Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 I have an apointment with a local RA specialist next week as I am working on a location too far from my regular Rheumy to make an appt. This is considered a specialist visit, and the blood work won't be covered under my copay as it will be sent out to a lab. However, I am going to my PCP this week for various blood tests (which are covered under my copay) and am asking him to include an ESR, RF, ANA, CRP and Anti-ccp. After reading in this blog for some time, I realize I should probably get a Vitamin D level test, too. From what I can find, there are two - does anyone have any recommendation as to which one (or both) I should ask for? Thanks, April Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 April, This is what osteoporosis expert Dr. Ott says about measuring vitamin D status: Measure 25(OH) vitamin D, NOT 1,25(OH)2 vitamin D 1,25(OH)2 vitamin D [1,25-D] is more difficult and expensive to measure than 25(OH)D; moreover, it is not a good measure of vitamin D status. When patients are vitamin D deficient, the parathyroid hormone increases and drives the renal 1-alpha-hydroxylase, so that 1,25-D levels increase. Only in severe deficiency, when substrate is depleted, does the 1,25-D become low. Partially treated vitamin D deficiency also results in marked elevations of 1,25-D levels. Some doctors, thinking they are sophisticated because they know that 1,25-D is more active, order the wrong measurement. Do not fall into this trap and waste money on this expensive but often misleading test! There are only a few situations where you would actually want to know the 1,25-D: unexplained hypercalcemia (looking for granulomatous disease or lymphoma), suspected genetic childhood rickets, suspected tumor-induced osteomalacia, some cases of nephrolithiasis or hypercalciuria. Patients with stages 4-5 chronic kidney disease have decreased 1,25-D levels but even in those patients the 25(OH) vitamin D is a better test of the stores of vitamin D, and the PTH is a better indicator of mineral abnormalities. Finally, some cells generate intracellular 1,25-D to fight tuberculosis, suppress cancer growth, or modify immune response. They need adequate substrate, as measured by 25(OH) vitamin D. http://courses.washington.edu/bonephys/opvitD.html Not an MD On Wed, Feb 16, 2011 at 9:42 AM, A <aftaylor5000@...> wrote: > I have an apointment with a local RA specialist next week as I am working on a location too far from my regular Rheumy to make an appt. This is considered a specialist visit, and the blood work won't be covered under my copay as it will be sent out to a lab. However, I am going to my PCP this week for various blood tests (which are covered under my copay) and am asking him to include an ESR, RF, ANA, CRP and Anti-ccp. > After reading in this blog for some time, I realize I should probably get a Vitamin D level test, too. From what I can find, there are two - does anyone have any recommendation as to which one (or both) I should ask for? > > Thanks, > April Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 My PCP has always ordered simply " Vitamin D " test, and the lab report comes back as 25 Hydroxy D3, 25 Hydroxy D2, and 25 Hydroxy D Total. Same thing when I had the test done online by ZRT lab. You might also ask for a test to measure homocysteine. High levels of homocysteine are commonly found in patients with RA. The test determines if a person has B12 or folate deficiency. Jan On Feb 16, 2011, at 10:42 AM, A wrote: > I have an apointment with a local RA specialist next week as I am working on a location too far from my regular Rheumy to make an appt. This is considered a specialist visit, and the blood work won't be covered under my copay as it will be sent out to a lab. However, I am going to my PCP this week for various blood tests (which are covered under my copay) and am asking him to include an ESR, RF, ANA, CRP and Anti-ccp. > After reading in this blog for some time, I realize I should probably get a Vitamin D level test, too. From what I can find, there are two - does anyone have any recommendation as to which one (or both) I should ask for? > > Thanks, > April Quote Link to comment Share on other sites More sharing options...
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