Vitamins & Calcuim

lori1964

I did the vitamin and calcuim before my journey with cancer started.. Now I'm trying to get the right vitamin and dosages.
Does anyone out there take vitamins? And if so is there a certain brand you prefer. I know my doctor told me I needed to take a multivitamin, and vitamin d and calcium

But I forgot to ask him if there are certain limits to the amount you take.
I get about 900 mg. in calcium a day just drinking my milk. I don't want to go over board. I'm 42 and post menpause.... Thanks

sherloc

if you are postmenopausal you should be getting 1200mg of calcium a day. Not sure of the vitD dose. I have osteoporosis so I take 1800mg calcium and 800units vitD per day. But that is on doctors orders.
I don't take a multivitamin.
Calcium Citrate is the type most easily absorbed by our bodies. I just buy the walmart brand.

roseg

Someone else told me that you can only absorb 500mg of calcium at a time, so I take it a couple of times a day. I try to separate the supplements by 5 hours so they've had time to get digested.

Sierra

I take Cal Mag.. a few times daily

also, am careful not to take chocolate
or coffee (at same time) when taking this

In fact, all my vitamins are spaced out

Best to you on your journey

Jorf

As an osteoporosis specialist this is what I recommend -

1500 mg calcium daily for post menopause. Get as much as you can from food sources (collards is my favorite - 200 mg in 1/2 cup) and supplement the rest. No more than 500 or so mg at a time so no supplement with a glass of milk or a plate of sardines with the bones (you'll pee out most of the supplement).

Ca carbonate needs to be taken with food and is more constipating. Ca citrate can be taken any time and is more expensive.

It can get so complicated tho and the idea is to just get it into your body the best way that works for you.

Magnesium should be anywhere from half the amount of calcium to twice the amount - there's mixed reviews from both the "conventional" and "alternative" sections of medicine as to how much is necessary - from "no one is every mag deficient" too "everyone is mag deficient". If nothing else, it seems to help decrease the constipation

Vitamin D should be at least 1000IU of vitamin D3 (cholecalciferol) daily but you should have your 25(OH) vitamin D level checked. If it's under 32 ng/ml you'll need to take 2000 per day (or prescription ergocalciferol 50,000 units weekly) for 12 weeks and have it rechecked in 3 months, dropping down to 1000 when you're in the normal range.

What works well for me is to take my 1000 IU D3 in the morning with breakfast and to look forward and love and (well, adore) my dark chocolate Adora after lunch and after dinner. I NEVER miss a calcium dose since I discovered that stuff!

My plan for next year (I dropped down to about 29 last winter) is to just automatically bump up to 2000 daily in November.

Of course I'm going to spend a month in Brazil. Do you think my insurance will pay for that since it's vitamin D therapy and I'm at higher risk for osteoporosis now that I've been thrown into menopause and my bone turnover markers are high?????

Darcy45

Hi Lori, I take Nature's Plus multi-vitamin which you can find in health food stores or buy in on-line (cheaper). It contains no soy, which er/pr positive girls need to keep an eye on. It's also high in beta carotene, a good source of anti-oxidant. I also take Caltrate with vitamin D and Omega 3 fish oil. Just starting 500 mg of vitamin C.

Check out the alternative thread, lots of good information.

Best wishes!

sherloc

Jorg, what do you mean you are an osteoporosis expert? That seems like an awfully high dose of vitD. I am under the impression that to much is a bad thing.
I have advanced osteoporosis. As well as 1800mg calcium and 800units VitD I also get aredia infusion every 3 months. Labs done every 6months, standard is NTX, Bone specific Alk Phos, VitD 25hydrox, and whatever else my endo decides to toss into the mix. Next round she has added ostoecalcin, and phosphorus to the list.

wallan

Well this is interesting and informative. I was told by my oncologist to take 1500 mg of calcium supplements a day. So I went to the pharmacist who told me to take calcium carbonate 1500 mg dose. The actual elemental calcium though is 600 mg. The pharmacist told me to pay attention to the amount of calcium carbonate. I wanted to get cal-mag supplements instead, to balance out the magnesium, but the pharmacist told me that I would be taking way too much magnesium if I took it to balance out the 1500 mg calcium carbonate. Hmm... I wonder if he knows what he is talking about?
I would prefer to take calcium citrate too. But they didn't have it in 1500 mg doses. So I think I should get alower dose and take it a few times a day. Because I do think you have to absorb small amts of calcium at a time.

As for vitamin D... I take 1000 IU a day. I have always wondered if this is too much or what.

Thanks for the info Jorg.

Wendy A

Sierra

Hi Wendy:

Actually, I am not taking the Vitamin D
now as I am out in the sun.. covered
protected, but dont want too much of it
until checking with my GP

In the winter, when I was depressed
my naturopath told me to take the Vitamin D

My cal mag is 2:1..

O/T

HAPPY CANADA DAY!

Enjoy, the weather is grand
and I am off to the island, likely
Wards of course, not Hanlans LOL


Best wishes


)

sherloc

Rose, my doc told me the same thing. And now the stupid drug companies are only putting out 600mg pills. What for if we aren't absorbing that extra bit. Anywhos I take mine 3 times a day.

Sierra, love your sig line......you aren't getting the vitD from the sun if you are slathered in sunscreen. My doc says 15 minutes a day unprotected. So I go without when I water my yard in the morning. Figure thats when the sun is least fierce.

sherloc

Wendy, sitting here reading the label on my calcium. It says...
serving size 2 tablets
Amount per serving 1200mg calcium corbonate (shoot didn't read that when I bought it) doc told me calcium citrate. Hmmmm have to look up what the difference is.
Moving on
suggested use: As a dietary supplement, take two tablets daily with a meal.

If we don't absorb more than 500mg at a time then why is the bottle telling us to take 1200 at a time?
Holy smokes now I'm totally confused.

slanderson

Girls, be careful about the calcium. Drink lots of water with it. I, for the first time in my life, (age 43), got a kidney stone and had to have surgery to remove it. I have had a baby and migraines and by far this kidney stone was the worst. I was in the ER crying like a little girl and I can take pain. The ER doc said, don't worry about it. We get grown men in here who act worse with kidneystones.

Just a warning...

Thanks, Shannon

sherloc

great Shannon, something else to worry about. Dang it never ends

BlindedByScience

Shirley, I agree with Jorf that 1000 iu of Vitamin D3 a day is not excessive or harmful for MOST people. If you have kidney or liver problems or some forms of lymphoma, you shouldn't take that kind of dose. Otherwise, it's very likely OK and very likely necessary.

A study was just published that followed people who live in Hawaii and get 11 hours or more of sun exposure (no sunscreen) a week. Even some of those people were Vitamin D deficient. They don't know why. And as we get older, we are less efficient at making Vitamin D from sun exposure. Many people on these boards live in the Northerly latitudes and can only get the UVB rays for 3-4 months a year. Many of us spend most of our time in doors or use sunscreen. Epidemiologists have been quoted as saying that nearly everyone becomes Vitamin D deficient as some time during the year. This, of course, raises the question of what test result is 'deficient'? The normal range reported on the 25(OH)D test is 20 - 100 ng/ml. If you test at 32 ng/ml or less, some would say you're deficient. My onc likes to see test results of 80-100 ng/ml for bc patients. You mentioned you get tested regularly for 25(OH)D. Do you know your test results? That would be highly informative as it looks like you get too much calcium and not enough D (to me).

Beyond bone health, Vitamin D is essential for our immune system. Vitamin D inhibits the growth of bc cells in culture. It requires a high calcium environment to work though, but if you take a lot of calcium and have too little Vitamin D, you may find that it deposits in blood vessels or creates kidney stones or brain lesions (that was a different tidbit from another thread).

I have to take 2000 iu daily to maintain 80 ng/ml of 25(OH)D in the summer and I get a lot of sun. At that dose, I drop to the low 50's in Dec/Jan.

We've discussed a lot of this in the Alt thread, including links to papers on the subject. I'd be happy to send those links to you if you want them.

sherloc

BBS, lots of good info there. I would appreciate the links. Thanks. My last vitD25 was 45, my labs reference range is 20-57ng. Thats pretty standard for me, it may fluctuate a point or two every 6 months. My calcium always runs at 9 or above. Lab reference is 8.8-10.5
The one thing we do know is that I'm not deficient in anything. What we don't know is why my bones have gone to pot in spite of that. So I'll keep doing what they tell me to and hopefully the bones will get better.

BlindedByScience

I'll just repeat some of the information that I believe is important for bone health:

Take 500 mg of Calcium with 250 mg of Magnesium (more Mg is OK but it can cause loose stools to diarrhea, depending on your tolerance) one to three times a day. If you eat food that is high in calcium, adjust your supplement intake accordingly.

Take your calcium 2 hr before OR 2 hr after prescription medications as it can inhibit the absorption of some medicines including bisphosphonates.

Consider taking strontium at half the dose of Calcium. Take it several hours before or after the calcium (calcium and strontium compete for absorption.)

Consider taking 1000 iu of Vitamin D daily with a fat-containing meal. Fat is necessary for Vitamin D to be taken up.

Get daily sunshine. The hours of 11-2 pm are typically the most potent rays for making Vitamin D. If you are fair-skinned and stand outside in shorts and a sleeveless top, you'll make 10-15,000 iu of Vitamin D in about 15-20 min. The darker your skin, the less Vitamin D you'll make in the same time period.

Calcium citrate is the best absorbed form of calcium and you can take it on an empty stomach or with food. If you suffer from an excess of stomach acid, take calcium carbonate instead. Calcium carbonate is best taken after a meal or with an acidic drink like orange juice. The carbonate form is not recommended for people who have low stomach acid.

Melatonin may help activate the bone formation process. If you take it, do so only at night and shortly before bed. It can help promote restful sleep and may have anti-bc activity. Some people can take and tolerate a lot, some have to start at low doses. Try 1 mg a night for a week or two and slowly build up to more. You'll know when you have too much as your sleep will not be deep and restful, but will be filled with many fleeting dreams.

Exercise. Walk 30 minutes a day. Every day that you can. Weight-bearing exercise is needed to build bone. Daily walks of 30 minutes or more can cut the risk of dying from bc by 40-50%. It can cut the risk of recurrence, too. No matter what stage, it will probably help. It's free and you can get good sun exposure if you do it during the day!

Here are some articles written for the general public on Vitamin D and its many functions:

Vitamin D from Muscle Strength to Immunity
http://www.sciencenews.org/articles/20041009/bob8.asp

Vitamin How Much is Enough?
http://www.sciencenews.org/articles/20041016/bob9.asp


And this one is more technical, but has a lot of good information:

The Vitamin D Epidemic and Its Health Consequences, M. Holick
http://jn.nutrition.org/cgi/content/full/135/11/2739S

Jorf

Shirley,

I don't call myself an osteoporosis "expert" by any means. I know experts, I know THE experts. I am no where, no how, anywhere near in the same league as them.

however, I go hear them speak as often as possible and read their articles since I do osteoporosis treatment for a living.

1000 of D3 is considered enough to maintain whatever level the person has in their bodies at the time. I found, personally and see it in lots of patients, that it isn't even enough to maintain some people over the winter and I advise them to automatically bump up to 2000 in November.

The last time I heard Mike Holick speak (a couple of months ago) he said that about 5000 IU of D3 per day is the area where healthy people can get in trouble. Holick is the endocrinologist/dermatologist who has done a lot of the big research in vit D. And a funny guy too. Do a search and read some of his stuff.

It sounds like you're being followed closely and carefully, especially being on pamidronate. I would figure that they're following your D and that it's at a good level and they're ok with the amount you're taking.

I have plenty of patients whose D is in the 50's and they only take what's in their calcium and multi - about 800.

Julie

Sierra

Hi Shirley:

I do the same
for instance
I usually am out early walking
no protection

but at the peak hours of the day
do use it (seldom out at noon)
usually in eating (of course)




Have a great week-end!

Happy July 4th

Happy Canada Day!

Must hike before it
gets too hot


O/T anyone in here
who has a good sunscreen
plse PM me
I am awaiting new samples
from my dermatologist



)

LizM

I am still trying to find the right calcium supplement and right amount of vitamin d.

My bone density test recently showed me to be on the high side of osteopena. My vitamin d test showed me to be at 48.

Here is what I was taking before I added fosamax with d3:

morning: organic OJ fortified with 300 mg of calcium and 100 IU of d3, organic Kefir with 300 mg of calcium and 100 of d3.

lunch: multi with 1000 D3, 250 mg calcium, 150 mag and calcium/mag/d3 supplement with 250 of calcium citrate, 100 IU of D3 and 100 of mag

dinner: chocolate citracal chew for dessert with 500 mg of calcium and 100 of d3

Total: 1500 of calcium, 1400 of D3 (1800 with Fosomax/D), 250 mag

With the Fosomax and D I am afraid I am getting too much vitamin D especially in the summer as I am out in the sun daily.

BBS and Jorf, do you think I am taking too much D3? I could look for a multi with less d3 or cut out the fortified OJ and Kefir with vit D.

Jorf - Do you think the Adora supplements are better than citracal chews? My concern with the citracal chews is that they added color and preservatives. Where do you buy the Adora chocolates? I looked online and noticed that they do not contain d3 instead they contain d2.

sherloc

BBS, thanks for the info.

Julie, "expert" was a misquote. Sorry. Are you a nurse? Doctor?
I am followed closely. Endo does labs and such every 6 months, onc does labs every 4 months. Think I got that part covered.
As of wednesday with my latest bone scan and one broken rib later, I officially have Advanced Osteoporosis. Pretty crappy for a 45 year old woman. Hubby wants to wrap me in bubble wrap and never let me leave the house.

Sierra, got your PM, will get back with you in a bit.

BlindedByScience

LizM, you're taking 1400 i.u. of Vitamin D. This is only a small amount of what most people will make in only a few minutes of sun exposure, assuming mid-summer sunshine with UVB rays. Unlike taking a supplement, our bodies will regulate how much Vitamin D to make from sun exposure. The way to overdose is through supplements--not sun exposure. And 1400 iu is unlikely to bring you anywhere near an overdose.

The recommendation still applies, though: get tested once or twice a year for 25(OH)D levels. You can adjust your supplement based on the test results. I think you'll find in December or January that your blood levels have dropped significantly!

Jorf

Ugh, Shirley - 45 with a fracture. Bummer. Well, sounds like you're getting really good care.

I'm a nurse practitioner in an endocrinology practice where our first love is osteoporosis. It's a fascinating topic.

Liz - I get my Adora at Whole Foods but will switch to getting it on line because it's a LOT cheaper. It's a zillion times better than any of the other chews - it's real chocolate. Really. It's good. I look forward to it! I don't worry about the vitamin D in it because it's such a minuscule amount anyway. I take my 1000-2000 of D3 daily (depending on the season) and get lots of sun during the summer and don't fret about what's in my Adora.

What is the multi that you're taking? Sounds like a good one to have that much D and calcium in it. How much of what kind of A is in it? (more than 3000IU of retinol is bad for the bones) Can you let me know?

Shirlann

Hi sisters, I take 1000mg C every day, with 800mg D, our gal is spot on with that recommendation, Co-Enzyme 10, Calcium, 100 E, twice a week, a good multi for the trace elements. AND, Cod Liver Oil, Fish Oil, Green Tea, Cranberry, Grapeseed capsules and a very good B-Complex. I have taken vitamins since childhood and I am now 72.

BUT, now this info may be old as I am 8 & 1/2 years post treatment, but they told me NOT TO TAKE SUPPLEMENTS during actual treatments. They thought that sending in especially C & E to attack free radicals might interfere with chemo & rads since they ARE free radicals that we have sent in to kill the cancer cells.

I am not sure if any newer studies or reports still support this thinking.

Gentle hugs, Shirlann

BlindedByScience

There aren't any large studies (that I'm aware of) testing moderate doses of antioxidants during chemo & rads. There are some small reports of Vitamin C given in the IV with chemo drugs, green tea enhancing the killing power of chemo drugs, resveratrol (from grapes) killing cancer cells and also enhancing the effects of chemo drugs.....without large studies the oncs are usually very conservative about their recommendations. The studies that have been done, though, show a neutral to beneficial result to the use of antioxidant supplements at moderate amounts with some interference at the very high doses.

An interesting one is L-glutamine. There's an on-going study testing L-glutamine as a mouth rinse for those who are at risk of mouth sores during rads & chemo. L-glutamine is converted to glutathione which is used to form a very potent antioxidant. Since L-glutamine is an amino acid, most docs don't see a problem in taking it orally as a supplement but I'm not sure they are aware of its use by the body.

Anybody have references to large studies?

LizM

BBS and Jorf, thanks for answering my questions.

Jorf, surprising the multi I take is Nature Made ForHer50+ with optimum nutrient levels that I buy at Giant. The regular 50+ only has 400 of D3 but the newer one has 1,000. I usually buy my supplements at organic markets but I could not find one with the levels I wanted and without added herbs which I didn't want because of being ER/PR ++. The vitamin A is 2500 with 60% from beta carotene and there are no added colors or preservatives which is important to me. I plan to go to Whole Foods this weekend and look for the Adora. I love dark chocolate and am not thrilled with the chocolate citracal chews as they don't taste so good and have added preservatives and colors.