Originally Posted by richarda123
On Lupron now and my once, what seemed to me, inexhaustable large
bottle of calcium/vitamin D is almost empty. I noticed there are separate vitamin D3 available. Was wondering if I should get the combo calcium/D again or try a calcium with the separate D-3 version? Does it matter? My 1st density bone scan came out OK.
I know what you mean about that seeminly inexhaustable supply. Those combined calcium plus D bottles are so large and full compared to other supplement bottles, but the pills are large too, and it's surprising how quickly they go.
You will probably need both the combo pills and the solely vitamin D pills to get the needed dose. If you try for the needed vitamin D dose using the combo pills, you will very likely get too much calcium.
It used to be thought that just 400 IU of vitamin D3 daily was enough. However, that conclusion was based on the amount proven to prevent vitamin D deficiency in children. It also used to be thought that you could easily exceed the toxic dose level for vitamin D; but we now know that exceeding that dose is not easy (though see my comment on my own experience below). Now, it is widely recognized that a great many adults are deficient in vitamin D.
That's why the amount you get along with calcium in a combined supplement is probably inadequate for you.
There are many factors that determine our levels of vitamin D, which most of us get plenty of from our skin after sun exposure in our youth. However, as we age, we are not as good at making it ourselves, and some of us ultimately make little. Those of us with dark skin automatically filter out much of the sunlight that produces the vitamin D, and for those of us with light skin, clothing, sun screen, and staying indoors also can drastically reduce the amount of sun exposure we need. So can living in lattitudes well to the north or south of the Equator, especially in the cold weather months when the angle of the sun, cold weather clothing, and less time out doors result in much lower production of vitamin D via the skin. Basically, this means that many of us are going to have to get vitamin D from supplements or food if we are going to have enough.
Dr. Charles "Snuffy" Myers, MD, an eminent medical oncologist specializing in prostate cancer and a patient with his own advanced case (ten year survivor, doing very well), took an early interest in vitamin D after he read a study by the pioneering Canadian doctor, Reinhold Veith in 1999. Before that time, vitamin D research had been a backwater, and vitamin D was not considered all that important. How that's changed over the past decade!
Another leading vitamin D researcher is Dr. Hollick from Boston, and there are many other researchers doing important work. Anyway, back to Dr. Myers.
He started checking the levels of vitamin D in patients coming to his practice near Charlottesville, VA, and he was surprised to discover that nearly all were deficient in vitamin D. Many of us in the southern US are getting plenty of sun and think we are therefor making ample vitamin D through our skin. However, Dr. Myers found that in his practice, which is not far from an airport with patients flying in from all over the US and from many foreign countries, vitamin D deficiency was commonly found even in patients getting ample sun exposure, even in Florida residents with skin deeply wrinkled by the sun.
Dr. Myers frequently features vitamin D in his talks to survivor groups, and he has written about vitamin D, and its importance in helping us combat prostate cancer, not only in his Prostate Forum Newsletter but also in his book "Beating Prostate Cancer: Hormonal Therapy & Diet." Here's what he says about dosing on page 151 of his book (in the original edition): "But how much vitamin D should you take if you never get any sun? The best current estimates are 4 to 5,000 IU a day. The best estimate for those of us with routine sun exposure would be 2,000 IU." However, because of the personal differences in producing vitamin D, he is strongly in favor of periodic testing to see that the level is in the desired range.
He and other leading experts in vitamin D and prostate cancer like to see the level between 50 and 80 ng/ml(corrected from nmol/L, page 158 of his book) or up to 100 on the 25-hydroxy vitamin D blood test, with a preference for values closer to 80 or 100 than to 50. I have a fellow survivor and friend who was found to have such a low level - below 20 as I recall it -that for a short period he was on a super-vitamin D therapy approved by the FDA: 50,000 IU!.
My own vitamin D level will drop below 50, especially in the winter, without supplements, even though I consume herring at lunch daily and also consume fish oil daily, both sources of vitamin D. My most recent test on March 18 was 75, right where I want it.
However, when my oncologist and I were just getting the hang of handling vitamin D and its testing a few years ago, along with many other patients and doctors, I was supplementing with about 4 to 5,000 IU per day - not unusually high compared to what many fellow survivors said they were taking. Apparently the outdoor exposure I had, plus the supplements, plus the daily pieces of herring, plus the fish oil were a lot more than enough for me, and my 25-hydroxy level rose to 141!
Well, that's very close to the level considered "vitamin D intoxication," but it comes without any pleasant buzz.
My doctor checked and found no adverse effects
, and I cut out supplements for a few months. That dropped the level to around 50, and I was able to restart the supplements.
To me, the lesson there is to get tested periodically. (By the way, I was the first patient in his large general oncology practice, including his partners, to be tested for vitamin D. He told me I also had had the highest score he had ever seen. Now if only that "outstanding" score had been in an athletic contest instead of a medical test!)
I hope this helps.