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Alfacalcidol for Vitamin D deficiency ? I have been suffering for a few years with some issues: – chronic fatigue (physical and mental) and letargy – anxiety – muscle weakness – cognitive difficulties: poor memory and concentration, unable to perform complex mental work – sleep disturbance Last November, I did some tests (common blood work, blood sugar, cortisol, thyroid, electrolytes) and the only thing, which came out abnormal was a mild hypercalcaemia (2.67 mmol/l, ref.range 2.15 – 2.57 mmol/l). In this case, the first thing to look out for, is hyperparathyroidism. PTH (parathyroid hormone) came out normal. Following that, I did a 25-OH Vitamin D test. I found the missing piece of the puzzle, the very reason I was suffering all this time – a very severe deficiency at a level of only 8.9 ng/ml ! All these symptoms started to make sense. The paradox with Vitamin D is that an eventual overdose could cause hypercalcaemia – that much is clear, but at the same time a deficiency can also be the reason for a mild hypercalcaemia (while PTH is normal). The symptoms I am experiencing are from the hypercalcaemia actually. I was prescribed by an endocrinologist Alfacalcidol for 6 months, 1 microgram/day (seems a proper dosage conversion to IU is not applicable). About 3 months have passed since starting taking it, and sadly absolutely no improvement is noticeable in general. The story with this particular form is that it is not exactly Vitamin D3, but something further up the metabolic chain. It just acts as Vitamin D by regulating calcium metabolism. I read it is being prescribed for osteoporosis, for primary hyperthyroidism, and for some other issues due to it's strong immunomodulating properties. Also, it is quite suitable for people with kidney issues, since kidneys are being circumvented along the metabolic chain. However I didn't manage to find a single source, where Alfacalcidol is suggested to be used as a supplementation for Vitamin D deficiency. Quite the contrary – I read that prescription of this particular form IS NOT ADVISABLE for this particular purpose. Due to being a relatively new form of Vitamin D, the available information about it is still quite limited. I suppose my endocrinologist may just have been very wrong. One other thought: since the only way to objectively measure Vitamin D in our bodies is by checking actual blood levels of 25-OH Cholecalciferol, we should not expect supplementing with a higher-up metabolite to raise actual blood levels of Vitamin D3. Am I right ? At 3 months into supplementing, I am about to undergo a second test (as advised), but it turns out it may be just pointless. Thanks in advance !

Asked by  Yavor Nachev on March 6, 2015

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