Vitamin D toxicity

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GDen
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Date Joined May 2009
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   Posted 8/27/2009 12:53 AM (GMT -7)   
I've been on prednisone for over 4 months now and after my GE confirmed last month I should probably be taking calcium supplements (which he never mentioned before), I started. I looked at the store and found that a few calcium supplements have zinc (and magnesium?) and most of the rest have vitamin D. I recalled that vitamin D is fat soluble and as such accumulates in the body and can be toxic. I already take a daily multi-vitamin which has 100% DV of vitamin D, so I figured it'd be better to get the calcium supplement without it. I did some research and it appears you'd have to take a large amount of vitamin D for months for it to be toxic. The daily recommended value for adults is 400 IU. In 1997, the Tolerable Upper Intake Level (UL) for vitamin D was 2000 IU. It was increased to 10,000 IU in 2007. It apparently takes 100,000 IU taken over months for toxicity to occur. Anyway, I'm just curious if anybody thinks there's any problem with taking 200% of the DV of vitamin D plus however much I get from food and the sun. Foods like herring or cod liver oil contain a lot of vitamin D (over 1000 IU). It sounds like too much vitamin D may possibly lead to kidney stones and other calcification problems, but probably not.

tsitodawg
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Date Joined Sep 2006
Total Posts : 845
   Posted 8/27/2009 3:10 AM (GMT -7)   
Many of us here are deficient in Vitamin D and thus are taking a supplement. I too, take the 50,000 supplement but weekly with a smaller daily dose of 2,000. If you are taking more than that then you may want to consult you doctor again. Even when I take the 50,000 unit pill, it is only for a month or 2 at most and then I have to hold off for a while. One reason that many of are deficient is that many of us have problems with absorbing vitamins or medications. I found this out when I tried a lortab 5 and it had no effect on me even though I had never done any other pain medications before that. My doctor found that I was not absorbing the majority of the medication and had to up the dose so that I can get a regular dose. Most vitamins and medications are absorbed in the small bowel and most of us have active disease or scar tissue there. Mine is in the Terminal Ileum and that causes many malabsortion problems despite me not having a bowel resection yet. This can be even more intensified with those that have had bowel resections.

Rider Fan
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Date Joined May 2008
Total Posts : 1445
   Posted 8/27/2009 6:59 AM (GMT -7)   
I wouldn't worry about getting too much D, I think that's the least of our worries.
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Tried SCD, didn't work, now avoiding gluten and dairy.


Go Saskatchewan Roughriders!


MMMNAVY
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Date Joined Jul 2006
Total Posts : 6927
   Posted 8/27/2009 7:06 AM (GMT -7)   
I actually have to take 50,000 units of D a day. But I have already had a fracture, and I have blood draws 3 times a week.
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

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njmom
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Date Joined Apr 2006
Total Posts : 1884
   Posted 8/27/2009 1:32 PM (GMT -7)   

The disease itself seems to interfere with absorption of vitamin D, BUT so does prednisone. So you might have to take 2000IU or more, daily.

Crohn's patients tend to be deficient in vitamin D. The Crohn's and Colitis Foundation recommends at least 800IU daily:

"Supplementation of this vitamin should be in the range of 800 I.U./day, especially in the non-sunny areas of the country, and particularly for those with active disease."

http://www.ccfa.org/info/diet?LMI=4.2

You can have a blood test done for vitamin D 25 hydroxy, the storage form of D, to find out whether you are deficient. My guess is you probably are, especially since you are on pred.


CrazyHarry
Veteran Member


Date Joined Mar 2006
Total Posts : 1034
   Posted 8/28/2009 9:41 PM (GMT -7)   
the research is showing, crohns or not, that most of society is deficient in vitamin D. dont worry about vitamin D toxicity. it is possible, but hard to do. lab corp is supposed to be the best lab for vitamin d testing (according to mercola.com)

yes, vitamin D is fat soluble, so take it with some fat, like a spoonful of coconut oil. also take vitamin D with your calcium supplement. research shows that taking vitamin D with calcium increases the absorption from like 20% to 80% (or something ridiculous like that). take the calcium supplement at night as calcium acts as a mild sedative. magnesium also helps with the absorption of calcium.

as for vitamin D supplements, make sure it is vitamin D3. D2 is synthetic and is being removed from milk, milk substitutes, etc but check the labels. D2 is actually not good for you.

imho, if you are on prednisone, you need to be on a calcium supplement. my doctors didnt tell me this until i was diagnosed with osteoporosis, a few years of consistent prednisone use at medium to high doses (thanks guys!). the stuff like fosamax and bonive et. al. are a joke and just trick the bone density test. they are bad stuff. dont take them.
Crazy Harry

---------------------------------------------
Crohn's since 1993 (17 yrs old then)
surgery in July '05 - removal of 2 inches at ileum and 8 inches of sigmoid colon (had fistula into bladder)
Nov '05 developed colonic inertia; July '06 told i needed ostomy surgery
began maker's diet in August '06 - now feeling the best ever with no symptoms of colonic inertia and i kept my colon
med free as of 10/31/07


Keeper
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Date Joined Jun 2008
Total Posts : 1058
   Posted 8/28/2009 10:18 PM (GMT -7)   
A bit off topic, but I read that there was a study done in Finland (a few years back) in which they gave new-born infants 2000 units of D a day. There was a fairly large contingent - 10,000 or 20,000 in the study. After two years, one result was an observed drop in the rate of diabetes of 80%. There was no observed toxicity from the supplement. This is connected to the observation that vitamin D deficiency is associated with several auto-immune diseases like MS and others.

Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 8/29/2009 7:43 AM (GMT -7)   
Where I live they recommend that all infants get supplemented with 400 IU of vitamin D a day.
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Tried SCD, didn't work, now avoiding gluten and dairy.


Go Saskatchewan Roughriders!


GDen
Veteran Member


Date Joined May 2009
Total Posts : 703
   Posted 9/2/2009 8:50 PM (GMT -7)   
Thanks everybody for the replies. I picked up some vitamin D and hopefully it helps. I did see one vitamin D supplement with 500% DV per pill, so I shouldn't have anything to worry about.

GDen
Veteran Member


Date Joined May 2009
Total Posts : 703
   Posted 9/8/2009 9:06 PM (GMT -7)   
Great, right after I bought a bunch of vitamin D/calcium pills.

Somebody said...
Vitamin D Often High in Crohn’s Disease Patients

ISLAMABAD: Contrary to expectations, people with the inflammatory bowel condition Crohn’s disease are likely to have excessive levels of the active form of vitamin D in their blood, researchers have found. This is associated with low bone mineral density, they report.

Dr. Maria T. Abreu from the Inflammatory Bowel Disease Center at Cedars-Sinai Medical Center in Los Angeles led the study. She told Reuters Health, "Most doctors think that Crohn’s patients automatically have decreased vitamin D levels and encourage supplementation with vitamin D. We would like to urge doctors to check vitamin D levels before making that recommendation."

As Abreu’s team explains in the medical journal Gut, under certain circumstances too much active vitamin D can actually contribute to the breakdown of bone, leading to osteoporosis. The researchers found "inappropriately high" blood levels of the active form of vitamin D in 42 percent of the 138 people they studied with Crohn’s disease. This was true of only 7 percent of 29 patients with ulcerative colitis, another type of inflammatory bowel disease.

Also, the higher the blood levels of active vitamin D in Crohn’s patients, the lower was their bone density -- regardless of whether they were treated with steroids -- the investigators found. "We believe that high vitamin D levels are most likely a manifestation of the underlying gut inflammation," Abreu said. A high vitamin D level is "an additional risk factor predisposing to development of osteoporosis" for some Crohn’s disease patients, the team concludes. Treatment of the underlying inflammation, "may improve metabolic bone disease."

www.onlinenews.com.pk/details.php?id=151547

njmom
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Date Joined Apr 2006
Total Posts : 1884
   Posted 9/8/2009 9:20 PM (GMT -7)   
GDen, Abreu is not being very clear, here.
 
Surely she knows what any decent endocrinologist knows, namely that a vitamin D deficiency (meaning that your storage form of the vitamin is low) tends to CAUSE high levels of circulating vitamin D.
 
Why? Because when your storage form of vitamin D is too low, this somehow signals the PTH (parathyroid gland) to kick in, in order to INCREASE circulating vitamin D, even to an unhealthy level...to ensure the level of calcium in your bloodstream is adequate. Unfortunately, the PTH can get exhausted and the circulating D can leach calcium from bones to maintain calcium in the bloodstream.
 
When my daughter was diagnosed with a vitamin D deficiency, she took vit D supplements and voila! The PTH settled down and the circulating vitamin D also settled down.
 
Ever since I read Abreu's research, years ago, I've wondered, "Does she not understand the vitamin D/PTH connection?"
 
Her advice to get tested sounds fine - but check the whole story: storage D, circulating D, and PTH levels.

GDen
Veteran Member


Date Joined May 2009
Total Posts : 703
   Posted 2/6/2010 11:05 PM (GMT -7)   
I looked again and found there are some pretty high vitamin D-3 supplements available over the counter. The highest I found is 5000 IU which is 1250% RDA.
Cimzia, Asacol


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 2/7/2010 8:11 AM (GMT -7)   
GDen, I take 3400 units of Vitamin D3 daily. I take 3000 vitamin D and the other 400 I get from my Calcium supplement. My doctor watches my vitamin D levels with occasional blood tests. Even healthy people in America are low on vitaminn D3 because those in the northern climates don't get enough sun because of weather conditions, but people also are using sunscreens alot to avoid skin cancer. Then there is the fact that most of us work inside most of the day when the sun is out, so most are low on Vitamin D. I live in sunny southern California and I am still low on Vitamin D3. I read that you should be taking at least 2000 units, because the old scale of 400 units per day is really outdated. I am sure its even higher for a person with IBD. Good luck!
Gail*Nanners* Co-Moderator for Crohns Disease & Anxiety/Panic
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

FunGuy
Veteran Member


Date Joined Oct 2009
Total Posts : 1070
   Posted 2/7/2010 9:29 AM (GMT -7)   
That book "Straight from the Guy" says that people who live in the northern parts fo Europe have an 80% higher rate fo CD than the southern IIRC.
That IMPLIES a relationship to the need for Vit-D........but who knows?
 


Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 2/7/2010 10:34 AM (GMT -7)   
I see an Endocrinologist who follows me for Osteoporosis. She has Rx'd me 50,000 IU 1 X Wk for many years. Despite that my Vitamin D level drop consistently so she asked me to increase my dose and take 1000 IU 1X daily in addition, which I did. After a year, my Vitamin D level still dropped. I have now increase to another 1000 IU. So I take 50,000 1X week, and 2000 each day. And my D levels are still falling. I don't think I could possibly overdose on D.
Suzanne

CD 20 years officially, 30 unofficially. 3 resections '93, '95 '97
Managing with strict low residue diet, keeping symptoms to a minimum. All test show small amount of ulceration, still have occasional blockages. But still have a great time with my 2 daughters and husband!


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....

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