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Vitamin D levels (Read 3938 times)
Katherinecm
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Vitamin D levels
Jun 28th, 2012 at 5:00pm
 
My CH got much worse with the heat wave that came through about 10 days ago.

I went to the doctor to have my 25 (OH) D serum and my thyroid tested, since both of those have made a difference in the past.

I've been taking 10,000 IU of D3 for 6 months.  Also, prenatal vitamins, vitamin A, and a very high iodine supplement (50 mg/day of iodine and potassium).  And I've been drinking a lot of milk, so calcium shouldn't be an issue.

My thyroid TSH result is the best I've ever had - down to 2.829.  All thyroid related symptoms seem to be gone.

But my 25 (OH) D serum levels are only 64.  After having taken 10,000 IU a day for more than six months!  I did change brands a couple of months ago, but until 10 days ago it still seemed to be working.

I'd spend more time in the sun, but it's 100 degrees outside and heat is a trigger.

How high of a dose do I need to go to get to the 150 nmol/L that Batch recommends?
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Bob Johnson
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Re: Vitamin D levels
Reply #1 - Jun 28th, 2012 at 10:47pm
 
It would be wise to be aware of this material and discuss it with our doc.
==============================

Re: WARNING-vitamin "D"
Reply #6 - May 28th, 2012 at 10:04am       Lenny, I appreciate your posting this warning for it serves to illuminate a special problem with self-help group, like ours. We lack the education/experience to be aware of the full range of potential outcomes surrounding any treatment we choose to use--or to recommend to others. While docs and mfgs are shaped by law and ethics to give this information, it's too easy for us to not pay attention to this issue--nor to even know how/where we would find such material.

A related issue: side effects are not neat, 1:1, effects from using any particular med, dose, or technique. There are so many variables affecting whether a troubling side effect develops that the best any medical authority can do is to provide ranges of variables associated with the potential for a negative effect.

You can see this in the following material. There is useful guidance but no, "use this dose and it's O.K.; use this dose and it creates problems." BUT to not have any guidance leaves us flying blind.
================================
[Source is the National Institutes of Health, the major medical research organization of the USA.]

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Health Risks from Excessive Vitamin D

VITAMIN D TOXICITY CAN CAUSE NON-SPECIFIC SYMPTOMS SUCH AS ANOREXIA, WEIGHT LOSS, POLYURIA, AND HEART ARRHYTHMIAS. MORE SERIOUSLY, IT CAN ALSO RAISE BLOOD LEVELS OF CALCIUM WHICH LEADS TO VASCULAR AND TISSUE CALCIFICATION, WITH SUBSEQUENT DAMAGE TO THE HEART, BLOOD VESSELS, AND KIDNEYS [1]. The use of supplements of both calcium (1,000 mg/day) and vitamin D (400 IU) by postmenopausal women was associated with a 17% increase in the risk of kidney stones over 7 years in the Women's Health Initiative [65]. A serum 25(OH)D concentration consistently >500 nmol/L (>200 ng/mL) is considered to be potentially toxic [5].
Excessive sun exposure does not result in vitamin D toxicity because the sustained heat on the skin is thought to photodegrade previtamin D3 and vitamin D3 as it is formed [6]. In addition, thermal activation of previtamin D3 in the skin gives rise to various non-vitamin D forms that limit formation of vitamin D3 itself. Some vitamin D3 is also converted to nonactive forms [1]. Intakes of vitamin D from food that are high enough to cause toxicity are very unlikely. Toxicity is much more likely to occur from high intakes of dietary supplements containing vitamin D.
Long-term intakes above the UL increase the risk of adverse health effects [1] (Table 4). Most reports suggest a toxicity threshold for vitamin D of 10,000 to 40,000 IU/day and serum 25(OH)D levels of 500–600 nmol/L (200–240 ng/mL). While symptoms of toxicity are unlikely at daily intakes below 10,000 IU/day, the FNB pointed to emerging science from national survey data, observational studies, and clinical trials suggesting that even lower vitamin D intakes and serum 25(OH)D levels might have adverse health effects over time. THE FNB CONCLUDED THAT SERUM 25(OH)D LEVELS ABOVE APPROXIMATELY 125–150 NMOL/L (50–60 NG/ML) SHOULD BE AVOIDED, AS EVEN LOWER SERUM LEVELS (APPROXIMATELY 75–120 NMOL/L OR 30–48 NG/ML) ARE ASSOCIATED WITH INCREASES IN ALL-CAUSE MORTALITY, GREATER RISK OF CANCER AT SOME SITES LIKE THE PANCREAS, GREATER RISK OF CARDIOVASCULAR EVENTS, AND MORE FALLS AND FRACTURES AMONG THE ELDERLY. The FNB committee cited research which found that vitamin D intakes of 5,000 IU/day achieved serum 25(OH)D concentrations between 100–150 nmol/L (40–60 ng/mL), but no greater. Applying an uncertainty factor of 20% to this intake value gave a UL of 4,000 IU which the FNB applied to children aged 9 and older, with corresponding lower amounts for younger children.
Table 4: Tolerable Upper Intake Levels (ULs) for Vitamin D [1] Age Male Female Pregnancy Lactation  {see at citation source}


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« Last Edit: Jun 29th, 2012 at 5:54am by Bob Johnson »  

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Re: Vitamin D levels
Reply #2 - Jun 29th, 2012 at 1:09am
 
Code:
THE FNB CONCLUDED THAT SERUM 25(OH)D LEVELS ABOVE APPROXIMATELY 125–150 NMOL/L (50–60 NG/ML) SHOULD BE AVOIDED, AS EVEN LOWER SERUM LEVELS (APPROXIMATELY 75–120 NMOL/L OR 30–48 NG/ML) ARE ASSOCIATED WITH INCREASES IN ALL-CAUSE MORTALITY, GREATER RISK OF CANCER AT SOME SITES LIKE THE PANCREAS, GREATER RISK OF CARDIOVASCULAR EVENTS, AND MORE FALLS AND FRACTURES AMONG THE ELDERLY. 



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Re: Vitamin D levels
Reply #3 - Jun 29th, 2012 at 7:30am
 
I've been on it for about 3 months. The lion's share of the time I was taking 20,000 iu / day with a loading dose of 50,000 iu once a week. Just had my second 25(OH)D test three weeks ago and I'm at 74 ng/mL. I got my first test after I'd been on the higher dose for a month and I was at 55 ng/mL.

I'm now down to 10,000 iu / day because I've been pain free for weeks.
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Re: Vitamin D levels
Reply #4 - Jun 29th, 2012 at 9:07am
 
Hey Katherine,

The short answer is see your doctor about increasing your intake of vitamin D3 from 10,000 IU/day to 15,000 or 20,000 IU/day... and ask for another set of labs in 30 days.

Bob has posted an earlier warning about the dangers of taking too much vitamin D3. I respect that.

I also respect the writings of several experts in the medical field of endocrinology, Principal Investigators conducting studies on vitamin D3 metabolism and physicians who routinely test and treat patients with vitamin D3 deficiency.

If you want to keep score, they outnumber authors of articles warning against taking too much vitamin D3.

That said, it is possible to take too much of this nutrient...  However, the amount of vitamin D3 we've been talking about here at CH.com is well below the sustained dose (>40,000 IU/day), that could result in vitamin D3 intoxication. 

The Vitamin D3 Council says it best in the opening paragraph of their discussion on vitamin D3 toxicity... 

"Can too much vitamin D be harmful? Yes, it certainly can - though anything can be toxic in excess, even water. As one of the safest substances known to man, vitamin D toxicity is very rare. In fact, people are at far greater risk of vitamin D deficiency than they are of vitamin D toxicity."

I would add to that, the key phrase I've seen that applies to your situation is "there is a wide variability in the rate at which people metabolize vitamin D3." 

I would also add that there have been no recorded deaths due to vitamin D3 toxicity and no Level I RCTs with results suggesting vitamin D3 is a health hazard. 

Unfortunately, the same can't be said for verapamil.  The FDA listed verapamil as the probable cause of 133 deaths between April 2009 to March 2010.  See the following link for details:  Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register.

I'm not suggesting CH'ers not take verapamil...  They just need to be aware it is a powerful medication and that it should only be taken under a physician's supervision.

I won't post or quote the full text of writings by two of the eminent experts in vitamin D3 therapy, Dr. Reinhold Vieth and Dr. Robert heaney.  However in his 1999 paper titled "Vitamin D supplementation, 25-hydroxyvitamin D concentrations,
and safety
" at the following link:  Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register, Dr. Vieth concluded a supplemental dose of vitamin D3 at 10,000 IU/day was the equivalent of spending 10 to 15 minutes in the mid day sun wearing a bathing suit and no sun block.

Dr. Robert Heaney, M.D. who has been kind enough to mentor me on the pharmacokinetics of vitamin D3 and how to improve the effectiveness of the anti-inflammatory regimen, authored results of a study of vitamin D3 titled: "Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol" at the following link: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register

This study concluded that any given dose of vitamin D3 resulted in an average equilibrium value for 25(OH)D and that higher daily intake of vitamin D3 results in higher average equilibrium values of 25(OH)D.  The operable word here is average... 

For example a vitamin D3 dose of 10,000 IU/day results in an average serum concentration of 25(OH)D around 90 ng/mL at six months in the chart below.

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A third vitamin D3 study by Garland, et al, that Dr. Heaney also participated in, provided similar results. During this study, people volunteered to take vitamin D3 at whatever dose they desired at their own expense then paid $65 dollars every six months to have their serum concentration of 25(OH)D tested by ZRT labs. 

Using the same medical diagnostic lab and same assay methods eliminated any variables due to testing.

The resulting chart shown below shows the average response to various doses of vitamin D3 after six months.  It also shows the 95% probability band where 95% of the results would fall after six months. 

If you'll check the minimum and maximum values for this 95% probability band at a dose of 10,000 IU/day vitamin D3, you'll see the resulting serum concentration of 25(OH)D could be as low as 30 ng/mL to as high as 110 ng/mL after six months.

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This is clearly another indication of the variability in the rate at which people metabolize vitamin D3 into 25(OH)D.

This study concluded that a universal intake of up to 40,000 IU vitamin D3 per day is unlikely to result in vitamin D toxicity.

Hope this helps,

Take care,

V/R, Batch

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