I have heard at a recent PMRGCA Support meeting that it is best to take calcium around 2 hours after taking your Preds rather than at the same time. Views please.
Taking calcium at the same time as Preds? - PMRGCAuk
Taking calcium at the same time as Preds?
Written by
PMRFEB24
To view profiles and participate in discussions please or .
Read more about...
35 Replies
•
DorsetLadyPMRGCAuk volunteer
Yep,it is correct...see this from the FAQs-
I have mine by prescription and a warning of at least two hours is printed on the sticky label on the box.
PMRproAmbassador
Quite true - our mantra: Pred for breakfast, calcium for lunch and dinner. You shouldn't take more than 5-600mg of calcium at a time, the body only absorbs so much at one time, and it is better absorbed when there is some fat around.
Whoops! I did not know this and have been taking AdCal and Pred at breakfast. Time to update my spreadsheets!
Me too! 😲
I take iCal-D3 1000mg in the evenings. Sounds like I should be halving the tablet and taking half at lunchtime and half in the evening?
I have no idea why manufacturers decided to make the double dose options - it is well known that almost half is wasted by the body. More convenience possibly - but doesn't work as well.
According to Tim Spector and Cyrus Cooper nearly all of it is wasted "I wouldn't give it to my dog". they say just because bones have calcium in them doesn't mean that taking calcium tablets helps your bones. There are far better options for bone-strengthening than Adcal. I'm surprised to learn GPs still prescribe it, I thought the standard cheapest first option now was Alendronic Acid?
But the AA still needs calcium to prevent low blood calcium levels. If blood calcium is low, the body scavenges it from bones. AA sequesters the calcium to the bones - and must be replaced from the absorption in the gut or the blood level falls and you can get into all sorts of trouble.
Thanks for the explanation, but does the body get it from tablets or from food, that's the question? AA seems to be given out instead of Adcal these days not in addition? I was given Adcal in the early years of PMR but later it dropped off my prescription and I was offered AA instead, which I couldn't tolerate, but I couldn't take Adcal either with my highly sensitive stomach and guts. Maybe I should have taken something else but didn't as my DEXA scores were always fine I (wrongly) thought I didn't need to
Oh it does get at least some from the supplements - and their condemnation of calcium supplements is a bit sweeping (as usual). There are better calcium supplements than the dirt cheap calcium carbonate but dietary is the best.
Do you know of any reliable research on calcium tablets? At the back of my mind I vaguely recall a long-term study I read as a footnote in a book but can't for the life of me remember what it was
Not really but have never looked. Oh-my has mentioned a study - at the bottom of this thread, ask her???
The one I'm thinking of followed a large cohort of women over many years, some took the calcium supplements and some didn't. A very quick Google showed several studies that support taking supplements post-menopause but also this that says good food and exercise are more effective:
hopkinsmedicine.org/health/...
I guess the key difference is what the best thing to do for us on steroids is given the way steroids destroy the trabecular faster so we are at even greater risk than those who are not on steroids. I personaly think from my research and bitter experience of fractures we should all be offered something stronger than AA or Adcal eg Zoledronic infusions
The Nurses Health Study maybe?
Diet is best - but supplements for some people aren't wrong. The calcium deposition in blood vessels was a skewed finding - later noted to be seen in women who didn't take vit D as well. Calcium supplements are not needed for many, the worried well with no risk factors. But we aren't them.
Could be, the Nurses study was oft quoted by the likes of Michael Mosley in his books. I'm not saying calcium is wrong, I'm saying it's barely effective for 'normal' post menopuase women and not good enough for us on steroids. AA is the cheapest option, but should we be getting better options?
A study done when bisphosphonates were not yet an option did find that supplements caclium and vit D DID reduce the loss of bone density in patients on pred. That is what its use is based on. Now we know there is more to it than merely density - but density is probably still part of it.
Wish I’d known that 5 years ago. I found out from here to take it at night but not a 1000 was too much in one go!
My doctor instructed me to take two 500mg and vitamin D first thing in the morning with Pred but I read on the container that they are not to be taken within 2 hours of tea or any whole food….cereals, seeds, wholemeal bread etc. and one at a time. As I always have musli or whole meal toast for breakfast, I ignored doctors advice and take one mid morning and one mid afternoon. Thank you for your comments. They are very helpful as I am never sure who is right!
I actually asked a pharmacist this recently, and he said it didn't matter. So I'm wondering whether this could be because I have e/c pred and so it's not going to be absorbed for a while anyway. Or is that daft?
Possibly - but it is usually the pharmacists who flag it up!!!! What is said happens is that the calcium forms a coating on the pred tablet and impairs its absorption.
Even with the delayed absorption of e/c?
It is something I have wondered about for a long time. You'd think the coating effect would be there whatever sort of pred it was wouldn't you?
Just read this about taking calcium 2 hrs after food- I've never been told this by my Doc, but then they don't seem to give any advice about taking medication at all now. I have calcium but also vitamin D in separate tablets-twice a day. When do I take the vitamin D then- with my breakfast & with my evening meal?
Same advice as in my link above -
Take the vit D with your calcium supplements, lunch and dinner
Many including me take their Pred with yogurt and my pharmacist said a glass of milk works too. Why is this form of calcium okay and not the supplement form? Is it because it’s in a bound form? But all forms of calcium , to be absorbed, have to convert to the ionic form Ca2+ which is why supplements work just as well as say dairy sources. I’m asking because I have very hard water and also have soya milk which is fortified with calcium carbonate - but these both might coat the Pred? Am I right?
Would love some more insight about it all if anyone knows.
Dietary nutrients are absorbed better than from supplements - possibly because of what they arrive with:
"It's best to improve the diet before using supplements, ... That's because vitamins and minerals are most potent when they come from food. In food, they are accompanied by many other beneficial nutrients, including hundreds of carotenoids, flavonoids, minerals, and antioxidants that aren't in most supplements."
I doubt your water would interfere, possibly not the soy milk, I think the sudden arrival of a lot of gooey calcium carbonate from a tablet has a lot to do with it. I think it is a mechanical problem.
I found an interesting article on the absorption of calcium from different sources. I'm fairly happy it's all pretty much the same whether natural or fortified. What does vary is how long it takes. I know having breakfast oats and seeds don't help as they prevent some of the calcium being absorbed so I've been delaying breakfast by an hour to allow the calcium in the yogurt and/or milk I take with my pred to be absorbed, but from this article it probably isn't long enough.
Also from the article, interestingly, cheese looks like a better option than yogurt as the absorption time is longer. It would allow pred to be absorbed first with less interference. But as it's all a titration.... and if I keep to the same routine I can't go wrong.
My reumy advised taking calcium tablets in the afternoon because of the adverse affect on steroids. However, I found that the given dose of two tablets gave me constipation which I did report on here. It seems that calcium sulphate can be the problem and Calcium cintrate may not be so bad. However my GP refused to provide these so I take one of the calcium sulphates (not the two prescribed) with plus a Vitamin D in the mornings. This seems to be ok
Since seen the reumatologist who promised to provide the cintrate but nothing so far.
I see from the posts that seeds could affect calcium intake. I eat those with breakfast and lunch! Oh dear. So my lunch time cheese may not be working as well as I had hoped. I am due for bone scan on 6 April so we’ll have to see
Not what you're looking for?
You may also like...
Should I be taking Prednisolone and Calcium at the same time?
Hi all - quick question, if anyone can advise me?
I've read somewhere that you should not take...
Taking pred at the exact same time each day
Does it matter if you are not that strict about taking your pred at the exact same time each...
Taking Preds & Aspirin together.
At the moment I am taking 5mg of Preds. Due to a Branch Retinal vein occlusion my G P has recently...
Can we take AD-cal at the same time as Pred?
Greetings one and all. At some time in the last year I read, somewhere (??) that I shouldn't take...
should you take supplements at the same time as the Pred dose?
taking preds at 2am, reason for doing this question
Preds at night ?
Tapering the Preds!!!!
Can I take Vitamin D at same time of day as Prednisolone?
