The Big Vitamin D Mistake (not enough)

[Liberty]

https://www.ncbi.nlm.nih.gov/m/pubmed/28768407/

 

There's been signs of this for many years. I've been taking 4000-8000 UI daily for over a decade now (in gelcaps -- vitamin D is fat-soluble, so the dry tablets aren't as well absorbed). I recommend you also look into Vitamin D supplementation, especially if you don't live in tropical areas where you get plenty of sun year-round.

 

One guy who's been writing about this for a long time is a cardiologist named William Davis, I remember reading some of his stuff maybe 6-7 years ago.

 

Some discussion here:

 

https://news.ycombinator.com/item?id=15867918

[rkbabang]

https://www.ncbi.nlm.nih.gov/m/pubmed/28768407/

 

There's been signs of this for many years. I've been taking 4000-8000 UI daily for over a decade now (in gelcaps -- vitamin D is fat-soluble, so the dry tablets aren't as well absorbed). I recommend you also look into Vitamin D supplementation, especially if you don't live in tropical areas where you get plenty of sun year-round.

 

One guy who's been writing about this for a long time is a cardiologist named William Davis, I remember reading some of his stuff maybe 6-7 years ago.

 

Some discussion here:

 

https://news.ycombinator.com/item?id=15867918

 

I too have been taking D3 in about the amounts you have for almost 10 years.  I take 10K UI 5-7 times per week.  I always take it on work days where I spend the whole day in the office.  I always take it everyday in the winter (not much sun in NH) and I'll take it or not on the weekends in the summer depending on what I am doing. If I'm going to be outside all day in August I'll skip it that day.

 

Also I look for the gell caps packed in olive oil or coconut oil rather than high omega-6 oils.

 

These are the two brands I've been using:

 

http://www.amazon.com/gp/product/B00JGCBGZQ

http://www.amazon.com/dp/B0032BH76O

 

I've also read somewhere that Vitamin K2 helps with the absorption of D3 (and vice versa) so I take K2 with it as well:

http://www.amazon.com/gp/product/B0771YC3GQ

 

 

[Cigarbutt]

With all due respect,

 

"been writing about this for a long time"

What do you mean by "this"?

?Skeletal health or extra-skeletal outcomes, including cancer, cardiovascular disease, diabetes (type 1 or 2), and autoimmune disorders?

 

Do you base your "recommendation" on a review of the literature and do you account for appraisal of info using evidence-based guidelines?

 

The questions are meant to be constructive.

 

[Liberty]

With all due respect,

 

"been writing about this for a long time"

What do you mean by "this"?

?Skeletal health or extra-skeletal outcomes, including cancer, cardiovascular disease, diabetes (type 1 or 2), and autoimmune disorders?

 

Do you base your "recommendation" on a review of the literature and do you account for appraisal of info using evidence-based guidelines?

 

The questions are meant to be constructive.

 

All of the above, looking at the varying amounts of evidence for each that there are benefits to supplementing, especially in northern countries like Canada, where I live. You can go read his stuff, I'm sure there's an archive on his site.

[Liberty]

https://www.ncbi.nlm.nih.gov/m/pubmed/28768407/

 

There's been signs of this for many years. I've been taking 4000-8000 UI daily for over a decade now (in gelcaps -- vitamin D is fat-soluble, so the dry tablets aren't as well absorbed). I recommend you also look into Vitamin D supplementation, especially if you don't live in tropical areas where you get plenty of sun year-round.

 

One guy who's been writing about this for a long time is a cardiologist named William Davis, I remember reading some of his stuff maybe 6-7 years ago.

 

Some discussion here:

 

https://news.ycombinator.com/item?id=15867918

 

I too have been taking D3 in about the amounts you have for almost 10 years.  I take 10K UI 5-7 times per week.  I always take it on work days where I spend the whole day in the office.  I always take it everyday in the winter (not much sun in NH) and I'll take it or not on the weekends in the summer depending on what I am doing. If I'm going to be outside all day in August I'll skip it that day.

 

Also I look for the gell caps packed in olive oil or coconut oil rather than high omega-6 oils.

 

These are the two brands I've been using:

 

http://www.amazon.com/gp/product/B00JGCBGZQ

http://www.amazon.com/dp/B0032BH76O

 

I've also read somewhere that Vitamin K2 helps with the absorption of D3 (and vice versa) so I take K2 with it as well:

http://www.amazon.com/gp/product/B0771YC3GQ

 

For some weird reason I haven't been able to find 5000 UI per unit in Canada for the past couple years. It's almost as if some weird regulation made it so that the max concentration in the country is now 1000 UI. Very annoying to have to take so many small gelcaps... I hope this madness will soon end.

[Cigarbutt]

Don't want to make a big deal out of this.

But, in a parallel to investing, delineating facts from beliefs has value.

 

Let's say:

-The Lancet has published an article saying that vaccines cause autism.

-On a widely followed Twitter feed, this "finding" is confirmed.

 

So, vaccines should be banned?

 

Respectfully submitted, there exist guidelines now (that may eventually change with new confirmed evidence) that are helpful if one wonders about the indications related to vitamin D supplementation.

 

 

 

[rkbabang]

Don't want to make a big deal out of this.

But, in a parallel to investing, delineating facts from beliefs has value.

 

Let's say:

-The Lancet has published an article saying that vaccines cause autism.

-On a widely followed Twitter feed, this "finding" is confirmed.

 

So, vaccines should be banned?

 

Respectfully submitted, there exist guidelines now (that may eventually change with new confirmed evidence) that are helpful if one wonders about the indications related to vitamin D supplementation.

 

<deleted>

 

Feeling grumpy today.  I should take my own advice sometimes.  :(

 

 

[doughishere]

Liberty,

 

you take multivitamins?

[Liberty]

Liberty,

 

you take multivitamins?

 

I don't. Daily I take Omega 3, vitamin C, and Vitamin D, and K2 (MK-7).

[Liberty]

Don't want to make a big deal out of this.

But, in a parallel to investing, delineating facts from beliefs has value.

 

Let's say:

-The Lancet has published an article saying that vaccines cause autism.

-On a widely followed Twitter feed, this "finding" is confirmed.

 

So, vaccines should be banned?

 

Respectfully submitted, there exist guidelines now (that may eventually change with new confirmed evidence) that are helpful if one wonders about the indications related to vitamin D supplementation.

 

I've been updating my bayesian priors on this for 15 years, this isn't just one article. I wanted to share it, though.

 

Make up your own mind, but please don't project things on me without knowing how much research I've done.

 

Vaccines don't cause autism, not because of one article, but because of a ton of evidence in one direction and little to none in the other.

 

Just from first principle, it's pretty easy to see how most of the world's population could be deficient in Vitamin D based on the conditions in which our bodies have evolved.

[rkbabang]

Vaccines don't cause autism,

 

It is the exact opposite.  https://www.smbc-comics.com/comic/autism-and-vaccines

 

[DooDiligence]

Kind of a fork in the discussion but what are your thoughts on fingernail supplements?

 

I asked a surgeon recently & he said Biotin.

 

After a little reading, it appears that it's the only nutrient with evidence based results (true or false?)

 

My thumb & pinky nails are super strong but my index, ring & FU nails are kind of bendy (no cracking or splitting, just weaker.)

 

I bought a bottle of Spring Valley Hair, Skin & Nails gummies with 2500 mcg of Biotin (most of what I read said that this is a sufficient dose.)

 

The product also contains 15 mg of vitamin C & 15 IU of E.

 

Nail health is super important to me right now & I haven't started taking it yet because I just had inguinal hernia surgery (left & right, 3 weeks apart) but I quit the pain meds yesterday & am thinking about starting this supplement today.

[Dynamic]

It's always good to take medical choices with a good dose of skepticism, but epidemiology is very hard.

 

I recommend searching on ScienceBasedMedicine.org - such as these results:

https://sciencebasedmedicine.org/?s=Vitamin+D&category_name=&submit=Search

 

and also Ben Goldacre's BadScience.net, which in this instance appears to have fewer relevant search results but is often good on health matters:

http://www.badscience.net/index.php?s=Vitamin+D

 

Both of these resources take great care to balance the evidence and Science Based Medicine is particularly strong on using Bayesian reasoning to account for prior plausibility. These are far better places to learn about health matters than the popular press or TV shows.

 

In this case, a pretty decent overview seems to be https://www.skepticalraptor.com/skepticalraptorblog.php/vitamin-d-review-another-overrated-supplement/#more-8480

 

In general, vitamins attract a lot of cranks and hopeful hypotheses that while superficially plausible frequently turn out not to work as expected in the complicated environment of the human body when subject to scientifically robust testing.

 

Megadosing vitamin C actually shows some signs of correlating with and quite possibly causing slightly worse health outcomes than simply obtaining about what the body needs. A plausible hypothesis is that free radicals are vital to function of the immune system, e.g. killer T cells rely on free radicals to destroy 'invading cells', and that megadosing disrupts this.

 

But dark-skinned people in northern climes are frequently advised to take vitamin D supplements in winter because their pigmentation reduces the absorption of sunlight and their innate production of vitamin D is insufficient at that time of year. I would be surprised if there's much danger to modest supplementation with most vitamins and the preference is usually to obtain as much of your daily allowance as possible through a varied diet.

 

But I'm not a medical professional, so please take medical advice before making a major step into or away from supplementation, especially if you are pregnant or have brittle bones (in the case of Vitamin D), have any medical conditions or regular medication. Likewise be wary of herbal medicine, traditional chinese medicine etc, as some of it has real side effects, such as St John's Wort which can cause liver damage, and some of it (especially bought online) is not the declared species or is adulterated with undeclared pharmaceutical drugs as powerful as Viagra (based on some analyses covered by the Skeptical media in the last year or two).

 

[Jurgis]

I am taking Vitamin D ~7000 a week (5K some brand from Amazon + 2K Trader Joe's brand).

 

I have a friend (*wink wink*) who had depression symptoms and taking Vitamin D got rid of them totally. So, don't self-diagnose since depression is serious thing, but also possibly take Vitamin D, especially if blood tests show deficiency.

 

One possible negative side effect: if you are prone to kidney stones, excessive Vitamin D may have negative effect ( https://en.wikipedia.org/wiki/Kidney_stone_disease ). I used to take 10K a week, reduced to 7K.

 

[havingheart]

I've been telling all my friends and family all about this topic!!  Just make sure to take magnesium with D3.

 

I'm pretty passionate about this because I no longer have to use my nebulizer/inhalers/montelukast for my asthma.  They also didn't even work that well for me, so every cold I got became an asthmatic nightmare.  But I am also an N=1 so take it with a grain of salt.

 

Magnesium as asthma treatment:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743582/

 

Low levels of Vit D + mag in asthma

https://www.ncbi.nlm.nih.gov/pubmed/27818797

 

Vit D3 supplementation requires magnesium

https://www.ncbi.nlm.nih.gov/pubmed/28471760

 

Mineral supplements depend on their forms, i.e. magnesium oxide is poorly absorbed.

[Liberty]

I've been telling all my friends and family all about this topic!!  Just make sure to take magnesium with D3.

 

I'm pretty passionate about this because I no longer have to use my nebulizer/inhalers/montelukast for my asthma.  They also didn't even work that well for me, so every cold I got became an asthmatic nightmare.  But I am also an N=1 so take it with a grain of salt.

 

Magnesium as asthma treatment:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743582/

 

Low levels of Vit D + mag in asthma

https://www.ncbi.nlm.nih.gov/pubmed/27818797

 

Vit D3 supplementation requires magnesium

https://www.ncbi.nlm.nih.gov/pubmed/28471760

 

Mineral supplements depend on their forms, i.e. magnesium oxide is poorly absorbed.

 

Interesting. I've been having seasonal asthma, mostly in the fall or winter. I get a cold, and then cough for a month+, with inhalers not helping all that much. Can you elaborate a bit on your experience and how you got to levels that work for you with D and Mg? Thanks.

[Jurgis]

Yes, I take Magnesium Citrate too. More for blood pressure normalization though.

 

I have allergies mostly not up to asthma level though. I don't think I saw any change/improvement with Vit D/Magnesium.

 

Edit/note: I possibly take lower doses than other people take, so ./shrug.

[havingheart]

Typically, when I get a cold, I end up coughing all night.  My lungs just feel incredibly itchy even if I take nyquil, benadryl, inhaler, nebulizer, montelukast, etc.  I just end up coughing in a drugged stupor, and my wife won't get any sleep for about 2 weeks either.  So part of my excitement is part of hers too as she's a lot less cranky than previously when I got sick.

 

Clarifying that when D3 != D2.  D2 is what doctors prescribe.  Also D2 is what's in soylent type meals.  D2 decreases D/D3 increases D

https://www.ncbi.nlm.nih.gov/pubmed/24001747

https://www.ncbi.nlm.nih.gov/pubmed/22552031

 

Long Term Upper Limit Daily ~= 10000 IU

https://www.ncbi.nlm.nih.gov/pubmed/17209171

 

Take it with a meal

https://www.ncbi.nlm.nih.gov/pubmed/20200983

 

My basic routine is to take 5000 IU D3/K2 + 100 mg magnesium citrate/100 mg magnesium glycinate + fish oil at the same time with a meal that includes fat once daily.  It's not as much as it seems since my D3/k2 are combined with each other and the magnesium supplement contains the two forms.

 

When I am sick, I double it (take it again at another meal).  And when I wake up in the middle of the night I toast a bread with butter on it and take the above without the fish oil and it's enough to help me sleep again.  This is without using any meds.

 

I'm not a doctor though!  There are many factors that will boost/reduce your need for vit D or amplify the vit D, weight/obesity, soda, genes (some people are missing receptors), k2, boron, drugs, etc. the list is endless, and they're all varying amounts (10%-?200%)  You can google these on the nih database.  Many of these factors can also be thin/broad and steep/shallow U/J shaped curves to add to the complexity.  So I suspect that my needs will probably be different from yours.

 

But the most exciting thing is this reduction in mortality!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196486/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196486/figure/fig2/

[Liberty]

Thanks for sharing. It's indeed incredibly hard to figure these things out, and even with self-experimentation, it's easy to get fooled by the placebo effect or too many variables changing at once..

 

Still, it's better to make your best effort than to give up and do nothing, IMO.

 

I think one concept that helped me think about this is understanding the difference between the "minimum recommended dose" and what would be the "optimal dose". You might need a minimum of X of nutrient Y to avoid getting certain known diseases (ie. a certain amount of vitamin C to avoid getting scurvy), but this tells you nothing about what would be the optimal quantity of nutrient Y that you should get.

 

For things where there's a known toxicity at relatively low levels, I tend not to even play around.

 

But certain nutrients have very low toxicity up to ridiculous doses, so if there's good evidence and logic for their benefits (like vitamin D3), I have no problem taking bigger doses than the minimum recommended because it's a very asymmetric risk profile.

 

P.S. Yes, it's bonkers that D2 is still being prescribed rather than D3.

[NewbieD]

Thx for the reminder, and tip about non-dry tablets. I get a small dose in a probiotic I take, but gonna start adding up dose, feels like it could help at this time of year.

 

Fat-soluble (liposomal) seems like a bit of a game changer in supplements in terms of the concentrations that can be achieved in blood. I take liposomal curcumin sometimes when sports injuries flare up.

[LC]

Examine.com is a good resource. You can search a compound and it provides a table which summarizes various studies and their conclusions.

[Liberty]

Worth watching, for a good rebuttal of the recurring meme in media about supplementation being all bad/BS:

 

[Cigarbutt]

Worth watching, for a good rebuttal of the recurring meme in media about supplementation being all bad/BS:

 

 

This is a rebuttal to a 2013 publication. To better understand, I would have liked to hear more about the "biases and agenda" of the authors.

 

Submitted as complementary information:

http://annals.org/aim/fullarticle/1789253/enough-enough-stop-wasting-money-vitamin-mineral-supplements

https://www.aafp.org/afp/2018/0215/p226.html

https://cmajnews.com/2018/06/19/trump-administration-shutters-clinical-guidelines-database-cmaj-109-5624/

 

 

[Jurgis]

Worth watching, for a good rebuttal of the recurring meme in media about supplementation being all bad/BS:

 

 

This is a rebuttal to a 2013 publication. To better understand, I would have liked to hear more about the "biases and agenda" of the authors.

 

Submitted as complementary information:

http://annals.org/aim/fullarticle/1789253/enough-enough-stop-wasting-money-vitamin-mineral-supplements

https://www.aafp.org/afp/2018/0215/p226.html

https://cmajnews.com/2018/06/19/trump-administration-shutters-clinical-guidelines-database-cmaj-109-5624/

 

The video is not a full rebuttal really. She raises a number of issues with studies that are possibly reasonable, but mostly pushes towards "we don't know", rather than "we know they are good" (which would be a real rebuttal to "we know they are not good/useful").

[Liberty]

Maybe rebuttal is the wrong word, but it's certainly an elaboration on what the actual science in the studies and meta-studies say (and don't say) rather than the headlines that everybody has seen and repeat.