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Old 06-09-2008, 03:42 PM   #1
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Vitamin D3

Hello friends,

I've been taking regular Vitamin D in my multi-vitamin, but I just started D3. I talked to my PCP about it on Friday, and he said not to take it for long periods of time. He said to take it for a few months, stop for a few months, etc. Is he right? I respect him a LOT as a doctor, but many of them are very ignorant in these matters!

Also, how much should I take? The kind I bought is 1,000 i.u. and it has calcium in it. It says to take it once daily. Should I follow the instructions? I do eat a lot of veggies, so I'm sure I get some in my diet, but I stay out of the sun for the most part, and I don't eat any dairy, which is usually fortified.

Plus, (sorry for all the questions!!) does it matter if I take it in the morning or at night? If it's something that will give me energy, I'd want to take it in the morning. I just started it yesterday and so far I haven't noticed a difference in how I feel--it's not making me sleepy or energized, but that could change.

Any advice would be much appreciated!
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April
dx 9/07
Avonex started 11/07,
Stopped 4/10 due to no insurance.

 
Old 06-09-2008, 04:00 PM   #2
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Re: Vitamin D3

Hi April...the reason your doc told you not to take it for long periods of time is D is one of the vitamins which can hurt you if you OD on it..however, 1000 iu is nothing. They prescribe Vitamin D in mega doses for short periods of time and the FDA is now stating that a minimum of 1000 ius should be taken daily...

Now, I know you eat well. I try to as well...and my doc has me taking 4000 ius in the winter, dropping it to 2000 ius in the summer. Remember, your body absorbs vitamin D from the sun (and thats what D3 is..calcipherol is the closest thing to the sun's actual Vitamin) so its not as necessary during summer months to take as much. Even if you are only exposed to the sun for ten minutes (on your drive to work each day) you are getting the amount you need...Vitamin D 3 is also necessary for Calcium absorbtion, so thats why your bottle also has calcium in it. You should be taking up to 1500 mgs of Calcium daily, factoring in any you might be getting from milk, yogurt, and a multi vitamin.

Basically, what Im saying is by taking 1 1000 iu pill each day, there isnt much chance of you "overdoing it" even if you take it year round..Vitamin D is a simple thing to find out about- next time you do your Avonex Blood work, ask him to run your D levels at the same time...you'll know if you are in normal range.

It shouldnt affect you whether you take it morning or night, D has very little to do with stimulation or energy..(B vitamins help more with that)..so take it when its most convienent.

hope this helps alittle..
Nikki
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Last edited by MSNik; 06-11-2008 at 04:26 PM. Reason: post traumatic accident disorder- means I screwed up a dosage, sorry!

 
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Old 06-09-2008, 04:23 PM   #3
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Re: Vitamin D3

Thank you, it helped a lot! I'm probably getting enough sun with my long commute, smoke breaks at work, and my daily escape to an abandoned parking lot during my lunch break. I do take a calcium supplement (my doc supplies me with samples) and I do eat yogurt every day--the only dairy I eat consistently. For some reason it doesn't seem to give me the lactose intolerance symptoms that the rest of dairy products do.

Thanks again, I was so confused!
__________________
April
dx 9/07
Avonex started 11/07,
Stopped 4/10 due to no insurance.

 
Old 06-09-2008, 05:35 PM   #4
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Re: Vitamin D3

No problem. There is some research that taking extra D3 can help with neurological issues, so it definately wont hurt you to take the extra 1000 each day..but get your levels checked after youve been on it for awhile and see where you are. Ive been taking 4000 a day all winter long and then vacationed in Mexico in March, in April, mine were only slightly high, so I decreased it to 2000 - but like you, I spend allot of time in the sun and probably dont even need that much right now.
Ill get mine checked again in the fall..
glad to help.
N
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Old 06-10-2008, 03:36 AM   #5
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Not 3,000!

I believe the current RDA for "healthy" adults is currently 600 IUs. It has been under review and a hot topic in the last year or 2 but there's no way it's 3,000. This is the amount I take but as Nikki said, it can be toxic in high doses.

It is difficult to get vitamin D through food -- there are actually not that many sources. (The preferable) D3 is often referred to as the "sunlight vitamin" and is metabolized like a hormone in the body. It can build up in the body, hence your PCP's thought process of on/off again. Some neurologists are also recommending 50,000 IUs once a week to their MS patients -- I asked my endocrinologist about this and he said administering in this manner does not seem to promote the same type of toxicity. Obviously, NEVER do this without a doctor's recommendation and if you're supplementing with D, you should let your doctors know. A complete D panel should be taken periodically, as well as checking liver function.

April, I recommend you doing a search for cholecalciferol on this board --you will find a lot of information.

 
Old 06-10-2008, 06:20 AM   #6
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Re: Vitamin D3

Hey Beary!

Anyone else find it ironic that my bottle of Neurontin (well, Gabapentin, the generic stuff, but a well known drug that quite a few MSers take for various reasons) has a big label on it saying "Avoid prolonged exposure to the sun or sun lamps"?

LOL. ~takes a D3 1000 IU~
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Old 06-10-2008, 09:54 AM   #7
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Re: Vitamin D3

Not a clue, Nenu, but I'd venture a guess that it has to do with UV rays and not D3. If you can't find any info. about it you might want to put in a call to the drug manufacturer.

Last edited by Bearygood; 06-10-2008 at 09:57 AM.

 
Old 06-10-2008, 11:25 AM   #8
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Re: Vitamin D3

Quote:
Originally Posted by Bearygood View Post
Not a clue, Nenu, but I'd venture a guess that it has to do with UV rays and not D3. If you can't find any info. about it you might want to put in a call to the drug manufacturer.
I'm quite sure it's the UV rays not the D3, because my neuro is well aware that I take 1000IU of D3 daily (he's the one that pushed for me to keep taking it, and prescribed the rest).

I just thought it was quite humorous that sunlight is generally something that's thought MSers may be lacking (with the D connection), and I'm on a drug that tells me to avoid it
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Old 06-11-2008, 02:43 AM   #9
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Re: Vitamin D3

Nenu and April. I was at my Neuro's yesterday and spoke to him about D3..he says FDA recommends 1000 ius for proper D3 consumption- dont know if that is the latest update or what, but I also read the same number in this months' health magazine..

Nenu, Garbapentin makes you more prone to sunburn....my doc, when he put me on it, told me the same thing. Much like some antibiotics, the drug can affect how your skin reacts to the sun and it can cause you to burn quicker. I believe that Amoxycillin and the cycline drugs (tetracycline, minocycline) have the same warnings....keep in mind most people who are prescribed Neurontin or antibiotics are NOT prescribed it with MS...Gabepentin (Neurontin and also Lyrica) are all developed as general use nerve pain drugs- but are not specific in anyway to MS...also, sunlight and heat are NOT recommended for MS- however lack of vitamin D is a theory on who developes it....the further from the equator you grow up, epidemiologically, the higher the risk that you will develope MS...but thats also a theory and really isnt proven for sure.

nikki
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Old 06-11-2008, 05:09 AM   #10
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Re: Vitamin D3

Quote:
Originally Posted by MSNik View Post
Nenu and April. I was at my Neuro's yesterday and spoke to him about D3..he says FDA recommends 1000 ius for proper D3 consumption- dont know if that is the latest update or what, but I also read the same number in this months' health magazine..

Nenu, Garbapentin makes you more prone to sunburn....my doc, when he put me on it, told me the same thing. Much like some antibiotics, the drug can affect how your skin reacts to the sun and it can cause you to burn quicker. I believe that Amoxycillin and the cycline drugs (tetracycline, minocycline) have the same warnings....keep in mind most people who are prescribed Neurontin or antibiotics are NOT prescribed it with MS...Gabepentin (Neurontin and also Lyrica) are all developed as general use nerve pain drugs- but are not specific in anyway to MS...also, sunlight and heat are NOT recommended for MS- however lack of vitamin D is a theory on who developes it....the further from the equator you grow up, epidemiologically, the higher the risk that you will develope MS...but thats also a theory and really isnt proven for sure.

nikki
Heya Nikki

Yup yup! I agree. My neuro also said 1000IU D3 supplements is the sweet spot, so I haven't looked back

As far as being more prone to sunburn, eek. Good thing I wear a long sleeve shirt when I go out. I burn very easily as it is
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Old 06-11-2008, 10:08 AM   #11
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Re: Vitamin D3

Quote:
Originally Posted by april1848 View Post
Any advice would be much appreciated!
Before anyone jumps on a vitamin supplement bandwagon (ANY vitamin), it is useful to:

1. determine if they are even deficient
2. assess whether they can obtain optimum levels from diet and/or lifestyle.

In testing for vitamin D deficiencies, there are two methods that labs use for reporting Vitamin D levels:

1. nanograms per milliliter (ng/mL)
(To convert ng/mL to nmol/l: multiply by 2.5, eg. 40 ng/mL *2.5 = 100 nmol/L)
2. nanomoles per liter [nmol/L]
(To convert nmol/l to ng/mL: divide by 2.5, eg. 100 nmol/L /2.5 = 40 ng/mL)

The optimum levels of vitamin D are defined as:

1. LESS THEN 20 ng/mL (50 nmol/L) is generally considered inadequate.

2. Between 20 (ng/mL) – 100 (ng/mL) is “normal”, by most accounts.

Where someone is deemed deficient (< 2o ng/mL), which can occur because of:

- dietary inadequacy, i.e. exposure to sunlight is limited or diet restrictions (milk allergies/lactose intolerance, vegetarianism, etc.)
- impaired absorption, i.e kidneys cannot convert vitamin D to its active form, or absorption of vitamin D from the digestive tract is inadequate

. . . The recommended FNB daily intake of vitamin D range is from 200 IU (5 mcg) to 600 IU (15 mcg) . . . dependant on age (as provided by the NIH & Food and Nutrition Board).

The best way to source Vitamin D naturally is by getting 5-30 minutes of DIRECT sun exposure between 10 AM and 3 PM, at least twice a week. This exposure can be to (NOTE: EITHER) the face, arms, legs, or back. However, one must realize that:

- complete cloud cover can reduce UV energy by 50%
- shade (including that which is produced by severe pollution) reduces UV energy by 60%
- Sunscreens with a sun protection factor of 8+ may block vitamin D-producing UV rays (but people generally do not apply sufficient amounts, or reapply their sunscreen frequently enough to cover all sun-exposed skin anyway)

People can also source sufficient vitamin D from their diet:

- fortified foods will provide most of the vitamin D people need, ie. U.S. milk is fortified with 100 IU/cup of vitamin D (which is already 25% - 50% of the daily recommended value, depending on age).
- 1 tbsp of cod liver oil = 1360 IU’s per serving (almost 3 X the average daily recommended requirment)
- The flesh of fish (such as salmon, tuna, and mackerel) = 200 – 350 IU’s per serving
- fish liver oils
- beef liver, cheese, and egg yolks (15 – 60 UI).
- some ready-to-eat breakfast contain added vitamin D, as do some brands of orange juice, yogurt, and margarine, ie. cereal flours and related products, milk and products made from milk, and calcium-fortified fruit juices and drinks.
- moderate use of commercial tanning beds (that emit 2-6% UVB radiation)

There have been some “theories” about lack of vitamin D being contributory to the initial development of MS, based on the “gradient latitude” hypothesis, . . . but the prevalence and distribution of MS has changed so significantly over recent years, that theory is becoming more and more obsolete. There is also no proof what-so-ever that increased vitamin D will affect the disease process in any way.

Even if the FDA follows through on their current proposal to encourage high levels of vitamin D to be added to more foods (to "reduce the risk of osteoporosis”), there is mounting evidence that widespread supplementation with vitamin D might, in fact, predispose the population to immune dysfunction.

Personally, I would first have my vitamin levels checked to DETERMINE if I was deficient . . . before starting on ANY vitamin regiment.

Cherie

 
Old 06-11-2008, 01:53 PM   #12
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Re: Vitamin D3

Cherie, not quite sure where you get your info from, but the newest FDA is suggesting 1000 ius daily. Ive verified this with several sources this week and just now checked what the FDA reports say, they are quoting 1000 IUs too. This is a recent upgrade (March 08)...just an FYI.
Thanks for the rest of the info.
N
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Old 06-11-2008, 03:02 PM   #13
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Re: Vitamin D3

Quote:
Originally Posted by MSNik View Post
Cherie, not quite sure where you get your info from, but the newest FDA is suggesting 1000 ius daily. Ive verified this with several sources this week and just now checked what the FDA reports say, they are quoting 1000 IUs too. This is a recent upgrade (March 08)...just an FYI.
Thanks for the rest of the info.
N
I guess we are permitted to post government sites, so I pulled up the FDA's. According to the most updated (Apr/08) "Guidance for Industry: A food labeling guide", "Appendix F: Calculate the Percent Daily Value for the Appropriate Nutrients", the daily recommened intake for Vitamin D is still 400 IU.

[url]http://www.cfsan.fda.gov/~dms/2lg-toc.html[/url]

I know they are talking about new proposals for 2010, but I haven't seen what they are for vitamin D.

Cherie

 
Old 06-11-2008, 03:44 PM   #14
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Re: Vitamin D3

okay, well thanks. Not trying to start an argument- I just have a book here which is from March 08 which states differently and it is an FDA book which we use at work. Ill have to call them and question why it says this...

I did go to my Neuro today and talked to him about my own supplements. He still wants me on 2000 ius until the fall, when I get my blood work done again, but that does go with your advice- this is based on my latest blood levels.

Thanks for letting us know where you got the info from.
N
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Old 06-11-2008, 03:48 PM   #15
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Re: Vitamin D3

Lady Express, I might not get enough. I don't get enough from sunlight most days, and the only Food Source you listed that I eat is cod liver oil, and I don't take a lot of that. Occasionally I eat granola cereal, and I do eat a few (maybe 10) flaxseeds a night for other reasons. I eat mostly fruits and veggies and whole grains, though I'm not a vegetarian, and I don't eat seafood. Thanks for all the information! I think I'm just going to take the 1000 iu and maybe take a break in a few months. I'll have blood work done in July and I'll request a D deficiency test, which I can't remember if I've had.

The only other supplements I take are calcium, Vitamin B Complex, a multivitamin, and cod liver oil, so I don't think I'll be overdoing it. My grandmother has rooms full of bark from Chinese trees, nuts, seeds, herbs, and her own mixtures, and that's not me!
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April
dx 9/07
Avonex started 11/07,
Stopped 4/10 due to no insurance.

 
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