Normally rational PCP freaked over my Vit D level

I had some mid-year repeat labwork done last week (don't have the full report in my hands yet), but they called me because my PCP -- who has been pretty good about learning about post-RNY life and nutrition up to this point -- was alarmed when my Vit D came in at 134 and he absolutely freaked out when he found out that I was taking 50,000 IU 3 times a week.

I tried to explain why the dosage was so high and how difficult it had been to get it up from the level of 9 right after my surgery (and he has copies of all the labs my surgeon's office drew) but he just kept saying that was way too much and that my surgeon never should have had me increase it to that much. (My D level was fine... 80-something... in April, when I had been on the same dose for over a year, so I am not sure why it is so high now.)

He wants me to not take any except what is in my calcium for a month and re-check it. I'm not really sure I'm willing to do that... need to think about it... but I think I am just going to drop to the 50,000 once per week instead (and maybe just not tell him). It was just so odd that he clearly didn't want to hear me explain anything about why 134 was high but not panic-level high for someone with a RNY. Usually he listens. It was frustrating. I will have to print off some information to take in to him, I guess. I have the web page from the Linus Pauling Institute indicating that a level of 80 is desirable, so I will be sure to take that.

Oh, well... Just one more hiccup in a really crappy day. Just needed to vent a little. I think I am going to take some Restoril and go to bed early.

Lora

I wouldn't panic over that at all.  I'd cut back some - for myself, I'd probably cut back to taking them twice a week.  I think it's the vitamin D council that says problems typically don't occur until you get your level over 200, so 134 is not cause for concern in my mind.

Yeah, it's high but *I* certainly am not all that concerned.  Perhaps you are right about cutting it back to twice a week.  We dropped it back to that at one point and it dropped a bit so I went back to three times a week.

it was just so odd that he reacted so strongly.  Maybe it was just a bad day for him, too.  Let me know if you come across anything else I can print out to take to him that's relevant.

Lora

I can see why his reaction was upsetting. That does seem like you are taking a lot though. I take 50,000 once a week.

Many post ops need that much, though.  I take 50,000 IU three times a week to maintain a level of around 100.

 It is a high dose, but that is what I have been taking for almost 3.5 years to keep my level in the 80s.  I messed around with taking 3000 per day, then 5000 per day, etc for almost a year trying to get it up from the 9... And it has been stable on that dose until now.

Lora

I really don't know 2 post ops that take identical amounts of dry D3 per week to keep their D labs at 80-90.  It varies with each pateint.  4 per week of the 50K IU give me a 65.  7 per week gave me a 104 for D labs 3 months ago.  I've now notched back to 6 per week.  DAVE

What is the normal range for your Vit D levels?  My Dr. called me about a month and a half ago and said my level was just below normal, so they increased my dosage.  I had it taken again about a week ago and she said to keep doing what I was doing, but that now it was low normal and it could be a problem later.  I think she said the number 25 or 27.  Is this normal, or should I look further into this? I am very ignorant to this stuff, and am trying to educate myself now that I am Post RNY!

25 or 27 is dangerously low.  According to the Linus Pauling Institute, it needs to be at least 80.  Unfortunately, it is common for docs to tell us our D level is OK when it's really quite low.  Many are not up to date on the latest research about vitamin D.  But 25 is terribly low and you're at increased risk for heart disease, osteoporosis (because you can't absorb calcium properly with your D that low, no matter how much you take), some kinds of cancer, bone and joint pain, depression, poor immune functioning, etc.

My D hit 87 and the NP freaked out, too.  She said she never saw a post op with a D level so high and she had to go research it.  My D was barely detectable in 2009 so I started taking 50,000 of dry daily until it hit 74 in January, 2011 when I was advised to cut back to 50,000 weekly, which I did and it still hit 87 in July, 2011.  She wanted me to cut back to every other week but I decided to keep taking it weekly and my D was 71 a few weeks ago.  My endo is happy with it at that level and the amount I am taking so I am going to keep taking it weekly unless it drops.  You may want to drop it to once or twice a week and see where it goes.