Calcium supplements - drawbacks

[Fatsiajaponica]

Was not prescribed calcium supplement or Vit D, taking the latter with K2 following advice from the forum. Now concerned about taking a calcium supplement given that there has been some (old) research indicating that it could be harmful to heart, kidneys and colon! Advice would be welcome. I try to ensure that my diet includes yoghurt and plenty of milk and spinach.

[DorsetLady PMRGCAuk volunteer]

Does the study state the amount of calcium taken that causes those issues?

The problem when taking Pred is that the calcium is leached from bones which is why you need to take a supplement to counteract that. The K2 is added because it directs the calcium to your bones rather than arteries.

Too much calcium certainly can cause issues, but so can too little.

[Hobbitses in reply to DorsetLady]

I’ve been on Denosumab a few years now and take AaceCa D3 tabs - I bought some K2 supplements but haven’t dared start them yet - medics and pharmacists seem a bit unhelpful on the subject except to point out possible blood clot issues as I’m on blood thinners… so thank you for that extra piece of info DL!

[DorsetLady PMRGCAuk volunteer in reply to Hobbitses]

See this re K2 and drug interactions - so maybe as you are on blood thinners you shouldn’t take it. I’d do a bit more investigation.

drugs.com/drug-interactions...

[Hobbitses in reply to DorsetLady]

Thanks DL - useful link

[DorsetLady PMRGCAuk volunteer in reply to Hobbitses]

Welcome -as PMRpro has said it seems to be warfarin that’s the issue (haveread that somewhere ) -and there is a difference between how K1 and K2 work which not all seem to grasp. But always best to double check.

[PMRpro Ambassador in reply to Hobbitses]

What sort of blood thinners? K2 is not the vitamin K1 that affects the way blood clots and it would only matter for warfarin anyway. If you are on a NOAC/DOAC anticoagulant (the new sort that don't need to be monitored) it isn't an issue as they work differently. It is only the UK that makes a fuss about vit K in foods like broccoli or dark green veg - as long as your intake is regular and the warfarin dose is adjusted while eating them regularly it isn't a problem. What is risky is if you don't eat them for weeks and then binge on them!

[Hobbitses in reply to PMRpro]

Apixaban

[PMRpro Ambassador in reply to Hobbitses]

Then the K2 is fine. Apixaban doesn't work via a vit K mechanism like warfarin and K2 has a very small effect on clotting.

[Hobbitses in reply to PMRpro]

Many thanks Pro

[Thelmarina in reply to Hobbitses]

I’m on Apixaban and it’s ok

[Hobbitses in reply to Thelmarina]

👍

[piglette]

Your body needs calcium to build and maintain strong bones. Your heart, muscles and nerves also need calcium to function properly. If you take under 1,500mg a day you should not have any problems.

[Polygolfer]

Supplements are probably one of the biggest ‘legal cons’ on earth! People spend fortunes on supplements that are simply being washing away down the toilet…. Unless you blood tests indicate some form of insufficiency or unless your GP or other doctor recommends supplements there is really no reason to take them!!

[Sharitone in reply to Polygolfer]

Hmmm, magnesium seems to be working wonders for my pred-induced sensitive teeth.

[marionofnorwich in reply to Polygolfer]

Well this is the thing. The doctor in my case, did recommend that I took extra calcium and vitamin D when I started taking pred. I did, but not as diligently as prescribed. Since then I have had an insufficiency fracture and a broken hip and awaiting a DEXA scan to see how my bones are. Whilst in hospital (broken hip) it turned out my Vitamin D was low. It may be that I will end up wishing that I took the supplement more regularly rather than just when I thought of it. Like you, I am not an automatic fan of supplements but we need more benchmark testing I think

[Polygolfer in reply to marionofnorwich]

Thanks Marion, sorry to hear the steroids intake led to more problems, but you well already had a bone condition?

As I said, if the doctor asks you to take any supplements or medication, or not, he will know why as only he and you have your full health history and current condition. Best wishes going forward!

[marionofnorwich in reply to Polygolfer]

No, I didn't have any pre-existing bone health or any other health problems at all in fact. When I was diagnosed with PMR, I was automatically prescribed Alendronic Aid, Lansaprozole (stomach protection) and Adcal as well as 15mg of pred. I had not long before had an Xray on my hip (which showed the hip joint was healthy but the muscles needed stretching) and in 2011 when I fell off my bike, the emergency doctor said he hoped that his bones were as healthy when he got to my age. The doctor that prescribed all of that did it because it is the standard precautionary medications to protect the body against the side effects of pred. I stopped the alendronic acid about 2 years ago because a DEXA scan showed I didn't need it which is why I am curious to know the results of the next DEXA following the hip break. To be fair, I did fall heavily on it and it was the first part of my body to hit the floor as my feet got stuck on a pice of skirting board but let's see what the DEXA says!

[agingfeminist]

I was told I must take calcium supplements when I began prolia (denusomab) injections 5 years ago but the bone specialist agreed to let me try to keep up calcium levels with diet and vit D3 and K2 supplement. Regular blood tests show it has been fine. Yogurts and cheese are great....spinach is not useful because it has in it a chemical (oxalate) which combines with the calcium and makes it unavailable for the body to absorb.

take the vit D3 K2 tabs with a meal with calcium in it...

the less supplements the better...real food much better source

[Sillydogsmum in reply to agingfeminist]

Calcium in the blood is maintained at the cost of calcium stored in the bones so satisfactory blood level does not indicate sufficient calcium in bones, as per PMR Pro below. Real food is a better source but it us worth totting up, every now and again, exactly how much calcium one averages daily , should be1000 - 1200mgs , as per Oh-my below. Calcium supplement tabs seem to contain loads of additives that might explain why folks have difficulty tolerating them.

[Fatsiajaponica in reply to agingfeminist]

Thank you for ypur reply. I got confused with the spinach as increased my intake of spinach to help with low folate! It's a conundrum really trying to get your head around all of this. Will now do a review of diet and supplements and work out the best way forward.

[PMRpro Ambassador]

This study comes up again and again, The results are for HEALTHY young women eating a normal diet and taking only calcium supplements, not combined supplements or other medication. The same results were NOT found in women taking vit D as well.

We are not healthy for a start but are also on pred. Pred make the body lose more calcium through the kidneys so less is available for the bones and other functions so there is a risk that your blood calcium level gets low and then the body scavenges it from the bones - potentially reducing their density. That is why the standard approach for patients on pred is a calcium and vit D supplement. If that is inadequate they add a bisphosphonate which ensures the calcium gets to the bones - and the supplement is essential then to reduce the risk of low blood calcium levels which can be dangerous. Real food as a source of calcium is better but if your diet is deficient for the purposes, it needs a bit of help.

[Fatsiajaponica in reply to PMRpro]

Thanks PMRpro and everyone who has replied, much appreciated. It's so good to have this forum to turn to when unsure of the way forward.

[Oh-my]

My GP didn’t put me on supplements either. Instead she gave me a diet sheet for calcium. I calculated how much milk & yogurts (dairy and plant based) I needed each day and have gone with that. I do take vit d and k2 too

[OilyWiggles]

It's my understanding (I'm sure you'll correct me if I'm wrong) that pred also reduces levels of magnesium and potassium. I take magnesium (the body easily deals with any excess) and make sure to eat plenty of potassium-rich foods.

[Fatsiajaponica in reply to OilyWiggles]

Thanks OilyWiggles (love the handle)

[Oh-my in reply to OilyWiggles]

How much magnesium do you think is a good amount to take? I read somewhere it reduces atrophy of muscles while on Pred.

[PMRpro Ambassador in reply to Oh-my]

Enough to deal with any cramps or so but not so much it has a laxative effect. Not sure it will prevent muscle wasting due to pred though.

[Oh-my in reply to PMRpro]

Not sure. I think magnesium is similar to potassium and calcium in that pred (like in old age) reduces the amount we absorb from our diets. So it's a good exuse to eat loads of dark chocolate!

ncbi.nlm.nih.gov/pmc/articl...

[DorsetLady PMRGCAuk volunteer in reply to Oh-my]

Not too much though! Just enough … 🍫