Should myeloma patients use vitamin D?

Should myeloma patients use vitamin D?

So vitamin D is a fat soluble vitamin that can be obtained from dietary sources, and our body also makes it through sunlight and UVB rays. from dietary sources, things that can have vitamin D are fortified milks and, fatty fish, mushrooms that are exposed to sunlight. These are some examples of foods. It is one of the most common vitamin deficiencies in the world.

Just because most of us are indoors now, or living at, places where we don't have as much sunlight. And so, this is something to think about in terms of in myeloma, we have a lot of retrospective studies or evidence where people have looked at, you know, patients who have low levels versus normal levels and how they have done.

And they've seen that patients with vitamin D deficiency tend to have a shorter progression free survival or overall survival. And they also have more likelihood of inflammation or potentially higher stages of disease, higher likelihood of bone, lower bone density and when they get bone strengtheners like bisphosphonates or, you know, zometa, xgeva, those drugs. There is a higher likelihood that they develop hypocalcemia with it.

So I think but we don't have any prospective trials where myeloma patients were given vitamin D. And then we see whether that improves survival or that they do better. We just know based on what the levels are, what happens. So I think with this limited evidence, it would be helpful to ask your doctor and get your levels checked and try to keep the levels, at least within the sufficient range, which is about over 20 or 30, but also to remember sensitive, fat soluble vitamin.

High levels are also associated with toxicity. And we see that sometimes where patients will have too high levels and then they will end up with high calcium levels or other symptoms from the toxicity of the vitamin. So it's important to stay within the range. And that can be done by, taking a regular supplement and adjusting it to the dose that’s right for you.

Another thing about vitamin supplements to know is that there are two forms that you can get it in. There's ergocalciferol and cholecalciferol. ergocalciferol is vitamin D two. And maybe in higher doses it, when you need to take really high doses, it may be the form that somewhat better. tolerated and absorb. But the cholecalciferol in general is a better absorbed one cholecalciferol, can be obtained from plant sources and animals sources. So you can tell based on the bottle whether it's, a plant based cholecalciferol or not plant based, if that matters. and I think since it has better absorption at lower doses, that maybe the vitamin D3 or cholecalciferol. that you're taking. And then in terms of a standard dose around somewhere between 400 to 1000 units per international units per day is what most people need.

But you have to adjust to your levels. If you are deficient, you may need a higher dose or not. And so it's important to monitor. There is a blood test for 25 hydroxy vitamin D levels, and that's the one you should be asking your doctor to check for you, when vitamin D from sunlight, when the UVB rays come to the skin and the vitamin D is made, we form cholecalciferol within our skin, and that gets metabolized into 25 hydroxy in the liver.

And then it gets activated in the kidneys. So people with liver or kidney disorders or dysfunction can also have, lower levels. If you have intestinal malabsorption issues that could affect the levels too. So it's something to just be mindful of. And most majority of patients have low levels.