NutriStack
Prednisone and Vitamin D3, a synergy.
Prednisone impairs vitamin D metabolism and reduces its active form (calcitriol) production. This contributes to decreased calcium absorption and accelerated bone loss. Vitamin D supplementation is considered essential during chronic corticosteroid therapy to maintain bone health.
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
- Prednisone and Vitamin D3
- Pair type
- Synergy
- Evidence (highest tier)
- Strong
- Source citations
- 4 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. Prednisone impairs vitamin D metabolism and reduces its active form (calcitriol) production. This contributes to decreased calcium absorption and accelerated bone loss. Vitamin D supplementation is considered essential during chronic corticosteroid therapy to maintain bone health.
Mechanism. Prednisone reduces 1-alpha-hydroxylase activity in the kidney (impairing conversion of 25-OH vitamin D to active 1,25-dihydroxyvitamin D), increases vitamin D catabolism via 24-hydroxylase induction, and antagonizes vitamin D receptor signaling in the intestine, reducing calcium absorption.
Recommendation. Take vitamin D3 (1000-2000 IU/day) while on chronic prednisone therapy. Higher doses may be needed based on serum 25-OH vitamin D levels. This is guideline-recommended for preventing corticosteroid-induced osteoporosis.
Sources (4)
- Buckley LM et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids. Ann Intern Med. 1996;125(12):961-968. PMID 8967706
- Zhang Y, Fang F, Tang J et al.. Association between vitamin D supplementation and mortality: systematic review and meta-analysis.. BMJ. 2019. PMID 31405892
- Chang MC, Choo YJ. Effects of Whey Protein, Leucine, and Vitamin D Supplementation in Patients with Sarcopenia: A Systematic Review and Meta-Analysis.. Nutrients. 2023. PMID 36771225
- Fiamenghi VI, Mello ED. Vitamin D deficiency in children and adolescents with obesity: a meta-analysis.. Jornal de pediatria. 2021. PMID 33022267
Stack Score
How this pair moves the number.
Effect on the composite score
If both Prednisone and Vitamin D3 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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