Dr. Sean Breen Discusses the Importance of Lab Follow-Up

Today I took care of a 73 year old man with severe Vitamin D deficiency. His primary care doctor told him take 2000 IU of Vitamin D3 every day which he did daily since 2011. Interestingly when I checked all his hormone levels his Vitamin D3 level came back at 11.3 (<30 is deficient and optimal is >60).

Here some points that are extremely important for patients to understand:

1. Not all supplement companies produce quality products. Unfortunately there is not the strict oversight over supplement companies like there is over pharmacies. As a result many supplements do not have what it says on the label. In this case my patient was taking 2,000 IU of vitamin D3 but it was not effecting his levels at all.

2. Some patients need more than others. In this case (assuming it was actually 2000IU in the product), 2000 IU was not nearly enough to produce adequate levels. It could be because he has gut disturbances and does not absorb nutrients as well as another patient. In this case he needed 10,000 IU of vitamin D to produce adequate levels. 

3. If you can, get as many nutrients as you can from a compounding pharmacy. The compounding pharmacist that I use produces a vitamin D3 capsule that is guaranteed to contain the exact amount I order. Typically I order a 25,000 or 50,000 IU capsule and have patients take it once per week. My compounder can make everything from CoQ10 to L-Carnitine to B12 shots.

Vitamin D is just one example of lab follow up. The same can be said for every hormone that I put patients on. When I start a patient on a hormone or adjust the dose I always follow up with lab tests to make sure it is doing exactly what I want it to do. In the case of progesterone for a post menopausal women we want the serum levels to be >10. If they are on 200mg and their levels are 5.5 then we have to adjust the dose up. Many times patients are started on hormones and the doctor just assumes that is the correct dose.

If you would like to schedule a consult with Dr. Sean Breen simply give us a call at 877-721-0047 and visit us online at www.breencenter.com