An Unexpected Vitamin D Test Result

[tex]

Hi All,

I got my vitamin D test results yesterday. I had to check the date to convince myself that I wasn't looking at last years results. Last July, I had a vitamin D test sent to Specialty Laboratories, Inc., in Valencia, CA. Their results showed a 25(OH)D level of 46 ng/mL. Since then, I've taken 2,500 IU of vitamin D daily, during the months of roughly May through October, and 4,500 IU daily, during the rest of the year. Today I boosted my daily dose to 5,500 IU, because I really expected my test result this week to be significantly higher, (I also get a decent amount of sun exposure, especially during the summer, and I live at a relatively low latitude, in Central Texas). I sort of expected my result to be nearly twice what it actually was.

46 ng/mL

This year, my doctor changed labs, so the vitamin D test was done by the Mayo Clinic, so I consider it quite a coincidence that the results should be identical. The puzzling part is a note on the test from Specialty Labs explaining that the 25 hydroxy D2 results reflect exogenous sources of vitamin D, such as dietary and supplementation. But, of course, any supplementary treatment should be based on the total D3 results.

On both tests, my D2 level was below 4, (which I assume is the minimum trigger threshold for the test), while my total D3 was 46. Something doesn't make sense, because the D2 test is obviously not detecting the supplements I take, (which are D3, of course), but why doesn't the test pick up the vitamin D in my diet. Surely, there's some vitamin D in the food that I eat. I suppose they still cling to the old-fashioned idea that everyone supplements with prescription vitamin D, (which is traditionally D2), rather than with OTC vitamin D supplements, (which are almost always D3).

My question is, has anyone ever received a significant result on their D2 portion of the test, (something higher than 4)? IOW, I'm wondering why they waste time and money on the D2 portion of the test.

Anyway, considering all the sunlight that I get, and significant yearround supplementation, I'm disappointed in my vitamin D test result, so I'll be taking a higher dosage, in the coming year. I'd like to see my level at least up in the 70 to 80 ng/mL range, and I'd be even happier at about 90 ng/mL.

Tex

[MBombardier]

I don't have an answer for you, Tex, but your results partnered with mine make me wonder if the test has changed. My result last year was 49ng/ml when I was taking sporadic cod liver oil in my smoothie without really knowing how much I was getting. This year, after taking 5,000 IU D3 daily quite consistently, my result was 46ng/ml. I figured I was getting way more D3 in the cod liver oil than I thought, but maybe just the test is different??

[tex]

The Specialty Laboratories report last year showed a normal level of 20-100 ng/mL, and stated that levels below 20 indicate deficiency, while levels between 20 and 30 indicate insufficiency. The Mayo's notes merely stated that optimum levels in the normal population are 20-80 ng/mL.

Tex

[sarkin]

How frustrating - comparing different forms of the test may or may not be valid. So... I am sure you are not taking an excessive level of D3. It will be interesting to see whether your increased 'dosage' has an effect next year, using the same lab/testing method. (This is why my husband says we need to build a lab in the basement - if we ever have a basement... 'cuz I need more data, and more consistent data!)

Interestingly, we're all in the ballpark - my level was 49. I actually suspect we're incredibly achievers, getting our levels this high, given MC and our various other health issues, but I, too, would like to see my level higher.

Thanks for sharing this, Tex. Marliss, I take 4000-6000IU daily as well. I upped it recently for a few days, because DH & I were both under the weather. That basement lab setup is looking like a great idea

Love,
Sara

[MotherGrizzly]

Hello to both of you!

Since I'm still new at figuring out my LC, I wondered what the Vitamin D is about--or how it helps to calm our symptoms?

I've just seen my GI again this week and got the typical "go eat salads" and "diet doesn't affect LC" and he even said "Lymphocytic colitis is a form or IBS." I am discouraged, but not surprised, and hopeful to get as much guidance as I can from you kind people here. This board is truly a lifesaver!

[tex]

Hi Jennifer,

First, most people in the general population are low on vitamin D, and low vitamin D is implicated in many diseases and health issues, because it weakens our immune system, and lowers our resistance to disease and infections, even including colds and flu virus. Inflammatory bowel diseases are known to deplete vitamin D levels, and conversely, low vitamin D is known to be associated with developing an IBD. Most people with Crohn's disease, for example, show very low levels of vitamin D, when tested. No one has researched the connection between vitamin D and MC, but it almost surely exists, so virtually all of us need extra vitamin D supplementation. Low vitamin D is also associated with GERD, which is a common problem for many of us with MC, as well.

As a society, we just don't get near as much sun exposure as our ancestors, and it seems to be making us vulnerable to many health problems, so most of us take a daily vitamin D supplement.

I'm sorry to hear that your gastroenterologist is so misinformed. Many of us here have had the same experience at one time or another. That's why we're here - to help each other, and to learn from each other. Thanks for the kind words, and please don't hesitate to ask any questions that come to mind.

Tex

[MotherGrizzly]

Tex,

No one ever told me about the Vitamin D connection--four doctors later, and your advice is much-needed and makes total sense! After reading everyone's experiences here, I know now which supplement I need to buy on my next outing to the store.

I have trouble digesting large pills; does anyone have a brand/ type that you would recommend?

Jennifer

[tex]

I use plain old Spring Valley, but they contain soybean oil, and many of us can't tolerate soy. Every brand that I've seen uses small, oval capsules, so none of them should be a problem for swallowing, or digesting. Many members here use Freeda vitamins, because they're some of the safest available, but maybe someone else can recommend some other safe brands that are available locally.

Tex

[sarkin]

Jennifer,

I use Carlson's brand Vitamin D3 drops. I find them locally, and they are also available online at sites like iHerb.com. I like the lack of 'extra' ingredients as well as the liquid/drops formula.

Hope this helps,

Sara

[Polly]

Interesting test result, Tex.

I have never received a result for D2 when I have had the 25,OH(D) test done. That's quite a difference from your previous test - wasn't it around 90 or 100 not too long ago? Or is that explained by different labs? I wouldn't expect much contribution from foods - even supplemented foods have neglible amounts of vitamin D. (We would have to drink 20 glasses of milk/day just to get 2000 IU., for example.) Of course, as you have often pointed out, the older we are, the less vitamin D our skin can make.

However, I am wondering if you are taking in any vitamin A (retinol) from cod liver oil or from eating liver or even in your multivitamin? Vitamin A in the retinol form interferes with the absorption of vitamin D. (Marliss, that may explain why your D level wasn't higher - the vitamin A in cod liver oil may have been "cancelling out" the D).

There is no reason for a healthy person to take vitamin A in retinol form. The vitamin A beta-carotene form is preferable and will not interfere with vitamin D absorption. Recently a recommendation was made to limit vitamin A retinol form to no more than 5000 IUs in multivitamins. However, there is no such limit on vitamin A beta-carotene form. I don't take a multi, but if I did, I would opt for the vitamin A to be in beta-carotene form.

Hugs,

Polly

[tex]

Hi Polly,

Yes, in July of 2009, my vitamin D test result was 96.8, so I stopped taking any for the rest of that summer, (I was out in the sun more than usual, that summer), and I took a little less than usual, the rest of the year, also. I think I took 2,500 to 4,500 IUs per day for most of the winter and spring. The first two tests, (96.8 in 2009, and 46 in 2010), were done at Specialty Labs, and the 46 test result this year, was from the Mayo Clinic.

The multivitamin I take, (Centrum Silver), contains 2,500 IU of vitamin A, (40% as beta-carotene). That's supposedly 50% of the RDA. Anyway, according to the label, only 1500 IU of that is in the form of retinol. I was hoping that wasn't enough to be a problem. Do you suppose I could be making a bad assumption there? I believe I was also taking that same multivitamin back in 2009 when I had the high vitamin D result, but I'm not absolutely certain.

Love,
Tex

[Polly]

Hi Tex,

I agree - I doubt that the small amount of vitamin A in your multi could be the culprit.

Hugs,

Polly