Q for MrsD or anyone- Vitamin D
 

Blood tests came back low on Vitamin D. Interesting also low on parathyroid. Doc said he did not knw if connection and this is an endo :eek:

Nutritionist said to take up to 5000 mg (?) of Vitamin D a day.

Is there a better form of Vitamin D?

ANd I saw this prescription Vitamin D - Rocaltrol? Any insight?

Thanks, I'll also do a search on it.

D3
 

you will want to use D3.

NatureMade and other good companies are now making D3 in 1000IU doses
over the counter. There are a few online places offering it in higher doses.

NOW has a version that is dissolved in oil. NatureMade is a dry tablet.
I just switched to NOW this week.(I suspect the oil version is better absorbed).
Fortunately it is not yet expensive.
This is the one I am using currently (2 perday)
http://www.iherb.com/ProductDetails....1&pid=543&at=0

CountryLife has a new one:
http://www.iherb.com/ProductDetails....333038146&at=0
2500IU

I don't know what to tell you about the parathyroids. They may get better with the D3. Many people develop a secondary hyperparathyroid issue, so it is good you don't have that.

This site explains more, but be aware it is confusing at first.
http://www.parathyroid.com/low-vitamin-d.htm
The fact that your parathyroid is low, is probably a "good thing".
The gist is that you should have a serum calcium drawn after your D3 levels normalize just to be sure.

The relationship--
 

--among calcium (and other minerals, especially phosphorous), the parathyroid and vitamin D is very complicated.

In short, the parathyroids regulate the amount of calcium in the body--specifically in serum--within a very narrow range (it's really their sole function). They secrete parathyroid hormone when they sense that calcium levels are low, drawing calcium from bone into the serum. But the hormone also has the effect of activating Vitamin D, which increases calcium absorption from the small intestine and also promotes calcium re-uptake by the kidneys.

High levels of calcium--or high intake of Vitamin D--will generally cause the parathyroids to become relatively dormant, producing less hormone. Many factors, including tumors, can casue overproduction of hormone (much more common than underproduction); this raises calcium levels to high, which has many deleterious effects such as the formation of kidney stones.

High serum calcium in the absence of higher parathyroid hormone levels usually points to a breakdown of bone and prompts a search for bone. cancers, although really high calcium and Vitamin D intake can casue this too. There is a category of people who are genetic "super absorbers"--activated Vitamin D, even in moderate amounts, promotes increased levels of calcium absorption for them. Parathyroid hormone levels in such people generally stay low as part of the feedback loop.

It seems, though, that Vitamin D deficiency is far more common nowadays. This has the effect of causing the parathyroids to release hormoone to keep calcium from falling too low, and in the absence of enough Vitamin D activated calcium being absorbed from diet, this calcium is leached from bone, leading to osteopenia/osteoporosis.

Take a look at this stuff--complicated, but interesting:

http://www.emedicine.com/ped/topic1062.htm

http://www.emedicine.com/med/topic3729.htm

My mom has low d and osteoporsis and she is on a prescribed med once a week I think for 6 months. Did your doc talk about this?I would ask? Do you have osteo or just low d cause I have ok d but osteo and my mom has both. No idea why I ask but I guess for overall treatment.

Hi. I'm hypothyroid so have been on Calcium w/D supplement for years. Started researching more about vitamin D3 (aka Cholecalciferol) after my MS dx because there is a suspected connection.

I started supplementing with vitamin D3 and as indicated above in a post above, it sure seems that in the general population, a deficiency is more common and goes undetected. I know that there has at least been some discussion about the RDA being officially raised.

When dosing with vitamin D3, the amount that most consistently comes up is 4,000 IUs daily although in the summer months (or if you live in a sunny climate year round) this should be reduced to 3,000. I have also read accounts from people who are taking 50,000 IUs (!) once a week on advice of their doctors.

Too much vitamin D can be toxic so my endocrinologist tested my level and liver function last week. I asked him about that 50,000 IU megadose I've read about some people taking and he said that they're finding that if it's spaced out like that (once a week) there doesn't seem to be the same problems with toxicity.

If you are supplementing, please let your doctor know so that they can check your levels and liver function. Vitamin D3 is really interesting because it actually functions in the body like a hormone. I use Jarrow -- they're little gelcaps and pretty inexpensive.

I'm happy to be here -- I am so impressed by what I've read! You guys sure know a lot and it's a breath of fresh air for me! Hope you don't mind me chiming in. :)

Thanks Mrs D. The one in oil looks appealing and I agree maybe better absorbed!

I too found it intersting that my parathyroid level was low. And the calcium was normal but the Vitamin D low. The real interesting thing is that the parathryoid is 1/2 of what it was on the last blood test.

Vit 2 25-Hydroxy 26.1 (range 32-100) Last time was 35. Doc wants up near 70

Calcium 9.5 range 8.5-10.6 (last test was 9.4) n/c

Parathyroid 17 (range 12-65) last time was 38.

Glenn thanks for the articles, fascinating stuff. Intersting, that my calcium is not that high but PTH is low.

Maybe it was a fluke. If the Vitamin D was not low I would say maybe I am absorbing better.

Someday I will get my biochemistry degree frm NT and understand everything. :D

Thanks I am off to get some Vitamin d

I have some doubts about the
 

50,000 IU all at one time once a week. Our bodies are not designed for that flood of D all of a sudden. We are biologically designed to have D come in smaller amounts. There are carrier molecules that move the D around, and they become saturated, and the excess is stored, where it may not be released.
Everything in our system has carrier limits.

Here are some links to read:
http://www.vitamindcouncil.com/vitaminDToxicity.shtml
This one quotes the RX ergocalciferol as toxic when used inappropriately.
That is D2.

This is a very complete paper that discusses toxicity and risk:
http://www.ajcn.org/cgi/content/full/69/5/842
It is long but worth it.

The data on D is changing rapidly.. I am sure we will see much more detailed recommendations in the near future.

Thanks for the info. mrsd! I haven't looked at the links yet but I certainly will. I'm not doing it myself; I just asked the first doctor I saw after hearing about this because knowing that too much can be toxic, this stumped me. There are at least 3 people with MS whose doctors have prescribed this for them. I will direct them to your post so that they can look at the links as well.

Two more question about D, if you don't mind. I believe that both the liver AND the kidney are implicated in converting the vitamin, correct? If this is the case, when checking for toxicity, should the kidneys be checked as well, or just the liver?

Also, if the problem in low levels is determined to be absorption, could the underlying problem in fact be something to do with the kidneys or liver?

try this article...
 

It explains the metabolism of Vit D.

http://www.merck.com/mmpe/sec01/ch004/ch004k.html

This is a difficult subject because the past studies have been confusing.
This is why I gave you Dr. Vieth's paper.

The D used by doctors in that shotgun high dose is D2, and it has a different
potency (about 1/2 as useful as D3) and more toxic potential than D3, which appears to be more useful.

There are a very few online sources for D3 in 50,000 units but I prefer to not post them. I think it is best to get tested first.

Like other metabolic disorders, hyperparathyroidism, and errors in D metabolism are not easy to understand. I don't expect doctors have a good handle on it yet. They are testing, but I am not convinced they are treating properly.
I saw all kinds of doses all over the place in the nursing home provider I used to work at.

I would suggest that people reading here, simply ask their doctors what is the difference between RX D they are offering and D3 over the counter. The answer to that question will reveal their ability and understanding.;)
If they tell you their RX is better... well... that is disappointing right there!

Ah, that's helpful -- and possibly a bit of a relief, too! I'm fairly certain that the 50,000 IUs I read about (from these MS patients) are in fact just D3 but it never hurts to double-check both the RX, ask about the difference in relationship to over the counter and investigate potential toxicity further.

Thanks again!