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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Klaus on May 21, 2010, at 16:49:14
Hello,
for 3 years I am struggling with depression and fatigue and recently I had my 25(OH)D3 checked which turned out to be very low (6.3ng/ml).
Due to my low level I started supplementing Vitamin D3 and noticed a strong increase in fatigue and depression. I have been successfully taking Selegiline/Deprenyl (MAO-B inhibitor) for some months against my fatigue and depression but once I start taking Vitamin D3 it doesn't seem to have any effect anymore. Once the Vitamin D3 dose has worn off again (which might take weeks) I magically feel better. I tried low doses of Vitamin D3 (200IU), high doses (5000IU), dry tablets and gelcaps and always come up with the same result. I also tried magnesium (as glycinate 600mg) and calcium (800mg) - no success. I understand that Vitamin D3 plays a big role and it is definitely recommended to increase my levels. However, what is the reason of this fatigue???? I spent hours googling a possible reason.. but didn't come up with a definite answer. I found things like die-off symptoms (herxheimer), magnesium deficiency, autoimmune diseases (sarcoidosis...),... It is much easier to cope with this Vitamin D3 induced fatigue if I know the reason of these adverse effects. A friend of mine (a healthy person) complains about similar issues after taking 4000IU for several days.- Does anybody have similar experience with Vitamin D3? If yes, did the fatigue resolve after some time?
- Does anybody know a possible reason of these effects?
Posted by Phillipa on May 21, 2010, at 17:18:37
In reply to Vitamin D3 and fatigue, posted by Klaus on May 21, 2010, at 16:50:44
Hi Klaus. I agree that is a low level. Do you get out in the sun? As they say 15-20 minutes of sun should provide enought D3? Autoimmune diseases with low D3? I will look also. Phillipa
Posted by Klaus on May 21, 2010, at 17:27:25
In reply to Re: Vitamin D3 and fatigue » Klaus, posted by Phillipa on May 21, 2010, at 17:18:37
Hello Phillipa,
thank you for your answer. To be honest, I don't go out in the sun often. I am definitely going to change that.
Posted by Phillipa on May 21, 2010, at 17:28:20
In reply to Re: Vitamin D3 and fatigue » Klaus, posted by Phillipa on May 21, 2010, at 17:18:37
Found nothing to explain fatigue from taking D3 but sun was really the recommended way. Phillipa
Posted by janejane on May 21, 2010, at 18:36:00
In reply to Vitamin D3 and fatigue, posted by Klaus on May 21, 2010, at 16:50:44
Wow, that's a low level. Has it come up at all since you started supplementing? I've heard of D3 improving mood and increasing energy, but not the opposite. What does your doc say?
I took 5000 IU/day for a while (my level was 30 and doc wants 50) and I didn't notice any change in mood or energy level. Now I'm at 2000 since last time I checked, I was very close to the target.
Posted by StillHopefull on May 21, 2010, at 19:54:27
In reply to Re: Vitamin D3 and fatigue, posted by Klaus on May 21, 2010, at 17:27:25
Hi -
When my Vit. D level was very low, my doctor prescribed a very high dose that was only available by prescription - 50,000 units (yes, 50,000) per day which I took for one month. Now I take 6000 units per day for maintenance.
I really don't feel more energetic now, but my depression is better. Its not all because of the Vit. D though...
I wonder why your doctor didn't go with the higher dose just to get you jump started?
Posted by Phillipa on May 21, 2010, at 21:04:58
In reply to Re: Vitamin D3 and fatigue » Klaus, posted by StillHopefull on May 21, 2010, at 19:54:27
I also wonder but didn't Klaus say that his fatique was worse on the D? Must read again. Phillipa
Posted by softheprairie on May 22, 2010, at 5:15:20
In reply to Vitamin D3 and fatigue, posted by Klaus on May 21, 2010, at 16:50:44
Klaus, I'm sorry for your worse reaction, and I'm totally stumped as to why. I've never heard of it doing that.
I usually take around 5,000 iu of supplemental D3 a day, starting maybe a year ago(?), and it coincided with (not necessarily caused) improved mood for me. Improved mood, but not much improvement in fatigue.I had comprehensive labs done in 2005, and my vitamin D rate was in the 30s if I recall correctly (I'm sorry I don't know the unit of measurement for the bloodwork). More recently, after starting on heavy vitamin D supplementation my rate around 6 months ago was 72. I follow a vitamin guru on this who says our goal should be 80-120, so I was pleased to be close. Mainstream labs that have not updated with the current literature may call 30-80 or 30-100 normal or standard, if I recall correctly, but I think I take issue with them.
Posted by Klaus on May 22, 2010, at 6:24:39
In reply to Re: Vitamin D3 and fatigue » Klaus, posted by softheprairie on May 22, 2010, at 5:15:20
Thank you for your answers!
Exactly this is what scares me so much: my problems are very uncommon and nobody really knows the reason why. On the internet I found several people with similar results: http://www.easy-immune-health.com/vitamin-d-and-drowsiness1.html
I wouldn't have a problem if I knew that this fatigue would go away after some time... I am afraid that this fatigue is connected to some adverse reaction of my immune system which in turn would show that something is seriously wrong with me.
As to my doctor, I have to say that he is a very bad one. He even wanted to talk me out of testing my vitamin D: "Vitamin D deficiency doesn't exist...". And when it turned out that I only have 6.3ng/ml he only gave me 1000IU tablets. He doesn't take my problems with Vitamin D3 induced fatigue seriously either.
Posted by chujoe on May 22, 2010, at 7:15:32
In reply to Re: Vitamin D3 and fatigue, posted by Klaus on May 22, 2010, at 6:24:39
Maybe a new doctor is in order. Not always easy, I know. I take 2000-3000 units a day of D & it's done nothing but good for me. Along with fish oil and 4000 units of vitamin C. My AD (Cymbalta) makes me a little sleepy in the afternoons, but I don't have general fatigue, though I now also take 10-20 mg of Ritalin per day, as needed for ADHD, so that probably keeps me awake. Vitamin C boosts the immune system, if that's a worry, and has virtually no toxicity, even at high doses.
Maybe you should talk to a nutritionist or an endocrinologist. Best of luck.
Posted by janejane on May 22, 2010, at 7:58:19
In reply to Re: Vitamin D3 and fatigue » Klaus, posted by softheprairie on May 22, 2010, at 5:15:20
> I follow a vitamin guru on this who says our goal should be 80-120, so I was pleased to be close. Mainstream labs that have not updated with the current literature may call 30-80 or 30-100 normal or standard, if I recall correctly, but I think I take issue with them.
You might want to check whether your guru goes by ng/ml or nmol/L. (30 ng/ml is about 75 nmol/L.) Just for clarification, I was going by ng/ml in my post, same as the original poster. There is a lot of controversy about what the optimal level should be, and it doesn't help that two different measurement systems are used.
Posted by janejane on May 22, 2010, at 10:46:27
In reply to Re: Vitamin D3 and fatigue » Klaus, posted by softheprairie on May 22, 2010, at 5:15:20
I just re-read what I wrote above, and realized it might sound snarky. (I think it's the word "guru.") If so, I apologize as it wasn't meant that way. I do think that if he goes by ng/ml, 120 seems high for the upper end, compared to what most Vitamin D advocates recommend (I'm talking here about people who consider the current standards to be too conservative, e.g., the Vitamin D Council, which considers 50-80 to be optimal). I've seen 3 holistic docs in the past year and all seemed to feel 50 is adequate though a bit higher is probably even better. (They did all agree that 30 is too low, though that's the cut-off most labs seem to use for insufficiency. In nmol/L, that'd probably be 75 or 80.) There is a lot of disagreement, though, so it's really hard to know what to aim for as an optimal number.
Posted by janejane on May 22, 2010, at 11:21:09
In reply to Re: Vitamin D3 and fatigue, posted by Klaus on May 22, 2010, at 6:24:39
Scroll down to the bottom of the following link where it talks about hypersensitivy:
http://www.vitamindcouncil.org/vitaminDToxicity.shtml
I looked up hypercalcemia and one symptom is fatigue. Here's another link (see paragraph 4, where it talks about hyperparathyroidism):
http://findarticles.com/p/articles/mi_m0ISW/is_280/ai_n16865219/pg_2/
And here (top paragraph):
http://findarticles.com/p/articles/mi_m0FDN/is_1_13/ai_n25332537/pg_12/
Honestly, I don't know if this relates to what's going on with you, but thought it might give you some leads. Maybe you should see an endocrinologist.
Posted by janejane on May 22, 2010, at 11:27:24
In reply to Vitamin D3 and fatigue, posted by Klaus on May 21, 2010, at 16:50:44
Oops. I accidentally submitted the last post when I wanted to keep writing. Anyway, you might want to look into Vitamin D hypersensitivity, hypercalcemia, and hyperparathyroidism. It's probably a long shot, but something that might explain what's going on.
Posted by Klaus on May 22, 2010, at 13:29:36
In reply to Re: Vitamin D3 and fatigue » Klaus, posted by janejane on May 22, 2010, at 11:27:24
Hmm, my doc did a calcium check as well. Despite my vitamin D deficiency the calcium value was normal. I read that in vitamin D deficiency the PTH value can be increased. If I suddenly start supplementing vitamin D3 the calcium level might increase too much and, therefore, cause symptoms of hypercalcemia. Could this be the case???
Posted by janejane on May 22, 2010, at 14:15:28
In reply to Re: Vitamin D3 and fatigue, posted by Klaus on May 22, 2010, at 13:29:36
> Hmm, my doc did a calcium check as well. Despite my vitamin D deficiency the calcium value was normal. I read that in vitamin D deficiency the PTH value can be increased. If I suddenly start supplementing vitamin D3 the calcium level might increase too much and, therefore, cause symptoms of hypercalcemia. Could this be the case???
Honestly, the chemistry stuff gets over my head, but I think that's what those links suggested as a possibility.
Posted by softheprairie on May 22, 2010, at 16:47:12
In reply to Re: Vitamin D3 and fatigue » softheprairie, posted by janejane on May 22, 2010, at 10:46:27
> I just re-read what I wrote above, and realized it might sound snarky. (I think it's the word "guru.") If so, I apologize as it wasn't meant that way. I do think that if he goes by ng/ml, 120 seems high for the upper end, compared to what most Vitamin D advocates recommend (I'm talking here about people who consider the current standards to be too conservative, e.g., the Vitamin D Council, which considers 50-80 to be optimal). I've seen 3 holistic docs in the past year and all seemed to feel 50 is adequate though a bit higher is probably even better. (They did all agree that 30 is too low, though that's the cut-off most labs seem to use for insufficiency. In nmol/L, that'd probably be 75 or 80.) There is a lot of disagreement, though, so it's really hard to know what to aim for as an optimal number.
I think my rates were all ng/ml, and the guru's also (lol). Maybe it's best that I try to keep mine in the 70s after all. I do respect groups like the Vitamin D Council, at least what little I know of them.
Posted by softheprairie on May 22, 2010, at 18:17:33
In reply to Re: Vitamin D3 and fatigue, posted by Klaus on May 22, 2010, at 13:29:36
> Hmm, my doc did a calcium check as well. Despite my vitamin D deficiency the calcium value was normal. I read that in vitamin D deficiency the PTH value can be increased. If I suddenly start supplementing vitamin D3 the calcium level might increase too much and, therefore, cause symptoms of hypercalcemia. Could this be the case???
I would request a PTH lab. Low Vit. D and/or low calcium shows up sooner as elevated PTH before your blood calcium shows deficiency, by a long shot (I have read multiple times, but I'm no expert). I don't imagine you would get to excess blood calcium with Vit. D and calcium supplementation (but I'm still a novice at this).
Posted by desolationrower on May 23, 2010, at 17:46:46
In reply to Re: Vitamin D3 and fatigue » Klaus, posted by softheprairie on May 22, 2010, at 18:17:33
um, it might be increasing dopaminergic function, which might be acting the same way a DA agonist does.
i think D3 is also needed for melatonin synthesis. more daylight might be good.
D3 should be taken with adequate k2 and enough a/pro-vitaminA caroteinoid. though i can't think of why that would matter here.
i'd guess the most likely reason is placebo
-d/r
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