The Dizzying Array of D Vitamins

I’ve been taking vitamin D supplements for seven years and apparently I’ve become complacent about them.  When Bear’s PCP prescribed vitamin D supplements for him, I piped up telling her we have mine at home and – if the dosage was what he needed -could probably just share the bottle.

Bear checked it when we got home and asked, “These are D3.  Can I take them?”  Bing!  Today’s blog. I didn’t know if he could take them, but did know it was time to research the D vitamins again.

Let’s start at the beginning.  What does vitamin D do for us? According to What Is It And How Did I Get It? Early Stage Chronic Kidney Disease,  it “Regulates calcium and phosphorous blood levels as well as promoting bone formation, among other tasks – affects the immune system.”  Short, sweet, and to the point.Book Cover

But I think we need more here. Why are there are different kinds of vitamin D? I went to Buzzle (my new favorite for easily understood renal information) at http://www.buzzle.com/articles/different-types-of-vitamin-d.html and hit pay dirt on my first foray.

There are five different types of vitamin D.  It seems to me that the source designates which number it is.  For example, vitamin D2 comes from plants, small invertebrates, and fungus (Pay attention, vegans.) while the D3 that I take is manufactured synthetically. The designation D1 is no longer used, D4 is such a recent discovery that not much is known about it, and D5 is not technically a vitamin.images

By the way, if your vitamin bottle doesn’t have a number after the D, that means it’s D2 or D3. You should know that the kidneys are responsible for transforming calcitriol into active vitamin D.

So, the sunshine vitamin is produced by our own bodies, but sometimes not at the rate we need it.  Hence, we are prescribed vitamin supplements.  As Chronic Kidney Disease patients, we need the extra vitamin D – whether from nature (D2) or synthetically produced (D3).

Why you ask? DaVita at http://www.davita.com/kidney-disease/diet-and-nutrition/diet-basics/the-abcs-of-vitamins-for-kidney-patients/e/5311 offers us this handy information:

Vitamin D Helps the body absorb calcium and phosphorus; deposits   these minerals in bones and teeth; regulates parathyroid hormone (PTH) In CKD the kidney loses the ability to make vitamin D   active.  Supplementation with special active vitamin D is determined by   calcium, phosphorus and PTH levels….

The site also suggests that vitamin D be by prescription only and closely monitored.  Since it was my PCP who prescribed it for me (seven years ago as a CKD patient) and for Bear (last week and not a CKD patient), I’m wondering if that caveat is for end stage Chronic Kidney Disease patients.

Notice we have a new term in the description above – parathyroid hormone. That’s not as odd as it sounds.  There is currently a controversy as to whether vitamin D is a vitamin or a hormone, since it is the only vitamin produced by the body.  Parathyroid hormone (PTH) explained:

The parathyroid glands are located in the neck, near or attached to the back side of the thyroid gland. Parathyroid hormone controls calcium, phosphorus, and vitamin D levels in the blood and bone.

Release of PTH is controlled by the level of calcium in the blood. Low blood calcium levels cause increased PTH to be released, while high blood calcium levels block PTH release.

fishAnd here you thought the kidneys worked alone to control these levels in the blood.  Thanks to MedLine Plus at http://www.nlm.nih.gov/medlineplus/ency/article/003690.htm for correcting us. This National Institutes of Health site is a constant fount of pretty much any kind of health information you may need.

Okay, so let’s say you don’t take the vitamin D supplements you need.  What happens to you then? I jumped right on to the Mayo Clinic site at http://www.mayoclinic.org/vitamin-d-deficiency/expert-answers/FAQ-20058397, but found their answer too general for my needs: “Vitamin D deficiency — when the level of vitamin D in your body is too low — can cause your bones to become thin, brittle or misshapen.”

The irony of this is that we live in the sunshine state.  Only 20 minutes of sun a day could give us the vitamin D we need… and melanoma.  Having had a brush with a precancerous growth already, I’m not willing to take the chance; hence, the supplements.

Let’s not forget that vitamin D also helps absorb calcium and phosphorous, so it’s not just your bones that are at stake, important as they are. I went back to the National Institutes of Health at http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts/ for more information. This is what they have to say:

Vitamin D is important to the body in many other ways as well. Muscles need it to move, for example, nerves need it to carry messages between the brain and every body part, and the immune system needs vitamin D to fight off invading bacteria and viruses.

Aha!  Keep in mind that as CKD patients our immune systems are already compromised and you’ll realize just how important this vitamin is to us.sun-graphic1

Let’s try it the other way.  Let’s say you are so gung ho on the benefits of vitamin D supplementation, that you take more than your doctor prescribed.  Is that a problem?  According to WebMD at http://www.webmd.com/osteoporosis/features/the-truth-about-vitamin-d-can-you-get-too-much-vitamin-d  it is:

Too much vitamin D can cause an abnormally high blood calcium level, which could result in nausea, constipation, confusion, abnormal heart rhythm, and even kidney stones.

To sum up, you may be vitamin D deficient.  Your blood tests will let you know.  If it is recommended you take vitamin D supplements, stick to the prescribed dosage – no more, no less.  While some foods like fatty fishes can offer you vitamin D, it’s not really enough to make a difference.

I get so caught up in my research that I often forget to mention what’s happening with the book or SlowItDown.  Back were discussed on this podcast http://www.stitcher.com/podcast/mathea-ford-2/renal-diet-headquarters?refid=stpr.  Renal Diet Headquarters interviewed me and I had a ball!  I must learn to be quiet just a little and let the interviewer get to ask the questions before I start answering them!

kidney-book-coverSlowItDown also has a new website at www.gail-rae.com. I would appreciate your feedback on this.

I hope you had a wonderful Valentine’s Day by yourself, with your love, your family, your friends, your animals, whoever you spent it with.

Until next week,

Keep living your life!

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