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Hello – I hope you can help me. I am 51, height 59 1/8" (150.5cm), weight approx. 81 lbs (37kg).  Ethnic origin. I had blood test done on December 31 2018 – because I had to have bunion surgery on both feet – which was carried out on January 14, 2019. From these blood test results, my doctor said my Hemoglobine was low and so prescribed me Bion3 multivitamin for 30 days. I had a blood test again on March 19, 2019 (approx. 2 months after my bunion surgery).My doctor said that my vitamin D was low (6ng/mL) and so prescribed me 100,000 IU (2ml in a vial) – to be taken once a month for six months – and to have a blood test again after 10 weeks during this period. During this consultation, I also mentioned to him that I had developed severe back pain and was struggling to bend over even to put my shoes on and I had pain especially in my knees and was struggling to walk.  (But he saw for himself that I was hobbling around like an old lady).  He said to see a physiotherapist as this pain was due to the fact that I have not been walking because of the surgery on my feet. So I took the 1 dose (100,000 IU) on March 26, 2019. After coming home, I took another look at the test results for the vitamin D and took the time to read the short paragraph under the table of recommendation values of vitamin D. It was the words “rickets” and “osteomalacia” that caught my attention.  So, I did my research on those and bearing in mind my symptoms, came to the conclusion that it’s extremely likely that I may have osteomalacia as I had rickets as a baby. Based on all the research and info I have gathered – I was thinking of taking a dose of cholecalciferol D3 40,000 UI daily for 1 week together with a dose of K2 MK7 600mcg, then reducing this to twice a week. I should receive these 2 items by this weekend. I am reaching out to you because I would appreciate your thoughts on this and just to make sure that I am on the right track to ‘recovery’ and not my ‘grave’. When I think about it now, I believe that my vitamin D levels have always been low (because of several symptoms over the past few years especially, without realizing it’s not normal) but because of this recent surgery, my body has been drained of what little supply I had and has been directed towards the healing and regrowth of bone in the feet – which has now basically left me crippled and not able to do simple daily chores.  It really saddens me, and I am not coping very well at the moment to say the least. I was also planning to have a retest after 2 months perhaps – and to also request to be tested for Total Calcium, Magnesium, Vitamin A, Zinc.  I don’t want to keep going for frequent tests so I’m trying to think of anything that is important and that matters. I can send you the detailed results of my blood test if that would be of any help. I look forward to hearing from you. Kind regards

Asked by  Mona on April 2, 2019

Answers
  •  Mona on

    See title

    Answered by  Mona on
  •  IAW on

    Hi Mona!
    You are correct with a Vitamin D level below 10ng/ml, it is highly likely you have Osteomalacia.
    Since you took the 100,000iu on March 26th, I counted 8 days and that averages 12,500iu a day. We recommend treating a deficiency by taking 8000-10,000 iu A DAY for 8 weeks and then retesting. It is far better to take a smaller amount daily rather than large dosing. Large dosing can cause the Vitamin D system to dis-regulate. I would stick to 10,000iu a day for 8 weeks. I have also seen several people take huge bolus doses and then that decreased mineral levels so much that they then had symptoms from that.
    It will do you no good really to test mineral levels. This is because blood tests for any mineral only measures the 1-2% in your blood stream and not total body stores. You can still be deficient but be “in” range and still have symptoms of the deficiency.
    You said “I should receive these 2 items by this weekend.” I hope both of these amounts can be broken down into smaller daily amounts.
    If you haven’t already please read http://www.vitamindcouncil.org/about-vitamin-d/vitamin-d-and-other-vitamins-and-minerals/. It is very important! You may just want to take some supplemental magnesium and calcium for the 8 weeks and the K2 is very important.
    In 8 weeks time your level when you retest should be at 80ng/ml orprobably higher since you do not weigh very much. If it is not anywhere near that level, come back and tell me. This would mean something is wrong if your levels have not recovered by then. IF your level is “high” AND you feel better you can then take a maintenance dosage of a minimum 4000iu. We usually recommend people weighing 150lbs take 5000iu but you weigh a lot less. If you take the 5000iu daily your level will be above 50ng/ml which is the minimum level we recommend. Having a higher level will not hurt you.
    If you have any other questions, just ask!

    Answered by  IAW on
  •  Mona on

    Hi IAW
    Thank you so much for your quick response – much appreciated.
    Just to let you know that I can regulate the amount of the vitamin D, as it comes in liquid form – 1 drop = 5,000iu – so I could take 2 drops each day. The K2 is 600mcg per capsule, so I can’t break that down, other than take 1 every other day, or even every third day, if you think that 1 per day might be too much per 10,000iu.(I’m not sure really).
    Thank you for all this information – it has been extremely helpful. I will look into the Magnesium and start taking a dose of that also. What do you think the ideal dosage of that would be in relation to the dosage that I would be on for the D3 and K2 – or does that not matter as such?
    Thanks again.

    Answered by  Mona on
  •  IAW on

    The co-factors for Vitamin D3 are not based on how much D3 you take. For the most part they are based on the governments RDA. For example the RDA for Vitamin K is 90mcg a day for women. So unless a study comes out that proves more is necessary, will that change. Even then it sometimes unfortunately does not change the RDA amount. An example of that is magnesium. In the link I gave above, it says there are studies that show the RDA “may” be too low. So maybe you should take the K2 every 3rd or 4th day.
    Everybody should look at their diet and decide if they need supplements and how much. For people like you, with a level that low, especially if they have Osteomalacia symptoms, you may want to at least take some supplements for 8 weeks at least. If your intake of magnesium is not high enough, Vitamin D will probably give you symptoms. Magnesium is also needed for bone growth. How much to take is a guess on my part. Maybe 200-300mg. If you take too much and your body does not need it, you will most likely get loose bowels. If you get adequate calcium in your diet then maybe around 500mg for the 8 weeks and then stop. High amount of calcium are not necessary if you have enough in your diet AND have adequate levels of Vitamin D.
    Hope this helps!

    Answered by  IAW on
    •  Mona on

      Hello again IAW
      I have been retested after 2 months.
      I started on April 8th and did a retest on June 5th. My Vitamin D level results are now at 101ng/mL.
      I have been taking Vitamin D (15,000iu daily) along with K2 (600mcg every 2nd day), Calcium (500mg daily) and some Magnesium (I’ve tried several different forms of magnesium – tablets were huge, so tried them crushed but couldn’t handle that either – then tried it in liquid form, which was better) – so it’s been on/off with the magnesium.
      My back feels much better and I can sit and stand up now without all the pain. My knees are still a problem though.

      Over the past few weeks I have also had the following examinations:- MRI of my knees (because they are still very weak and cause me pain so unable to stand/walk normally for any length of time. The results showed that I have degenerative changes in the medial meniscus but no tear. The cartilage under my knees has worn out quite badly.
      I’ve had x-rays of my back – result = I have a compressed disc at lower end of spine and not so good at the top end of my spine.
      I’ve had a bone density test – result = I may have osteopenia (it’s in French so I don’t understand the report fully – I’m seeing my new GP next week to find out what the results mean).

      So based on the dosage I’ve been on for the past 8 weeks and what my levels are now – what would you recommend I take for my maintenance dose of Vitamin D? At the moment I am still taking the dosage as I’ve mentioned above – but I need to reduce it now to how much?
      Thank you.
      I look forward to hearing from you.

      Answered by  Mona on
  •  IAW on

    I am glad you feel better but sorry we could not fix everything!
    I am “surprised” that at a weight of only 81lbs and taking 15,000iu a day, that your level was not “a lot” higher than 101ng/ml.
    Normally I would say taking 5000iu a day should be enough for a maintenance dosage BUT it does not look that way when you look at “your” figures. My first guess would be if you take half the amount you were taking, 7000iu, your level should go down to around 50ng/ml. Another way to look at this is the following. A “general rule of thumb”, is for every 10ng/ml you want to lower or increase your level, take 1000iu less or more. “Healthy” is 50ng/ml. So if I do that and work back from 101ng/ml, that would mean you should take 10,000iu.
    Maybe you are still trying to repair some “bone” and that is why the levels are not working out like they should. (This is a guess on my part.)
    So now we have to “guess”. You could take 10,000iu for 8 weeks and retest. If your level is right around 50ng/ml, then you need to keep taking the 10K. If after 8 weeks your level is 70ng/ml, then you could take 7-8000iu. If you want to try taking 7-8000iu for the next 8 weeks, you can do that. I “highly” recommend that you get retested at that time to make sure you levels are not falling below 50ng/ml.
    If it turns out that the above is true and you need to take higher amounts, the thing I do not know is for how long you might have to take the higher amounts for.
    So I would suggest testing every 4-6 months and if all of a sudden your level increases a lot, then I guess your body finally “repaired” what it needed to and does not need the “extra”.
    I hope I explained that well enough but if you have more questions, just ask!

    Answered by  IAW on
    •  Mona on

      Dear IAW
      Thank you for your quick response.
      It’s thanks to you that I have made such a recovery so far – you’re a God send.
      And thank you so much for the detailed explanation, it’s very helpful.
      I’ve started taking the 10,000iu daily and will retest after 8 weeks. I will let you know what the results are.
      I am still looking for a magnesium in liquid form that’s not a silly price.

      Since 2012 I’ve been struggling with frequent headaches and living with a sore tongue (amongst other ailments).
      But since starting on the Vitamin D, my tongue got back to normal immediately, I still can’t believe it!!
      Since 2015 I have this sound in both my ears and I’m very sensitive to certain sounds (I have Hyperacusis & Tinnitus) – and I thought that perhaps this was causing my frequent headaches – anyway I started to log down my hours of listening to pink noise and I thought to make a record of my headaches also. Some months I could take anything up to 30-40 tablets per month. But that has dropped down now and I am guessing that’s because of the vitamin D that I’m taking now. In April I’ve only taken 6 and in May it was 14.
      So this is also another reason why I would also like to add Magnesium supplement because I read that Magnesium Citrate could help with headaches, fatigue, memory etc.
      I’m not sure if this has been proven or not – but it would be a bonus for me if it helped towards the headaches and memory.
      I’ve never taken supplements of any kind before, but it looks like I’m going to have to rely on a few essential ones now – because I don’t have a very big appetite and so I believe I can’t get enough nutrients from my daily food intake (it’s very poor compared to the average person – I just don’t get hungry!). So I’ve been looking into Vitamin A, C & E combined, hoping it would help me along.
      Thank you so much again for your time and help. I’m looking forward to the next retest after 8 weeks.
      Kind regards.

      Answered by  Mona on
  •  IAW on

    Yes, please let me know what happens in 8 weeks!
    As for the magnesium, I guess you do not like to swallow pills. What happens when they are “crushed”? Does it taste bad even if you mix it in something?
    I am not sure if this will be better but there is such a thing as “magnesium oil”. You rub it on your skin, and it absorbs that way. People say it does work and will increase levels. You may even be able to make your own but you will have to “google”. You might be able to make more progress, if you can increase those levels.
    I am glad we could make you feel better!

    Answered by  IAW on
    •  Mona on

      Thank you – I will look into the oil. And yes, I’ve tried crushing them into powder and mixing it in with some yoghurt for example, but it’s just so drying, I gave up with that. I will definitely look into the oil – thank you again.

      Answered by  Mona on

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