Vitamin D deficiency (6.56 vs. 30 - low normal), normal calcium, normal PTH
Can ONLY severe Vitamin D deficiency cause muscle twitching (all over body) ? PTH, CA, Magnesium, Phosphorus, Sodium, B12, thyroid levels, lupus tests, RA tests in normal range. EKG (including nerve conduction tests), MRI DONE and OK.
Symptomathology started after 4 weeks of gut pain and continued with arthicular pain and electric feeling, transitory, moving all over my body, cracking and popping sounds, panic attacks, arithmias, pinpricks. After starting vitamin D and Calcium, I only have twitches in my lips and soles of my feet. Also have a buzzing sensation ( feeling a vibration in the left foot on and off).
I had 2 months of complete symptoms remission in the summer after 2 weeks at the seaside.
Can Vit D be a cause of all my symptoms ? Also puzzeled why my PTH and Calcium/Phosphorus levels are normal while D deficient.
I currently take Calcium & D3 (2000UI).
Waiting for your helpfull answers.
Low magnesium can also cause all over twitching. Blood tests for magnesium rarely show low levels as over 95% of our mag is stored in tissues, not the blood. By the time a blood test shows it's low, you are almost completely depleted. Mag and calcium work together, but I have read that the combined supplement is not very effective. Try adding magnesium supplements, up to around 600mg a day is a limit for most people before you get a laxative effect. Magnesium ending in -ate is absorbed more readily by the body (such as magesium citrate, aspartate, or orotate). Epsom salt baths are even better as it soaks in through the skin. It can take a week or two before mag levels come up enough to feel a difference.
Have you been checked out for MS (other than the MRI)? I don't know where you are located, but could you have been exposed to Lyme Disease? Lyme can cause all the symptoms you describe (even the panic attacks). Lyme is known to cause Vit D and B12 and magnesium deficiencies. It can be tricky to diagnose as the symptoms can wax and wane, come and go, and seem to move around the body. You could ask your doctor for blood tests, but the CDC does say that a negative does not exclude it.
I had a similiar experience low vitamin d level with loads of twitching,and weird sensation in foot.
my doctor prescribed high dose vitamin D over a period of weeks, and most of my symptoms went away. i still have a funny sensation at times in my foot. all my other levels were normal.
Vitamin D levels below 30 ng/mL (75 nmol/L) are associated with a fall in the absorption of calcium from the intestine. Vitamin D deficiency may lead to muscle twitching due to calcium deficiency. Magnesium deficiency does cause muscle twitching however vitamin D levels will rise slowly or not at all (vitamin D resistance) without enough magnesium.
As your symptoms and vitamin D levels improved in the sun, the muscle twitching is most likely related to low calcium levels. The vitamin D council recommend vitamin D levels between 50 - 80ng/mL (125 - 200nmol/L) for optimal health.
Secondary hyperparathyroidism shows normal calcium levels with vitamin D deficiency. Excerpt from Linus Pauling Institute - Vitamin D deficiency...
"In vitamin D deficiency, calcium absorption cannot be increased enough to satisfy the body’s calcium needs (2). Consequently, PTH production by the parathyroid glands is increased and calcium is mobilized from the skeleton to maintain normal serum calcium levels—a condition known as secondary hyperparathyroidism. Although it has long been known that severe vitamin D deficiency has serious consequences for bone health, recent research suggests that less obvious states of vitamin D deficiency are common and increase the risk of osteoporosis and other health problems (16, 17)."
@ricobord: as far as all neuros told me, MS would be accompanied by other distinctive signs (visual, balance, numbness etc). The EMG. MRI and nerve conduction test should have showed smth wrong with the muscles/nerves. I know MS is difficult to diagnose due to almost invisible lesions. It could be a possibility, I know, but they said that my symptoms do not look like MS.
Lyme was tested and came back negative. Know it can be inconclusive.
@red_star: Quoting what you wrote, I need to ask smth that puzzles me:
"Vitamin D levels below 30 ng/mL (75 nmol/L) are associated with a fall in the absorption of calcium from the intestine". Why don't I have low calcium then visible in the tests due to this severe deficiency or high PTH (knowing that these two are connected). I understand (if correctly) that if I have low vit. D, the PTH should have been very high. Why are my PTH levels normal ?
@Helens1967: May I ask how low was you D level ?
My vit D was 14 about 8 months ago, and I don't feel much disconfort besides fatigue (which was probably caused by low WBC count). My doc put me on 50,000IU/wk D3 supplement and 2,000IU/day OTC after. 2 months ago, I went in fir recheck and it dropped to 11, that's about when the pain started to kick in. My own doc was town, and the substitute doc did not refill my prescription, only to continue 2000IU/day plus 30min daily sunshine. The last couple of weeks has been like hell for me - I feel achy everywhere. I'm waiting for the updated lab now. So from my personal experience, I have come to conclude that if your vit D level is under 10, it will be exceedingly difficult to function in a normal life without any prescription strength supplements. I doubt 2000UI per day would be enough for you.
Yes, I have had low vitamin D levels too; it was @ 8. I have also experienced the same symptoms you have. One physician told me that my fatigue couldn't be from this and I told him.....hmmmm....I don't agree.
I had a look at my labs from a few years ago and my results showed low normal PTH at 26 (14 - 72), very low normal "corrected" (i assume due to pH) serum calcium at 2.27 (2.25 - 2.65), moderate normal phosphorus 1.0 (0.8 - 1.5) and vitamin D deficiency at 30 (50 - 300). 30nmol/L is converted to 12ng/mL in your lab measurement.
So i too had "normal" PTH, CA and P with vitamin D deficiency. I had magnesium deficiency (unknowingly at the time however i had many symptoms with no diagnosis) which lowered both calcium and PTH levels. Magnesium is one of the causes of hypoparathyroidism.
My existing magnesium deficiency worsened further after i started taking high doses of vitamin D. After 6 months of 5000IU of vitamin D daily, i was still vitamin D deficient at 40nmol/L (16ng/mL). It's where your numbers fall in the "normal" range that may give you a clue to what is going on.
I had a very positive Chvostek sign so i requested an ionized calcium test (more accurate than calcium serum) and my results showed calcium deficiency. 90% of the time the Chvostek sign is positive due to calcium deficiency. For the other 10% this sign is normal. Tapping the facial nerve at the angle of the jaw in front of the ear causes spasm of facial muscles typically showing a twitch of the lips or nose. Youtube have a few demonstrations of the Chvostek sign.
A good quote from Dr Rind..
"Normal rather than Optimal. The frequently used term of ‘normal’ refers to a mathematical or statistical situation. Thus, a ‘normal’ state of health probably means you have some medical problems. It may be normal to die at 76 yrs of age, but at 75 years old, you may decide that what you really want is ‘optimal’ health as opposed to ‘normal’. Normal is not the same as optimal, whether it relates to longevity of life, a body temperature or a lab test result."
Thank you for your answer. Mine also are all in the lower normal.
Ionized calcium: 4 (3.6 - 5.2)
Phosphorus: 2.9 (2.7 - 4.5)
Magnesium: 1.9 (1.6 -2.6)
Potassium: 4.23 (3.5 - 5.1)
Sodium: 136 (136 - 145)
Pth: 31.79 (15 - 65)
During this lab test I was on Magnesium, Calcium and Potasium supplements. I was expecting them higher. I will also due an urine test to see if I lose smth there.
Never had the positive Chvostek sign but if I tap my checks, soles or my palms in certain areas, the muscle with visibly start to twitch. Before this there was no need for me to apply pressure in a certain area in order to make them twitch. They were visibly twitching. Now t's like they are "iritated" after applying pressure and start to twitch.
How long have you been taking your supplements? Levels take a few months to improve if you were deficient. Sodium levels are borderline. I had low normal sodium on my last lot of lab results which is no doubt due to hypothyroidism (started treatment two months ago) and adrenal insufficiency. Mayo clinic have a list of cause of hyponatremia (sodium deficiency). Just something to keep an eye on. :)
Two weeks of 1000 UI/day and one month of 2000 UI/day (and Calcium + Mg). My dr. is checking also the adrenal function now. This is the reason she gave me the urine tests. She thinks there might be a posibility of losing electrolytes.
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