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One of the main complaints I took to the dr. on the day of my annual physical was musculoskeletal pain. My back aches all over, pretty much all the time - both muscles and bones.
Dr. did labs and they showed a Vitamin D deficiency. I had 20 when the minimum acceptable is supposed to be 21 (according to this lab). I read that the adequate amount for good health is actually much higher.
All other tests were very good.
Dr. prescribed a 50,000 unit a week capsule of elgocalciferol (Vit D2) for 12 weeks and said I should be back for labs when done. I have 5 more weeks to go but in the meantime I came in again because my back pain continues to bother me.
I read more on Vit D deficiency and learned that aches and pains in the back are a big symptom of Vit D deficiency.
Yet the dr. never really drew the connection between the two. He kept saying that he will do a few other tests to weed out everything, including specific inflammation in the body, but he never said "chances are your aches and pains are bc of the Vit D deficiency".
He said it is probably stress and over-work (which I am - both stressed and over-worked).
I also don't know why he put me on the D2 when you read everywhere the D3 is the way to go. Many people seem to report that the green pill of 50,000 IU D2 a week didn't do squat for their lab numbers.
Questions:
1. Does he sound like a good dr.? I should mention that I do like him overall, I like his personal style and love the fact that he takes his time and does not rush you through the visit (which is rare nowadays). I was just surprised at his apparently intentional failure to attribute my aches and pains to the Vit D deficiency. I guess he knows better...(???)...
2. Is it OK to supplement with a dry Vit D3 5000 IU a day while I am taking the dr-prescribed D2 once a week? Would it be too much? I really need those numbers up because I am so paranoid about serious chronic illness, I'd rather not get myself sick just stressing over the possibility of developing cancer because of a lack of D.
3. I DO plan to stay out in the sun without sunscreen (at least some!) from now on. Not enough to fry myself into another type of threat but SOME. The question is how much?
Looking back, I have indeed been the type of person who does not get much sun exposure at all (days in a row inside); when I do, I usually wear clothes that cover most of my body; I am not overweight but I just never felt like I had legs nice enough to show off ...so when I get out in the summer I either wear maxi dresses or long linen pants. Never shorts, not even when I exercise (which has been rarely lately).
Tops are usually short sleeve instead of strapless.
I also rarely, if at all, ate eggs, fish or drank milk. So go figure.
4. If I become a good girl Vitamin D-wise and do the works (continue with the supplements, eat the right kind of foods, stay out in the sun some every day)... how long should I expect until I recover from the 20 level deficiency and get into mid range?
5. Can a prior Vit D deficiency leave some damage even after recovery?
I will leave it to others to address specific questions . . .I just want to say, "Why are you not trusting yourself and your research?" Do you view doctors as gods who have all of the answers?
It looks like you have answered many of your own questions. If I were you, I would seek out a good medical doctor who is also schooled in holistic health . . .or maybe someone who has an M.D. and is also an acupuncturist. I would also see a nutritionist.
Why do you have Vitamin D deficiency? Do you get outside?
Before questioning your doctor's expertise it might work better if you asked your doctor the questions you have posed here. You did say he spent a lot of time with you.
Perhaps he did not want to attribute the pain to the vitamin D deficiency until he saw what happened when the deficiency was corrected.
It is possible to get too much vitamin D, so taking more than what has been prescribed is not a good idea.
From what you describe, your deficiency is probably due to inadequate intake. Modern lives make it hard to get Vitamin D from the sun, and the benefits of using sunscreen outweigh the risk of not making your own vitamin D. The supplement is the best way to go.
From the above link:
"In supplements and fortified foods, vitamin D is available in two forms, D2 (ergocalciferol) and D3 (cholecalciferol) that differ chemically only in their side-chain structure. Vitamin D2 is manufactured by the UV irradiation of ergosterol in yeast, and vitamin D3 is manufactured by the irradiation of 7-dehydrocholesterol from lanolin and the chemical conversion of cholesterol [6]. The two forms have traditionally been regarded as equivalent based on their ability to cure rickets and, indeed, most steps involved in the metabolism and actions of vitamin D2 and vitamin D3 are identical. Both forms (as well as vitamin D in foods and from cutaneous synthesis) effectively raise serum 25(OH)D levels [2]. Firm conclusions about any different effects of these two forms of vitamin D cannot be drawn. However, it appears that at nutritional doses vitamins D2 and D3 are equivalent, but at high doses vitamin D2 is less potent."
"Conclusion: D3 is approximately 87% more potent in raising and maintaining serum 25(OH)D concentrations and produces 2- to 3-fold greater storage of vitamin D than does equimolar D2."
Conclusion: A 1000 IU dose of vitamin D2 daily was as effective as 1000 IU vitamin D3 in maintaining serum 25-hydroxyvitamin D levels and did not negatively influence serum 25-hydroxyvitamin D3 levels. Therefore, vitamin D2 is equally as effective as vitamin D3 in maintaining 25-hydroxyvitamin D status."
Same journal, conflicting reports.
So high dose D3 might be a bit more potent than high dose D2. The studies are inconclusive. Since your deficiency appears to be marginal, it would seem reasonable to wait a few more weeks and see what the level is. Or, you could ask your doctor about switching to D3.
How long the level takes to come up will depend on sp many variables that it would be hard to predict. Seeing what the next one is will give you a better idea.
So I see no reason to doubt your doctor's judgment at this point. And your level is so close to the lower limit of normal that it would be unlikely that you will suffer any long term effects from the deficiency.
I will leave it to others to address specific questions . . .I just want to say, "Why are you not trusting yourself and your research?" Do you view doctors as gods who have all of the answers?
It looks like you have answered many of your own questions. If I were you, I would seek out a good medical doctor who is also schooled in holistic health . . .or maybe someone who has an M.D. and is also an acupuncturist. I would also see a nutritionist.
Why do you have Vitamin D deficiency? Do you get outside?
No, I never just throw myself in the hands of the drs. I always try to understand and educate myself as much as possible.
I am pretty much as educated as they are, only I have a PhD instead of an MD and IT IS related to health.
That being said I can't deny that they do have a whole lot more knowledge than I do in the health area so I am also waiting to hear what they have to say too.
Btw, it is not easy to find an MD who is also schooled in holistic health. I have tried in the past with no luck.
From what you describe, your deficiency is probably due to inadequate intake. Modern lives make it hard to get Vitamin D from the sun, and the benefits of using sunscreen outweigh the risk of not making your own vitamin D. The supplement is the best way to go.
I am now taking supplements because my levels really are too low and I will take tjem until the numbers look better.
However, generally speaking, I don't think supplements are the answer to health problems.
If humans have gotten their vitamin D for millenia from the sun, this to me is a red flag from nature that we might consider doing just the same as our ancestors did. Genetic mutations don't happen over night, the night being the terribly short amount of time that took humans to modernize their lives.
Just because we decided that modern humans are to spend their lives indoors in windowless offices, doesn't mean this is normal and that such modern human won't get a serious spanking from nature for doing so.
Nature doesn't care about our socio-economic arrangements and our so-called "advancements"; SHE still wants us to live like aborigines in many different ways. As in "get your Vit D from sun and some fish" as opposed to pills made in a lab, as "scientific" as that lab might be.
I am lucky because I have the kind of job that allows me to make some significant changes in this direction - now that I have become aware of the need to make them.
Right now I am typing from my deck as I took the computer outside and got my butt (actually my back) out in the morning sun.
However, I know that not everybody is so lucky and that people stuck daily in a car, then a dark office/cubicle, then a car again from 8 till 7 pm, might only have the chance to stuff themselves with D pills hoping for the best.
I also don't believe in the sunscreen hysteria. Not the recs that say you should drown yourself in sunscreen every time you step out. If people have not done this for all history, why would they have to do it now?
Has the sun gotten closer to the Earth? Doubtful.
I DO put on sunscreen when at the pool, on the beach, or just when outside longer (and yeah, when would THAT be?).
I just know that if you get carried away by modern life (which I have, like most people) you will be in trouble sooner or later.
I am now taking supplements because my levels really are too low and I will take tjem until the numbers look better.
However, generally speaking, I don't think supplements are the answer to health problems.
If humans have gotten their vitamin D for millenia from the sun, this to me is a red flag from nature that we might consider doing just the same as our ancestors did. Genetic mutations don't happen over night, the night being the terribly short amount of time that took humans to modernize their lives.
Just because we decided that modern humans are to spend their lives indoors in windowless offices, doesn't mean this is normal and that such modern human won't get a serious spanking from nature for doing so.
Nature doesn't care about our socio-economic arrangements and our so-called "advancements"; SHE still wants us to live like aborigines in many different ways. As in "get your Vit D from sun and some fish" as opposed to pills made in a lab, as "scientific" as that lab might be.
I am lucky because I have the kind of job that allows me to make some significant changes in this direction - now that I have become aware of the need to make them.
Right now I am typing from my deck as I took the computer outside and got my butt (actually my back) out in the morning sun.
However, I know that not everybody is so lucky and that people stuck daily in a car, then a dark office/cubicle, then a car again from 8 till 7 pm, might only have the chance to stuff themselves with D pills hoping for the best.
I also don't believe in the sunscreen hysteria. Not the recs that say you should drown yourself in sunscreen every time you step out. If people have not done this for all history, why would they have to do it now?
Has the sun gotten closer to the Earth? Doubtful.
I DO put on sunscreen when at the pool, on the beach, or just when outside longer (and yeah, when would THAT be?).
I just know that if you get carried away by modern life (which I have, like most people) you will be in trouble sooner or later.
Since Mother Nature is also responsible for hurricanes, volcanic eruptions, and the ebola virus, I am not sure that the argument that it is better to forgo the Vitamin D from the lab in favor of sunshine will hold.
My DH and his mother have both has melanomas, his very superficial and hers a bit deeper. His was on his face, hers on the back of her hand. I do believe that daily sunscreen is a good idea.
Getting vitamin D from the sun without incurring other sun related skin damage is problematic, too. Depending on the time of day, cloud cover, smog,season of the year and how far you live from the equator, the time you need to spend outdoors varies greatly. In some areas, during the winter, it may be impossible. Even the amount of subcutaneous fat influences blood levels of Vitamin D (See the link in my last post.) Then you have to consider your level of skin pigmentation, too.
If you read some of my previous posts, you will find that I am not a fan of supplements in general. But in your situation we are not talking about a dietary supplement, we are talking about therapeutic doses. I have had my Vitamin D levels checked. I do not need a supplement. Apparently my lifelong milk intake has been sufficient. If I did need to increase my level, I would not trust the vagaries of sun exposure to do it.
Since Mother Nature is also responsible for hurricanes, volcanic eruptions, and the ebola virus, I am not sure that the argument that it is better to forgo the Vitamin D from the lab in favor of sunshine will hold.
With all due respect, I think this is a very unfortunate analogy.
Quote:
Originally Posted by suzy_q2010
But in your situation we are not talking about a dietary supplement, we are talking about therapeutic doses. I have had my Vitamin D levels checked. I do not need a supplement. Apparently my lifelong milk intake has been sufficient. If I did need to increase my level, I would not trust the vagaries of sun exposure to do it.
Oh, I AM taking the prescription supplements, no question about it!!
And I will continue to supplement the D for a good while until I am convinced the numbers can stay up without supplementation.
I just would not trust some pills exclusively without doing what LIFE expects us to do: eat well, be out in the sun at least a bit every day (yes, without sunscreen!), take fresh air, get your sleep, don't eat the junk sold as "food" by the Food industry. The works.
All these are supposed to be "common sense" and yet they are in fact excruciatingly hard to achieve for your average modern person, especially the moderns of America.
Thank you for the link, I will read it. And let me return the favor and recommend what I found to be two phenomenally good books about health:
You can get plenty of sun and still have a deficiency. If your body doesn't efficiently process what it's getting from the sun, like it's supposed to do, then you will need to supplement.
It's entirely possible that for -whatever- reason, your body just simply isn't processing the sun it does get, efficiently enough to provide you with the proper amount of vitamin D. That could be, because you're not exposing yourself to direct sun for long enough on a daily basis, 365 days per year. Or maybe you're not exposing -enough- of yourself on a daily basis, 365 days per year.
Perhaps just exposing your face and arms to the sun isn't enough. Try nude sunbathing at high noon, as close to the equator as possible, for no less than 20 minutes per day. Without sunscreen.
Or - be a little more pragmatic, get out in the sun when you can, and supplement.
The earth's atmosphere wasn't like it is now, back when our ancestors didn't have vitamin D deficiencies. We -cannot- safely do what our ancestors used to do. But our bodies still need what our ancestors needed. So - if your body needs a boost, then you get a boost.
You can get plenty of sun and still have a deficiency. If your body doesn't efficiently process what it's getting from the sun, like it's supposed to do, then you will need to supplement.
It's entirely possible that for -whatever- reason, your body just simply isn't processing the sun it does get, efficiently enough to provide you with the proper amount of vitamin D. That could be, because you're not exposing yourself to direct sun for long enough on a daily basis, 365 days per year. Or maybe you're not exposing -enough- of yourself on a daily basis, 365 days per year.
Perhaps just exposing your face and arms to the sun isn't enough. Try nude sunbathing at high noon, as close to the equator as possible, for no less than 20 minutes per day. Without sunscreen.
Or - be a little more pragmatic, get out in the sun when you can, and supplement.
The earth's atmosphere wasn't like it is now, back when our ancestors didn't have vitamin D deficiencies. We -cannot- safely do what our ancestors used to do. But our bodies still need what our ancestors needed. So - if your body needs a boost, then you get a boost.
Thank you, Anonchick. These are good points. I am much more sun conscious now and will make efforts to get more sun exposure as I really think I wasn't getting enough, hence the defieciency.
In addition, I rarely, if ever, eat any of the few foods that contain Vit D. I will from now on, that's for sure...
But there's really no shame in having to take a Vitamin D supplement. Thankfully they're a lot smaller than calcium pills. The downside, is D's don't come in chewables that I know of.
I take a kid's chewable multivitamin every morning. It doesn't have a lot of D in it, but it does have -some- in it. Plus I try to get outside in fresh air for at least 15 minutes every day (average around 1/2 hour and on weekends often for a few hours each day). I -also- like fortified cereal for breakfast in the morning (highly processed crap that organic junkies insist is bad for you, like Frosted Mini Wheats). Plus I eat a couple eggs every week, and I'm a cheese freak. All of these foods have at least -some- vitamin D in them, more than other foods. So if you enjoy these foods, try eating a little more of them every week. If you never thought to eat some of them, now's the time to consider it.
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