Vitamin D Deficiency

I had my surgery back in 2009, and I have lost 289 pounds since, still have another 70 I'd like to do but possibly not realistic without some more plastic surgery.  

My numbers in most respects are great (had raging diabetes, now perfect A1C, perfect cholesterol, almost all my vitamin screens are good, slightly low calcium), but my Vitamin D is a shocking 4 and nothing my doctor is doing for it seems to be working. Right now I am on 50,000 units of Vitamin D by prescription 3 times a week but I do not feel confident that will solve it. I need some advice from those who have gone through it and suggestions of best supplements to work this out on my own along with doctor's efforts. 

The prescription D is useless to us because the D is immersed in oil inside of the capsule and we malabsorb it at the rate of around 80%.  

Strangely enough, you can purchase dry Vitamin D from Biotech brand without a prescription at all at the 50,000 iu level.  You can get it on Amazon.com, vitalady.com, and even Walmart pharmacies.  You ask for it at the pharmacist, but they don't require a prescription.  You just ask specifically for it.  If you find you're falling short on A, you can also get dry A at 25000 iu dosage.

A good majority of us take that much daily - not just a few times a week, and many take two or three times that amount daily to either raise their levels or even maintain them.  It took me six months on 100,000 iu daily to move my D from 12 to a normal range, and then 50,000 iu daily to keep it there.

That's super helpful, thanks. I'll go order it right now. 

Yup when I was low - I live in the PNW so low is a common for me - I was taking 50,000 of the Biotech daily. Once my number got up I switched to 3 times a week. I bought mine on amazon. I also take biotech vitamin k weekly and used to take their vitamin a as well. I highly recommend the brand. 

Val is right, and what's more, even with the "dry" D which you WILL absorb (unlike the prescription stuff which is useless for us) you need to be taking it every day, not 3 times/week. Your doctor clearly does not understand the nature of our malabsorption of fat, and therefore of fat soluble vitamins, or does not understand how the prescription stuff is formulated, or both.

I take the dry D twice daily, as once daily was not successful in keeping my PTH within range...and btw, is your doctor checking your PTH or just your calcium level? Does he/she understand that without enough D on board, your body is leaching calcium from your bones to maintain a safe blood level, and that your body does this by raising PTH? If you don't get both your D level and your PTH in range, you will develop osteoporosis, and it won't be your fault, if will be the fault of a doctor who didn't understand your medical needs, but you'll be the one stuck with the problem.

It is so sad that doctors don't learn more about the ramifications of bariatric surgery, when there are more and more post-ops out there every year needing their docs to understand the effects these operations have on us and how to properly take care of us. And it's not really that difficult, just understanding what supplements are needed and what labs to check. But either you or the operation will be blamed for the results of their ignorance.

Sorry about the rant! Get going on the D right away, and take it at least twice daily. You have a lot of catching up to do.

Larra

Hi Larra

What is PTH? How do I check for that on my labs? Just had 18 month labs done and I am trying to be diligent about looking at not just ranges, but looking at trends as well. I want to be my own advocate for my health. My Iron is in the low end of normal and slightly moving up since my last labs due to supplements ( I am doubling the dose on those to twice daily) to move it up faster. My D and A are in the normal range (low end of normal). I take extra D but not extra A at this point. 

I only take 2 multi with extra D, 2 calcium with extra D, and 1 iron daily which I just upped to 2. Also just added a probiotic as well.

Again, all my labs are in the normal range except the iron which I am addressing. Some are in the low end of normal so I am watching them. Any advice would be helpful. 

Jennifer

PTH is parathyroid hormone. Your body needs to keep blood levels of calcium within a tight range to protect your heart. So, if you either aren't taking enough calcium or aren't absorbing enough, your body steals calcium from your bones by your parathyroid glands (small glands in your neck near they thyroid gland) churn out more PTH, which causes your bones to release calcium. That keeps your heart healthy but damages your bones in the long run.

So, since we absorb both D and calcium poorly, it's essential that we take lots of both in the forms we absorb best, which means dry D and calcium citrate. And the calcium citrate must be taken in several doses throughout the day. It's best IMHO to keep your D level at least in the midrange rather than at the low end of the "normal" range. How much D you need and how much calcium depends on your labs. I've increased my intake of both over the years based on my labs, because even though my D and calcium levels were normal, my PTH was high (note that HIGH PTH means you are not getting either enough D or calcium or both). My PTH has gradually improved with taking much more calcium than I started with.

It's also important for us to follow our labs ourselves, because if you call your pcp's office, the nurse (or receptionist or whoever answers the phone) may just say everything is "normal" or "fine" when you are actually at the low end and headed downward. It's much easier to maintain good levels than it is to catch up after they tank. And frankly, multi's with "extra D" and such have so little extra D, for someone with the DS, as to be useless for your D level. Everyone seems to need the dry D at least 50,000 units/day, if not more. An extra 5,000 units here or there isn't going to do the job. We may not be MO anymore, but we aren't normal and our needs are not normal.

Larra

Thanks so much for the detailed response. My PTH is 50 range is 12 to 67....a little high. Vitamin D is 40....optimal is 30 to 100. Calcium is 9.1 and range is 8.6 to 10.3. What do you think? 

Your labs are ok for now, but it's important to follow the trends. If PTH is going up, or D is going down, you will need to adjust what you are taking. I'm very surprised that your D is ok on such a low amount. It sounds like you are taking plenty of calcium - I hope it's calcium citrate, as we don't absorb calcium carbonate at all well.

Larra

I do take calcium citrate I did learn that early on in the process. I will watch the D and now the PTH.....thanks so much for that.....no one ever explained that before it is very helpful. Something else to kerp an eye on. Again....thank you.