If you’re living with polymyalgia, your bones need extra attention—especially if you’re using steroids. Vitamin D helps you absorb calcium, and calcium is the raw material your body uses to keep bones strong. The right foods (plus smart habits) can do a lot of the heavy lifting.
Why bone nutrition matters in PMR
Prednisone and other glucocorticoids reduce bone formation and speed up bone loss. That’s why many people with PMR are advised to prioritize vitamin D and calcium from day one. Diet won’t replace medical therapy, but it can lower risk, support strength, and make every step of your treatment plan more effective.
How much do you need?
Most adults aiming to protect bone health do well with ~1,000–1,200 mg of calcium per day from food plus, if needed, a small supplement, and ~800–1,000 IU of vitamin D per day (sometimes more if your blood level is low). Your clinician may tailor these targets after checking your vitamin D level, kidney function, and fracture risk.
The 10 best everyday sources (with practical tips)
1) Fatty fish (salmon, mackerel, trout, sardines)
Fatty fish are among the most reliable natural sources of vitamin D. Canned salmon and sardines bring a bonus: edible bones that supply meaningful calcium. Aim for two fish meals a week; swap in canned options for a quick lunch.
Try this: mashed sardines with lemon and herbs on whole-grain toast; baked salmon over greens with a yogurt–dill dressing.
2) Fortified dairy (milk, yogurt, kefir)
Most dairy milks are fortified with vitamin D and naturally rich in calcium. Yogurt and kefir add gut-friendly cultures. If you’re watching sugar, choose plain versions and add fruit.
Tip: one cup of milk or ¾–1 cup of yogurt is an easy anchor for breakfast or a snack.
3) Fortified plant milks (soy, almond, oat, pea)
Prefer plant-based? Many brands add vitamin D and calcium to levels comparable to dairy. Shake cartons before pouring—calcium can settle.
Label-check: choose unsweetened varieties; look for ~20–30% daily value (DV) calcium and added vitamin D per cup.
4) Tofu set with calcium sulfate
Not all tofu is equal. When it’s calcium-set, a half block can deliver a significant portion of your daily calcium, with plant protein that pairs well with anti-inflammatory vegetables.
Pan-sear: cubes with garlic, ginger, and bok choy (another calcium helper).
5) Leafy greens you actually absorb (bok choy, kale, collards)
Some greens (like spinach) are high in oxalates that block calcium absorption. Bok choy, kale, and collards offer more usable calcium. Lightly sauté or steam to make big portions easy.
Add-on: toss chopped greens into soups, eggs, or grain bowls.
6) Eggs (especially the yolk)
Egg yolks provide a modest but steady amount of vitamin D, and eggs are friendly to many meal patterns. Combine with a calcium-rich side (greens, cheese, or fortified toast with nut butter).
Simple start: veggie omelet with a side of kefir or unsweetened fortified milk.
7) UV-exposed mushrooms
When mushrooms are exposed to ultraviolet light, they can contain meaningful vitamin D. Some grocery labels now specify “UV-exposed” or “vitamin D mushrooms.”
Roast and top: add to grain bowls or serve over calcium-rich polenta.
8) Canned salmon or sardines (with bones)
Worth a second mention because they do double duty: vitamin D from the fish, calcium from the softened bones. They’re budget-friendly and shelf-stable.
Mediterranean twist: sardine-tomato pasta with parsley and lemon.
9) Nuts, seeds, and tahini (almonds, chia, sesame)
These aren’t heavy hitters alone, but they accumulate calcium across the day, and their healthy fats fit an anti-inflammatory pattern.
Everyday habit: sprinkle chia on yogurt; whisk tahini with lemon for a quick dressing.
10) Fortified breakfast staples (oatmeal, cereals, orange juice)
Select fortified cereals or oatmeal packets with added calcium and vitamin D. Fortified orange juice can help too—just use modest portions to keep sugars reasonable.
Breakfast build: fortified oatmeal cooked with fortified milk, topped with almonds and berries.
Smart pairing: unlock more from what you eat
- Vitamin D helps your gut pull in calcium. That’s why combining, say, salmon (vitamin D) with a calcium-rich side (greens, yogurt sauce) works so well.
- Spread calcium through the day. Your body absorbs moderate doses better than one big bolus.
- Go gentle on salt and soda. Excess sodium and high-phosphate soft drinks can nudge calcium out of bones over time.
- Move daily. Weight-bearing activity (walks, light strength work) signals your bones to hold on to the minerals you’re feeding them.
What about sunlight?
Short, regular mid-day sun exposure can boost vitamin D, but skin type, latitude, season, and sun protection all matter. Because PMR treatment often spans months and seasons, many people still need a dietary source and, when appropriate, a supplement.
Prioritize skin safety and follow your clinician’s guidance — especially if you’re at higher risk for skin cancer.
Supplements: when and how (if your clinician recommends them)
Food first, supplements when needed. If your blood level of vitamin D is low or your diet falls short on calcium, your clinician may suggest targeted doses.
- Vitamin D: many adults do well with 800–1,000 IU/day, sometimes more for a limited time to correct deficiency. Levels should be re-checked.
- Calcium: if diet doesn’t reach ~1,000–1,200 mg/day, consider a small supplement to close the gap (calcium citrate is gentler if stomach acid is low).
Timing matters:
- Separate calcium from thyroid medication (levothyroxine) and certain antibiotics (tetracyclines/fluoroquinolones) by several hours.
- Space calcium away from iron supplements.
- If you take a bisphosphonate (e.g., alendronate), follow the empty-stomach instructions strictly, then wait before any calcium/food.
- Bring a complete medication list to your clinician or pharmacist to personalize timing.
A simple one-day bone-smart menu (mix and match)
- Breakfast: fortified oatmeal cooked with fortified soy milk; berries; sprinkle of almonds and chia.
- Lunch: salmon salad (canned) over kale and bok choy slaw with tahini-lemon dressing; whole-grain toast.
- Snack: plain yogurt or kefir; a few walnuts.
- Dinner: tofu-veggie stir-fry (calcium-set tofu, mushrooms—UV if available, and greens) over brown rice.
- Evening: herbal tea; if using supplements, take them at the times that fit your other meds.
Key takeaways
- You’ll protect bones best with daily vitamin D plus steady calcium, mostly from food.
- Fatty fish, fortified milks, calcium-set tofu, absorbable greens, and nuts/seeds are your everyday anchors.
- Spread calcium throughout the day and pair vitamin D with calcium to get more from both.
- Ask your clinician about blood testing for vitamin D and whether supplements fit your plan — especially if you’re on long-term steroids.
