vitamin defficiency

I am hoping that there is a professional opinion to cover this and if this is redundant, forgive me for I am new to the whole forum thing. I get my blood and urine tested about every 3 months so far.  I am 8 months out (5-11-07) and my Vitamin d levels are low.  What do I do?  What do I take?  I am taking bariatric advantage multi vitamims (2 capsules, 3 times per day) and a b 12 sublingual once per day. Thanks for any help. Carrie

Hi Carrie! Not a professional opinion here...just someone in the same boat.  My vitamin D and vitamin A levels were both low.  My surgeon's office suggested just buying the highest dosage I could find on the shelf and taking it as recommended.   After doing a little searching on here I found out that was going to do almost nothing to fix my problem and went to vitalady.com.  Michelle (vitalady) was kind enough to go through my lab numbers with me and suggest what I should be doing.  If you don't know, she had the surgery something like 14 years ago and has a passion for researching malabsorbtion and helping people out before it's "too late".  A lot of people on this site trust her opinion.  I'm still taking her advice with a grain of salt because she's not a doctor and she does recommend REALLY high dosages to fix and then pretty high to maintain.  I'm trusting her with the Vitamin D though because I've heard so many people complain that they've worked so hard for months and can't get their D levels to go up more than a point or 2.   My vitamin D was so low (15) that Michelle actually suggested a 25,000iu vitamin D 2 times a day for 30 days and then 25,000iu 1 time a day for 30 days and then get my blood work done again to see where we're at.  (for reference, the highest vit D I found on the shelf was 1,000iu!) The other good thing about her site is that all the vitamins she sells are able to be absorbed well by the bariatric patient.  (However, I do think some of her supplements are on the pricey side).   The way I actually ended up talking to her is that I placed an order for what I thought I needed and then in the comments section I explained I was deficient and asked them to call me if I was ordering the wrong thing.  They did!   Good luck!  And don't play around with letting it go to long...I'm sure you know, but w/o sufficient vitamin D you're not absorbing your calcium right...and that's a BIG problem.   Heather

We have covered Vitamin D before, so I'm going through the recent posts and 'cutting & pasting' for you. You may see multiple messages from me regarding this -- As you will read, I don't recommend supplementing Vitamin D -- you can get all the vitamin D you need from the sun -- unless you're living in Alaska in the winter time. Also, I STRONGLY, STRONGLY, STRONGLY caution you from allowing someone who SELLS supplements to tell you how much to take. If your doctor wants you on it -- he or she should prescribe it for you. In addition -- you should never supplement based on a blood level alone --- this is NOT a full work up and can cause more problems for you. Vitamins are toxic if you take too much - especially Vitamins A, D, E, K. In any event, I'll provide you with the information ... ****"Because vitamin D3 can be endogenously produced by the body and because it is retained for long periods of time by vertebrate tissue, it is difficult to determine with precision the minimum daily requirements for this vitamin (although it's really a steroid, not a vitamin). The requirement for vitamin D is also known to depend upon the concentration of calcium and phosphorus in the diet, age, sex, degree of exposure to the sun, and the amount of pigmentation in the skin. In the US, adequate amounts of vitamin D can be readily obtained from the diet and from casual exposure to sunlight. However, in parts of the world where food is not routinely fortified and sunlight is often limited during some periods of the year, obtaining adequate amounts of vitamin D becomes more of a problem. As a result, incidence of rickets in these countries is higher than in the US. Blood tests only measure what is in the blood. Vitamin D levels measured by blood are not an accurate measure of what your body has stored. I know people think that blood levels tell the whole story - THEY DON"T. Blood levels are one piece of the puzzle - there are many nutrients that are stored in the bones, the liver, the fat tissue, or vertebral tissue, etc. To treat a blood level is irresponsible, unless you have other evidence that leads you to suspect a deficiency. We treat patients, not lab work. However, these are SAFE levels of supplementation: Doses of 400-600 IU (10-15mcg) vitamin D3 have been used safely. There are preparations of up to 1000 IU, but those are reserved for parathyroid dysfunction and renal bone disease. An upper limit (do not exceed) of 2000 IU is recommended. With total body sun exposure, your body can produce 10,000 IU (250 mcg) of vitamin D Doses that reach "intoxication" are caused by large amounts of vitamin D3 and its conversion in your body to a form called 25(OH)D3 - this is an unregulated step, meaning if you put too much D3 into your body, this is what your body will do with it. Patients suffering from hypervitaminosis D have been shown to have a 15 fold increase in blood levels of 25(OH)D3 and can lead to a massive stimulation of intestinal calcium absorption, increased leaching of calcium from the bones, deposition of calcium in the soft tissue, and development of kidney stones." So, TOO MUCH vitamin D can cause low calcium levels & soft bones. Go****'s sooo important that you understand what you're doing with these vitamins ....

More on vitamin D: ***"I absolutely respect alternative therapies and understand the value they offer. I do take issue with large doses of Vitamin D. All of the fat soluble vitamins (ADEK - though we know D isn't really a vitamin...) have the potential for toxicity. From a biochemistry perspective, vitamin D absorption is not dependent on your gut. Vitamin D is dependent upon your liver, kidneys and parathyroid - too much can alter calcium and phosphorus absorption and distribution in your body. I don't think it is wise to over-do this particular compound because it does present an opportunity to do harm.****" ******"For everyone else who is thinking about megadosing on Vitamin D - Let's start with this, Vitamin D is not really a vitamin at all, but rather in its active form - a steroid hormone. Vitamin D has no daily requirement because your body is able to produce it with exposure to the sun. Vitamin D was added to food to improve calcium absorption mainly to assist people who live in cloudy and dark places (no sun...) Vitamin D can reach toxic levels in your body - this is always caused by over-supplementation. The result of too much vitamin D: too much calcium goes to your bloodstream (hypercalcemia) which is then spilled in your urine (hypercalciuria), anorexia, nausea, vomiting, thirst, polyuria (you have to urinate frequently), muscular weakness, joint pain, de-mineralization of bones (contradicts the whole reason for taking it - eh?), general disorientation, and death. So what do I think - having a calcium and vitamin D combo is fine. To take large doses of Vitamin D - foolish (unless you have been diagnosed with rickets or osteomalacia and this is part of your prescribed medical therapy).***"

Thanks for all your excellent info Sara...I'm going to continue to research and talk to my dr's before starting those mega-doses I ordered. Heather

The mega doses make me nervous .... I'm going to ask a few of my doctor friends as well -- but really, those mega doses seem crazy to me. But hey -- maybe I'll learn something .... :)

And, I know all this can be really confusing -- hearing two people make strong cases with totally opposite opinions..... I'm glad you are going to review with your doctor.