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Wednesday, August 27, 2014
I have active sarcoidosis. My vitamin D level is at 7. My primary doctor has recommended vitamin D because I have also been diagnosed with spinal osteoporosis. My Pulmonologist has warned me against vitamin D, what should I do?
Dear Sir/Madam- This is an excellent question, and one that needs some explanation. It is not uncommon for sarcoidosis patients to present with elevated calcium levels relating to activation of vitamin D.
The inactive form of vitamin D (25-OH vit D) is converted to the active form (1,25-OH vit D) in immune cells at the sites of inflammation. It is likely that the inactive form of vitamin D was measured in your case.
Assuming that your sarcoidosis is under reasonably good control, your serum calcium levels are normal, and you do not have a history of high levels of calcium in your urine, it would be reasonable and probably beneficial for you to take vitamin D supplements.
Low vitamin D levels can lead to a number of problems, including osteoporosis, fatigue, and some evidence links low vitamin D levels to altered immune function and cardiovascular disease.
Thus, as long as you do not have high levels of active vitamin D (1,25-OH vit D), it makes sense to enhance your intake of vitamin D to get your levels of inactive vitamin D (25-OH vit D) back to the normal range.
Since little research has been done to determine the best way to manage altered vitamin D metabolism is sarcoidosis, these recommendations should be viewed as a "professional opinion".
More research on this topic is needed to definitively answer your question.
Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University