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Osteoporosis: Calcium & Prednisone Side Effects

Osteoporosis: Calcium & Prednisone Side Effects

The Silent Side Effect of Prednisone: Osteoporosis

Often we are so distracted by the other miserable side effects, we don’t notice the most irreversible and permanent side effect of them all. In this article, find out how prednisone steals calcium from your body, which leads to osteoporosis. See how prednisone causes osteoporosis and discover what you can do about it.

Why is osteoporosis silent? This is surprising because so many prednisone side effects are so loud–like the munchies! In this article, find out all about this irreversible side effect of this prednisone.

Watch now!

Other Side Effects of Prednisone Are LOUD!

When you take prednisone you just want to eat everything even if you’re full! It makes no sense and you crave salt or sugar and those hunger pangs are so loud and overtake your willpower. Insomnia is just another side effect that keeps you up all night! These other side effects kind of dominate the attention of people on prednisone. Yet we can’t forget the silent side effect: osteoporosis.

When does Prednisone cause Osteoporosis?

The risk of bone loss is worst in the 1st 3 months of treatment. The most dramatic bone loss occurs at this time. However, the bone loss does progress over time as well, so just because you are beyond the first 3 months of treatment does not mean you are no longer at risk for osteoporosis. The amount of overall exposure to prednisone increases your risk for osteoporosis.

A recent scientific article stated:

Glucocorticoids cause significant bone loss, predominantly affecting trabecular bone, with consequent fragility fractures. The risk of fractures is related to the dose and duration of glucocorticoid use, but an increased risk may be observed even at low doses and even in the first month of treatment. Steps to prevent or treat osteoporosis should be considered in all patients who take the equivalent of prednisone at a dose of 2.5 mg or more per day for 3 or more months.

What Dose of Prednisone Matters for Osteoporosis?

There is no safe dose of prednisone. However, certain doses have been shown to be worse for bone loss. Typically, the higher the dose, the worse the side effects.

Prednisone doses over 7.5 mg daily cause:

How Prednisone Causes Osteoporosis

  • Gut – This is being affected by prednisone because it is also blocking the ability to absorb calcium.
  • Kidney– They get rid of things that are in the urine. When taking prednisone, kidneys get rid of more calcium from the body.
  • Gonads– That’s our sex organs like the testes or testicles for men, and the ovaries in a woman. Those secrete sex hormones like estrogen and testosterone which build up bones and prednisone is blocking their ability to be secreted.
  • Muscles – Muscles are being broken down when you take prednisone.

So all of that together leads to low bone growth and eventual bone loss that actually causes osteoporosis.

Prednisone Osteoporosis Guidelines

There is a guideline about osteoporosis made by the American College of Rheumatology. These are the doctors who prescribe prednisone the most, especially for the people who have rheumatoid arthritis.

What can I do to prevent prednisone causing osteoporosis?

For all diseases, lifestyle modification is the first step! For most chronic diseases, like if you have heart disease, diabetes, or osteoporosis, doing what you can to improve your habits is the first step.

Lifestyle Modifications include the following below:

Supplement with Calcium

The doctor’s guideline continues with this statement:

“All adults taking prednisone at a dose of more than 2.5 mg a day for more than 3 months should optimize their calcium and vitamin D intake.”

Find out my best tips for optimizing your calcium intake throughout the rest of this article. To learn more about optimizing vitamin D, read this article.

Warning: Don’t take all the calcium at once!

When we are taking calcium it is really important to understand that we can only absorb 500 mg at a time. So, if you’re eating a meal with foods high in calcium you can’t be supplementing with calcium at the same time or your body won’t absorb it. If you do take calcium supplements, take the supplements at a different time of day than your calcium-containing meal.

Drug Interactions

When we are taking calcium it is really important to avoid drug interactions. So, either the calcium is blocking the other drug or the drug is blocking the calcium from being absorbed.

Example: Levothyroxine, a common drug in the US that is prescribed for people who have hypothyroidism. Levothyroxine is a replacement thyroid hormone. If you take it with calcium, the absorption of levothyroxine will be blocked by the calcium. So be sure to take calcium and this drug separately.

Drugs to Avoid with Calcium:

  • Levothyroxine
  • Iron
  • Zinc
  • Atenolol
  • Propranolol
  • Salicylates: aspirin, bismuth subsalicylate (Pepto Bismol), choline salicylate, diflunisal, magnesium salicylate, and salsalate.
  • Bisphosphonates: alendronate (Binosto, Fosamax), ibandronate (Boniva), risedronate (Actonel, Atelvia) and zoledronic acid (Reclast, Zometa)
drug interaction with calcium

How to Eat Enough Calcium

We all know calcium is found in dairy foods. But did you know you can get it as well in green leafy vegetables, nuts, and beans? Here’s some of the foods that contain calcium.

Foods that has calcium

Read more about how to eat the nutrients that prednisone steals in this article and stop the prednisone weight gain.

How Do You Get Enough Calcium?

Here are some examples of different supplemental calcium options, since it can be hard to eat enough calcium in our diets.

1.  TUMS

tums for prednisone osteoporosis

Tums is great for people who are having digestive issues, like ulcers, or reflux. If that’s you, this is a great way to get your calcium. With Tums Regular you need to 5-6 tums tablets spread out throughout the day to get 100% of the calcium that you need.

When you take calcium we need to understand that calcium is not all by itself; it’s not the only ingredient. There are other molecules involved. We don’t eat straight elemental calcium metal. Instead, it is bound to something like calcium carbonate. For example, imagine calcium is like a fist and carbonate is like your other hand covering on top of it to make it solid. So 40% of the weight of the calcium carbonate molecule is the calcium, represented by the fist. The remaining 60% is carbonate. And, you’re only getting the 40% from one tablet of 500 mg. That means when you take 500 mg calcium carbonate, you’re actually getting 200 mg total of calcium. But we need 1000 mg a day or more while on prednisone.

2. CitraCal

prednisone osteoporosis

Another good product is calcium citrate. This is another calcium salt. It’s well absorbed by people who have a low pH in their stomachs or people who are taking medicines that can help their acid reflux. Calcium citrate can still be absorbed even with low pH. Because calcium citrate is not very potent, if you are using the regular calcium citrate you need a dozen tablets or more to reach your goal.

3. Viactiv

prednisone osteoporosis

When I was on prednisone, I needed an outlet. I was trying to not eat sugar but I needed something that wasn’t as bad as cookies, sugars, or candy and that was still giving me a benefit. So I used Viactiv. It says on the label “2 chews is your 100% daily value of calcium.” How convenient, right?

But you can’t take both chews at the same time if you want it to be absorbed. It’s best to take it one in the morning and one in the afternoon. Remember we can only take 500 mg at a time. I loved to get my chocolate fix while getting calcium! It seemed like a great idea. However, the other ingredients besides calcium… not so good for us (fake sugars, oils, and other refined “food-like substances”).

Introducing Nutranize® Zone™

When I took prednisone, I knew that it depletes calcium. But what I didn’t realize was that prednisone steals other nutrients, too.

When I realized that, I decided to make a supplement that would help me feel well even if I had to take prednisone.

Nutranize Zone is a dietary supplement formulated especially for people on prednisone! It gives back the nutrients that prednisone depletes. Nutrient depletion is a huge risk with prednisone stealing calcium.

I called it Nutranize Zone because I wanted it to “neutralize the negative through nutrition and get you back in the Zone” of health. It is designed to reduce your suffering by replenishing your nutrients so that you can recover from prednisone.

Not Just Bone Support…

Prednisone also steals chromium. When chromium’s low, that leads to blood sugar dysregulation, which can lead to diabetes. Nobody wants to gain weight and have diabetes. This supplement also contains the other 9+ nutrients which prednisone steals. I used the best ingredients that will not only help you to sleep peacefully at night, but it will also help you to have stable blood sugar. Having a stable blood sugar makes you less hungry, which can result in keeping a healthy weight!

Just take it twice a day, in the morning and at bedtime. It’s the only supplement you need while on prednisone.

Support your bones and feel like yourself again while on prednisone by buying Nutranize Zone today.

Nutranize for prednisone

Dr. Megan Milne, PharmD, BCACP

Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.

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