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Hello. I'm just about to start on Anastrozole following a mastectomy. I've also been prescribed a "Calci-D" supplement for my bones and have started a schedule of going out for a 30-45-minute walk every day. I've been taking cod liver oil capsules for a long time. There's no suggestion that I have osteoporosis but because of the Anastrozole, I'm due to have a bone scan in a couple of weeks.
Could you please suggest a diet which will help my bones during the treatment, please?
Anastrozole lowers the amount of oesotrogen in the body. Oestrogen helps your body take up calcium. This is why you are more at risk of osteoporosis.
Taking a Calcium and Vitamin D supplement helps to make sure that enough calcium is taken up by the body and vitamin D ensures that it is used properly for bone strengthening. Taking regular weight bearing exercise such as walking also plays an important role in strengthening bones.
As well as the supplement, it can be helpful to increase the amount of calcium and vitamin D you get through food. This diet sheet has a great list of foods high in calcium and vitamin D.
You are already doing really well with you supplement and walking so continue that, and see if you are able to include more calcium and vitamin D rich foods as part of a balanced diet.
Remember you can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or by email.
Thank you very much for all the advice. I was a bit confused by some information on the CALCI-D leaflet:
"CALCI-D with food and drink
Tell your doctor if you usually eat food that contains oxalic acid (e.g. spinach and rhubarb), phosphates (especially from food additives) or phytinic acid (whole cereals) since these may reduce the absorption of calcium contained in CALCI-D. Tell your doctor and ask for advice before taking foodstuffs which may be fortified with vitamin D." This sounds as though we shouldn't be having too much spinach or whole cereals or vitamin D! I have asked the breast care nurse about it and she's going to look into it.
I already take an unrelated daily supplement in the form of cod liver oil capsules with vitamin D added and I wondered if I should stop taking them because of the extra vitamin D.
Thank you again.
Oxalates (oxalic acid) and phosphate bind to calcium directly in the gut and reduce it's absorption. Phytinic acid also reduces mineral absorbtion. However, these are all present in essential healthy foods and make up part of a balanced diet so I would not advocate removing them from your diet. Instead, you could take your Calci-D supplement either early in the morning or late at night, (away from the times when you are likely to have consumed these foods) as this will keep these nutrients apart and promote good absorption of all of them independently.
The vitamin D statement will likely be to protect against accidental over consumption of vitamin D. This scenario is very unlikely as most people in the UK are vitamin D deficient. Unless your cod liver oil capsules contain an extremely high dose of vitamin D (over 10 micrograms) it is likely to be safe to continue.
Pharmacists tend to be the best sources of information when it comes to medications. Speak to the dispensing pharmacist when you get your prescriptions if you have further questions.
Thank you so much. That all sounds like very good advice. The CALCI-D leaflet suggests taking with the evening meal so I'll check that part with the pharmacist.
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