so, momma, all things considered, it looks like you were not in fact seriously deficient to start with. not cool for the doc to put you on a megadose like that. do you think you get a lot of dietary d3 to compensate for your low sun exposure?
Yup, Dr. Kerr said I must be deficient by just looking at me and told me to take the D without pre-testing what my levels were before treatment.
what to do now depends on how long ago this all was, and whether the usual problems associated with hypercalcemia have resolved on their own or not. i think you would be very wise to have a serum calcium test ordered at the very least.
i'm on the phone with my hospital's drug information desk (these people are GOLD as a resource)...
okay i basically framed some questions around d3, hypercalcemia, how to deal with it, what about the skeletal architecture etc...
up til the point when my phone battery died i got you this:
yes definitely on the serum calcium, and they also mentioned renal function and bone mineral density tests. they didn't know why calcium or bone mineral tests hadn't been done first off before getting into vitamin d at all, so i explained that it was in the autoimmune/inflammatory context not osteo stuff. so with that context they figured maybe the doc had made a decently educated guess on your baseline status, based on ms dx and low sunlight exposure. and then they agreed that there was certainly a link to the bones. (of course)
so creatinine is a measure of renal (kidney) function and in that 1987 case i mentioned before, where 50K d3 daily for 6 weeks ended up with 320 nmol/L and serum calcium 3.75 mmol/L, the creatinine level was 388 mumol/L. i fudged some numbers a bit to get an idea of the right ballpark in mumol/L and it's more like 77mumol/L! here's the background and 'math' on that:
"Reference values for serum creatinine were almost identical to previously published ones obtained with the same methods: 0.73–1.18 and 0.55–1.02 mg/dl for males and females, respectively"
converting that to mumol/L for comparison, it works out to a reference 'average' of 77 mumol/L (that's splitting the difference between the midpoints of those two ranges)
i don't think there is any method other than time to deal with your possible hypercalcemia situation. i said on the phone with the drug info desk that i would check the literature on timing for resolution of hypercalcemia after d3 overdose and she said she did not think it would take that long. although the next bit is talking about advanced renal failure cases, this looks like a useful tidbit:
'Therapy of renal diseases and related disorders By Wadi N. Suki, Shaul G. Massry also provides relevant info on vitamin d3 and hypercalcemia because high doses are needed in renal failure cases:
'There is a great variability in the required amount of vitamin D by patients with advanced renal failure. Doses as high as 50,000 to 200,000IU per day may be needed to achieve beneficial effects ... hypercalcemia is a real and frequent hazard. Such hypercalcemia may persist for weeks after the discontinuation of therapy...'
[JL edit: i forgot to put this in the first time - 'A variety of symptoms may accompany even mild hypercalcemia in uremic patients. Nausea, vomiting, mental confusion...' sounds familiar i bet huh momma!?!]
HYPERCALCEMIA, CALCIUM SUPPLEMENTATION, AND THE KIDNEYS
again, this info is for advanced kidney failure patients but might be useful in your case:
Therapy of renal diseases and related disorders By Wadi N. Suki, Shaul G. Massry
'... weekly or bimonthly monitoring of the concentration of serum calcium and phosphorus is advisable. if the serum concentration of calcium exceeds 10.5 mg/dL [JL edit: that's 2.63 mmol/L; compare 3.75 mmol/L in 1987 overdose study mentioned above], calcium supplements may be cut in half or may even be discontinued temporarily... '
and as to restoring calcium, should your bone mineral density test indicate that it's warranted, this could also be something to consider: '...calcium chloride should be avoided in uremic patients because of its acidifying properties... calcium carbonate is inexpensive, tasteless, and relatively well tolerated.'
for bone mineral density, of course there are a number of pharmaceutical alternatives out there, and there are plenty of ways you can also work on bone health nutritionally if it turns out to be an issue.
this article looks like an excellent place to start reading:
Journal of the American College of Nutrition, Vol. 19, No. 6, 715-737 (2000)
Nutrition in Bone Health Revisited: A Story Beyond Calcium
Jasminka Z. Ilich, PhD, RD and Jane E. Kerstetter, PhD, RD
free full text at http://www.jacn.org/cgi/content/full/19/6/715
let me know if you have more questions
i'll do my best