Orig Post: My wife's 55, 5'2, 120lbs. SAD eater. She's been in pretty good health her whole life. A routine lab turned up elevated platelets (600) so doc requested more labs. After a month, she hadn't heard anything from doc, so requested to see her lab results. Platlettes still high (621), but what jumped at me was Vit D, 25-OH total 9 ng/ml! A lab from 2008 showed it was 7. She immediately called the doc, his nurse said, 'Oh, Wow, how'd we miss that?" They gave her 50,000IU to take 2X week for 12 weeks then reevaluate. However, she doesn't appear to have any classic signs of Vit D deficiency other than a case of wrist tendonitis that isn't healing after 6 mo. How can she be so healthy with such a huge Vit D deficiency for many years?
Update: She finished the D2 and had a recheck: Vit D, 25-OH D3 - 7ng/mL Vit D, 25-OH D2 - 74 Vit D, 25-OH Total - 81
Total Chol 298 Trig 161 LDL 280 HDL 52
Dr wants to see her ASAP. I know he'll say "Low-fat, whole-grain, and Statins" I'm afraid she will cave in and take the drugs, what is ya'all take on this situation?
asked byakman (3175)
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on September 30, 2011
at 09:04 AM
Thanks for the update!
The D2 increased since the Rx is D2. Natural vitamin D made in our skin is D3 however. I would second the insightful comments by Laurie D. D2 is unnatural in high amounts. Personally I have observed D2 cause the same symptoms as D3 deficiency because the pharmaceutical D2 is non-bioidentical and appears to cause insulin dysregulation in many folks (high glucoses, high insulin, insulin resistance).
The dosing is off. D2 has only 1/3 the 'potency' of vitamin D3 but again it is not bioidentical and the 25(OH)D3 test shows no change at all.
'The case against ergocalciferol (vitamin D2) as a vitamin' www.ajcn.org/content/84/4/694.full
A low HDL (< 60) and highish TG (> 60) indicate insulin resistance and often vitamin D deficiency, IMHO.
Von Hurst used vitamin D 4000 IU x6mos which lowered insulin resistance (but vitamin D blood levels only increased a little to ~40 ng/ml 'best' at highest average achieved). Von Hurst et al discuss 'considerable evidence from animal studies that adequate 25(OH)D concentrations are required for normal insulin secretion.' [Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand55ho are insulin resistant and vitamin D deficient - a randomised, placebo-controlled trial. Br J Nutr. 2010 Feb;103(4):549-55.]
Vitamin D 3000-6000 IU/day (20k 40k) improve wellness depression scores Norway which is pretty north of the equator and vitamin D deficiency is pandemic, like Alaska. [Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial.J Intern Med. 2008 Dec;264(6):599-609.]
Finally you can show this article to your wife's physician.
http://www.businessweek.com/lifestyle/content/healthday/650258.html "We found that daily intakes of vitamin D by adults in the range of 4,000-8,000 IU are needed to maintain blood levels of vitamin D metabolites in the range needed to reduce by about half the risk of several diseases -- breast cancer, colon cancer, multiple sclerosis and type 1 diabetes," study co-author Dr. Cedric Garland, a professor of family and preventive medicine at the University of California at San Diego, said in a university news release.
Garland is one of the advocates at grassrootshealth.net
on July 09, 2011
at 11:14 PM
The vitamin D that doctors prescribe is vitamin D2. This is not the same vitamin D that we synthesize from the sun. That is vitamin D3 which is available almost anywhere you can purchase supplements. Here is a good source of information about vitamin D including the two types and which is best. (Hint: the prescribed version is NOT the best form). http://www.grassrootshealth.net/documentation
on July 09, 2011
at 09:03 PM
How can she be so healthy with such a huge Vit D deficiency for many years?
She's not. Healthy people heal.
other than a case of wrist tendonitis that isn't healing after 6 mo.
on July 09, 2011
at 09:00 PM
Glad your wife is now getting her Vitamin D deficiency corrected. And it is possible that she has not been at her current low consistently, due to differing levels of sun exposure, etc over her normal course of daily living.
It is important to understand, also, the diffence between acute changes biologically and chronically developing changes. Take, for instance a woman who as she gets further into perimenopause, begins to have progressively worsening abnormally heavy bleeding with her periods. She then also begins to have disturbance in the frequency of these abnormally heavy periods, as in having two periods per month in which now, instead of bleeding for 3-4 days, her period now lasts for 7-8 days. I've seen a number of instances of this in which early on, the woman goes to her MD and labs are drawn, exam done etc, and she leaves frustrated with the advice that her blood work is good, hematocrit and hemeglobin fine, etc, and if the problem gets worse, a d and c could be done, or hysterectomy etc, but that the problem is not at that level now and the woman isn't too excited about those options either. "wAit and watch."
So, this goes on and on and maybe gets worse... (I have known any number of women in whom this got to the point where they literally had difficulty being at work as they were bleeding so much they were frequently having "accidents" and having to make many bathroom trips.)
Now, cut to the chase, say 8 months post MD visit...woman goes back to MD as nothing is changing. This time bloodwork is done and holy smokes! She has an H and H that is that of a person with an acute, life threatening bleed out whose pulse would be through the roof and BP through the floor, unable to stand, function, etc and who needs a transfusion NOW. And yet our woman, though she doesn't feel good and has low energy and may be pale, etc, does not have a significantly elevated pulse nor a bottomed out BP, though it may be lower than her normal and she drives herself to her appt and walks fine and has been working, albeit feeling more and more exhausted.
The difference is that one process is very rapid and the other is gradual. In the rapid onset, the body has no chance to adjust - equilibrate. In the chronic process, the body adjusts slowly and the person does not experience the acute symptoms that they would have easily identified as a BIG problem, if the onset had been rapid.
This can be true for a variety of health issues, both in the realm of what we call "physical" health issues as well as what we call "mental" health issues. (I do not accept the split. In my book, all disease, all health issues =biopsychosocial.)
There are many other examples.
A sort of habituation can and often does occur with a slowly evolving process.
on July 09, 2011
at 05:55 PM
I had my vitamin D levels tested right after finishing a strict Whole 50 in March (I asked for the test because I was experiencing constant fatigue, which was new to me). Result on March 13: 20 ng/ml.
I took 50,000 IU of vitamin D once each week (probably the same thing your wife was prescribed) and ramped up my sun exposure big time.
I was tested again on May 31 and my levels had risen to all of 29 ng/ml.
My doctor prescribed another 12 weeks of the 50,000 IU of vitamin D. I'm also getting sun and taking an additional 1,000 IU daily. Hopefully my levels will continue to rise.
I have a friend who had the almost exact same experience as I did, over the same time period - but hers rose from 16 to 20 ng/ml. She has two young sons, though, and I've read that sometimes pregnancy results in long-term depressed vitamin D levels. I've never been pregnant.
I may have had depressed vitamin D levels for a long time and just never noticed any symptoms - the fatigue I was experiencing could have been caused by something else because the fatigue disappeared in early March, around the same time I had the first test, and my vitamin D levels are still low.
I'm already bracing myself for the criticism - maybe the optimal level of vitamin D is lower than some people think?
on July 09, 2011
at 04:25 PM
She got lucky?
How about asking how there's a huge population of SAD eaters who stay skinny and live until 100 with no heart disease?
I think it comes down to luck and good genes. Sorry that it's not a very scientific answer but I don't think you're really going to find one in this case.