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06-07-2012, 04:30 PM   #1
mainekitty
 
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Low Vitamin D Question

I'm new to the forum, but I've had Crohn's for about 14 years now. My symptoms have always been fairly mild, and the disease has been mostly in my stomach, duodenum and terminal ileum. I've really never experienced serious weight loss with it, or had any surgeries, and have maintained pretty well for most of the time with Pentasa.

I've been suffering with low-level back pain lately, and general fatigue and feeling "unwell" and my doctor (GP) tested my vitamin D levels and found it to be very low - at 11. She put me on 4,000 IU/day of supplements and prescribed physical therapy for my back.

The thing is - I have a healthy diet and go outdoors for at least 20min almost daily. Is it even possible for this amount of deficiency to have come about because of diet and lack of sunshine? Or should I assume that this is something to do with malabsorbtion because of the Crohn's? I'm due to go to the GI next week and was thinking of raising this with her, but I am a new patient to her, and I don't want to seem like I'm a hypochondriac, or trying to link things to Crohn's that have nothing to do with it.

Basically, I've never had an issue like this before. I'd be interested in others' thoughts. Thanks for reading!
06-07-2012, 04:36 PM   #2
Supreme_2
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Everyone I have been talking to has Vitamin D defiency. I think they recently started testing everyone for this. My level was really low , I was put on supplements and when I retested my thyroid was underactive. So I seem to think there is a link between Vit D and the thyroid. So now I am on Thyroid medication. My symptoms were fatigue, cold all the time and hair loss.
06-07-2012, 08:16 PM   #3
Beach
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Mainekitty - Love the name, the kitty part at least! I'll be kitty shopping this weekend and have a young nephew anxious to help choose the young cat. Looking forward to it, should be fun.

I don't think it surprising to have that low of vitamin D3 levels living in Massachusetts. Recently I read a mention about gardeners in the state of Nebraska, that were outdoors for most the day, making only around 1000ius of D3 a day. The reason given for such low D3 production was how far north the location was, and that the gardeners were covered up with clothing over most of the body.

UVB rays are what manufacture vitamin D3 in our body. And UVB rays are largely filtered out by the atmosphere for most of the day. It is only for a few hours, with noon being the peak, that larger amounts of UVB rays make it to ground surface. If going into the sun early in the morning or later afternoon, it will be largely UVA rays that you receive. UVA rays are good at tanning but not at creating vitamin D3.


Supreme 2 - I can relate to the cold today! I've been playing with my diet, having success on and off doing so recently, which is very nice. I added some foods back over the last couple days and doing so put me in the deep freeze, today in particular! It was a warm summer like day, temps in the middle 80s, and I have been bundling up. Anyway, strange disease. Hopfully kicking these suspect foods, gelatin, beef, pork, out of the diet once again will bring some warmth back. I'm guessing it will.

Thought to add that personally my thyroid tested fine after I began taking vitamin D3. I do take kelp tablets though to help with thyroid health. I've read of some people even seeing their TSH levels go back to normal after taking a kelp/iodine supplement.

"Iodine deficiency is REAL"

http://blog.trackyourplaque.com/2009...y-is-real.html

snippet:

Like many health-conscious people, Kurt avoids salt. In fact, he has assiduously avoided salt ever since his heart attack back in 1995.

Lately, Kurt had become tired, often for little or no reason. His thyroid panel:

TSH 4.2 mIU/L (0.27-4.20)
Free T3 1.74 pg/ml (2.50-4.30)
Free T4 1.05 ng/dl (0.9-1.7)

Kurt’s TSH of 4.2 mIU/L is sufficient to increase LDL cholesterol by 20-30% and increase the (relative) risk for heart attack 3-fold.

Kurt’s thyroid was also palpably enlarged. While it was just barely visible–just a minor bulge in the neck (in the shape of a bowtie), it could be clearly felt when I examined him.

I asked Kurt to add 500 mcg of iodine every day. Three months later, another thyroid panel showed:

TSH 0.14 mIU/L (0.27-4.20)
Free T3 2.50 pg/ml (2.50-4.30)
Free T4 1.1 ng/dl (0.9-1.7)

Kurt’s thyroid function normalized to nearly ideal levels just with iodine replacement. (The free T3, while improved, remains low; an issue for another day!)

I see this response with some frequency: low-grade goiter and apparent hypothyroidism (low thyroid function) that responds, at least partially, to iodine replacement. In Kurt’s case, iodine replacement alone normalized his thyroid measures completely....
06-07-2012, 08:48 PM   #4
Irene3
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Vit d deficiency is common with crohns. I didn't take vit d supplements for ages, and after having back pain, was sent for a bone density test. Turns out I have osteoporoses, and my gi said I have the hips of a 50 y old (I'm 29). My phisio said with vit d and calcium you can improve it though.
I tell my gp and gi everything, and yes, I too felt like my gp might think im a hypochondriac, but I'd rather tell him all my symptoms. So ask your doc anything your unsure of with your symptoms. Best wishes
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06-07-2012, 09:41 PM   #5
Beach
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I've not had a bone density test done, but I undoubtably have some bone loss/ osteoporoses also. I had a heart CT scan done at 36, and the results showed high levels of calcium in an artery - or another way of putting it, heart attack causing plaque. At that age, that was rare! And not a diagnosis I wanted to hear, but was glad I caught it early. I mention this about plaque because the two conditions of osteoporoses and plaque buildup often go together. Here's an article from a cardiologist on that:

"Osteoporosis and coronary calcium"

http://blog.trackyourplaque.com/2008...y-calcium.html

I'm not mentioning this to frighten! But something to keep in mind. Vitamin D3 has many uses in the body, one of the main being to help with the absorption of calcium. You might also look to eat foods high in vitamin K2, or even take a supplement, as K2 is thought to work with D3 in helping place calcium where it should go in the body.

"Homegrown osteoporosis prevention and reversal"

http://blog.trackyourplaque.com/2010...-reversal.html

snippet:

...1) Vitamin D restoration–Vitamin D is the most important control factor over bone calcium metabolism, as well as parathyroid function. As readers of this blog already know, gelcap forms of vitamin D work best, aiming for a 25-hydroxy vitamin level of 60-70 ng/ml. This usually requires 6000 units per day, though there is great individual variation in need.

2) Vitamin K2–If you lived in Japan, you would be prescribed vitamin K2. While it’s odd that K2 is a “drug” in Japan, it means that it enjoys the validation required for approval through their FDA-equivalent. Prescription K2 (as MK-4 or menatetranone) at doses of 15,000-45,000 mcg per day (15-45 mg), improves bone architecture, even when administered by itself. However, K2 works best when part of a broader program of bone health. I advise 1000 mcg per day, preferably a mixture of the short-acting MK-4 and long-acting MK-7. (Emerging data measuring bone resorption markers suggest that lower doses may work nearly as well as the high-dose prescription.)...
06-08-2012, 09:06 AM   #6
mainekitty
 
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Yeah, I read somewhere that like 70% of the population in the Northern Hemisphere is Vit D deficient. I just thought that this seemed unusually low for someone with a fairly healthy lifestyle. Maybe not - we'll see what the supplements do. :-)
06-08-2012, 12:59 PM   #7
CrohnsCHES
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Yes, MaineKitty, being deficient in Vitamin D is very common among people with Crohn's - even if you eat a healthy diet and spend a bit of time in the sun every day. There is even increasing research that shows it may either contribute to the development of Crohn's or the aggravation of its symptoms. A study on Crohn's patients (would link but can't yet) even treated women with short periods in a tanning bed to up the Vitamin D levels and it worked - it helped eliminate their bone and muscle pain and fatigue.

I hope the Vitamin D supplement works for you - I know when my mom was told she was deficient she started taking the supplement (you can take a lot without overdoing it!), she started feeling more energetic and had less back pain.
07-11-2015, 08:25 PM   #8
drewpalermo
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A year or so ago I had a blood test and it was found I was severely deficient in vitamin D. Had a level near 7.5 when they consider the normal range something like 20-50. They wanted to put me on 50,000iu D3 supplement but decided not to and got back into the normal range with getting much more sun exposure than I used to (put olive oil on my skin for increased absorption and exposed plenty of bare skin). The Minnesota winters certainly don't help, I'm thinking about moving to a place like South Carolina where you can probably get vitamin D year round
07-11-2015, 08:39 PM   #9
DJW
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I'm on 3,000 iu/day.
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07-15-2015, 03:10 PM   #10
ap17
 
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A year or so ago I had a blood test and it was found I was severely deficient in vitamin D. Had a level near 7.5 when they consider the normal range something like 20-50. They wanted to put me on 50,000iu D3 supplement but decided not to and got back into the normal range with getting much more sun exposure than I used to (put olive oil on my skin for increased absorption and exposed plenty of bare skin). The Minnesota winters certainly don't help, I'm thinking about moving to a place like South Carolina where you can probably get vitamin D year round
I had the same situation, but went ahead and took the 12 week treatment since Chicago doesn't see that much sun anyway.

Now I just supplement daily with 2000 IU, I used to take 600's.

D3 is responsible for so many processes in the body, and the FDA and private drug companies have no interest what-so-ever promoting it, since its unpatentable.
07-29-2015, 09:02 PM   #11
jtp
 
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Here is a good book recommendation on Vitamin D and the different roles it plays in our bodies: The Vitamin D Solution: A 3-Step Strategy to Cure Our Most Common Health Problems by Michael Holick.

I take a 4,000 I.U. pill every day manufactured by Carlson. I order them online and they're pretty reasonably priced when you order a larger quantity bottle. It's nearly impossible to get TOO much Vitamin D, especially when you live in a northern part of the country.
07-30-2015, 07:34 AM   #12
InstantCoffee
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If you check on Amazon there's a once weekly 50,000 IU supplement you can get, it's therapeutic grade. It's about $20 and will last you over a year.
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07-30-2015, 11:37 AM   #13
wildbill_52280
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up to 90% of all americans are deficient anyways, it's a modern epidemic. There is a small possibility that people with crohn's just need more of this vitamin, not sure if any research out there supports this claim. Despite me getting 50 min of sunshine everyday, when i take my supplements i always react well them, which suggests I'm still not getting enough. I, starting to wonder if they only way you get enough from sunlight is exposing your back and most of your body to the sun, 3x a week for 30 minutes might do it, but fully clothed will only give you so much.
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07-30-2015, 11:40 AM   #14
ap17
 
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There's Vit D crohns studies going on right now. One with 2000 IU one with 10000 IU.
07-31-2015, 04:51 AM   #15
UnXmas
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I never used to be deficient, now I am despite supplements. I go outside but use sunscreen if it's at all sunny, but I've always done that. My doctor seemed to take it for granted that the change was due to worsening digestive function. I recently became deficient in both iron and b 12 too, having had digestive problems for years these deficiencies only came about now.
07-31-2015, 05:29 AM   #16
DJW
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There's Vit D crohns studies going on right now. One with 2000 IU one with 10000 IU.
Good to know.
Do you know where?
07-31-2015, 11:12 AM   #17
ap17
 
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Good to know.
Do you know where?
I think the study amounts are 400 IU and 10000 IU.

Here-->https://clinicaltrials.gov/ct2/show/NCT02208310
07-31-2015, 12:49 PM   #18
wildbill_52280
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here is an old study where vit d supps reduced CDAI around 100 points. Most patients had to take 5000iu to obtain a certain blood level of vitamin d, so crohn's patients requirement may be higher then normal people.

Clin Transl Gastroenterol. 2013 Apr 18;4:e33. doi: 10.1038/ctg.2013.1.

Therapeutic effect of vitamin d supplementation in a pilot study of Crohn's patients.


Abstract
OBJECTIVES:
Low vitamin D status may be associated with Crohn's disease. A pilot study was performed in patients with mild-to-moderate Crohn's disease to determine the dose of vitamin D needed to raise serum vitamin D levels above 40 ng/ml.

METHODS:
Patients were evaluated for severity of symptoms using the Crohn's disease activity index (CDAI) and patients with mild-to-moderate (150-400 CDAI scores) Crohn's disease were entered into the study (n=18). Vitamin D3 oral therapy was initiated at 1,000 IU/d and after 2 weeks, the dose was escalated incrementally until patients' serum concentrations reached 40 ng/ml 25(OH)D3 or they were taking 5,000 IU/d. Patients continued on the vitamin D supplements for 24 weeks. CDAI, quality of life measures, bone mineral density, dietary analyses, cytokines, parathyroid hormone, calcium, and several other laboratory measurements were evaluated at baseline and after 24 weeks supplementation.

RESULTS:
Fourteen of eighteen patients required the maximal vitamin D supplement of 5,000 IU/d. Vitamin D oral supplementation significantly increased serum 25(OH)D3 levels from 16±10 ng/ml to 45±19 ng/ml (P<0.0001) and reduced the unadjusted mean CDAI scores by 112±81 points from 230±74 to 118±66 (P<0.0001). Quality-of-life scores also improved following vitamin D supplementation (P=0.0004). No significant changes in cytokine or other laboratory measures were observed.

CONCLUSIONS:
Twenty-four weeks supplementation with up to 5,000 IU/d vitamin D3 effectively raised serum 25(OH)D3 and reduced CDAI scores in a small cohort of Crohn's patients suggesting that restoration of normal vitamin D serum levels may be useful in the management of patients with mild-moderate Crohn's disease.
07-31-2015, 04:16 PM   #19
SmellyMelly
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The thing is - I have a healthy diet and go outdoors for at least 20min almost daily. Is it even possible for this amount of deficiency to have come about because of diet and lack of sunshine? Or should I assume that this is something to do with malabsorbtion because of the Crohn's?
My doctor told me that most people are deficient; regardless of good diet. And yes it has something to do with malabsorbtion also. Well that is what he said anyway.
08-03-2015, 06:34 AM   #20
kikig
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Malabsorption is my problem, VitD levels are plaguing me right now. I'm on 15000 i.u. per day and my GI is threatening to give me daily shots if I don't sort it out.

Interestingly, my hypo thyroid issue is getting worse so I have to up those meds as well. I'm at 5.3 and I should be max 4.2 or something.
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08-03-2015, 08:58 AM   #21
DEmberton
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Everyone should consider taking vitamin D supplements to counter the lack of sunshine in England, government experts are proposing.
The draft Scientific Advisory Committee on Nutrition guidelines suggest, from the age of one, 10 microgram pills be taken to ensure people get enough.
http://www.bbc.co.uk/news/health-33757929
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