Hey all,
I was wondering if anyone knows what I should take for vit d and k2?
My level is 146 nmol/l (range up to 125, over 125 indicating excessive), I take 8,000 units daily, I also take 100 mg of K2 separately.
My gp had suggested 2,000 units of Vit D, but to me it seems rather low. Also, not sure how much K2 to take, should I split my 100 pill into two?
Any ideas? 
Thank you!
Cuppa
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Hi Cuppaofcha. 8,000 IU daily is a lot. Were you deficient before you started taking that high of dose? How long had you been on that dosage before retesting? Since you are over range, you need to completely stop taking D for 2-4 weeks, then retest your levels of D. Your body needs to be cleared of the excess D. At the time of testing if your level is found to be within range, then you can resume taking D. There is no reason you can't continue to take 8,000 IU, just don't take it every day. You could try 4 days a week, for example. After you retest and find your level to be within range, you could try 2,000 IU for awhile and see if you can maintain a high enough level. If you were on 8K daily, became over range, stop taking D for several weeks until you are within range, reducing the dose to 2K might be too low. You could always try 4K. Whatever you choose to do, take it for several months, retest your D again and if your levels are good, continue with what you are doing. If they are too low in range, increase your dose.
If you get sun during spring, summer and fall months compared to winter, keep this in mind because your body will be producing it's own D when exposed to sun. Some people take a lower dose of D during sunny months and a higher dose of D during dreary months.
K2 is dosed in micrograms, or mcg. Do you mean 100 mcg? The recommended dosage of daily K2 is 90 mcg, so you are fine with 100 mcg. It should be taken at the same time that you consume your vitamin D.
Thanks ShootingStars, this is very helpful. Are you sure I should stop taking it completely for a few weeks? I was insufficient about a year ago, I had to take loading doses. Then I tried to take 4,000 units and was insufficient again. Then I upped to 10,000 units a day, my level were high range at 126 nmol/l. Reduced to 8,000 units a day. Now I'm at 146 nmol/l. Thank you! SeasideSusie I'm trying to figure this out, my gp says this is excessive, then my polish lab says something else...confused. re k2, sorry I meant mcg, I take 100 mcg thank you ShootingStars
You're welcome Cuppaofcha! I'm glad I could help. Yes. Your level is too high, although not super high and you have vitamin D toxicity. Your doctor should have informed you that by having excessive levels of D, you are at risk of kidney problems, kidney stones, irritability, heart palpitations, bone pain, constipation, nausea, etcetera. You need to bring your level down quickly. Taking more D before your level is down will only prolong possible problems.
You can retest as many times as necessary until your level is within range, and then resume taking D. On the conservative side, you could always stop taking it for a week and then retest. You might find that in just a week of no D it has not reduced much. You could continue for another week of sustaining from D and then retest.
How long were you one 4,000 IU before you retested? By insufficient, how low was it? How long were you on 10,000 IU before testing at 126? How long were you on 8,000 IU before discovering your level is 146? Your GP is correct that your level is excessive, or toxic. What do your polish labs say? Are they the same unit of measurement?
Thank you, that makes perfect sense. I'm already skipping doses the last two days, the only problem is due to coronavirus I can get my bloods tested for another while, who knows how long.the polish lab results are from end of December 2019, 53,8 ng/ml (136 nmol/l), it says under 30 is insufficient, 30-50 range is optimal, 50-100 is high,over 100 is toxic,while my Irish labwork say anything over 50 ng/l (125 nmol/l) is toxic. I have seen SlowDragon posting somewhere it's good to have readings between 80-100 nmol/l. I have been taking 10,000 units until Xmas pretty much,then went down to 8,000 units. 10,000 I have been taking for almost the full year of 2019.
Hidden
My level is 146 nmol/l (range up to 125, over 125 indicating excessive)
I think possibly ShootingStars is in the US and they have a different unit of measurement for Vit D - ng/ml instead of nmol/L.
I always go by the recommendations of the Vit D Council, the Vit D Society and Grassroots Health.
The Vit D Council recommends a level of 125nmol/L (50ng/ml), the Vit D Society and Grassroots Health recommend 100-150nmol/L (40-60ng/ml).
Here in the UK, one NHS lab offers Vit D testing for the public and this is how their results:
behealthynow.co.uk/wp-conte...
You will see the different categories and "Greater than 50 = Adequate". Below that you'll see "Total Vit D levels above 220nmol/L are considered 'High' and increase the risk of toxicity".
So you can see that the recommendations of the Vit D Council, Vit D Society and Grassroots Health sit nicely within the range, are not excessive and do not increase the risk of toxicity.
So your GP may be saying it's excessive purely because the lab report says that, or because he believes, like most doctors, that just being within the "adequate" category (i.e. 50+) is enough.
I think your GP has actually made a sensible suggestion. Your current level is 146, I would be very happy with that and would be looking to find my maintenance dose to keep it there. Your GP has suggested reducing your dose of D3 from 8,000iu to 2,000iu daily and I think that's sensible. I don't agree that you should stop supplementing, your level isn't anywhere near high enough for that. You had Vit D deficiency and had the loading doses. You've managed to raise your level to the recommended level and now need to keep it there. General advice is once we reach the level recommended by the Vit D Council, etc, then we find our maintenance dose to keep it there, testing regularly and adjusting dose when necessary. 2,000iu daily is a good place to start for a maintenance dose. I would suggest you take that and retest in 3 months then make any further adjustment to dose based on the new level after retesting. You may be lucky enough to make Vit D from the sun, not all of us are, and you may then be able to reduce your dose in the summer and increase again in the winter.
We should retest twice a year when taking Vit D and aim to keep within the range suggested by the Vit D Council, etc.
As for your K2 supplement, 90-100mcg is enough for up to 10,000iu D3 so it's OK to continue with the dose you have.
As for timing of taking D3 and K2 supplements and whether they should be taken together, this depends on what form of supplement you use. Oral spray D3 is absorbed through the mucous membranes in the oral cavity, so they bypass the stomach, so you could take your K2 at the same time if you wish, but remember that K2 is fat soluble so needs some dietary fat when you take it to aid absorption.
If you take oil based softgels for both D3 and K2 then you could take them at the same time as they each have their own fat within the softgel to aid absorption. And just to be sure, I'd still take them with some dietary fat.
If your supplements do not contain oil, eg if they are a tablet or capsule without oil, if you take them at the same time with dietary fat then they will complete for the fat. In this case it is better to take them at different times of the day and ensure that you take each with some dietary fat.
Thank you so much SeasideSusie this makes sense, since my Polish lab results are from end of December 2019, show 53,8 ng/ml (136 nmol/l), and it says under 30 is insufficient, 30-50 range is optimal, 50-100 is high,over 100 is toxic,while my Irish labwork say anything over 50 ng/l (125 nmol/l) is toxic - big difference.I have been taking 10,000 units until Xmas 2019 pretty much,then went down to 8,000 units. 10,000 I have been taking for almost the full year of 2019.
I guess my worry is that when previously taking 2,000 units, my levels were 29, insufficient.
I'm in Ireland and with covid now I doubt I'll be getting a lot of vitamin D from the sun 😀
I guess my worry is that when previously taking 2,000 units, my levels were 29, insufficient.
Yes, but you've built your level up now from deficient to recommended level, the idea now is to maintain it there. If you continue taking 8,000iu then you will continue building up your level and you don't want that, the fact that your level continued to rise after reducing dose from 10,000 to 8,000iu is telling you that you don't need that amount.
2,000iu may be enough to maintain your new level but you wont know until you've given it a trial and retested. If it was me I'd aim to keep my level at your current level, or between 125 and 150nmol/L (50-60ng/ml). Retest in 3 months and see what your new level is. If it's dropped lower than 125nmol/L you might want to try adding an extra 1,000iu D3 and see where that takes you.
I don't sit out in the sun as it feels like it burns my legs even through clothes, so I don't make much Vit D in the summer, if any at all. I need to supplement the same amount all year round, but others who like to be out in the sun and make Vit D easily that way will be able to lower their dose in the summer.
Okay, that very reassuring SeasideSusie, I will start 2,000 units and do bloods in 3 months again, it's true that 8,000 is pushing it over further, thank you.
I might try to expose my face to the sun a bit, otherwise I burn too
Thank you again for your advice!
Hi SeasideSusie. I’m going by the actual lab results that she provided, and the respected lab range. No conversion of units was involved. Just reading her labs. 😉
The units of measurement don’t matter. When reading any lab results, the range provided by the lab must be noted. Labs vary in units of measurement and lab ranges. What matters is the lab range and where you fall within it. Your results show that you are over range, under range, or somewhere in between, according to the lab range.
ShootingStars
The units of measurement don’t matter. When reading any lab results, the range provided by the lab must be noted. Labs vary in units of measurement and lab ranges. What matters is the lab range and where you fall within it.
I agree with you. But Vit D has categories - deficiency, insufficiency, sufficient, etc. and it's the sufficient/adequate category that we need to look at and the range within that category when there is one. And, of course, what matters is being in the sufficient/adequate category and not in the deficiency or insufficient catagory.
Both units of measurement have their sufficient categories, i.e. 40-60ng/ml and 100-150nmol/L so what matters is coming somewhere between those two numbers depending on the unit of measurement. So there you have what you said "What matters is the lab range and where you fall within it" but we are talking about the range within the sufficient category, it's the only one we can use when talking about Vit D, we can discount the deficiency and insufficient categories.
Did you look at the results sheet that our NHS hospital lab uses for Vit D categories - here it is again:
behealthynow.co.uk/wp-conte...
And have you checked out the Vit D Society and Grassroots Health websites to see their recommendations:
vitamindsociety.org/ who say:
Maintain your Vitamin D level between 100 – 150 nmol/L
grassrootshealth.net/projec... who say:
An international panel of 33 scientists.... Call to Action has been issued to alert the public to the importance to have vitamin D serum levels between 40 and 60 nanograms/milliliter (100-150 nanomoles/liter) to prevent these diseases. Implementing this level is safe and inexpensive.
Most ranges in the sufficient/adequate category in the UK from 50-175, the OP's range is very unusual in saying that >125 is excessive (and we haven't actually seen that on a results sheet, just what the OP says). As she is in Ireland I have looked at what's recommended there.
From marycarmodynutrition.ie/vit...
What is the optimal range on a blood test?
Optimal range is 50-100 ng/mL (125-250 nmol/L). Mary likes to see readings over 80ng/mL at the Vitamin D tests in her Cork clinics.
That optimal ranges doesn't agree with the Vit D Society and Grassroots Health, it seems higher than what is recommended elsewhere.
So at 146nmol/L (=58.4ng/ml) the OP sits nicely in the upper part of the range within the sufficient category of 100-150nmol/L or 40-60ng/ml recommended by the Vit D Society and Grassroots Health and it would be in her best interest, taking into account her history of deficiency, to maintain a level within the range of the sufficiency level.
Thank you again! I have copied it from my results, it's a local public hospital:
25(OH)Vitamin D *145 nmol/L (30-125
)
At increased risk of bone disease: <30 nmol/L
At increased risk of vitamin D inadequacy: 30-50 nmol/L
Vitamin D adequacy: >50 nmol/L
*At risk* of vitamin D excess: >125 nmol/L
It says At Risk Of Excess, but my Polish labwork identifies it as High, excessive is much higher
Cuppacha
Thank you for clarifying that.
It seems to be out of step with other ranges for the sufficient/adequate category members post here. The one we normally see from NHS results is 50-175nmol/L. And the one from the NHS lab who does tests for the general public is >50 is adequate and 220nmol is considered high with increased risk of toxicity.
I still prefer to follow the guidance of the many scientists mentioned on Grassroots Health, ie 100-150nmol.
That's why I was so confused, couldn't find anything that would match it and now it makes sense why, thank you, Irish labs seem to be more conservative then! I'll start 2000 tonight with 100 k2 thank you again! Hope I can maintain it well!
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