171 replies to this topic

[DukeNukem]

I take 10,000 IU daily, regardless of season now. Latest blood level at 79ng, exactly within the sweet spot range I want to be: 70-90 range.

[Dmitri]

I take 10,000 IU daily, regardless of season now. Latest blood level at 79ng, exactly within the sweet spot range I want to be: 70-90 range.

Other members say that optimal levels are 49ng, yet you want a 70-90 range? What is your rational for that? Also, how much Vitamin A are you taking?

[Dmitri]

I take 2,500 IU twice daily for a total of 5,000 IU of vitamin D-3; I take it mainly for mood enhancement. I'm currently at 46 ng/mL at this amount.

I'm upping it from 5,000 IU to 6,000 IU until the end of July (yes -- with my doctors permission!) to get my liver enzymes lowered down to the normal range. They have already come down but there is still work to do.

John Cannell of the The Vitamin D Council sent me a study on vitamin D and liver enzymes.

PubMed:

http://www.ncbi.nlm....pubmed/16928437

cod liver oil as a good vitamin d source?

I'd like to know that as well. I'm planing to buy Carlson labs new Solar D gems which contain D3 and Omega 3. The D3 source comes from Norwegian cod liver oil. According to them it's approved by the FDA but I wanted to know if it's a good source. Anyone here know?

[balance]

Add this to the list:

http://www.nutraingr...ight-loss-Study

[Matt]

I take 10,000 IU daily, regardless of season now. Latest blood level at 79ng, exactly within the sweet spot range I want to be: 70-90 range.

Other members say that optimal levels are 49ng, yet you want a 70-90 range? What is your rational for that? Also, how much Vitamin A are you taking?

Isn't that about the range that we would get into 'without supplements' if we lived near the equator?

[Matt]

Disease prevent by serum 25(OH)D levels. The X marked in the box is what they would expect with increase serum levels of D. Though no acutal data yet

Attached Files

•  disease_prevent_serum__25OHD_level.jpg   147.93KB   20222 downloads

Edited by Matt, 22 April 2009 - 05:31 PM.

[tunt01]

nice chart, thanks matt

[Dmitri]

I take 10,000 IU daily, regardless of season now. Latest blood level at 79ng, exactly within the sweet spot range I want to be: 70-90 range.

Other members say that optimal levels are 49ng, yet you want a 70-90 range? What is your rational for that? Also, how much Vitamin A are you taking?

Isn't that about the range that we would get into 'without supplements' if we lived near the equator?

According to the first few posts the optimal levels are between 40-50 ng based on NHANES III data. So, why is duke aiming for a 70-90 range? Your chart compliments kismet's 40-50 range not duke's.

[Joey]

Can someone comment on these two recently published studies on vitamin D effects in lung cancer & in autoimmune/inflammation related diseases.
These two studies seem to agree only on the proposition that vitamin D deficiency may be a result but not the cause of some diseases.
And the study on auto immune/inflammation related diseases even concludes that long term supplementation may be counterproductive & severely so in some cases based on observations (not definitively proven).
If both studies are later confirmed by others, could it mean that vitamin D supplementation can be both beneficial & detrimental to health?
The way I see it for a cancer patient, if vitamin D could help, the possibility of getting sometimes in the future some other less dramatic ailment might not be an immediate concern. However, if the immune system is degraded by vitamin D over the long term does this imply a higher risk for cancer relapse?

Low Levels Of Vitamin D In Patients With Autoimmune Disease May Be Result, Not Cause, Of The Disease
http://www.scienceda...90408164415.htm

Human Lung Tumors Destroy Anti-cancer Hormone Vitamin D
http://www.scienceda...90420151223.htm

Also this previously published abstract:
Vitamin D discovery outpaces FDA decision making.
http://www.ncbi.nlm....Pubmed_RVDocSum

Edited by Joey, 24 April 2009 - 11:23 PM.

[VespeneGas]

That last link is written by Trevor Marshall, the iconoclastic miscreant of the vitamin D research field. His ideas aren't really accepted, like, at all, and he has no in vivo research to back his claims, mostly just computer modeling I believe. It's ludicrous to suggest that vitamin d food fortification has caused the diseases of civilization anyway, given that the amounts you get from food (100 iu from a cup of whole milk) has virtually no effect on serum levels, which is why so many people are insufficient in vitamin d.

[kismet]

If both studies are later confirmed by others, could it mean that vitamin D supplementation can be both beneficial & detrimental to health?

That wouldn't be surprising. The inverted u-shape response curve is only an approximation of "classical" side-effects. Many substances can have side-effects at "physiologic" doses. If GH deficiency similarly extends life span in humans as in rodents, it would be a perfect hormonal example. 

The way I see it for a cancer patient, if vitamin D could help, the possibility of getting sometimes in the future some other less dramatic ailment might not be an immediate concern. However, if the immune system is degraded by vitamin D over the long term does this imply a higher risk for cancer relapse?

Low Levels Of Vitamin D In Patients With Autoimmune Disease May Be Result, Not Cause, Of The Disease
http://www.scienceda...90408164415.htm

Human Lung Tumors Destroy Anti-cancer Hormone Vitamin D
http://www.scienceda...90420151223.htm

2 of the 3 articles are talking about Marshall's work. So far the data on autoimmune diseases and vitamin D is not bad; let's wait and see. For example:
Phase I trial of vitamin D in MS. Patients improved, but could be explained by regression to the mean. http://www.ajcn.org/...t/full/86/3/645
A recent cross-sectional study was also positive, causality cannot be inferred, but there's no causation without correlation: ”In RRMS patients (disease course < or = 5 years), high 25(OH)D levels were associated with a high chance of remaining relapse-free. Low 25(OH)D levels were associated with high EDSS-scores “ (1)
Marshall's hypothesis is that 25(OH)D is an antagonist, while the current view is that it's a weak agonist. Performing an experiment to prove either theory can't be that difficult (you need a cell culture lacking 1-hydroxylase [CYP27] activity, 25(OH)D and an assay to measure expression of VD regulated genes)

Regarding the cancer study. It is well established that cancers can express CYP24, the cytochrome responsible for 24-hydroxylation and deactivation/catabolism of calcitriol. We still need a good workaround to that problem.

(1) Mult Scler. 2008 Nov;14(9):1220-4. Epub 2008 Jul 24.
Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis.
Smolders J, Menheere P, Kessels A, Damoiseaux J, Hupperts R.

Edited by kismet, 25 April 2009 - 10:58 AM.

[Matt]

This BioEssay explores how lifelong supplementation of the food chain with vitamin D might well be contributing to the current epidemics of obesity and chronic disease

How can anyone take this guy seriously? Vitamin D deficiency or rather low levels of Vitamin D are common. The epidemic of obesity is caused by too many calories and bad food choices.

[Joey]

Thanks to VespeneGas, Kismet & Matt for your clarifications & debunking of the extrapolations of one researcher based only on in-vitro experiments & computer simulations.
I just got a recent anecdoctical report supporting the comment of Kismet regarding the U curve on possible double edge effect of vitamin D according to the dosage. And it comes from the personal experience of an elderly conventional MD who is following his own advice in practicing frequent physical exercises (a lot of countryside bicycling among other things) but found that repeated injuries & muscle soreness could be either succesfully treated or agravated by vitamin D depending on dosage:

Muscle Soreness, Exercise Injuries and Vitamin D http://www.drmirkin....zine041909.html
(Note: Dr Mirkin is both a dermatologist & sports medecine specialist)

[nancyd]

My doctor just called with the results of my vit D test. The number was 37 and she told me to cut my current vitamin D dose in half. What number are doctors aiming for? (I don't think they're correct. Just curious what they base it on.)

Edited by nancyd, 29 April 2009 - 08:45 PM.

[DukeNukem]

My doctor just called with the results of my vit D test. The number was 37 and she told me to cut my current vitamin D dose in half. What number are doctors aiming for? (I don't think they're correct. Just curious what they base it on.)

The opinion of a cardiologist who's been using vitamin D3 in his practice for years:

Virtually all of us should be supplementing vitamin D at a dose that generates healthy blood levels, regardless of VDR genotype. For those of us following the Track Your Plaque program for coronary plaque control and reversal, that means maintaining serum 25-hydroxy vitamin D levels between 60-70 ng/ml.
http://heartscanblog...l-and-mary.html

[niner]

My doctor just called with the results of my vit D test. The number was 37 and she told me to cut my current vitamin D dose in half. What number are doctors aiming for? (I don't think they're correct. Just curious what they base it on.)

I just got the results of my D test today. It was 57 ng/ml and my doctor was fine with it. (Not that he knows much about it...) You are on the low side. If I was at 37 ng/ml, I'd be more inclined to double my dose, assuming you haven't just been taking an insanely large dose for the past few weeks. What do you take, anyway? I'm taking 3000 IU in a gelcap formulation plus another 1000 of a dry formulation as part of a bone formula. Dr. Davis, the above cardiologist, likes fairly high levels for plaque regression. Some people don't like to go over 50 ng/ml based on a recent paper that found (somewhat vague, imho) increases in all-cause mortality above that number.

[Dmitri]

My doctor just called with the results of my vit D test. The number was 37 and she told me to cut my current vitamin D dose in half. What number are doctors aiming for? (I don't think they're correct. Just curious what they base it on.)

I just got the results of my D test today. It was 57 ng/ml and my doctor was fine with it. (Not that he knows much about it...) You are on the low side. If I was at 37 ng/ml, I'd be more inclined to double my dose, assuming you haven't just been taking an insanely large dose for the past few weeks. What do you take, anyway? I'm taking 3000 IU in a gelcap formulation plus another 1000 of a dry formulation as part of a bone formula. Dr. Davis, the above cardiologist, likes fairly high levels for plaque regression. Some people don't like to go over 50 ng/ml based on a recent paper that found (somewhat vague, imho) increases in all-cause mortality above that number.

I have a question, how much Vitamin A should we be taking compared to D? I hear some people say 6;1 others say 1;1 so which one is it? If I'm taking 2,000 IU of D3 a day how much Vitamin A should I be taking? I'd like to point out that I don't take Vitamin A supplements, my source of A comes from salads which contain about 1,500 IU and a multi which has 5,000 IU in the palmitate form (the multi also contains 800 IU of D3). Is this enough or should I be getting more?

[stephen_b]

Disease prevent by serum 25(OH)D levels. The X marked in the box is what they would expect with increase serum levels of D. Though no acutal data yet

Correct me if I'm wrong, but I believe that the disease prevention numbers come from epidemiological data. To prove that vitamin D supplementation will reduce disease rate, you need to do some controlled experiments.

StephenB

[kismet]

@stephen_b
All the values in that graph are from epidemiology, but there are interventional studies suggesting that there is a causal relationship. I've added some references to interventional studies and reviews dealing with interventional studies in case you want to look them up.
Vitamin D & cancer
Yes, it's mostly epidemiology. On the other hand, many argue that the currently available data (from different lines of evidence) is sufficiently strong to imply causation. Garland among others argues that the inverse association between vitamin D and breast & colorectal cancer is most probably causal as it satisfies Bradford Hill's criteria for causality. (1)
Others most recently the IARC and probably soon the IOM are going to claim that the evidence is not sufficient.
Some interventional trials performed: Lappe's much criticised secondary analysis (1100IU/d), Autier's meta-analysis (2) of interventional trials showing that vitamin D reduces mortality in the elderly (which is only possible if it reduces CVD, cancer mortality or both)  and all the small trials showing that vitamin D (both calcitriol & cholecalciferol) have anti-neoplastic activity.
Vitamind D & muscoskeletal health
There is overwhelming interventional evidence that vitamin D reduces fracture and fall risk in the elderly. Most probably via increased calcium absorption, bone quality and strength. Recently Lappe et al. have shown that 800IU vitamin D and a huge dose of calcium greatly decrease fracture risk in female navy recruits. (3) Thus a synergistic influence of calcium and vitamin D on bone quality in the young is very likely.
Several lines of evidence (including interventional trials from the 40s, 50s and 60s) suggest that vitamin D is ergogenic in the young, summarised in Cannell's impressive research. (4)
CVD
The list of epidemiologic trials (and other lines of evidence) showing benefits of vitamin D is endless NHANES, LURIC, HPFS, Framingham offspring study, etc
There is no definite interventional trial, but many have shown very good results (i.e. changes in markers of CVD). For instance Dr. Davis' open-label study wherein he documents the success of his TYP program. Several of his patients achieved 50% regression of atherosclerosis (measured as CAC), he's using high dose vitamin D, fishoil, statins and dietary changes. Zittermann repeatedly showed that vitamin D improves markers of inflammation and recently that it also improves triglycerides. (5) Then there's also the infamous trial showing that low dose vitamin D (400IU) and 1000mcg of K1 greatly improves the elastic properties of arteries in postmenopausal women (while most of the benefit can be attributed to vitamin K1, low dose vitamin D also showed a trend towards improvement and presumably it is necessary for vitamin K & synergistic). (6)
Again Autier's meta-analysis provides another hint. (2)
BP & insulin resistance
I don't want to look up all the interventional trials, because I don't have a lot of time. So let me quickly summarise; the evidence for improved insulin metabolism and diabetes prevention is very strong (including many small RCTs) and currently many well-sized RCTs are under way. (7, 8)
The evidence for improved BP is mixed, but also rather positive: "The recent publication of several studies, highlighted in this brief review, supports an association between vitamin D status and blood pressure." (9)

Why do we still need RCTs?
I believe residual confounding from exercise is a huge issue in the case of vitamin D research (more exericse normally means more outdoor activity...)

(1) How strong is the evidence that solar ultraviolet B and vitamin D reduce the risk of cancer? An examination using Hill’s criteria for causality
William B. Grant
http://www.landesbio...gy/article/7388
(2) Arch Intern Med. 2007 Sep 10;167(16):1730-7.
Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials.
Autier P, Gandini S.
(3) Bone Miner Res. 2008 May;23(5):741-9.
Calcium and vitamin d supplementation decreases incidence of stress fractures in female navy recruits.
Lappe J, Cullen D, Haynatzki G, Recker R, Ahlf R, Thompson K.
(4) Athletic Performance and Vitamin D.
Cannell JJ, Hollis BW, Sorenson MB, Taft TN, Anderson JJ.
Med Sci Sports Exerc. 2009 Apr 3. [Epub ahead of print]
Vitamin D council (earlier version of the theory): http://www.vitamindc.../2007-mar.shtml
(5) http://heartscanblog...flammation.html
(6) Thromb Haemost. 2004 Feb;91(2):373-80.
Beneficial effects of vitamins D and K on the elastic properties of the vessel wall in postmenopausal women: a follow-up study.
Braam LA, Hoeks AP, Brouns F, Hamulyák K, Gerichhausen MJ, Vermeer C.
(7) Diabetes. 2008 Oct;57(10):2565-6.
Vitamin D and type 2 diabetes: are we ready for a prevention trial?
Scragg R. Comment.
http://diabetes.diab...full/57/10/2565
(8) J Clin Endocrinol Metab. 2007 Jun;92(6):2017-29. Epub 2007 Mar 27.
The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis.
Pittas AG, Lau J, Hu FB, Dawson-Hughes B.
http://www.pubmedcen...bmedid=17389701
(9) Nutr Rev. 2008 May;66(5):291-7.
Vitamin D and blood pressure connection: update on epidemiologic, clinical, and mechanistic evidence.
Martini LA, Wood RJ.

Edited by kismet, 30 April 2009 - 01:18 PM.

[Joey]

Two secondary factors may come into play in dosing vitamin D.
In the case of people with obesity the fact that vitamin D tends to accumulate in fatty cells has for consequence a reduction in the level of circulating vitamin which is delivered to body organs.
This situation may be a particular concern for those suffering of osteoarthritis of the knees as excessive weight increases the risk of cartilage dammage & added pain & the lowered level of vitamin D robs the person of the pain reducing benefits of the supplement. So, for these people obesity may be a double whammy as far as pain is concerned.
A more general factor is the relative lack of precision of current blood test to evaluate the level of vitamin D in the cells.
Here are two recent articles which deal (in part or in total) with vitamin D testing:
http://www.scienceda...90325132153.htm
http://www.scienceda...90420151223.htm

[nancyd]

What do you take, anyway? I'm taking 3000 IU in a gelcap formulation plus another 1000 of a dry formulation as part of a bone formula. Dr. Davis, the above cardiologist, likes fairly high levels for plaque regression. Some people don't like to go over 50 ng/ml based on a recent paper that found (somewhat vague, imho) increases in all-cause mortality above that number.

For almost a year I've been taking 4000 IU in a gel capsule along with 1000IU in a dry capsule that is included in my calcium supplement. Also another 1000IU in my multi tablet. I really think the amounts in the dry capsules/tablets don't count because they're difficult to absorb. I recently switched my gel capsule to 5000 IU. Her reason for recommending that I lower my dose was that vitamin D can be toxic, which makes me think she's basing her toxicity concerns on the amount I take as opposed to the test results.

Edited by nancyd, 30 April 2009 - 10:24 PM.

[david ellis]

My doctor just called with the results of my vit D test. The number was 37 and she told me to cut my current vitamin D dose in half. What number are doctors aiming for? (I don't think they're correct. Just curious what they base it on.)

I just got the results of my D test today. It was 57 ng/ml and my doctor was fine with it. (Not that he knows much about it...) You are on the low side. If I was at 37 ng/ml, I'd be more inclined to double my dose, assuming you haven't just been taking an insanely large dose for the past few weeks. What do you take, anyway? I'm taking 3000 IU in a gelcap formulation plus another 1000 of a dry formulation as part of a bone formula. Dr. Davis, the above cardiologist, likes fairly high levels for plaque regression. Some people don't like to go over 50 ng/ml based on a recent paper that found (somewhat vague, imho) increases in all-cause mortality above that number.

My doctor was happy with 66 ng/mL, that's close to the middle of her target zone.

[stephen_b]

@stephen_b

Thanks for putting together that list of trials. My instinct is that the RCTs will have positive outcomes. For me at least the risk/benefit ratio for D supplementation is strongly pro supplementation. I have some family history of cancer, and D along with curcumin are my number 1 and 2 preventative supplements.

StephenB

[Pablo M]

I took 10,000 IU of D3 all winter (in a dry capsule, always with fat-containing meals). A few times I took 50,000 IU for 2 days when I felt unwell. Towards the end of March I switched to a liquid D3 emulsified in sesame oil. On April 4th, I had my 25-hydroxy D measured and it was 216 nM/L (I live in Canada). John Cannell of the Vitamin D Council says optimal levels are 135-200 nM/L. So next winter I'll likely supplement around 6000.

[ajnast4r]

216 nM/L (I live in Canada). John Cannell of the Vitamin D Council says optimal levels are 135-200 nM/L.

back in canada eh?

what does nm/l convert to in ng/dl?

[Pablo M]

what does nm/l convert to in ng/dl?

According to vitamindcouncil,org, the 50–80 ng/mL range equals 125–200 nM/L. So a bit over 80 would be my guess.

[stephen_b]

what does nm/l convert to in ng/dl?

Divide by 2.5.

[kismet]

I'm wondering, does Marshall argue that Vitamin D causes classical immuno-suppression? Or does he argue that it causes some form of selective immuno-suppression (not affecting immunity)? The former is quite obviously untenable: Vitamin D can't cause classical immuno-suppression without classical symptoms of i-suppression. Two secondary analysis of RCTs and one RCT show that vitamin D does not increase the risk of infection, on the contrary, it might decrease incidence. Maybe there's a difference between long term and short term (several months) effects in his model to account for this inconvenient truth?

[gregandbeaker]

I had my levels tested a of weeks ago and was at 39. I was taking 2000 iu's and spending a lot of time outside all summer and that's all the higher it got. Now that winter is descending upon the upper midwest and the Sun is all but gone I'm up to 5000 iu's.

FWIW my Doctor said I should aim for 50ng/dl.

[nito]

i take 5000 every three days. I'm 26 and suffer from depressive sypmtoms. I know for sure i didnt get eneough sun on my arms and legs but only on my face the last 1 and a half years.