AdCal supplement

[HCOYS]

I’m on 4mg Prednisolone daily. Is it safe to stop taking AdCal supplements?

[Koalajane]

I personally would stay on it. I intend to for the rest of my life

[DorsetLady PMRGCAuk volunteer]

Any particular reason why you want to come off it? Bit difficult to answer as we don’t know your bone health history. Probably something you should discuss with person prescribing it as you are still on Pred, albeit a low dose- and therefore bones may still be adversely affected.

[PMRpro Ambassador]

Depends on your bone health and your diet. If you have plenty in your diet then supplementary calcium is less important - I used supplements when I didn't eat a massive amount of calcium-rich food. But calcium caused me problems and I stopped the calcium supplement, increasing dietary calcium at the same time. My bone density didn;t seem to be adversely affected at the next dexascan,

But I do continue with 4000 IU vit D - which I think is far more important than loads of calcium and not available in your diet.

[Koalajane]

I did nt eat as much dietary calcium as I used to do continuing to take it plus k2 which sends the calcium to the bones. The D3 I know I will take now for life

[piglette]

Have you had a Dexascan? If so what were the results?

[SheffieldJane]

Are you experiencing side effects? I found that Adcal irritated my bladder, my GP took me off them and prescribed vit D. I take vit K for calcium absorption and have a dairy rich diet. It won’t harm you.

[Daffodilia]

Interesting item in latest PMR mag on how pred affects bones so maybe stay on Adcal? I find it causes constipation so eat prunes if needed

[Exflex]

Why do you want to? You’re getting calcium and D in one tab. I’m transitioning from 2.5 to 2mg of Pred and will continue with the supplement. Having a DEXA scan is a snapshot, and some say if the results are normal then you don’t need CalcichewD3 and / or AA. But once you stop there could be bones loss. The way I look at is this: if someone is prepared to study and gain clinical practice lasting 12 or plus years, who am I who has very little knowledge of biology to argue with medical advice. I’m aware they may be cautious (perhaps over cautious) but I prefer the medics to be like that instead of being blasé with my health. Incidentally, I’m also taking Risedronate 35mg on more or less a weekly basis.

[PMRpro Ambassador in reply to Exflex]

I would happily agree with you - except most doctors just listen to the pharma rep singing the praises and don't subsequently keep up with the independent findings about downsides.

Dietary calcium is better than supplemental calcium which can lead to various forms of stones (gall stones and sludge, renal calculi and psuedo gout are all possibilities), AA has its own downsides and not everyone needs it.

[Exflex in reply to PMRpro]

Indeed so. I hope to be off Pred by the end of the year (this year 🤞) at which point CalcichewD3 and Risedronate will stop. I will then have been on bisphosphonates for 3 years and that’s about the limit I’ve heard, otherwise bone complications really mount up, eg if bisphosphonates are kept up for 5 years. If I could be confident about K2 I would take it, but we’ve discussed this before I know. It’s just me and the fear of blood clots having a heart artery stent.

[Blackcatlover]

My rheumatologist had me stop AA as soon as I dropped to 5mg of prednisone. My bone density showed I have osteopenia and it has remained the same for the last six years I have been taking prednisone. I’m 76 and eat healthy and do take calcium supplements. I did take AA until I reached 5mg of prednisone. I am currently down to 4mg of prednisone.

[Exflex in reply to Blackcatlover]

It is astonishing that your rheumatologist has different ideas to ‘mine’ (actually I don’t have one having been discharged over 12 months ago). My GP asked for advice and rheumatology said I should stay on Bisphosphonates until the bitter end. I’m currently wk 1 of a DL taper from 2.5 to 2mg. I’m thinking of just taking Risedronate 35mg once a fortnight. How does that sound?

[Blackcatlover in reply to Exflex]

My research shows if you take Risedronate once a month it should be 150mg tablet. I’m not sure the lower dose would do you any good.

[Exflex in reply to Blackcatlover]

I meant on the basis that 35mg every two weeks (equivalent to an average of 17.5mg per week) is better than no Risedronate at all. The GP under Rheumatology’s guidance said no, keep taking 35mg weekly. I suppose they would if they wish to cover their backs and not get challenged for negligence.