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Plaquenil Depletes Vit D?!?

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Old 09-29-2007, 04:48 PM   #1
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Exclamation Plaquenil Depletes Vit D?!?

I just started on Plaquenil on Thursday after months and months of putting it off. I have a positive ANA and SSA but no definite symptoms of Lupus (rashes, joint pain, mouth ulcers, etc) just muscle pain and fatigue. Anyhow, Rheumy is retesting several antibodies to see if anything has changed and suggested I go on Plaquenil and see if I get any relief. She says I have all signs of Fibro and that may actually be causing me more distress than the antibodies. Anyhow, I was researching to see if Plaquenil interferes with any vitamins or supplements since I take quite a few and read several articles on how Plaquenil depletes Vit D and Calcium. Well, not such good news since I am Vit D deficient (only borderline now with supplementation) and just found out I'm hypoparathyroid. I'm definitely going to ask my Dr. about this next week but just wondering if anyone else had heard of this. Well, the good news is I have noticed zero side effects with this medication but I'm only on 200 mg. because of my weight (104 lbs).

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Old 09-30-2007, 03:01 AM   #2
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Re: Plaquenil Depletes Vit D?!?

Laura, Hello. I've read steadily, but I haven't seen anything about either of your concerns. The most detailed info about Plaquenil I've seen is in several lupus hardcovers: one by Dr. Daniel Wallace, and the other by Dr. Robert Lahita. Most libraries & larger bookstores have one or both.

Many people with lupus are vitamin deficient & some are flat-out anemic, due to chronic inflammation. I was, but my numbers improved over months after I started Plaquenil. As for calcium, I think I've probably always had trouble storing it, and osteoporosis certainly runs in my family. I've taken Fosamax for some years now & have an annual bone density test (and I'm now holding my own bone-wise.)

I was also positive for SSA. I had rashes (for years), photosensitivity, and numerous other episodic problems. I was Dx'ed with the SCLE subset (= subacute cutaneous LE). Like many people positive for SSA, I'm very photosensitive, so I can't do sun & get its Vitamin D benefits. You may want to ask your rheumie about sun exposure, too, just to be sure.

I started on 200 mg of Plaquenil 2x daily, and I weighed then about what you do now. I had multiple blood values off, severe rashes, and many other things going on; and I was happy to take Plaquenil instead of steroids. I was cut back to 200 mg daily after about 16 months, when my blood values had improved.

Also, I wonder if your rheumie is also considering the possibility of Sjogren's syndrome, the other condition in which a positive SSA is seen? (Just curious.)

I hope your rheumie addresses all your concerns & that you feel better soon. Good luck & take good care, Vee

Old 09-30-2007, 03:25 PM   #3
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Re: Plaquenil Depletes Vit D?!?

I did a search for Plaquenil and Vitamin/Supplement interactions and that is how I found the information. It may not be anything serious enough to be concerned about I just worry because I am deficient already. I will ask my Dr about it and see what she thinks. My Vit D and Calcium levels are still being monitored so I guess we'll see if anything changes with the Plaquenil.

As far as being photosensitive, I don't think I am. I don't feel any worse in the sun and I don't get any rashes with sun exposure. My Dr. did consider Sjogren's but I do not have any of the symptoms (well, except for the non-specific symptoms of fatigue and muscle pain). I guess whatever I have is just in the very early stages. Hopefully, taking the Plaquenil now will keep it from evolving into something worse. It's really going to be a waiting game. I should get the test results for the antibodies this week. I know she was retesting my complement levels, Anti-Smith, and the several others.

Take Care!

Old 09-30-2007, 04:48 PM   #4
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Re: Plaquenil Depletes Vit D?!?

Hi, Laura. Later I found something along the lines of what you describe, but I didn't recognize the authors of the findings & thought that the article was possibly a sales pitch...? (Not sure...) The rheumie/authors I listed are considered mainstream and are "big names" in the field, for what that's worth.

FYI, Plaquenil can take upwards of 4 months to reach its full effect.

Your rheumie sounds very together, by the way. I'm smiling over that, because I meandered from dr. to dr. while covered with bizarro rashes, and STILL none of the suburban dermies or rheumies (etc.!) I saw recognized an SCLE annular-type rash, so none believed I had any form of lupus, even after multiple telling skin biopsies. You may have hit the rheumie jackpot? Anyway, take good care. Sincerely, Vee

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