If you are vitamin D deficient, what have you been prescribed?

[whowantsadog]

I've recently found out that my vitamin D levels are so low that it's not possible to get a reading on them (apparently below 30 doesn't register?) However, when I've collected my prescription they seem a much lower dosage on prescription than what I bought last week in Sainsbury's, and on googling it seems people are taking doses of around 5000iu for similar deficiencies. Do I need to double up? (Picture shows prescription on left and over the counter on the right).

I'm also hoping that you're going to tell me that getting your vit D levels back up transformed your life, helped you drop 2 stone and stopped you feeling 90 years old?

My daughter was prescribed 3200 daily as her vit D is 31. I've given her a week at 10000 though to raise it more quickly as i think it should be around 100 to 120 to make her optimal.

10,000 twice weekly and yes didnt take too long to feel awesome!

That's really useful to know. Thanks for your replies.

My DD had her hospital appointment this morning and, somewhat to my surprise, we were advised that for her level of 34 she wouldn't need to take any extra vitamin D other than what she would get from a multivitamin tablet! The doctor didn't seem to think there was any link between her tiredness, low mood and lethargy and low vitamin D levels. I really don't like going against medical advise, but having read what other people have been prescribed, I'm quite certain she needs more than a multivitamin (at least for a few months), although I'm aware that too much vitamin D can be toxic.

I think these sprays look really good - betteryou.com/vitamin-d . So in line with the advice on the website, I'm thinking of giving her the 3000ui spray for a month (which is in addition to 800 ui in the multivitamin) and then dropping down to 1000ui as a maintenance dose. I really hope this will make a difference to her energy levels.

Thanks to everyone who has posted on this thread, it's been really useful!

She'll probably need 3000 for longer than a month and definately retest befire you reduce to a maintenance dose. The sunshine should help but only if she spends some time outside without suncream.

My level as tested about a month ago is 31. GP advised 800 dose and said they do not prescribe any supplements at all. Still have a lot of pain so thinking of doubling or tripling that dosage.

That's a totally ineffective dose if you are deficient. My GP is quite conservative about vit D and he still prescribed 3200 to my teenage daughter at a level of 31. Adults can take a high dose short term when levels are so low. I personnally took 2000 a day through winter and that only raised my level from 60 to 88.

He told me to go back in 3 months so will up the dose and see if symptoms ease as well as test levels rise. Thank you.

My vitamin D level is/was 28 and classed as deficient.

The doctor told me to take 40, 000 vit D once a week for 7 weeks and retest.

The pharmacist told me that level would make no difference in my vit D levels as I have a malabsorbtion issue which is probably why I am so low to start with. He sent me back to the doctors.

Long story short. The doctor agreed the level of vit D I was given wasn't right for me but had no idea what to put me on !

I asked if I could be referred to someone who would know and he said no, let's wait 7 weeks and retest !

I am due to have a new blood test next week. If my levels have gone up a lot then okay.

But if they stay low what do I request the doctor to do?

Would a referral to the consultant who diagnosis my bowel condition (which led to this malabsorbtion issue) be the best route or is there another department that can help ?

I am so tired, I need some energy. :(

Mine was 24 and was given 10,000 to take twice a week. Retest after 4 weeks then new prescription for 3 more months then will have them retested.

You can do plenty for fatigue before getting tested or seeing your doctor. Sunshine and eggs and fish for a start.
Plus iron and red meat.
And exercise.
In combination there is lots to be done in parallel with prescriptions.
I had low iron and it was dreadful I cannot imagine having that and low vitamin d together.

I also have low iron and take supplements for that too.

Sunshine and diet make zero difference with my vitamin D level as I have a malabsorbtion problem. I could eat fish whilst running under the sun all day and my body can't absorb it. :(

I have to time my daily bowel medication in order to have a time slot at 9pm when I can take oral supplements which will be absorb.

I am so tired that I fall asleep if I sit down during the day ! I just need some energy.

I lost a stone last month, so though very fat at, I am working on my diet.

I have a treadmill and aim to walk 5 miles a day. Some days I do it and some I don't as I am do tired.

Also recently diagnosed with moderate obstructive sleep apnoea but compliant on a apap machine for 8 hours a night and therefore this is not part of my tiredness.

Hi babieseverywhere ,

                From your posts  these few things may be helpful to know...

You can bypass your gut malabsorption by taking Vitamin D as an Oral spray , which is absorbed directly into the bloodstream.

There is a 6 to 1 variation in the response to supplementation. i.e. people are very different. Reasons are varied, but can be gut problems, genetic variability, efficiency with which the liver transforms VitD3 ( the supplement) to the compound which is measured in the blood ( calcidiol) by your doctors tests and so on. BMI can have a dramatic effect upon the level your blood calcidiol level reaches with any given dose of supplementation. This is because VitD is fat soluble , hence the desirability of testing your level . Do not just assume that such and such a dose will have such and such an effect. As mentioned there is a 6 to 1 variability in response. I have outlined the average response ... you may not have that response.. as your pharmacist thought !

An average person will increase their blood level of calcidiol ( i.e. 25hydroxyD3 ) .... by 25 nmol/L if they supplement with 1000 IU daily ...over the long term.

It is better to dose daily: this is because VitD3 ( the supplement ) is used by your cells as well as the blood storage form 25hydroxyD3. When you have a low blood level such as yourself , your body ( liver) quickly transforms the VitD3 into 25hydroxyD3, such that within 3 days the VitD3 form is almost entirely gone ... i.e.the half life is 24 Hrs.

More than likely you will need to supplement with oral spray with say 6000 IU per day , this will increase your blood level reaching an equilibrium level in about 60 to 90 days , you should then retest your blood level . The test actually measures the level of 25hydroxyD3 ( calcidiol) in your blood in nmol/L . Your level should be 100 or more, this is a natural normal level , it is accepted as normal by the NHS , because humans that live outside a lot in a sunny climate reach that level. Unfortunately the NHS also accepts 50 as normal , it is not , it is distinctly too low. Some sectors of the NHS now accept that at least 75 is necessary, so at least some improvement. Many vitamin D researchers have concluded that a level between 100 and 150 is optimal.

 My advice would be  to get your level checked after prolonged supplementation as outlined above.   If the doctor won't test,  then you can get a test here   <a class="break-all" href="http://www.vitamindtest.org.uk/index.html" rel="nofollow" target="_blank">www.vitamindtest.org.uk/index.html</a>

It is an NHS Lab at Sandwell hospital, they will do tests ordered by the general public, but if not doctor ordered they charge £28. It is a blood spot, you send to them on their test kit, the result is emailed back within a week.

 IF  you  simply stop supplementation  after a few weeks then your Vit D level will fall unless you make lifestyle changes....i.e. go outside in sunshine in the middle of the day ... for at least 20 mins.   In the UK,   sun is only strong enough between mid-April  and  mid-October. In the winter  the UVB radiation is absorbed by the atmosphere. So there is a 6 month period in which you cannot make vitamin D in your skin.  
   Your gut malabsorption will not have any effect upon  skin made Vit D ,   it passes directly into your bloodstream from your skin , and then your liver. So you can make it from sunlight. However -   whenever the suns elevation is below 45 degrees ,  the suns UVB is absorbed by the atmosphere.  This means that even in summer ,   early morning  , or evening sunshine does NOT contain UVB.  

SAFE and moderate use of sunbeds with some UVB output ( not all sunbeds have UVB ) would be another avenue for you if the other options fail.

Well,   I hope all that is useful.   !

Best of luck

BTBH

PS. I have posted quite a bit here on Mumsnet about VitD , search my nick , and you should find lots of other interesting info there as well

.

Thank you. That is a lot of useful information.

I will ask about oral spray.

The doctor has already said 50 is the target for vit D.

Glad that I will be getting vit D from sun (in correct season and time)

I agree I do need a daily dose of vit D.
But I am following GP instructions for now until after my next blood test and see if I am getting a higher level or not.

I had a reading of 17 and was told that the normal range was between 75-125. I had a letter from Rheumatology confirming this so I know I am not wrong so don't know where the below 30 thing not registering came from. I was prescribed a dose of 20,000 iu. I had to take 1 tablet every day for a week then 1 a week for a further 8 weeks.

I had my bloods tested after completing the course and my levels had risen to 79. I then had it tested again a few weeks later and it dropped to 61 again. I knew something wasn't right as started to have knee pain and achy legs again. This time I was prescribed a 2 month course at 800iu. Have just finished this prescription so will get my bloods done again in a few weeks to see where we are at.

Hi crinkle ,
it is great that your medical professional has indicated that your blood level of 25hydroxyD3 should be 75 to 125.

 Many parts of the NHS  don't even recognise this level as normal.      Some practitioners even say that        " levels as low as 26 nmol/L   do not need to be treated because  although it is insufficient it is not deficient. "  
 Nobody wants to be insufficient in an  essential nutrient  : of which  Vit D  is a prime example.   Long term consequences of insuffiency will arise. 

    As explained in the long post above,    a daily long term dose of 800 IU  is likely to raise your blood level by about  20  nmol/L ,        above your prevailing natural level.,  which was 17 .     

As you have taken  around  300,000 units spread over 9 weeks then your level will rise ,      whilst taking them ,   and then gradually drop , when you stop.   Vit D has a half life in your blood  , of about 60 days.  

      Imagine a bucket with a hole in the bottom ,   the water draining out slowly ,  is your vitamin D ,   by quickly half filling the bucket , your blood level becomes higher ,    but that level needs to be maintained  by a constant input ...preferably daily. The amount of input required is dependent upon your own metabolism , which  may require only 800 IU  per day .   But more than likely will  require more ,   say 2000 IU daily ,  possibly  3000 IU  or even more.      Check your level every few months  until you can establish what you need. Then a yearly test ...around late March or early April ,  will enable you to ensure you don't go deficient again !   

     My advice would be to keep it up at the top  end of that level recommended to you by your endocrinologist.   120 say   to  140 ,   is perfectly acceptable ,   in fact   a human , living an outdoor , healthy lifestyle , in plenty of sun will reach those levels. 

Good luck  !

   BTBH

I realise this is quite an old thread but I'd really like to supplement the entire family and I'm overwhelmed by the choice on Amazon!

BTBH could you recommend supplements that you think actually work please? DH & I are mid-late 40s and our children are ages 10 and 7 - the 7 year old won't swallow any tablet, no matter how small, so would a spray be ok? Also, should we be taking Vitamin K alongside it?

just bumping this thread in case anyone doesn't know that Vitamin D deficiency in winter month can cause all sorts of symptoms, anxiety depression, fatigue joint pain...

Hi, I know this is an old thread but have been reading with interest. I went to the docs last week, thinking I was perimenopausal. Aching muscles, bones aching, tired every day without doing anything. Pins and needles sometimes. I thought it was the perimenopause. They tested my blood to check thyroid and diabetes but turns out everything fine apart from low on vitamin d. My reading was 30nmol/L. I have been prescribed vitamin D3. To take 4000 IU a day for a month followed by OTC vitamin D. My question is why has my vitamin D levels suddenly gone down when I have not been doing anything differently? Also will I now have to take OTC vitamin D for life? And what amount of Vitamin D should I be taking after my prescription ends? I guess this is something to ask the doc, but thought I would see if you could help...PS is it possible to overdose too much on Vitamin D tablets? Thanks in advance.

Hi, Mint
You ask how come you have suddenly become deficient , well , it is likely that it is not sudden , your blood level was probably low , for quite a time . It is just at this time of the year, now , at the end of a vitamin d winter . you have had a particularly low level and it is now showing up as various symptoms. IF your primary source of Vit d was sunlight on your skin , you would not make any from Mid- Oct to Mid - April. here in the UK , at our latitude of 50+ degrees , UVB is absent from sunlight except when the sun's elevation is above 45 degrees. i.e only in the summer months , and only then in the middle part of the day ... 11am to 3 pm. This is just basic physics, and the interaction of sunlight and the pathlength of sunlight through the atmosphere.

 You have probably been lowish for a long time .   It is a really good idea to keep your level at a respectable  100  or a bit more , for the whole year.  To do this you will need a regular dose ( daily is preferable -  in order that your autocrine system has vit d available every day )  .   Each of us is different ,   as I mentioned before ,  some people will only need 800 IU  , on a daily basis ,  after your loading dose of 4000 IU   per day for a month.   Others will need more . 

I would recommend that you measure your level again after several months treatment. Say, take the loading dose , then take 1000 IU per day, for a couple of months then measure your level. Get the doctor to do it , IF he won't, then get it done by a Lab, that does private work. Here is one , an NHS lab. www.vitamindtest.org.uk/

IF your level is above 100, say 120 ish - 140 is then that is a good level to be at. IF it is still low, you may need to increase by another thousand or two. Your test result should guide you as to how much you should supplement with. Repeat the test after several months on a continuous daily dose. It takes 60 to 90 days to reach an equilibrium level after you change your daily dose.

   You ask , is it possible to overdose.   IF you have rare diseases, such as sarcoidosis , granulomatosis , hyperparathyroidism, then you should  not take vit d , except under medical supervision.  The fact that the doctor has given you a dose , like 4000 IU  per day   presumably means you don't.      An normal average person has never ever been reported in the medical literature with overdose  except at doses greater than 30, 000  IU  per day ,     or  with blood levels above 500 nmol/L.  It is very unlikely.  

The  IOM  ( Institute of medicine )  in the US  has reported that  4000 IU   can be taken daily , continuously  ( for ever )  with no risk of harm.    In fact their report states that  10,000 IU  is the  No Adverse Event Level ( NOAEL ).        This is a very well respected medical organisation ,     which is often taken into account by  British medical authority. 

           Hope that is helpful. !  Get back if you need any more information .  

Best of luck
BTBH.
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If you are deficient you need loading sides which is something like 300,000iu over 8/10 weeks. Have at look at NICE guidelines. 25 is or 400iu is not going to do much.

I'm glad you bumped this thread up, Mintmallow! I had some blood tests done at the end of February and my vitamin D was 24nmol/L. I have obviously been taking supplements since then, but only the standard OTC tablets, which I think are 1000 iu. It sounds as though I should be taking considerably more than that.

Thanks for all the info, Bettertobehealthy. Very interesting and useful. I never knew Vitamin D was so important until I was classed as deficient!

Hi Better to be healthy, sorry to bother you again. I just wanted to ask your advice as you are very knowledgeable on the subject. Since my last post I have been taking OTC vitamin d3 since I finished the loading dose. Sometimes 1000IU and sometimes 2000IU depending on how much sun I feel I have got over the summer. I haven’t been back to the docs because my symptoms are much better. But recently over the last few weeks I have been getting a bit more achy especially my feet! I have no idea why it seems to be mainly my feet, but some days I wake up and I can barely walk down the stairs! Eventually it feels a bit better after walking around more. But there is still that aching feeling, like I am walking on my bones and feels like no cushioning on the soles of my feet. Anyway, I just wondered if it would be ok to up my dosage to say 3000 or 4000IU a day and see what happens? Or would it be better to get tested again at the docs? I haven’t been back to the doctor since they gave the loading dose. Is it ok to vary your vitamin d dosage depending on how you feel?

I also wanted to ask. When going out in the sun, does the vitamin D last long in the body? Or does it deplete quickly? Is it better to take vitamin D supplements every day whatever the weather?

Many thanks.