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Patricia asked...

As I have an under performing thyroid and high cholesterol I am trying to eat a diet rich in wholegrains...

As I have an under performing thyroid and high cholesterol I am trying to eat a diet rich in wholegrains (muesli for breakfast, granary bread for lunch) so I've been taking Adcal mid-morning to avoid a clash with phytic acid. However I notice that the instructions are to take it with meals. Why is this? Is it less readily absorbed on an empty stomach? Grateful for your advice.

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The answer

Adcal-D3 is a brand of tablet that contains calcium and vitamin D3, both essential for healthy bones and teeth. Adcal-D3 is offered to people who require more calcium and vitamin d3 to prevent conditions like osteoporosis or for those not getting sufficient amounts from their diet. Certain foods containing oxalic acid (spinach, rhubarb etc), phosphate or phytic acid (seeds, nuts, soy etc) may reduce the absorption of calcium.

Look for foods that contain calcium and Vitamin D to boost you own dietary deficit or are known to aide their absorption – such as eggs, butter, fatty fish, milk and orange juice. Hot chocolate (with milk) in evenings as you desire should be okay. If you’d like to try an alternative drink at bedtime, you may opt for chamomile tea which has been known to have calming properties.

Safe foods for consumption within the two hour Adcal-D3 administration period are obviously going to be those that do not contain oxalic acid, phosphate or phytic acid. Avoiding seeds, nuts and leafy green vegetables would minimise oxalic acid and phytic acid exposure. Suitable foods for bedtime snacks to prevent hunger include jam, honey, bread, pears, plums, peppers, crackers and cream cheese.

Another solution would be to amend the time that you take Adcal. For example, if you normally eat breakfast at 8am, it would be better to take Adcal nearer 10am or Adcal immediately upon waking. At night, have an early dinner at 6pm, then take the medication at 8pm, and have bedtime snacks at 10pm.

There is no cautionary advisory label exert in the British National Formulary, nor is there any reference to taking Adcal with food on either the summary of product characteristics or the patient information leaflet so on this basis it can be taken independently of meals.

Answered by the Health at Hand nurses