NutriStack
Calcium and Prednisolone, a synergy.
Chronic prednisolone therapy accelerates bone loss and increases fracture risk, especially at higher doses or when used for several months. Calcium intake is part of guideline-based prevention for glucocorticoid-induced osteoporosis because steroids reduce calcium balance and impair bone formation.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Calcium and Prednisolone
- Pair type
- Synergy
- Evidence (highest tier)
- Strong
- Source citations
- 2 sources
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Strong evidence
Synergy
What is happening. Chronic prednisolone therapy accelerates bone loss and increases fracture risk, especially at higher doses or when used for several months. Calcium intake is part of guideline-based prevention for glucocorticoid-induced osteoporosis because steroids reduce calcium balance and impair bone formation.
Mechanism. Systemic glucocorticoids reduce intestinal calcium absorption, increase urinary calcium loss, suppress osteoblast activity, and increase bone resorption. Supplemental calcium helps offset negative calcium balance but does not replace fracture-risk assessment or osteoporosis pharmacotherapy when indicated.
Recommendation. Aim for total calcium intake of about 1000-1200 mg/day from diet plus supplements while on chronic prednisolone, unless your clinician gives a different target. Pair calcium with vitamin D status monitoring and osteoporosis risk assessment rather than using calcium alone as protection.
Sources (2)
- Humphrey MB, Russell L, Danila MI, et al. 2022 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Care Res (Hoboken). 2023;75(12):2405-2419. PMID 37884467
- Homik J, Suarez-Almazor ME, Shea B, Cranney A, Wells G, Tugwell P. Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database Syst Rev. 2000;1998(2):CD000952. PMID 10796394
Stack Score
How this pair moves the number.
Effect on the composite score
If both Calcium and Prednisolone are in the same stack, this pair applies +2 to your Stack Score (per scored synergy row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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