Vitamin D

I found out today that my vitamin D level is low.  I am 6 months post-op and the Dr.'s office left a message for me to add a vit D supplement.  Is it OK to take this at the same time I take my multivitamin or is there a limit on how much Vit D our bodies absorb at one time.  I am taking a multivitamin in the morning and night and a calcium citrate w/ vit d mid morning and mid afternoon.

If you read my profile, you'll see I had a difficult time with my vitamin D levels, even though my exercising was walking outside.  I too the 50K IU's of Vitamin D- a course of 12 weeks. I did this 3 times and still failed. I finally got a liquid vitamin and a liquid vitamin D I take with my daily oatmeal and powdered calcium citrate. All other blood work came out fine. I finally came up to a low normal reading on my last test.  If you're low on vitamin D, you'll have to take more. Even I walked daily in the sunlight, my levels were still very low.

You can take your vitamin D with other vitamins, no problem. The recommended dose of vitamin D is 1000 IU/day. However, a low blood level does not mean you are vitamin D deficient. There has been many, many posts on this -- you may consider checking some old posts. Good luck,

"However, a low blood level does not mean you are vitamin D deficient." Please explain this for me, I wasn't sure what you mean by this. Thanks, Jennifer

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 mega doses of 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 ....

Here's the link to the multiple posts on this. In addition, if you check the archives, you will find many, many more posts. http://www.obesityhelp.com/forums/nutrition/board_id,5389/cat_id,4989/topic_id,3501030/a,messageboard/action,replies/#27687625

Thanks for posting this.  When I searched the archives all I seem to find were the posts supporting Vitamin D supplementation.  Lately what I have read has been supporting the idea that getting Vitamin D from the sun may not be enough.  I know for me, I'm not in the sun a lot and when I am, I have sunscreen on -- which reportedly affects your ability to absorb the Vitamin D from the sun. My Vitamin D levels were 23 last October and my doctor just reinforced getting dietary sources of vitamin D and then recently retested.  They are now at 25.  He now acts like they are fine.  (And then a friend of mine had her doctor tell her to supplement at similiar levels)  I have had a lot of achy bones feelings for the last month or two -- which I was reading in those posts can be related to low Vit D.  I'm not sure where to go with this, my doctor is very relaxed on the lab levels and supplementing.  When I asked about my b12 being at 580 - he said what is wrong with that, it is range.  But then recent studies have pointed to b12 levels should be above 800.  Who do I trust with this?  I'm a nurse and I know that doctors definately are not an all-knowing source -- they have their area of interests which they are great at and their weaknesses. Thanks, Jennifer

Since Vitamin D is fat soluable & can be toxic, I would NEVER recommend anyone to take a mega dose.  Supplementing with 1000 IU is believed to be safe.  I would recommend you taking 1000 IU each day.  No more.  If you continue to have bone problems, a bone density test may be in order and if that shows issues with your bones that your doctor believes is caused by vitamin D, and he/she gives your a prescription for the vitamin, then, by all means, take it.  But, for now, stick with 1000 IU (or less).  As for B12, since it's not toxic, I don't have problems with people taking more.  In addition, since a B12 deficiency can lead to CNS problems, I tend to promote more B12 than less.  Your B12 is in range, and if you feel good, there is no real reason to add more.  But, if you'd like it to be 800 or more, then go ahead and increase your dose.  If you have scientific evidence (fact-based research), then go ahead and show it to your doctor.  Doctors (and dietitians for that matter), need to be educated too.  Recommendations change so often that sometimes we are not always up to date.  Good luck.  :)