But you can't just go popping Vitamin D's because Anne said so. Just because I tell you how much I take daily does not mean it is the correct dosage for you because I am not you - we are all different. Like other things I talk about here, this is one of the biggies and it all begins with a blood test that you MUST ASK for because it is not done routinely. If you have MS, EBV (Epstein Barr Virus), mononucleosis, Crohn's Disease, Sjogren's Disease, Rheumatoid Arthritis, Lupus or any disease that compromises the immune system, INSIST on having this blood test included every time in your bloodwork.
In simple terms, if you’re vitamin D deficient, your immune system will not activate to do its job. And since vitamin D also modulates (balances) your immune response, it prevents an overreaction in the form of inflammation, which can lead to autoimmune flares in Multiple Sclerosis, Lupus, RA and in Crohn’s disease.
******* Page and paragraph breaks have been inserted so you can come back and read at your leisure because this is another long one!
WHAT BLOOD TEST TO ASK FOR
Before you attempt to introduce Vitamin D into your regimen, it is important to get your blood levels tested so you have a "baseline." This is the number that all future tests will be measured against to see if your are taking in adequate amounts of Vitamin D. To start taking the vitamin without blood testing is silly; you will never know if it is doing good for you or, in some cases, doing harm to you. So the only way to know you are getting the correct dose is to have the blood test to start and then every three to six months after.
However, there are two different blood tests for Vitamin D:
1,25(OH)D, and 25(OH)D.
The correct test your doctor needs to order is 25(OH)D, also called 25-hydroxyvitamin D, which is the better marker of overall D status. This is the marker that is most strongly associated with overall health.
RESULTS AND INTERPRETATION
How do you, as a patient, know what the blood test results mean? DO NOT take the following answer from your doctor -- "Your blood tests look good; all levels within normal range." You may as well throw your money away when you paid for the blood work because that answer is NO answer.
As the patient, it is your right to have a COPY of your blood test results - each and every time you get bloodwork. Keep a file of them so you can see your progress or lack thereof. As an informed patient, this is one of the ways you can take back control of your health program. An informed patient will often bring things to the doctor's attention because doctors don't investigate - they take the interpretations of lab values that the lab gives them.
Question your doctor - what does "this" mean? regarding tests or their results. You'll be surprised at what the doctor "doesn't" know. Watch him closely as he gives you his answer. I never ask a question that I don't already know the answer to -- I research and do my homework before I ask my question so I know the value of what is being told to me.
YOU must be your own health advocate. A busy doctor will look at blood results and only look at the column that shows which tests are "out of range" but not what to do about it. I hope I can help you understand blood results better in this post. Feel free to comment with your questions.
While many labs have their own set of values and the ranges they consider to be "normal", the same is true for the many doctors out there too. The report that the lab sends to the doctor showing results can change from lab to lab. When you are going to be tested, stick with one lab so your results are consistent.
You must make sure the lab is performing the correct test ---- 25(OH)D, also called 25-hydroxyvitamin D, which is the better marker of overall D status.
If you get it done by Quest Labs, you’ll need to divide your result by 1.3 to get the number that actually correlates with all the chart below.
Next, the “normal” 25-hydroxyvitamin D lab range is between 20-56 ng/ml. As you can see in the chart below in the paragraph titled THE NUMBERS AND WHAT THEY MEAN, this conventional range is really a sign of deficiency, and is too broad to be ideal.
In fact, your vitamin D level should never be below 32 ng/ml, and any levels below 20 ng/ml are considered serious deficiency states, increasing your risk of as many as 16 different cancers and autoimmune diseases like multiple sclerosis and rheumatoid arthritis, just to name a few. A lot of MSers who never took vitamin D have first blood work with alarmingly low vitamin D values.
The OPTIMAL value that you’re looking for is 55-65 ng/ml.
This range applies for everyone; children, adolescents, adults and seniors.
Vitamin D status is measured by looking at blood levels of 25-hydroxyvitamin D3. There are three common methods used for measuring vitamin D3 but the one you want is :
LC-MS/MS – This test measures 25-hydroxyvitamin D2 and D3 separately
The LC-MS/MS (liquid chromotatography-mass spectrometry) method is the preferred method for many labs, including the Mayo Clinic, Esoterix, ZRT, and others. That doesn't mean you have to ask for this specifically, but this is just a FYI that there are a couple of methods of performing the test. Whatever the method, be consistent and have the same one done each time so your better informed of your blood levels consistency without having to worry about what lab or what method was done.
THE NUMBERS AND WHAT THEY MEAN
Vitamin D Hydroxy D Values - the number you must ask your doctor to tell you. And make sure he tells you the number next to your Vitamin D3 test.
Less than 50ng/ml is considered Deficient
50 to 65ng/ml is considered Optimal
65 to 90ng/ml is considered Toxic (cancer starts to occur around 80ng/ml)
More than 100ng/ml is Excessive
HOW MUCH VITAMIN D DO I NEED AND WHAT KIND?
A Pill or the Sun, which Vitamin D is best? Actually, you need BOTH.
Vitamin D is a fat soluble vitamin and can be quite toxic. Once you have vitamin D toxicity you can't easily turn it around, which is why it is recommended getting your levels checked prior to taking oral vitamin D supplements.
Sunlight is the best source of Vitamin D. How much do you need? Just until your skin starts to warm or turn slightly pink -no more than half an hour in direct sunlight WITHOUT sunscreen is the norm. Avoid sunburn. When you can't get adequate sunlight, supplementing with Vitamin D capsules is the next best choice.Tanning beds are another post entirely for another time.
It can take 3-6 times longer for darker pigmented skin to reach the equilibrium concentration of skin pre vitamin D. However, skin pigmentation does not affect the amount of vitamin D that can be obtained through sunshine exposure. However, someone with MS is probably much less concerned with the risks of skin cancer than the risks of the MS and therefore the benefits of the sunlight would be much greater.
A common misconception is that occasional exposure of your face and hands to sunlight is "sufficient" for vitamin D nutrition. Indeed, this exposure can provide 200-400 IU vitamin D during those months when appropriate sunlight is available, but for most of us, this is an absolutely inadequate exposure to move vitamin levels to the healthy range.
Please also remember that just because it is sunny and hot outside, it is absolutely not an indication of the amount of UV-B present. If your latitude is above 30 degrees north or below 30 degrees south, you will likely benefit from vitamin D supplementation from September to mid-April if you do not live in Florida, California, Hawaii, Arizona and other "sunny" states.
If you don't know the latitude of your city you can use a latitude finder. If your latitude is lower than 30 degrees, then you have access to good sunshine and may not need oral vitamin D supplementation.
While vitamin D has enormous potential for improving your health, it has significant potential to worsen it, if you use it improperly. For safety purposes it is advisable to optimize your vitamin D levels only with the help of a trained health care professional. The current Recommended Daily Allowance (RDA) is 400 units for most infants and children, 200 units for people up to age 50, 400 units for age 51 to 70, and 600 units for seniors over age 71. So if you are taking 1,000 units a day and think you are getting too much, chances are you are not getting enough since the RDA has not been changed from the thinking of the 1960's.
VITAMIN D SUPPLEMENTS
There are two types of vitamin D supplements: vitamin D3 (cholecalciferol), which comes from fish oil, and plant source D2 (ergocalciferol), which is found in fortified foods and some supplements. D2, found in plants and made active by irradiation, is less biologically active.
Vitamin D3 is found in eggs, organ meats, animal fat, cod liver oil, and fish. It is the equivalent to the vitamin D3 formed on your skin from UV-B rays. You should stay away from the synthetic D2 as it has been shown to be toxic at the higher dose ranges.
You will only want to use vitamin D3 (cholecalciferol).
If you have sarcoidosis, tuberculosis, or lymphoma, it would be best for you to avoid oral vitamin D supplementation based on this test. It is highly recommended that you perform the 1,25(OH)D test before you supplement with any sun exposure or oral vitamin D as it is a better indicator in people with this health challenge.A good source of vitamin D is a whole food product - cod liver oil. No, this is not the same one many remember as disgusting tasting. That cod liver oil usually tasted bad because it was rancid!! Processing of cod liver oil has improved considerably since those days.
RECOMMENDED DOSES - 25 micrograms equals 1000 units of Vitamin D
Ages 5 and under = 35 units per pound of weight per day
Ages 5 -10 = 2500 units per day
Ages 18 - 30 = 5000 units per day
Pregnant women = 5000 units per day
There is no way to know if the above recommendations are correct. The ONLY way to know is to test your blood first. You might need 4-5 times the amount recommended above. Some patients need as much as 50,000 units for three to six months to get regulated and even though it may seem toxic, as long as it is done under a doctor's CARE/MONITORING, and blood tested monthly, it has been an acceptable practice.
Ideally your blood level of 25 OH D should be 55 to 65ng/ml.
In addition to vitamin D, cod liver oil also has an excellent supply of vitamin A and essential omega 3 fatty acids, DHA and EPA.
WHAT MOST PROFESSIONALS WILL NOT TELL YOU
Vitamin D3 needs other factors in order to utilize the vitamin properly. They are magnesium, zinc, Vitamin K2, boron, and Vitamin A. Magnesium is the most important of them all because as Vitamin D levels rise, it can show any underlying magnesium deficiency. So if someone is having problems supplementing with the D vitamins (not getting good blood test results after being on Vitamin D3 for six months or so), then magnesium deficiency could be the reason why.
For that reason, magnesium should ALWAYS be part of your blood panel. If you are taking a calcium/magnesium supplement, it usually has Vitamin D (400 units) added to it. Manufacturers know that Calcium and Magnesium need Vitamin D for the body to assimilate it.
WHAT KIND OF VITAMIN D SUPPLEMENT SHOULD I BUY?
Brand name is not the most important thing when choosing a Vitamin D product.....the list of ingredients is. So you want to make sure there are not a lot of additives you can't pronounce on the label. I order from Puritan Pride, but that is my preference because they offer buy 2 get 3 free which is a great value for me - I get 5 bottles of 200 for under $30. I have also bought at the warehouse stores at considerable savings.
Basically, you are looking for Vitamin D capsules 2,000 to 5,000 unit bottles. My bottle says Vitamin D on front label but in list of ingredients it says vitamin D3, 2000 units - so every other day I take 4,000 (2 capsules) and every in between day I take 6,000 (3 capsules) so that I am within the 5,000 unit range. I could have bought 5,000 unit capsules but I have better control in the smaller doses.
If you take Calcium Magnesium, it should have vitamin D added written on the label and it is always 400 units. Check your label to see how many tablets equal the amount they specify in ingredients. My bottle says 1,000 mg Calcium, 500 mg Magnesium and 400 units Vitamin D, but the serving SIZE is 3 tablets. That means you have to take 3 tablets to get the amount they state on label.
So read your labels.
Another long post I know, but please leave me your questions and comments. Thanks for reading.
Sources: Dr. Mercola, WebMD, Physicians Desk Reference, Quest Labs
@ Taxingwoman - You really need to have your blood tested to get a baseline number/value, then consult with your doc as to how much more you need to be optimal, and always have regular bloodwork (@ 3-6 months) to make sure you are not toxic or deficient in the doses.
The names of the tests are listed above. Thank you for your comment and compliment. :-)