, I take my second Adcal-D3 after evening meal because some food help absorption. …and a BP tablet at bedtime.

But if you want to take yours just before bed, suggest you take it with a snack.

Well remember R,Frome in full spate when hubby was water bailiff/gamekeeper!

[GpaJ in reply to DorsetLady]

Thanks for the advice as always. Hopefully the Salisbury meetings will resume soon.

[DorsetLady PMRGCAuk volunteer in reply to GpaJ]

Not sure where though…Wilton EWM shop is no more apparently…

[GpaJ in reply to DorsetLady]

I wondered if the Pub near by could help and Patrick mentioned Wilton Garden Centre as a possibility.

[PMRpro Ambassador in reply to GpaJ]

Calcium taken with a meal is said to be best - it reduces potential adverse effects and there is some fat around somewhere in the meal.

[GpaJ in reply to PMRpro]

Thanks so much I’ll bring the bedtime Calceos forward to supper!

[Nextoneplease]

I’ve been wondering this too 😊Have been taking

- Vit D and magnesium first thing on waking

- Vit B complex with Pred after breakfast

- zinc and Vit C with evening meal (with LMZ3 for macular degeneration)

- magnesium before bed (for muscle cramp)

Have just taken delivery of calcium citrate and vit K2 order so need to add these in somewhere. Was thinking maybe before bed with magnesium 🤔

Any comments anyone? I’d be most grateful.

Many thanks

Nextoneplease x

PS Would you suggest moving the Vit D to before bed and taking it with the calcium then?

[DorsetLady PMRGCAuk volunteer in reply to Nextoneplease]

PMRpro advice above - “…it is best to take calcium and vit D together with some fat to improve absorption.”

So Calcium, VitD and VitK2 either with breakfast or evening meal unless you are intending to eat something before bed.

[pal-o-mine in reply to DorsetLady]

My calcium and vit D is combined in one chewable tablet - so that makes it easier. When you say take it with some fat, what kind of fat do you suggest? I had one slice of bacon with an avocado sandwich for lunch, but cut the fat off that, as I don't like fat

🥓

[DorsetLady PMRGCAuk volunteer in reply to pal-o-mine]

Avocado is good source of Omega 3 fatty acids – which offer many health benefits, including increasing calcium absorption and deposition.

So no worries about the bacon fat!

[pal-o-mine in reply to DorsetLady]

That's great news

[PMRpro Ambassador in reply to pal-o-mine]

A cup of tea or coffee with milk is enough - just needs to be a bit around for transport.

[pal-o-mine in reply to PMRpro]

That's great news - always got a cup of tea in my hand and I even put milk in herbal tea - I know, sacrilege right?

🤭

[PMRpro Ambassador in reply to pal-o-mine]

Why spoil good milk with herbal tea????

[pal-o-mine in reply to PMRpro]

Ha,Ha, You're right of course, although it's skimmed milk. When I was young my mother always bought gold-top full fat milk. She used to make cream with it as well - yum. The milk I drink now is more like white-wash.

😃

[PMRpro Ambassador in reply to pal-o-mine]

Then it ISN'T enough with your calcium!! They sell it has having more calcium than full-fat or semi - that is purely due to maths and it is useless because without the fat, the calcium is not absorbed as well. So you might just as well have decent milk ... Full-fat milk is still only 3.5% fat - which by any normal standards is low fat!

PS - I don't do full-fat, doesn't taste right in tea But give me a tub of cream and I'm there with the spoon

[pal-o-mine in reply to PMRpro]

How do you know all this stuff? Might have to order "decent milk" or just take cream in my tea in future!

[PMRpro Ambassador in reply to pal-o-mine]

A degree in physiology and a lifetime of working in the medical science field!!! I know - sometimes I look at what I've just written about and wonder how or why on earth I know all this stuff My preferred reading and viewing is factual stuff -I have become mildly addicted to crime fiction but reality documentaries are preferable ...

[pal-o-mine in reply to PMRpro]

That explains a lot then. I'm with you on the reality documentaries and crime fiction. My OH on the other hand is deeply into the films on the Christmas channel. I don't think he really watches them - they're just a pleasant background while he dozes off.

[PMRpro Ambassador in reply to pal-o-mine]

I've only just seen that - living in Italy our access to UK TV is via FilmOn and they have just added a selection of channels recently which I just look at and boggle!!! It's October - and all this xmas stuff! What do they show at xmas itself? Urgh ...

My OH likes Midsomer Murders - I;ve watched one, that was more than enough! But there has been such a paucity of his sort of stuff recently he has started watching my medical/999 documentary recordings!

[pal-o-mine in reply to PMRpro]

Result - then you can watch them together I have to go to another TV and to bed early as I can't stand the Xmas films - besides they're all repeated on a daily basis. What do they show at Christmas indeed - probably beach holiday adverts and movies.

[PMRpro Ambassador in reply to pal-o-mine]

Oh no - he's deaf so I can't stand the volume level! And he fits my stuff around MM and Heartbeat ... So companionable, each in our own room

[pal-o-mine in reply to PMRpro]

Are you sure we're not married to the same man? And they say the art of conversation is dead - that could be why. As an aside, I have to laugh - if he's watching a film and the doorbell or telephone rings (in the film) he gets up to answer it!

🤣

[PMRpro Ambassador in reply to pal-o-mine]

Nah, he's not that bad yet! He did get quite iffy at one point when I complained - so he suggested we sit together watching the same TV programme. I honestly don't think there is anything we both like - he was going through a phase of watching old films at the time, NO, NO, NO ...

There are a lot like them out there!

[pal-o-mine in reply to PMRpro]

As a family (OH, me, and - still living at home, son) during lunch and dinner, we all sit down together on the front room sofa (dining room table is currently being used as a larder for all our tinned and packet foods, so can't be used). We collectively watch either The Chase, Tipping Point or any other quiz show, so that I can try to answer the questions. Other half puts up with it because he knows he can skip through the ads and cut it's run time down. As soon as the meal is finished son & I disappear to our respective rooms and leave OH to watch what he wants. Works for us but not everyone's idea of sociable.

[PMRpro Ambassador in reply to pal-o-mine]

I can't watch live TV - have to be able to skip the ads!!

[cycli in reply to pal-o-mine]

We haven't had TV since 1977. Don't miss it.

[pal-o-mine in reply to cycli]

Gosh - that's quite extraordinary. I couldn't live without my Blaze channel UFO fodder. Used to watch the News a lot but it became too depressing! No, I would definitely miss the TV.

[Rosbud in reply to pal-o-mine]

Oh you should be married to my OH , Blaze is his favourite channel !

[pal-o-mine in reply to Rosbud]

Lol. I sometimes wonder if I'm the only female who likes watching Blaze, however I don't like watching Hardcore Pawn - too aggressive for me - too much arguing! I turn it off straight away when it comes on.

[Rosbud in reply to pal-o-mine]

OH lines it got all things sci -fi , bores me to tears , go upstairs and watch murder mysteries on tv and at my own low sound level , bliss x

[cycli in reply to PMRpro]

If you want, a story teller, observational, nature, factual, informative, humerous and beautifully written English in one author try Farley Mowatt.

[cycli in reply to PMRpro]

after my own heart. I've NEVER deviated from full fat anything. I don't have high cholesterol. never believed the marketing speel about "healthy" fats in processed food. Always eat natural, fresh, and homegrown where possible. Everything in moderation except for treats.

[pal-o-mine in reply to Nextoneplease]

Wow - makes me realise how lucky I am to only have five tablets to take a day

[Nextoneplease in reply to pal-o-mine]

I take a total of 25 a day for various conditions 😳 Will be 27 once I add calcium and K2 🤷‍♀️x

[pal-o-mine in reply to Nextoneplease]

That must be some kind of record!

[Nextoneplease in reply to pal-o-mine]

If so, it’s not one I’d have been aiming for!! x

[pal-o-mine in reply to Nextoneplease]

Indeed, not the sort of Guinness Book of Records any of us would want to be entered in!

[Broseley]

Holland and Barrett in the UK do all-in -one calcium, vit D and vit K. That's what I take.

[pal-o-mine in reply to Broseley]

Will take a look at that, but I get the Calcium and VitD free on prescription so really only need to buy the vit K.

[arvine in reply to pal-o-mine]

oh my goodness, I had no idea you could get prescription vitamins, I guess depends on your insurance company, and whether or not they cover vitamins, doubt mine would Sun Life, sure would save some money though

[pal-o-mine in reply to arvine]

I see you're in Canada. I'm in the England and we get it free from our doctors - so no need for insurance company. Move to the UK and you can have as many free tablets as they're able to throw at you, they just love giving us as many, and more, as we need. Course, that's if you can get to see the doctor in the first place.

🤣

[arvine in reply to pal-o-mine]

Oh I wondered, yes Ive heard UK provides free meds, well that is good for you, here in Canada, would not happen, although we do fare better than US as far as health care goes, thank you

[Nextoneplease in reply to arvine]

The only vitamin I get ‘free on the NHS’ is Vit D for osteoporosis- all the others I buy myself as preventative/ quality of life measures.My GP’s approach to things like magnesium is ‘well, I suppose you could try it if you like’ - she would only prescribe Vit D as things stand….🤷‍♀️

[pal-o-mine in reply to Nextoneplease]

True, I too only get the calcium and vit D free on prescription and have to buy everything else on-line, but I'm not complaining as the price of prescriptions is outrageous, so I was very pleased to become a bona-fide pensioner

[Broseley in reply to pal-o-mine]

The pills I mentioned are only £4 for 120. Might be cheaper than just vit K.

[pal-o-mine in reply to Broseley]

That sounds really reasonable. Are they K2 Mk7, those seem to be the ones recommended on here?

[Broseley in reply to pal-o-mine]

Yes it's on the bottom of the ingredients list.

Label on a tablet bottle

[pal-o-mine in reply to Broseley]

Everyone should know about these then - thanks for the heads-up

[pal-o-mine in reply to Broseley]

Thanks, have placed my order with H&B, two bottles, second half price, what's not to like?

[Broseley in reply to pal-o-mine]

They do a repeat order scheme too called Subscribe and Save. They warn you a couple of weeks before when it's due to be sent out and you can change the date or cancel if you want. I read on here about using vit K with calcium but my GP knew nothing about it!

[187Smokey]

I have been prescribed Accrete calcium tablets whilst on Prednisolone and was told they were necessary.

[Sharitone in reply to 187Smokey]

I think that's fairly standard

[Nextoneplease]

Thanks all 😊 So basically it doesn’t matter when I take the Vit D, calcium and K2 as long as with food, preferably including some fat? In that case, so as to clash with as few other meds as possible, I think I’ll take them at lunchtime….and move the calcium to bedtime if, as hoped, it makes me sleepy 😴 😉x

[cycli in reply to Nextoneplease]

If they give me any more I think I'm going to get a wee dram of Laphroaig and down them all in one.

[Nextoneplease in reply to cycli]

😂I know the feeling!!!

[cycli in reply to Nextoneplease]

haha I'd forgotten this post. A couple added since then and as for single malts I have several others to choose from.