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. I know it seems like a doctor should know these things, but the reality is, many do not.

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 an fat soluble vitamin. Being in oil is supposed to make it absorb better. That’s true for non-RNY folks, but is not true for RNY-folks because we malabsorb fat. We need dry D3. But some docs don’t know that, either.

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. But that’s another topic for later discussion.

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 had RNY, 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, you need to make sure it is dry D3, not in oil.

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

I agree 100%. I've been through the issues you not in your post. 8 for initial D levels. One script D (D2) per week for six months, 3 sets of labs, and a high of D of 14 between the 3 tests.  5-6 weeks on a liquid vitamin with 600 IU dry D3, and my next labs showed a 33 for D.  I had researched vitamin D during this time, and found your statements validated by several sources. I began getting dry D3 capsules from Vitalady about 3 years ago.  I was taking 4 of the 50k IU dry D3 per week for over a year.  My Oct. 2010 labs had my D at a 65.  Far improved over the old 33, but not at the 80+ levels noted for best long range health. Levels above 80 have shown in several studies to decrease chances of several cancers, MS, nerological disorders, and other issues.  Cancers included prostrate, cervical, breast colon rectal cancers.  In an effort to get my D to an 80-100, I now take a 50K IU dry D3 daily.  Each patient is somewhat different in how their body absorbs D, so you personal needs may vary. This is one important reason to get labs done on a regular basis. Lastly, don't cheap out and get the dry D3 in a softgel, as it's packed in oil, and you won't absorb a good portion of the D3. DAVE

This always confuses me so thanks for the reminder. I guess I need to get off my backside and get up to vitalady for some dry D3, but just want to clarify first:

So, I take 50,000IU DAILY, but since it's prescription it must be D2 and I'm absorbing only about 5000IU daily and that is not sufficient, is that correct?

I just want to make sure because my insurance covers this prescription supposedly high dose vitamin D, but will not cover anthing OTC so before I go forking over extra $$$ I just want to be doubly certain.

Do I have it right now?

Thanks Kelly =)

How much you need daily depends on your labs.

If you need 50,000 IU daily, what you're getting is not sufficient.  We don't know exacly how much of that D2 you'll absorb.  But definitely not all.  Not much.

How much is your insurance copay?  Because vitalady's 50,000 D3 is not expensive.  About $20 for 100 capsules.  And that's a three month supply.

Only $20?  For some reason I thought it was considerably more than that - must have been looking at the wrong stuff (no surprise there lately).

With insurance,  30 of the 50000IU caps are about $2.  But I can deal with the prices you're referencing, especially if I'm not getting benefits from the prescription stuff.  It's not even worth the $2 if it's not working. 

Thanks Kelly. When I brought this up at the surgeons office last time they just blew me off and said the gelcaps were fine.  My labs are extremely wacked out  in lots of areas so I need all the help I can get (which is why they prescribed such a huge dose daily, and not weekly) so you'd think they might be more careful.  Just a good reminder that we always have to be our own advocates, I guess.

REALLY appreciate all of the time and energy you put into educating all of us about these vitamin issues.

Yeah, I think it's $19.25 plus shipping.  That's for just over a three month supply, if you have to stay on daily.  It's affordable and you're right, the Rx is not worth $2 if it's not working.

You may be absorbing $2 worth of it, though.  But still. 

You want to keep your bones, right?  Don't want heart disease anytime soon?

All I can say about your surgeon's office is, they haven't done the research.

I just received a prescription for 8 weekly doses of the 50,000 softgels, so thank you for posting this. My level is 21, so I need a big boost. I know I posted a couple of weeks ago, but I have been so caught up in trying to figure out my protein that my D3 has fallen by the wayside.

Now when you say Dry D3, that just means that it is not a softgel - that it is a dry tablet? Can I get the Dry D3 at GNC or someplace local instead of ordering it off the Internet?

Thanks!!

Yeah, the script you got will do you no good at all.  And 21 is dangerously low.

When I say dry, I mean a dry tablet, or a capsule with dry powder inside.  Just not a softgel.  No oily stuff inside.

You can get dry D3 at stores but not a big dose, and you need a big dose.  You need 50,000 IU a day and you won 't find that in stores.  Gotta go to vitalady.com.

No, you need to get it at vitalady.com and take it about 3 times per week to start.  Many will recommend taking it daily but that can really boost your levels fast but in some cases too fast - if you are going to do that, you need to get your levels rechecked in 1 month.  If you take it 3 times per week, you can go 2 months but it is very important to recheck to make sure you dont' go to high, this stuff really works.