Anecdotally, I had this discussion with a cardiovascular interventionist specialist about seven or eight years ago when I was managing a team of cardio theatre orderlies in a private hospital. He made the comment, "mark my words, in about five to ten years time there will be a major scare about needing to absorb more vitamin D".
His opinion was that the increase in sunscreen usage and the push to avoid skin cancer by staying covered up was likely to blame. I find it interesting when articles such as this pop up, because it directly reflects his concerns from those years ago.
For reference, this was the late Dr Geoffrey Mews (who I only just realised has passed on while I was looking for a reference to post. That's made me a bit sad now)
Related to this topic, if you have IBS/IBD, some interesting research been coming out in the last couple of years indicating that low vitamin D may play a role in this issue as well. This [1] 2015 study found 82% of people with IBS had low vitamin D levels relative to 31% in the control group. This [2] 2016 one proved causation of vitamin D supplementation improving symptoms, by randomly splitting into two groups and treating only one. This [3] speculative writeup by the Vitamin D Council in 2014 discusses some possible mechanisms of action.
This seems like such low-hanging fruit that it was extremely surprising to me that this is at the cutting edge. Causes and cures for IBS are not clear and one third of patients find current treatments unsuccessful [4]. But the above doesn't seem to be well known in online discussion because it's so new, and my gastroenterologist didn't bring it up at all either.
Anecdotal: nothing helped my IBS. Dietary changes, exercise, nothing. Drs said nothing looked wrong. By the time I was 26, it was so bad I would stay home and not socialize often. I would need immodium like candy just to get through a social function. It was truly a nightmare. I was ready to give up.
4000 UI vitamin D a day, and about four weeks in it magically goes away 90%. I've gotten thanks from other people I passed the tip to.
Incidentally, the symptoms started abruptly about a year and a half before my diagnosis of melanoma; another disease with a vitamin D link.
Anecdotal: I have Chrohns and take 2000 UI Vitamin D everyday. I've been prescribed the lowest dosage anti-inflammatory (Mesalamine) for years and rarely had a flare up. My Vitamin D blood tests always come back in the normal level.
Thanks for this. I have IBS and began taking a 2000 IU supplement of Vitamin D awhile back for unrelated reasons. Maybe I'll bump it up to 3000 to see if it helps.
Pubmed is sort of like arxiv.org and the fact this has an nih.gov base url should not be taken as an endorsement of it by the NIH.
That said I do actually believe that more then the recommended amount of vitamin D can be beneficial and the recommendations are in need of reevaluation.
Just to back this up: the journal it's published in has a very very low impact factor of 0.235 (i.e. it publishes 4x more papers that it gets citations, probably most of it's papers are never cited by anyone) [1]. If this paper was considered a big a deal by the wider research community you would expect it to be published in a high profile journal.
What? It's nothing of the sort. Pubmed is not a preprint server. The paper in question was accepted by a journal. The quality may not have been great - I agree - but it is not like the archive at all.
If taking EPIC series morbidity and mortality endpoint analysis at face value, best outcomes on average are around 2500 IU/d intake. (In generally healthy individuals.)
So this recommending 4000 IU/d is not too far fetched.
vitamin D testing was a huge money maker to labs. the EU cut this test from its health plans and a few equipment makers (in labs, equipment works like big iron, you get it leased for free while your reagent subscription is active) are bankrupting.
This supports my lived experience. Found to be incredibly low in vitamin D, and diagnosed with autoimmune thyroiditis. Doctor said to supplement with 2000 IU being the max per day.
After seeing no improvement whatsoever in vitamin D levels, and after talking with others with the same issue, I self medicated to 10000 IU / day.
Lo and behold my vitamin D levels went back up and my auto-antibodies went back down.
>it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality, demolishing the previously presumed U-shape curve of mortality associated with vitamin D levels.
What is IU/d? What is nmol/L? Could someone ELI5 the entire abstract for me? Well, maybe a little more than 5, I get that there was an error estimating recommended levels and we're not getting enough.
I have been taking 5000IU Vitamin D for the past 7 years, with a little more over the winter months. It's stupidly cheap, I get 360 5000IU capsules for $13, so it has cost me less than $100 over that period.
Anecdotally, it was a game changer for me personally. I got less sick during the winter, and my overall wellbeing improved greatly.
A word of advice, increase Vitamin K intake aswell. Vitamin D helps calcium absorption, but Vitamin K directs it to where it needs to go (skeleton).
Has anyone had experience ordering blood work (e.g. the vitamin d 25 hydroxy test) without visiting a doctor? I've seen very few references to the set of sites that pop up first online [0, 1, 2, 3] when I've gone looking for reviews in the past. Any suggestions? I'm in CA.
I've tried DirectLabs, WalkInLabs, and Life Extension, and have been happy with them all. All of those companies are basically just "doctor ordering resellers" for the two big test labs (LabCorp and Quest), so you generally don't have to worry about the quality of the testing.
I specifically use Life Extension for vitamin D because they're the cheapest one I'm aware of.
In case you have a health insurance - many plans provide a free yearly preventive care doctor visit, which include basic blood lab work. I took advantage of it many times with different insurance companies.
I self-paid for a handful of labs a few months ago, including Vit D (and thyroid, and blood related stuff, and cholesterol, and a few other related things).
I went in, the nurse drew some blood and charged me $150. A week later, they mailed me the results.
None of this was done online, and insurance never was involved. I found a lab in town, asked their cash price, and they told me, and it was fine. Specifically the lab was associated with a larger medical facility, so call around to any local hospitals to see what they quote you.
The "Vitamin D 25 Hydroxy Blood Test" was $47. I got a blood draw order signed by a doctor that I had to take to a LabCorp - so make sure you've got one near you.
I joined one medical in sf and while I did meet with a doctor, you can also do walk-ins for blood tests. It was fast. There is a yearly fee to be a member and they have offices all over CA. https://www.onemedical.com/blog/health-guides/lab-test-guide...
Bloodwork is a core utility of naturopaths so one would probably know the best place to visit. You don't have to be incredibly lucky for your preventative plan to cover the visit.
Interesting that this stems in part from misinterpretation of confidence intervals. The referenced paper, A Statistical Error in the Estimation of the Recommended Dietary Allowance for Vitamin D [0], seems like an excellent example to illustrate how (and how not) to interpret confidence intervals.
A couple years after I moved to Seattle I started noticing some odd aches and pains. After a coworker had similar issues, I went to the doctor, and they tested my Vitamin D levels. They were ridiculously low. They had me on a high initial dose, and than taking supplements ever since. I've heard the same story from tons of neighbors. Nowadays it's one of my first suggestions for new transplants. It's made a marked difference (along with a sunlamp).
If you intend to take vitamin d I read in various places you should also take magnesium and probably vitamin k as well. And less calcium. Everything is interconnected.
I recently started taking 3000mg of magnesium per day as magnesium chelate. The bottle recommends three capsules per day for muscle spasms / cramps.
Historically, I have a couple of basic assault charges, an assault with sexual intent charge, I was charged with two counts of trafficking a controlled drug (later dropped).
Shortly after I commenced taking six capsules a day I started feeling a lot less psychotic.
Everything is very interconnected. The underdose and overdose numbers are determined in isolation, just as any good scientific experiment should.
Casual observation reveals that vitamin D overdose results in hypercalcemia, a condition treatable by vitamin K. Vitamin E overdose results in hemmorrhaging, a condition treatable by vitamin K. There are no known symptoms of vitamin K overdose. Vitamin A overdose (from retinol) can be treated by vitamin E and vitamin K.
Magnesium is balanced with calcium. Sodium is balanced with potassium.
So naturally, I wonder what happens when you supply vitamin K in excess, then determine the overdose amounts for the other fat-soluble vitamins. Once that number is found, reduce the K by steps and repeat, until you have the recommended minimum ratio of K to the other vitamin.
About once every 6 months I remember to start taking my vit D supplements again. I've always taken more than the recommended dose because vitamin D is not extremely bioavailable in pill-form, and I notice amazing improvements in mood, mostly. Usually I am sad in the mornings. I have a cup of coffee, browse around on HN, and then convince myself to do work, and the sadness goes away with the distraction, and by the evening I feel pretty good for "doing so much work". When I take vitamin D, after about a week I begin to wake up and set to work immediately, leaving time in the evening for fucking around. I really should do that now, before finals.
Same experience for me. The University of Washington headache clinic recommended Vitamin D and Magnesium supplements and it made a marked difference in my mood. Turns out having constant mild headaches is pretty depressing.
If the recommendations of this study become the guideline, it may validate the other studies suggesting that nearly everyone is deficient in magnesium, which is a co-factor in the Vitamin D / calcium cycle.
AFAIK (and correct me if I'm wrong), the vitamin D metabolism requires magnesium, calcium, vitamin K2, and vitamin A. K2 in particular needs special attention, as it's the hardest of the substrates to get.
This article recommends around 100 nmol/L. Most people are between 20-30, because they don't get enough Sun and do not take supplements. It gets really really bad when the number gets below 10 and it takes months to recover.
Another Vitamin whose deficiency cause irreversible damage is B12. Folks, get both of these checked.
I happen to have a gene mutation that makes methylation of B12 inefficient. I never did well in chemistry or biology for that matter, but my limited understanding is that methylation is necessary for it to be useful.
It turns out that you can buy methylated B12 called methylcobalamin. The more common form is cyanocobalamin, and is not very useful for people like myself.
That is my understanding, if anyone here knows better or more, please correct me.
Because of impaired kidney function, I get my vitamin D levels monitored every month. Yes supplements can take 2-3 months to increase the levels. The sun actually works pretty good if you can stay outside 15 minutes in noon sun. But that's difficult in the winter months.
I've never read a recommendation for 100 nmol/L before. Previous numbers were around 50-70 nmol/L. So this seems noteworthy.
There also appears to be some evidence to support Vitamin K2 as a complement to Vitamin D supplementation, in order to reduce or prevent cardiovascular calcification.
I just want to say the b complexes are indeed super important, but recent studies indicate a potential link between overly high dosage and some types of cancers, particularly in men. So be wary of overdoing it with those 3000% dv supplements.
Yes, please. I'm spreading this news for years. Many are deficient in both. B12 has a name for being low in veg*ans, while that is true many omnis are deficient as well.
It's good to have more papers published on "high-dose D3". But by what I read this has been know for many years.
And shun multi-AZ tablets, they provide a false sense of security. Eat loads of fresh produce and beans, that should help with most of your nutrition needs. Shun dairy and processed foods -- they kill you. Limit (or drop) meat, fish and eggs. Finally you want to eat a brazil nut every day for your selenium.
Supplement D3 and B12. Possibly (after doing your research) iodine, iron, high-DHA omega 3.
[+] [-] King-Aaron|8 years ago|reply
His opinion was that the increase in sunscreen usage and the push to avoid skin cancer by staying covered up was likely to blame. I find it interesting when articles such as this pop up, because it directly reflects his concerns from those years ago.
For reference, this was the late Dr Geoffrey Mews (who I only just realised has passed on while I was looking for a reference to post. That's made me a bit sad now)
[+] [-] dcx|8 years ago|reply
This seems like such low-hanging fruit that it was extremely surprising to me that this is at the cutting edge. Causes and cures for IBS are not clear and one third of patients find current treatments unsuccessful [4]. But the above doesn't seem to be well known in online discussion because it's so new, and my gastroenterologist didn't bring it up at all either.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412886/
[2] https://www.ncbi.nlm.nih.gov/pubmed/27154424
[3] https://www.vitamindcouncil.org/health-conditions/inflammato...
[4] https://www.vitamindcouncil.org/study-finds-high-dose-vitami...
[+] [-] noam87|8 years ago|reply
4000 UI vitamin D a day, and about four weeks in it magically goes away 90%. I've gotten thanks from other people I passed the tip to.
Incidentally, the symptoms started abruptly about a year and a half before my diagnosis of melanoma; another disease with a vitamin D link.
[+] [-] neonhomer|8 years ago|reply
[+] [-] unknown|8 years ago|reply
[deleted]
[+] [-] AdmiralAsshat|8 years ago|reply
[+] [-] micro_cam|8 years ago|reply
Pubmed is sort of like arxiv.org and the fact this has an nih.gov base url should not be taken as an endorsement of it by the NIH.
That said I do actually believe that more then the recommended amount of vitamin D can be beneficial and the recommendations are in need of reevaluation.
[+] [-] davidshepherd7|8 years ago|reply
[1]: https://journal.komci.org/ViewJournalInfo.php?JID=109#Impact...
[+] [-] icelancer|8 years ago|reply
What? It's nothing of the sort. Pubmed is not a preprint server. The paper in question was accepted by a journal. The quality may not have been great - I agree - but it is not like the archive at all.
[+] [-] AstralStorm|8 years ago|reply
So this recommending 4000 IU/d is not too far fetched.
[+] [-] madhadron|8 years ago|reply
[+] [-] gcb0|8 years ago|reply
[+] [-] tathougies|8 years ago|reply
After seeing no improvement whatsoever in vitamin D levels, and after talking with others with the same issue, I self medicated to 10000 IU / day.
Lo and behold my vitamin D levels went back up and my auto-antibodies went back down.
[+] [-] jhwhite|8 years ago|reply
>it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality, demolishing the previously presumed U-shape curve of mortality associated with vitamin D levels.
What is IU/d? What is nmol/L? Could someone ELI5 the entire abstract for me? Well, maybe a little more than 5, I get that there was an error estimating recommended levels and we're not getting enough.
[+] [-] rmm|8 years ago|reply
Anecdotally, it was a game changer for me personally. I got less sick during the winter, and my overall wellbeing improved greatly.
A word of advice, increase Vitamin K intake aswell. Vitamin D helps calcium absorption, but Vitamin K directs it to where it needs to go (skeleton).
[+] [-] noahdesu|8 years ago|reply
[0]: https://www.privatemdlabs.com [1]: http://www.directlabs.com/ [2]: https://www.walkinlab.com/ [3]: https://www.health-tests-direct.com/
[+] [-] dwich|8 years ago|reply
I specifically use Life Extension for vitamin D because they're the cheapest one I'm aware of.
[+] [-] pauljurczak|8 years ago|reply
[+] [-] darshan|8 years ago|reply
[+] [-] cschneid|8 years ago|reply
I went in, the nurse drew some blood and charged me $150. A week later, they mailed me the results.
None of this was done online, and insurance never was involved. I found a lab in town, asked their cash price, and they told me, and it was fine. Specifically the lab was associated with a larger medical facility, so call around to any local hospitals to see what they quote you.
[+] [-] exhilaration|8 years ago|reply
The "Vitamin D 25 Hydroxy Blood Test" was $47. I got a blood draw order signed by a doctor that I had to take to a LabCorp - so make sure you've got one near you.
[+] [-] STRiDEX|8 years ago|reply
[+] [-] zamalek|8 years ago|reply
[+] [-] menacingly|8 years ago|reply
[+] [-] hyperopt|8 years ago|reply
[+] [-] ravar|8 years ago|reply
[+] [-] yufengg|8 years ago|reply
existing standards from the NIH: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona...
[+] [-] growlix|8 years ago|reply
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210929/#!po=22...
[+] [-] moonka|8 years ago|reply
[+] [-] Mouse47|8 years ago|reply
[+] [-] PeachPlum|8 years ago|reply
a regular sunlamp? They are UV-A and don't help with Vit D at all
You need a UV-B one which doesn't tan - https://www.amazon.co.uk/dp/B004NOPC9S/
[+] [-] andy_ppp|8 years ago|reply
https://www.precisionnutrition.com/stop-vitamin-d
[+] [-] guilty001|8 years ago|reply
Historically, I have a couple of basic assault charges, an assault with sexual intent charge, I was charged with two counts of trafficking a controlled drug (later dropped).
Shortly after I commenced taking six capsules a day I started feeling a lot less psychotic.
[+] [-] logfromblammo|8 years ago|reply
Casual observation reveals that vitamin D overdose results in hypercalcemia, a condition treatable by vitamin K. Vitamin E overdose results in hemmorrhaging, a condition treatable by vitamin K. There are no known symptoms of vitamin K overdose. Vitamin A overdose (from retinol) can be treated by vitamin E and vitamin K.
Magnesium is balanced with calcium. Sodium is balanced with potassium.
So naturally, I wonder what happens when you supply vitamin K in excess, then determine the overdose amounts for the other fat-soluble vitamins. Once that number is found, reduce the K by steps and repeat, until you have the recommended minimum ratio of K to the other vitamin.
[+] [-] creep|8 years ago|reply
[+] [-] whowouldathunk|8 years ago|reply
[+] [-] piotrkaminski|8 years ago|reply
[+] [-] theprotocol|8 years ago|reply
AFAIK (and correct me if I'm wrong), the vitamin D metabolism requires magnesium, calcium, vitamin K2, and vitamin A. K2 in particular needs special attention, as it's the hardest of the substrates to get.
[+] [-] borplk|8 years ago|reply
(And please, yes we get it you are a smart ass, don't link to the page that you are going to. The horse has been beaten to death.)
[+] [-] juskrey|8 years ago|reply
What about side effects of such massive UNCONDITIONAL top-down recommendations?
[+] [-] kieranmaine|8 years ago|reply
[+] [-] timewarrior|8 years ago|reply
Another Vitamin whose deficiency cause irreversible damage is B12. Folks, get both of these checked.
[+] [-] DigitalJack|8 years ago|reply
It turns out that you can buy methylated B12 called methylcobalamin. The more common form is cyanocobalamin, and is not very useful for people like myself.
That is my understanding, if anyone here knows better or more, please correct me.
[+] [-] nlperguiy|8 years ago|reply
[1]: http://ascopubs.org/doi/abs/10.1200/JCO.2017.72.7735
[2]: http://edition.cnn.com/2017/08/22/health/vitamin-b6-b12-lung...
[+] [-] pkaye|8 years ago|reply
[+] [-] nugget|8 years ago|reply
There also appears to be some evidence to support Vitamin K2 as a complement to Vitamin D supplementation, in order to reduce or prevent cardiovascular calcification.
[+] [-] arca_vorago|8 years ago|reply
[+] [-] cies|8 years ago|reply
Yes, please. I'm spreading this news for years. Many are deficient in both. B12 has a name for being low in veg*ans, while that is true many omnis are deficient as well.
It's good to have more papers published on "high-dose D3". But by what I read this has been know for many years.
And shun multi-AZ tablets, they provide a false sense of security. Eat loads of fresh produce and beans, that should help with most of your nutrition needs. Shun dairy and processed foods -- they kill you. Limit (or drop) meat, fish and eggs. Finally you want to eat a brazil nut every day for your selenium.
Supplement D3 and B12. Possibly (after doing your research) iodine, iron, high-DHA omega 3.
[+] [-] klht|8 years ago|reply
100 nmol = 40 ng/ml
ng/ml is the most common measure in India and many other places.
[+] [-] tgb|8 years ago|reply