Q. My physician recently found that my vitamin D level is very low. I find this hard to believe since I drink nearly a gallon of milk weekly and take a multivitamin and supplement of calcium plus D each day.

I also take prednisone, tramadol, gabapentin, methotrexate and leucovorin. Could one of these drugs interfere with vitamin D absorption?

A. Many Americans have low vitamin D levels, especially in winter when they don’t get regular sun exposure. A glass or two of milk daily combined with vitamin supplementation does not always correct the imbalance for healthy people.

Your medications are likely making the situation much worse. Prednisone, gabapentin and methotrexate can all interfere with vitamin D.

You may need at least 2,000 International Units daily which is much more than you are getting from your supplements and diet. Have your doctor monitor your progress. Vitamin D is crucial for immune function, muscle strength, balance and blood pressure control as well as bone density.

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  1. Rachel
    Reply

    Keep taking your vitamin d, there is nothing to be afraid of. It will take awhile to feel the results, but you should improve! Good Luck! Let us know how you are doing.

  2. RLS
    Reply

    As like almost all of you, I have had anxiety issues and was afraid to take my vit d 50000u, I’m glad I saw this site, I took my first pill while reading all the positive posts. I am taking 50000 u once a week for 3 months. I also have pains in my thumbs and my arms felt weak. I thought it was arthritis or carpel tunnel, I also have pain on my left side, shoulder, and down my legs. My endo dr. said I had a low vid d deficiency.
    Thank you for all the posts, I feel more confident in taking my meds. I will repost in a month to let everyone know my results, hopefully they will help others.
    RLS

  3. Rachel
    Reply

    Hi, I was just checking in to see how everyone is doing! I was treated in March of 2011 for being vitamin D deficient. Still didn’t feel much difference after D therapy. However, I went to have a tooth implant due to an infected root canal and the Specialist put me on 1200 mg of D taken in doses of 600 mg at a time and 500 mgs. of calcium twice a day. Said to take it for the rest of my life… after a few months of that I started feeling much better and have energy again.
    Downside, another doc diagnosed me with Fibromyalgia. So I’m thinking that everyone who is D deficient that perhaps it’s a sign of something else going wrong in the body. I’m not getting treatment for Fibro as my PCD believes it’s a made-up condition, but staying on these vitamins has totally changed my life. Has anyone else experienced this as well? Take care everyone!

  4. B.
    Reply

    Did your symptoms get better after the vitamin d supplements?

  5. Rachel
    Reply

    Don’t stop with just checking the vitamin D. I have been there done that. Get more blood tests! believe it or not, have your teeth checked…I mean REALLY CHECKED! I had some similar symptoms and it was found that I had an infected root canal for four years…you can’t feel it but It can poison you whole system slowly!!! So get a new work up, a new doctor, and stop by the dentist! I hope you feel better!!!!! Hugs.

  6. elss
    Reply

    It has been extremely informative reading this site regarding Vitamin D. I just found out today that my Vit D level is 10. For years I’ve been progressively getting sicker and sicker and sicker. My internist was convinced that I had fibromyalgia (along with a dozen other diagnoses). I’ve been tested for Rheumatoid arthritis, but negative. I have bursitis in my hips and have for 4 years. I hurt pretty much from my neck, all the way down my spine, in both hips, in both shoulders, and frequently in my hands and feet. I do not take any kind of pains meds, so don’t think I’m a drug seeker. Definitely not.
    I’ve been to physical therapy several times. I own a TENS unit, which I can’t live without when the pain gets really bad. I take 3 meds for my blood pressure. I have hypothyroidism (synthroid 200 mcg daily). I went from being a normal, extremely organized person with great coping skills who was getting a double masters degree to completely falling apart 3 years ago. I couldn’t shake the anxiety and depression that came on. I can’t tell you how many people I saw trying to figure out what was going on with me.
    I alternated from being super sleepy all the time to not sleeping for days at a time. I finally just became a chronic insomniac and I don’t sleep for days and then I’ll finally crash for 16 hours, then I repeat the cycle. I had sleep studies. Nothing was wrong. My sleep specialist doctor said I just needed to take Ambien because it works and it’s not addictive. It does work, but tolerance develops quickly. Last year, I felt so horrible from head to toe with no explanation that I was suicidal for the first time in my life.
    I knew something bad was wrong with me! I blamed it on my age (40) and too many stressors. I saw my 3rd or 4th counselor trying to make me feel better (which never worked at all), and was referred to a psychiatrist, who then told me I had bipolar type II. Fast forward to now. I am just 40 years old. Healthy until 10 years ago with no complaints whatsoever, then simply found to have hypertension and hypothyroidism. No big deal. No pain until 3+ years ago. No anxiety or depression until the same time.
    I finally asked my friend, who is a nurse practitioner, if she would mind checking my vitamin D level last week. I got it back today. It was less than 10, and I have been taking Calcium, magnesium, and vitamin D supplements for months. She put me on 50,000 units weekly with a 4 month prescription. I am hoping and praying that this answers most of this wacko stuff that I’ve had happen to me. I really would hate to have seen what the level was before I started taking my own OTC vitamin D months ago. Anyway, I’ll let you know. I have hope!! :) :)

  7. ejm
    Reply

    My story matches many that have been posted. Started with a fuzzy, brain fog feeling that progressed to fatigue, hair loss, memory loss, no concentration, tendonitis,low grade headache, etc. Vitamin D came back at 12. Dr put me on 50,000IU 3 times per week for 12 weeks. I felt good about 3 weeks into taking my Vitamin D. I then felt worse……brain fog, headaches, pressure and pounding in throat and head, no energy at all…..at 9 weeks I couldn’t stand it anymore so called Dr to have labs redrawn. I was over 150! You can get too much of a good thing.
    Everybody reacts differently. People’s medical conditions and other medications affect how your body will react so this is not a one size fits all solution. It has taken 6 weeks for my Vitamin D to come back down to normal. I will be retested and put on a new regimen as I now feel like I’m going back to low. The 50,000IU is good but track how you feel and pay attention to what your body is telling you. Get retested when YOU think you need it. High is just as bad as low…..

  8. Lynn
    Reply

    marie, you are so correct! For about ten years I’ve been exhausted, told I have fibromyalgia, stopped getting my period but have hot flashes ( I’m only 43 ) and was told it’s this or that. I changed doctors and the first thing she did when I said I am constantly tired, can’t sleep, pain, was to take blood work for vit b and d.
    Came back and my vitamin D is 5, so she prescribed the 50,000 twice a month. I have not felt so good in YEARS!!! I am able to get off of the predinose, and other horrible meds they gave me saying it was this or that, and I am sleeping again at night, my husband is grateful for that :) I’m all but 89 lbs so I was afraid of the high vit D level in this rx but this doctor knew right away what to check for, so I did NOT hesitate to take the vit D.
    I would encourage you all who are prescribed it to try it, it does take a while till you feel the FULL benefits, but after two doses I can feel a difference. They wanted to do exploratory surgery on me to find out the source of my pain but now that I’m on the vit D 50,000 it’s gone, so no surgery that is not needed, whew!!!!! Don’t be afraid to take this, you will feel a difference.

  9. CTR
    Reply

    I got tested on Wednesday, and this morning my lab results were up on the online database. I am vitamin D deficient at 10. My B12 is borderline low at 219 (last year it was 177 and I got shots for 6 months). I am annoyed that it is a long weekend, as I won’t hear from my doctor about the results until at least Tuesday! I have mitochondrial disease, so I thought my symptoms were all from that, but reading your posts, I think it could be partly from the vitamin D deficiency, so I really want to start fixing it and see if it helps get rid of my symptoms!

  10. jmr
    Reply

    Hi, I’m 53 and for years have experienced the same symptoms you described and more. I was just diagnosed with low Vit D and hypothyroidism. both of these conditions produce many of the same symptoms. It’s definitely would be worth have your MD check your TSH level. I’ve been taking 5000iu’s of OTC Vit D for the last 2 years and my levels have stayed low. Just started taking Synthroid and 50,000iu’s of scrip Vit D. I’m hoping I’m going to be feeling better soon, and I hope you do too!

  11. Kat
    Reply

    There is hope and sanity to be found by taking D3! I had been experiencing, severe bowel issues, blurred vision, fatigue, depression, muscle cramps. I seriously thought I was so stressed that I had made myself sick or that I was just mental. I went to general practice dr. and got blood work for Celiac’s (it runs in my family) and had a ultrasound done on my uterus. Got a negative on anything wrong and was prescribed med.’s for gerridia (intestinal parasites without any test run for this. I knew this was wrong and would not even fill script).
    After many months I went in to my gyno to get a over due annual exam and the dr. also ran blood work. Amazingly my gyno tested for Vit. D levels, I was at 10.2. I have been taking 5000 iu’s of D3 daily for 2 months now and get retested in a month. I may not be as high as I should be, but what a difference. My bowels are improving, my vision not blurring, the fatigue is greatly improved, and my state of mind is much better. I have no other health issues and have never taken med.s unless I had to, so to take anything daily was not my idea of ok. The capsules are about the size of a TicTac and have no side effects. Such a simple fix for such a life consuming issue. Please don’t be afraid to take the Vit. D when so much is to be gained from it. Plus it is a fairly cheap vitamin over the counter.

  12. NHC
    Reply

    After picking up my prescription, the doctor has prescribed 50,000 IU twice a week for 8 weeks. Does this seem like a large amount to anyone else?

  13. NHC
    Reply

    I was diagnosed with RA almost a year ago. I have been on 10 mg of prednisone and also on weekly methotrexate injections. My doctor called this morning to say my Vitamin D levels were extremely low, (didn’t even think to get the numbers) and that she was calling me in a prescription of hi dose D.
    From what I am reading, the symptoms of Vit D deficiency seem to be very similar to the RA symptoms. Since I don’t seem to be responding to the prednisone and MTX, can’t help but wonder if the vit D deficiency is causing the symptoms and not the RA.
    This knowing what the right thing to do and right medicine to take is so hard and confusing. Sure helps to have these blogs to see what others are dealing with.

  14. Rachel
    Reply

    Hi Lilo, funny I should see this post today. I was at the doc today as I have a cold and I told him I stopped taking my 1,000 unit maintenance dose… he told me to start up again on the maintenance dose, as some folks can’t absorb the vitamin D from Sun. So make a call to your doc and see if he/she wants to put put you on the maintenance dose as well. Good Luck

  15. Lilo A.
    Reply

    My Vit. level dropped in 4 month from 30,2 to 15,6.
    I wonder whether it is because of winter, or do I need supplements too?
    Who can answer?

  16. GPG
    Reply

    Based on what my experience has been, and my asking the identical question, I now realize that it is a different ‘number’ for different circumstances. I am a true believer in the benefits of VitD3 (and supplements in general). BUT I am beginning to finally ‘get it’ that, indeed, ‘more’ is NOT necessarily better. Everything in moderation…. based on relevant research…. and evidence-driven. You want a so-called therapeutic-dose appropriate to YOUR OWN medical circumstances. You are not me.
    I have MS, so it appears (it is still not, yet, a done-deal number) that [ > 50ng ] is what I need to maintain in my system, this per my neurologist ( I am at [ 57 ] now). My PCP says [ > 30 ] is fine w/ her, but….. So – get an endocrin’s opinion, and as well, any other specialists you see. At the worst, you will end up (perhaps, perhaps) just ‘averaging’ their disparate-figures in order to come up w/ a goal you can shoot for. You are your own case-manager. Read, read, read….and of course: Good luck!

  17. Anu I.
    Reply

    Your suggested range is 32-100 ng/mL or 80-250 nmoL/mL.
    Anything above 32ng/mL is good

  18. PLA
    Reply

    Can anyone tell me what the suggested range should be on labwork for Vitamin D? Mine was at 16 when first diagnosed. Went to 34, then to 32. Will get tested again next month. I’ve increased the D3 from 2,000 to 3,000 IU’s daily.
    Thanks!

  19. GLE
    Reply

    I must disagree with Marie’s comment that D levels can only be raised with the use of Prescription 50,000iu D products, and not with OTC products or by sitting in the sun!
    My doctor suggested I aim to raise my D levels from the 20s to the 50-70 range. I have succeeded in achieving those levels using 5,000iu/day of OTC D3 supplements.
    Many researchers/experts are of the opinion that D3 is better utilized than D2, which is what most prescription products are. VitaminDCouncil.org is an excellent resource for research about vitamin D.
    OTC D3 products are available up to 50,000iu.
    And depending on your location and the time of year, 15-20 minutes of sunlight on bare skin can produce 20,000iu.
    I feel its important to correct the record.

  20. Cathie
    Reply

    Thank You so much. Your words have really helped me.

  21. Lokolo
    Reply

    I am 55 and was diagnosed with osteoporosis last April. This week, I find that I am deficient in Vitamin D (23) and will pick up my prescription tomorrow. I have felt fatigued and mentally foggy as long as I can remember. My question – Could it be that I have been Vitamin D deficient for years and this lead to osteoporosis?
    I know you have to have adequate amounts of Vitamin D and Magnesium in order for your bones to be able to absorb the calcium and keep your bones strong and healthy. Another question – Could this prescription (getting my Vitamin D to optimum levels) along with Calcium supplements start to rebuild my bones and reverse the osteoporosis? I refused the Fosamax due to all the side effects I read about when I researched this drug, however, I will take the Vitamin D since the effects mostly seem to be positive.

  22. Geri
    Reply

    Theresa, many docs prefer D3 (aka cholecalciferol) to D2 (ergocalciferol) (generally the Rx kind). I take 5000iu of D3/day to keep my levels where my doc likes them – 50-70. A great site for reading up on Vitamin D is http://www.vitamindcouncil.com

  23. PLA
    Reply

    I chose to take over the counter D-3 instead of the prescription strength. The Endocrinologist agreed and had me take 2,000 IU’s of Vitamin D-3 (gelcap form). My levels came up and that was over 3 years ago. During the winter months I have to take 3,000 IU’s. But am feeling much better. Helps with the aches, pains, and sleeping is better.
    By the way, the doctor said that this D deficiency is a widespread epidemic.
    Here’s to increased Vitamin D levels!

  24. Theresa
    Reply

    I got a message from my doctor on a Friday afternoon, but didn’t get to speak to anyone… Then Saturday, I received a call from the Pharmacy saying my prescription is ready. I never have prescriptions, unless in dire need of a serious illness, which hasn’t been in years… I just had my routine physical with blood work, SO, I am curious as to WHY I have a prescription. It’s the weekend and I decided to call the 24hour pharmacy to ask what was ordered and I was told VITAMIN D, 50,000 units to be taken once a week…. and I thought, WHAT??? WHY???
    So, I did some research and THIS BLOG was VERY VERY HELPFUL!!!!! And I am impressed with my doctor/internist… I am 44, not menapausal yet… So, I look forward to talking with my doctor on Monday… But, in the meantime, I will search for a NATURAL VITAMIN D… or alternative versus synthetic, I like WHOLE FOOD SUPPLEMENTATION… AND I REALLY LOVE the ADVICE with DOUG KAUFMAN on his show, “Know the Cause”…. I will report an update after I talk with my doctor & even though I am a very healthy woman, I do have aches in my elbows and knees, and I just thought I was getting older, but this VITAMIN D may just be my answer!!!!! YAY…… =)

  25. MDA
    Reply

    Great to hear….same diagnosis here….nurse explained that the low Vitamin D can cause muscle and bone pain….and tiredness…. I thought it was all because I was a bit overweight… can’t wait to get started on the once a week regiment!

  26. Rachel
    Reply

    @ Chris, hi, I just saw your post… gosh your symptoms sound very familiar! Yes, you will feel better but it takes about a month, maybe a little more. So glad you found someone who tested you for the “D”. Since my diagnosis I’ve shared my story with friends who have “weird” muscle pains, fatigue etc. and they were tested and found to be low as well! So make sure you get that information out there! Slowly you will start to feel better! Keep us posted my friend!

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