Which vitamin D?

erin

erin

Senior Member (Voting Rights)
There are various different forms of vitamin D supplements. I found this confusing. I bought calcitriol over the counter thinking it is the most direct form of vitamin D with my limited knowledge and confused state about this vitamin.

I didn't use it for a long time because I still was not sure to take this supplement; I had other health problems to deal with and was on so many other medications. A month after the purchase it was sunny and I opt for natural sunshine.

In December my blood test show I was a little low on vitamin D, just over the limit. My previous test in July showed my vitamin D level was perfect. I can't remember the exact values, this time I didn't bring my test results with me. But I remember this pattern last year too. I feel I need to supplement in winter months.

Now I'm in the UK, sunlight is very limited in January so, I started using this calcitriol. However, I'm kind of worried about it as I found out few articles mentioning calcitriol as a hormone, it is used treating parathyroid problems and supplementing vitamin D for kidney patients. It is not sold here in the UK over the counter. I guess I need to see my GP about this. She mentioned I need to supplement, vitamin D is so important she said.

I had 5 doses of this and I think it is fare to say that it helped in many ways, especially the flank pain is improved and a better mood, little energy boost. The dose of it quite high so I take it every other day.

Any thoughts?
 
erin said:
There are various different forms of vitamin D supplements. I found this confusing. I bought calcitriol over the counter thinking it is the most direct form of vitamin D with my limited knowledge and confused state about this vitamin.

I didn't use it for a long time because I still was not sure to take this supplement; I had other health problems to deal with and was on so many other medications. A month after the purchase it was sunny and I opt for natural sunshine.

In December my blood test show I was a little low on vitamin D, just over the limit. My previous test in July showed my vitamin D level was perfect. I can't remember the exact values, this time I didn't bring my test results with me. But I remember this pattern last year too. I feel I need to supplement in winter months.

Now I'm in the UK, sunlight is very limited in January so, I started using this calcitriol. However, I'm kind of worried about it as I found out few articles mentioning calcitriol as a hormone, it is used treating parathyroid problems and supplementing vitamin D for kidney patients. It is not sold here in the UK over the counter. I guess I need to see my GP about this. She mentioned I need to supplement, vitamin D is so important she said.

I had 5 doses of this and I think it is fare to say that it helped in many ways, especially the flank pain is improved and a better mood, little energy boost. The dose of it quite high so I take it every other day.

Any thoughts?
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I don't think we've managed to find the cure for 'Vitamin D shortage' in winter yet. I supplement Vitamin D all year, but I still get symptoms.

I think that they improve as the year progresses, and then worsen again as the days shorten.

I think that energy may depend on something we haven't figured out yet.
 
Vitamin D supplementation is likely to be sensible for anyone not going outside a lot and may be helpful if there is an issue of osteopenia from inactivity. But a plan needs to be discussed with a doctor. Vitamin D is toxic in too large doses and very dangerous in the context of undiagnosed problems that raise calcium. Calcitriol in particular needs to be used with care.

Vitmain D is unlikely to have any effect on symptoms as such. Its main benefits are in protecting against fractures and against myopathy, but vitamin D deficiency has to be pretty severe to produce myopathy. The main debate is about whether keeping levels well in the normal range helps prevent bone-thinning and that would have no relevance to symptoms.
 
erin said:
A month after the purchase it was sunny and I opt for natural sunshine.
Click to expand...
Unless you live in a sunny climate, between October and March you need to supplement with D3 as the sun isn't strong enough for Vitamin D production through your skin.

Most doctors here in Canada now recommend that their patients take between 2,000 and 4,000 IU per day. At one time those were considered high doses, but the thinking is changing. Especially as we get older, our bodies can't produce Vitamin D as well as when we were younger. And the darker a person's skin, the less Vitamin D their body can produce. Dark skin acts as a sun screen.
 
I forgot to mention that I become allergic to dairy. I stopped eating dairy which breaks my heart because I love cheese. So, I'm now deprived of calcium and the vitamin D that I get from the dairy too. Do you still think calcitriol 0.50 mcg taken every other day can be dangerous for me @Jonathan Edwards ? Maybe I should stop completely until I see my GP?

I can't remember the last blood tests exactly, but the calcium levels were bordering and so was the magnesium. I use a dermal magnesium supplement spray.

I feel my intestinal issues are now much better since moved back to the UK and start using calcitriol at the same time. This could be due to many things though, changing countries means changing the drinking water, all the foodstuffs therefore changing the gut flora.
 
@erin . . . I take cholecalciferol 2000i.u/day with no problems. My blood tests indicate I only need this dosage to maintain 'normal' levels, if I increase my levels go too high. My functional doctor told me that blood tests aren't that reliable.

As you probably already know, you can find good sources of calcium in sesame seeds (I like to make my own tahini) etc. Doesn't have to dairy.
 
erin said:
Now I'm in the UK, sunlight is very limited in January so, I started using this calcitriol. However, I'm kind of worried about it as I found out few articles mentioning calcitriol as a hormone, it is used treating parathyroid problems and supplementing vitamin D for kidney patients.
Click to expand...

The active form of vitamin D, calcitriol, does act as a hormone - that is its normal role - nothing to worry about. It has widespread metabolic effects well beyond bone mineralisation and bone growth.

The usual form of vitamin D supplement is cholecalciferol, aka vitamin D3. Think of this as a prohormone.

This is formed in the skin by the action of UV light on precursors. It is also the form of vit D found in foods like egg yolk and liver. Two further steps are needed before this prohormone becomes active.

The first step occurs in the liver where an hydroxy (OH) group is added to D3. This forms 25 OH D3. When you have a vit D blood test, this is what is tested for.

This reaction is only loosely regulated and the substance has a long half life (several weeks). In effect a stable reservoir of precursor hormone is created ready for final conversion to active D3 when needed. Blood levels largely reflect dietary consumption and UV activity on the skin.

The final conversion to calcitriol occurs in the kidney and adds an additional hydroxy group, so calcitriol can be represented as 1,25 diOH D3. This can also be tested in blood but needs to be specifically requested (asking for a vit D test won't do it even though this is the active form of vit D).

Calcitriol has a very short half life and its production is very tightly controlled. This is why testing for it in isolation may not give a good idea of vit D status. Testing it together with the usual vit D test however can be useful in some circumstances.

Supplementation with calcitriol is usually reserved for people who have defective kidneys and who can't make that final conversion step, or in people with defective parathyroid glands since the major inducer for the kidney enzyme is parathyroid hormone.

For all other people, vitamin D3 or cholecalciferol is the usual supplement.

So you don't need to supplement calcitriol, vit D3 would be fine, but given that you have it, there is no reason that you shouldn't take it, unless you have some problem which is causing hypercalcaemia (you say you are borderline low). Just make sure you take an appropriate dose.

By all means talk it over with your doctor and have some more blood tests, including blood calcium.
 
Thanks everyone and especially @alicec for a proper scientific explanation.

I'm going to phone for an appointment with my GP tomorrow. Both discuss vitamin D issue and forthcoming Synacthen test.
 
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