Good diet so no need for Adcal?

[Mfaepink1973]

I asked my GP (again!)about taking Adcal and explained that a lot of people on this forum were automatically prescribed it when put on steroids. GP asked about my diet and said I was getting plenty of calcium in my diet. He said calcium and Vitamin D levels were good on my last blood test and the DEXA scan last year was ok but if I was worried I could have another DEXA in a years time. I already take an OTC vitamin D and K2 but any advice would be appreciated as to what form and amount of calcium I should buy or whether I should accept GP’s decision that I don’t need any. I’m currently on 3.5mg prednisolone and just starting a slow taper to 3mg.

[Sophiestree]

I don't take calcium, only Vit D and K2, and do have bad bones, but my diet is good enough for calcium intake so am happy with that side of things. What makes you want to still take calcium after their comments?

[Mfaepink1973 in reply to Sophiestree]

I’d read on here something about prednisolone causing calcium to leak from your bones and the recommendation to take extra calcium. I think this link to an answer given by PMR pro confirms it

healthunlocked.com/pmrgcauk...

[Sillydogsmum]

Why not tot up how much calcium you actually ingest per week , divide by 7, then if you are sure to be getting at least 1200mgs daily on average or thereabouts then your dietary intake is sufficient. If not you could increase the calcium rich foods or take the supplement. Its a bit if a chew to measure/ weigh stuff but you only need to do it once to get an idea of your intake.The ROS has a calculator for calcium content of various common foods- others are available. Unless your GP is perched on your shoulder at mealtimes I dont see how he can opine as to your intake being adequate! Calcium level in blood is not an adequate proxy for calcium available to bones. I did this because i cant tolerate calcium tabs, but lots if folks can take them without a problem.

[Mfaepink1973 in reply to Sillydogsmum]

Thanks for your reply. I hadn’t thought of working out how much calcium I ingest, thanks for suggesting it. My GP is lovely but hasn’t got much of a clue about PMR although he did diagnose it but I’ve been pretty much left to get on with it since then.

[PMRpro Ambassador]

How much calcium are you taking in diet? Dietary calcium is preferable to supplements. And it also depends on other medication - if you are on a bisphosphonate you really need a supplement because the bisphosphonate directs calcium to the bones and blood levels can get low which can be dangerous.

You do need a bit more than the usual RDA but not necessarily as much as the AdCal 2x daily. He can't tell just by blood vit D and calcium - the body scavenges both from body stores to keep the blood level up and you can be quite depleted in vit D before that shows. Calcium is the same in that it may be hauled out of the bones but bloods look fine. There are other tests that are better,

[Mfaepink1973 in reply to PMRpro]

Thanks PMRpro, I have full fat yogurt with fruit for breakfast then usually meat, fish or cheese omelette for lunch. Dinner is a bit hit and miss depending whether I’m at work or home, work days it’s usually a sandwich but at home meat or fish with veg and a bit of pasta or potatoes. I’ve got moderate arthritis in my back, hips, big toe joints and hands.

You said there are other tests that are better than a blood test, would you tell me what they are please

Thanks

[PMRpro Ambassador in reply to Mfaepink1973]

No - better blood tests than just calcium. It is usually called a bone panel or something.

And it isn't what you eat, it is how much calcium there is in it. To work that out you need an accurate list of what and how much you eat and check the calcium content using online nutritional data. There are apps that do it for you.

[Mfaepink1973 in reply to PMRpro]

Thanks, a job for tomorrow then x

[Sillydogsmum]

To be fair to yr GP the various guidelines do say that as long as ones intake is 1200mgs plus, no calcium supplement is needed but you should have been offered Vit D.The problem is that a prescribed calcium guarantees an adequate intake , whereas the dietary route route needs attention to detail week in week out and lots of dairy/ sardines. I just make up 1200mgs from measured dairy/alpro, sardines , nuts and broccoli, and accept that other foods give me in excess of that . The Royal Osteoporosis Society has some good info re vit D as,well. If I could tolerate calcium supplements I think I would take at least one a day.

[Mfaepink1973 in reply to Sillydogsmum]

Thanks, I’ll try and work out what my average daily calcium intake is. Thanks for your advice about the ROS

[AgedCrone]

Why don’t you have a word with one of the Specialist Nurses at the Royal Osteoporosis Society.

Tel No 0808 800 0035

They are really helpful giving advice on diet…especially explaining very clearly the correct amount of Calcium you need or don’t need to take as a supplement. As you are already taking supplements they will advise the dose you should aim for.

I hope you find them helpful.

[Mfaepink1973 in reply to AgedCrone]

Thank you so much, that’s really helpful. Love your name by the way!

[AgedCrone in reply to Mfaepink1973]

My name describes me perfectly ….old & decrepit..,but still soldiering on!

[Odosmum]

I used to take prescribed medication, alendronic acid, until I had a bone scan which said my bones were OK. I am careful with my calcium intake though - lots of milk in tea, coffee etc and two portions of cheese or yogurt daily. If I feel that my dairy intake is low for a day or so, I make an effort to make a milky pudding or just drink a glass of milk for a few days. I think it's important to be aware of our need to take calcium, because women are generally deficient in dietary calcium, but as long as you do take about 1200 mg daily (approx 2 glasses of milk), you should be fine. Continue the Vitamin D too.

[Mfaepink1973 in reply to Odosmum]

Thanks Odosmumx