Vitamin D drops - GP says one dosage, pharmacist other

[hartmel]

My bloodwork shows that my vitamin D is by 25 where it should be above 75.. That is reason why I'm so tired, have headaches

My GP told me to take 3000 IU drops per day, and the pharmacist said for pregnant lady not to take more than 2000 IU..

I'm confused now. Which dosage should I take? I took for now 2000 IU (that is 2 drops)

Go with the pharmacist and get a second GP opinion. In my experience pharmacists know their stuff when it comes to drugs dosage better than anyone else.

The standard supplement in pregnancy (and generally for adults) is, I believe, 1000IU. So if you take two you're already taking double that. I'd probably go with the pharm recommendation.

Call your GP practice and ask them to confirm dosage? This isn't a supplement dose- you are deficient and therefore need more. Some evidence linking low vit D with increased risk of pre eclampsia. More evidence to suggest we are overly conservative when it comes to vitamin d dosing.
Get in the sun for 20 mins if you can find any ( without sunscreen) and that'll boost you by around 10000 units. Interestingly no one freaks about about vit d toxicity when we get that sunny day once a year :)

In my experience pharmacists know their stuff when it comes to drugs dosage better than anyone else.

Ask for the senior pharmacist.

In my experience you can get the opposite from less experienced ones, and I have heard horror stories (e.g. once to me being denied medication - clexane and aspirin, prescribed by a specialist to ward of miscarriage, because inexperienced pharmacist thought it wasn't allowed ... and another where someone who had previous stillbirth and was prescribed something had it queried and told it 'could cause stillbirth' which made her hysterical. Turned out to be incorrect and an inexperienced pharmacist. In both cases the pharmacist in charge sorted it out.).

Both are a safe dosage. Some studies have been done with pregnant women taking 4000 iu a day, which showed several benefits, so 3000 iu would be fine. The important thing is you need to up your levels, which can only be done with a high dosage. You can take up to 10,000 iu a day, also pregnant women.

The standard dose for pregnancy is 10mg which is equivalent to 400IU, and the standard treatment dose for someone with low Vitamin D is 20mg (800IU), though this seems to be less than effective for a lot of people, hence some GPs prescribing much higher doses in line with more recent studies. Blamber is right though that there's no evidence that taking much higher doses than this has caused any harm, though pregnancy studies are quite limited due to pregnant women not generally being willing to try stuff out! My vitamin D was as low as yours pre-pregnancy and I was taking 4000IU a day, which the GP I saw first immediately advised me to stop and told me to rely on the 400IU standard dose... When last tested (at 20 weeks) my levels had gone up slightly but not hugely, so a different GP told me to up to the standard treatment dose of 800IU and that's actually making me feel loads better.
Incidentally, I'm a medical student so looked all this up and there is no standard advice, but what GP said to me is that although Vitamin D is one of the few vitamins you theoretically could overdose on eventually, because it stays in the body instead of excess just being peed out, it would take far longer than the period of pregnancy, even on very high doses, to get to that point.

I read this during pregnancy, took 5000IU all throughout my pregnancy since I work from home and rarely get outside sometimes - both me and DD fit as fiddles!

www.cnn.com/2010/HEALTH/04/30/vitamin.d.pregnancy/

Actually I still take the same amount, I upped it to 7000IU when DD was getting breastmilk, then when she stopped I went back to 5000IU a day.

Agree with the others id get a second gp opinion. I have to take 1000iu but I've been increasing my vitamin d slowly for 2 years. They got to 21 and at my last test they were 46. Waiting on my booking appointment bloods to come back to find out what my levels are now.

I'll add I have to take calcium tablets with my vitamin d too to help absorb vitamin d

If gradually increase your dose at first and see how you go. X

Squizita - most community pharmacies will only have one pharmacist working at any one time. They will all have access to the same reference sources and be in a position to give the same advice. The senior pharmacist role only tends to exist in hospital.

Tranquilitybaby - what have you based your advice on? What dose should the OP start with and where should she finish? At which points during her treatment should she ask for blood tests?

Borset Our two most local ones seem to have two (who are labelled as pharmacists) one of whom is named the "Senior Pharmacist" or "Pharmacist in Charge" - is the other one a trainee then? It does say 'pharmacist' not assistant on their badge. Or perhaps with larger branches they have 2?
One is a community pharmacy attached to a GP, the other is in a supermarket.
I'm afraid I am rather wary of some pharmacists actually not trusting the prescription as we did have to push for the medication (standard dose) for my APS because the pharmacist 'knew better': missing a day leaves me at risk of DVT or miscarriage. I had to show the more senior one all my notes.

We go to the other one now.

If they have a badge which says "pharmacist" then they are a pharmacist. Other wise it would say Pre-Reg or similar. There is a career pathway within hospital pharmacy, but the same does not exist in the community. Some of the multiple groups may give titles such as "senior" or even "consultant" but this doesn't mean they have any additional qualifications, just more experience.

Pharmacist in Charge - As long as you have a degree, have passed the pre-reg exam and are registered with the GPhC then you can take use this title if you are the pharmacist in charge on the day. It relates to the Responsible Pharmacist Regulations (RP) and means you have overall responsibility.

Pharmacies who have a high dispensing volume may have two or more pharmacists working, they may both have the same experience, but one is signed in as in charge from a legal point of view.

??? Borset I never implied I was a medical professional, I just said what I'd do (and did). starting from the lower dose advised and increasing if necessary is what I was advised. NHS advised no more than 1000iu but naturopaths tend to advise having around 4000 iu, a big difference.

OP did they advise taking magnesium with it too for absorption?

Tranquility - I find threads like this worrying, because they give advice based on anecdote not evidence.

Don't get me started on the poster (medical student) up the thread confusing mg and mcg.