Which to take (D2 vs D3)

I just got a prescription called in for me by my surgeon for prescription D2 50 (50,000 iu) gel capsules. I bought D3 50 (50,000 iu) Capsules on Amazon a week ago. I am confused why if D3 is more easily absorbed by RNY patients they ordered me to take D2 (and it's prescription, not OTC). Any ideas on this? I don't know which one to take now and feel a bit stuck...

I don't know why they recommended D2.  I could guess, but if you really want to know, you could just call in the morning and ask.

I can, however, tell you why we absorb dry D3 better.

First, it's not exactly that we absorb D3 better, although that's what people usually say because it's just an easier way of thinking about it.  What it really is, is that D2 has to get converted into D3 inside your body in order to be absorbed and used by the body.  It takes a lot of D2 to make a little D3.  How much depends on who you ask.  I've read anywhere from three units of D2 to make one unit of D3 to ten units of D2 to make one unit of D3.  So what that means, if you do the math, is that if you take 50,000 IU D2, your body might only be able to make 5,000 IU D3 out of that.  So you'd end up getting a much smaller dose than what you were prescribed.

Second, the prescription is D2 in oil.  Fat soluble vitamins, including vitamin D, are often packaged in oil because oil is a fat and taking them that way helps most people (as in, those with normal digestive systems) absorb the fat soluble vitamins.  However, we malabsorb fats since we had RNY, so we do not absorb vitamins in oil as well as dry vitamins (or vitamins not in oil).  So while D3 in oil would be a great choice for most people, it's not for RNY folks.  (D2 is not a good choice for anybody, RNY or not).

I take dry D3, and that's what I would continue to take even if my doctor wanted to prescribe D2 in oil.  You'll have to make your own decision about what is best for you.  Perhaps you want to call your doctor in the morning and discuss it.

Thanks so much Kelly - that is what I had read during my research too. The D3 I bought is in capsule form, does that mean it is also in oil or is that irrelevant with the D3? It was the Bio-Tech brand ones. Thank you!

You don't want D3 in oil, either.  Or vitamin A or any other vitamin.  What you bought is a capsule with dry powdery stuff in it, no oil.  It's good.

Perfect- thanks! I think the D2 must be in oil, it's a clear (greenish) colored gel looking capsule. I took a dose today assuming that I had to be on this, but then did some more researching and then wondered if I should be on this D3 I bought on my own instead...I just wish all of the bariatric surgery centers would get on the same page about this stuff!

Yes, the D2 prescription is in oil.  If you cut open the soft gel, you'll get oily gel-type stuff oozing out.

My PCP is pretty open with me when he doesn't know something, especially as it relates to treating patients who have had gastric bypass (and he is always very open to me bringing him information from medical journals or medical studies). 

When he and I were discussing my Vitamin D supplementation, he suggested the prescription D2 and when I explained the dual issues of D2 having to get converted into D3 and of RNYers not absorbing vitamins in oil very well, he had no idea about the D2 to D3 conversion that the body has to do, and this is a doctor who now includes Vitamin D checks whenever he runs an extended set of labs on someone because so much of the "normal" population is Vitamin D deficient!  So if HE didn't know it, with his concern with Vit D deficiencies, it doesn't surprise me that other physicians don't know it either.

Lora

If you consider the fact that some doctors complete medical school without taking a single class in nutrition, it's not surprising many don't know this stuff.

Some medical schools require docs to take a class in nutrition, but it's just one class, and covers only the basics.  At some medical schools, they have the option of taking an elective class in nutrition if they want to.  Some medical schools do not offer a single class in nutrition.  Doctors that know a lot about nutrition generally do so because they've gone to a lot of effort to educate themselves about it.  But not all docs have the time or inclination to do that.

I just went through this whole process. I got the D2 but switched to the Vitalady D3- 50,000iu from reading on this board and my level went from in the 30's to getting checked last week and it was 97 after a couple months of extra supplementing. It helps also that I'm getting some sun also.  I just need to figure out what dosage keeps me at this level now.

How often were you taking the 50,000 IU D3 to get to 97?  You'll probably need 50,000 IU two or three times a week to maintain that level, but some people need less, and some need more.