Author: Admin (---.vnnyca.adelphia.net)
Date: 10-19-02 12:20
Kevin,
The Vitamin D in your body comes from two sources
1. Solar synthesis in your skin from going out of doors
2. Intake of Vit-D in diet
The level of 25-D in your body (which can be stored in body-fat) comes from
1. Solar synthesis in your skin from going out of doors
2. The 25-D stored in your body fat
3. Conversion of dietary Vit D from food and supplements
The level of 1,25-D in your body comes from two sources
1. Direct Solar synthesis in your skin from going out-of-doors
2. Conversion of the 25-D in your body by both the kidneys and the sarcoid inflammation
Only the 1,25-D is the active hormone, the other substances are just intermediary metabolites. Only the level of the 1,25-D determines the effects from all these sources upon your body. The level of this hormone is very low, and it is very hard to measure. This is why the 25-D level has historically been used as an indicator of 1,25-D activity. However, this has led to errors in our understanding of the effects of the D-metabolites. Only the 1,25-D level is the one that drives our body and our symptoms..
When you discontinue the dietary Vit-D, you still have to deplete the 25-D stored in your body-fat. Depending on the individual, this can take from 2-12 months (it takes a while to work that storage down (and hence the 25-D level down)). 25-D is not a very expensive test, and it can be performed every couple of months to track your progress.
Click here for a graph of 25-D vs time taken from "Gains in Bone Mineral Density with Resolution of Vitamin D Intoxication." Annals of Internal Medicine, 1 August 1997. 127:203-206
The time scale is years, and you can see four graphs for 4 different patients. The 25-D of one patient fell in just a few months, while one took nearly a year to use up all the fat reserves (the 25-D axis is expressed in the SI international unit, nmol/L , which is divided by 2.5 to get ng/ml).
Nevertheless, the level of 1,25-D in your body can vary very quickly (4-6 hours) when you are exposed to sunshine or have a dietary intake. These surges are what takes the level up to a value which causes symptomatic problems. After the exposure, the 25-D takes a week or so to stabilize down again to the steady state value determined by the fat storage.
I wish there was some drug that could immediately use up all those fat reserves, or block new D intake. But there is not. The ARBs (in the correct dosage) will make you less sensitive, but not immune. Exercise and weight loss will get the fat storage down more quickly, but it will take a lot of willpower.
Once you start spending your time indoors you notice an immediate benefit (within a few weeks). To get back to something like "normal" will take 6weeks-6months, depending on your exposure history.
Diovan taken once a day is not very effective in lowering the 1,25-D symptoms. The reason for that is given in this paper. Benicar is a more modern ARB which seems to block receptors in more organs than Diovan. If your doc thinks that our recommended 40mg of Benicar every 8 hours might be too much for you, it is possible for him to start you on a dosage as low as 20mg every 8 hours. IMO, you do not need to wait for the Diovan to clear your system when changing ARBs.
..Trevor..
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