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[CE1976]

Im after some advice please! For the last 6 weeks I’ve been experiencing palpitations and heart rate spikes and feeling very fatigued. Gp suggested it could be hormone related so I’m having a consultation next week about hrt (I’ve also had very irregular periods for the last 2 years).
 However I’ve also just found out my vitamin D levels are pretty low. So now I’m not sure whether to go down the hrt route or just try vitamin D supplements for now?
Has anyone else had any experience of this? I’m worried the vitamin D will take a long time to take effect and am fed up with feeling rubbish but not  sure about trying too much at once! Thanks.

[CLKD]

Hi! I would go for the discussion about HRT.  MayB keeping a mood/food/diary would be useful, something to discuss.  My periods waxed and waned for a few years - then went.  After I had cold flushes from the back of my neck to the waist, this didn't last for many months.  Itchy skin has been my main issue along with vaginal atrophy.

As oestrogen levels drop the body may become dry: inside and out  ; skin, vagina, deep in the ears, eyes, nostrils ....... and muscles may become lax = aches and pains.

Some GPs still don't think that we can be peri if we don't complain of hot flushes, because they believe that the loss of periods and flushes are the 'only' symptoms 

VitD is recommended in the Northern Hemisphere as we don't get as much sunshine as we require due to people not exercising outside as we did years ago.

Let us know how you get on.

[CE1976]

Thanks for replying. I’ve been to the gp a few times over the last few years with perimenopause symptoms but as I’ve not had hot flushes they’ve always been dismissed. This is the first time they’ve actually suggested hrt so I guess I’ll give it a try!

[SundayGirl]

You can increase your Vitamin D levels very quickly if you use loading doses.

Here's a handy calculator if you know your current level. Just pop your current figures in.

You should aim for VitD levels of about 100 nmol/L

https://www.grassrootshealth.net/project/dcalculator/

[CE1976]

Thanks that’s really interesting. Didn’t realise you could take such high levels of vitamin D! Hopefully won’t take too long to recover then.

[CLKD]

Did your GP prescribe VitD capsules?

[CE1976]

Haven’t spoken to gp yet (saw the results on my NHS app) so going to ask at hrt consultatation. Level was 25nmol/L which looks quite low to me… going to self-prescribe supplements in the meantime!

[JS79]

On this crazy journey I tested insufficient for vit d, for some strange reason I wasn't given loading doses and told to take a little supplement a day. Fast forward 11months and although HRT has stopped some symptoms others remain. I'm awaiting more bloods to see how my vit d is now and also check my b12 which was borderline but advised not to supplement.
At our age it could be a combination of everything but I would say especially in winter everyone should be taking some form of vit d, the amount will depend on your levels.

[SundayGirl]

The reference ranges for vitamin D, according to the NHS:

below 25 nmol/L – Deficient
25-50 nmol/L – Insufficient
50-75 nmol/L – Adequate
75 nmol/L or above – Optimum

JS79 is correct in saying the amount you need to take will depend on your levels. More is not necessarily better. You don't want to end up with hypercalcaemia (literally too much calcium) so you need to monitor and adjust until you find the maintenance dose your body needs.

Edit -- This is all from personal experience not just googling.🙂

[CE1976]

Thanks. Going to take a general supplement for now and see what the gp says… as I’m on the border of deficient I assume I’ll need something extra, but will see!
Just hard to know if the palpitations and fatigue are due to vitamin d deficiency, hormones or both…or when I’m really anxious, something even worse!

[Seasidegirl]

I am midway through this situation. 

In short I've been fatigued since I had lots of surgery in 2016/17/18.  I also have an elevated heart rate for the last year 
 
It was assumed to be peri but nobody tested Vit D, Folate,  B12 etc.    I was avoiding HRT (early breast cancer history) so it just seemed to be how it was and nothing to be done so I put up with feeling unwell constantly.

Started HRT last year in desperation as I felt so poorly.   HRT helped with some symptoms (anxiety/ overwhelm/ joint pain) but the fatigue and elevated heart rate remain.

I've just had D, Folate, Iron, ferritin measured (amongst others) and my D (53.9) & Folate are both low,  B12 is debatable.   I've been taking a 1000iu D supplement since Feb anyway so who knows what it would have been without that.   

I also have an odd thyroid issue which might be being made worse by the low vitamins or the thyroid might be effecting the vitamins 🤷‍♀️

Personally if it was starting this again,  I would get bloods done for D, Folate, B12, iron, ferritin AND I'd get estradiol, progesterone, testerone and SHBG before I started HRT to understand the baseline.  If you may have a thyroid issue I'd do TSH  T4 and T3.   This will give you an absolute baseline before you start adding anything.   You will probably need to pay for these.   

I didn't do this and I'm now trying to work out what is causing what.   Taking HRT sends to have triggered some changes or is really coincidental.     I really wish I had the pre HRT baseline to compare. 

Sunday Girl know her stuff about this. 

With a D level as low as yours,  your GP should prescribe a loading dose. 

It's been suggested to me that low D and Folate could be making me feel as shocking as I do so I'd get baseline bloods.   Take the loading dose,  also take a good B supplement if those are down and then see how you feel.

HRT definitely helps me but I'd have done it differently if I knew then what I know now. 

[CE1976]

Hi, thanks so much for your message. Sorry to hear you’ve been suffering too. I’m so fed up with feeling awful…
Just spoke to gp and she’s giving me a 4-week loading dose of vitamin d (not 7-weeks as my levels weren’t quite in the deficient range!). She’s also going to prescribe hrt but I’m seeing a cardiologist on weds so will probably see what he says first.
It’s so hard knowing what to do for the best. I’m so desperate to feel better I few like I’d try anything at the moment!

[Seasidegirl]

That's how I felt when I started HRT, absolutely desperate.

Can I ask what loading dose the GP has prescribed?  I'm going to see the pharmacist next week to see if they can advise on a loading dose, I'd be interested in what you've been given. 

Did your GP  check folate, B12, iron and ferritin?   Both low folate and B12 can make you feel horrid.   The in range figures may not be sufficient for you to feel well.   

[CE1976]

The loading dose is one 40,000 unit capsule per week for 4 weeks. 
Folate, iron & ferritin were all pretty much in the middle of where they should be, according to the NHS app anyway! B12 was low at the beginning of the summer but higher when re-checked 6 weeks later after I’d been taking supplements. It all feels a bit “trial & error” at tte moment 
Hope you start feeling better soon too x

[SundayGirl]

Unfortunately making sure your vitamin levels are optimal, not just ok, is a bit trial and error and you really need to take matters into your own hands.

GP's know next to nothing about nutrition and will only prescribe supplements to get you into the bottom of the ranges. This doesn't mean that you feel better, just that they've ticked another thing off their list.

As Seasidegirl said, low folate and B12 can cause tiredness as well as vitamin d and make you feel bad.(Been there done that and felt like death warmed up  ) I can now keep my D and Bs where I feel best but i always have issues with keeping my ferritin level up.

CE1976 - what were the numbers of those? The folate, B12 and ferritin I mean.

I can't really comment on iron panels. I'm not certain that I fully understand all the different parts of one but I'm happy to do some research if that will help