Has your doctor suggested dosing for Calcium and Vitamin D during ADT?

jime51,
bone loss is an expected consequence of ADT. It is thought by some that high doses of D3 can prevent some bone loss. https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.35275#:~:text=A%20phase%202%20randomized%20controlled,formation%2C%20and%20resorption%20were%20measured.
Some doctors recommend a bone density test DEXA before beginning ADT and periodically during use, or after use. Some are prescribed anabolic osteoporosis medication, but only after any scheduled radiation.
Best wishes for your health.

Neither my radiation oncologist nor my medical oncologist recommended Calcium or Vitamin D during my radiation+ADT treatments. They both told me that bone density loss can occur as a consequence of ADT, but not to jump the gun treating on the possibility.

I had a baseline DEXA scan on 3/31/2021 prior to my starting 6 months of Eligard (two 3-month injections) and 28 proton radiation sessions.

I had a follow-up DEXA scan two years later (4/10/2023). Results were:
> right hip bone density decrease of 9.7%.
> left hip bone density decrease of 10.2%.
> both still within normal range.

I had another follow-up DEXA scan two years later (6/13/2025). Results were:
> no significant change since the 4/10/2023 study.

As with most everything related to prostate cancer, I try to let the numbers guide my diagnostic and therapy decisions.

(Expect the best; have a plan in place for the worst.)

When I did 18 months of Lupron, my urologist suggested I do the supplements...I did,

Funny thing, he did not do a bone density scan to establish a baseline.

Knowing what I do now, I would have told him to place the order...

When I did 12 months of Orgovyx, I asked my oncologist about the bone density test and supplements.. He looked at me, said, you work out five to seven days a week, do resistance training, swim, ride your bike, ski, hike in the mountains, walk....you can take the supplements but nothing in your clinical data or health history is indicative of needing them. So, I didn't.

He did order a bone density scan, results were normal.

"CONCLUSION: Based on the World Health Organization Guidelines, Bone Mineral Density values show normal density in the lumbar spine and proximal femurs. "

"FRAX Assessment: Not reported, as all values are in the normal range and the patient has a history of fracture."

So, my thoughts, while bone strengthening supplements are "normal" while on ADT, follow the clinical data.

as @brianjarvis says, "As with most everything related to prostate cancer, I try to let the numbers guide my diagnostic and therapy decisions..."

My experience though, maybe an outlier

Kevin

I haven't been at this long (March 2025), but none of my docs (urology, oncology, cardiology, radiology) have mentioned any additional supplements. It's entirely possible that since I have been taking D3 for years, they felt it unnecessary though. I'll ask the next one I see.

Have your calcium checked by a blood test. I have to take 500 mg of calcium citrate three times a day to keep mine up. You are taking plenty of vitamin D.

Yes

My urologist (and also a family member who is a MD) strongly recommend calcium and D supplements for prostate cancer patients even after ADT and other treatments.

I just had my 3 month post-radiation checkup and was told I needed to see endocrinology for bone loss. DEXA showed >3% risk of hip fracture, and the BMP shows low calcium, in spite of me taking 1200mg calcium citrate and 800IU of D3. I believe most bone loss was prior to the cancer treatment, but prior DEXA wass 6 years ago.

When you take calcium, you can’t take more than 500 mg at a time, anything more is just thrown away by your body. I need to take calcium citrate three times a day, 500 mg each time. That finally raised my calcium above the minimum for normal.

A bone doctor at a recent conference discussed the fact that anybody on ADT has to be on bone strengtheners. I was on Fosamax for six years and I am now on Zometa. That’s kept my bones strong enough that If I fall I don’t break them. I’ve tested it a few times, Not intentionally.

My doctor has never suggested this and I haven’t really asked. When I went on ADT in early Aug ‘25 I started taking calcium citrate based off of suggestions in this support forum.