Calcium needed or not…?: This is an open-end... - PMRGCAuk

PMRGCAuk

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Calcium needed or not…?

Boss302Fan profile image
13 Replies

This is an open-end question, for which there might not be an answer. After diagnosis of PMR my Rheumy prescribed a DEXA scan. Showed mild Osteopenia. Was told to take 1,000 mg / day to help prevent degrading into Osteoporosis as taking Prednisone can progress that disease.

So, started reading scientific papers. Leaned that for women maximum daily supplementation should not exceed 1,000 mg daily, for men not to exceed 800 mg daily. This applied for Ca from supplements, not natural sources. So, reduced to 750 mg/day as Calcium citrate and added in Vitamin D3 which got to be 4,000 IU / day based on blood results for 25 (OH)D now holding at 37 ng/ml. Also, took Vitamin K2 @ 100 mcg/day (vs reading in “1” paper that 180 mcg/day for women yielded beneficial results after 2 years. What about men? Who knows?

Now, as I reduced my Pred, I also reduced Calcium supplementation by an approximate amount, leaving D3 & K2 unchanged.

It’s been forever ago since I’ve taken Anatomy & Physiology. But remember there is an ongoing process pertaining to bone structure. If do strenuous dead weight lifting the adde stress to the bones results in increased calcium being deposited, less exercise, the reverse. The amount of calcium that’s in the blood is an indicator.

My Calcium had been constantly 9.7-9.8 mg/dL on every blood work up for 5 results each every 6 months. That has not changed one bit, regardless as to my intake of Ca from supplements.

2yr later DEXA scan, little difference. Due to taking extra Ca? Totally confused. Does this mean my natural calcium intake was sufficient? My BP is still okay. EKG is fine. Last Ca score was nil. Where did excess go, in my urine? GP has no opinion.

Sorry, just an old man rambling. But if anyone has an answer I’d like to hear it.

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PMRpro profile image
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First and foremost: those papers are based on healthy subjects. When you take pred it increases the rate at which the body loses calcium through the kidneys and unless you are eating a load of dairy, most people's dietary calcium is at best only scraping in these days - big bogy dairy and its fat. The idea of adding calcium and vit D supplements is that a study showed a protective effect in patients on pred - sorry, no idea of the reference, I have read it many years ago. By increasing the amount available, you are more likely to get what you need.

That said, if your diet is OK, you probably don't need the full wack of the supplements but you do need the vit D. Your blood calcium level with always remain in that range, too low or too high calcium would make you very unwell are muscle needs the right amount. If it isn't in your diet, the body will rob the bones to maintain the blood level (same applies to magnesium, the bulk is in the cells, the blood remains at the right level until there s none left in the cells to top it up. You can look replete according to blood level - but the cells/bones are deficient. There are conditions that mess it all up - sarcoidosis interferes with your utilisation of the vit D and parathyroid disorders mess up the calcium story.

And yes - you pee it out if it isn't being deposited in the bones, That is one of the problems that can arise if you take supplements but bones are fine- the excess in the kidneys and urine can cause calcium grit to form and eventually stones, of the renal and gall variety, both painful. Or it can be deposited in the joints as psuedogout - also very painful.

Lookingforideas profile image
Lookingforideas in reply to PMRpro

am I right in saying that taking the K2 supplements helps to encourage more calcium to stay in the bones rather than ‘swirling around’ & being deposited in the kidneys & urine etc? I’ve read that too somewhere, but I always forget to reference things. Just make scribbled notes - always in a hurry & then can’t find them again🙄🤦‍♀️☺️

PMRpro profile image
PMRproAmbassador in reply to Lookingforideas

No idea if it has been proven - and I think it is more directing the calcium to the bones rather than other tissues that it does as opposed to stopping calcium being taken from the bones. That must happen if the blood calcium level falls or you would become very ill.

Boss302Fan profile image
Boss302Fan in reply to PMRpro

Yes, it “supposedly” activates Osteoblasts and suppressed Osteoclasts promoting mineralization of the bone. I’ve been taking 100 mcg of the MK-7 for 2 years. According to this publication the recommended daily supplementation is 180-240 mcg and if have osteoporosis possibly 1,500 mcg daily.

This article seems to promote it as a wonder drug similar to vitamin D. I don’t think enough research has been done to support that conclusion.

laddmcnamara.com/2019/05/14...

HeronNS profile image
HeronNS in reply to Lookingforideas

This appears to be the case. Japanese scientists did some research with natto (fermented soy which is actually the source of our K2 supplements) and are on record as saying if there is such a thing as a superfood, natto is it! On a personal level, I used to have terribly sensitive teeth, and I noticed after a while that they weren't so sensitive any more (still can't bite into ice cream but I never could!) and the main, relevant, thing which was different in my diet was taking a Vitamin K2 supplement. I did not at the time link it to K2, I learned after the fact that this is indeed a thing. As the jaw seems particularly vulnerable to bone changes I think this is some evidence for the effectiveness of K2 helping to stabilise the jaw, and the teeth in it.

PMRpro profile image
PMRproAmbassador in reply to HeronNS

OTOH - my PMR-related sensitive teeth improved when I used Sensodyne toothpaste ...

HeronNS profile image
HeronNS in reply to PMRpro

I'd been using toothpaste for sensitive teeth for awhile! Unfortunately I can't use Sensodyne as it irritates my mouth. Use Colgate's version. In fact (pre-PMR diagnosis) I even remember phoning hubby asking him to bring my toothpaste to where I was doing my volunteer job so I could rub some on my teeth and gums my teeth were hurting so much.

PMRpro profile image
PMRproAmbassador in reply to HeronNS

I used Sensodyne because it was the only one that worked for me - detested the taste though!

Boss302Fan profile image
Boss302Fan in reply to PMRpro

I’ve been using Sensodyne for years before they came out with Pronamel to which I switched. Still helps with sensitive teeth but a lot better flavor.

PMRpro profile image
PMRproAmbassador in reply to Boss302Fan

Yes - eventually ProEnamel made toothpaste taste OK! I'm struggling to work out what the new name is and no doubt they have changed it as well as rebranding. And it won't be an improvement ...

Boss302Fan profile image
Boss302Fan in reply to PMRpro

Not a rebrand a newer product line by Sensodyne. The original product is still available. I’ve not had issues with temperature sensitivity using the Pronamel.

PMRpro profile image
PMRproAmbassador in reply to Boss302Fan

Not here - doesn't exist ...

Boss302Fan profile image
Boss302Fan in reply to PMRpro

My recent blood workup, pre-physical later this month had every test close to center of the reference range. The reference range for Ca was 8.6 - 10.3 mg/dL keeping me in the upper quadrant, but below the UL. For the first time in ages my total cholesterol is below 200 (184) and my GP I think is dancing in the street! 😄

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