Get Enough Calcium

Many people with MS are at risk for osteoporosis. If you are taking corticosteroids or are less mobile (using a wheelchair or confined to bed), you are more at risk for this condition that usually occurs later in life. Be sure to talk to your healthcare provider about having your bone density checked and taking prescription medicines for preventing or treating osteoporosis if necessary. You can decrease the risk by limiting alcohol intake, quitting smoking, doing weight-bearing exercise (like walking, dancing, or stair climbing), and taking in an adequate amount of calcium. Depending on your age, the recommended daily intake of calcium is between 1,000 and 1,300 mg per day, the amount in three to four 8-ounce glasses of low fat milk per day or the equivalent, so be sure to include milk, yogurt, and cheese often. If you are lactose intolerant, you can choose lactose-free dairy products or try Lactaid pills. Calcium-fortified soy milk is another alternative. If you don't like milk:

• Whip up a shake with fruit and milk or fruit and yogurt.

• Add grated cheese to your pasta, soups, and vegetables.

• Include a toasted cheese sandwich or a slice of pizza as one of your meals or snacks.

• Have fruit and cheese and crackers for a meal or snack.

• Cook your oatmeal with milk in place of water.

• Cook canned cream soup with milk instead of water.

• Choose pudding or ice cream for dessert or a snack.

• Choose dark green, leafy vegetables like kale, collards, broccoli, or turnip greens often.

• Eat the bones in canned salmon or sardines. (Never eat the bones in fresh or frozen fish!)

• Choose calcium-fortified juices—drink a glass every day.

While food is the best source of calcium, if you do not include the recommended number of servings on most days, speak with your healthcare provider about taking a calcium supplement to supply the difference.

• Take no more than 500 to 600 mg of elemental calcium at one time. This is the amount your body can use at one time.

• If you choose a supplement of calcium carbonate, such as Tums® or Caltrate®, it will be best used if taken with a meal, but not with a high fiber meal. Calcium should not be taken at the same time as iron or with any medication to be taken on an empty stomach.

• If you choose a supplement of calcium citrate, such as Citracal®, it can be taken any time without regard to food, medications, or supplements.

• Be sure to get enough vitamin D with your calcium, but not too much—a total of 400 to 800 IU for the day.

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