Vitamin D level is 15nmol/L, only on 800UI Fultium?

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Hey all, this is my first post here and I'm hoping to get some advice.

After a year or so of intermittent aches and pains, lethargy and my depression and anxiety worsening, I went to my GP as I wondered about vitamin D. I'd been working in a call centre for a while so knew I probably wasn't getting enough sunlight, and my mum had even diagnosed with a vitamin D deficiency last year after having similar symptoms.

Had the blood test last week and my levels are very low at only 15nmol/L. They also did a FBC which I was all fine (they didn't check my calcium though). I haven't had the chance to see my GP since, it was just a phone call from the surgery to tell me that my levels were low and that a prescription was ready for me. I've been prescribed Fultium 800UI, one to be taken daily for 3 months, then repeat the blood test. The patient leaflet says for severe deficiency between 1-4 can be taken daily (depending on how deficient), and says 1-2 for a maintenance dose! This information here says 4 a day for a loading dose too: http://www.surreyandsussex.nhs.uk/wp-content/uploads/2013/04/Vitamin-D-Guidelines-KSS-HPSU.pdf I'm in West Sussex so those would be the correct guidelines.

I'm not sure what to do; obviously I'm concerned about getting my levels back up, so I'm not happy that I appear to be on just a maintenance dose, but I'm apprehensive about questioning my GP and doing the whole "I found this information online" thing!

Also do factors such as age, height and weight affect the loading dose (particularly height/weight)? I'm 26, only 5ft2 and just under 8 stone.

Or has anyone else been on the same dose and had their levels go back up within the 3 months?

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  • Posted

    You need to go back to your doctor, 800 is not enough, my level was 17 and I was taking 3 lots of 800 a day, then later on my doctor changed it to  one lot of 32,000 a week, and my levels took months to go back up, dr Holick who specialises in vitamin d recommends at least 1500 a day, you do need a lot more than 800 a day, this won't do anything.

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  • Posted

    With a low level like that the recommended approach is a high dose supplement where you take 40,000 -  60,000 IU per week for about 7 weeks and then get the level checked again. 

    Google "vit d deficiency gateshead trust recommendations" - the first link that came up for me was the westcheshirecgc recommendations but they are fairly similar. 

    The only thing that really affects the loading dose is how deficient you are and what body tissue you have. The bigger the "hole" the more it will take to fill it!

    As the others say - 800Iu is the recommended MAINTENANCE dose (the amount you need anyway), it is unlikely to correct a deficiency. It's like a bucket with a hole in it being filled by a dripping tap! If the hole lets out as uch as or more than the dripping tap adds - it will never fill up!

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  • Posted

    If your low Vitamin D is caused by more than a lack of sunshine then it is possible that you aren't eating enough "animal produce" - for example

    Cod liver oil 

    Tuna canned in water.

    Sardines canned in oil.

    Milk or yogurt 

    Beef or calf liver.

    Egg yolks.

    Cheese.

    If diet is the cause of your low Vitamin D it is quite likely that you may also be Vitamin B12 Deficient as that too can only be sourced naturally for foods such as red meats, fish, seafoods, poultry, eggs and dairy produce.

    The symptoms of Vitamin D Deficiency are very similar to some of those of low B12 so if your current symptoms of "intermittent aches and pains, lethargy and my depression and anxiety" do not improve I suggest you ask your doctor to test your serum B12 and Folate levels.

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    • Posted

      Well that is good that they were done - so that just leaves you to find out what caused your low Vitamin D

      I was tested earlier this year, found to be low and put on 800IU for three months, retested and found to be OK. Tested again in October and it was down again so now I'm permanently on 800IU.

      I think in my case it's due to my age and the fact that I have absorption problems resulting from gastric surgery 57 years ago causing me to have Pernicious Anaemia (a Vitamin B12 Deficiency) for the last 45 years - however I'm still "clivealive" at 75.

      Keep eating healthily and I hope you get well soon.

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    • Posted

      Unfortunately diet can only supply about 10% of your needs - unless you eat silly amounts of oily fish!

      Lack of sunshine comes in various forms - not just not going out in the sun in the middle of the day in the summer. That is the only time you can make vit D from sunlight on skin. Using sunscreens, covering up from the sun, having dark skin or even a suntan and just a malfunctioning skin process do the same. And as we age the skin process doesn't work so well. 

      Supplements it is then!

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    • Posted

      Thanks Eileen - I do actually eat fish three times a week and take Omega 3 capsules and "over 70" supplements daily - but as at my age as I rarely leave the house I think that contributed to my doctor's decision to put me on them permanently.

      I used to turn a lovely crispy brown when holidaying in Portugal in the 80s and 90s but sadly no longer. cool

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    • Posted

      I eat fish - although I take no supplements at all. However, despite spending a LOT of time outside with enough time in the midday sun to make vit D (and never using sunscreen at that time, otherwise I'm in the shade), I became very vit D depleted. I live level with Turin so theoretically we can make vit D all year round unlike further north, but it is estimated that 80% of the local population have low vit D levels! Even we are advised to take at least 1,000 IU/day all year round.

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    • Posted

      So what's going on in the food chain?  

      I can understand the problem of over exposure in the sun (because of the risk of cancer) for sourcing Vitamin D but there is also an epidemic of B12 Deficiency.

      It is reckoned that 40% of Americans are B12 Deficient and aren't even aware of it

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    • Posted

      Nothing to do with the food chain in the case of vit D - there simply aren't many foods that have significant amounts of vit D as it is a fat-soluble vitamin. There is none in plants at all (except in mushrooms that have been UV-irradiated) and really only oily fish (tuna, mackerel and salmon), beef liver and egg yolk with much besides the fortified foods in the USA. That doesn't happen in Europe. How many people eat liver nowadays - there are warnings about eating too much. Farmed salmon doesn't have as much vit D as wild - and we are dissuaded from eating tuna for ethical reasons plus the contaminants. You see articles all over the place about what to eat for vit D - but they haven't got all the facts and diet really doesn't help a lot.

      B12 deficiency is another matter - but people live much longer and it isn't unusual for people over 60 to suffer some degree of deficiency because of deterioration of their gastric lining - 1 in 10 over 75 year olds is deficient. The mass use of PPIs for gastric acid also contributes to a lack - the body doesn't absorb B12 if there is a lack of gastric acid, the same problem as in in the elderly. There are also a lot of vegans and vegetarians who aren't fully aware of how they should compensate for the lack of meat and other ommissions from their diet and then you have to add in the fad diets and generally poor diet eaten by so many. Main sources of B12 are red meat - eaten far less - egg yolks - also eaten far less and cheese (fattening!). For vegans the only dietary source is Marmite! So it isn't so much the food chain - as our use of it in combination with the other factors.

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    • Posted

      Well said and very succinct Eileen so it seems we must ll rely on supplements to keep out levels up.

      With regard to B12 Deficiency Folate the level needs to be "healthy" in order to process the B12.  Folate is derived from leafy green vegetables, sprouts, broccoli, asparagus, beans etc etc etc.

      This gives credence to the old traditional meal of "Meat, potato, greens and gravy" as a balanced source of both B12 and Folate.

      I can still "hear" my mother saying "Eat your greens Clive"

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    • Posted

      That's what I forgot to put in the tray of roast veg last night - brussels sprouts! Have to eat a raw one or two to make up! Someone cooked sprouts, dipped them in a chocolate coating and wrapped them in saved Ferrero Rocher foil for Halloween...

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    • Posted

      Nice idea, Ferrero Rocher brussels sprouts. I had something even better today, I was sitting drinking a coffee after swimming and the people near me were celebrating a birthday. When they left they gave me all their left over cakes, I obviously looked hungry! Mini eclairs, mini lemon meringue pies, lovely rasberry stacks, scones, whirly things and a load more. No vitamin D in sight! I did share them out with others passing by I should add. Even for me there were too many at one sitting. 
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    • Posted

      Hadn't you got a doggy bag in your handbag?

      I also sinned at lunchtime - we went to a local very very good but normal priced restaurant (as opposed to merely very good) where they make all their own bread. Which is definitely worth itching for...

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    • Posted

      I did think about a doggy bag but decided I had probably had my sugar rush for the month! 

      I love home made bread particularly if the crust is slightly crispy and the inside soft and warm. I was out at lunch yesterday and they had home made onion bread which was to die for. 

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    • Posted

      Their baguette-shaped white was a sort of golden colour - and the crust was to die for! It wasn't QUITE warm but obviously only an hour or so old. Disappointingly, today's spread was "squash", it is usually made with whipped butter or ricotta. What it REALLY needed was a slice of good salty butter...

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    • Posted

      That brought back happy memories of when I was an electriical apprentice back in the 1950s and based in a Co-op bakery in Birmingham.  We were allowed to "requisition" a loaf of bread straight out of the oven which we'd take to our workshop, tear the loaf apart, throw away the middle and slather butter over the crusts....  Hey Ho!

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