D2 vsD3 and other stuff about vitamin D
There are two types of vitamin D, D2 and D3. It’s important that we know this because one type, D3, is absorbed well and the other type, D2, is not. Unfortunately, many doctors do not know the difference. They may not even realize there are two types of vitamin D, and if they do know there are two types, they may think they are both equally well absorbed or may have no idea what the difference is.
D2 must be converted to D3 in the body in order for the body to use it. It takes a fair amount of D2 to make a little bit of D3. I’ve seen anywhere from three units of D2 to make one unit of D3 to ten units of D2 to make one unit of D3.
When your vitamin D level is low, doctors often want to give you a prescription for vitamin D. What they prescribe is called Drisdol, and it’s D2. They prescribe it in 50,000 IU soft gels, those little things that look like footballs and have oil inside. The reason they put it in oil is because vitamin D is a fat soluble vitamin. Being in oil is supposed to make it absorb better. That’s true for most folks, but is not true for RNY and DS folks because we malabsorb fat. We need dry D3.
OK. So your D is low and they give you 50,000 IU D2 and usually tell you to take it once a week. That’s not enough if your level is really low – and if your doc is prescribing vitamin D, it’s usually because it’s very, very low.
If it takes three units of D2 to make one unit of D3 in your body and you take 50,000 IU of D2, you’re really only getting about 16,666 IU of vitamin D. If it takes ten units of D2 to make one unit of D3, you’re really only getting about 5000 IU of vitamin D.
Now, keep in mind that recent research suggests that folks that have not had WLS and that have normal levels of vitamin D need 1000 – 2000 IU per day just to maintain their levels. If you needed 7000 – 14,000 IU per week just to maintain your level, do you think 5000 – 16,666 IU once a week is going to bring your level up? Not likely.
And if you had RNY or DS, that prescription D2 in oil will help you even less because you won’t absorb much of it at all because you malabsorb fats. But even if you are pre-op, or had lap band or VSG, the D2 is not going to be sufficient for you.
You cannot get D3 by prescription. It is only available over the counter. Even if your doc knows the difference between D2 and D3 and writes a prescription for D3, the pharmacist will give you D2. That’s because there is no D3 available by prescription and legally pharmacists are allowed to make certain substitutions. You have to get your D3 over the counter and if you had RNY or DS, you need to make sure it is dry D3, not in oil.
Many people don’t notice any symptoms of low vitamin D, at least not until it’s super super low. Then they might get tired easily, feel weak, have muscle pain, feel depressed and get sick easily. High blood pressure is sometimes a symptom of low vitamin D, too.
Keep in mind that we want our D levels about 80-100. Lower than that, we are at increased risk for things like osteoporosis, heart disease and some cancers.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
I do have a question tho--is the D3 that is combined with most calcium citrate supplements sufficient, or should I also be taking the 5000 IU of D3 daily? My vit D level is low, but I'm too lazy to look it up to tell you how low. Obviously low enough to require a prescription.
Thx!
HW: 272 lbs. (BMI 49.7) SW: 237 lbs. (BMI 43.3) GW: 140 lbs. (BMI 25.6)
So most likely you will need more than what's in your calcium but the way to know for sure is by getting your labs done.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
on 5/22/12 9:58 pm, edited 5/22/12 10:23 pm
BUT i will say that common sense ( and research both ) dictate that at least 15 minutes ( !!!
) of SUN exposure a day WILL keep Ur D levels up ...( and health level up too ) .U CAN'T take PILLS , stay inside , eat junk and expect to remain healthy lol ....
We need SUN, air , movement and inspiring BEAUTY to keep us going ...
this is the rose and perrennial border I'm building as a testament to MY health ( and gratitude ) ....
What I've read says that the amount of time in the sun needed to keep vitamin D levels up depends on a number of factors, including the time of year, the latitude (further from the equator, you need more time in the sun) and skin time. Someone with very fair skin may need only 15 minutes in the sun but someone with dark skin may need 90 minutes of sun to get the same amount of vitamin D.
www.vitamindcouncil.org/about-vitamin-d/how-to-get-your-vita min-d/uvb-exposure-sunlight-and-indoor-tanning/
I don't stay inside all the time, though I'm not a real outdoorsy kind of person. I don't eat junk. I take a number of supplements, based on the American Society for Metabolic and Bariatric Surgery guidelines for RNY patients and based on my labs. And I do expect to remain healthy, and right now, I am healthy - I have a normal BMI, normal blood pressure, good cholesterol levels, good blood glucose levels, bloodwork indicates vitamin and mineral levels are all in the optimal range.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
on 5/22/12 10:18 pm, edited 5/22/12 10:18 pm
Wouldn't want to scare anyone off saying U need more than 15 minutes .... but trusting that once they get out there ( like me ) they'll get HOOKED .
A lot of ( effective) personal training is like that .... guide someone motivated to the RIGHT ( and Rewarding ) place and they keep coming back ...
I CERTAINLY wasn't accusing lol... have the highest respect for U and Ur knowledge and caring for others here
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
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