D3 and me?

July 7, 2015 9:13 AM

I'm taking 5000 IU/day, getting sun, and am still deficient. What now?

Two years ago my D3 level came up at 9 nm/L, so severely deficient (I was not feeling good). Doc treated me with weekly megadose, and the level came back up to normal (feeling much better!). I've taken 5000 IU/day since then.

This summer my D3 just registered at 30 nm/L, which is the cutoff line between deficiency and insufficiency. This is with the daily dose of 5000 IU, and it's summer -- I'm getting as much sun as I'm going to get. I use sunscreen to prevent burn when I'll be out for a day in the sun, but not otherwise for shorter stints in the sun. I have my usual summer light-brown base tan. I have a family history of melanoma, so I'm not about to go tanning on purpose, but I'm not manic about sunscreen either. I do not have celiac, or other complicating disease.

The conundrum is: my doc thinks I'm taking too much D3, and that I'm not producing it in reaction to that. I don't see any evidence for that type of negative feedback loop in my reading (nb: I'm a scientist). So I don't know whether to take less, or to insist on taking more. What say you, AskMe?

posted by Dashy to Health & Fitness (11 answers total)

Taking it with some kind of dietary fat can help absorption. I've had very low vitamin D in the past and it has taken 6 months to a year of supplementation to get mine up to optimal levels, but I see you've been taking it for two years, so that's an unlikely cause. I use a liquid vit D3 supplement and that has seemed to keep my levels up in the 50-60 nm/L range consistently. Are you taking any other supplements?
posted by bedhead at 9:19 AM on July 7, 2015

Nthing a liquid supplement. I tested at 29 nm/L, and started taking Wellesse. Three months later, I tested over 70 nm/L.

I always take it after eating something with fat. I was pleasantly surprised by the taste. The taste and consistency are more like fruit juice, than say, cough syrup.

I'm Filipino, and spend all day in an office. I should probably be spending upwards of at least half an hour in direct sunlight, but in this mid-Atlantic humidity that's not going to happen any time soon:)
posted by invisible ink at 9:31 AM on July 7, 2015

Have you been tested for parathyroid disease? If you have high blood calcium then (IANAD) you have it. Go to www.parathyroid.com. Low vitamin D is one of the symptoms and taking vitamin D won't help until you're cured.
posted by cacao at 9:36 AM on July 7, 2015 [3 favorites]

Response by poster: The supplements I take are oil-based softgels, so equivalent to liquid. I don't take any other supplements.
posted by Dashy at 9:36 AM on July 7, 2015

Another option may be to try getting some supplemental vitamin D from naturally occurring whole foods. Wild caught salmon, cooked by baking, was shown to have about 1,000 IU/ 3.5 oz piece of cooked fish. It sounds a bit woo, but there may be cofactors that help absorption of the vitamin in whole foods. Other than that, thyroid problems also sound like a really good avenue to explore.
posted by permiechickie at 9:41 AM on July 7, 2015

I've been in the same boat and I was recommended this D3 supplement which, as Bedhead suggested, has some coconut oil in it to help with absorption.
posted by Major Matt Mason Dixon at 9:47 AM on July 7, 2015 [1 favorite]

If you can afford a second opinion, talk with an endocrinologist -- it's their area of expertise.
posted by Jesse the K at 10:30 AM on July 7, 2015 [3 favorites]

My doctor switched me to sublingual and it helped. Some people don't absorb the D when it's taken as a pill. You can get the sublingual tabs, or drops.
posted by ereshkigal45 at 11:20 AM on July 7, 2015

The endocrinologist I used said she wants my level to be right at that cutoff - 30 or thereabouts. She believes that excess vitamin D is a problem. A great deal of conflicting information can be found online about excess vitamin D and problems with calcium. My maintenance prescription is for 50,000 IU taken twice a month, I think my initial reading was 18 or so. My most recent tests were right around 30.
posted by txtwinkletoes at 11:50 AM on July 7, 2015 [1 favorite]

Best answer: My one data point, as someone who is/was deficient, but not as severely as you, and who still does not get enough sun (totally my fault/responsibility).

I was recommended D3 from my endocrinologist, and I initially took a high dose (20,000 IU) which was actually prescribed by my primary (for insurance reasons; it's complicated and not relevant outside my specific situation) which did absolutely nothing whatsoever for me after four months. I switched to a non-prescription 2000 IU dose daily on my endo's suggestion and my levels have slowly been rising ever since.

I've been told that sometimes people can't metabolize too much D3 at a time, and basically your body just jettisons the whole thing. So it seems that in my case, the idea that too much D3 orally = not enough D3 in the blood turned out to be true.

Also, for me deficiency was one of many triggers for depression; it seemed that switching from 4000 daily (which I started with using the supermarket brand) to 2000 daily slightly improved my mood as well.
posted by Urban Winter at 1:04 PM on July 7, 2015

Maybe 30 nm/L is the level that your body actually wants to keep the D3 at. Are you currently showing any signs of deficiency, other than the blood readings?
posted by sam_harms at 4:44 PM on July 7, 2015