[Jay] MD help with work-up of poor sleep and fatigue

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Sonnyboy
Posts: 637
Joined: Sun Nov 23, 2014 8:56 am

Re: [Jay] MD help with work-up of poor sleep and fatigue

Post by Sonnyboy » Wed May 25, 2016 12:32 pm

Jay Aitchsee wrote:Sonnyboy, In my newsfeed this morning this article listing 27 health items associated with Vitamin D3 deficiency came up and I thought of you. These items are associated with Vitamin D3 deficiency not necessarily caused by it.

The "normal" blood range for D3 is considered to be 30 to 100ngl/ml; however, many, including the Vitamin D Council, suggest higher lower levels. The Vitamin D Council suggests
a level of 50 ng/ml is the ideal level to aim for.
Your doctor said you didn't need supplements, but did you get your levels for D3 and B12?

It could be coincidental, but when I began supplementing my D3 and B12, both of which were low normal, bringing my D3 up into the 50-60 range, my deep sleep as measured by my Zeo increased. Again, it could have been coincidental since I began implementing better sleep hygiene at the same time, but it didn't hurt, for sure.

There are essentially two ways to improve serum Vitamin D3 levels, supplements and more exposure to sunlight. How's your exercise program coming along? Nudge, nudge.
Jay Aitchsee wrote:Sonnyboy, In my newsfeed this morning this article listing 27 health items associated with Vitamin D3 deficiency came up and I thought of you. These items are associated with Vitamin D3 deficiency not necessarily caused by it.

The "normal" blood range for D3 is considered to be 30 to 100ngl/ml; however, many, including the Vitamin D Council, suggest higher lower levels. The Vitamin D Council suggests
a level of 50 ng/ml is the ideal level to aim for.
Your doctor said you didn't need supplements, but did you get your levels for D3 and B12?

It could be coincidental, but when I began supplementing my D3 and B12, both of which were low normal, bringing my D3 up into the 50-60 range, my deep sleep as measured by my Zeo increased. Again, it could have been coincidental since I began implementing better sleep hygiene at the same time, but it didn't hurt, for sure.

There are essentially two ways to improve serum Vitamin D3 levels, supplements and more exposure to sunlight. How's your exercise program coming along? Nudge, nudge.
Hi Jay,

1/12/16 labwork showed:
D3: 37 [reference range: 30-100 ng/mL]
B12: 575 [reference range: 200-1100 pg/ml]

1st sleep doctor said everything was normal in 2014,
PMD in January grudgingly ordered supplement related lab, muttering under his breath his D3 is low and not a problem, office staff called and told me my results were normal.

Last month the Stanford sleep specialist said I do not need supplements and did have my January blood work but I need to clarify next month if he was looking at all lab work or just the lab related to PLMD supplements which would not include B12 and D3.

I have a bottle of each and will start taking them.
Always good to have the docs on your side because Medicare + supp will cover the lab and also Vitamin B12 shots 100%.

I am exercising more but not enough yet.
Lots of vegetables in the fridg. now. Thinking about a vegetarian diet which requires some planning to get enough protein so I am eating meat.
Years ago I was a strict vegetarian, except I allowed dairy. Followed this diet for 5 years, my weight and energy level were great and I could eat all I wanted. I played racquetball at least 4 times a week. Didn't have a sleep problem that I was aware of at the time. Gave in to a sudden urge for a McDonald's hamburger and fries.

EPR at 2 is working great. AHI this morning was .40, no mask leaks. No fragmented sleep the first two nights but did recur last night, could be related to trying to decrease the Provigil dose.

_________________
Mask

User avatar
Jay Aitchsee
Posts: 2936
Joined: Sun May 22, 2011 12:47 pm
Location: Southwest Florida

Re: [Jay] MD help with work-up of poor sleep and fatigue

Post by Jay Aitchsee » Wed May 25, 2016 1:42 pm

Gee, Sonnyboy, that all sounds pretty good!

I've had pretty good luck with a "whole foods" diet. I probably mentioned it in one of your threads. It's basically no processed or refined foods, unless an argument can be made in their favor, like virgin olive oil, no grains, and no root vegetables. So I shop the outside of the grocery store aisles, produce, meats, and dairy, being a little picky about dairy. Lower fat dairy usually has a lot of natural and/or added sugars. Eggs for breakfast, melon, nuts, and cheese for lunch, meat or fish, vegetable, and tossed salad for dinner. No counting calories, fats, or carbohydrates, just eating much like our parents and grandparents did.

My tested B12 was only 374 and was considered "normal". As a footnote, my lab report stated "... patients with values below 400 may experience neuropsychiatric and hematologic abnormalities..." I supplement with 500mcg daily and it now runs around 700. Here's a bit from the WSJ re B12: WSJ Article

My tested D3 was 33, also normal. I began supplementing with 5000iu daily, decreasing to 2000 after a while and now take 1000 to 2000 daily depending on my level. I try to keep it between 50 and 60, testing about every 3 months.

As I've mentioned several times, after I began supplementing, I started feeling better. But I also started exercising and implementing other good sleep hygiene elements. I would still recommended sensible supplementation for you, regardless of what your doctors say. But I also recommend periodic testing as well. Vitamin D levels can be too high.

It's great you started exercise. It doesn't have to be much. Just get the routine started. Try to get outside in the mornings, too. And I'm glad to hear that EPR is working out for you. I like it a lot since I switched to nasal pillows. Not so much with a FFM. It does seem to be an individual thing.

You may want to stay with the Provigil for a while. I do think it helped consolidate my sleep with less fragmentation, but be sure to take it first thing in the morning. It doesn't seem to have too many ill effects, but it's another pill. Like you, I would rather not take any, but if it helps, then...

As I said at the top, your results (and maybe attitude?) sound pretty good so far!!

References:
Depression, Diet, and Exercise; Medical Journal of Australia
Diet and Mental Health; MedScape
Importance of B12 and D3; Psychology Today
B vitamins and Depression; American Journal of Clinical Nutrition

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Auto, P10 mask, P=7.0, EPR3, ResScan 5.3, SleepyHead V1.B2, Windows 10, ZEO, CMS50F, Infrared Video

viking
Posts: 22
Joined: Thu May 26, 2016 7:17 pm

Re: [Jay] MD help with work-up of poor sleep and fatigue

Post by viking » Mon Jun 06, 2016 2:30 pm

I just read a article where people who take a ppi(nexium etc)have a better chance low vitamin b12 because of lack of acid in your stomach and also the bigger the dose the percentage of being low goes as the longer you take it,i have took nexium for a while I may need to look into this with my Doc and see what he says