Perhaps an introduction is in order.

I just called them, total vitamin D was 10 (n-25-70), but d2=<4 (normal) and d3=10 (normal)...how could the D level be low and the D2 and D3 be normal???
Vitamin b was not ordered, nor was calcium.
Iron was 13 (n=40-175) and zinc was .45 (n=.65-1.05)

Perhaps they were thinking some of this would resolve soon since he's been eating more...
I will go today for the folate.

Old Hat said...
Too many people here are second-guessing the doctors! Simplified's son IS RESPONDING to steroids, for crying out loud. It is not your place to insist that he has to be put on 5-ASAs at this point!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! The doctor does seem weak on vitamin supplementation, though-- probably one who either doesn't keep up with current pro lit or doesn't believe that it impacts on inflammation. Remember guys replying here: this is a pediatric case, NOT AN ADULT. Grrrrrrr. / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)

Thank you for reinstating that this is a pediatric case. It does seem that my doc is unknowledgeable on the supplement side of things, but he did give me two weeks worth of VSL3.

But to be clear, I am not certain my son is seeing improvement with the steroids. Things didn't seem to turn until I added the Claritin and the DAO (the other stuff, herbs & glutamine, has only been a couple days). I'm still not sure how steroids affect HIT if at all, but I have witnessed histamine aggravating his symptoms.

It's good that the doctor listens to your son's self-report. He will gradually have to learn to manage UC himself in cooperation with reliable medical care providers. It seems there are now reasons for you to feel more positive, especially if he is able to eat regularly. The doctor probably does deem it better to get nutrients from food rather than to supplement intensively at this stage in your son's treatment. I'm not surprised if that is the case. Many times a conservative approach works very well to heal UC inflammation. Best wishes for your son's continuing improvement; definitely keep us posted as time permits. / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)

I don't know about the pediatric norm values for vitamin d, but it seems pretty low to me. I guess you might be able to google it especially since your doc seems clueless.

For adults, the ideal should be 40-55, and for those with auto-immune conditions (of which UC is one), I've read higher levels are indicated.

My own levels are in the high 60's.

Old Hat said...
Too many people here are second-guessing the doctors! Simplified's son IS RESPONDING to steroids, for crying out loud. It is not your place to insist that he has to be put on 5-ASAs at this point!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! The doctor does seem weak on vitamin supplementation, though-- probably one who either doesn't keep up with current pro lit or doesn't believe that it impacts on inflammation. Remember guys replying here: this is a pediatric case, NOT AN ADULT. Grrrrrrr. / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)

if you think prednisone is some kind of long term answer for a pediatrics case, then i'll just agree to disagree.

But, simplified said it herself, she isn't certain he's responding that well to steroids... And read simplified post about how the doctor wanted to eventually transition to a mesalamine. The alternatives being REMICADE or 6MP which BTW in a pediatrics case, or any case for that matter are substantially riskier drugs, especially in ped's cases. (this isn't meant to scare you simplified, just point out that remicade and 6mp are usually brought into the game when more mild drugs have failed)

Mesalamines generally are the most ideal of the maintenance drug as long as the patient can tolerate them (speaking from personal experience, i haven't been lucky with them but the majority of people do).

Regardless, the most important thing is that he starts to feel better. I can't imagine what it has to be like for a 13 year old to go through this... But he's a trooper and sounds very disciplined when it comes to making dietary changes.

Old Hat said...
Steroids treat SEVERE UC flares. I did not write a word ANYWHERE EVER on this forum recommending that ANY UCer stay on steroids long-term, however. Try to calm down, Josh, and be more objective. We old folks on the forum have had to deal with severe flares when the only existing UC meds were steroids & sulfasalazine!!!!!! / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)

no offense, but you telling me to calm down and be more objective is a joke. especially when you seem to love to overuse caps and exclamation points to emphasize your rudeness. you attacked me, not the other way around.

i'm plenty objective, and would hate to see simplified's 13 year old go straight to remicade or 6mp before trying a mesalamine type medicine which has far fewer risks and side effects. i mention something about mesalamines and you jump down my throat quoted directly by you "Simplified's son IS RESPONDING to steroids, for crying out loud. It is not your place to insist that he has to be put on 5-ASAs at this point!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!" Sorry but Simplified later corrected you stating she was unsure if her son was even improving from steroids.

In any event this thread is about Simplified's 13 year old child, not some kind of contest about who's right or not. bottom line, we don't live in days of old where medicine options are limited. there's a broader array of options but all have their fair share of drawbacks. mesalamines if they work is by far the better option when it comes to medications.

5-ASA meds are NOT the 1st line treatment for severe flares. Period. / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)