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Vitaimin D deficiency and supplementation while on Atripla
Apr 16, 2012

Dear Doctor,

At my most recent visit, my HIV doctor checked my vitamin D levels for the first time, and I turned out to be very deficient; if I recall the test result correctly, it was something like 12. So, he has me on a prescription of 50,000 IU once-a-week vitamin D for eight weeks with a re-check after that.

Since my HIV therapy remains unchanged, what would keep my vitamin D level from returning to deficiency once this prescription is over? Is it possible to "store up" vitamin D and then resume normal vitamin intake, along with a balanced diet, after having gone through such a short course of vitamin D therapy, or is this simply a warm-up for a permanent weekly vitamin D pill for as long as I take Atripla?

I most recently tested at CD4 803 and 45%, UD VL, positive for well over 20 years, on Atripla or its components for more than 7 years, with other lab markers satisfactory and no other health issues.

I live in a northern area of the US and had the vitamin D test after a long, dark winter, so maybe I would improve if I just spent more time outside. I've read responses on this web site that seemed to take a dim view towards vitamin supplementation if one has a well-balanced diet, which in my view has been the case, but in the setting of Atripla would permanent high-level vitamin D supplementation be a likely situation? Up until now I only sporadically took vitamin supplements.

Response from Dr. Young

Hello and thanks for posting.

Vitamin D is important for a variety of health reasons, particularly because of it's importance in maintaining bone health. Vitamin D deficiency is very common in the general population; there's also additional data that suggests that people taking efavirenz might have lower levels.

We're testing vitamin D in all of our patients annually, and finding that at least 50% of people have low levels. Some individuals, like you have very low levels (less than 20).

Your doctor has chosen a very reasonable strategy for refilling your vitamin D tank- 50,000 units once weekly is very simple, inexpensive and well tolerated. I've found that it takes anywhere from 2-6 months to get levels like yours back to normal.

Thereafter, you'll need to continue to intake the usually recommended daily amount of vitamin D. If you're a 20-50 year old adult, the Institute of Medicine recommendations are to continue taking about 600 units of vitamin D with about 1000 mg of calcium daily. You can get these from dietary intake, but for most American adults, this is difficult and supplements easily do the job.

I hope that helps. BY



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