Reduce calcium along with pred?

[Phoebenooby]

I have been taking calcium tablets (800 strength whatever that is) only been taking vit k since October after reading about it on here . I’ve read lots of negative posts about calcium but have continued to take it. Just wondered if I should only take 1 tablet (400) now I’m down to 4.25 pred from 15mg starting dose. Thanks

[DorsetLady PMRGCAuk volunteer]

Where have you ‘read a lot of negative posts’? And in what respect negative ? And are they a combination of Calcium and VitD supplements prescribed by GP? They are usually something like picture.

Recommended dose when on Pred is 800UI per day as Pred depletes calcium… or do you think you get enough calcium in your diet?

Cal/VitD

[PMRpro Ambassador]

No reason why not providing you have plenty of calcium in your diet, that is important - but as DL asks, what sort of negative stuff?

[posthinking01 in reply to PMRpro]

There is a problem with calcium setting down in the arterial system - what is actually needed is magnesium which dilutes calcium and stops it doing damage. Or alternatively take a calcium/Magnesium product which has 2:1 - Mg/calcium.

[PMRpro Ambassador in reply to posthinking01]

I was asking what Phoebenooby had heard to concern her - I know the things that it usually, When taken with vit D the effects seen in the study that found the deposition in the arteries didn't occur. The study included young and healthy participants, the worried well. It applies less to us since we aren't young or healthy and we always emphasise the vit D aspect which is essential. Actually, combining magnesium and calcium may NOT be a good ides as they interfere with each other's absorption - so if you are deficient, you may not be getting as much as you expect.

[Jbobby in reply to PMRpro]

Oh gosh! I thought magnesium HELPED the absorption of Calcium… I must have got that wrong. So it’s Vit D that helps it most ? So does the intake of Vit D override magnesium’s inhibiting effect on absorption? It’s all such a juggling act!

[PMRpro Ambassador in reply to Jbobby]

Just take the mag and cal at separate times. How MUCH it interferes I don't know - but it probably isn't the end of the world anyway! You need vit D to transport calcium. And some fat - which is why full fat milk is better than skim milk!!

[Jbobby in reply to PMRpro]

Helpful info as always. Thank you so much PMRpro.

[Jbobby in reply to PMRpro]

Helpful info as always. Thank you PMRpro

[Hugh_Marc in reply to PMRpro]

And of course not all milk is the same. Most supermarket milk is homogenised. This means that as well as pasteurised they take all the fat out & then add about 3.5% back again.

Better to get milk from a farm if you can as it will be slowly pasteurised & retains much more of the micronutrients in the milk.

[PMRpro Ambassador in reply to Hugh_Marc]

Here where I live you can even get unpasteurised from a farm! But I think a few less nutrients is probably fair enough against the bugs that get chucked out!! Milk isn't the wonder source of calcium it is believed to be anyway,

[Oh-my in reply to Hugh_Marc]

The fat content of milk won’t affect the calcium content. I have hard water which is almost as good as drinking milk - plant or dairy.

[Phoebenooby in reply to PMRpro]

Hi, I have read and seen if you take calcium it can go to arteries instead of your bones and cause blockages. Vitamin k2 helps direct it to your bones (I already have blocked femoral arteries ) I have taken 800 calcium every day for a year but wondered if I should reduce along with the pred

[PMRpro Ambassador in reply to Phoebenooby]

But WHY are the femoral arteries blocked? IS it calcification? There are other reasons.

[Phoebenooby in reply to PMRpro]

No one knows , they said it’s not calcified, it happened just after my undiagnosed PMR started, I’m convinced it is connected to PMR but as they are already blocked I don’t want to add to the problem , my calcium is prescribed and has added vit D2, I just thought as I’m on lower pred I could take less calcium update: I emailed prof Luqami one of the top rheumys at the Oxford Nuffield last week and he sent me an appointment for today ! Lovely man , went all through my pet scan from last year. ( I haven’t had any contact with them since my pet scan a year ago except a phone call after I had emailed them for an update saying we were going to “watch and wait “ 🙈 He is pretty certain the PMR inflammation blocked my arteries, but likely not there now but scar tissue blocking them. Is requesting another pet scan to check. If the inflammation is still there will try Methotrexate

[HeronNS]

It's the Vitamin K2 which sends calcium to the bones and prevents it from settling into blood vessels or organs where it causes problems. Vitamin D enables the body to absorb the calcium in the first place but cannot direct it to the bones. Both D and K2 are necessary, I think in some way they even need each other. Magnesium is also an important mineral for bone health and we may experience a deficiency when taking a relatively high dose of calcium, which 800 mg in a single dose is (better to split the dose into two and take it twice a day). If supplementing magnesium be sure to take it at a different time than calcium as calcium will interfere with absorption of magnesium. I usually take magnesium at the same time as pred as we shouldn't take calcium with pred either. (In fact I now avoid taking calcium with any other supplement.)

FYI for years without problems I've been taking two 300 mg doses of calcium daily, one dose of 200 mg magnesium bisglycinate, two 100 mcg doses of Vitamin K2 and because my D level tends to run high if taking recommended amount, 1000 IU every second day. The only supplement to avoid taking with another is calcium. All of them should be taken with food, and apparently calcium is absorbed best with something like a little yoghurt.

[Phoebenooby in reply to HeronNS]

I’ve been taking the calcium with a vit K tablet !

[HeronNS in reply to Phoebenooby]

I'm sure that is perfectly okay. Calcium seems to be a bit of a bully when it comes to other elements (like iron, magnesium and zinc, all of which I am currently trying to take at present time, avoiding calcium, although usually I don't take zinc and iron is sporadic). And calcium can interfere with the absorption of *some* medications, like pred of course, but a quick google can discover an interaction. I should have been more clear but as pred is my only actual med I didn't think to mention checking anything else specific.

[Phoebenooby in reply to HeronNS]

I have actually taken one of my calcium tablets a couple of hours after my pred in the morning for over a year! A couple of months ago I added vit k to the calcium and an aspirin. I have high BP also I take another calcium tablet at night with amlodipine and a cod liver tablet…. I only occasionally take a magnesium tablet in the evening….. bit of a nightmare! I am supposed to take a statin but that’s a bit hit and miss…..

[HeronNS in reply to Phoebenooby]

Sometimes I think a spreadsheet would be helpful! Trying to fit four elements into a day isn't easy, although magnesium and iron might be okay together and also okay with pred. Zinc is supposed to be taken separately from anything else. You kind of run out of meals to take things with. I feel like I'm grazing all day long! When someone posted that they read Vitamin K2 and Vitamin D should be taken separately I was concerned for about two seconds. A quick google and you immediately find one article telling us to take them separately, another to take them together, each claiming their method improves absorption. 🤷‍♀️

[PMRpro Ambassador in reply to Phoebenooby]

A couple of hours after pred is fine - plenty of time for the pred to be absorbed, it takes about an hour. The calcium is thought to coat the tablet and stop it breaking up with digestive juices/

[herdysheep in reply to PMRpro]

presumably less of an issue with e/c tablets?

[PMRpro Ambassador in reply to herdysheep]

I assume so - but I suppose the calcium coating might persist???