Hello everyone. Thought I’d kick off here with a question in relation to my second infusion of Zoledronate next week. Blood test showed borderline calcium levels which was a surprise. I don’t take a calcium supplement as I get plenty through my diet (dairy, green veg, sesame seeds, sardines, almonds, oranges etc) and I take Vit D3 and Vit K2. The hospital have instructed me to heavily supplement over the next week to nudge levels up and to continue normal dose post medication which makes sense. I don’t rate Adcal that we are prescribed on the NHS (calcium carbonate is not well absorbed particularly as you get older) so I’ve invested in a calcium citrate malate supplement that is balanced with magensium, zinc and a herb called moringa that is scientifically proven to promote bone health according to Dr Google. Aother concern with Adcal…it’s basically cheap calcium and vit D 
Just wondeirng if anyone else taking bisphosphonates has had trouble keeping their calcium levels up and if so how they resolved it? I’m now allowed to endorse products on here but if the moringa calcium citrate helps I can probably DM the details.
I’m concentrating on boosting my calcium ( and protein) levels at present so would be interested to Learn more if you’re able yo share please.
Hi Trish, I think you’re asking for the supplement I use:
If you’re taking vitamin D3 and K 2 my understanding is that you also need high doses of magnesium ( malate or glycinate) to activate the D3 to make calcium. You might like to look at the well researched protocols on the FB Group called “ vitamin D and cofactors - uk”.
Thanks and I will check on magnesium, which I understood had to be treated with caution. When I was on the parathyroid hormone treatment I was prescribed high doses of calcium and (to my horror as I was supposed to be monitored) suddenly got an urgent alert from a random blood test unconnected with osteoporosis saying that I had damaging levels of calcium in my blood (which can cause kidney stones).
Regarding accepting treatment from a GP, I would ask for a referral to, say, an endocrinologist (or consider paying a consultation fee if not possible through the NHS). Ideally we need to know the reason for the osteoporosis and treat that rather than the end result.
It is my understanding g that we are all short on magnesium so need supplementation and it is the magnesium which activates vitamin D to form calcium. Calcium supplements are not well absorbed. Do have a look at the well researched protocol on the group I suggested.
Hi everyone I had my first zoledronic infusion last June. I have only been taking 4000IU vitamin D. My next appt with rheumathologist is in April I am not in control with anyone (?) other than annual appt. Should the GP order for blood test before my appt and next infusion? I see that vitamin K2 has been mentioned … any advice will be much appreciated. This osteoporosis and treatment are scaring me big time . Thku so much
Hi I have had the same problem with vitamin D & C not being adequate so upt the dose so I could have the Zoledronic acid infusion. I put it down to winter days as not much sunshine. You do seem to need more vitamin D & C when on these drugs.
It’s good hear others are having the same problems. Take care.
Hi Simdo, You should hear from the hospital or wherever you have your Zoledronate infusion 6-8 weeks before the due date with blood test forms (that’s what happens for me after 2 doses now). You’re taknig a very high dose of Vit D (!) and would probably be better with a combined calcium, magnesium, vit D supplement like I suggested above. Mg is needed to activate Vit D which helps with calcium absorption from the gut which gets more inefficient as we age 
Vit K2 helps direct calcium out of the blood and into the bones so it’s a good supplement to take at the same time as your calcium supplement. I agree with Maryann that you seem to need high doses of calcium when taking bisphoshonoates partcularly as a large does annual infusion. I thought I could get enough from diet but it’s part of living with osteoporosis and really not a probelm to pop a supplement or two every day. Hope this helps/reassures. The helpline nurses may be able to give you more specific advice re: supplements or you could even ask GP for referral to a dietician to help you.
Hi, your comment caught my interest as I had calcium levels outside the normal range for the first time in my recent blood tests. It is only slightly over and I did not get an alert, but am concerned. Was you issue resolved and if so, how? I just need to figure out what questions I can ask my doctor. Thank you!
Hi Gala, My calcium levels were slightly below the normal range so I can’t help you with above the normal range…except to say don’t take a calcium supplement. Speak to your GP or the ROS nurses but I’d think a vit K2 supplement is a good idea to encourage all that blood calcium into your bones.
At the time, I was taking part in some research on the effectiveness of parathyroid treatment, I understand the parathyroid regulates calcium, which had been approved in Britain but was not yet available on the NHS. This was taking place at the osteoporosis department of an NHS hospital. I did think I would be monitored. However, as I said a blood test by the GP for another reason resulted in an alert that my calcium levels were much too high (and I was having some weird health experiences). I felt very let down, especially at the response of ‘if you do develop kidney stones, we can treat that).
It sounds that your levels are only just into high so you probably shouldn’t be alarmed but mine were a matter of concern and could have resulted in detrimental health effects, such as kidney stones.
Since my original diagnosis of ‘advanced spinal osteoporosis’ in 2006, I have learned that I cannot rely on any sort of monitoring. I now get a print of any blood test from my GP, then I can judge the results for myself. I have had regular instances of an exclamation mark appearing on the results to act as an alert but have always been told my results are ‘normal’. When I did question this, I was told that the department should just stop putting these remarks on the report.
If you are taking calcium, ask if you should stop or reduce it. I was given to understand that calcium supplements are not readily absorbed by the body and the better way is to help the body absorb calcium from the food eaten, eg with K2 and D3, K2 aiding the absorption of D3 as I understand it.
Don’t hesitate to ask questions. It is your body, your health and your future you will be trying to safeguard and, in my opinion, there is too much concentration on cure rather than prevention. For instance, I am having kidney problems at the moment but my NHS hospital tells me I am ‘not bad enough to be seen’. Hence my comment about cure rather than prevention.
Thank you everyone . All the information shared is ever so useful. Feel that you are not alone
Thank you for your detailed reply. Yes, I am going to discuss it with my doctors and for now I am going to stop taking the calcium supplement. I do try to take most calcium with food, but I find it challenging to reach 1200 mg sometimes. I am also planning to add K2 to my vitamin D. I did check how much K2 I consume with food and it appeared enough, so I did not supplement, but now will try to supplement and see if it helps. I hope your calcium levels are now within the normal range. I have an autoimmune condition for which I take methotrexate. You have to take folic acid when on methotrexate to prevent toxicity. Now, my folic acid blood levels are outside the normal range (too high), I believe it is because of supplementation, but my doctors are not bothered and I am not sure if this will also cause health issues down the line. It’s all really difficult to get your had around.
Yes I agree. Since joining this site very recently I am absorbing so much information re protecting my bones. It does feel like a minefield at times as I am still experimenting with bisphosonates, because of side effects, mainly muscle pain. Hopefully I will find one to suit!
I am not recommended to take vitamin K as I’m on anticoagulants. Is anyone else in this position and do you have any recommendations.
i’d like to know please
I’m in the same position, and would like to know