I'm Vitamin d deficient . My number is 27. Pre... - Thyroid UK

Thyroid UK

137,624 members161,395 posts

I'm Vitamin d deficient . My number is 27. Prescription for fultium d3 800 iu I pill per day

Thyroidmeg profile image
50 Replies

I asked for vitamin d testing myself as tsh is normal but I have lots of symptoms

Written by
Thyroidmeg profile image
Thyroidmeg
To view profiles and participate in discussions please or .
Read more about...
50 Replies

Hi, just seen your post.

I was originally prescribed Fultium D3 at 800IU per day and my Vitamin D was 43.6. I get a lot of symptoms too but am not sure if it's due to the Hashi's, iron deficiency, folate deficiency or Vitamin D deficiency.

When I spoke to my thyroid therapist about being put on the Fultium D3 at 800IU, she called a fellow thyroid sufferer who suggested I look into getting a higher dose of Vitamin D. I went online and ordered a Vitamin D supplement at 3000IU.

If you would like to look into it let me know. :)

Hope this helps.

Jo xxx

Thyroidmeg profile image
Thyroidmeg in reply to

Hi I'm going to go in and get a bp check so I'll ask her . I thought it was a low dose

Marz profile image
Marz

I agree with Jo - 800 is far too low for your deficiency. The optimal number should be at least 70 which means you are about 40 under - so for every 10 you are under you will need a 1000 IU's. 5000 IU"s may be a good starting dose. I am not an expert but learnt this from the website - grassrootshealth.org A Canadian website that has a graph with the results v dose required. You may wish to start lower and build up to the 5k.

I have recently read that VitD is required in the nucleus of every cell in the body - that's an awful lot of VitD. I have just been re-tested and am still at 49 ng/ml with a daily dose of 10,000 IU's a day. It's inexpensive to treat yourself. There are sprays to pop under the tongue with VitK included. Some people also have their calcium tested as VitD is inclined to increase production - and too much is none too good !

Hope you soon feel better...

Thyroidmeg profile image
Thyroidmeg in reply to Marz

They phoned me so I don't know if it's because they're not checking calcium til April that it a low dose I'll query it next week I've got a blood pressure check. Many thanks

Coastwalker profile image
Coastwalker in reply to Marz

Hi Marz ,

we both now take the vitD3 + K2 (I think it's the K2 that make sure that calcium goes where it's meant to and doesn't end up in the wrong nooks and crannys of your body, but it's only what my brain is recalling ;) )

X

Marz profile image
Marz in reply to Coastwalker

:-)

bantam12 profile image
bantam12

You should take what you have been prescribed, that dose may well be adequate for you. Large doses do not suit everyone, VitD is not always easy to tolerate so starting on 800 is a good way to find out if you are ok with them, you can always ask your GP later on if you can increase the dose if you need to.

Calcium level is important so advice to take large amounts of Vit D without knowing your other levels and history i personally think should be ignored. I do have high calcium so if i had followed advice from here on doses of Vit D i would have ended up in trouble.

Thyroidmeg profile image
Thyroidmeg in reply to bantam12

Thanks I'm to get calcium checked after a month, 3 months and 6 months . They're not good at explaining but as far as I know they haven't checked it yet. I'm actually a bit happier already at the thought of feeling better. I asked for this to be tested last year and was told no by the nurse but I asked a different nurse this year to test vit b and d. She only testing d though and I was right about it not being right..

Thyroidmeg profile image
Thyroidmeg

I've to go In after a month 3 months and 6 months for calcium check. Maybe that's why the dose is low I'll need to ask next week I'm in for bp appt thanks

Thyroidmeg profile image
Thyroidmeg

Thanks all

Jackie profile image
Jackie

HI Vit d should not be started without a calcium test first. it can put calcium over range, very dangerous as an electrolyte. However, if calcium below range, then you need some calcium to absorb the vitD. For this treason, it should be stated on a fairly low dose then retests in 3-4 months. It takes 3 months for the D to effect the blood.

As you can see complicated, hormonal, so important to be prescribed it under an Endo if possible, otherwise GP. Retests, every 6 months when stable , as it may change. if calcium ( corrected) goes over range at any time ( can, especially from parathyroid) then all D has to be stopped , however low.

I have Osteomalacia/adult rickets so now my D is very low indeed but can no longer take it as my calcium is very high, dangerously. This shows in my lower thyroid tests too.

Best wishes,

Jackie

Thyroidmeg profile image
Thyroidmeg in reply to Jackie

I'm wondering now what my calcium level is I don't know if it was even checked with vit d. Getting calcium blood test on 2nd April then after 3 then after 6 months . Receptionist seemed to think. 27 was borderline .

Jackie profile image
Jackie in reply to Thyroidmeg

Hi Usually if D low then the calcium should be checked. it is only the corrected calcium that matters, if 2 done, if one that is it.Once you are on D , usually for life, if calcium OK. Receptionist!!!!Ask for the range. i do not recognise that , although I have 2 different D tests a lot!D is very important for lots of reasons besides the thyroid, however, n ot so important as calcium.

Jackie

Thyroidmeg profile image
Thyroidmeg in reply to Jackie

Many thanks

Clutter profile image
Clutter in reply to Thyroidmeg

27 is not borderline, it is insufficient imperialendo.com/for-doctor...

Contact your practice manager and tell him you would like him to instruct the receptionist to provide you with print outs (including lab ref ranges) of your blood tests. If they try to charge you more than a few pence per sheet ask for an appointment to view your records and make your own notes, free of charge. You are entitled to your medical data (Data Protection Act) and it should not be used as money making stream although cost of paper & ink can be charged. Local shops charge 20p per sheet A4.

My PM wanted to charge £10 and I said I'd make an appt to view my records on line, foc. Another time I asked the recptionist to read them out while I made a note. She decided her time was more valuable and printed them off.

Thyroidmeg profile image
Thyroidmeg in reply to Clutter

After she said borderline I said what number. She said 27. Right away I checked and saw that according to vitamin d council it's insufficient. I'm going there Thursday so will be asking lots of question

Thyroidmeg profile image
Thyroidmeg

They are not keen to give results I asked for thyroid ones last week and was told I'd need to write to practice manager. So when the receptionist called saying I was d sufficient I asked what the results said and she said 27. Do they check calcium when checking d automatically? Ill phone and ask on Monday.

I remember my calcium was low after total thyroidectomy but I think that happens after tt sometimes and it was ok by the time I left hospital .

Maybe calcium isn't ok either

bantam12 profile image
bantam12 in reply to Thyroidmeg

Calcium is included in a bone profile test and not usually done routinely with Vit D, your GP may have requested it but don't get too stressed about calcium levels, if you are having it tested next time that should be fine. My calcium has been way over range for over a year (parathyroid disease) my VitD is also very low, i do still have to take VitD supps even though i don't tolerate them well.

Thyroidmeg profile image
Thyroidmeg in reply to bantam12

It's all so confusing. I just worry that the doctors don't know enough about thyroid

Karispitit profile image
Karispitit

Hi my calcium levels have never been checked. My vit D levels are 23nmol and I take 10,000 IU a day.

Thyroidmeg profile image
Thyroidmeg in reply to Karispitit

I think my dose seems very low ill mention it next week. You should get your calcium checked judging by everyone's comments on hear it's very important. Did your doctor prescribe that dose?

Lostmymind profile image
Lostmymind

Hi, I'm a little confused. I have to have vit d injections every 3 months. I was not given the option of a supplement. I have no idea why I have to have the injection, the doctor never said. Should I be questioning this ? My calcium levels must be poor as my diet have never had much dairy and no milk products. I'm a terrible eater and if my hub did not cook for me I would live on cereal and toast ! Why is vit d so important, they said it was because I was not getting enough sunlight ?

Thyroidmeg profile image
Thyroidmeg in reply to Lostmymind

What is your vitamin d level mine is 27 maybe hours is less? Vitamin d is really important I think it can affect your immune system etc if it's too low. I had shingles last year I think deficiency maybe lowered my immune system

Lostmymind profile image
Lostmymind in reply to Thyroidmeg

Hi there I have no idea what my levels are. They prescribed me with 9 ampules. I went for my first injection and they did not even know when I was to have it again. a week later they called me to make me an appointment for 3 months time and did it on the spot. I have to take the ampules when I go. so why give me 9 if I'm only having them over 3 months. I feel no different before I had the drug to now. I think I have a lot of questions to ask the consultant on 23rd. They obviously deem me as unimportant as my original consultant 2nd appointment was meant to be feb 23rd and they cancelled it !

Thyroidmeg profile image
Thyroidmeg in reply to Lostmymind

You should maybe ask for a copy of your results and post them on here. Maybe your is lower and pills not enough .im a bit like you though totally lost as to why this is happening and why I'm on the dose I'm on

Thyroidmeg profile image
Thyroidmeg in reply to Thyroidmeg

What is the treatment for vitamin D deficiency?

The treatment is to take vitamin D supplements. This is a form of vitamin D called ergocalciferol or calciferol. Vitamin D can be given as an injection or as a medicine (liquid or tablets). Your doctor will discuss the dose, and best treatment schedule, depending on your situation, age, severity of the deficiency, etc. Briefly, one of the following may be advised

Injection

A single small injection of vitamin D will last for about six months. This is a very effective and convenient treatment. It is useful for people who do not like taking medicines by mouth, or who are likely to forget to take their tablets.

Lostmymind profile image
Lostmymind in reply to Thyroidmeg

Thanks. I have to have it every 3 months. Not sure why just came up on thyroid results.....

Thyroidmeg profile image
Thyroidmeg in reply to Lostmymind

Did you have thyroid symptoms? Sometimes the symptoms are low vit d so they test vitamin d.

My tsh was normal so I requested a vit d blood test

Thyroidmeg profile image
Thyroidmeg

It's the same with tsh . Wish they'd look at symptoms not just numbers :(

bantam12 profile image
bantam12

VitD along with others must be treated by blood results as toxic levels have to be avoided.

Funtimefrankie profile image
Funtimefrankie

I just wrote a post about D3. I was very ill for 8 years. Diagnosed with fibromyalgia. I did have a deficiency which was found in year 1 and was given a D2 injection and supplementation. Apparently there is something about D2 not being as good as D3, I think it has to do with conversion? Anyway, my levels went up to what my GP said was normal but I was still feeling unwell. In fact I got worse over the years. Some days I could not even get out of bed. Long story short, I recently came across the Vit D Council and also a very good thread called The Great Vitamin D experiment, it's on a low carb site and can be googled if you're interested. I upped my dosage to 60,000 D3 a week. I have 20,000 capsules so I took three pills a week. Vitamin D can become toxic if you take more than 10,000 a day and for longer than three months. It's also important to get enough calcium or the body will leach calcium from the bones I'm told. I am now completely cured of an illness that totally ruined 8 years of my life. I should add that it's important to have your calcium checked. My doc knows what I am doing and does this for me. Unfortunately, she would only prescribe 20,000 D3 a week as she said her hands were tied and that health professionals are only just realising some of the benefits of vitamin D so I had to purchase some of the pills which are obviously more expensive than a prescription. Good luck

Thyroidmeg profile image
Thyroidmeg in reply to Funtimefrankie

That's great to hear how far you've come . I'm just confused why I was told borderline when it's 27 it could explain why I've not been myself for a while. I would still like to know that I'm converting ok but the nurse assures me I am . Same nurse told me I didn't need vitamins tested though..

Thanks for posting :)

Funtimefrankie profile image
Funtimefrankie in reply to Funtimefrankie

Wanted to add this. Thought it might be useful for some. If not, please ignore.

By Dr Mercola

If You Take Oral Vitamin D You MUST Avoid Making This Serious Mistake

February 23, 2012 | 809,136 views

Spread the Word to

Friends And Family

By Sharing this Article.

2,981

109

74

3.1k

Email

Print

By Dr. Mercola

Did you know there are two types of vitamin D, and they are NOT interchangeable?

In fact, taking the wrong one could do you more harm than good...

Drisdol is a synthetic form of vitamin D2—made by irradiating fungus and plant matter—and is the form of vitamin D typically prescribed by doctors.

This is not the type produced by your body in response to sun or safe tanning bed exposure, which is vitamin D3.

A recent meta-analysis by the Cochrane Databasei looked at mortality rates for people who supplemented their diets with D2 versus those who did so with D3, the form naturally produced by your body, highlighting the significant differences between the two.

The analysis of 50 randomized controlled trials, which included a total of 94,000 participants, showed:

A six percent relative risk reduction among those who used vitamin D3, but

A two percent relative risk increase among those who used D2

According to the Vitamin D Councilii:

"You would think a paper that took a look at tens of thousands of subjects and analyzed the efficacy of prescription vitamin D (D2) and over-the-counter vitamin D (D3) would warrant a news story or two.

To my knowledge, these papers are the first to paint such a clear picture about the efficacy between D3 and D2.

While there may be explanations for D3's superiority other than improved efficacy, for the time being, these papers send doctors a message: use D3, not D2."

The Difference Between Supplemental Vitamin D2 and D3

The notion that vitamin D2 and D3 were equivalent was based on decades-old studies of rickets prevention in infants. Today, we know a lot more about vitamin D, and the featured study offers compelling support for the recommendation to take vitamin D3 if you need to take an oral supplement—which is the same type of D vitamin created in your body when you expose your skin to sunlight.

Supplemental vitamin D comes in two forms:

Ergocalciferol (vitamin D2)

Cholecalciferol (vitamin D3)

I personally recommend getting your vitamin D from safe sun exposure (or a safe tanning bed), as there's compelling reason to believe the vitamin D created in your skin in response to sun exposure has some slight but important differences that make it even more beneficial than supplemental vitamin D3. I will address this more in just a moment, but first, let's review the differences between the two types of supplemental vitamin D. Aside from the featured findings that supplemental vitamin D3 reduced the relative mortality risk by six percent, while D2 actually INCREASED mortality risk by two percent, the two types differ in the following ways:

According to the latest research, D3 is approximately 87 percent more potentiii in raising and maintaining vitamin D concentrations and produces 2- to 3-fold greater storage of vitamin D than does D2.

Regardless of which form you use, your body must convert it into a more active form, and vitamin D3 is converted 500 percent faster than vitamin D2.

Vitamin D2 also has a shorter shelf life, and its metabolites bind poorly with proteins, further hampering its effectiveness.

What about Dietary Sources? Animal-Based versus Plant-Based Vitamin D

Aside from taking an oral vitamin D supplement, you can also obtain small amounts of vitamin D from your diet. Here too, it's important to realize that not all food sources provide the same kind of vitamin D. Plant sources provide you with D2. The more beneficial D3 can only be had through animal-based sources such as:

Fish, such as salmon, mackerel, tuna and sardines

Egg yolk

Raw milk

Dairy processors producing pasteurized milk have also been fortifying milk with vitamin D since 1933. Today, about 98 percent of the milk supply in the U.S. is fortified with approximately 400 International Units (IU) of vitamin D per quart. While dairies used to fortify their milk with vitamin D2, most have now switched over to D3. But, if you still drink pasteurized milk (which I don't recommend), check the label to see which form of vitamin D has been added. (If you drink raw milk, then you're getting the naturally-occurring vitamin D in the milk fat.) Keep in mind that although milk is fortified, other dairy products such as cheese and ice cream does typically not contain added vitamin D.

Vitamin D Can Make or Break Your Health, So Get the Right Kind!

There's overwhelming evidence that vitamin D is a key player in your overall health. This is understandable when you consider that it is not "just" a vitamin; it's actually a neuroregulatory steroidal hormone that influences nearly 3,000 different genes in your body. Receptors that respond to the vitamin have been found in almost every type of human cell, from your brain to your bones.

Just one example of an important gene that vitamin D up-regulates is your ability to fight infections, as well as chronic inflammation. It produces over 200 antimicrobial peptides, the most important of which is cathelicidin, a naturally occurring broad-spectrum antibiotic. This is one of the explanations for why it can be so effective against colds and influenza.

Optimizing your vitamin D levels should be at the top of the list for virtually everyone, regardless of your age, sex, color, or health status, as vitamin D deficiency has been linked to an astonishingly diverse array of common chronic diseases, such as:

CancerHypertensionHeart disease

AutismObesityRheumatoid arthritis

Diabetes 1 and 2Multiple SclerosisCrohn's disease

Cold & FluInflammatory Bowel DiseaseTuberculosis

SepticemiaSigns of agingDementia

Eczema & PsoriasisInsomniaHearing loss

Muscle painCavitiesPeriodontal disease

OsteoporosisMacular degenerationReduced C-section risk

Pre eclampsiaSeizuresInfertility

AsthmaCystic fibrosisMigraines

DepressionAlzheimer's diseaseSchizophrenia

The IDEAL Way to Optimize Your Vitamin D Levels

While this article is focused on the two types of oral vitamin D supplementation, it's important to realize that the IDEAL way to optimize your vitamin D levels is through appropriate sun or safe tanning bed exposure. While your skin does create vitamin D3 in response to sun light, which is theoretically the same as the D3 you get from an oral supplement, there's cause to believe that the vitamin D created from sun exposure may have additional health benefits, and here's why:

When you expose your skin to the sun, your skin also synthesizes high amounts of cholesterol sulfate, which is very important for heart and cardiovascular health. In fact, according to research by Dr. Stephanie Seneff, high LDL and subsequent heart disease may in fact be a symptom of cholesterol sulfate deficiency. Sulfur deficiency also promotes obesity and related health problems like diabetes

When exposed to sunshine, your skin also synthesizes vitamin D3 sulfate. This form of vitamin D is water soluble, unlike oral vitamin D3 supplements, which is unsulfated. The water-soluble form can travel freely in your bloodstream, whereas the unsulfated form needs LDL (the so-called "bad" cholesterol) as a vehicle of transport. According to Dr. Stephanie Seneff, there's reason to believe that many of the profound benefits of vitamin D are actually due to the vitamin D sulfate. As a result, she suspects that the oral non-sulfated form of vitamin D might not provide all of the same benefits, because it cannot be converted to vitamin D sulfate

You cannot overdose when getting your vitamin D from sun exposure, as your body has the ability to self-regulate and only make what it needs

So essentially, getting regular sun exposure has much greater health ramifications than "just" raising your vitamin D levels and preventing infections. Sun exposure also appears to play a role in heart and cardiovascular health, and much more!

If you cannot get your vitamin D requirements from sun exposure, I recommend using a safe tanning bed (one with electronic ballasts rather than magnetic ballasts, to avoid unnecessary exposure to EMF fields). Safe tanning beds also have less of the dangerous UVA than sunlight, while unsafe ones have more UVA than sunlight. If neither of these are feasible options, then you should take an oral vitamin D3 supplement. It will certainly be better than no vitamin D at all.

How Much Vitamin D Should You Take?

Some 40 leading vitamin D experts from around the world currently agree that there's no specific dosage level at which "magic" happens; rather the most important factor when it comes to vitamin D is your serum level (the level of vitamin D in your blood). So you really should be taking whatever dosage required to obtain a therapeutic level of vitamin D in your blood.

That said, based on the most recent research by GrassrootsHealth—an organization that has greatly contributed to the current knowledge on vitamin D through their D* Action Study—it appears as though most adults need about 8,000 IU's of vitamin D a day in order to raise their serum levels above 40 ng/ml.4 For children, many experts agree they need about 35 IU's of vitamin D per pound of body weight.

At the time GrassrootsHealth performed the studies that resulted in this dosage recommendation, the optimal serum level was believed to be between 40 to 60 ng/ml. Since then, the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml, as illustrated in the chart above.

What this means is that even if you do not regularly monitor your vitamin D levels (which you should), your risk of overdosing is going to be fairly slim even if you take as much as 8,000 IU's a day. However, the only way to determine your optimal dose is to get your blood tested regularly, and adjust your dosage to maintain that Goldilocks zone.

How Vitamin D Performance Testing Can Help Optimize Your Health. Additionally, a robust and growing body of research clearly shows that vitamin D is absolutely critical for good health and disease prevention. Vitamin D affects your DNA through vitamin D receptors (VDRs), which bind to specific locations of the human genome. Scientists have identified nearly 3,000 genes that are influenced by vitamin D levels, and vitamin D receptors have been found throughout the human body.

Funtimefrankie profile image
Funtimefrankie in reply to Funtimefrankie

Also thought this might be useful. It's from GP Notebook

Consult expert advice and local guidance.

Vitamin D entails a range of fat-soluble compounds with similar activity on calcium and phosphate physiology: enhancement of gastrointestinal absorption and an increase in bone deposition

major biological functions of vitamin D are to regulate calcium and phosphate absorption and metabolism, and to maintain plasma calcium levels via bone resorption and formation

these actions help to form and maintain healthy bones

observational studies suggest that vitamin D also helps to maintain a healthy immune system and regulate cell growth and differentiation, so could protect against certain cancers (1)

Agents include:

vitamin D2 - ergocalciferol

pro-vitamin D3 - 7-dehydrocholesterol

vitamin D3 - cholecalciferol

25-hydroxycholecalciferol - 25-HCC - calcidiol

1,25-dihydroxycholecalciferol - 1,25-DHCC - calcitriol

Notes:

vitamin D supplementation in vitamin D deficiency

over-the-counter preparations (e.g. capsules, liquids) of cod or halibut liver oils are available and contain 2.5-20µg (100-800 IU) doses of vitamin D (1,2,3)

calcium and vitamin D combined supplements are not routinely indicated in patients with low vitamin D3 levels unless the patient also has hypocalcaemia. The calcium component may be unnecessary and can reduce compliance due to unpalatability. Serum calcium levels should, however, be monitored

short acting potent analogues of vitamin D such as alfacalcidol or calcitriol should NOT be used in this situation because there is no evidence to support efficacy and it can lead to hypercalcaemia

treatment of vitamin D deficiency in adults (4):

the following adult vitamin D thresholds are adopted by UK practitioners in respect to bone health:

serum vitamin D (serum 25OHD) < 30 nmol/L is deficient serum

25OHD of 30-50 nmol/L may be inadequate in some people serum

25OHD > 50 nmol/L is sufficient for almost the whole population

treatment thresholds (4):

Serum 25OHD < 30 nmol/L: treatment recommended

Serum 25OHD 30-50 nmol/L: treatment is advised in patients with the following:

fragility fracture, documented osteoporosis or high fracture risk

treatment with antiresorptive medication for bone disease

symptoms suggestive of vitamin D deficiency

increased risk of developing vitamin D deficiency in the future because of reduced exposure to sunlight, religious/cultural dress code, dark skin, etc.

raised PTH

medication with antiepileptic drugs or oral glucocorticoids

conditions associated with malabsorption

serum 25OHD > 50 nmol/L: provide reassurance and give advice on maintaining adequate vitamin D levels through safe sunlight exposure and diet

oral vitamin D3 (colecalciferol) is the treatment of choice in vitamin D deficiency (4)

where rapid correction of vitamin D deficiency is required, such as in patients with symptomatic disease or about to start treatment with a potent antiresorptive agent (zoledronate or denosumab), the recommended treatment regimen is based on fixed loading doses followed by regular maintenance therapy:

a loading regimen to provide a total of approximately 300,000 IU vitamin D, given either as separate weekly or daily doses over 6 to 10 weeks

maintenance therapy comprising vitamin D in doses equivalent to 800-2000 IU daily (occasionally up to 4,000 IU daily), given either daily or intermittently at higher doses

1) Loading regimens for treatment of deficiency up to a total of approximately 300,000 IU given either as weekly or daily split doses. The exact regimen will depend on the local availability of vitamin D preparations but will include:

50,000 IU capsules, one given weekly for 6 weeks (300,000 IU)

20,000 IU capsules, two given weekly for 7 weeks (280,000 IU)

800 IU capsules, five a day given for 10 weeks (280,000 IU)

the following should be borne in mind:

supplements should be taken with food to aid absorption

calcium/vitamin D combinations should not be used as sources of vitamin D for the above regimens, given the resulting high dosing of calcium

2) Maintenance regimens may be considered 1 month after loading with doses equivalent to 800 to 2000 IU daily (occasionally up to 4,000 IU daily), given either daily or intermittently at a higher equivalent dose.

Notes:

dose conversion (2):

the dose of vitamin D in micrograms can be calculated by dividing the number of international units by 40. Vitamin D2 (ergocalciferol) and vitamin D3 (colecalciferol) are considered equal in potency

although there are suggestions that the onset of action of vitamin D3 is quicker

calcium and vitamin D combined supplements are not routinely indicated in patients with low vitamin D3 levels unless the patient also has hypocalcaemia. The calcium component may be unnecessary and can reduce compliance due to unpalatability. Serum calcium levels should, however, be monitored

short acting potent analogues of vitamin D such as alfacalcidol or calcitriol should NOT be used in this situation because there is no evidence to support efficacy and it can lead to hypercalcaemia

WARNING: NUT/SOYA ALLERGIES

vitamin D preparations such dekristol and Fultium D3 contain peanut oil; Drisdol, Calceos and Adcal D3 contain soybean oil. For full details of excipients, refer to individual SPCs

all patients receiving pharmacological doses of vitamin D should have the plasma-calcium concentration checked at intervals (initially weekly) and whenever nausea or vomiting are present (3)

serum calcium concentrations should be checked regularly for a few weeks after starting treatment for vitamin D deficiency; then vitamin D, parathyroid hormone (PTH) and calcium concentrations should be checked after 3-4 months of treatment to assess efficacy and adherence to therapy

after this check at 3-4 months then vitamin D and calcium concentrations should be checked every 6-12 months

breast milk from women taking pharmacological doses of vitamin D may cause hypercalcaemia if given to an infant (3)

vitamin D supplementation is contraindicated in patients with hypercalcaemia or metastatic calcification

relative contraindications include primary hyperparathyroidism, renal stones and severe hypercalciuria

patients with mild to moderate renal failure or known to have mild hypercalciuria should be supervised carefully when taking vitamin D In patients with a history of renal stones, urinary calcium excretion should be measured to exclude hypercalciuria, a problem which requires specialist referral

assessment of improvement in vitamin D (25OHD) status on replacement therapy (4)

routine monitoring of serum 25OHD is generally unnecessary but may be appropriate in patients with symptomatic vitamin D deficiency or malabsorption and where poor compliance with medication is suspected.

there is considerable variability between the results of studies examining the dose response to vitamin D supplementation, but it appears that much of this inconsistency results from the confounding effects of UV exposure in the summer months. When consideration is confined to the results of studies that examined the effect of supplementation on winter 25OHD levels, the results are more consistent:

a daily supplement of 20 to 25 µg (800 to 1000 IU) calciferol will cause an increase in 25OHD of 24 to 29 nmol/L. Most of these studies have suggested that a new steady-state 25OHD level is reached by about 3 months and possibly not until 6 months.

"..accordingly, it is a waste of resources to measure vitamin D levels too soon after the therapy has started. A minimum of 3 months treatment must be given and it may be more prudent to wait until 6 months have passed..."(4)

local guidance (5) has stated that "...only those patients with risk factors and signs and symptoms of Vitamin D deficiency or insufficiency should have their levels checked..". Other guidance suggests that (4):

serum vitamin D measurement is recommended for:

patients with bone diseases that may be improved with vitamin D treatment patients with bone diseases, prior to specific treatment where correcting vitamin D deficiency is appropriate patients with musculoskeletal symptoms that could be attributed to vitamin D deficiency

specialist supervision in vitamin D supplementation (4)

if a patient has tuberculosis or sarcoidosis

patients with granulomatous disease are at risk of hypercalcaemia because of increased 1alpha-hydroxylase activity (which converts 25OHD to active 1,25(OH)2D). Toxicity has been reported during vitamin D treatment of tuberculosis and in patients with active sarcoidosis.specialist advice should be sought before starting these patients on vitamin D therapy

there may be sub-groups of patients identified who are unable to maintain adequate vitamin D status. These may require a more aggressive replacement or maintenance schedule provided under specialist supervision in a secondary-care setting

local guidance suggests seeking specialist advice eGFR<30ml/min, pregnancy, hyperparathyroidism (5)

recommended daily intake of vitamin D in the UK is around 400IU (10mcg) for an adult, 280IU (7mcg) for children aged 6 months to 3 years and 340IU (8.5mcg) per day for infants under 6 months (6)

Reference

1) Drug and Therapeutics Bulletin 2006; 44(2):12-16.

2) Fraser, D.R.. Vitamin D. Lancet 1995;345: 104.

3) Drug and Therapeutics Bulletin 2006; 44(4):26-9.

4) National Osteoporosis Society (2013). Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management.

5)NHS Coventry and Warwickshire. Brief Prescribing guide - Treatment of Vitamin D Deficiency in Adults (May 2013)

6) nelm.nhs.uk/en/NeLM-Area/Ev...

7)BNF 9.6.4

Thyroidmeg profile image
Thyroidmeg in reply to Funtimefrankie

I'm hoping it will help hypertension too..

Thyroidmeg profile image
Thyroidmeg in reply to Funtimefrankie

Very interesting a lot to take in ill need to read it again now ;) I'm on the d3 gel pills

Funtimefrankie profile image
Funtimefrankie in reply to Thyroidmeg

Tell me about it! I've read it a few times myself. We'll be qualified doctors at this rate, lol.

1973GB profile image
1973GB

I have an under active thyroid and persuaded an endo to test Vit D. The result was 32 but he said this was fine. I asked my doctor about Vitamin D needing to be "optimal" but my doctor doesnt know anything about this! I did take some VitD without calcium but i think in the dose i am taking it will do very little and take for ever. Should i see another doctor as i am still really tired despite having T4 increased to 125mcg very recently?

Thyroidmeg profile image
Thyroidmeg in reply to 1973GB

Having read up on vitamin d the target range is 30 - 60 but hormone experts kent holtorf and Sara gottfried believe that a level of around 80 is more effective as a weight loss aid ..

1973GB profile image
1973GB

I think i might start tasking the D3 again then as i have gained 5 stone prior to being diagnosed with underactive thyroid and fibro and can't shift a pound!

Thyroidmeg profile image
Thyroidmeg in reply to 1973GB

Try the thyroid diet revolution by mary j shomon :) I'm in the same situation as you that's where I got that info from . I'm desperate to

Lose the weight I've gained too :(

1973GB profile image
1973GB

Good luck Thyroidmeg! I'm really cheesed off with the weight gain as prior to this all kicking off i had lost 2 1/2 stone so not happy either! I'll check out the thyroid diet revolution.

Thyroidmeg profile image
Thyroidmeg in reply to 1973GB

Me too I'd lost loads a few years ago then after tt I put on loads. That book says that although tsh is correct it could be low vit affecting the conversion so if I were you I'd ask doctor for more tests esp t3 . I'd like to try t3 but I doubt I'll get it ..

1973GB profile image
1973GB

My T3 is currently 4.3 which my doctor says is in range (which it is for the lab test reference range) but in my opinion it is the low end of being within range. I asked doctor if maybe i had a conversion problem and was referred to an endo who to be perfectly frank suggested i didnt have a thyroid problem and couldnt understand why my doctor had put me on meds despite being 9.28 TSH originally and with anti thyroid antibodies so the chances of me getting any T3 are zilch! I think the D3 might help though!

Thyroidmeg profile image
Thyroidmeg in reply to 1973GB

They won't even test my t3.. I might get private tests just to put my mind at rest. Meanwhile I'm hoping d3 is the answer I need ;)

1973GB profile image
1973GB

Good luck.

My first test result was very similar to yours: 28.

I'm doing very well on 5,000 IU Vitamin D3 day, and have tested my levels twice since and both times the level was optimal (somewhere around the 130 mark).

I love vit D3, it has helped my finger joints immensely and gives me a sunny feeling inside :-)

Thyroidmeg profile image
Thyroidmeg in reply to

It might be psychological but I felt better after my first week there but I'm only on 800iu d3. Getting calcium checked in a couple of weeks . After that will ask doc if I can up my dose a bit:)

IshY profile image
IshY

well my levels are 24 and I am on 800UI 4 times a day, is that about right? I am only 25

Thyroidmeg profile image
Thyroidmeg in reply to IshY

Your doctor seems better than mine ! I only got told 1 a day and after 6 months it hadn't improved so I took extra and the next blood test it had improved.

So I think your levels will improve quickly ;)

You may also like...

Vitamin D - has anyone else been prescribed 50,000 iu a day for 6 days with 50,000 iu a month for 6 months for vitamin D deficiency?

this amount (or anything similar) If so, did you have any side effects please and what time of day...

My vitamin D deficiency

new here, and am hypothyroid having only been diagnosed last month. I have posted my previous...

Vitamin D I'm I getting enough?

regarding supplementation. I have been diagnosed with ostiopien so vitamin D has been given but it...

Got my T3 without prescription from Greece incredibly fast (thanks to all who gave me the link). I'm now on 25mcg, when should I increase?

hypothyroid and since I was reading around that tests can be normal and you can still be hypo I...

I have been told my Vit D is a bit low and the doctor said to try and get fifteen mins. in the sun each day and then see him in September fo

September to have another blood test done and see if the Vit D is now o.k. Well, i have been...