Hi. Good job for taking th initiative to be healthier in ways you can. I am trying to do that as well. For me I either had a junk food diet or anorexia diet so I am also trying to be healthy all around with hopes of it helping my pain and healing. I am thinking though it takes time and though 3 months is awesome it may be slow changes but in the long run you will see a difference.Mrs D stated the magnesium and I take that as a supplement and have read it helps many. I do have a ? on the potassium and vitamin e I heard these you can overdo in supp is that true? What is a safe amount to take and is vitamin e a good supp to take? That is something I may be low in but potassium I eat cantalope and other fruits/veggies with it. I started eating cantalope because it has more then a banana who would of thought it. The only thing I could add and I don't know your actual diet but also to include healthy fats so you can absorb the nutrients and also it aids inflammation and can help I would think the skin.

Hey everyone,

I've been lurking on the forums ever since I registered but haven't really posted since I started this thread.

However I now find myself in the midst of a vitamin related problem and wanted to ask your opinion and advice. Basically about a month ago I started feeling very tired, with pretty bad muscle pains and muscle cramps. I went to the doc and he did a cbc and checked my potassium levels and lo and behold I was anemic and with a potassium level of 1.7 (the range being 3.5-5.0). My potassium supplementation was increased and more tests were ran to check if the anemia was iron deficient or not, which it wasn't. Now, the muscle pain and cramps stopped with the extra potassium but the docs ran pretty extensive tests to check for other vitamin levels and it turns out my b6, b12, b9 levels are incredibly low, my vitamin d levels have crashed to a mere 5 (with a range of 50-80), my homocysteine levels are at 30 (with normal levels being below 10), my magnesium levels are low, but calcium levels are pretty high (at 20 with normal levels being anything below 9). Also my albumin/globulin ratio is elevated, my tsh is at 3.9 but my free t3 is elevated and my free t4 is normal (so really what in God's name is my thyroid doing...!!!), my cholesterol is very low and I'm still mildly neutropenic.

I realise that's a lot of information and thank for bearing with me so far!

My docs basically said that there's a chance I'm not absorbing nutrients and wanted to admit me to hospital for yet another series of endoscopies (I'm still undecided about that) but in the meantime they want me to increase my b12, b9, b6 supplement dose so we can bring the homocysteine levels down, they've started me on vitamin d pills and a magnesium supplement. However they really don't know what to make of the thyroid tests and don't really have a long term "plan of action" vitamin wise if my endoscopies are ok yet again. I generally follow a pretty healthy diet and though I don't really eat meat (other than chicken once in a while) I do eat fish and cheese.

Basically I'm wondering if there's anyone here with similar vitamin deficiencies and/or anyone with any ideas on what to do about all this?

Hope you're all doing well!

Ziggy

I have one major suggestion about poor absorption:

The scoping is to see if you have frank damage to the lining of the stomach and intestines. But it will NOT show gluten intolerance per se. The blood tests for this would be better and more revealing. There is also a stool test by Enterolab that can reveal intolerance.

http://neurotalk.psychcentral.com/thread115630.html
and
http://neurotalk.psychcentral.com/thread115919.html

jccgf has a website called The Gluten File:
http://sites.google.com/site/jccglutenfree/

This can be helpful too.

Don't hesitate to post on that forum here and ask further questions.

I would also recommend the activated forms of B6, B12 and folate if you can get them where you are.
Methylcobalamin
Methylfolate
P5P (for B6)

iherb.com does ship to some European countries.

Some people have genetic failures in converting the vitamins in pills to the active forms in the body. The RX vitamin Metanx has all 3 active forms, but I don't know if you have it where you are.
Some doctors don't know about "activated" vitamins, and assume all pills are used equally by everyone, and that is not true.

Your calcium may be high due to the low magnesium and low D possibility. You need a test for D.
The calcium may become normal after you get things balanced.
Magnesium is needed to get calcium into the bones. If you are low the bones are giving up calcium to the blood to help run the heart and nervous system. Vit D enables absorption from supplements and food. Low D means poor absorption, so the bones get robbed.

That homocysteine is dangerous... it can lead to stroke or heart attack. So your focus should be on that first, and Vit D levels.

Mrs D,

Thank yo so much for your reply!!!

The iherbs website is really very cool and with incredibly reasonable prices!!

I do take methylcobalamin, but I didn't know there were activated forms for b6 and folic acid too! I have been taking health aid's b6 and solgar's folacin and I think they're just pyridoxine and folic acid vs the activated forms of the stuff... I'm in the UK at the moment so I don't think Metanx is an option but I ordered methylfolate and solgar's p5p from iherbs today so that will hopefully help!

What you said about the calcium and vitamin d/magnesium connection is incredibly interesting! My vitamin d level was 5, with the normal range being 50-80 for the lab. The doc I saw said it's a pretty low level and that I should take 2000 IUs per day in tablet form for a while. He didn't tell me which ones to get brand-wise but the pharmacist suggested vitabiotics D3 tablets; so I hope they're ok... If that, combined with the low magnesium, is causing the high calcium it would be absolutely fantastic as it's fixable at least! Thank you for explaining the different tests for celiac and for the links; will need to look at them in detail pretty soon!

Ziggy

Hi, Ziggy...

I think the Vit D liquigels D3 5000 units would be better for you.

The rate of improvement for D blood levels is 1000IU gives about 10ng/ elevation. At 2000IU you won't get near normal.

The liquigels I think are absorbed better.
iherb has NOW brand very inexpensively.

Keep an eye on the calcium levels... Taking D you should be tested for the calcium every 3 months or so.
Some people get hypercalcemia when on D for a long time, and since you don't know what is really causing yours, just keep an eye on it.

Hi everyone,

When I last posted here a couple of months ago, I mentioned my vitamin d levels were very low (at 5 with a normal range of 50-80), I had slightly elevated calcium levels, low b12, b6, b9 and elevated homocysteine. After talking with my docs (and being informed about activated forms of b6 and b9 here!!) I began taking daily vitamin d capsules at 5000 iu and daily b12, b6, b9 tablets (the activated form) in hopes of increasing my vitamin d levels and lowering the homocysteine ones. Well my b12 levels have increased ever so slightly (still below normal though) but unfortunately my homocysteine does not seem to want to respond to the b6, b9, b12 and has increased even more these last few months... The vitamin d is even lower than it was three months ago (at 2 now which is rather mad with all the capsules I’ve taken....), my calcium levels have gone up and now my phosphorus levels have gone up too. The docs seem to think this indicates hyperparathyroidism secondary to the low vitamin d.

To top this off my ferritin levels have crashed, my red blood cells, white blood cells and platelets are down and I’m feeling rather exhausted... The doctor’s plan this time is basically as follows: Epoetin alpha injections to get the red blood cells and haemoglobin levels up, neupogen shots for the white blood cells, interferon to maybe help calm down the misguided immune system that they think is causing all this trouble, oral ferrous fumarate supplements for the iron and if I don’t respond to that iv iron dextran again and injectable vitamin d (I think the shot is called Calcijex though I may be spelling it wrong) to the tune of 600,000 iu to help replenish vitamin d stores. On top of all this they’ve also put me back on heparin as they’re worried the homocysteine elevation combined with my clotting tendencies/history can’t lead anywhere good...

My reasons for posting here at this point are two-fold. One I wanted to ask a question I can’t seem to get a satisfactory response from my doctors about re the vitamin d injections; I read (online but still...) that injectable vitamin d should not be given to people with hypercalcemia (like I have now, granted probably because of low vitamin d but...). Now my docs seem to think that because the hypercalcemia and hyperphosphatemia are due to the low vitamin d, that they will correct themselves when vitamin d stores are replenished but I still wanted to ask if anyone here with low vitamin d (and maybe even with high calcium and/or phosphorus levels?) has had vitamin d injections? And if so, how did it go? And two I wanted to ask if anyone has any idea and/or experience with homocysteine levels that just won’t respond to b6, b9, b12 daily supplementation (the activated forms)?

Thank you for reading this! Hope you're all doing well!

Ziggy

did you f/u on the celiac angle?? going gluten free is sounding better and better.....http://www.ncbi.nlm.nih.gov/pubmed/18569985

Puzzling:

What doses of the vitamins were you taking? And how were you taking them?

It sounds like you have an absorption problem.

This is the injection information:
http://www.medicinenet.com/calcitrio...le/article.htm

When Vit D is so low, you cannot absorb calcium from food. The parathyroid then sends out signals to rob your bones of calcium and this sometimes overshoots and raises calcium in the blood temporarily. This is probably what your doctors are thinking.

You may need megadoses of P5P, methylfolate and methylcobalamin. If there is serious inflammation of the small intestine, absorption will be blunted for everything you consume. You may have to get your Bs by injection too.

Have you had your kidneys tested? Elevated phosphate sometimes signals kidney trouble.

Pabb and Mrs D, thank you so much for replying to my long and rather strange post!

I have been tested for celiac, blood tests and GI biopsies, in 2007, and everything was negative. My docs are considering the possibility of re-testing though given the present circumstances...

Mrs D , thank you for the vitamin d explanation (and the injection link!); I think I hadn’t understood exactly how vitamin d interacted with calcium. I think I got it now though!

Re the vitamins:

I take vitamin D3 softgels to the tune of 5000 IU per day

Methycobalamin (2000 μg per day) with 50 mg b6 (the activated kind, p-5-p) and 800 mcg folic acid (the activated kind again l-methylfolate-metafolin); I don’t eat or drink anything an hour before I take the b vitamins and a couple of hours after as I was told that can hinder absorption of b vitamins.

I also take evening primrose oil and omega three fish oils as my essential fatty acid levels were practically nil upon testing and spironolactone for the hypokalemia. The iron supplements I’ll start taking this week.

My kidneys are ok, leaking protein and blood, but urea and creatinine are fine; the only slightly strange thing being that the urea level is well below normal but I was told that might have something to do with decreased protein levels in the blood (and they were also very low on testing) rather than kidney function.

Would the megadoses of P5P, methylfolate and methylcobalamin you mentioned be higher than what I’m taking now? Yes, injections have been discussed but they would have to be Neurobion injections and they have cyanocobalamin vs methylcobalamin (and if I had to guess I’d say they probably don’t have the activated form of b6 either) so I don’t know if that would be wise....

Ziggy

Gosh, I have no idea how kidneys can be fine when you are losing protein and red blood cells! Infection, inflammation and nephrotic syndrome all cause that.

I don't think there is anything further I can suggest. Your situation is confusing and something is wrong somewhere.

You'll have to rely on your doctors to find out why you are not responding to oral vitamin supplements. I hope they figure this out quickly, for you too!

If you are not absorbing D, and B's you are probably not absorbing other things too.