Baby girl, dilated miocardyopathy from Argentina, need help

[Willy]

That's fine but skip one day if she is a lot in the sun

[Aleta]

OK! thanks a lot!!!

[Corrij (therapeut)]

Hi Willy,

Isn`t 1000IU vitamin D not to much? We recommend a adult 45 mcg = 1800IU
Her weight is about 7 kg.

For children, many experts agree they need about 35 IU's of vitamin D per pound of body weight.That would be 500IE.

At the time GrassrootsHealth performed the studies that resulted in this increased dosage recommendation, the optimal serum level was believed to be between 40 and 60 nanograms per milliliter (ng/ml). Since then, the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml,

Her value 70 ng/ml is the same as 174.72 nmol/l ( reference range 50 - 150 )

[Willy]

So happy that you are not mad!

The reference here is 30-150 of vitamin D, remember? There is 50-150 so is better she gets higher than 50!

I belive this are measures that this particular Lab has.

Desireble value, more than 30- Insufficient value, from 11 to 29- deficient value, less than 10.

Lara´s result is 70.

Corrij I worked on this basis. Do you think that this reference is wrong?

Could be, because I do not understand why it is more or less the same reference in The Netherlands and we are using nmol/l and NOT ng/ml

Aleta you have to look into this. Corrij came up with OTHER reference values. Check this with your lab and do not PANIC there is nothing wrong. The only thing is that we do not want to give Lara pills she does not need

[Aleta]

Hi Willy and Corrij,

I´m sorry to get back to you so late, I was alone with kids all day, and Lara is climbing averywhere and falling, she doesen´t want to get quiet in the cradle no more, which is great, but some times I have no time for nothing!

I´ll have to make a little research on this, because I don´t know exacly what those measures means and the equivalences...

The resuls of the blood test we did in september was 38,4ng/ml (desirable value more than 30ng/ml- Toxic range more than 150ng/ml).

Do you want me to send the sheet of the lab by mail?

Should we stop de vitamin D3 for a few days?

Not in panic, don´t worry

Ale.

[Corrij (therapeut)]

Hi Aleta,

There is a little confusion about the different values

38 ng/ml = 94.848 nmol/l

reference for ng/l = 30 - 150

reference nmol/l = 50 - 150

Grassroots-health - the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml.

In september it was 38.4 ng/l

In december it is 70 ng/l is that correct?

Conversion details

1,25D (pmol/L) - divide pmol/L by 2.4 to get it in pg/ml
25D (nmol/L) - divide nmol/L by 2.5 to get it in ng/ml


There has been a poor consensus in defining normal levels of 25(OH) D. It has been traditionally recognized that 25(OH)D serum levels below 5-7 ng/ml induce osteomalacia, serum levels below 10-12 ng/ml induce secondary hyperparathyroidism and osteoporosis, and serum levels above 18-20 ng/ml are usually considered normal or adequate.

Due to the results obtained in several studies, a more functional classification has recently been proposed defining serum 25(OH)D levels > 40 ng/ml or > 100 nmol/l as "desirable",

serum levels between 20 and 40 ng/ml or 50 and 100 nmol/l as hypovitaminosis D,

levels between 10 and 20 ng/ml or 25 and 50 mmol/l as vitamin D insufficiency and

25(OH)D levels below 10 ng/ml or 25 nmol/l as deficient.

These new cut-off levels, suggest that, in the past, we had been using a wrong statistical approach for defining "normal serum 25(OH)D levels".

In agreement with this new classification, in a recent study conducted in a random sample of our population, a high prevalence of low levels of 25(OH)D and secondary hyperparathyroidism was found. In our study, only in those people having "excellent" renal function, representing only 15% of the sample (serum creatinine < 1 mg/dl in men and < 0.8 in women, mean age of 68 years) hyperparathyroidism was not diagnosed despite observing 25(OH)D serum levels around 18-30 ng/ml or 45-75 nmol/l). In the remaining people (85% of the sample), who showed the expected serum creatinine increments according to their age, secondary hyperparathyroidism was avoided only if the serum 25(OH)D levels were higher than 30 ng/ml or 75 nmol/l.

These remarkable findings demonstrate the importance of maintaining higher 25(OH)D levels--in addition to normal calcitriol levels--in order to avoid stimulation of the parathyroid gland. In 87 patients with a functioning renal transplantation only a 11.5% of they had levels of 25(OH)D higher than 30 ng/ml and it was correlated with PTH. These remarkable findings demonstrate the importance of maintaining higher 25(OH)D levels--in addition to normal calcitriol levels--in order to avoid stimulation of the parathyroid gland in aged people. Thus, the deficiency or even "subtle deficiency" of 25(OH)D, currently neglected in the daily management of patients with chronic renal failure, may play an important role in the maintenance of hormonal and mineral homeostasis.
PMID: 12778859 [PubMed - indexed for MEDLINE]

greetings,
Corrij

[Willy]

Hi Aleta,

There is a little confusion about the different values

38 ng/ml = 94.848 nmol/l

reference for ng/l = 30 - 150

reference nmol/l = 50 - 150

Grassroots-health - the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml.

In september it was 38.4 ng/l

In december it is 70 ng/l is that correct?

Conversion details

1,25D (pmol/L) - divide pmol/L by 2.4 to get it in pg/ml
25D (nmol/L) - divide nmol/L by 2.5 to get it in ng/l

Hello Corrij I am getting a littlebit confused here. If you for instance divide 175 nmol/l by 2,5 you get 70 pg/l

175 nmol/l is above the Dutch reference 50 - 150

70 pg/ml is within the Argentina reference 30 - 150

Aleta can you check the reference for vitamin D ng/l please with your laboratory. You can phone them and ask

[Aleta]

Hi Corrij and Willy!

I´m confused to... the reference value in Argentina is in ng/ml. What should I ask in the laboratory,
what is the reference in nanograms and the equivalence in nanomol?

in the results are expresed in ng/ml, the same at the other results.

[Willy]

ng/ml is not the reference value it only tells something how it is measured

30 - 70

50 - 150

Are reference values it tells you about too low and too high

[Aleta]

And then exactly what should I ask in lab? I'm sorry, sebastian and I are both confused about this...

[Aleta]

I´ve call the laboratory... they told me tha the doctor should call and talk to the biochemistry, they talk to the doctor, not parents

Maybe we can talk to some biochemistry that we know, can´t remember anyone now, but we´ll try to caontact sombody.

[Willy]

Try to solve this problem with the doctor who ordered the blood test, he should now the references

[Aleta]

ok we´ll do that, i´ll try to reach her today, but maybe we need to wait until monday

[Corrij (therapeut)]

Hi Willy and Aleta,

I am sorry for bringing this confusion, but I want be sure.

There is considerable discussion of the serum concentrations of 25(OH)D associated with deficiency (e.g., rickets), adequacy for bone health, and optimal overall health, and cut points have not been developed by a scientific consensus process. Based on its review of data of vitamin D needs, a committee of the Institute of Medicine concluded that persons are at risk of vitamin D deficiency at serum 25(OH)D concentrations <30 nmol/L (<12 ng/mL). Some are potentially at risk for inadequacy at levels ranging from 30–50 nmol/L (12–20 ng/mL). Practically all people are sufficient at levels ≥50 nmol/L (≥20 ng/mL); the committee stated that 50 nmol/L is the serum 25(OH)D level that covers the needs of 97.5% of the population. Serum concentrations >125 nmol/L (>50 ng/mL) are associated with potential adverse effects [1] (Table 1).
Table 1: Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health* [1]
nmol/L** ng/mL* Health status
<30 <12 Associated with vitamin D deficiency, leading to rickets in infants and children and osteomalacia in adults
30–50 12–20 Generally considered inadequate for bone and overall health in healthy individuals
≥50 ≥20 Generally considered adequate for bone and overall health in healthy individuals
>125 >50 Emerging evidence links potential adverse effects to such high levels, particularly >150 nmol/L (>60 ng/mL)
* Serum concentrations of 25(OH)D are reported in both nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL).
** 1 nmol/L = 0.4 ng/mL

greetings,
Corrij

[Aleta]

So, Lara is having 70ng/ml, is even a little high?