ferritin

[eers]

Hi Everyone,

One of the annoyances that I see some of us are having are muscle twitches. I understand that there could be many causes - inadequate iron, calcium, magnesium, potassium as well as others that have been discussed on this board. I personally have tried to have adequate intake of all of the above without much success, and now I have read that a shortage of ferritin, this protein found in the liver, spleen, bone marrow which helps bind iron could contribute to muscle twitches as well.

I did a google search to see if it could be associated with statins and came up with this:

"According to the results of the analysis, 53 entrants who were assigned to statins at baseline trended toward lower ferritin levels (mean 114.06 ng/mL) compared with 47 patients who were not assigned to statins (mean 127.6 ng/mL). A longitudinal analysis revealed that after adjusting for the phlebotomy treatment effect, statins had an effect on the reduction of ferritin levels (–29.78 ng/mL). Mean ferritin levels were higher in the 23 patients who died during follow-up vs. the 77 survivors (132 ng/mL vs. 86.3 ng/mL). The researchers also reported that mean IL-6 levels were higher in the patients who died vs. the survivors (P=.03)."

Here is the link:
*http://www.cardiologytoday.com/view.aspx?rid=42320

Would some of the scientists be able to clarify what this means in layman's terms? It seems I'm reading that people taking statins could have their ferritin levels lowered (I realize this is a very small sample group). I just wanted to get a more learned opinion of what I'm reading.

Thanks,
eers

[Biologist]

Hi, errs,

Interesting thoughts. The first question for me would be: do any such ferritin/iron-related statin effects remain after statin cessation? As we know, some of the bad side effects of statins do correct quickly including the side effect of cholesterol levels being lowered. (Yes, no typo there. That is indeed what I meant to write. It is well known in science at this time that the small positive effects of statins are NOT attributable to their lowering of cholesterol levels at all, but rather by other biochemical mechanisms; and it is also known that the higher your cholesterol levels, within reasonable limits such as being below about 300 mg/dl, the longer you will live.)

My concern is having ferritin/iron levels that may be too high rather than too low. Have you had your levels checked? I particularly liked the comments at the end of the abstract about the abstract that you cited/hyperlinked.

Here is a clip from a June 12 post of mine in another thread:

"I requested a Ferritin test (i.e., serium iron level)
which we added since I can no longer give blood
to the Red Cross due to the finasteride that I take
for hair loss. (It causes birth defects to the fetus
when perfused in pregnant women). I measured at
224 ng/mL on a referrence range of 22 - 322 ng/mL."

Here is Dr. Mercola's publication two days later (which may be evidense that Dr. Mercola is responsive to issues arising on this forum, as noted previously by another posters on Spacedoc):

*http://articles.mercola.com/sites/articles/archive/2009/07/14/Little-Known-Secrets-about-Optimal-Iron-Levels.aspx#atuid-48f011e902e9aef7

So I am concerned that my levels may be too high regardless of falling into the "reference range" for the lab that did my blood work. Also, the levels found in your study indicate my levels may be atypically high. I put more credence on Dr. Mercola's findings on healthful levels than acceptable levels from such a lab. (The lab indicates what is "normal" not what is most healthy). I have just not had time to follow up on this, but I will and I appreciate your bringing the issue back to my attention.

When giving blood, they always test you first for the weight of your blood to make sure you are not anemic, I think, or alternatively, "iron heavy." The girls always use to say: "Wow!" at how fast my sample sank in the solution. So I suspect I have atypically heavy blood (i.e., iron is heavy). But again, I have not had time to research this well. My guess is that I will be having blood periodically removed in the future, as he suggests.

For gluttons for punishment, here is more on that biochemical iron storage molecule:

*http://en.wikipedia.org/wiki/Ferritin

I hate to bring this up, but probably should. I believe muscle twitches with the statin damaged patient are sometimes thought to be evidence of dying nerve/muscle junctions. But not necessarily. There are certainly other causes, so don't be too alarmed.

Biologist

[eers]

Thanks for your reply Biologist.

I haven't gotten my levels checked so far, but since I was diagnosed with a severe Vit D deficiency this was one of the major issues I kept seeing (muscle twitches) - my previous problems with fatigue and dizziness/lightheadedness improved greatly as I took the supplments.

I did a little more reading last night - and it seems the Vit D symptoms are very vague. They could be associated with my muscle twitches as well. As of this past Thursday, I was on my fifth weekly dose. The first month was slow but steady improvement in many symptoms I've mentioned - in addition to my blurry vision and so on. But the latter part of this week it was steadily worse. Yesterday I had bad bouts of fatigue, lightheadedness and muscle twitches and again a sensitivity to bright lights - this eventually led to blurry vision from what I can recall earlier.

I'm wondering if it's possible that I got a bad batch. I switched pharmacies - but the pill looked the same (dark green translucent) although that doesn't necessarily mean anything I suppose. I'm thinking prior to digging deeper into ferritin, it might be the more obvious.

I'm scheduled to get a blood test at the 3 month mark to assess my levels. Can you speak to these issues with Vit D? How long might it take for the body to "recover" to optimum levels and so on? At least for now I take 2 tpspns of Cod Liver Oil - they give me 200% DV but maybe I should talk to my pharmacist...

[Biologist]

eers,

What does DV mean?

You have a PRESCRIPTION for vitamin D? Why?

Is it D2 or D3?

It apparently takes a few months at 5,000 iu per day, if you are low. When we start talking about 50,000 units once week, like some doctors recommend, I don't really know how much less time it might take.

You are currently taking the Cod Liver oil on your own, right? Instead of the prescription vitamin D?

Biologist

[eers]

DV should have been Recommended Daily Value or Allowance or whatever. I take about 200% through Cod Liver Oil which no doctor prescribed, I took this on my own for about 2-3 months now.

A little over a month ago I had a Vitamin deficiency exam done and I was found to have 16 out of a normal range of 30-100 for Vitamin D. I'm not sure of the units. I was told to get on a weekly doesage of 50,000 IUs. That was about five weeks ago. Prior to that - I was complaining a lot of fatigue, dizziness, blurry vision in addition to cramping and so on. I noticed a significant improvement but this past week was a relapse that has now gone into several days.

I switched pharmacies on Thursday - but I made a call, the Vit D is manufactured by the same company.

Just as an update - my doctor asked me to come in have another Vitamin D assessment done along with a complete blood work to see what else might have gone awry. I'll get the results by the end of the week I'm guessing.

Just an aside regarding muscle twitching. I am taking about 500mg Magnesium Orotate in addition to my Acetyl-L-Carnitine (500mg), CoQ10 (900mg) and Cod Liver Oil (2xday). That's not a huge amount of Magnesium, but I would think that might not be the cause. I guess we'll see if Calcium could be contributing to this but I've been pretty good about taking a fair amount every day (no supplement).

eers

[Biologist]

The magnesium is a real good bet. My bet is there are many cardiologists who wish it were prescription such that they could benefit from it -- you would have to go to them to get it. Still, few people know about it, and it's so cheap, its basically free.

You did not answer about what type the vitamin D is you are/were taking. D2 is pretty worthless, and it is prescription. D3 is what you need and it is dirt cheap.

Here is Dr. Mercola recently on the issue:

*http://articles.mercola.com/sites/articles/archive/2009/10/10/Vitamin-D-Experts-Reveal-the-Truth.aspx

Here's an excerpt:

"Only Supplement with the Right Kind of Vitamin D

There is one other thing you need to be aware of if
you choose to use an oral vitamin D supplement
and that is that there are basically two types – one
is natural and one is synthetic.

The natural one is D3 (cholecalciferol), which is the
same vitamin D your body makes when exposed to
sunshine

The synthetic one is vitamin D2, which is sometimes
called ergocalciferol

Once either form of the vitamin is in your body, it
must be converted to a more active form. Vitamin
D3 is converted 500 percent faster than vitamin D2,
and is clearly a better alternative.

Vitamin D2 also has a shorter shelf life, and its
metabolites bind with protein poorly, making it less
effective. Studies have even concluded that vitamin
D2 should no longer be regarded as a nutrient
appropriate for supplementation or fortification of
foods (although it continues to be used). So if you
choose to use vitamin D supplements make sure it
is in the form of vitamin D3.

Please be aware that nearly all the prescription-
based supplements contain synthetic vitamin D2, so
if you receive a prescription for vitamin D from your
doctor, you’re most likely receiving the inferior
vitamin D2."

Biologist

[eers]

Ok, I just called the pharmacy - this refill that I got on Thursday is D3. Not sure what I was taking earlier, but I'm guessing it might have been the same - they both were a translucent dark green color made by the same company...

I'll see what my magnesium levels are in a few days via bloodwork.

Thanks for your feedback.

[eers]

Well the results are back. As of tonight, I'll be on my 6th weekly dose of Vit D at 50,000IUs. Prior to starting I was at 16.8, currently I'm up to 27.2. The range is supposed to be 32 - 100.

My doc is concerned enough that he wants me to double my dosage weekly. I wonder if that's really warranted as it seems to be moving, although slowly? Also, I've heard here and elsewhere that it takes perhaps months to resurrect low levels back to normalcy. Can anyone attest to that? I don't understand his concern especially as the initial prescription was for 3 months.

The other thing - my calcium is within normal limits. 10.1 out of a normal range of 8.5-10.6 range.

Unfortunately it seems they never recorded my Magnesium range. I'm thinking I'll give this a few more weeks before I experiment with increasing my magnesium orotate dosage from 500mg.

[Biologist]

Hi, errs,

I don't claim to be no expert on nothing* [see below], however it is my understanding that magnesium can be tricky to test. But if you are given a solution of it to drink, and none can be found in solution on the way out, it means that your system scarfed it up and needed it, so therefore you were low on it.

Your doctor may be trying to get you up to speed quickly on the Vitamin D (VD) such that your new levels will help during flu season. Best guess.

Your numbers were educational for me. First case study I have seen on the progression of VD levels with supplementation. Thanks. Here's a guy that knows his VD. He has written a peer reviewed paper on his theory of VD (boy, for some reason I just hate that abbreviation/"acronym"!) toxicity that appeared in one science or medical journal or another. I read the abstract one time. He hits on it a little in some of the text sited below.

*http://www.cholesterol-and-health.com/Vitamin-D.html

"Vitamin D Deficiency: Do Cholesterol-Lowering Statin Drugs Inhibit Vitamin D Synthesis?

Researchers know that vitamin D synthesis declines
with age -- and so does the concentration of
7-de-hydrocholesterol in the skin. Without 7-dehydro-
cholesterol in the skin, sunlight has nothing to turn
into vitamin D. The researchers consider it likely,
then, that the decreased synthesis of 7-dehydro-
cholesterol is responsible for the decreased synthesis
of vitamin D that comes with age.

It follows then, that the cholesterol-lowering drugs
known as statins, or HMG CoA reductase-inhibitors,
which inhibit the synthesis of 7-dehydrocholesterol,
also inhibit the synthesis of vitamin D.

As of May 25, 2006, there are no studies indexed for
Medline that tested the effect of statins on vitamin D
levels for longer than three months, and only one,
single study out of three that tested the effect of
statins on vitamin D levels for longer than one month
-- conducted a whopping fifteen years ago. The small
handful of short-term studies found no effect.

By contrast, researchers who showed that statins
induce dramatic deficiencies of coenzyme Q10 in
humans first retested coenzyme Q10 levels after six
months of administering the statin. They further found
that coenzyme Q10 levels kept decreasing over time
for over 18 months before settling.

We would expect statins to take even longer to cause
a drop in vitamin D levels, because, whereas coenzyme
Q10 is measured directly in the blood, the 7-dehydro-
cholesterol takes time to migrate to the surface of the
skin and accumulate there. So what is the effect of
statins on vitamin D levels one year down the road?
Two years? Five? Ten?

The truth is we have no idea, because no one has
bothered to study it.


Vitamin D Safety â€â€

[eers]

Biologist,

That's a great site. David mentioned the same thing earlier - regarding how cholesterol is a precursor to VD production. I know josie1952 went through something similar and it took months for her to recover.

*http://spacedoc.net/board/viewtopic.php?p=9897&highlight=vitamin++deficiency#9897

I'm surprised that we don't hear more of this on this board. Most worrisome is that too many doctors don't realize this could be an issue.

eers

[valgators]

Hi all,

Back in the spring of 2008 I had a Vitamin D test and my level was 19 when 40-50 is the more preferred minimum (according to the endocrinologist). I took 50,000 IU's (prescription) once weekly for 4 months and got my level up to 31. I have had periodic tests and it is steadily moving up with supplementation and a fair amount of sunlight.

What I couldn't understand then was how I could be so low since I lived in Florida and had always gotten out in the sun. Of course, I had been taking statin drugs since the early 90's, so I believe that is likely the answer.

We put more pieces of the puzzle together everyday, don't we?

Best to all. Valgators

[Biologist]

Hi, valgators,

Thanks for posting. How long were you off statins prior to having your Vitamin D level first checked?

Do you know what your current level may be?

How did you hit on the idea to have it tested?

I can't help but to have a theory or two starting to shape up here. BTW, my above cited court work was not health related.

Biologist

[eers]

Here's my history on this.

-Was on Crestor 10mg since January 2007.
-Stopped all medication as of July 21 2009.
-Had a vitamin d deficiency test on September 4 2009 - 16.8.
-50,000 IUs Vitamin D/week prescribed.
-Retest on October 12 2009 showed a level of 27.7.
-Am now up to 50,000 units Vitamin D 2x weekly.

eers

[valgators]

Hi Biologist,

I believe my Vitamin D level was 41 or 42 at last testing several months ago.

I can't take credit for knowing about Vitamin D deficiency. I actually had been referred to a neurologist for muscle pain. Of course, I had the CK test and it was normal as well as the EMG. The neurologist referred me to an endocrinologist who immediately ordered the 25 Hydroxy Vitamin D test which revealed the low level of 19. He prescribed 50,000 IU's of Vitamin D weekly for 4 months. He told me it would take time before improvement was noted and it did. The good news is I believe I am better with a higher level of Vitamin D.

I stopped the statin drug (Pravastatin) in February, 2008. So, it was only a few weeks between stopping and getting the Vitamin D test. Oh, and I was the one who decided to stop the statin. No doctor recommended I stop.

Best to all, Valgators

[Biologist]

Thanks, eers and valgators.

For now, we have at least further defined an issue to be resolved: is Vitamin D production a long-term casualty of statination?

We also now have some data on how long it takes to get levels up with supplementation.

I think we agree that everyone who finds this forum should immediately have their levels checked, and then supplement.

Those who do not yet know to stop their statins should be similarly advised. Once they check, it might help make a believer out of them.

Biologist

[Biologist]

Dr. Graveline's newsletter today included the following informative piece on Vitamin D:

http://www.spacedoc.net/statins_vitaminD.html

A previous post of mine in this thread cites Vitamin A in regards to its regulatory powers over Vitamin D. However, I will quit supplementing any Vitamin A and only use Beta Carotene (as you will see why) due to this recent piece by Dr. Mercola. Only in recent weeks had I switched from Beta Carotene to Vitamin A when I ran out of of the former -- so its very timely info for me. I thought I would pass it on:

*http://articles.mercola.com/sites/articles/archive/2010/03/16/warning-new-proof-confirms-if-you-take-this-supplement-vitamin-d-will-not-work-as-well.aspx

I'm a big believer in Vitamin D and will have my levels checked again for the first time in months in the next few days along with Folic Acid/Folate levels. Also Ferritin levels which I suspect will still be too high as I have previously posted. If so, I will start having small amounts of blood drawn regularly to correct it. Other people may be low, so it's a good one to check.

Dr Graveline suggested Powered Vitamin C over pill forms of VC in his most recent book. He did not comment on why. Here's my best guess: Almost all pills (and capsules too, I think) use a lot of Magnesium Sterate as a binder for manufacturing the pills. Magnesium is great, but this particular form is not helpful for the digestive tract and may impede absorption. It should be minimized. I now only take powdered forms of VC, as I have for months, per his suggestion.

Biologist

[Biologist]

In the above post, "Powered Vitamin C" should have read "Powdered Vitamin C." Also the capitalization was unnecessaary, and probably makes it look like some kind of retail product. Nope.

Biologist

[pops]

Question about vitamin D and statins:

Statins block cholesterol production in the liver. Cholesterol is necessary for the production of vitamin D in the skin on exposure to sunlight. Does that mean that if a person's source of vitamin D is not sunlight (IE: they get their vitamin D from milk, supplements, fortified orange juice etc.) that statins won't affect their vitamin D levels?

Or is there another pathway for statins that affects vitamin D levels irregardless of the source of vitamin D?

And if the above is true, then is it possible that vitamin D is more of a factor in statin side effects than coenzyme Q10?

[Biologist]

Good questions, pops. I could speculate, but I'm not sure of the answers.

All the answers should be common knowledge to all statin-prescribing doctors, but I'd imagine few have ever even considered the questions.

The word about statins is certainly getting out to the public though. I think the smarter doctors are trying to figure out how to get ahead of the wave. Good career move.

The fact that their collective credibility will be taking a solid hit due to the statin fiasco is probably a good thing. It may save a lot of lives. As long as doctors rely on the drug industry for their medical knowledge and their practice, they are dangerous. Patients need to know this, and it seems to me they are figuring it out pretty quickly now.

Biologist