Me to my PCP: I *told* you so! (Vit D plummeted in 4 weeks)

Ok, so 5 weeks ago, my Vit D level was 134 and my PCP freaked out. he got even more freaked out when he found out that I had been taking 50,000 units 3x per week, even though I tried to tell him that, yes, it was high, but no reason to panic. Despite my protestations, he wanted me not to take ANY Vit D except what is in my multi and the calcium supplements. I debated about still taking the 50,000 units once a week (and telling him that only once we had rechecked it), but I decided that I needed to "pick my battles" and would do it his way, let the level drop, and then fight the battle over the amount of supplementation since I just knew he would go back to the "take 2000 per day" nonsense.

I had my D level rechecked on Monday. Four weeks with no separate D supplementation. My Vit D level is now 64. So it dropped to LESS THAN HALF
of what it was in just 4 weeks! As I predicted, he wanted me to start taking 2000 units daily and check again in 4 weeks. Uh, no. We tried that right after my RNY and in THREE MONTHS that only increased my D from 9 (yes, it was 9 when they did my pre-op blood work!) to something less than 20! So I to,d the nurse that I will do ONE of the 50,000 per week and then we can recheck in a month. I heard her tell him, but couldn't distinctly hear his response. The nurse just said, "ok, be sure to get it redrawn in a month". On only 50,000 per week, my guess is that it will be even lower in another 4 weeks. Three times a week was too much, but I was taking it twice a week for over 2 years and it was just under 80.

Just wanted to share some actual numbers to show folks who are early out how quickly our Vit D level can drop after RNY (and how high a dose some of us have to be on to keep our numbers between 80 and 100 (which is where my surgeon wanted it)).

Lora

Some of us need the 50k iu dry D3. I've battled getting my numbers above 80 for over 6 years. I finally got to a 104 on 7 of the 50k iu per week. My bariatric liason doc said it was ok on a consult, yet I got a msg within Kaiser that it was too high.  I still take 6 per week, and that will likely put me near 90, the target range desired for post ops. DAVE

Lora-

My Vitamin D is almost identical to yours. When I had it checked last month it was 132. I was taking 50,000 once a week. My pcp told me to stop taking it until my next appt in 3 months. I'm so afraid it's going to be way too low by my next appt. I think I'm going to start taking it every other week. 

Mercy! I am currently on 50,000 1x week. Thanks for the heads up and motivation to keep up on it!

I take 50,000 IU D3 three times a week to maintain a level of about 100.

When my doctor tells me something like I am taking too much of some vitamin but I know I'm right and she's mistaken, I just say "Thanks for your advice" and continue doing what I know my body needs.

You know, though, when I was in the hospital last week, I knew they wouldn't have the right vitamins in the hospital pharmacy (and they didn't, they only had calcium carbonate and D2 and ferrous sulfate, etc) so I asked if I could have someone bring my own vitamins in from home, and they said OK.  My doctor had to write an order allowing me to take them, but he did that and they were willing to give me the doses I told them that I take.  No one told me I was taking too much vitamin D or vitamin A or anything.  I was surprised.

I doubt that he will fight me on the dose once we recheck it in 4 weeks, but I am prepared to just do what I know I need to do and not tell him if he DOES fight me. Since he has seen the drastic drop over 4 weeks, and will likely see a smaller drop on "only" the 50,000 once a week, I think (hope) he will listen when I tell him that the 50,000 TWICE a week is necessary for me.

Lora

Does he understand you need your D level to be at least 80?  A lot of docs don't realize that.

Yes, thanks to you, actually, I had printed off the information from the Linus Pauling Institute and gave that to him along with the info from my surgeon, so he has no problem with the higher range, but the 134 was apparently well beyond his comfort zone.

Lora

Well, you have a good opportunity to help him learn some new stuff about RNY folks and vitamin D.  I wish someone would do a study of how much D3 RNY folks need to maintain a good D level.  I've actually done an informal survey so I kind of know the answer to that (at least 10,000 IU a day, often more) but I'd love to see an actual study on it.

I have a few more weeks on my 6000iu per day to see if it did anything for my D level - was 23.   I figure it is going to take more than that to get me up around 80!