Vitamin Supplements for PMR

[Thiago1396]

I have had PMR since February 2023, diagnosed end of April, started on 15mg Pred, increased to 20mg to get fully on top of pain. Now tapering, down to 17.5mg and plan to go to 15mg at the end of July. Then slowly from there. I have been taking Alendronic Acid tablet one weekly since mid May.

I am thinking of taking ‘one a day’ vitamin D tablets and Multivitamins plus Iron (touch aneamic when blood tested). Wondering if these will help or hinder my PMR and if there are others I should consider?

I’m in a very good place with my PMR since starting steroids, by comparison to many on here and I don’t want to disrupt this. I also fully intend to be a tortoise with tapering, especially from 10mg on.

[PMRpro Ambassador]

You should have had your blood vit D level checked at diagnosis since low vit D can cause similar symptoms. It is also normal to have calcium and vit D supplements prescribed in the UK and at least recommended. In many patients that is enough to protect from loss of bone density with pred but is essential when you are on AA or the like since it can lead to a low blood calcium level if you are low on calcium.

They certainly won't hinder your PMR, they may help if your blood level is low. You really need the level checked though - I take 4000 IU vit D a day, any less and my blood level slowly drops to a deficient level. The supplements from the doctor are far lower than that.

[Thiago1396 in reply to PMRpro]

Thank you, I have obtained the 4000IU Vitamin D tablets, 1 year supply. What calcium supplement should/could I take with them?

[PMRpro Ambassador in reply to Thiago1396]

What is your diet like? I don't take calcium any more as it caused bladder problems but I have plenty in my diet. Otherwise, ask at a health store or chemist for a suitable option - DL has quoted the right sort of amounts.

[Thiago1396 in reply to PMRpro]

my diet is generally good. Having diabetes type 2 severely restricts me on carbs and somewhat on alcohol. I’m following up on Adcal D3 as DL mentioned.

[Thiago1396 in reply to Thiago1396]

I have had a discussion with my doctor, my diet, which includes plenty yogurt, milk and cheese etc appears quite sufficient. Feeling somewhat ‘normal’ 😀

[PMRpro Ambassador in reply to Thiago1396]

That's good - but the vit D is important.

Interesting new work here

medicalnewstoday.com/articl...

[Lollybygolly in reply to Thiago1396]

I’m pretty sure that D3 Keir me safe from infections for the past few years, generally

[ladygigger in reply to PMRpro]

Calcium causing bladder problems...

I've been on Adcal for YEARS, probably since the age of 50 when I finally managed to get a DEXA scan (my mother had osteoporosis, I had an early change and wanted to see whether I'd got it - I have osteopaenia). I also take solifenacin succinate for an overactive bladder/urgent need. I did have surgery about 5 years ago but it didn't help.

Tapered yesterday down to 10mg pred, I was prescribed AA when I first saw the rheumatologist in January this year but not yet taken it due to required dental work. I also ended up having part of my lung removed in April after the rheumatologist recommended a chest x-ray to see whether I would be able to tolerate methotrexate (obviously not!)

I hadn't seen about calcium causing bladder problems before - as I was probably prescribed them at around the same time, I wonder if one has been feeding the other for years?

[PMRpro Ambassador in reply to ladygigger]

My problem - and that of others - was grit forming in the urine and causing mechanical irritation which was just like irritable bladder, urgency, pain. I've had urethral stretches 4 times, they always help for about 10 years but there was always something there in the background. Stopping calcium supplements and getting it in diet may not have helped my cholesterol much but sorted the bladder things reasonably well.

[Thiago1396 in reply to PMRpro]

thankfully I have always had low range cholesterol. I have decided that my diet has enough calcium. My Exercise must be increased to help reduce my sugar levels with my diabetes type 2. I am delighted with the constructive advice on here!

[DorsetLady PMRGCAuk volunteer]

As PMRpro says VitD/Calcium supplement should have been prescribed with Pred at outset - doctor didn't read guidelines!... (very often Adcal D3 - 2 tablets per day @ 1500mg Calcium carbonate/400 I.U. VitD)

Many also take VitaminK2 Mk 7 to assist the calcium to be directed to bones...not on prescription.

But you do need to get levels checked.

[Thiago1396 in reply to DorsetLady]

thank you, I have contacted my doctor re Adcal D3

[LMali]

In addition to Alendronic Acid, my GP prescribed, and I take: Calci-D every day bar the Alendronic Acid day. As I was feeling all round poorly last year I now also take, on GP's recommendation not prescription, B12, Folic acid, and a multi-vitamin with iron! Hard to say what effect these have but I don't mind taking them!

[PMRpro Ambassador in reply to LMali]

No reason not to take the Calci-D on AA day as long as it is later. More important is to take it at least 2 hours later than your pred.

[Thiago1396 in reply to PMRpro]

does the 2 hours later than your Pred apply to D3 and other vitamin supplements?

[PMRpro Ambassador in reply to Thiago1396]

No, not really, just calcium which can form a coating on the pred tablets and stop them being absorbed so well from the stomach. Later, in the gut, having pred and calcium present together will reduce absorption of the calcium. Double whammy!