Posted by Larry Hoover on March 10, 2007, at 14:14:34
In reply to Re: Vitamin D deficiency-- Follow Up, posted by natrfrk on March 9, 2007, at 11:52:12
> Ok, here is the test name:
> Vitamin D, 25 - Hydroxy, LC/MS/MSLiquid chromatography/tandem mass spec. Sounds appropriate.
> Reference Range 20 - 100 ng/mL
>
> Vitamin D, 25 - OH, Total, Out of Range 15
> Vitamin D, 25 - OH, D3 this one is listed under the "in range" 15, although it is not in the range.
> Vitamin D, 25 - OH, D2 also under the "in range" <4
> Then it says: Vitamin D, 25 - OH, D3: Endogenous form of Vitamin D present in the body.Okay, you're clearly deficient. Blood sampling actually offers an historical average of D exposure, as it is one the vitamins that is fat soluble, and stored for later requirements. To have your blood stores that low means your liver is virtually empty, too. That's why such large doses over extended times are recommended. You need some now, but you need to store a bunch away, too.
> Vitamin D, 25 - OH, D2: Used for therapeutic purposes in Vitamin D deficient states.
>
> This test was performed using the LC/MS/MS methodolgy.
>
> 25-OHD3 indicates both endogenous production and supplementation.Right. Though eating flesh provides some.
> 25-OHD2 is an indicator of exogenous sources such as diet or supplementation.
Ergocalciferol is plant-based. I don't recommend it as a supp, though. All the fears of vitamin D toxicity arise from two factors. Ergocalciferol is toxic in high doses; they assume bioequivalency between cholecalciferol (D3) and ergocalciferol (D2). As you note, there is a profound difference.
> Therapy is based on measurement of Total 25-OHD, with levels <20 ng/mL suggesting Vitamin D deficiency while levels between 20 and 30 suggesting insufficiency. In both situatios there is need for intense to moderate supplementation. In patients using D2 (ergocalciferol) supplementation, levels of 4 ng/mL of 25-OHD2 or greater suggest compliance.
That's about the only possible argument for D2. Compliance? How about taking a D3 level again?
> That's the whole page on Vitamin D
> And my prescription is for D3 @ 50,000
> All the pharmacies I have called have D2 and tell me it's the same thing , Vit D is Vit D.
> I know better than that. And it's $20.I'm glad you know that. They couldn't be more wrong.
> I want to be sure I get the Correct D since it's such a high dose.
If I had to pay for the supp (i.e. you won't get reimbursed by medical insurance), I'd just go buy a bunch of 1,000 IU D3 tablets at Walmart. You can distribute your dose as you see fit (noting your earlier concern).
> Please share with me your thoughts, when you can.
I'll also go back to earlier posts.
> Oh, and Maddie, I don't drink milk. I rarely go outside either. My doctor thought I had hypothyroid, and I read that hypothyroid interferes with metabolization of Vit D. My ranges came back within normal range though (2.15 , Their range was .4 - 5.5). So I guess mine is caused by years of avoiding the sun...That would do it. Apparently, you've been avoiding cod liver oil, too. ;-)
Lar
poster:Larry Hoover
thread:739011
URL: http://www.dr-bob.org/babble/health/20070227/msgs/739888.html