Twelve-months after surgery, 72% of subjects taking 50,000 IU D2 weekly had optimal vitamin D status. Fifty percent of subjects taking 2800 IU D3 daily and 50% of the subjects taking 1200 IU D3 daily had optimal vitamin D levels. That means 28% – 50% were not!

In another study published in the February 2008 issue of Obesity Surgery: “VITAMIN D AND THE BARIATRIC SURGICAL PATIENT: A REVIEW” this was the conclusion: Both secondary hyperparathyroidism and bone loss were common, particularly when the obesity surgery included a malabsorptive component. Standard postsurgical supplementation with vitamin D and calcium have not been adequate to suppress secondary hyperparathyroidism or to restore 25-hydroxy vitamin D status.

The reason this is so startling is that these patients were taking high doses of the vitamin and on a frequent and monitored basis. As I’ve posted before, Vitamin D is not a vitamin most doctors tell their patients to supplement with. I received some blowback from my prior “Flintstones” postings from those who were just fine. But based on this study, anywhere from 28%-50% can still be deficient even with supplementation. What does that say for all of those patients who aren’t supplementing with Vitamin D – and studies show as many as 30% don’t even take a multi-vitamin – I bet it’s even higher for Vitamin D because they just don’t know?

I have been taking 5,000 – 6,000 IU of vitamin D3 per day and my levels were only 46. I would have thought they would be higher considering the supplements I was taking.

What does Vitamin D do and what are the symptoms of deficiency? I think that is the biggest problem – that most doctors aren’t familiar enough with symptoms of nutrient deficiencies and do not associate behavioral changes with nutritional deficiencies – in addition to which there may not be laboratory testing methods available. And unfortunately today’s doctors live and breathe by lab results rather than the old fashioned physical exam.

Deficiency in vitamin D can cause cognitive impairment, impairs the body’s ability to appropriately utilize the calcium that many patients do take compliantly, impairs the immune response systom, is associated with increased cardiovascular problems, high blood pressure and increased risk of cancer. How can it affect so many areas? Because other nutrients (vitamins and minerals) are dependent on it to do their job – it’s the limiting factor. So when looking at symptoms of vitamin D deficiency you also need to look at symptoms of calcium deficiency, parathyroid impairment, pancreatic impairment, etc.

Vitamin D is one of the fat-soluble vitamins and you can obtain it from only a handful of natural dietary sources (fatty fishes), fortified dietary sources (milk, yogurt, cereals) and your body can generate it in the presence of sunshine. Supplements use either vitamin D2 (ergocalciferol) or D3 (cholecalciferol). Most medical professionals are recommending the D3 form, but this study seemed to indicate not much difference between the two. Most fortified foods use the D2 form as it is the cheaper form.

When they test your blood for vitamin D, they test mean serum 25(OH)D concentrations. There was been much debate in the medical community of late as to what is an optimum level for health, versus the minimum to keep adverse health effects such as rickets away. Normal values according to the lab are considered between 33-49 ng/ml and optimum levels are 50-65 ng/ml. I am still only in the normal range. I would rather be in the optimum.

Here is an exerpt from the following website: “Obese individuals who have undergone gastric bypass surgery may become vitamin D deficient over time without a sufficient intake of this nutrient from food or supplements, since part of the upper small intestine where vitamin D is absorbed is bypassed and vitamin D mobilized into the serum from fat stores may not compensate over time”.

http://www.endotext.org/parathyroid/parathyroid3/parathyroidframe3.htm

You can find the studies I referenced here:

http://www.umaine.edu/graduate/research/efficacy-three-different

http://www.ncbi.nlm.nih.gov/pubmed/19017827?dopt=Abstract

http://www.ncbi.nlm.nih.gov/pubmed/18176832?dopt=Abstract