Vitamin D & B12 deficiency in Depression

[Blahblah]

My pdoc just tested my Vitamin D, blood cell counts, platelets, for base reading.

Even though I take megadoses of Vitamin D in the winter months (80,000 ui every other month, for 6 months) +  I take a daily Multivitamin, eat super balanced diet, my Vitamin D is still "insufficient"...How can this be? Do you think she will increase/continue my doses or give me injections? I don't know how this works....

Should I get my B12 levels (or any other B vitamins) checked? I read that some people lack the enzyme that breaks down B12 to Folic Acid (I don't know how common this is)? I hear this is very important in mood disorders/depression. Is there anything else you guys would suggest testing?

If you have insufficiency (along with chronic mood disorder) does this mean you should take the injections for life?

[melissaw72]

8 minutes ago, Blahblah said:

Even though I take megadoses of Vitamin D in the winter months (80,000 ui every other month, for 6 months) +  I take a daily Multivitamin, eat super balanced diet, my Vitamin D is still "insufficient"...How can this be? Do you think she will increase/continue my doses or give me injections? I don't know how this works....

When you take the vitamin D, do you also eat something with fat in it?  Because vitamin D is fat-soluble, it is absorbed better when taken with food that has fat in it. Also taking calcium with it absorbs it (D3)  better.

Getting sunlight is another way to get vitamin D.

Also, do you take D3 or D2?  Not one DR I have has said that D2 was better than D3 (it can be worse ... maybe it is better for some, but I have never anyone say that to me. It is always D3).  So if you are on D2, you might want to consider trying D3.

20 minutes ago, Blahblah said:

I read that some people lack the enzyme that breaks down B12 to Folic Acid (I don't know how common this is)?

It is the intrinsic factor in your stomach that, if it doesn't work, you will not absorb B12.  I have this problem and get B12 shots monthly.  My Vitamin D level is ok though.  Also, I would ask your DR to get a folic acid level done to.  A high folic acid can mask a B12 deficiency.

http://www.medscape.com/viewarticle/726357_6

Quote

Nutritionists have expressed concerns that folic acid fortification masks B₁₂ deficiency

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https://www.ncbi.nlm.nih.gov/pubmed/17972439

Quote

One recent study indicates that high serum folate levels during vitamin B12 deficiency exacerbate (rather than mask) anemia and worsen cognitive symptoms.

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Idk about being given Vit D injections, I haven't had any experience with them.

----------

Vitamin D can be linked to depression in some cases ...

http://www.healthline.com/health/depression-and-vitamin-d#Overview1

Quote

Studies have shown a link between vitamin D deficiency and depression. Researchers behind a 2013 meta-analysis noticed that study participants with depression also had low vitamin D levels. The same analysis found that, statistically, people with low vitamin D were at a much greater risk of depression.

The researchers believe that because vitamin D is important to brain function, insufficient nutrient levels may play a role in depression and other mental illnesses. An earlier 2005 study identified vitamin D receptors in the same areas of the brain associated with depression.

^One of many articles^ (more links on google)

[notloki]

I take 2,000 IU every day or 60,000 IU a month. Perhaps you are not taking enough. I'm not so sure about a large dose every other month. I took 50,000 IU twice a week for a few weeks to build up my stores (Vitamin D is stored) and once tests showed me back to normal levels we worked out how much I would need to maintain my D level (2,000 IU) and I take this every day.  My doctor said there are several reasons for low D levels, those need to be checked if aggressive supplementation does not do it.

[Blahblah]

2 hours ago, melissaw72 said:

Also, do you take D3 or D2?  Not one DR I have has said that D2 was better than D3 (it can be worse ... maybe it is better for some, but I have never anyone say that to me. It is always D3).  So if you are on D2, you might want to consider trying D3.

It is the intrinsic factor in your stomach that, if it doesn't work, you will not absorb B12.  I have this problem and get B12 shots monthly.  My Vitamin D level is ok though.  Also, I would ask your DR to get a Folic acid level done to.  A high folic acid can mask a B12 deficiency.

One recent study indicates that high serum folate levels during vitamin B12 deficiency exacerbate (rather than mask) anemia and worsen cognitive symptoms.

Thanks for the reply. I looked at the 80,000 ui vitamin D ampoules and it is D3 (I'm not sure which one is in my daily Multi, but the amount there is 400 ui). I didn't know about the taking it with fat thing - I did know that with Calcium is recommended. I try to get as much sun as possible, but winter months here are dark!

The Folic Acid/B12 stuff seems confusing to me. My multivitamin has (Folic Acid 800 mcg) and (B12 8mcg) =100% RDA. I had always thought they were the same thing (like B12 converts to Folic Acid or something)? I actually used to have Anemia and supplemented for several months (years ago) to build up my stores. I think i am now within normal range (but possibly borderline Iron "insufficient") As far as "worsening cognitive symptoms" does that mean everything from memory to processing and organizational issues?

2 hours ago, notloki said:

I take 2,000 IU every day or 60,000 IU a month. Perhaps you are not taking enough. I'm not so sure about a large dose every other month. I took 50,000 IU twice a week for a few weeks to build up my stores (Vitamin D is stored) and once tests showed me back to normal levels we worked out how much I would need to maintain my D level (2,000 IU) and I take this every day.  My doctor said there are several reasons for low D levels, those need to be checked if aggressive supplementation does not do it.

Good to know thanks. Sounds similar to Iron in that it builds up and then you can decrease the dose. I know that too much Iron is bad for you - Can you have "too much" Vitamin D?

At any rate i'm sure she will advise and I'll ask her about the Folic Acid/Vitamin B12 testing.

Edited February 21, 2017 by Blahblah

[melissaw72]

5 minutes ago, Blahblah said:

Can you have "too much" Vitamin D?

Yes, you can.

http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-toxicity/faq-20058108

Quote

Vitamin D toxicity, also called hypervitaminosis D, is a rare but potentially serious condition that occurs when you have excessive amounts of vitamin D in your body.

Vitamin D toxicity is usually caused by megadoses of vitamin D supplements

 

[notloki]

You can take too much and you have to watch that with the stored vitamins. Testing is essential if you are taking large doses and you should not take high doses without being under a doctors supervision. It would take a lot of pills to get a toxic dose so it is rare to happen.

[notloki]

I have B-12 and folic acid checked once a year as my levels are always normal.

[sugarsugar]

My vid D was super low. I took 25.000 units/week and got to the marginal range but dropped when I quit. Now I take 5000 units daily and get my levels checked. I'm maintaining in a good level not in the low end. Note that I do get checked since thats a high dose but 2000/day was too low for me. I do have more energy and less depressed feelings but I'm on meds also. With low D I was very tired. I've never checked or tried vit b12 and don't take other vitamins anymore. I'm a vit D believer though. 

[notloki]

That's why I advocate for testing as the dosage to maintain a normal level is highly individual. I get 600 IU from my multi so I am taking more like 2,600 IU/day.

[sugarsugar]

Just a follow up to my saying I took 5000 units daily. After 2-3 years of that dose keeping me in the normal rsnge, my most recent test of vit D level was slightly sbove normal. The solution is to take it only 5 days a week. So it is possible to get a high level on a high dose, eventually. I do feel better than when my levels were low, but I can see a yearly test is necessary. My insurance covers it so I don't know how expensive that might be. 

[melissaw72]

4 hours ago, sugarsugar said:

Just a follow up to my saying I took 5000 units daily. After 2-3 years of that dose keeping me in the normal rsnge, my most recent test of vit D level was slightly sbove normal. The solution is to take it only 5 days a week. So it is possible to get a high level on a high dose, eventually. I do feel better than when my levels were low, but I can see a yearly test is necessary. My insurance covers it so I don't know how expensive that might be. 

It is expensive ... It isn't covered by medicare, but medicaid picks up the cost.  IIRC, it is about $120 to have done.  That seemed to be a lot to me and I was wondering why it isn't covered by insurance.  But for me it isn't.  Fortunately I can still have it done though.

For me, when I was taking 5,000 mg Vit D a day, my level actually went down a little.  I think it has to do with the Vit D being stored in my fat (I have gained weight over the year) ... because vit D is fat soluble, it will be stored in the fat ... with not all of it going into your system.

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001383

Quote

That is, these findings provide evidence for obesity as a causal factor in the development of vitamin D deficiency but not for vitamin D deficiency as a causal factor in the development of obesity. These findings suggest that population-level interventions to reduce obesity should lead to a reduction in the prevalence of vitamin D deficiency and highlight the importance of monitoring and treating vitamin D deficiency as a means of alleviating the adverse influences of obesity on health.

 

[aquarian]

My pdoc recently ordered bloodwork for me including a Vit D test (because I don't see a primary doc every year). She (pdoc) spent quite a few minutes writing up the bloodwork order on her prescription pad and looking up codes related to each test because she said that now that I'm on medicare, medicare is very particular about how often bloodwork can be done and when tests will be covered. Whatever she wrote on the rx pad seemed to work, because the claims came through on the medicare website last week and supposedly I'm not going to owe anything; Part B is covering all of the blood tests she ordered that I had done. So for me, medicare Part B did cover my Vit D blood test. I have a supplemental plan as well but it's a high deductible plan so has yet to cover anything.

And FWIW, I'm giving up on D2 for now and have switched to 5000 iu's of D3 daily per my pdoc. Previously I was taking 7200 iu's of D2 per day. I didn't start the D3 until after the bloodwork came back so I'll have to wait awhile to find out if D3 works out better for me. With D2, I was able to keep my D levels hovering just barely in the normal range or slightly below. But my pdoc gave me a mini lecture about the D2 and I've been meaning to give D3 a try anyways so here goes.

[melissaw72]

6 hours ago, aquarian said:

because she said that now that I'm on medicare, medicare is very particular about how often bloodwork can be done and when tests will be covered. Whatever she wrote on the rx pad seemed to work, because the claims came through on the medicare website last week and supposedly I'm not going to owe anything;

Do you know how the Vit D lab was written so Medicare would cover it?

6 hours ago, aquarian said:

And FWIW, I'm giving up on D2 for now and have switched to 5000 iu's of D3 daily per my pdoc.

I agree with your pdoc.  Here are some reasons why:

http://www.medscape.com/viewarticle/589256_4

http://articles.mercola.com/sites/articles/archive/2012/02/23/oral-vitamin-d-mistake.aspx

 

 

Edited March 12, 2017 by melissaw72

[notloki]

I know people on medicaid who have gotten the D3 test paid for so it can be done. Coding is everything.  

[melissaw72]

22 minutes ago, notloki said:

I know people on medicaid who have gotten the D3 test paid for so it can be done. Coding is everything.  

Thanks.  Medicaid picked up the cost for me too ... I was just more interested as to why medicare wouldn't cover it in the first place. (sorry if it was a tangent!)

[notloki]

Opps, I ment Medicare, reimbursement for D3 level tests.

[notloki]

Actually there are 2 possible tests:

 

Quote

When is it ordered?

25-hydroxyvitamin D
When calcium is low and/or a person has symptoms of vitamin D deficiency, such as bone malformation in children (rickets) and bone weakness, softness, or fracture in adults (osteomalacia), 25-hydroxyvitamin D usually is ordered to identify a possible deficiency in vitamin D.

The test may be requested when an individual is known to be at risk of vitamin D deficiency. Older adults, people who are institutionalized or homebound and/or have limited sun exposure, those who are obese, who have undergone gastric bypass surgery, and/or who have fat malabsorption are at an increased risk of a vitamin D deficiency. Also included in this group are people with darker skin and breastfed infants.

25-hydroxyvitamin D is often requested before an individual begins drug therapy for osteoporosis.

1,25-dihydroxyvitamin D
This testing may be ordered when kidney disease or abnormalities of the enzyme that converts 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D is suspected. Rarely, this test may be done when calcium is high or a person has a disease that might produce excess amounts of vitamin D, such as sarcoidosis or some forms of lymphoma (because immune cells may make 1,25-dihydroxyvitamin D).

When vitamin D, calcium, phosphorus, or magnesium supplementation is necessary, vitamin D levels are sometimes measured to monitor treatment effectiveness.

^ B

 

[notloki]

9 hours ago, aquarian said:

And FWIW, I'm giving up on D2 for now and have switched to 5000 iu's of D3 daily per my pdoc. Previously I was taking 7200 iu's of D2 per day. I didn't start the D3 until after the bloodwork came back so I'll have to wait awhile to find out if D3 works out better for me. With D2, I was able to keep my D levels hovering just barely in the normal range or slightly below. But my pdoc gave me a mini lecture about the D2 and I've been meaning to give D3 a try anyways so here goes.

Supplementation should be with D3.

[melissaw72]

15 minutes ago, notloki said:

Opps, I ment Medicare, reimbursement for D3 level tests.

How did the people on Medicare get reimbursed for the D3 level?

The one test I was curious about was the D3.

I agree that supplementation should be with Vitamin D3.

[notloki]

All I can say is medical billing is a bitch and Melissa I would call your providers billing dept and see if they can take another look or resubmit it. Many have posted where their insurance pays for it, I think Medicare will, too. 

Edited March 12, 2017 by notloki

[300.3]

On 2/21/2017 at 5:13 AM, Blahblah said:

My pdoc just tested my Vitamin D, blood cell counts, platelets, for base reading.

Even though I take megadoses of Vitamin D in the winter months (80,000 ui every other month, for 6 months) +  I take a daily Multivitamin, eat super balanced diet, my Vitamin D is still "insufficient"...How can this be? Do you think she will increase/continue my doses or give me injections? I don't know how this works....

Should I get my B12 levels (or any other B vitamins) checked? I read that some people lack the enzyme that breaks down B12 to Folic Acid (I don't know how common this is)? I hear this is very important in mood disorders/depression. Is there anything else you guys would suggest testing?

If you have insufficiency (along with chronic mood disorder) does this mean you should take the injections for life?

The folic acid issue your referring to is the mthfr gene mutation. You would need to get genetic testing to see if you have it. It's basically an issue with poor methylation.

[aquarian]

4 hours ago, melissaw72 said:

Do you know how the Vit D lab was written so Medicare would cover it?

Unfortunately I didn't make a copy of the written prescription for myself and my medicare billing stuff doesn't give that level of detail. I've had low Vit D tests in the past, so I'm assuming she used a code that indicated that but I don't know. I can check with my pdoc though when I see her in 3 months. She saved a copy of the prescription so she wouldn't have to look up the codes again if she orders blood tests for me again in a year.

[melissaw72]

5 hours ago, notloki said:

All I can say is medical billing is a bitch and Melissa I would call your providers billing dept and see if they can take another look or resubmit it. Many have posted where their insurance pays for it, I think Medicare will, too. 

I'm sorry if what I wrote was confusing ... Medicare doesn't cover it for me but Medicaid did cover the vit D test (I have both Med/Med).

If I didn't have medicaid though I would have had to pay out of pocket to Medicare, and if that ever happens in the future I'll definitely re-submit it.  Thanks for the advice.

[melissaw72]

4 hours ago, aquarian said:

Unfortunately I didn't make a copy of the written prescription for myself and my medicare billing stuff doesn't give that level of detail. I've had low Vit D tests in the past, so I'm assuming she used a code that indicated that but I don't know. I can check with my pdoc though when I see her in 3 months. She saved a copy of the prescription so she wouldn't have to look up the codes again if she orders blood tests for me again in a year.

Thanks.  That would be interesting to know.

[Blahblah]

Just to follow-up on this topic, because it's of interest to me (the connection between vitamin/nutritional/amino acid deficiencies and mental health). Since my Vit D was still "insufficient" my doc but me on 80,000UI of D3 for 2 more months. Then after testing, will probably lower the amount or stop because summer is coming.

An interesting point she made was about multivitamins. In her opinion, they are sort of useless because when you take a multivitamin with so many different things, your body cannot absorb all of it anyway. However, realistically, one cannot take 22 different vitamin supplements separately (and most people don't get everything needed from diet alone) so it can help if you eat poorly.

She will also test: Ferritin/iron, Vitamin B12, B9, Creatine, SGOT & SGPT (I'm assuming these detect liver or kidney dysfunction?), Albumin (not sure what this is), and Calcium. I am happy to be getting a solid baseline test of this stuff for the first time.

Other than extra supplements of Omega 3s, vitamin D and B12 - what other common supplements do you take that actually work? I've seen some people here that take CoQ-10 and NAC but since I already will be taking many pills, I probably won't add more!

 

[notloki]

3 hours ago, Blahblah said:

She will also test: Ferritin/iron, Vitamin B12, B9, Creatine, SGOT & SGPT (I'm assuming these detect liver or kidney dysfunction?), Albumin (not sure what this is), and Calcium. I am happy to be getting a solid baseline test of this stuff for the first time.

Other than extra supplements of Omega 3s, vitamin D and B12 - what other common supplements do you take that actually work? I've seen some people here that take CoQ-10 and NAC but since I already will be taking many pills, I probably won't add more!

 

Creatine is kidney function. SGOT, SGPT and Albumin are the liver function test. SGOT & SGPT are also known as AST and ALT. ALT is what is raised when the liver is under some form of distress.

[melissaw72]

4 hours ago, Blahblah said:

Other than extra supplements of Omega 3s, vitamin D and B12 - what other common supplements do you take that actually work? I've seen some people here that take CoQ-10 and NAC but since I already will be taking many pills, I probably won't add more!

 

I also take magnesium and vit C.  Not sure exactly what they do, but I feel a lot better when I take them vs when not.

Edited March 15, 2017 by melissaw72

[aquarian]

8 hours ago, Blahblah said:

Other than extra supplements of Omega 3s, vitamin D and B12 - what other common supplements do you take that actually work? I've seen some people here that take CoQ-10 and NAC but since I already will be taking many pills, I probably won't add more!

 

The only vitamins I take other than D3 are an iron pill (325mg ferrous sulfate) every other day and a B12 sublingual pill about once every few weeks. Even with taking the B12 only once every few weeks, the last B12 test I had showed me at above the recommended range. I never had a B12 deficiency to begin with but I think it makes my primary doctor happy to take the B12 just in case since I'm a vegetarian with depression and fatigue issues.

I started taking the iron pill when I was so tired I could barely get up and down the stairs to the basement or walk to the back of a big box store. My ferritin levels came back low, so the doctor said to take 2 iron pills a day until my levels went back to normal. Eventually I arbitrarily decided on an iron pill every other day and my iron and ferritin levels have been normal ever since.

ETA: My sister kept bugging me to take magnesium so I tried it for a couple weeks but all it seemed to do is make my poops extra soft so I stopped taking it.

Edited March 15, 2017 by aquarian

[Blahblah]

1 hour ago, aquarian said:

ETA: My sister kept bugging me to take magnesium so I tried it for a couple weeks but all it seemed to do is make my poops extra soft so I stopped taking it.

Is the B12 you take over the counter or prescription only? I had the same issue with Magnesium. It is calming/relaxing but gives me the runs the next day

[aquarian]

3 hours ago, Blahblah said:

Is the B12 you take over the counter or prescription only? I had the same issue with Magnesium. It is calming/relaxing but gives me the runs the next day

The B12 I take is over the counter from Sam's Club. It's Simply Right sublingual vitamin B12 2500mcg methylcobalamin. It tastes kind of fruity. However, it's actually expired* since it's Sam's Club size and I take it infrequently. I just looked online and it looks like Sam's Club offers a slightly different product these days. It's Members Mark, still sublingual and methylcobalamin, but now 5000mcg.

*The B12 apparently expired in September 2015 but I still take it. My D3 vitamins, however, are current and unexpired. FWIW, it's the Nature's Bounty D3 5000iu from Costco, recommended by my pdoc.

[melissaw72]

When I take a sublingual, I take Nature's Bounty 1,000 mcg (methylcobalamin) ... got it from CVS OTC.  Taste is "ok." 

When you put the pill under your tongue, the box says to put the pill under your tongue for 30 seconds before swallowing.

[notloki]

It is important to have B-12 tested, there are a number of levels tested, each indicating something different:

overall vitamin B-12
methylmalonic acid (MMA)
homocysteine
holotranscobalamin (holoTC)

http://www.healthline.com/health/vitamin-b12-level#Overview1

Excess B-12 is excreted by the renal route (you pee it out) so unless you are deficient supplementation just makes expensive pee.

Some drugs can make for lower levels, Metformin and the H2 blockers (Zantac, Tagamet,) and proton pump inhibitors among others.

 

Edited March 16, 2017 by notloki

[melissaw72]

FWIW I can't absorb B12 so I get a 1000 mcg shot IM every month.

The stomach meds I have been on since the early 90s are probably the reason for the deficiency.

http://www.everydayhealth.com/digestivehealth/gerd/treating/specialist/babyatsky-effects-of-reflux-drugs.aspx

Quote

The major long-term side effects of PPIs are vitamin B12 deficiency and, much more rarely, iron deficiency. The cells in the stomach that make acid also make a protein called intrinsic factor, which is necessary for the absorption of vitamin B12. Proton pump inhibitors block the release of intrinsic factor, so, over years of use, they can cause some patients to develop vitamin B12 deficiency,

 

[notloki]

6 hours ago, melissaw72 said:

FWIW I can't absorb B12 so I get a 1000 mcg shot IM every month.

The stomach meds I have been on since the early 90s are probably the reason for the deficiency.

http://www.everydayhealth.com/digestivehealth/gerd/treating/specialist/babyatsky-effects-of-reflux-drugs.aspx

 

Interesting.  I'm on 1000 mg Metformin and 600 mg Zantac and yet have normal B-12 labs with just a multivitamin.  Both are well known for effecting B-12.

[melissaw72]

11 hours ago, notloki said:

Interesting.  I'm on 1000 mg Metformin and 600 mg Zantac and yet have normal B-12 labs with just a multivitamin.  Both are well known for effecting B-12.

I'm glad you don't have a problem with it.  It is a big PITA to have to go to the DRs office to get the shot (where I am in and out in less than 5 minutes.  And the shot costs I think now $33, just to have a B12 shot.  At least the insurance pays for it. 

I think I can do it myself at home (it was a very long time ago, but I remember getting a B12 vial from the pharmacy and they said to bring it to the person giving me the shot.  Not sure why that happened).  Also I think someone here did it themselves. 

I would just feel better if the nurse gave me the shot.  I mean how do I give myself a shot in my lower deltoid muscle, you know?  I'd have to give it to myself at an angle and it wouldn't work.

I also have chronic gastritis, but not sure if that would be part of the problem too.

[Cetkat]

On 3/12/2017 at 9:36 PM, notloki said:

On 3/12/2017 at 9:36 PM, notloki said:

When is it ordered?

25-hydroxyvitamin D
When calcium is low and/or a person has symptoms of vitamin D deficiency, such as bone malformation in children (rickets) and bone weakness, softness, or fracture in adults (osteomalacia), 25-hydroxyvitamin D usually is ordered to identify a possible deficiency in vitamin D.

The test may be requested when an individual is known to be at risk of vitamin D deficiency. Older adults, people who are institutionalized or homebound and/or have limited sun exposure, those who are obese, who have undergone gastric bypass surgery, and/or who have fat malabsorption are at an increased risk of a vitamin D deficiency. Also included in this group are people with darker skin and breastfed infants.

25-hydroxyvitamin D is often requested before an individual begins drug therapy for osteoporosis.

1,25-dihydroxyvitamin D
This testing may be ordered when kidney disease or abnormalities of the enzyme that converts 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D is suspected. Rarely, this test may be done when calcium is high or a person has a disease that might produce excess amounts of vitamin D, such as sarcoidosis or some forms of lymphoma (because immune cells may make 1,25-dihydroxyvitamin D).

When vitamin D, calcium, phosphorus, or magnesium supplementation is necessary, vitamin D levels are sometimes measured to monitor treatment effectiveness.

 

 

On 3/12/2017 at 8:58 PM, melissaw72 said:

Thanks.  Medicaid picked up the cost for me too ... I was just more interested as to why medicare wouldn't cover it in the first place. (sorry if it was a tangent!)

I had the same issue.  I believe this info solves it.  Mine was always ordered as the 25-hydroxyvitamin D.  I have high blood calcium though, no rickets or bone issues. So that would be a good reason why Medicare denied coverage.  But, since high calcium is a reason listed for the 1.25 - dihydroxyvitamin D -- I bet if it had be done instead, with billing notating the high calcium level as justification... Medicare would have covered it.

It sounds like simply having low Vit D isn't sufficient enough to warrant the testing.  Which is just fucked up... but I suppose not surprising.

[Cetkat]

On 3/16/2017 at 1:07 AM, melissaw72 said:

I also take magnesium and vit C.  Not sure exactly what they do, but I feel a lot better when I take them vs when not.

Have you run the standard labs and looked at the potassium/magnesium balance with and without taking the magnesium and vit C?  That would be my first curiosity. 

[Cetkat]

First off, here's a good meta-study to read: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4128480/

As far as injections vs pills.  Injections just bypass the digestive tract, so other medications and stomach/gastrointestinal issues are avoided.

Personally, I just take 4,000 IU per day of D3 (D2 is worthless, I agree with that). I have wondered about switching to injections since it's a constant every-day thing, but I haven't gotten far enough into my new medical offices to get the Endo appointment to ask.

I won't discount or comment on the stomach absorption thing, as I have no real knowledge of that.  I can say that my issue is in my digestive tract itself.  IBS is known to mess with Vit D absorption, and after realizing just how much Vit D I got from sunlight in FL and still had a deficiency -- It wasn't from lack of supply. (Or at least normal supply.. I read something talking about a skin-related conversion/absorption difficulty when getting Vit D though sunlight -- but I haven't looked into it really.  It's on a low-level to-research list.)

Also, I do take a B complex (Gummy Vitamins) from Nutrition Now when I feel like I'm getting sick. (My B-12 level is fine).  Googling the ingredients though: I learned that the ingredients (other than a small amount of Vit C 15mg, 25% daily value) are all B vitamins.  Niacin, Vit B-6, Folic Acid, Vitamin B-12, Biotin, and Pantothenic acid.  Google them.  That makes me suspicious of claims that folic acid is a broken down form of B-12, cause it's a B vitamin itself.

It also has 7mg of Inositol (as Inositol Niacinate *whatever that means)..

But from this study: https://www.ncbi.nlm.nih.gov/pubmed/9169302  "Inositol is a simple polyol precursor in a second messenger system important in the brain. "

I'm betting the goal is to facilitate the B vitamins conversion/positive mental effects/etc..  In any case, the study definitely makes it sound like a good thing, even at such a tiny dose not meant for that stuff.

In any event, one point of sharing that is that so many B-complex or B-whatever vitamins on store shelves have a bunch of shit you don't necessarily need, or could even be harmful in certain instances. (Like the ones that have Calcium ). 

But yeah, I've only seen it on Amazon, but they're gummies (strawberry flavored) that taste mostly like a red gummy bear that you sweetened with strawberry juice instead of sugar.  The fact that they're gummies also seems to be easier on the stomach.

 

Anyway, I think the only other thing I wanted to say was that, other than getting an Endocrinologist to handle this if at all possible (cause it does make a difference)... you should definitely test Calcium levels (serum particularly), Vit D, and PTH (when it's serious enough for those mega-doses).  Vit D increases Calcium absorption in the digestive tract.. so if you're going to take Vit D pills - you need to know where your blood calcium stands.  It didn't make my high levels worse, but it can and needs to be regularly re-tested with me every 6 months.  To ensure medicating my D3 deficiency doesn't make my hypercalcemia dangerous.

 

Oh, also, since we're dealing with Mental Health... getting a B12 test is never a bad idea, IMO.  It's rarely low enough to be significant - but there is a genetic condition that keeps you from absorbing it - and that can and will cause severe MI.  Barring a dual causation, a shot in the ass could cure your MI -- as well as keep you alive, as you'll eventually die from not having it.

That's when it's exceptionally low though.

For the most part, it's just something to check if it's slightly low and take a B-Complex if it is.  You could go ahead an test all the B vitamins (that aren't already included in a normal yearly blood panel).. if insurance/money isn't an issue.  But I doubt their levels compared to the norm would be so different as to need to treat them separately.

But, again - This is big Endo territory.  I'm still following his orders even though I'm no longer under his care, and I'll continue that until I can see another one in my new state.

 

[melissaw72]

2 hours ago, Cetkat said:

It sounds like simply having low Vit D isn't sufficient enough to warrant the testing.  Which is just fucked up... but I suppose not surprising.

Makes sense.

2 hours ago, Cetkat said:

Have you run the standard labs and looked at the potassium/magnesium balance with and without taking the magnesium and vit C?  That would be my first curiosity. 

No, I haven't. 

[HAL9000]

On 3/15/2017 at 8:45 PM, aquarian said:

The B12 I take is over the counter from Sam's Club. It's Simply Right sublingual vitamin B12 2500mcg methylcobalamin. It tastes kind of fruity. However, it's actually expired* since it's Sam's Club size and I take it infrequently. I just looked online and it looks like Sam's Club offers a slightly different product these days. It's Members Mark, still sublingual and methylcobalamin, but now 5000mcg.

*The B12 apparently expired in September 2015 but I still take it. My D3 vitamins, however, are current and unexpired. FWIW, it's the Nature's Bounty D3 5000iu from Costco, recommended by my pdoc.

You can probably google this but if memory serves me the US Army tested a variety of drugs that had expired 12 years ago and other then antibiotics found all the drugs they tested were still "good" to go.  

[HAL9000]

8 minutes ago, Dphxa said:

My mom and I have found Tylenol to be very time and temperature sensitive.  If it gets too warm, it kills it almost immediately and it works the best when it's new.

Well light and heat ruin almost any drug so thats true.   What I read was about meds that had been stored properly and were still ok after 12 years.

[aquarian]

4 hours ago, HAL9000 said:

You can probably google this but if memory serves me the US Army tested a variety of drugs that had expired 12 years ago and other then antibiotics found all the drugs they tested were still "good" to go.  

Yes, I think I vaguely remember this. I've never had an issue taking a variety of somewhat expired meds, including benzos and abilify, and feeling like they weren't working properly. There are some meds I'd never take once they expired (e.g. antibiotics) and I do try to rotate my meds to reduce the amount of expired meds onhand, but I don't stress if occasionally I take something expired.

[melissaw72]

4 minutes ago, aquarian said:

I do try to rotate my meds to reduce the amount of expired meds onhand, but I don't stress if occasionally I take something expired.

Exactly the same with me.

[Cetkat]

I actually have a friend who was an Army nurse when they did that study.  They were throwing away too much medication, so they wanted to reduce costs.  According to her, they concluded that they'd keep the meds for 5 years past their expiration date because they were all still valid. That was on the pharmacy dispensary side.  I wouldn't doubt however, that they also found that some of the meds kept their efficiency longer and those got the 12 year rating.  I'd be curious as to what those ones are.  Probably Ibuprofen and some other NSAIDS.  It's a running joke (at least in the Marines) that 800mg Ibuprofen cures all.  I don't doubt that it stems from it actually being used all the time.

But, yeah, apart from a small handful of meds that break down into toxic & harmful stuff.. it's pretty much just that over time the meds still work, they just lose efficiency.. so you'd just have to take more to get the right mg.  Temperature and light play a big role in that though.  The better you store it, the longer it will keep.

One big thing to know however: the expiration on the bottles you get from the pharmacy are automatically dated as a year from when it's dispensed.  But, when the pharmacy gives you the actual bottle they depense from, the expirations are normally 3-5 years. All US pharmacys also remove medications from their shelves before they reach within a year of expiration... some extend that to (and I'm guessing here: 1 1/2 to 2 years).  It's ultimately the Pharmacist's and company's call.  It's something I've noticed by getting the real bottles from different pharmacies & seeing some patterns in how often it's 3 vs 5 years.

So, yeah, you can automatically (safely) add an additional 2-3 years to the date printed on the bottle to find the actual expiration date from the pharmaceutical company.

-------------------------------------------------------------------------------------------------------

[Auto-Merge... Treat as two separate posts please]

On 3/23/2017 at 9:10 PM, melissaw72 said:

No, I haven't. 

Well, if you're up to it and your doc approves.. I'd think about checking it out.  It may give you more information.  .. Just an outsider's suggestion.  Grain of salt and all. 

Edited March 27, 2017 by Cetkat

[Yuna]

On 2/21/2017 at 5:13 AM, Blahblah said:

My pdoc just tested my Vitamin D, blood cell counts, platelets, for base reading.

Even though I take megadoses of Vitamin D in the winter months (80,000 ui every other month, for 6 months) +  I take a daily Multivitamin, eat super balanced diet, my Vitamin D is still "insufficient"...How can this be? Do you think she will increase/continue my doses or give me injections? I don't know how this works....

Should I get my B12 levels (or any other B vitamins) checked? I read that some people lack the enzyme that breaks down B12 to Folic Acid (I don't know how common this is)? I hear this is very important in mood disorders/depression. Is there anything else you guys would suggest testing?

If you have insufficiency (along with chronic mood disorder) does this mean you should take the injections for life?

I've been doing alot of research on this topic. I don't think science yet understands what the optimal level of D should be in the body, or how to even supplement or even if supplements will work. The quality of supplements varies dramatically. Everybody has a different level of D which is normal for them. The only thing science can prove is what "low" is. The classic symptoms deficient symptoms (rickets, depression whatever). And a count of <20 or whatever.  

 

Its all still a mystery. 

[Yuna]

On 2/21/2017 at 5:13 AM, Blahblah said:

My pdoc just tested my Vitamin D, blood cell counts, platelets, for base reading.

Even though I take megadoses of Vitamin D in the winter months (80,000 ui every other month, for 6 months) +  I take a daily Multivitamin, eat super balanced diet, my Vitamin D is still "insufficient"...How can this be? Do you think she will increase/continue my doses or give me injections? I don't know how this works....

Should I get my B12 levels (or any other B vitamins) checked? I read that some people lack the enzyme that breaks down B12 to Folic Acid (I don't know how common this is)? I hear this is very important in mood disorders/depression. Is there anything else you guys would suggest testing?

If you have insufficiency (along with chronic mood disorder) does this mean you should take the injections for life?

 

On 2/21/2017 at 5:13 AM, Blahblah said:

My pdoc just tested my Vitamin D, blood cell counts, platelets, for base reading.

Even though I take megadoses of Vitamin D in the winter months (80,000 ui every other month, for 6 months) +  I take a daily Multivitamin, eat super balanced diet, my Vitamin D is still "insufficient"...How can this be? Do you think she will increase/continue my doses or give me injections? I don't know how this works....

Should I get my B12 levels (or any other B vitamins) checked? I read that some people lack the enzyme that breaks down B12 to Folic Acid (I don't know how common this is)? I hear this is very important in mood disorders/depression. Is there anything else you guys would suggest testing?

If you have insufficiency (along with chronic mood disorder) does this mean you should take the injections for life?

They way I look at all supplementation- its a crap shot. There is only so much you can try.

D, the B-vitamin family, some essential minerals- magnesium, selenium and zinc. 

 

Its all inconclusive as to what will work. Quality and quantity of all supplements are in question. 

[notloki]

It is not inconclusive when you have a deficiency and correct it with supplementation along with lab tests to assure proper levels. Then you know your supplements are good.

[notloki]

I agree on the supplement market being a crap shoot. The FDA did a study of the benefits of essential vit/min supplementation and found one benifit. When supplementation is used to treat known deficiencies. Otherwise supplementation is a waste of time and money.

[Yuna]

3 hours ago, notloki said:

I agree on the supplement market being a crap shoot. The FDA did a study of the benefits of essential vit/min supplementation and found one benifit. When supplementation is used to treat known deficiencies. Otherwise supplementation is a waste of time and money.

I have heard of people supplementing stuff even without a known deficiency- could it be placebo? I don't know, I believe I have personally responded to B vitamins, possibly magnesium and D (my D wasn't technically low- it was between 20-30) but I believe 1000 units lifted me out of a winter depression.

 

Ketogenic diet/intermittent fasting is the only thing i can prove worked for me beyond a doubt. (too bad it doesn't work well enough/raises cortisol levels).

[Cetkat]

On 4/2/2017 at 7:09 AM, Yuna said:

I have heard of people supplementing stuff even without a known deficiency- could it be placebo? I don't know, I believe I have personally responded to B vitamins, possibly magnesium and D (my D wasn't technically low- it was between 20-30) but I believe 1000 units lifted me out of a winter depression.

I don't think it's a placebo.

I can absolutely believe that extra 1000UI made a difference, especially since you say it was in the winter.  The range for D3 is very broad.  I believe where you fall within the range, low-med-high, can make a real difference in how you feel; mentally and physically.  Being out of range is normally when you start having medical issues, but that doesn't mean you can't have an optimum level somewhere within range.  The range is also based on "normal population" values... it doesn't take conditions like depression into account.

My B vit levels are normal, but taking my supplements when I'm around people who are sick, or when I know I'm going to be in an environment where you're likely to catch something (like a large convention) does boost my immune system & makes a difference on if I get ill.  It doesn't seem to make any difference with my depression; but, that doesn't mean it couldn't have that effect in someone else.  MI in general does have an immune factor to it - so I believe people when they say taking B vitamins helps.

I think the biggest thing is just to make sure you know where your levels are when supplementing, so you don't take too much.  

[melissaw72]

18 minutes ago, Cetkat said:

My B vit levels are normal, but taking my supplements when I'm around people who are sick, or when I know I'm going to be in an environment where you're likely to catch something (lik

Do you mean D levels?

[Cetkat]

42 minutes ago, melissaw72 said:

Do you mean D levels?

No, I do mean B there.  My D levels are low so I'm on 4000IU for that. But all my B vit levels are normal (including B12 - I had that tested individually).. so when I use my B complex, I'm not doing it to get into range.  I'm increasing the normal levels temporarily & it gives my immune system a boost.

[melissaw72]

1 minute ago, Cetkat said:

No, I do mean B there.  My D levels are low so I'm on 4000IU for that. But all my B vit levels are normal (including B12 - I had that tested individually).. so when I use my B complex, I'm not doing it to get into range.  I'm increasing the normal levels temporarily & it gives my immune system a boost.

Ohhh, ok ... thanks for posting that ... I get B12 shots every month and I don't have a deficiency in that.  And I do take a B-complex also, but not for a deficiency.

I didn't realize it could help you boost your immune system ... do you know if it is better than Vitamin C?

[Cetkat]

1 minute ago, melissaw72 said:

Ohhh, ok ... thanks for posting that ... I get B12 shots every month and I don't have a deficiency in that.  And I do take a B-complex also, but not for a deficiency.

No problem.  Do you take the B12 shots for mood or something else?  I tried a B-12/B-6 combo before to see if it would help... but I didn't notice a difference.  I've never thought of trying the shots.

 

2 minutes ago, melissaw72 said:

I didn't realize it could help you boost your immune system ... do you know if it is better than Vitamin C?

I don't know scientifically, but I feel like it is.  The combo I found to avoid con crud (getting sick at conventions) is the B-complex, Vit C, Airborne, and Echinacea.  It was a trial and error type of thing.  Out of all of that, I've found that I can drop any one of the last three and have it remain effective - but the B-complex is essential.

This is an interesting study where they used B-6 to increase immunity:

https://www.ncbi.nlm.nih.gov/pubmed/16670691

[melissaw72]

35 minutes ago, Cetkat said:

No problem.  Do you take the B12 shots for mood or something else?  I tried a B-12/B-6 combo before to see if it would help... but I didn't notice a difference.  I've never thought of trying the shots.

I get the B12 shots for a B-12 deficiency ... because of all the stomach issues over a long time, I don't have the intrinsic factor in my stomach to absorb B-12.  So the only way for me to get it is the IM shot.  I probably could use the dissolvable B12 vitamins, but the shot is a definite.

When they first discovered the deficiency I was so low that after the initial week of shots (4 days of shots, then the next week it was every other day, then the next week once/week, then after that 2x/month.  I am now on 1 shot a month.  Each shot is 1,000 mcg.

Thanks for the link!

[Yuna]

4 hours ago, Cetkat said:

I don't think it's a placebo.

I can absolutely believe that extra 1000UI made a difference, especially since you say it was in the winter.  The range for D3 is very broad.  I believe where you fall within the range, low-med-high, can make a real difference in how you feel; mentally and physically.  Being out of range is normally when you start having medical issues, but that doesn't mean you can't have an optimum level somewhere within range.  The range is also based on "normal population" values... it doesn't take conditions like depression into account.

My B vit levels are normal, but taking my supplements when I'm around people who are sick, or when I know I'm going to be in an environment where you're likely to catch something (like a large convention) does boost my immune system & makes a difference on if I get ill.  It doesn't seem to make any difference with my depression; but, that doesn't mean it couldn't have that effect in someone else.  MI in general does have an immune factor to it - so I believe people when they say taking B vitamins helps.

I think the biggest thing is just to make sure you know where your levels are when supplementing, so you don't take too much.  

I plan on taking at least 1000 units of D during the cold months from now on. My levels in the dead of winter were 22 (I was depressed at the time, 1000 units saved me). At the end of summer (after being half baked) my levels were only 33. Strange isn't it? I must have a weird range.

Also I was taking 120mg lithium orotate (4.6mg elemental lithium total) for a while, I swear it effected me in a positive way, I think I plan on trying that experiment again under more controlled conditions. 

The low carb/Ketogenic diet definitely worked- best thing I've ever tried. I recommend it to anyone with bipolar to briefly experiment with (a longer detailed post will come later on my views on this).

Are you a final fantasy X fan by any chance? I see you have a Yuna avatar >.> possibly. >.>

 

edit: 200-400 mg magnesium citrate per day helps with anxiety for me. I recommend it.

Edited April 11, 2017 by Yuna

[mcjimjam]

There are different ideas about what a normal Vit D level is so perhaps get a second opinion on your current level.

there has been a real vit d craze these past few years and some think the claims made about the prevelence and effects of deficiency are overblown. There is an article about this on the New York Times website at the moment.

[Cetkat]

On 4/12/2017 at 0:45 AM, Yuna said:

I plan on taking at least 1000 units of D during the cold months from now on. My levels in the dead of winter were 22 (I was depressed at the time, 1000 units saved me). At the end of summer (after being half baked) my levels were only 33. Strange isn't it? I must have a weird range.

Also I was taking 120mg lithium orotate (4.6mg elemental lithium total) for a while, I swear it effected me in a positive way, I think I plan on trying that experiment again under more controlled conditions. 

The low carb/Ketogenic diet definitely worked- best thing I've ever tried. I recommend it to anyone with bipolar to briefly experiment with (a longer detailed post will come later on my views on this).

Are you a final fantasy X fan by any chance? I see you have a Yuna avatar >.> possibly. >.>

 

edit: 200-400 mg magnesium citrate per day helps with anxiety for me. I recommend it.

Those levels sound pretty normal to me.  I think there's also a possibility that there can be something going on that limits your Vit D production from the sun.  When I was still in FL, I got triple the recommended amount of direct sunlight - yet my level was still really low.  I think there's something medical going on with that.

The range is 20-50, but there's talk that it should be changed to 30-50.  I'd consider upping your level to ~40 and see if you get any more benefit.

I found this on lithium orotate: http://psycheducation.org/treatment/mood-stabilizers/the-big-three-for-bipolar-depression/lithium/lithium-orotate/

So, yeah, you were taking lithium, so of course it did something.  It's the lithium part in the lithium orotate and lithium carbonate that does the job.  The orotate is just a low dose lithium med. Do you have a pdoc helping you with all of this?  I did notice that it says 300mg is the point where you really need to do kidney and serum level testing.  So be mindful of that.

Magnesium for anxiety? Hmm.. I'll have to research that.  How did you come about discovering that?

 

And, yes, I am a fan.   Ironically, I haven't actually played the game yet.  It's on my to-do list..  But I love her storyline & character.  I also look a bit like her.  .. You could say I'm a lapsed gamer atm.  But once a gamer, always a gamer. 

I take it you're a fan as well?

 

On 4/14/2017 at 9:15 PM, mcjimjam said:

There are different ideas about what a normal Vit D level is so perhaps get a second opinion on your current level.

there has been a real vit d craze these past few years and some think the claims made about the prevelence and effects of deficiency are overblown. There is an article about this on the New York Times website at the moment.

Yeah, something will get popular and people will act like it's a cure for cancer or something.  Vit D does do a lot & it's very important that you keep it within range.  Increasing your dose within that range, however, won't necessarily do anything at all.

[notloki]

My levels are usually in the upper 30's and we are going with that. They were 14 when first tested. Doc said there are several reasons for low levels in general and even if you supplement. You really need a test at least once to assure you are storing enough D.

[Yuna]

1 hour ago, Cetkat said:

Those levels sound pretty normal to me.  I think there's also a possibility that there can be something going on that limits your Vit D production from the sun.  When I was still in FL, I got triple the recommended amount of direct sunlight - yet my level was still really low.  I think there's something medical going on with that.

The range is 20-50, but there's talk that it should be changed to 30-50.  I'd consider upping your level to ~40 and see if you get any more benefit.

I found this on lithium orotate: http://psycheducation.org/treatment/mood-stabilizers/the-big-three-for-bipolar-depression/lithium/lithium-orotate/

So, yeah, you were taking lithium, so of course it did something.  It's the lithium part in the lithium orotate and lithium carbonate that does the job.  The orotate is just a low dose lithium med. Do you have a pdoc helping you with all of this?  I did notice that it says 300mg is the point where you really need to do kidney and serum level testing.  So be mindful of that.

Magnesium for anxiety? Hmm.. I'll have to research that.  How did you come about discovering that?

 

And, yes, I am a fan.   Ironically, I haven't actually played the game yet.  It's on my to-do list..  But I love her storyline & character.  I also look a bit like her.  .. You could say I'm a lapsed gamer atm.  But once a gamer, always a gamer. 

I take it you're a fan as well?

 

Yeah, something will get popular and people will act like it's a cure for cancer or something.  Vit D does do a lot & it's very important that you keep it within range.  Increasing your dose within that range, however, won't necessarily do anything at all.

http://evolutionarypsychiatry.blogspot.com/2012/12/alternative-therapies-and-bipolar.html

 

http://evolutionarypsychiatry.blogspot.com/2011/02/basic-science-energy-is-everything.html

Its kind of an interesting website. 

 

Get ffx/x-2 remastered hd for ps3 or 4.

[melissaw72]

1 hour ago, Cetkat said:

Magnesium for anxiety? Hmm.. I'll have to research that.  How did you come about discovering that?

I've read about this too.

http://www.livestrong.com/article/486457-the-dosage-of-magnesium-for-anxiety/

If you google "magnesium and anxiety" there are more articles about it there.

[Yuna]

On 4/11/2017 at 9:46 AM, Cetkat said:

No problem.  Do you take the B12 shots for mood or something else?  I tried a B-12/B-6 combo before to see if it would help... but I didn't notice a difference.  I've never thought of trying the shots.

 

I don't know scientifically, but I feel like it is.  The combo I found to avoid con crud (getting sick at conventions) is the B-complex, Vit C, Airborne, and Echinacea.  It was a trial and error type of thing.  Out of all of that, I've found that I can drop any one of the last three and have it remain effective - but the B-complex is essential.

This is an interesting study where they used B-6 to increase immunity:

https://www.ncbi.nlm.nih.gov/pubmed/16670691

What b-complex/brand are you using?

[Cetkat]

Thanks for the links!  I'll have to check them out a bit more once things calm down.

This is what I take:

https://www.walgreens.com/store/c/nutrition-now-b-complex-adult-gummy-vitamins-strawberry/ID=prod6155790-product?skuId=sku6138856

I used to get it from Drugstore.com, but apparently they went out of business. The product got updated by the manufacturer, but all they did was switch the "color" (purple carrot juice concentrate) for (Black Carrot Juice Extract).. and got rid of a small amount of Inositol 7mg that was just used for added sweetness.  Makes sense cause extract flavor is stronger than concentrate.  I really like it because it doesn't have any added vitamins or minerals outside of B.  That's rather hard to find.  I normally take two, but I use it prn rather than daily.  It'd be easy enough to check the individual daily %'s to see if any can become toxic.

You didn't ask, but I also take Nutrigold Vitamin D3 Gold 2,000IU (x2) for my D3.  It's held up consistently in my bloodwork, so I can vouch for the quality.

[Cetkat]

Oh, and it's a bit off topic, but you should also check out Bromelain (It's stuff in a pineapple's core).  I heard about it flipping though Dr. Oz of all things.. but I did my research and it's really promising with inflammatory markers.  Most of the research is focused on cancer, but most of the markers are the same ones we're seeing in things like MI and Fibromyalgia too.

My GP at the time was rather surprised and happy that I was taking it.  I just need to remember to take it more often.. lol.  It's a take up to two 2400gdu/500mg pills after food 3x a day (based on research amounts, not bottle instructions).  I went with the more expensive SuperiorLabs version.

[melissaw72]

I agree with the bromelain helping with inflammation.

[aquarian]

On 3/12/2017 at 5:53 AM, melissaw72 said:

Do you know how the Vit D lab was written so Medicare would cover it?

Finally saw my pdoc today and asked her. On the prescription paper where she wrote down the tests she wanted the lab to run, she also wrote down several codes. The code she wrote to make sure the Vit D test would be covered by medicare was E55.9 unspecified vit D deficiency. She said that's because I've had my Vit D levels come back low in the past, so that code works to justify (to medicare) future vit D testing. She used a separate code to justify the iron testing, and there was one code that allows her to test for lots of things including diabetes blood sugar stuff because I take abilify (even though I'm on a tiny dose). By "allow", I mean "medicare will cover".

Anyways, just wanted to let you know. 

[melissaw72]

2 minutes ago, aquarian said:

Finally saw my pdoc today and asked her. On the prescription paper where she wrote down the tests she wanted the lab to run, she also wrote down several codes. The code she wrote to make sure the Vit D test would be covered by medicare was E55.9 unspecified vit D deficiency. She said that's because I've had my Vit D levels come back low in the past, so that code works to justify (to medicare) future vit D testing. She used a separate code to justify the iron testing, and there was one code that allows her to test for lots of things including diabetes blood sugar stuff because I take abilify (even though I'm on a tiny dose). By "allow", I mean "medicare will cover".

Anyways, just wanted to let you know. 

Thank you so much for getting back to me!  I probably wouldn't be covered then because my D level is normal ... the reason i want it done yearly is to make sure it stays that way.  I don't have a deficiency anymore.  The iron testing is covered for me, so I don't need to worry about that one. 

Thanks for reminding me about the abilify and getting tested for things related to that. I think being on all the meds I am on covers just about everything being tested (except vit D ... I think MA Health picked that one up to cover it).  Even cholesterol is covered ... I forget why, but I found out from pdoc it was because of a certain med (forget which one) I am on.

Thanks again!