Can you be vitamin D2 deficient, as opposed to vit D deficient in general?

[wittyusermane]

To cut a long story short I have been feeling awful for months. Had full blood panel done back in October- everything within normal ranges (bar one white blood cell result) but they were still awaiting vitamin D test results when had my follow up appt.

I live in Germany and my German isn't up to detailed medical discussions. My GP is Eastern European and speaks zero English as German is his second language. I never bothered chasing up my vit D results as I assumed they'd have called me back if there was an issue, and frankly the language thing put me off trying to make a tricky phone call to ask.

Fast forward to today and I got an invoice in the post for my October appointments. At the bottom it had the diagnosis which said (in German, naturally): vitamin D2 deficiency E55.9.

E55.9 is apparently the code for 'vitamin D deficiency, unspecified', according to google.

Now, all my symptoms might actually fit with vit D deficiency: exhaustion, sore muscles and joints, insomnia, etc. However, when I googled D2 deficiency it seems you could have zero D2 in your blood yet your vit D Levels could still be perfectly healthy if you had a good level of D3? Therefore if I'm only D2 deficient then I'm not deficient?!

I have no idea what my D3 level is (or what my D2 is for that matter, just that it's deficient).

I guess I just start taking some vit D and see if it helps. We move back to the UK soon anyway so can get to the bottom of it then, but can anyone explain the D2 vs D3 thing in terms of deficiency?

Google just brings up stuff about the differences between D2 and D3 sources no matter how I word my searches!

Hi,

Vitamin D2 is very slightly different from Vitamin D3. D2 is a plant derived version , it is not as effective in mammals ( i.e. Us ).

The natural  vitamin ,   that you produce in your skin is  D3 .     IF  you consume some Vitamin D  fortified items, often they will be fortified with Vitamin D2 ,   so    you blood will show small amounts of D2. ,   but much greater amounts of D3.     D2  is cheaper to produce.    

At one time Vit D2 and Vit D3 were considered to be equivalent , and so interchangeable. NOW however we consider that D3 is the version to use. Almost no doctors will prescribe D2 supplementation nowadays, it is usually D3.

          IF  your lab results say you are D2 deficient ...  that is  either a mistype , or incorrect.       Almost certainly  they are referring to  D3.    Most people have very small quantities of D2 in their blood ,   but that is not significant,   what matters is the D3 levels. 

        Some people ,    were treated with D2 supplementation , it does cure rickets ,   etc ,   however it is not as effective  as  D3 in that and other respects.  That is why  D3 is preferred. 


            To clear all this up ,     I would recommend you get a Vit D test ,  which can be obtained from an NHS lab , and posted internationally.  A fingerprick of blood on blotting paper. Sent to the lab,   they will email your results .  You will need to pay for the test ,   Probably  £29 ,   plus  £5 postage.      go here.   

www.vitamindtest.org.uk/

 Your result will give you   D3 level   and  D2  level.          It is immaterial what your  D2  level is ,   it most likely will be    around  1   , 2, 3    , very low,   and your  D3  ,  should be over 75 nmol/l .    

You are right , your symptoms could be caused by Vit D deficiency.

Most vitamin D researchers , and some people within the NHS would recommend a level of 100 nmol/l or above.

Throughout human evolution , our levels were approx 120 - 140.

When we get exposed to plenty of sunshine , we do rise to those levels. here in the UK , because our latitude is over 50 degrees North, sunlight is so weak , that we do not create Vit D3 in our skin ,
for 6 months of the year ... Mid - Oct to Mid - April. That is why many Northern Europeans are deficient.

                If you are deficient .... then supplement with D3 ,   probably   between  3000 IU   per day    and   5000 IU  per day. ,   in order to bring your level up to the required level .   You new level will stabilise ,  on a particular daily dose ,   after  60  - 90  days.    You can then adjust your supplementation  , such that you maintain a good healthy level.   Your symptoms should start to improve in a few weeks , months,. ( IF  indeed , they are caused by  Vit D deficiency ).    So after 3 months of supplementation , with a DAILY  dose ,  you should re-check your level.  

It is a very safe supplement.        
Don't take it if you have hyperparathyroid problems, hypercalcaemia, sarcoidosis , granulomatosis .   These a very rare 

I have posted lots on here about Vit D , search my posts for a lot more information.

Best of luck,

Get back to me if you want more info.

BTBH.
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Thanks so much for such an informative reply @Bettertobehealthy, I really appreciate you taking the time.

I hadn't considered that it could be a mistype, quite possible. I have dug out the original invoice from the lab that did all my tests and it looks like they only tested D3 in any case.

After the vitamin D diagnosis in the dr invoice it says something about (hard to translate due to medical abbreviations auf Deutsch!) 'suspected thyroid disease, rule out an origin illness (thyroid disorder). Not sure if that means I need more thyroid tests to rule out that as a cause of the vitamin D, or whether it means they HAVE ruled out thyroid as a cause (my TSH came back normal, I have that result) or whether it's completely unrelated. Odd to mention it when the only thyroid test they did was fine

Urgh, this sort of stuff is hard in your own language let alone a different one 🙈😂

I think it would probably be cheaper to get tested again via the link you posted, rather than pay more for the doctor's time giving me the original results. Besides, my symptoms have worsened a lot since October when the test was done so probably sensible to find out where things are at now.

Have ordered a good D3 supplement today so will get started on that very soon.

Thanks again, really kind of you!

Hi Again,

yes,sounds like a good plan. The result that you get back from the Lab, will state that a level of 50 to 200 , is within the adequate range. Most vitamin d researchers would consider 50 or thereabouts significantly lower than optimum. As I mentioned above.

The fact that you have reported your symptoms have worsened since Oct fits with what we know about likely Vit D levels , which usually drop over winter, depending upon the latitude at which you live , and your exposure to sunlight during the hours when UVB radiation is present in sunlight. In the UK and depending upon your latitude in Germany , then sunlight between the hours of 11am and 3 pm , contains UVB in the Summer months. NONE during mid - Oct to mid - April. Even in the summer months , you cannot make vitamin D in your skin in the early morning or late evening. The sun's elevation is too low.
I mentioned above our evolutionary levels , they were due to our development in African sunshine , over millions of years at latitudes below 33 degrees. Sunlight will there make vitamin D every day , it is much stronger. Our migration to higher latitudes only occurred at the end of the last glaciation , i.e. 10,000 years ago, but our bodies are adapted to a different circumstance, a different UVB environment. Scientific studies have shown how our levels return to the " norm " , when we are exposed to that environment. i.e. 120 - 140. nmol/l .

                 Our  digestive system can absorb Vit D from ,  our food ,   but unfortunately  , in modern times our food contains very little vitamin D .  Mainly in meat products.  Vegetables contain none.  IF  you are vegetarian,  you should be aware of that fact.  Eggs contain a very tiny amount ,  40   IU   per egg. Wild  Oily fish is quite a good source ,   but farmed fish like salmon , only contain about  1/4   the amount  than wild salmon. 

                      IF  you are  even more interested in Vit  D    here is a thread , where we discussed it quite a bit ,   lots of people with low levels , how it affected them , what treatments they undertook etc.  I posted quite a bit there.

www.mumsnet.com/Talk/general_health/2421492-Vitimin-D-can-it-have-this-effect

         best of luck. 

BTBH.
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Thanks again @Bettertobehealthy,
and for the link to that thread- lots of great info on there!