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Vitamin D deficiency

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Posted 1/28/2013 7:00 PM (GMT 0)
My GI just called to say that all the other levels were fine but I have a vitamin D deficiency, it's 22,9 when it should be 50-150. He said to take supplements of 1000 units daily. Does this happen often after the colon is gone?
Posted 1/28/2013 7:14 PM (GMT 0)
     It must be quite common.  My vitamin D is low too, but the doctor didn't say anything about taking a supplement.  I suppose mine is not THAT low.
Posted 1/28/2013 7:58 PM (GMT 0)
No.. this really has nothing to do with the colon being removed. It is common that lots of people.. even with colons..have vit.D deficiencies.
Posted 1/28/2013 8:02 PM (GMT 0)
Vitamin D is absorbed in the terminal ileum - a place where, unfortunately, many people w/Crohn's have problems w/absorption.

Here is, in part, what the Mayo clinic says:

Vitamin B-12 shots. Vitamin B-12 helps prevent anemia, promotes normal growth and development, and is essential for proper nerve function. It's absorbed in the terminal ileum, a part of the small intestine often affected by Crohn's disease. If inflammation of your terminal ileum is interfering with your ability to absorb this vitamin, you may need monthly B-12 shots for life. You'll also need lifelong B-12 injections if your terminal ileum has been removed during surgery.

link: http://www.mayoclinic.com/health/crohns-disease/DS00104/DSECTION=treatments-and-drugs
Posted 1/28/2013 8:16 PM (GMT 0)
Well maybe I was always vitamin D deficient - who knows. I wouldn't have gotten my vitamin levels checked if I didn't have a jpouch.
Christine - you might want to check it because it can cause rickets and ostheoparosis because you need D to absorb calcium - and dd, thanks for relativizing that.
Nena, the doctors said all my B's are fine.

I'm going to pick up my supplements tonight from the 24 h pharmacy.
Posted 1/28/2013 10:20 PM (GMT 0)
It's definitely not 'colon' related. I know more people with intact colon's that have Vit D deficiency,than people without a colon.

Sue
Posted 1/28/2013 10:29 PM (GMT 0)
Not sure why but my husband takes B12 and Vit D every day. Never was a problem prior to his colon being removed I can honestly say but the labs indicate below normal ranges now.

His D levels have been very low and he also has a once a week 50,000 units he takes every Sunday for 9 weeks which just ended yesterday...this is the 2nd time he has had to supplement his daily D intake with a 9 week regimine to boost it up. Next set of labs we will see what his PC Dr says.
Posted 1/29/2013 1:46 AM (GMT 0)
50% of white people and 75% of people of color are vitamin D deficient is what my doctor told me. Me, my husband, and and all of our children are vitamin D deficient and I'm the only one without a colon. I take 5000iu a day and the kids take 2000iu a day. My husband takes 1000iu everyday.
Posted 1/29/2013 2:04 AM (GMT 0)
My doc said the same thing as above that basically most of the population is vitamin D deficient.
Posted 1/29/2013 4:31 AM (GMT 0)
Coincidental then as hubby's labs never showed this until after the surgery...plus we are full time Florida residents so we get the natural Vitamin D too.
Posted 1/29/2013 5:44 AM (GMT 0)
Another UC wife - did your hubby have his ileocecal valve removed as well? The very end of the small intestine/ileum, where it joins to the colon/large intestine, is where vit D is absorbed and where the ileocecal valve is located. I had a subtotal colectomy w/anastomosis in 1997 and my ileocecal valve was removed - that was enough to cause my vit D levels to drop below normal.

Here is a link to an article discussing just that: http://www.ileo-cecalvalve.com/category/surgery-on-the-ileocecal-valve

snip from link:

The purpose of the ileocecal valve is to keep the food in the small intestine and mix it with enzymes and promote digestion. It is not what you eat, it is what you breakdown and absorb. You can put the best gas in your car, but if it is not functioning properly you don’t get the performance you want. Post surgery of the ileocecal valve also affects the absorption of the fat soluble vitamins D,A, K, and E.
Posted 1/29/2013 1:40 PM (GMT 0)
     I take a Women's Over 50 multivitamin which contains D and also calcium with D.  The doctor didn't seem concerned, so my level couldn't be THAT low. 
Posted 1/29/2013 2:26 PM (GMT 0)
nenagirl...I am not sure....I'll have to check the operative notes and see if it is so mentioned....if not then maybe I can try to find that out for curiousity sake
Posted 1/31/2013 4:26 AM (GMT 0)
Hard to answer this question with all of our issues...

My B/D levels were better 6 months after surgery than before...

Of course, as with UCWife, I"m in Florida..so, no issues with not having enough "D" vitamin..15 minutes in the scorching mid-day sun and wallah...
Posted 1/31/2013 11:12 AM (GMT 0)
Nena,

We apparently had the same surgery, and yes my valve was removed too.. But no one has ever checked these levels for me. So I guess my question is, should I request that they be checked? My immune system has been shot to hell with all this! (sorry, but true). It is like I never really fully recovered from surgery, then everything else fell apart..
I seem to get infections REALLY easy, and then can't get rid of them..to the point where my primary care is so careful of antibiotics so I don't end up with c-diff on top of everything else!
I do know SOMETHING has to be off in the vitamin category because quite frankly all I can seem to digest with no issue is junk food. any "real" food that takes my belly time to process is awful! I have to eat much smaller portions, and it just seems to take forever to get anything to go thru my system.
I know I can't stay hydrated for crap! In fact, thinking I am going to have to go get iv's in the next day or 2..uugghhh. Then god only knows what I'll get from the e.r..... gggrrrrrrr... oh well, it could be worse!
Posted 2/3/2013 3:54 AM (GMT 0)
My ileocecal valve was also removed. My lowest Vitamin D score was less than 4. I took 5000 IU of Vitamin D3 a day for four weeks and my levels increased to 18.3. I am now taking 7000 IU of Vitamin D3 a day. Research is showing a correlation between consistent low levels of Vitamin D with pouchitis and irritable pouch syndrome. It is worth asking for the test. It is not part of a regular blood panel and in many places must be a special request from your doctor.
Posted 2/3/2013 10:33 AM (GMT 0)
Mrsbugzy - I would certainly ask your dr. to check your B-12 levels. As Subzero mentioned, make sure your dr. specifically orders the B-12 test as it's not always included on a regular metabolic panel (neither is magnesium).

The malabsorption/hydration/nutrition issues can be tricky when those most important pieces of intestine are gone or not in working order.

Good luck, I hope your dr. is able to get things back on track for you and that you feel better.
Posted 2/4/2013 11:41 AM (GMT 0)
A month after takedown my Vitamin D level was 9! The good news is the Vit D is one that responds very well to supplementation. I am obviously not a doctor but, 1,000 units seems low to me. I was on 4,000 units for one month and then moved to 2,000 units for maintenance.
Posted 2/4/2013 12:00 PM (GMT 0)
My GI wrote and said low D has nothing to do with colectomy, because it's taken up in the small intestine, he didn't mention where. D can drop to low levels after the colectomy because we've been sick in bed, at home, for ages.

Pancakes, I am not sure but it could be that units are different in Europe than in the US? I'll check what a unit is here. In any case, they will take blood again on march 4th to see how I responded to 1000 units and then make adjustments as necessary.
Posted 2/4/2013 6:40 PM (GMT 0)
I had my colectomy 2 1/2 years ago, have felt fine. I have just blood work done 2x a year when I see my hematologist.

Last month, saw my GI for the first time since surgery, because of some gallbladder pain. He suggested getting a CBC, B12 (like what was said above, depending what was removed from your small intestine, your B's going to be affected), Comprehensive Metabolic Panel, Folate, and D25.

I'm fine with the exception of Vitamin D....19. Regimen 50,000 IU's once a week for 8 weeks and I get retested. He also stated that it has nothing to do with a colectomy. Also, typical that I didn't realize the deficiency. But important to get supplemented because of bone density.
Posted 2/5/2013 8:39 AM (GMT 0)
Vit D is indeed absorbed in the small intestine - in the terminal ileum. However, not everybody who has an ileostomy or who has had a colectomy has all of their small intestine left intact. I have about 8 ft. (meaning about 13-15 feet has been removed) of small bowel, ending at the ileostomy/stoma located on my left side. Also, those with Crohn's disease often have inflammation in the terminal ileum that can lead to scarring and malabsorption in that critical area. Removing the ileocecal valve (a common site for obstruction/resection) entails removing a small bit of terminal ileum along with it - and that can also affect the absorption of vit D. The vast majority of total colectomies include the removal of the ileocecal valve.
Posted 2/6/2013 1:24 AM (GMT 0)
Vitamin D is so good for the immune system and a lot of adults are deficient on Vitamin D. We take 10,000 units a day for years now and haven't had as much as a cold and it did help my wife heal very quickly after the surgery. A friend of ours is a P.A. and she said half of the population is short on Vitamin D.
Posted 2/6/2013 1:23 PM (GMT 0)
Even though one may have the body part that absorbs D, we can still have a problem. Without a colon, our effluent differs chemically from feces. I have read that a higher fat content interferes with the adsorption of fat soluble vitamins (A,D,E, and K.) It is important to understand that we should sometimes check vitamin levels if we are unusually fatigued or have another problem. In our situation, we can become unbalanced!
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