Vitamin D on Treatment

[momof2jewels]

Would like to begin taking Vit D to help with depression while on treatment.  Anyone know what is considered an average dosage?  I've seen from 400mg to 5000mg.  Has anyone here taken Vit D for depression?

[momof2jewels]

Not at all.    Thanks for posting the info that you have.  You are fortunate to be able to have the care of Dr. Gish.

[momof2jewels]

Thank you for your responses!  I've come to learn there are no black/while answers with this treatment!  As soon as you find the answer to one thing...

[orphanedhawk]

Yes, it's D3.
My suggestion is to buy the liquid variety that takes 5 drops for 2000 IU. This way if your vitamin or calcium already contains D, you can adjust the drops to compensate and not be taking too much.

[JungleHeart]

What would you say to all this?  Vit D is ... just Vit D?  It comes like that?  Vit D .... period?

Again, I am writing like crazy, but this is an important issue as according to that linked article, Vit D plays a role in SVR.

[JungleHeart]

Sorry to keep blabbing here, but I have to say that now I am confused about Vit. D as far as treatment.  D3, yes with calcium.  But .... the list I posted says Vit D (nothing more).  I read flcyclist's link - and although it was written before the triple tx, it does mention Vit D.  

So - basically - clarification is needed from your treating physician (and mine).  I hope I haven't totally confused this issue - if I have, I apologize.

[JungleHeart]

But now I am wondering about the Vit D requirement that Dr. Gish has.  I will have to ask for specifics on that.  It would seem that it's Vit D3, but I'm not sure.  I AM sure that you need to take Vit D3 with Calcium.

Maybe someone else here has info. on this.

[JungleHeart]

This (below) is what is on Dr. Gish's list re. supplements.  It is prefaced by "Nutrition consultation:  Assess for vitamin A, vitamin D, vitamin E and zinc.... replace all supplements as needed."  I haven't done any consultation - my next appt. at his clinic in Vegas is August 30 - treatment starts after that (Victrelis) once everything (and it's a lot of stuff for him) is in order.

I will add the disclaimer that this is Dr. Gish's list, so you want to check with your treating physican in case this does not apply to you.  For Dr. Gish, it applies to all his patients who are on Triple Therapy.

Vit D 2000 IU per day or equivalent  Vit D target is 50 (whatever that means)  And I'm sure it's Vit D3 although he didn't specify.  I can't check on that until I go back on August 30, but it has to mean D3

Vit E 400 IU, Trader Joe brand (well, I'm not near a TJ's but will get at health food store)

Fish Oil 1 large capsule per day

Folate 800 mcg per day

Calcium 1200 mg per day (but this would increase per your pdoc if you have lower bone density as I do)

Baby ASA (aspirin, I think) 81 mg 2x per day as per your PMD (pdoc) if no cirrhosis

Hope this helps, but again, I can't answer questions specific to you, like if it's Vit D in all cases.  I'm not a doctor.  But yes, you do need Vit D3 if you're taking calcium.

[momof2jewels]

Do I only need Vitamin D3 if I'm taking Calcium?  Or is it Vitamin D3 in all cases?

[momof2jewels]

Are you taking Calcium also.  I honestly don't know if I can force another pill.  My chiropractor has Vitamin D liquid that I'm considering.  Any thoughts on that?  Thank you for your great input, as always.

[JungleHeart]

I don't know what the difference is between D3 and the "other D's" but for sure it is Vit. D3 that you need.  Definitely.

[JungleHeart]

Susie, I'm glad you mentioned that it has to be Vit. D3.  I went to bed last night and realized that maybe this hadn't been stated - so thanks for adding that.  Vit. D3 is required for the Calcium to "work" - right everyone?

And I wonder if it's better to split up the dosages like you do.  It seems like a good idea.  I'm going to do that.

[willbb]

Studies have shown that approx. 60% of people with HCV are either Vitimin D deficient or have insufficient amounts when measured.
The normal reference range is 30 -100 ng/dl as flycyclist mentioned.
The message seems to be that adequate levels should be monitored for as it "may"be of a benefit for general health and possibly improved treatment response.
Vit D however is a fat soluble vitamin and stored in the liver ,therefore excessive amounts could  be harmful.
Seems like everything else...moderation to insure adequate levels is best..

.I was tested for Vit D when I started tx. and was slightly deficient  and my hepatologist put me on 2000 per day while treating ,,which I still take and my level is maintained at 40ng/dl.

Will

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950664/

G&H What research is needed with regard to vitamin D deficiency associated with liver disease?
SN As noted above, clinicians and patients need to be more aware of the potential for and risks of vitamin D deficiency. Current research needs include evaluating the role of vitamin D supplementation to enhance treatment response among patients with hepatitis C and the role of actin-free vitamin D binding protein in hepatocellular carcinoma. In addition, it is important for us to learn the optimal duration and dose of vitamin D replacement for patients with liver failure.
G&H Should patients with liver disease be monitored for vitamin D deficiency?
SN Yes. All hepatologists should monitor vitamin D levels and treat deficient patients. The goal for all patients with chronic liver disease should be a 25-OH vitamin D level of 30 ng/mL. Anything less than 15–20 ng/mL is considered deficiency.
G&H Has vitamin D deficiency always been a problem for people with liver disease, or has this been changing recently?
SN It is likely that it was always a problem, but the data from the National Health and Nutrition Examination Survey indicate that the mean serum level of 25-OH vitamin D has decreased over the last 2 decades. It may be that the more severe vitamin D deficiency is only now coming to light.

.

[momof2jewels]

Really?  I didn't even know there was a Vitamin D3.  What's the diff?  Thanks for the tip!

[SusieS2010]

I take 600 mg 2 times a day with my calcium and then take 1000 mg alone. My vitamin D levels run at high normal. BTW, make sure it is vitamin D3.

[Dee1956]

This is really good information, thank you all for sharing

[orphanedhawk]

Yes, not only is it okay but it is recommended during tx.

http://www.hivandhepatitis.com/2010_conference/easl/docs/0518_2010_b.html

http://hepatitiscnewdrugs.blogspot.com/2010/10/what-about-vitamin-d-and-hcv.html

Oops, I just saw flcy already posted the links !

[rivll]

Thanks, that is exactly what I was looking for. On it next week.
:-)

[JungleHeart]

Dr. Gish says 2,000 mg of Vit. D per day.  Always - tx or not on tx.  Most of us are deficient in this vitamin to begin with.

Rivil, I have been taking Calcium Citrate for a while.  But I'm going to solo both the Calcium and the Vit. D.  It's hard to find a combo that has 2000 mg of Vit. D and enough calcium for me (I have osteopenia).  OR if you have a calcium/D combo that works for you, yes, just take enough D to get to the 2,000 mg mark.

Just my humble opinion :)

[Dawn703]

OOps this is it

http://www.hivandhepatitis.com/2010_conference/easl/docs/0518_2010_b.html

copied the other from another post to check out

[Dawn703]

I have read the same as ceanothus. Also, I have been taking vitamin D all during treatment, with Dr's approval. Adding vitamin D was due to this that I read and the fact that most people are deficient. I have to add that I only take fat soluble vitamins for six days and rest a day.

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Next%20steps.pdf

[rivll]

I have Vit. D and calcium together. If I increase the Vit. D should I take it solo?

[ceanothus]

Hi Mom, I have the best primary care physician in the world (sounds like hyperbole, but I do genuinely believe it). She makes time for a lot of journals, to keep up with the latest research in medicine. A few years ago she started recommending vitamin D  (2000 mg daily) to most, if not all, of her patients, as more studies were showing that defiency is fairly common and that supplementation can bring a broad range of health benefits. There were a lot of details that I've forgotten but I was totally persuaded. When I started triple tx with Incivek in October 2011 I asked my hepatologist about vitamin D and was told it was fine to continue during tx. Your situation may be different but my own story can give you a general idea anyway.

[Revalation]

My doctor suggested I take Vit D as my level were low.
Has you're doctor checked your D?
Maybe you should ask about you situation.

Reva

[flcyclist]

Prior to taking vitamin supplements you should consult with your doctor to get their approval.  Vit D deficiency has been associated with anxiety and depression and a high % of patients with chronic HCV have been shown to be Vit D deficient.  

The first step would be to have your Vit D level checked which is an easy test.  I had mine tested early in tx and was found to be deficient.  I took 5,000 IU/mg per day thoughout tx and it took about 1 month to bring the Vit D level into normal range.  It doesn't happen quickly.  

There have also been several studies done and articles published on the positive benefits of Vit D supplements, such as increased SVR and improvement in liver fibrosis.  You can google these studies yourself, but following is one:

http://www.hivandhepatitis.com/2010_conference/easl/docs/0518_2010_b.html