Vitamin D deficiency

[ShesAGreatGas]

I had some blood tests done last month as I have been feeling really rundown and tired. The results showed that I have very low Vit D, and I have been given high strength capsules to take for a month, and then will need to take normal supplements every day after that.

However, since starting the high strength capsules 5 days ago I have been feeling worse than ever. I am so exhausted it is unreal. I could barely keep my eyes open by lunchtime yesterday and today - not great when you're at work!

I also feel nauseous and really out of sorts, and I look shockingly pale.

Def not pregnant (had period 2 weeks ago). All my other blood results - thyroid, iron, B12, liver function, diabetes etc - came back fine.

I'm starting to feel really down about how awful I feel. Going to go back to doctors next week, but just wondered if anyone else had had Vit D deficiency and how quickly they felt better after starting treatment?

The first couple of weeks I felt AWFUL, even worse than before, like you. Then about three weeks in, I woke up and didn't. It was GREAT. It was as if my body was "eating" the extra Vit D and going "I NEED MORE" at first.

Been on the high strength capsules for 9 months now and I almost feel normal (although even with the supplements, my levels are only at the low end of the normal range, apparently, so I'll be on them for a while).

what strength are the high strenght ones? I am concerned i am deficient and have started on supplements

There was a thread last year about Vit D which prompted me to get my Vit D levels checked. I did that privately, though it’s an NHS laboratory that does the testing. While I waited for the results to come back, I started taking one D3 1000IU/25micrograms tablet. I didn’t really notice much difference.

The results showed that I was just marginally into the normal range, so I upped the dosage to two tablets a day. Again, I didn’t really notice much difference, until suddenly realising that I had been feeling much better for quite a while. The low feelings weren’t so low, I felt more motivated, more energy/less tired, etc. I guess because I started with a low dose and then increased it, the effects weren’t sudden.

I’ll find that other thread (should be easy, as I posted on it!), which had a poster who was very helpful and seemed to know a lot about Vit D, as that might be useful.

I was very low but felt OK but had strange dry red patches of skin on my face. I don't feel different now but skin much better and my head sweats less. I hadn't realised I had a sweaty head until it stopped - apparently caused by low vit d.

Hope you feel better soon - maybe ring GP see what they say between appointments?

I had super strength ones - finished now so can't check but box said take one every fortnight. I was on three a week. Now meant to take supplement daily but sometimes (often) forget.

This is the other thread: www.mumsnet.com/Talk/general_health/2421492-Vitimin-D-can-it-have-this-effect?

It's a good idea to check with your GP. There's growing awareness of increasing cases of low Vitamin D (possibly as a side-effect of the campaign to use sunblock) but there also needs to have some feedback from people being prescribed high doses and what the effects can be.

thanks wanda

Aaaahh. I have just started high dose and feel even more exhausted too. So glad to know this is normal!

Hello again Wanda , ,

                       glad to hear my advice was useful .         

This time of year is the worst for Vitamin D deficiency , in winter, from Mid -October til Now ( mid April ) we cannot make vitamin D in our skin , UK sunshine is too weak. That is why supplementation is so important.

      A great deal more research has been published , over the last few months  confirming our discussions on that other thread.   It is even more relevant now , than ever .  For good health , it is essential that your vitamin D level is high enough to enable your cells to express  genes  when called upon to do so.   Vitamin D enables your cells to work properly. !    All cells in our body require vitamin D .

    I hope more people take notice  of that thread.

Thanks for all the replies.

Bettertobehealthy - thanks for the link to the other thread. Have trawled through it - really interesting read. I found it nteresting that (I think) you said that the end of March/beginning April is when our Vit D can be most depleted, as for about a decade this is always the time of year I feel absolutely awful. I get flu or tonsillitis around this time most years, and often have a depressive episode too (thankfully not this year!). Bit of a lightbulb moment for me, there!

I have a few questions if you have any time (hope you dont mind).

I've been prescribed 20,000 IU (colecalciferol, D3..?). The box says take once a month, but I have been told to take one a day for 30 days, and then a 'normal, high strength supplement' every day after that for the foreseeable future. I am having my bloods re-tested in 8 weeks time. What strength would you recommend for the future? My doctor was a bit vague and just said any normal, over the counter bit D supplement is fine'.

Also - how long is it supposed to take to start feeling better?? I feel worse than ever this week - no energy, muscle weakness and aches, nauseous and just absolutely exhausted. My doctor said I would 'almost certainly be feeling better after the 30 day course'...I really hope so, as the exhaustion is affecting my work and everyday life quite badly now.

I've just started the high strength capsules too, I have to take 2 a day for ten days then go onto an over the counter supplement after that. I'm just over a week in and don't feel any better at all. My main problem is aching bones and fatigue. GP said to go back in a month so hoping to have good results by then.

www.amazon.co.uk/gp/aw/d/B00NR241FI/ref=mp_s_a_1_2?qid=1460659290&sr=8-2&pi=SY200_QL40&keywords=vitamin+d3+k2+spray&dpPl=1&dpID=317AtUyS42L&ref=plSrch

I use this one - i take 2 or three sprays a couple of times a day. Apparently the vit k helps the absorption of the vit d.

Hi shesagreatgas, and mrsmichael

              The important thing to know  is your vit d blood status , where is it going with the treatments you are taking.     That is not quite as simple as - "I'm taking such and such many units" -  "what will be the result?"

            People can have different responses to the same dose, by as much as 6 to 1.  This apparent discrepancy , could  for instance be caused, by absorption problems caused by a gut malady...possibly IBS, Coeliacs, Crohns, etc or  no gall bladder , bile acid abnormality, deficiency in co- factors such as magnesium , zinc etc..  Weight is another very important factor which can determine how much you need. 

An average 75kg adult will increase their blood level by 25nmol/L per 1000 IU of daily supplement. However suppose you are taking 5000 IU and increase by 1000 IU , then your blood level response in this case, will be less than 25nmol/L. The more you take , the less of an incremental effect it will have. This is one of the reasons that is difficult to become toxic with vitamin D. Toxicity has never been found at blood levels below 500nmol/L. The only toxic effect known , is hypercalcaemia ( blood calcium - too high ) and the consequences thereof. If you are taking large doses over long periods , then get your calcium level checked as well. I assume your doc did this before starting on your high dose regime. ? ( It is just possible - though highly unlikely , that your initial symptoms may be caused by hypercalcaemia - so checking calcium is highly advisable before embarking upon high dose supplementation.)

Sorry to be a bit longwinded , but by mentioning this variability I am hoping to show that , with knowledge of your blood level ,by regular measurement , over the longer term ,you can determine what your supplement should be, in order to maintain a "healthy level". Every person is different , if you have been diagnosed with very low levels now, then there is the distinct possibility that you are not an average responder. It could however be that you have simply avoided most of the common sources of vitamin D , i.e sun, oily fish etc or that you do not absorb it as efficiently. Whatever the reason , the important thing is to maintain a healthy vitamin D status in the longterm. My advice would be to get your levels, from the doctor's surgery and keep a note, time of year taken etc. Even to get private measurements taken, if possible. Different labs have different methods of assay , so I would try and stick with one lab if possible.

        If you are taking 20,000 IU  per day  for 30 days your level should rapidly rise to 100nmol/L or more,   then if you continue with 5000 per day till your next test you will have a good idea of what your level will be over the year.  My advice would be to have another test , 6 months after that ,  and hope to see your level in the 120 -140 range.  If it is well below , then you probably need more   than 5000 ,   IF  it is way above ,  say 200 nmol/L or more ,  then  drop down from 5000 IU daily .     Try and have a healthy diet , particularly containing magnesium  ( dark green veg ), and all the other nutrients. This will help Vit D absorption AND  utilisation.  It takes roughly 3 months for your blood level to stabilise on any particular daily dose.

   How quickly should you see a response .... well that really is determined by what causes you to feel so symptomatic.  Vitamin D is involved in many many bodily processes , it is utilised by all your cells.  If you have symptoms of osteomalacia ,  (bone weakening/pain -  caused by lack of calcium absorption ) then it may take  many months,  if you are not making enough serotonin  it might only be a few days.  Over 2000 genes are involved in processes with Vit D .If you have been very low for a long period of time then please give it a chance to work.It seems that your immune system has been hampered by your low level of Vit D , as shown by infections etc around late winter/early spring. Vit D has been shown to be very involved in effective immune response. 

An important concept to bear in mind, when thinking about Vitamin D supplementation , is that it not a good idea to have sudden changes. i.e. a monthly very high dose , then nothing. The cells in your body expect a pretty constant level , they work best that way , the enzymology will not work efficiently with pulse doses. In other words do not supplement , then stop, then start again , much better to maintain a constant level.

I hope this is helpful. A testing lab can be found here. They are an NHS Vit D lab, and will test for the general public. www.vitamindtest.org.uk/ . Many people get their daily supplements from Amazon , gel caps , seem popular. 3 to 5 thousand is common , although 10,000 can be found there( for low responders, or higher requirements). My advice would be to avoid monthly 50,000 IU caps as a maintenance dose. Daily is better than Weekly which is better than Monthly.

About 1 in 300 people seem to show intolerance or allergy to the filler or carrier in specific caps sprays or tablets. Try and choose good quality. They are classed as a nutraceutical , so regulation is not as strict as a medecine , from the doctor.

Best of luck,
If you have any more questions --- ( that I can attempt to answer ...! ) let me know . Have a look at some of the other threads about Vit D. I have posted on a few. ( mainly in the General Health category ).

BTBH

Better - do you recommend any brands specifically? I was taking the Holland and B spray, but admit I've slowed down due to summer coming. Thanks for pointing that out.

Vit D is also necessary for the proper function of the thyroid gland. A lack of Vit D could explain why you are so completely knackered as it will have a massive effect on your thyroid.

Please can you offer some advice ? You seem to know so much. I originally went to drs with feeling low tired achy depressed muscle pain. Blood tests shows low ferritin 8 and v low d at 23nmol. Had high strength prescription for 6 weeks then over the counter stuff. Still taking ferrous fumerate and levels were up to 41 at the 3 month point (have another 3 months to go)

Now I feel a lot better generally but I got so depressed I had to take sertraline. Aches are a lot better etc. But not completely better?? What should I do next. I’ve been taking cofactors but no calcium as tests showed it was normal. All other tests were ok. Will it take more time even tho my levels have recovered for bones and muscle to heal fully. I have some really good days tho and others that I feel crappy. In week 15 now. Any advice appreciated xxx

Hi Ljlucock ,

                          Glad to hear Vit D   is having some beneficial effects for you.    Yes,   23nmol/L   was very low.         If you were a child ,  you could even have been in the rickets area.   However , as an adult, you might experience bone pain and muscle weakness from a condition known as osteomalacia.  This is caused by your bones donating calcium to your blood.     Your calcium level is a very important for bodily processes,  nerve conduction , muscle operation i.e. heart etc.   That is why your calcium reserve might be mobilised from bones if your bowel is not absorbing enough.    The fact that your blood calcium was normal, is a good sign.     It doesn't however mean that you are definitely absorbing enough.   It does mean that your parathyroids are doing their job,  and keeping blood calcium where it should be.    Vitamin D  enables your body to regulate the amount of calcium you absorb from your food. IF you are below about  80 nmol/L   ,    the regulation is hindered.  IF your food contains plenty of calcium , (dairy  etc ) then  if your vit D is as low as 50 ,   it can work sufficiently well. 

           The reason I am explaining the above action of vit D ,  is to show how important it is to know your level.        I am assuming your level of  41  you mention is your ferritin level.   That is a great improvement.   
       Do you know your Vit D level ?  You have said you are taking over the counter preparations,   how  many   IU   per day?    I'm assuming you are on a daily maintenance dose ,   and have been for the last nine weeks,  following your loading dose ,   which was probably 40, 000 per week  for 6 weeks. ?     

    IF  your daily dose is 1000 IU  or 2000 IU ,   that might not be enough to bring you up to the required level.  You really should measure your level,  if the doctor won't ,  then get it done privately.  It is not very expensive   try  this NHS lab ... <a class="break-all" href="http://www.vitamindtest.org.uk/" rel="nofollow" target="_blank">www.vitamindtest.org.uk/</a>   , or other reputable labs.  

    I would wait  say three weeks ,  continuing the daily dose you are having  now,   then , after you have been on that dose for 12 weeks ,  your level will have stabilsed. Then , when you measure , you will know how to alter your dose ,  IF YOU NEED TO.      Lets say your level comes back as 60 .   It would be advisable to raise your level to over 100.        For each 1000 IU  you take daily ,    on top of what you are taking now,   you will raise your level by 25 nmol/L  ( If you are an average responder )    So in this case I would be saying that an additional 2000 IU  daily will bring you up to near the most desirable 120 - 140. level.         It does really depend upon your measurement. Without it you are blind.   

              Yes you can expect improvements  at different rates for different problems. Muscle weakness , pains etc. Even sleep apnoea and insomnia.       Possibly,   bone problems ,  IF  you do indeed have them ,  may take quite a few months to repair.   Make sure you are getting enough protein.  1.2 gram daily , per kilo of your weight.    This is a bit more than normal recommendations ,  but research has shown that it does help rebuild bones under certain circumstances. Make sure your diet has plenty of greenstuff... as well as other fruit and veg.    IF you can ,  it would be advisable to get out in some sunshine.  Sunlight on skin, not only produces Vit D ,   but other compounds such as beta-endorphins , which have anti-depressant  and painkiller properties.  Do not burn ,  slow and steady, is best. 

         If you can ,  let us know what your current levels are,  what you are taking now.  

best of luck ,   hope this is helpful. 

    BTBH.

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