Vitamin D levels

I have no experience of the drugs you have mentioned but many drugs do often impact on various vitamin levels.

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I have damaged parathyroids following TT 4 years ago. I take Adcal 1 tablet twice daily. Although this has has vitamin D added it was not enough and I have to take extra vitamin D as well. It has been hard to keep my calcium levels satisfactory without this and I need to keep my vitamin D around 95 to keep calcium levels stable and stop muscle twitching. I would think your vitamin D levels have dropped due to reduction in Alphacalcidol and are too low and doubt the amount in 1 Adcal will improve them in my experience, but I am no expert. I am sure others on this site will know more. Try googling Hypopara UK - I am sorry I am a technophobe and cannot copy the link for you but the website has loads of useful information.

Vitamin D3 supplements are easily obtained over the counter and aren't very expensive. Why not just buy your own? Based on a level of 24, you would need a very high dose to raise your levels. I felt very achy with levels around the 50 mark, which improved enormously when I got my levels up to near 100, so I would guess you must feel dreadful.

"Alfacalcidol undergoes rapid hepatic conversion to 1,25-dihydroxyvitamin D, the Vitamin D metabolite which acts as a regulator of calcium and phosphate metabolism."

I've had a bit of a read and to be honest, this looks like a specialist question for the endo. If you're being monitored and your levels are dropping then it looks as if you need to see him sooner than the six months.