Blood test for Vitamin D levels

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18 January 2016 at 5:53 am #9590
Dr James
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@fixhepc
Hi all

I saw Dr Freeman’s post regarding some patients’ (on the old treatment) low Vitamin D levels which may or may not affect SVR. Just a quick question, I have only 2 1/2 weeks to go on my treatment and was wondering if it is worth having a blood test to check my Vitamin D level or not. Have had so many blood tests over the last 12 months one more won’t hurt but if it is not necessary I won’t have it done…thanks in advance.

Cheers
Lynne

YMMV
18 January 2016 at 3:24 pm #9664
Dr James
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@fixhepc
Hi Lynne,

Probably no point in having it checked but if you don’t see much sun chances are your levels are low. 5 tablets on day 1 and then 2 a day for the next 2 weeks then stop would give you decent blood levels for the last 2 weeks and be highly unlikely to cause any problems.

YMMV
19 January 2016 at 12:33 am #9703
Dan
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@dan
My last Vit D test result was 86, which was in March 2015. My GP told me that I don’t need to take additional Vit D tablets if it is >50.

Dr James – Do you know what is the range for Vit D, B and E?

Thanks

Gen 1b, F1-F2. Naive.
Started Twinvir tx on 2 nd of December 2015 for 12 weeks.
Starting VL 400000, Alt 49/AST 44
1 week VL 29, ALT 44/AST 30.
4 weeks VL 12, ALT 33, Platelets 145, all other tests normal.
7 weeks VL Detected, ALT 28, all other normal
8 weeks UND, 12 week UND, 24 week SVR UND
19 January 2016 at 12:50 am #9704
flyingfox66
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@flyingfox66
I got 23 ng/ml and my GP told me that was fine, but since then google has told me it’s too low…
https://www.vitamindcouncil.org/about-vitamin-d/testing-for-vitamin-d/
There seems to be a major disconnect between what is considered normal by my GP and by the Vitamin D council…more than double in fact, so it’s a good thing I checked online. I wonder why there is such a huge difference? Just getting my GP to do vitamin tests is like pulling teeth.
Doing the sun baking and supplementation in preparation for treatment (and in the hope that it will help my teeth)

F49HepC25ysGT1a
mild”
19 January 2016 at 1:54 am #9707
LondonGirl
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@londongirl
There seems to be a major disconnect between what is considered normal by my GP and by the Vitamin D council.

That’s for sure. My previous hospital did a test, but I had to ask. Not sure why it’s not standard for people with HepC.

Apparently , in the UK Ricketts and similar illness are making a return due to lack of sunshine!

GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 ‘In the slow lane’
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC
19 January 2016 at 2:23 am #9713
flyingfox66
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@flyingfox66
Interestingly Australia has some of the highest levels of Vit D deficiency around, in spite of all the sunshine.
Possibly because we are trained to cover up at all times for fear of skin cancer.
I’m a bit curious too now about B 12 levels, which are a bit harder to check up on online.

It’s pretty astonishing to me how little interest has been shown in monitoring my Hep over the years. My GP seemed to think if the liver functions were okay thats an end to it, but reading everyones stories now I realise this was far from the truth. My experiences of symptoms are too similar for them to be a coincidence so clearly, even when its not actively destroying your liver, the Hep is still taking its toll.

F49HepC25ysGT1a
mild”
19 January 2016 at 3:44 am #9719
Gaj
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@gaj
flyingfox66 wrote:

There seems to be a major disconnect between what is considered normal by my GP and by the Vitamin D council.

Well, possibly the VitaminDcouncil are strong advocates of higher levels? They recommend more than everyone else they list. Here is a quote from wiki ( which of course could also be wrong ) but it does suggest your GP is in the ball park for general recommendations.

”The Institute found serum 25-hydroxyvitamin D concentrations above 30 ng/ml (75 nmol/l) are “not consistently associated with increased benefit”. Serum 25-hydroxyvitamin D levels above 50 ng/ml (125 nmol/l) may be cause for concern.[59] However, the desired range of serum 25-hydroxyvitamin D is between 20 and 50 ng/ml.[59]

The risk of cardiovascular disease is lower when vitamin D ranged from 8 to 24 ng/ml (20 to 60 nmol/l). A “threshold effect” appears to occur once a level of 24 ng/ml (60 nmol/l) has been reached i.e., levels of vitamin D over 24 ng/ml (60 nmol/l) did not show added benefit.[145]”

https://en.m.wikipedia.org/wiki/Vitamin_D

And from the Doc’s post on the subject.

“High rates of SVR were observed in HCV individuals with vitamin D levels above 30 ng/mL”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793147/

That would suggest to me that during Tx for HCV we should be aiming for >30 Ng/mL but not too much more. Otherwise 23 Ng/mL is probably acceptable?

– someone with very little knowledge on the subject but who is eagerly awaiting the results of his Vitamin D & B12 tests.

G3a since ’78 – Dx ’12 – F4 (2xHCC)
24wk Tx – PEG/Riba/Dac 2013 relapsed
24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 – 22/06/17 UND
SRV12 – 27/07/17 UND
SVR24 – 26/10/17 UND
19 January 2016 at 5:05 am #9735
Gaj
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@gaj
Make sure you are comparing apples with apples though. There are two different measurement systems in use: ng/mL and nmol/l

nmol/l is 2.5 times as high as ng/ml so:

20 ng/ml = 50 nmol/l

30 ng/ml = 75 nmol/l

40 ng/ml = 100 nmol/l

50 ng/ml = 125 nmol/l

I suspect Dan’s result of 86 is nmol/l which is 34 ng/ml and is >30 ng/ml so should be fine?

G3a since ’78 – Dx ’12 – F4 (2xHCC)
24wk Tx – PEG/Riba/Dac 2013 relapsed
24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 – 22/06/17 UND
SRV12 – 27/07/17 UND
SVR24 – 26/10/17 UND
19 January 2016 at 5:42 am #9743
flyingfox66
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@flyingfox66
Well it would make sense that I’m not too low. I sunbake regularly in winter (a habit that keeps my skin issues under control). It’s just in summer here, with such high levels of UV radiation….I tend to avoid the sun. Anyway I will drop the supplements as soon as I am done with treatment. I find them a little corrosive unless taken with plenty of food.
Yes I’d say Dan is talking nmol/l while I am talking ng/ml. They love to make it confusing. Took me ages to decipher my GPs handwriting to even figure out thats what he meant. I am 59 nmol/l.

F49HepC25ysGT1a
mild”
19 January 2016 at 5:47 am #9744
Dr James
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@fixhepc
Thankyou Dr Freeman for your response. Hate the heat so am not out in the sun much at all. Mind you it is 40 degrees outside at the moment so that is one of the best reasons to avoid the outdoors! I will take the supplements for the next two weeks and when I get my four week post treatment test done I will ask my GP to run the Vitamin D one as well just to check the levels.

YMMV
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