Letrozole and vitamin D

Oh yes should add I am due to have a bunch more bloods taken before starting zolenodronic infusions, guess that’s normal 

Following my dexascan I received a letter from the breast surgeon suggesting that I might want to think about taking Vitamin D and calcium supplements and to speak to my GP. He said taking Vitamin D was a no-brainer, that he did so himself. Regarding the calcium; he said that it used to be the case that everyone on Letrozole was prescribed calcium supplements. There is now new thinking. Too much calcium is apparently associated with a higher risk of kidney stones and has cardiac implications. He sent me a link to calculate my weekly intake of calcium. If it was above a certain level I had no need for supplements. He said if I needed Adcal he could provide it on prescription. If, however, I only needed Vitamin D he was not able to prescribe - I would need to buy it myself. He didn't say why that was the case. I'm 71 so there was no question re: free prescriptions. I asked if he could do a blood test to estimate calcium and vitamin D levels. He said the tests were not reliably accurate. I have been on Letrozole now for four months and no-one has suggested a blood test. The last one I had was in January when I was first diagnosed. I do wonder about the lack of monitoring on Letrozole. I've been watching my blood pressure slowly creeping up and it occurs to me that if I was not keeping an eye on it, no-one would know. 

Hello, I am 71 too and was prescribed vitamin d from my GP. You shouldn't have to pay, well not down here anyway x

Thanks for that Snozzle. I'm in Warwickshire. Do you think it's a post code thing? Or maybe GP policy? I bought from Tesco and three for the price of two packets still cost me £10.00. 

Hi, I was prescribed Calcium along with letrozole and I choose to buy them from Boots and they are the Calcium and Vit D max (the prescription ones were chewy and tasted disgusting)

I am 6 monthly Zometa infusions, so get my bloods monitored due to these, but I agree, there is really no monitoring on letrozole. During a medical at work I discovered my cholesterol has gone high, and I read this is a side effect of letrozole, but I really found this all out by accident and my own research. When I went to my GP about the cholesterol, he was actually really supportive, but I do think the NHS struggles to have the resources for good follow up. 

Hi Dulciana , I would definitely follow up on the dexa scan as well. I had one shortly after starting on Anastrozole (similar to letrozole) because both of these medications can cause bone thinning. My scan showed mild osteopenia (precursor to osteoporosis) which at my age then (59) wouldn’t be considered that unusual but as I’m on Anastrozole I was advised to take calcium and vitamin D. I take a Vitabiotics one which I pay for but I could get it prescribed free, just not that brand. As someone else has said, it’s not generally recommended to take calcium unless you need it. But in my case the combo of osteopenia and anastrozole means I should. The dexa scan should then be repeated every 2 years if you are shown to have osteopenia or osteoporosis. There are often waiting lists for dexa scans here, don’t know how it is in Scotland. I’ve now had 3 and the last one showed some worsening but apparently not enough to need treating with bisphosphonates. I’m due another next summer so I’ll be asking my GP to request it soon to allow for waiting! It was my oncologist who requested the first one, at the same time as he prescribed my first month of Anastrozole. Thereafter it’s down to my GP for both. Again, might be different in Scotland! Sorry such a long ramble I do blame Anastrozole for my wittering! Xx

Hi HappyFeet1.  I've just had a chat with my GP, who said that I should be taking vit D, at a daily dose of 10mg.  I'm surprised it's as low as that, as I thought the shops sold packs of 25mg tablet  Now I'm wondering what other people are taking

Further to my blurb below, HappyFeet1, I'm now on the waiting list for a Dexa scan, thank goodness. 

Dulciana

Hi, it’s 10 microgrammes (mcg), which is equivalent to 400iu of vitamin D, I think. I am prescribed 1600iu a day of Vitamin D3 (by the oncologist originally) as I was found to have low levels. 

Hello, have a word with your GP x