Vitamin D discrepancy Medichecks vs GP

[Mionaonthehill]

A month ago I had a Medichecks Vitamin D test which came back as 25nmol/L (50-250nmol/L normal range) or insufficient. I told GP and they ordered their own test and the results are 39 nmol/L (50-250). Both tests were done in the morning fasting. GP still fobbing me off and saying this result is just slightly abnormal but he did agree to a supplement when I asked. I suppose my question is can your vitamin D levels change so quickly (without any supplements) or are Medichecks unreliable?

[greygoose]

The difference is negligeable. They're both well under-range, and that's the important thing. But, doctors just do not understand nutrients because they don't learn about them in med school. How much has he given you?

[SeasideSusie Remembering]

Nothing is static. Lots of food are rich in Vit D - fortified breakfast cereals, liver, oily fish, egg yolks, cheese, mushrooms - maybe you ate some of these before the second test. Vit D testing doesn't need to be fasting or at any particular time.

Regardless of what dose has been prescribed, you will need 5,000iu D3 daily and need to retest in 3 months.

Best to aim for the level recommended by the Vit D Council and Vit D Society which is 100-150nmol. Once that level is reached a maintenance dose will be needed plus retesting twice a year to ensure that your level remains within the recommended range.

Also needed are D3's important cofactors - magnesium and Vit K2-mk7. Magnesium is needed for the body to convert D3 into it's usable form. D3 aids absorption of calcium from food and K2-mk7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissue where it can be deposited and cause problems.

[Teac in reply to SeasideSusie]

I have a question. I have hashimoto's and just tested my vitamin d level and it is 18. My doctor wasn't concerned at all and just said it's because I'm dairy free. Ugh. But I want to take vitamin D despite him saying it's not a concern. I understand the need for K2 but I have read that mk7 is from fermented soy and I've read that soy is dangerous for anyone with thyroid problems. Do you know anything about that? Is there an alternate k2 that you would suggest?

[SeasideSusie Remembering in reply to Teac]

Teac

First question would be is that 18nmol/L or 18ng/ml? There's a big difference. And are you in the UK?

If it's nmol/L and if you are in the UK then your GP should follow the NICE Clinical Knowledge Summary because you have severe Vit D Deficiency.

Dairy is not a particularly rich source of Vit D so I doubt being dairy free is the main reason for you being deficient.

As for K2-MK7 being from fermented soy, that is said to be OK for us Hypos, it's unfermented soy that we should avoid. Soy is not "dangerous", it's just that unfermented soy can affect absorption of thyroid hormone.

If you're not happy with a natto form of MK7 then I believe there are some MK7 supplements made from chickpeas.

[Teac in reply to SeasideSusie]

Hi SeasideSusie. No I am not in the UK and it is actually 18 ng/ml. I'm sorry I didn't specify. The ranges given to me are (21-100). And also unfortunately my doctor hasn't prescribed me any hormones yet as he said my numbers are still good. That is something that frustrates me as my last TSH was 5.2. He didn't run any others and only ran the vitamin D as I begged him to. So taking fermented soy I am thinking may do more hard than good. Thank you for your very timely response and help. It's much appreciated. Be safe.

[SeasideSusie Remembering in reply to Teac]

Teac

it is actually 18 ng/ml (21-100)

The Vit D Council recommends a level of 50ng/ml and the Vit D Society recommends 40-60ng/ml. As you are below range, your doctor must surely see that you are in the "insufficient" category. For your current level, to reach the Vit D Council's level, they would suggest you take 4,000-5,000iu D3 daily then retest in 3 months to check your level. Once you reach the recommended level then you'd need to find your maintenance dose to keep it there, retesting twice a year to ensure you stay within range.

I have been taking a K2-MK7 supplement made from Natto for about 4 years and it hasn't affected the absorption of my thyroid hormone replacement, but it is, of course, entirely your choice what you do.

[Teac in reply to SeasideSusie]

Thank you so very much for your help. I think I will go ahead and take this bottle of K2 then and see how I do. Since you have done fine with it, hopefully I will too. Thank you again.

[Polly91 in reply to SeasideSusie]

Adcal D3 is something an elderly relative takes for vitamin D. Does anyone know how that equates to D3 in IU?

My aunt gets it from NHS. She’s 80 and doesn’t get out much but I don’t know what her vit D levels are.

Any advice greatly appreciated

Thanks

Polly

[SeasideSusie Remembering in reply to Polly91]

Polly91

The Patient Information Leaflet that comes in the box will tell you.

There are different types of Adcal. There is Adcal-D3 and Adcal.

Adcal-D3 comes in 2 strengths:

One is Calcium carbonate (750 mg) and vitamin D3 (200 I.U.)

Another is Adcal-D3 which is 1500mg calcium and 400iu D3.

Then there is Adcal 1500mg chewable tablets which contain 1500mg calcium (equivalent to 600mg of elemental calcium) but no Vit D.

So you'll need to have a look at either the box or the leaflet.

Is she taking it for the calcium or for the D3?

[Polly91 in reply to SeasideSusie]

Thank you so much Seaside Susie

She takes it for osteoporosis. She’s on the Adcal D3 1500 mg calcium and 400 IU D3.

Thanks

[Mionaonthehill]

thanks for your reply. I don’t know yet I have to pick them up. He said I didn’t need anything just sit under the sun for a bit but I said I wanted a supplement and he said OK.

[Mionaonthehill]

I am just a bit wary of taking vitamin D because I have raised calcium levels but I knew I wouldn’t get any sense asking him about that.

[SeasideSusie Remembering in reply to Mionaonthehill]

I am just a bit wary of taking vitamin D because I have raised calcium levels

In that case you really need to discuss this with your GP or a different GP if yours isn't helpful. My reply was based on someone with normal calcium levels and is probably not appropriate for you.

[Marz in reply to Mionaonthehill]

You have inadvertently replied to yourself - click the blue Reply button so members receive an alert ... 😷

SeasideSusie

[Mionaonthehill in reply to Marz]

Thanks Marz

[LyraBelasqua]

Yes, levels can change quickly. See:-

grassrootshealth.net/research/

Second paper down: "25-Hydroxyvitamin D variability within-person due to diurnal rhythm and illness: a case report"

[Rebec]

Don’t worry so much about the level of vit D. I have high calcium in the blood due to parathyroid working “too hard” so my GP decided I can take 800 IU. I don’t take it very often but still it was enough to have had better blood results in this direction.

[Mionaonthehill in reply to Rebec]

Thanks for that information. I also have parathyroid problem so it’s good to know it has worked for you and given me more confidence to try it.

[Rebec in reply to Mionaonthehill]

I remember my GP looking on the internet which maybe it’s similar to asking a colleague for advice!

How are your bones doing? I imagine you have had some Dexa scans done already.

Good luck!

[Mionaonthehill in reply to Rebec]

GP reluctantly agreed to DEXA ( he thinks I have nothing wrong) and scan is scheduled for April 11 but of course it may be postponed. My calcium is 2.69 and PTH 13

[Rebec]

I don’t have my details next to me but I find it strange for a GP to feel reluctant to send you to have a Dexa scan. How long ago have you discovered the parathyroid problem?

[Mionaonthehill in reply to Rebec]

It was since I had my partial thyroidectomy for suspicious nodule last June. I struggled for GP to agree I had Hypothyroidism after the op even though I saw private endo who diagnosed Hashimoto’s but that is another story. Discovered the parathyroid problems when GP did parathyroid test by mistake and readings were abnormal. All GPs in practice kept fobbing me off even after three PTH tests came back abnormal. They said results were “slightly raised” and of no concern. But I went again about three weeks ago and asked to be referred to endo. They refused referral but sent letter and from the letter back from hospital endo he reluctantly agreed to DEXA scan. Sorry for long story.

[Rebec]

In which city or area those GPs practise as I’ve never heard a doctor not to be interested in finding out the state of a patient’s bones if they see the parathyroid hormone is raised.

[Mionaonthehill in reply to Rebec]

You will probably be surprised to hear I live just outside Oxford

[Rebec]

Can’t find my calcium results but my PTH is....almost 30! The normal maximum is 7.63. I should have had the special test to find out which one of my parathyroid glands need to come out but for this I’d have to get a die injected into my bloodstream and once I had a bad reaction before to a die so I decided not to have the test.

Funny that I live in the city they’re trying to connect by a direct route to the one next to you!

Is there a university hospital nearby?

P.S. on my notes, they write the following (about vitamin D):

30-50 nmol/L: may be inadequate in some people

Above 50 nmol/L: is sufficient for almost the whole population

[Mionaonthehill in reply to Rebec]

That’s terribly high PTH! Can’t they try ultrasound to find the bad one without the dye? You must be suffering a lot with those levels.

[Rebec]

Thank God, the parathyroid don’t hurt. The only (!) problem can be in developing kidney stones which do hurt.

I had ultrasound done by very good specialists but it’s not easy to differentiate between them and nodes and also, the glands might be even lower in the chest.

That’s why I had quite a few Dexa scans to check I’m not getting osteoporotic. So if you add to it the fact that I had breast cancer in 2012 and for five years I had to take medicine which stopped my body producing oestrogen (which could have made me also osteoporotic), I can thank the Almighty that I’m OK from this point of view. I just hope that this virus won’t finish me though!

[Mionaonthehill in reply to Rebec]

You are a strong fighter and have been through a lot. I certainly hope you don’t get the virus either.

[Rebec in reply to Mionaonthehill]

Thank you for your kind words. Hope you won’t get it either.