Supplements? What should I be taking...

[bumble_bee]

I just got some bloodwork done and my doctor tested my B12 which I've had issues with before due to resection surgery in 2005. I had about 2.5 feet of small intestine removed in the terminal ileum area. My B12 level is quite low from what I can tell even though it is within the 'normal' range. It's 183. My doctor in the past has said oral supplements should be enough but I'm wondering if that is in fact the case. I take 1000mcg of B12 a day but have to admit I am not very good at staying on top of this on a regular basis. When I got the bloodwork done recently, I hadn't really been taking the supplement that much. Also, I take 2000IU of vitamin D daily when I remember also. I've never had my vitamin D levels tested so I have no idea where they stand.

I was hoping I could get some valuable info from the wealth of knowledge on this site regarding supplements and what I should be looking into and talking to my doctor about. Thanks everyone :thumright:

 

[David]

Your doctor is likely mistaken. A score of 183pg/ml in conjunction with having Crohn's disease and a resection just about guarantees that you are deficient. Normal individuals with scores between 200 and 400pg/ml have a 50% chance of actually being deficient based upon this paper. Only 1-2% of high dose oral B12 is absorbed and you want to have a score of 500pg/ml or higher which is going to be VERY hard to attain with oral formulations. I would strongly suggest discussing getting loading doses of B12 injections and then monthly injections thereafter with your doctor. Get regular testing of your B12 levels to ensure you are above 500pg/ml and at that point if you want to start trying high dose oral formulations to maintain that level (with continued testing to make sure you are) then that's fine. But you want to get your level up, and FAST.

I'm of the opinion that supplements should be treated like medication and you shouldn't blindly supplement. Get your vitamin D levels tested. 2000iu may not be enough. Or maybe you don't even need it (doubtful). But until you get tested, you don't know and can't track your level over time to determine optimal dosage. I would also request testing of magnesium, potassium, calcium, and folate (vitamin B9) to start. If you were deficient in any of those, I'd broaden the testing unless your doctor was willing to start broad.

 

[nogutsnoglory]

David how much vit D are you taking? I'm currently at 3,000 IU daily but get even more D from sunlight and food.

 

[David]

I'm an example from the other end of the spectrum why it's good to be tested. I live in Florida and garden a lot, most of the time with my shirt off and short shorts that embarrass/mortify my wife. As such, I haven't been taking vitamin D and the last time I was tested (a few weeks ago) my level was 82.

:dance:

If I had been blindly supplementing, at best I would have been throwing my money away but I also wouldn't have known that my D levels were fine with the amount of sun exposure I was getting. In addition, supplementing may have done more harm than good in my case.

 

[Jennifer]

I agree with David, you have to have them tested. Test before beginning supplements, test again ~2 (at least wait a month) months and see if you need more or less. If more isn't helping (after waiting another month or two) then for things like B12 and Iron (and I believe there are more) can be given in a shot (B12) or infusion (Iron and others).

My B12 was low so I started supplements. Didn't do anything. Added more using the type that dissolves under your tongue. Still didn't do anything. GI requested shots from my GP (cause my GI doesn't do shots in office) so I started getting them once a month. B12 was in the thousands after that so we went to every 2 months and its still high (above 1,000) but that's fine.

My vit D is also low so I started taking 5,000IU of liquid vit D. I'll retest in a month to see if its actually doing anything.

Always retest to make sure they are within range. This should become part of your regular treatment regimen. You can have your GI or GP run these tests for you on a regular basis.

 

[nogutsnoglory]

What is the downside to supplementing even if at regular blood levels? I haven't tested for D but should.

 

[Jennifer]

Wasting money

 

[Rebecca85]

The possibility of 'hiding' symptoms (eg excess folic acid can mask b12 deficiency on blood tests, or is it vice versa?). Plus too much of anything can be toxic. And excess supplementation can mess with your body's natural regulation systems and make it more likely that your levels rise too high. Like with Vit D, it's almost impossible to overdose on sun exposure and food alone, but if you supplement unnecessarily then you run the risk of pushing levels up too high- which might not be immediately toxic but is not good for your health in the long run.

 

[nogutsnoglory]

I think over 5,000 iu may be dangerous. I am interested in the studies that show Vit D prevents crohns or helps with it. I also get D from sources I don't want but many pills have extra stuff. I get the D from my calcium/mag/d pills but it's also in my multi, fish oil, and I think in something else.

 

[bangarang]

If your vitamin D and B12 levels are fine then the best supplement is to get is a juicer and juice as much as you can. Never going to get better if you don't put real nutrition in your body. Theres other things but thats the only thing I would think your doctor would approve of.