Stuff to know about vitamin D - long

Probably not.  Like I said, we need our D level to be at least 80 and I have not known one person post op to keep their level at 80 or above taking less than 5000 IU a day, and most need twice that much or even more.  You're only taking 1200 IU.  That's a very tiny dose for us.

My last labs showed my D was at 11. Yes, 11. My PCP prescribed me D2, but I knew not to get it filled and bought some dry D3 from Bariatric Advantage. After reading this I KNOW I am not taking enough to make a difference because I only take 2000 a day. Dammit. Thanks, Kelly. You never know what a difference you make with these posts.

Just a caution to those who want to just start taking the higher doses of Vit D3.....you have to get your levels checked and rechecked. My levels were low pre op and I started with 50,000 units daily. The next time my levels were checked I had a 2500 result. I've been off of Vit D3 now for 1 month and my level is down to 1500. I recheck in 2 months and should probably be where I need to be. My point is how important it is to keep up with our labwork. It's the only way you'll know that you're staying on track.

Yes, you gotta keep up with your labs.  It's very unlikely that you're gonna need 50,000 IU daily forever.  I take that amount three to four times a week now, because that seems to be what I need to keep my level around 100, and I know that because I get labs done every six months.

My pre-op D level was 22. I took 50,000 IU daily for about 6-8 weeks. My follow up level was >200. The NP told me to stop taking all vit D except for what was in my multi-vit. I will be retested in a month (Jan 10).

 Anyone have a list of what our common lab values should be? I get the printout with what a "normal" person should have but I'm thinking on some things we would be different (?).

All my surgeon ever says is, "you're a little low on so and so." It would help if I could read it myself. I have enough medical training to be dangerous (CNA/GNA/CMA).

Our lab values should be the same as a "normal person."  The reference ranges on the lab report do not indicate the values necessary for good health, though.  I know it seems like that's what they would be, but no.  They are just an average of what some people they tested had - so therefore if a lot of the people tested had vitamin D deficiency, for instance, the reference range is lower than what's needed for good health.

Always get a copy of your lab report, don't just get "you're a little low" from your doc. 

So look at your lab report. They are really easy to read and you don't need any special medical knowledge to read them. Your lab report will list the normal ranges and on mine, if something is high or low, they have it in bold type and put a big H or L next to it so it's easy to spot.

The normal values they list will all be accurate except two. You want to pay close attention to those two.

It will say something like 211-911 for B12 and you really want your B12 to be about 900-1000, but it's OK up to at least 2000. Below 550, people get symptoms like depression and fatigue. Below 400, people get permanent nerve damage in their hands and feet. I have no clue why they list it normal below that.

It will say something like 30-80 for vitamin D but you really want your D about 80-100.  Lower than that, we are at increased risk for things like osteoporosis, heart disease and some cancers.  It can safely be higher than 100.  If your D is really low, you want to pay close attention to your PTH and calcium levels.  If your D is low, you won’t absorb calcium well, no matter how much you take.  When that happens, your PTH usually goes up so you start leaching calcium from your bones to keep the calcium level in your blood good (because your heart won’t work right if the level of calcium in your blood gets too low).

Most other things, like iron and ferritin and protein, etc, you want near the top of the normal range.

Your PTH, you'd rather have near the bottom of the normal range.  High PTH suggests you aren’t getting enough calcium and are leaching calcium out of your bones.

Calcium is better around the middle of the normal range.  If your calcium is on the high side, strange as it may seem, that’s often a sign that you need more calcium.  It can be an indication that you’re leaching calcium from your bones because you’re not absorbing enough calcium.

Thank you Kelly for all you share about vitamins.

And I just want to add..... be sure to get a copy of your labs.  Do not depend on the sugeon's staff to interrupt your needs.  They look for the report for H (high) or L (low). Sometimes all the lab results aren't in when you are at  your appt..

Example:  I went for my 6 month appt. in mid December.  I was told my labs were all okay.  I told RN that I supplemented zinc because it had been low (they never told me,  I saw it on the report after my 3 mo. appt).  She told me I could stop because my zinc was fine.  Yes, it's fine because I am supplementiing it. I asked twice what my zinc level was and she did not say.   I am not going to stop.  Supplementation put me in the mid of the normal range.  If I stop I will go low again. 

I was told all my levels were fine,  B-12 was high,  I could cut back.  Again,  not going to do that.  They felt 800 was fine.  I want it over 1000. 

I specifically asked if my D was okay and she said it wasn't back yet,  sometimes it took 2 weeks but the dietitian would call if it was low.  I picked up a copy of my labs this week giving time for D to be returned.  They never called me so it should be okay but wanted to be sure.  It is well below 80 and also below range for normal people which is 30.  Why didn't I get a call.  I called the RD as soon as I received it to get a prescription for D3 50,000 IU so my medical spending plan will cover the expense.  I placed an order with Vitalady for D3.  Until then I am taking several lower D3 a day to get in 10,000 IU per day.

 

Yes always get a copy of your labs. You can also see if you are still within normal ranges but going down from the last lab you had. You can see trends before they go to very low levels.

Yeah, that is something your doc usually won't tell you.  They don't generally compare your labs to the last labs you had done.  If my iron was 88 last time and is 66 this time, it's still not below the normal range, but it's dropped a lot.  And will keep dropping if I don't start supplementing more.  I prefer to address drops in levels as soon as I can isntead of waiting until they are actually super low.