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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Phil on January 7, 2015, at 9:34:38
to order a Vitamin D test? My psychiatrist had that test done which costs $336.50 and he is not helping me get out of this bill. I thought, maybe there was no medical reason for the test as applies to bipolar so he's doing nothing. This could lead me to seek help from a doctor that does his job. I've asked half a dozen times and he does nothing. If this happened with my GP it would be taken care of immediately. My level was very low. Can't it help depression in some cases when the level is brought up to normal? Thanks.
Posted by Christ_empowered on January 7, 2015, at 9:42:20
In reply to Is there a medical reason for a psychiatrist...., posted by Phil on January 7, 2015, at 9:34:38
Sorry about the bill. Its kinda trendy to put people on D2 (Rx) or D3 (OTC) these days. I don't know what the standard medical literature says, but the alternative literature links D to...everything, lol. There's even a Vitamin D Council. You can check them out online...
...anyway, I've never had blood work, but I take 5,000 IU D3 daily. Its super cheap from vitacost. Even comes in a convenient, once daily, 365 capsule bottle.
What's your doc's plan of action?
Posted by Tomatheus on January 7, 2015, at 10:49:00
In reply to Is there a medical reason for a psychiatrist...., posted by Phil on January 7, 2015, at 9:34:38
Phil,
My understanding of the literature on vitamin D and depression is that low vitamin D clearly seems to be related to depression in some way, but that the jury is still out on the causality of the vitamin D-depression relationship and on whether vitamin D supplementation can treat depression. Even though there are some studies that have found vitamin D to be an effective treatment for depression, there are other studies (all of which went on for six months or less) that have found that vitamin D supplementation didn't outperform placebo as a treatment for depression. I personally don't think that six months is long enough to evaluate whether or not vitamin D3 might serve as an effective antidepressant because of study data that I've come across suggesting that it takes between one and three years for vitamin D levels to return to baseline levels after individuals supplement with the vitamin for a year and then stop supplementing with it. There is only one year-long controlled clinical trial that I'm aware of that evaluated the effectiveness of vitamin D(3) in the treatment of depression, and the results of the trial indicated that vitamin D3 significantly outperformed placebo. Still, that's just one study, and more research is needed to determine just how effective vitamin D might be as a treatment for depression. I would personally hypothesize that when more year-long trials looking at vitamin D as a treatment for depression are conducted that they'll show supplementation to outperform placebo in depressed patients who have low vitamin D levels. As of right now, though, it's my understanding that there isn't enough evidence to conclusively say that vitamin D can effectively treat depression, even though there's some evidence that points toward that possibility.
I think that I'd describe the use of vitamin D as a treatment for mood-disordered patients with low levels of the vitamin to be a cutting-edge type of treatment for psychiatry. A lot of patients, in my view, will ultimately be better helped by getting their vitamin D levels checked than they are with psychiatry's current trial-and-error approach, and I think that it's because some psychiatrists can see this that they're ordering vitamin D level tests currently. However, I don't think that testing vitamin D levels in depressed patients is part of the standard protocol that psychiatrists follow, largely because I don't think that there's enough evidence in yet to say just how effective vitamin D supplementation might be for depression. So, because of this, insurance companies might not see a vitamin D level test as being medically necessary for patients with mood disorders, and psychiatrists would probably have a hard time making a case to insurance companies that vitamin D level tests should be covered. If there were conclusive evidence that vitamin D can treat depression, the situation would be different, as psychiatrists would be able to point to conclusions in scientific papers indicating that vitamin D is an effective treatment for depression.
So, what I've written basically sums up what I suspect your psychiatrist's reasoning might be for not making a case for the coverage of your test, but of course, I don't know for sure what might be going through his head. I think that it would be helpful of your psychiatrist to explain to you why he hasn't, as of yet, made a case that your test should be covered, but it doesn't sound like he's done that, and that's too bad. It could be that your psychiatrist doesn't think that there's enough evidence to support the idea that a vitamin D test is medically necessary, but I'm just speculating here, and my speculations only mean so much.
I hope that you can get your psychiatrist to offer you some sort of explanation.
Tomatheus
Posted by Phil on January 7, 2015, at 12:50:09
In reply to Re: Is there a medical reason for a psychiatrist.... » Phil, posted by Tomatheus on January 7, 2015, at 10:49:00
Thanks Tomatheus, I think that's what's happening. It's amazing that doctors want you to be able to communicate your symptoms but when you need their info it isn't forthcoming. I would prefer that he said, I screwed up, you will have to pay it. These labs were done April 2014 and I'm still dealing with it.
He took me off of Lithium many months back and when I asked why he mumbled. I asked him the next appt and he said because of my tremors. I had tremors forever, why now? The positive is that I don't miss Lithium.
One day at a time.
Posted by Phil on January 7, 2015, at 13:10:04
In reply to Re: Is there a medical reason for a psychiatrist...., posted by Christ_empowered on January 7, 2015, at 9:42:20
> Sorry about the bill. Its kinda trendy to put people on D2 (Rx) or D3 (OTC) these days. I don't know what the standard medical literature says, but the alternative literature links D to...everything, lol. There's even a Vitamin D Council. You can check them out online...
Thanks! When I started the supplements I read a bit on Vit D and thought to myself, how have I lived without this? LOL. I take 4000 IU daily.
I bet that the Vitamin D council is a rocking place to work, don't you? I'll check it out.
>
> ...anyway, I've never had blood work, but I take 5,000 IU D3 daily. Its super cheap from vitacost. Even comes in a convenient, once daily, 365 capsule bottle.Oh, I use vitacost, love those guys. Between meds and supplements my mega size pill container is bursting at the seams. One a day, fish oil, D3, B12.
>
> What's your doc's plan of action?He recently added Latuda to my Seroquel and I'm hoping things will get a bit better. Hahaha! I hope his plan of action is retirement but we usually deal with right now.
Posted by herpills on January 7, 2015, at 14:26:37
In reply to Is there a medical reason for a psychiatrist...., posted by Phil on January 7, 2015, at 9:34:38
Hi Phil- sorry to hear you got hit with such a big bill...I do think vit D level plays a role in not only overall health but also mood disorders. My D level was below 30 a year ago...I've been supplementing with 4000 since and not long ago was retested and I'm at 54. I have been feeling better, although I can't attribute it directly to the vitamin D.
It does take time to get it up, my doctor said minimum of six months of supplementing to get to a healthy range.
At least it's a cheap supplement...hope it helps you!
Posted by Phil on January 7, 2015, at 16:42:27
In reply to Re: Is there a medical reason for a psychiatrist.... » Phil, posted by herpills on January 7, 2015, at 14:26:37
I'm still paying $20 a month to pay off a $900 ambulance ride. I have a lot of these bills and more on the way. Medicare sucks but it could be worse, I think.
My level was 5. The sun is best but I'm dealing with a second case of skin cancer on my nose. It doesn't motivate me to get 20 minutes of sun a day without sunscreen.
If I'd known I would live this long I would have taken better care of myself. :(
Posted by Phillipa on January 7, 2015, at 17:43:58
In reply to Re: Is there a medical reason for a psychiatrist.... » herpills, posted by Phil on January 7, 2015, at 16:42:27
Phil there is a lab site on facebook where you can order your own labs. I deleted them as a like yesterday but betting you can google on facebook. The lab that they give you prescription for is Lab corp. Their prices are very reasonable. I forgot the proceedure for getting the script but remember is was very easy. Phillipa
Posted by Phil on January 7, 2015, at 19:18:38
In reply to Re: Is there a medical reason for a psychiatrist.... » Phil, posted by Phillipa on January 7, 2015, at 17:43:58
The lab was paid for except Vit D and I'm not having that one done again. I might call them and ask for a price quote for fun.
Posted by Phillipa on January 7, 2015, at 21:25:12
In reply to Re: Is there a medical reason for a psychiatrist.... » Phillipa, posted by Phil on January 7, 2015, at 19:18:38
Price should be listed. Each test on the site I view had the cost posted. I need to find that lab again. It was just combined with my thyroid testing. Only 51 though now I think 80's not sure though. Phillipa
Posted by 10derheart on January 8, 2015, at 3:20:05
In reply to Re: Is there a medical reason for a psychiatrist.... » Phil, posted by Phillipa on January 7, 2015, at 21:25:12
Vitamin D, 25-Hydroxy was $62.00 for me last year.
http://www.privatemdlabs.com/index.php
https://www.labcorp.com/wps/portal/patientI wrote a whole post about this and about my own vit D and then lost it all. Cr@pola. Too tired to recreate tonight. Maybe tomorrow.
Posted by Phil on January 8, 2015, at 10:00:50
In reply to lab testing sites » Phillipa, posted by 10derheart on January 8, 2015, at 3:20:05
This is exactly the reason that it's more expensive to live when you are broke. You get f*ck*d and never see it coming. No apologies for my vocabulary.
Thanks for the info guys.
Posted by Phil on January 8, 2015, at 10:38:22
In reply to Re: lab testing sites, posted by Phil on January 8, 2015, at 10:00:50
My doc contacted CPL yesterday. I'll know the results of that in a month or so.
So, I ask this person why they charge $336 when a lab within walking distance charges under $70? She said that's our 'competitive rate.' I said "that isn't competitive and I feel that CPL is preying on under insured, unsuspecting patients. How would you like buying a new phone for $350 and two months later you see the same phone/plan for $50? Would you be upset?"
Silence.
Posted by Phillipa on January 8, 2015, at 19:54:25
In reply to lab testing sites » Phillipa, posted by 10derheart on January 8, 2015, at 3:20:05
Yes Private MD labs is the site I spoke of thank you. Phillipa
Posted by Phil on January 9, 2015, at 4:31:04
In reply to Re: lab testing sites » 10derheart, posted by Phillipa on January 8, 2015, at 19:54:25
No, thank you! :)
I told my doc yesterday. Hey doc that vit D test is not your fault. I can get it done for $62.99. He freaked out. "You're kidding me!!!" I said they have several labs near hospitals and his office.
He sent them some of my records etc to CPL. If 30 days from now I still owe it I'm offering $5 a month. Take it or leave it. They can take $5 a month or I will pay them a settlement of $62.99. If they are smart they will take the settlement.
If I continue with these big bills and no way to pay I'll see a bankruptcy lawyer. I've done it before but I'm not there this time..yet.
I've been down this road before. I'm good at confronting people straight up. No fear.
This is the end of the thread.
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