A Case Of Vitamin D Deficiency

During these winter months when many of us find getting enough natural Vitamin D through sunlight difficult at best, we are pleased to share this interesting case study of how a woman in Malaysia successfully achieved a much-desired pregnancy after her Vitamin D levels were discovered to be too low. Dr. Lek-Lim Chan, an Associate Director of WOOMB International and the President of Natural Fertility Awareness Service of Malaysia, has spoken at a few of our BOMA-USA conferences and received great reviews.

​by Dr. Lek-Lim Chan
 
Note: Permission has been granted by client to share this case study.
 
Case History & Background – This case was first referred in October 2012 by a Billings Ovulation Method® (BOM) teacher from Kuala Lumpur. The client was aged 31, married 6 years trying to conceive unsuccessfully. She had just learned BOM charting in July 2012.
 
Weight 46 kg; height 161 cm; waist 26 inch = 66 cm BMI=17.75
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Maternal grandmother had diabetes for perhaps 15 years before she died aged 85. She was only on medication.
 
She said Vitamin D was tested in April 2012 and was well below normal, although she was not able to find her report.

She had seen a gynecologist in August 2012 who tested her female hormones and found her FSH to be “unreasonably high”. She was then told she may reach menopause in 2 years.
 
Author first met her on 8 November 2012. Her charts showed regular bleeds with follicular development, but no Peaks. This means there is follicular activity probably not reaching ovulation although there is some ovarian activity. (See chart below)

Chart of 7 July 2012 – 5 January 2013 is as follows (with a gap between 20 September and 17 November):

​The following tests were done on 24 November 2012:
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Glucose

Note: At that time, author only did 2-point test for insulin to save money for patient. Now he is convinced that the full 5-point test as devised by Prof. Pilar Vigil must be done to ascertain for sure if the woman is insulin resistant. Sometimes, any one of the 5 readings can exceed Prof. Pilar’s reference range, already indicating insulin resistance.
 
The only abnormal reading was Vitamin D with a slight elevation of testosterone above Pilar’s limit.
 
The woman commenced Cholecalciferol (Vitamin D3) 1000 IU twice per day - one in morning and one in evening. Started in January 2013.
 
The next chart (5 April – 3 June 2013) shows she has reached Peak. However, not every bleed cycle has a Peak.
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Chart of 5 April – 3 June 2013:

A Peak occurred on 17 April 2013, but there was no pregnancy although intercourse occurred on Peak day. However, there was no Peak in the next bleed cycle.
 
Author advised her to consider retesting the Vitamin D level. She hesitated. But on 4 pm, 21 Nov 2013, an SMS was received:

I used a home pregnancy kit yesterday, and it came out positive. Haven’t gone to the doctor to confirm result yet.
 
Chart of 24 Sep – 19 Nov 2013, during which pregnancy achieved:

She identified a Peak with only 2 days development on 6 October 2013; there was intercourse but no pregnancy. Then, she identified 4 November as a day of extreme slipperiness and therefore a day of very high fertility. But a Peak cannot be identified because there was no changing developing pattern. That does not mean there was no ovulation. It is just that ovulation cannot be confirmed if there is no Peak. And the one intercourse on this very slippery day without a Peak resulted in pregnancy.
 
Ultrasound scanning later estimated the date of conception as 5 November 2013, thus confirming that she did ovulate on or around that very slippery day.

Author then advised her to recheck her Vitamin D and testosterone, and her results were:

Vitamin D was then well within normal range, and testosterone had dropped slightly from 2.0 nmol/L to 1.9 nmol/L.
 
She continued with Vitamin D supplementation throughout pregnancy, and the baby girl was born on 25 July 2014.

Baby girl at birth

Girl at age 1

Final note from the BOMA newsletter editors: This article is not intended to be construed as medical advice. Please consult your physician with any personal concerns.