![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by iforgotmypassword on October 19, 2008, at 0:42:15
it looks like i am very vitamin d deficient. i am wondering if this could be what is causing my neuropsych and extrapyramidal and parkinsonian-like problems, and why my response to medication is incomplete, unpredictable, untolerable and seem to be risky in my case (since i have permanent extrapyrmidal symptoms.)
currently my most effective medication is lorazepam, which i have to use to function and move properly. this has worried me as it is gaba-ergic, and gaba is one of the neurochemicals which seems to plummet with parkinson's. but it is both a inexplicable hesitance and an inexplicable tension with screwy sensations with akathisia and rage that is very unpredictable. i have had screwy mouth movements, and problems talking in an organized conclusive way (and especially trouble with inhibiting talking,) that have been diagnosed both as psychosis and i have been asked if i abuse psychostimulants at the E.R. and i have seen "psychostimulant abuse" on my file, which kindof wierds me out. i have in the past tried to self-medicate out of desperation with higher doses of dexedrine leftover from trials that went nowhere, but responded very badly and certainly in no way i would consider recreational. i think the only time i went to the E.R. over overreaction to psychostimulants was when my doctor tried to add concerta to my desipramine.
in any case i will share the numbers my psychiatrist gave me over the phone, he said for 25 D i had a "10", and that the reference ranges for 25 D are:
<25 is "deficiency"
26-75 is "insufficiency"
76-250 is normal
>250 is "toxicity"but here is what is wierd, while my vitamin D stores (what 25 D is) seem to be quite low according to this, he said the 1,25 D (the active hormone converted from the stores (which are converted from the vitamin)) test was apparently normal, i didn't ask for the number, since i was trying to remember enough already.
there seem to be a certain other physical problems that may cause paradoxical results like this, but i haven't read enough. from what i read, apparently: sarcoidosis and hyperparathyroid disease, but it seems hypoparathyroid as well. i found it interesting and worth remembering that when i was reading about one of the parathyroid diseases, they mentioned parkinson's disease occuring as a consequence of the illness.
not sure what to make of all of this...
then there is the debate over D2 and D3, that i cannot make sense out of. it seems that D2 effectively contributes to 25 D stores, so that then it should also contribute to reliable availability of these stores for conversion to 1,25 D (again the process seems to be in this order: D2/D3 -> 25 D -> 1,25 D) it seems that there are bot studies saying that D3 is better, and studies saying that D3 and D2 are the same. it still does not explain why i am not hearing the same miraculous getting better stories from other "chronic lyme" patients taking D2, that i am hearing from those taking D3. and possible immediate explaination may be is that certain popular sentiments that D3 is better (that seem to get stronger in the alternative realm) may indicate that too few people are buying and trying D2, and that's why i'm not hearing anything. but also, it is interesting, it appears that vitamin D3 may be its own hormone with its own effects? is this plausible. there seem to have been favourable studies on vitamin d supplementation for mood, but i don't remember if they used D3 or D2. i should look into that.
i am also a vegetarian. so i do not want to take D3 unless there is solid reasoning it could be better, the larger sheep industry is absolutely vile.
i had to get these tests through my psychiatrist since a requisition from my naturopath (who initially had the idea to do the test) would not be covered. it was apparently cc'd to both my naturopath, and my GP. but this seems to be taking forever. and my GPs office is so busy, i hesitate to ask for appointments anymore. the staff can be very moody and they can be booked for quite long periods, i was hoping that they would call me. my psychiatrist called and told me about the results because they indicated that my 25 D result was clearly not normal, but he had no further knowledge of the meaning of the results.
sorry this is another exceptionally long, and possibly quite incoherent post.
Posted by Phillipa on October 19, 2008, at 12:12:32
In reply to quite vitamin D deficient, strange results, posted by iforgotmypassword on October 19, 2008, at 0:42:15
Well I don't want to sound insensitive but I did have trouble following your thread. I know that my endocrinologist wants me on Vita D and my bottle from the health food story doesn't mention D2 or D3 just vita D. Well the endo tested my Vita D level as I can't take the meds for osteroporosis and D with CA And Mg is good for bones. There lab levels were anything under 20 was abnormal and my level was 40 so was told it was great. Want me to take 1000IU's a day. I seem to recall seeing other uses. Let me google and see what I see. you also mention chronic lymes as I have that and hasimotos thyroiditis. So lets see. Love Phillipa Be back.
Posted by Phillipa on October 19, 2008, at 12:23:38
In reply to quite vitamin D deficient, strange results, posted by iforgotmypassword on October 19, 2008, at 0:42:15
One study no mention of psychosis? Phillipa
Vitamin D3
Its Critical Role in Overall Health
By Jason Barker, ND
Weve come a long way in our understanding of the importance of vitamin D in health. It was only 40 years ago that scientists reasoned that vitamin D was necessary for bone health, and no other aspects of proper physiologic function. It was correctly assumed that a lack of vitamin D led to the bone condition osteomalacia, or softening of the bones in adults and presented as rickets (bowing of the legs) in children. And like much of the Recommended Daily Allowances (RDA) of the day, amounts of vitamins were based on prevention of outward disease conditions, rather than on optimal health. For instance, the RDA in 1963 for vitamin D was 400 IU for children and half that for adultsamounts shown to be just enough for prevention of osteomalacia and rickets.1 Only in the last several years has our understanding of the importance of vitamin D in other areas of health come to light.Vitamin D is made in our bodies after skin is exposed to sunlight. However, the latest medical dogma that sun exposure will cause skin cancer has caused many people to slather on the sunscreen when outdoors prior to receiving any sun exposure. This fact, along with busy work schedules that prevent us from emerging outdoors in the middle of the day, has created a widespread vitamin D deficiency linked to various forms of cancer, high blood pressure, poor blood sugar control and impaired immunity.
In this article, I will discuss a number of ways vitamin D (especially vitamin D3) is crucial to good health, emphasizing the importance of why sun-challenged individuals should consider supplementation with this important vitamin.
Vitamin D: Important Facts
When one refers to vitamin D, we must acknowledge its two main supplemental forms: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3).Ergocalciferol can be obtained from plant sources while cholecalciferol is the form primarily synthesized in the skin by absorbing light energy from UVB rays. Vitamin D3 is considered to be the more bioavailable form of the vitamin and is the preferred form when supplementing.
Both vitamin D2 and D3 may be considered prohormones and do not have any intrinsic biological activitythey must undergo further metabolism in the liver and kidney before becoming the final active form 1,25 dihydroxycholecalciferol. The true name of Vitamin D is calciferol.
Vitamin D is not a true vitamin. Under normal circumstances, it is manufactured in the body and is not required in the diet (given adequate sun exposure at the correct intensity); its mechanism of action and structure closely resemble that of a steroid hormone.
The action for which vitamin D is best known is regulation of calcium and phosphorus concentrations in the serum. Vitamin D enhances the absorption of these two minerals in the small intestine; if dietary intake of calcium falls below adequate levels, calciferol (vitamin D) in conjunction with parathyroid hormone will mobilize calcium stores from the bones into the serum.
Possible Consequences of Vitamin D Deficiency
Vitamin D Deficiency has Been Linked to:Various forms of cancer including breast, prostate and colon cancer
Fractures
Hypertension
Heart Disease
Pain and Muscle Aches
High CRP Levels
Insulin Resistance
Decreased immunity and lowered resistance to influenza and viruses
Osteoporosis and osteomalacia
Depression
Seasonal Affective Disorder (SAD)
Lifestyle Induced Vitamin D Deficiency
Vitamin D occurs freely in relatively few foods; based on this fact and the skin-synthesis model, one must assume that this natural process instilled within the body is the preferred way for humans to obtain vitamin D from sun-stimulated conversion in the skin. While the human body is incredibly efficient at creating vitamin D from sun exposure (it is estimated that full-body exposure for a few hours will create 10,000 IU),2-3 it also has excellent control in limiting the creation of potentially toxic amounts of the vitamin as prolonged exposure also results in photodegradation of vitamin D produced in the skin.4However, many factors have compounded the irrelevance of sun exposure as a source of vitamin D. Centuries ago, humans moved northward into cold, sun-limited climates, the majority of us spend most if not all of our days inside, and clothing covers 95 percent of our skin. Even (now fortified) dietary sources are proving inadequate to offset our lack of vitamin D production. One eight-ounce glass of milk contains only 100 IU vitamin D while other dairy products have little or none of this crucial vitamin added. Cereal has 40-100 IU in each serving.5 Salmon, sardines and mackerel contain roughly 200-360 IU vitamin D per 3.5 ounce serving.6
This leaves strict vegetarians and lactose intolerant people at a disadvantage, while the elderly (inefficient conversion), the obese and dark-skinned people (additional melanin) have additional challenges producing Vitamin D.7-8 It appears now that even infants and toddlers are at risk for vitamin D deficiency. A newly released study found that 12 percent of otherwise healthy infants and toddlers in the Boston area were vitamin D deficient and 40 percent of those children had vitamin D levels that were defined as suboptimal, meaning they were at risk for rickets.9
Colon, Breast and Prostate Health
Approximately 5,000 research papers have been written about vitamin D in the last 40 years; only recently have we begun to appreciate vitamin Ds influence on health. Epidemiologic studies are showing that cancer survival rates are lower when diagnosis occurs in months of lower vitamin D levels suggesting a protective role of the vitamin against cancer growth and development.10Research into vitamin D is being conducted on approximately 17 different kinds of cancer, the main forms being breast, prostate and colon. Research is revealing that vitamin D may stop the initiation of cancer and that treatment outcomes may be influenced by vitamin D. A recent review article estimates that 50,000 to 70,000 Americans may die prematurely from cancers due to inadequate vitamin D intake.11
Vitamin D is thought to influence cancer outcomes through several mechanisms: it promotes cell differentiation, regulates programmed cellular death (apoptosis), limits metatastic spread of cancers and growth of tumor blood supplies (angiogenesis).12
Precancerous growths (adenomatous polyps) are a colon cancer precursor that are also associated with low vitamin D and calcium intake; a recent trial showed that these polyps tend to recur more frequently in people with lower vitamin D and calcium intakes.13 Another study showed that vitamin D level at the time of colorectal cancer diagnosis had an effect on survival; lower levels were associated with poorer cancer outcomes.14 Vitamin D intake of 1,000 IU or more each day correlated with a 50 percent reduced risk of developing colorectal cancer.15
Researchers also have studied the relationship between breast cancer and vitamin D and calcium intake. Women with more dense tissue revealed on mammography (which is a stronger risk factor for breast cancer) had lower intakes of vitamin D and calcium.16 Increased amounts of vitamin D and calcium apparently affect breast tissue composition. In this particular study, women with less dense mammography had a daily intake of only 100 IU vitamin D and 750 milligrams (or more) of calcium. In the Nurses Health Study, investigators showed that over time, women with higher levels of vitamin D in their blood had a lower risk of breast cancer, and this association was stronger in women 60 years or older.17
In prostate cancer, vitamin D enhances the differentiation of new cells (poorly differentiated cells are a cancer harbinger) while it slows the ability of the cancer to proliferate, invade and spread.18 Another study showed that men without prostate cancer enjoyed more time in the sun and thus had a 50 percent decreased risk of prostate cancer compared to those who spent relatively little time in the sun. This was related to the observation that sun exposure increased synthesis of vitamin D, exerting the observed protective effect.19 In men with prostate cancer, the prostate-specific antigen (PSA -a prostate cancer marker in the blood) is followed as an indirect way to monitor cancer growth. Men who were supplemented with vitamin D had a 75 percent lengthened doubling time of their PSA, meaning that cancer growth was greatly slowed.20
Widespread Role in Health
Studies show a link between moderate sun exposure or vitamin D levels and benefits to bone health, multiple sclerosis, heart health in people with hypertension, and overall mortality.21Vitamin D deficiency is also correlated with elevated blood pressure, and vitamin D (along with calcium) can significantly lower systolic blood pressure.22-23 It is thought that these effects are carried out by vitamin Ds ability to influence the blood pressure-related hormone renin.24
C-reactive protein is an indirect measurement of general inflammation in the body and elevated levels can be associated with conditions such as heart disease. Vitamin D has been shown to have potent CRP-reducing effects.25
Another way vitamin D can influence health is through its blood-sugar-stabilizing effects. Diabetes occurs more frequently in people with lower vitamin D levels and vitamin D supplementation helps to reduce blood sugar and increase insulin sensitivity.26-27
Vitamin D may also have an effect on immune function. It is hypothesized that influenza is in part related to overall lower levels of vitamin D in the colder times of year, and this may predispose more people to the flu and other winter illnesses.28
Conclusion
Having vitamin D levels measured and monitored is important since excessively high levels are counterproductive to good health. Testing should be carried out under medical supervision.From this brief review of vitamin D, it is apparent that optimization of vitamin D levels is of paramount importance for a number of health conditions. Since sunscreen can interfere with the bodys ability to make vitamin D and since outdoor time is often limited even at this time of year, supplementation can ensure that the body achieves its optimal level of wellness.
References
1. Park EA. The therapy of rickets. JAMA.1940;115(5):370-9.
2. Shearer MJ. The roles of vitamins D and K in bone health and osteoporosis prevention. Proc Nutr Sci. 1997;56:915-37.
3. Gesensway D. Vitamin D and sunshine. Ann Int Med. 2000;133:319-20.
4. Holick MF. Sunlight and vitamin D: both good for cardiovascular health. J Gen Intern Med. 2002;17:733-5.
5. Holick MF, Shao Q, Liu WW, Chen TC. The vitamin D content of fortified milk and infant formula. N Engl J Med. 1992 Apr 30;326(18):1178-81.
6. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006 Mar;81(3):353-73.
7. Zadshir A, Tareen N, Pan D, Norris K, Martins D. The prevalence of hypovitaminosis D among US adults: data from the NHANES III. Ethn Dis. 2005;15(4 Suppl 5):S5-101.
8. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000 Sep;72(3):690-3.
9. Gordon CM, Feldman HA, Sinclair L, et al. Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers. Archives of Paediatric Medicine. June 2008, Vol 162, No. 6.
10. Porojnicu AC, Dahlback A, Moan J. Sun exposure and cancer survival in Norway: changes in the risk of death with season of diagnosis and latitude. Adv Exp Med Biol. 2008;624:43-54.
11. Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005 Jun; 10(2):94-111.
12. van den Bemd GJ, Chang GT. Vitamin D and vitamin D analogs in cancer treatment. Curr Drug Targets. 2002 Feb;3(1):85-94.
13. Hartman TJ, Albert PS, Snyder K, et al. The association of calcium and vitamin D with risk of colorectal adenomas. J Nutr. 2005 Feb;135(2):252-9.
14. Giovannucci E. The epidemiology of vitamin D and colorectal cancer: recent findings. Curr Opin Gastroenterol. 2006 Jan;22(1):24-9.
15. Gorham ED, Garland CF, Garland FC, et al. Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol. 2005 Oct;97(1-2):179-94.
16. Berube S, Diorio C, Verhoek-Oftedahl W, Brisson J. Vitamin D, calcium, and mammographic breast densities. Cancer Epidemiol Biomarkers Prev. 2004 Sep;13(9):1466-72.
17. Bertone-Johnson ER, Chen WY, Holick MF, et al. Plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D and risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1991-7.
18. Lou YR, Qiao S, Talonpoika R, Syvala H, Tuohimaa P. The role of Vitamin D3 metabolism in prostate cancer. J Steroid Biochem Mol Biol. 2004 Nov;92(4):317-25.
19. John EM, Schwartz GG, Koo J, Van Den BD, Ingles SA. Sun exposure, vitamin D receptor gene polymorphisms, and risk of advanced prostate cancer. Cancer Res. 2005 Jun 15;65(12):5470-9.
20. Woo TC, Choo R, Jamieson M, Chander S, Vieth R. Pilot study: potential role of vitamin D (Cholecalciferol) in patients with PSA relapse after definitive therapy. Nutr Cancer. 2005;51(1):32-6.
21. Moan J, et al Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure Proceedings of the National Academy of Sciences 2008; 05: 668-673.
22. Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C. Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab. 2001 Apr;86(4):1633-7.
23. Lind L, Hanni A, Lithell H, et al. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995 Sep;8(9):894-901.
24. Li YC. Vitamin D regulation of the renin-angiotensin system. J Cell Biochem. 2003 Feb 1;88(2):327-31.
25. Timms PM, Mannan N, Hitman GA, et al. Circulating MMP9, vitamin D and variation in the TIMP-1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders? QJM. 2002 Dec;95(12):787-96.
26. Martins D, Wolf M, Pan D, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin d in the United States: data from the third national health and nutrition examination survey. Arch Intern Med. 2007 Jun 11;167(11):1159-65.
27. Zittermann A. Vitamin D and disease prevention with special reference to cardiovascular disease. Prog Biophys Mol Biol. 2006 Sep;92(1):39-48.
28. Cannell JJ, Vieth R, Umhau JC, et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006
Posted by oceancat on October 19, 2008, at 17:28:19
In reply to quite vitamin D deficient, strange results, posted by iforgotmypassword on October 19, 2008, at 0:42:15
Hi,
How is your calcium level? There is a connection between calcium, low vitamin D, and hyperparathyroidism, I believe, but I don't know if hyperparathyroidism would explain any of your symptoms...you could look at Wikipedia...I know vitamin D deficiency is related to psychiatric symptoms and body aches, and my level is borderline low and I have these problems, so I just started taking a supplement for the heck of it even though my doctor said not to worry.
oceancat
Posted by bleauberry on October 21, 2008, at 17:54:34
In reply to quite vitamin D deficient, strange results, posted by iforgotmypassword on October 19, 2008, at 0:42:15
According to the "Marshall Protocol", a vitamin D deficiency is a hint at something gone awry in the immune system, where hidden infections/critters are using the vitamin D.
Makes me wonder though, because a few years ago when I was taking large doses of vitamin D, drank a lot of milk, and got a lot of sun, my blood test for vitamin D came back very low. And I have been battling skin infections, gluten intolerance, and other weird immune-based things all along.
All theory. Just thought I would throw that out there for something to toss around. I would say ask you doctor why your vitamin D is so low, but I won't, because they don't know. In fact, many are not aware that your body can create all it needs from other materials even if you don't consume enough of it. Ask what will happen if it is increased, other than helping bones maybe, and well, they don't know.
If it's low, it's low for a reason, and probably not because you aren't consuming enough. Just some food for thought though, not that it helps any. Just babbling.
Posted by yxibow on October 22, 2008, at 22:34:45
In reply to quite vitamin D deficient, strange results, posted by iforgotmypassword on October 19, 2008, at 0:42:15
> it looks like i am very vitamin d deficient. i am wondering if this could be what is causing my neuropsych and extrapyramidal and parkinsonian-like problems, and why my response to medication is incomplete, unpredictable, untolerable and seem to be risky in my case (since i have permanent extrapyrmidal symptoms.)
EPS symptoms aren't normally permanent that I know of -- Tardive ones are and should be examined by a neurologist to evaluate them.> currently my most effective medication is lorazepam, which i have to use to function and move properly. this has worried me as it is gaba-ergic, and gaba is one of the neurochemicals which seems to plummet with parkinson's. but it is both a inexplicable hesitance and an inexplicable tension with screwy sensations with akathisia and rage that is very unpredictable. i have had screwy mouth movements, and problems talking in an organized conclusive way (and especially trouble with inhibiting talking,) that have been diagnosed both as psychosis and i have been asked if i abuse psychostimulants at the E.R. and i have seen "psychostimulant abuse" on my file, which kindof wierds me out. i have in the past tried to self-medicate out of desperation with higher doses of dexedrine leftover from trials that went nowhere, but responded very badly and certainly in no way i would consider recreational. i think the only time i went to the E.R. over overreaction to psychostimulants was when my doctor tried to add concerta to my desipramine.
>
> in any case i will share the numbers my psychiatrist gave me over the phone, he said for 25 D i had a "10", and that the reference ranges for 25 D are:
>
> <25 is "deficiency"
> 26-75 is "insufficiency"
> 76-250 is normal
> >250 is "toxicity"
>
> but here is what is wierd, while my vitamin D stores (what 25 D is) seem to be quite low according to this, he said the 1,25 D (the active hormone converted from the stores (which are converted from the vitamin)) test was apparently normal, i didn't ask for the number, since i was trying to remember enough already.
>
> there seem to be a certain other physical problems that may cause paradoxical results like this, but i haven't read enough. from what i read, apparently: sarcoidosis and hyperparathyroid disease, but it seems hypoparathyroid as well. i found it interesting and worth remembering that when i was reading about one of the parathyroid diseases, they mentioned parkinson's disease occuring as a consequence of the illness.
>
> not sure what to make of all of this...
>
> then there is the debate over D2 and D3, that i cannot make sense out of. it seems that D2 effectively contributes to 25 D stores, so that then it should also contribute to reliable availability of these stores for conversion to 1,25 D (again the process seems to be in this order: D2/D3 -> 25 D -> 1,25 D) it seems that there are bot studies saying that D3 is better, and studies saying that D3 and D2 are the same. it still does not explain why i am not hearing the same miraculous getting better stories from other "chronic lyme" patients taking D2, that i am hearing from those taking D3. and possible immediate explaination may be is that certain popular sentiments that D3 is better (that seem to get stronger in the alternative realm) may indicate that too few people are buying and trying D2, and that's why i'm not hearing anything. but also, it is interesting, it appears that vitamin D3 may be its own hormone with its own effects? is this plausible. there seem to have been favourable studies on vitamin d supplementation for mood, but i don't remember if they used D3 or D2. i should look into that.
>
> i am also a vegetarian. so i do not want to take D3 unless there is solid reasoning it could be better, the larger sheep industry is absolutely vile.
I appreciate your tenacity to a vegetarian diet -- I'm a vegan, but at some point I knew that not 100% of everything could be so.
Also when I go out to eat, I know that something is going to have eggs or milk in it, its just the way it is -- yes, I ask about fish sauce and stuff like that but there is a limit to things at some point -- social cooperation and going out to eat with people. A personal view.
When I first took Prozac, I took it liquid because I didn't want the gelatin capsules. But I've abandoned that, because things aren't typically available that way and there's no way to completely avoid it.To me, health comes first. And I would say the same thing about D3 -- I hadn't realized it was part of the lanolin industry (mostly, there is a algae form apparently), but again, a lot of soaps that you're going to encounter in public washrooms have lanolin. I'm not going to endanger myself and not wash my hands.
In fact if you analyze every possible chemical in the shampoo and soap industry, you're going to find chemicals that you don't really know what source they're from.
I also don't wear leather, but lately I've had to wear whatever I can find in shoes, one because its too expensive now to import non-leather shoes, England being where they're mostly from, where Vegan activity started anyhow, and two, I have some form of arthritis after having many bouts of weight loss and gain and I can't afford the choice to both have non-leather and not destroy my feet.
I also take my vegetarianism as a personal choice... but anyhow that's getting about me, not about you.
I'm just saying if it comes down to needing supplements and your GP says so, I think whatever belief system you may have should let you have the health you need. Just a personal statement anyhow.
I take what is probably almost completely vegetarian multivitamins, except I guess D3 is probably the only one that isn't, who knows, I use vegetable sources of omegas, etc.
> i had to get these tests through my psychiatrist since a requisition from my naturopath (who initially had the idea to do the test) would not be covered. it was apparently cc'd to both my naturopath, and my GP. but this seems to be taking forever. and my GPs office is so busy, i hesitate to ask for appointments anymore. the staff can be very moody and they can be booked for quite long periods, i was hoping that they would call me. my psychiatrist called and told me about the results because they indicated that my 25 D result was clearly not normal, but he had no further knowledge of the meaning of the results.
>
> sorry this is another exceptionally long, and possibly quite incoherent post.No, its not incoherent, but no matter how annoying your GPs office can be and I know about how bureaucratic things can get -- your psychiatrist, while being an MD, is not the best place to get a blood panel, except for the occasional diabetes test, say, for monitoring medications.
I'm sure he's been through residency and probably remembers a panoply of conditions but what his specialty is currently is psychiatry and that is what he/she gets their CMEs in, etc.
A GP, a family physician is more used to reading results from tests and has probably gone over hundreds if not in to the thousands of them, and knows what the meanings are, rather than searching the net and a) scaring yourself about some condition and b) not getting the best treatment if there is something to be done.
A D.O. still has to go through medical training and is actually in at least this state as good as an M.D. for most common purposes. Its just the schools are cheaper for them.
If you have these results, and you have a signature relationship between your psychiatrist and your GP to release information between them (often a good choice but up to you), I think they should communicate.
-- best wishes
Jay
Posted by mav27 on October 22, 2008, at 23:44:50
In reply to Re: quite vitamin D deficient, strange results » iforgotmypassword, posted by Phillipa on October 19, 2008, at 12:12:32
Yeah my tests were described just like yours.. i had no idea there was d2 or d3 ect. My level though was 8.. severly deficient. I have managed to get it up to 30 but i can't say i've noticed any difference between having normal levels and being deficient.
> Well I don't want to sound insensitive but I did have trouble following your thread. I know that my endocrinologist wants me on Vita D and my bottle from the health food story doesn't mention D2 or D3 just vita D. Well the endo tested my Vita D level as I can't take the meds for osteroporosis and D with CA And Mg is good for bones. There lab levels were anything under 20 was abnormal and my level was 40 so was told it was great. Want me to take 1000IU's a day. I seem to recall seeing other uses. Let me google and see what I see. you also mention chronic lymes as I have that and hasimotos thyroiditis. So lets see. Love Phillipa Be back.
Posted by oceancat on October 23, 2008, at 1:25:04
In reply to Re: quite vitamin D deficient, strange results » Phillipa, posted by mav27 on October 22, 2008, at 23:44:50
I have low 25 D (39) and normal 1,25 D (25) too! My doctor said it wasn't anything to worry about -- is this generally true? I've been trying to find the source of my back pain and general muscle aches/weakness, so I'm taking vitamin D supplementation anyway in case it might help...
oceancat
Posted by Phillipa on October 23, 2008, at 19:50:48
In reply to Re: quite vitamin D deficient, strange results » Phillipa, posted by mav27 on October 22, 2008, at 23:44:50
I feel this link explains why my endo wants me on it the article is extremly long. Phillipa ps it affects the autoimmune system.
Posted by Larry Hoover on October 26, 2008, at 14:10:08
In reply to quite vitamin D deficient, strange results, posted by iforgotmypassword on October 19, 2008, at 0:42:15
> it looks like i am very vitamin d deficient.
Yes, you are.
> in any case i will share the numbers my psychiatrist gave me over the phone, he said for 25 D i had a "10", and that the reference ranges for 25 D are:
>
> <25 is "deficiency"
> 26-75 is "insufficiency"
> 76-250 is normal
> >250 is "toxicity"
>
> but here is what is wierd, while my vitamin D stores (what 25 D is) seem to be quite low according to this, he said the 1,25 D (the active hormone converted from the stores (which are converted from the vitamin)) test was apparently normal, i didn't ask for the number, since i was trying to remember enough already.What that indicates is that you have secondary hyperparathyroidism. Parathyroid hormone increases the activity of the kidney sites that convert 25-D to 1,25-D. This skews the ratio of the inactive precursor/storage form to the active form, in favor of the active form. Your parathyroid gland is in overdrive to try and elevate the activity of vitamin D, despite gross deficiency. The serious consequence of this is that osteoclasts, the bone cells that dissolve bone minerals, are also highly activated. You are at substantially enhanced risk of osteomalacia/osteopenia. And, as you indicated early, your risk of a number of other serious medical conditions is also elevated.
> there seem to be a certain other physical problems that may cause paradoxical results like this, but i haven't read enough. from what i read, apparently: sarcoidosis and hyperparathyroid disease, but it seems hypoparathyroid as well. i found it interesting and worth remembering that when i was reading about one of the parathyroid diseases, they mentioned parkinson's disease occuring as a consequence of the illness.
>
> not sure what to make of all of this...Your labs are consistent with secondary hyperparathyroidism (i.e. due to another factor, vitamin D deficiency) rather than primary hyperparathyroidism, as caused by a parathyroid tumour. It's possible to have both, however.
> then there is the debate over D2 and D3, that i cannot make sense out of. it seems that D2 effectively contributes to 25 D stores, so that then it should also contribute to reliable availability of these stores for conversion to 1,25 D (again the process seems to be in this order: D2/D3 -> 25 D -> 1,25 D) it seems that there are bot studies saying that D3 is better, and studies saying that D3 and D2 are the same.My take on that is that some experiments are of sufficient quality that they demonstrate the superiority of D3 over D2. Other experiments simply fail to obtain statistical significance. If the findings of superiority of D3 over D2 were a fluke, if they really were both the same, then some studies would show superiority of D2 over D3. To my knowledge, there are none of those.
D3 has a longer half life, a higher affinity for vitamin D enzymes, a higher affinity for vitamin D storage proteins, and something else that I forget for the moment.
> it still does not explain why i am not hearing the same miraculous getting better stories from other "chronic lyme" patients taking D2, that i am hearing from those taking D3. and possible immediate explaination may be is that certain popular sentiments that D3 is better (that seem to get stronger in the alternative realm) may indicate that too few people are buying and trying D2, and that's why i'm not hearing anything. but also, it is interesting, it appears that vitamin D3 may be its own hormone with its own effects? is this plausible. there seem to have been favourable studies on vitamin d supplementation for mood, but i don't remember if they used D3 or D2. i should look into that.
It is quite plausible that D3 has effects not directly related to its ability to be converted into 1,25-D.
> i am also a vegetarian. so i do not want to take D3 unless there is solid reasoning it could be better, the larger sheep industry is absolutely vile.
I think there is such reasoning, but I can't make a moral judgment for you.
Your vitamin D status is so low that it almost couldn't get any lower. I'm really concerned that you take immediate action to supplement your vitamin D intake. Your blood level of 25-D is only 4% of the "high normal" value. Frankly, I don't like the categories they use. What they call low normal may in fact be typical, but that cannot be equated with the concept of health or optimal function. In a relative sense, you barely have any vitamin D at all, and your body is reacting abnormally to try and keep you alive.
Take care,
Lar
Posted by Phillipa on October 26, 2008, at 19:33:54
In reply to Re: quite vitamin D deficient, strange results » iforgotmypassword, posted by Larry Hoover on October 26, 2008, at 14:10:08
Lar when the endo tested D levels for bones and results for D alone were 40 sent results in mail that said it was excellent and below 20 would be low and what is this D 2? Am I getting unrealiable info again? Was told to take l000Iu's of D a day for osteoporosis which I have. Phillipa
Posted by Larry Hoover on October 26, 2008, at 20:20:12
In reply to Re: quite vitamin D deficient, strange results » Larry Hoover, posted by Phillipa on October 26, 2008, at 19:33:54
> Lar when the endo tested D levels for bones and results for D alone were 40 sent results in mail that said it was excellent and below 20 would be low
It's important to know exactly what your results were, including the units. Was it ng/ml or nmol/l? And was that the level of 25-hydroxycholecalciferol (25-D or calcidiol), or 1,25-dihodroxycholecalciferol (1,25-D or calcitriol)?
>and what is this D 2?
Vitamin D2 is ergocalciferol. Prescription strength vitamin D is usually in this form, more as a tradition than for any other reason. Most OTC supplements are Vitamin D3, cholecalciferol. In food, plants supply D2, whereas animal sources are D3.
> Am I getting unrealiable info again? Was told to take l000Iu's of D a day for osteoporosis which I have. Phillipa
I don't know if you're getting unreliable information or not, but if you let me know your actual lab results, I can hazard a guess.
In the last decade, minimum recommended intake levels for vitamin D have been raised three times. Some labs, and some doctors, may not have kept pace with the news.
Lar
Posted by Phillipa on October 26, 2008, at 20:55:58
In reply to Re: quite vitamin D deficient, strange results » Phillipa, posted by Larry Hoover on October 26, 2008, at 20:20:12
Who knows this endo and all the other docs here only write normal or not normal. Have asked for actual results and they refuse to give them. I seriously have tried so many docs here I'm about ready to throw in the towel. thanks maybe that's another reason for being so tired on lower doses of benzos that and thyroid. Phillipa
This is the end of the thread.
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