13 ms·

While hypervitaminosis D is a real syndrome, as evidenced by this story, low Vitamin D levels are endemic in temperate and northern latitudes. We did a study se

While hypervitaminosis D is a real syndrome, as evidenced by this story, low Vitamin D levels are endemic in temperate and northern latitudes. We did a study several years ago ( Vitamin D Status in an Elective Orthopedic Surgical Population. Foot Ankle Int. 2016 Feb;37(2):186-91. doi: 10.1177/1071100715609054) in Vermont among healthy folks who were going to get surgery and roughly 2/3 had low vitamin D levels (<30ng). Low vitamin D is a significant risk factor for fractures, such as hip fractures in the elderly which is a major cause of mortality. So please don't interpret this story as a reason to avoid any vitamin D supplementation. 1-2000 IU/day has been shown to be safe with long term use, but if you have any questions, you should absolutely talk with your primary care provider. PS - Yes, I am a practicing physician.

baccheion 6y ago
It's harder to be too high than too low, especially with enough magnesium and vitamin K2. When high, just lower calcium to the 500-600 mg range and use magnesium to eclipse phosphorus.
- 205guy 6y ago
  The sentiment of nutrition hacking with supplements expressed in the parent comment just seems wrong. Not factually wrong, I'm not able to judge, though it could be--one expert says one thing and the other the opposite. It just seems like a dangerous attitude of over-confidence to think you can mix and match supplements based on numbers from blood results. And who has their blood tested so often they can adjust their supplements weekly or monthly--because you wouldn't want to go too long at the wrong level. There are so many complex systems in the body, and so many interactions such as vitamin D and calcium, that it just seems risky. Some people are knowledgeable about supplements and interactions, others sound knowledgeable but are just selling the next fad. Not to mention that it all depends on the person's specific metabolism and any conditions they might have (such as the patient in the article). Or do we even need supplements at all if we just ate well and had an active lifestyle? Speaking as someone who just had yogurt and a banana: "Let thy food be thy medicine and thy medicine be thy food."
  - trhway 6y ago
    >It just seems like a dangerous attitude of over-confidence to think you can mix and match supplements based on numbers from blood results. unfortunately that seems to be the the only option we have - "Let thy be thy doctor" :) From personal experience - thanks to Epic software i was given the total printout of my visit to a doctor few months back - the doctor somehow completely skipped low RBC and other related counts in my blood results which were clearly showing anemia and actually did match my feelings of overall fatigue, especially setting up quickly upon trying to exercise, restless leg syndrome, etc. After looking at those blood numbers myself, i started B12 (B12 deficiency is one of the reasons for iron deficiency, and i have an underlying condition known to cause B12 deficiency which the doctor was actually aware too - though, nevermind, the doctors could do nothing with that condition too) and iron, and the things improved remarkably, in particular RLS is gone and i can exercise without hitting almost immediately that fatigue ceiling. >Or do we even need supplements at all if we just ate well and had an active lifestyle? Speaking as someone who just had yogurt and a banana: "Let thy food be thy medicine and thy medicine be thy food." you're enjoying condition which can be summed up as confirmation bias of a healthy person. It is a really great condition - i've enjoyed it myself for about the first 40 years of my life.
  - baccheion 6y ago
    There are 2 tests (a few months apart) needed to calibrate vitamin D dose. One could even go through the Coimbra protocol induction (though they don't have MS) to find the optimal amount for them.
ErikAugust 6y ago
As a Vermonter, I have to ask - does the locale have anything to do with the low Vitamin D levels, any more than most of the rest of the northern United States? Would 5000 - 10000 IU/day be toxic?
- mod 6y ago
  Your body makes its own vitamin D in response to sunlight exposure.
  - ErikAugust 6y ago
    Well, yes. But does the region have significantly less sunlight than others? Or is it just the people in question didn't get nearly as much exposure?
    - liability 6y ago
      Latitude, local geography and weather will all play a role in how much sunlight you get. If you're living in a valley you can have much shorter days than your latitude would suggest. And if the weather is shitty enough to keep you inside much of the year that will obviously have an impact.
      - mixmastamyk 6y ago
        Yes, age and skin color also have a large influence on whether your body can utilize the sunlight you receive.
        trhway 6y ago
        Yep, there were studies that Somali refugee populations in MN and Sweden have very low vitamin D levels (and associated high rate of children autism)
        selimthegrim 6y ago
devaboone 6y ago
I'm the physician who wrote the article. And I agree with you. Vitamin D deficiency is a problem because it leads to bone loss (see part 1: https://www.devaboone.com/post/vitamin-d-part-1-back-to-basics https://www.devaboone.com/post/vitamin-d-part-1-back-to-basi...). And Vitamin D supplements can be very helpful for those with a deficiency. The point that I am trying to make is that Vitamin D should not be thought of as a dietary supplement. I am seeing more and more people with high calcium levels from being on high-dose Vitamin D. If you treat Vitamin D like the steroid hormone that it is, you will treat it like a medicine, and not take outrageous doses because someone online suggested it. At least, that's what I'm trying to get across.
- mrfusion 6y ago
  How do you feel about vitamin k2 (and magnesium) for lowering the risk of high calcium?
  - velox_io 6y ago
    As far as I'm aware it's only B vitamins that aren't toxic in high volumes. I take 1,500ug of B12 (60,000% nrv - B12 has fairly poor adoption) for a nervous system disorder, seems to stops my toes going purple...
    - nowandlater 6y ago
      I dose a similar amount of B12 as you and likewise see real benefits, but I recently stumbled across some research that claims vitamin B6 and B12 supplemenation show increased incidence of lung cancer in men [1]. I'm wondering if any of the above physicians can comment on this research. 1. https://examine.com/nutrition/vitamin-b-cancer/ https://examine.com/nutrition/vitamin-b-cancer/
      - velox_io 6y ago
        ">55 mcg/day [B12] was associated with a 98% greater risk" Wow, that is quite a staggering increase! Luckily it was men who smoke; "As for never-smokers, the paper states they “were excluded from the smoking-stratified analysis because of the low number of participants with incident lung cancer in that group.” It's interesting how woman weren't affected, but I am all too aware of the link between smoking and lung cancer as the two go hand in hand. My father died of lung cancer and we didn't part on the best of terms as he had a bad cough for a over a decade before being diagnosed, I lacked sympathy as it was virtually a given. Seeing patients needing to go outside to smoke (often with an IV attached) as they are dying is something I'll never get my head. I would name it the Darwin ward, but that is probably insensitive... (ASD) It makes me angry that medics won't even condon, let along recommend smokers switch to vaping due to politics. They could save 100,000's of lives per year in the US alone (480k smokers die per year).
jonnycomputer 6y ago
This actually reinforces for me the idea that people need individualized expert advice on this. I know that lay people (and I include myself here) tend to think if x is good for you then more x is even better. So you see vitamins marketed with extreme %s over daily recommended levels. Supplementation really seems it should be last resort. This reminds me somewhat of how people are so concerned about the health effects of too much salt that they end up getting too little, which is also detrimental.
- DoreenMichele 6y ago
  If you are a lay person, as I am, you can still make judgements symptomatically. If you have good reason to believe you are probably deficient, you can conservatively experiment with taking supplements and see if it helps. If your status improves, adjust doses downward as needed. Keep a journal. Keep a journal. Keep a journal. If you can't manage it yourself in that manner, yes, seek testing and so forth. Don't ever take supplements of any kind for any reason if you don't have reason to believe you in particular actually need the supplement. Period.
  - treeman79 6y ago
    Journal is huge. I also keep a log of every medication and supplement and notes on how it affects me. Doctors like being handed a 2 Page document with everything listed and the results. I also got diagnosed with a rare condition from this. Doctor saw more to the reactions then I had.
    - DoreenMichele 6y ago
      People don't realize it, but journaling doesn't have to be hard. If you are talking to yourself, really brief notes can help jog your memory about "That was the day I had two eggs instead of one and otherwise did everything the same" and you don't necessary need to write down every single morsel of food to let yourself know next week "That was the day I had an extra egg with that meal." You know what your "usual" is. "My usual, but with an extra egg" is something that will mean something to future you next week, even if it means nothing ten years from now. Journaling as a health management tool doesn't have to be complicated and burdensome. Write down what you feel you will need help remembering in a few days when you are wondering "What truck ran me over this time???" and as you get value out of it, you may feel like writing more because you can see it isn't a waste of time. Just start, no matter how pathetically.
mrfusion 6y ago
I’m thinking of flagging this since it seems to overweight the risk of high vitamin d vs the more common risk of low vitamin d?
- floatingatoll 6y ago
  It came across to me as a warning that we wouldn’t be so cavalier about any other hormone, so we shouldn’t be with Vitamin D either. In that context it’s fine.
- not2b 6y ago
  Please don't, unless your expertise is comparable to that of the physician who wrote the article.
- devaboone 6y ago
  I'm the one who wrote the article. I would actually argue that the risk of low Vitamin D has been overplayed. There are very alarmist articles out there about this epidemic of Vitamin D deficiency - which causes people to go out and buy supplements. But there is very little actual data showing that healthy people should take Vitamin D. This is where you get into the large human trials of Vitamin D supplementation, which I want to get into for part 3.
  - EvanAnderson 6y ago
    Thank you for writing these articles. Even more thanks for coming here and participating in the discussion.
- exhilaration 6y ago
  Your average HN reader has probably seen enough articles posted here about vitamin D deficiency that we are in fact the perfect audience to read about the dangers of taking too much of it.
jjcon 6y ago
Funny question I know but how effective are D supplements at improving low D levels?
- deleted 6y ago
  [deleted]
- cactus2093 6y ago
  As I understand it, very effective. But most of the research that correlates low vitamin D levels with various diseases is from observational studies, so there's always a question of whether a low vitamin D level is the causal problem or if it's more complicated, for example maybe lack of sunlight causes other effects in addition to low vitamin D levels and those other effects are the real problem rather than the low vitamin D levels. IFAICT, most doctors will still prescribe supplements for low vitamin D though. It certainly doesn't seem to hurt, as long as the levels don't get too high as discussed in this article.
- spfzero 6y ago
  There is a site with some data on supplementation's effect on serum D3 levels. Short version, they are effective. https://www.grassrootshealth.net https://www.grassrootshealth.net
cbanek 6y ago
I totally agree. Right now I'm actually very vitamin D deficient (10 ng/ml) and on 50,000 IU Rx dosage weekly, and I'm in Arizona! I just don't get enough sunlight and wear sunblock all the time due to being extremely fair and feeling like meat in a frying pan when the sun is on me. Also staying indoors due to Corona! But I wouldn't have guessed Vitamin D deficiency. I haven't had any bone fracture issues (thankfully) since I'm still young, but low vitamin D levels can also apparently give you brain fogginess and depression, which I'm suffering from. But it does seem like Vitamin D testing isn't on most normal testing regimes, it was only when I presented with depression that I got tested.
- gojomo 6y ago
  Important news from the future: use shade not sunscreen whenever possible. And, as long as you're not often getting peeling-levels of sunburn, don't fear the sun, or the feeling of the hot sun, so much. Sun exposure is sufficiently correlated with so many health benefits that it is almost certainly causative for those benefits – especially lower rates of heart disease. Endogenous Vitamin-D production is just one mechanism/signal of the sun's influence, not the full story, so supplementation of Vitamin-D can't reproduce all the sun's benefits. And, other than preventing sunburns, the health benefits of sunscreen are suspiciously under-proven, and the potential effects of long-term exposure-to/blood-absorption-of their ingredients under-studied. In another decade or two, the current levels of sunscreen use, and recommendation by expert bodies that should know better, will likely be considered a public health failure up there with "use margarine not butter" or "replace fats with sugars" or "masks don't help against respiratory epidemics". Use shade not sunscreen whenever possible.
  - cbanek 6y ago
    I would normally be with you but I burn in just a couple of minutes, and I've unfortunately had some really bad burns in the past (where my skin is still very freckled). I'm totally with you on shade over sunscreen though, I only put sunscreen on my face, and just try to shade everything else. Sadly my skin hates sunscreen too!
    - 6y ago
DNtBlVtHhYp 6y ago
What’s your opinion on K2? K2/D3 ratio and how would age affect the ratio?
duncanawoods 6y ago
> low Vitamin D levels are endemic in temperate and northern latitudes When this last came up, jusssi commented about the actual counter-intuitive distribution of D deficiency: > under 20% in Northern Europe, 30-60% in rest of Europe, up to 80% in Middle East. https://eje.bioscientifica.com/view/journals/eje/180/4/EJE-18-0736.xml https://eje.bioscientifica.com/view/journals/eje/180/4/EJE-1... https://news.ycombinator.com/item?id=23255533 https://news.ycombinator.com/item?id=23255533
- SamBam 6y ago
  We probably wouldn't even expect it to be a straight correlation with "the higher your latitude, the lower your vitamin D." Skin color is very tightly coupled with latitude, with melanin concentrations evolved to let in a small window of sunlight that (1) allows enough production of vitamin D and (2) prevents destruction of folic acid. (A few exceptions can be found in communities that have historically eaten large amounts of fish, such as Inuits, who tend to have skin color slightly darker than "expected" because they are getting more vitamin D from diet, and so the the folic acid side of the fitness function "wins.") Given that, we shouldn't necessarily expect populations whose ancestors have been at one latitude for hundreds/thousands of years, and who get plenty of out-door time, to necessarily be vitamin D deficient. What is more likely to contribute to higher vitamin D deficiencies in a population would be (1) immigration/expatriation of people to higher latitudes (even over the course of hundreds or thousands of years) and (2) living indoors more. Naturally, this may result in a hodge-podge of communities with vitamin D deficiencies, which may not be clearly correlated with latitude (although may still show correlation).
zzz61831 6y ago
> So please don't interpret this story as a reason to avoid any vitamin D supplementation. 1-2000 IU/day has been shown to be safe with long term use I'll give you a more regular story. Some time ago I thought I needed to take D3 supplements after being exposed to all this PR pushing it and given that I don't eat food rich in it, rarely get sunlight, don't go outside in daylight (densely populated area, supermarkets work 24/7, etc.). So I bought some and took 2000 IU/day for a few days. Suddenly I started feeling numbness on the tip of my toes. After a bit of research I attributed it to D3, immediately stopped taking it, but numbness went away only after a few weeks. It's hard to see how taking it longer could have been safe. So please don't generalize that 2000 IU is safe just because something showed that it was for some people in certain circumstances given certain country-specific lifestyle, foods, etc. I don't think a decent study on D3 safety even exists.
- ping_pong 6y ago
  No offense, but this sounds like a bad diagnosis on your part. It takes more than a few days for Vitamin D problems to arise. The fact that the numbness took a few weeks to go away after taking Vitamin D for only a couple of days means it was most probably some other thing causing the problem.
  - zzz61831 6y ago
    It took a few weeks to go away completely, but got noticeably better just after a couple of days. I'm pretty confident in that diagnosis, as nothing else have changed.
sizzle 6y ago
Do you recommend vitamin D3 or D2 and why? Please advise.
amai 6y ago
Explain that: Low vitamin D is also common in Africa! https://theconversation.com/think-vitamin-d-deficiency-is-not-common-in-africa-think-again-140080 https://theconversation.com/think-vitamin-d-deficiency-is-no...
- slim 6y ago
  Because too much clothes maybe? Western clothing style was introduced by colonization
ysavir 6y ago
Thanks for your input. I think a valuable thing that can be added to the conversation is a rough evaluation of how long vitamin D takes to leave the body. It's easy for us to look at a bottle and control how much we're putting in, the tricky part is managing that we're only putting in enough to compensate for what has been used or lost since the last dosage. If people were given a vague idea of the Vitamin D "burn rate", and what factors might increase or decrease that number, I believe your and Dr. Boone's points may be significantly better received by others.
baccheion 6y ago
Before adding supplemental vitamin D, first ensure nutrient sufficiency and that all RDAs are being met (with just food). For example, low magnesium impairs vitamin D conversion and is a more common problem. Further, hGH/IGF-1 also pushes for conversion of vitamin D. Insufficient potassium, insulin resistance, and some other things clip hGH/IGF-1. In some cases, fixing diet and sleep (ZMA for males) normalizes vitamin D. After other steps are taken, then add some amount of D3 if necessary. It's been said it's better gotten from red light (one of those special lamps/light) on the skin, as the body is able to regulate/limit absorption. Either way, some supplementation is likely to be needed with age. Response of the skin to sunlight declines over time, especially due to rising cortisol.

baccheion 6y ago

It's harder to be too high than too low, especially with enough magnesium and vitamin K2. When high, just lower calcium to the 500-600 mg range and use magnesium to eclipse phosphorus.

205guy 6y ago
The sentiment of nutrition hacking with supplements expressed in the parent comment just seems wrong. Not factually wrong, I'm not able to judge, though it could be--one expert says one thing and the other the opposite. It just seems like a dangerous attitude of over-confidence to think you can mix and match supplements based on numbers from blood results. And who has their blood tested so often they can adjust their supplements weekly or monthly--because you wouldn't want to go too long at the wrong level. There are so many complex systems in the body, and so many interactions such as vitamin D and calcium, that it just seems risky. Some people are knowledgeable about supplements and interactions, others sound knowledgeable but are just selling the next fad. Not to mention that it all depends on the person's specific metabolism and any conditions they might have (such as the patient in the article). Or do we even need supplements at all if we just ate well and had an active lifestyle? Speaking as someone who just had yogurt and a banana: "Let thy food be thy medicine and thy medicine be thy food."
- trhway 6y ago
  >It just seems like a dangerous attitude of over-confidence to think you can mix and match supplements based on numbers from blood results. unfortunately that seems to be the the only option we have - "Let thy be thy doctor" :) From personal experience - thanks to Epic software i was given the total printout of my visit to a doctor few months back - the doctor somehow completely skipped low RBC and other related counts in my blood results which were clearly showing anemia and actually did match my feelings of overall fatigue, especially setting up quickly upon trying to exercise, restless leg syndrome, etc. After looking at those blood numbers myself, i started B12 (B12 deficiency is one of the reasons for iron deficiency, and i have an underlying condition known to cause B12 deficiency which the doctor was actually aware too - though, nevermind, the doctors could do nothing with that condition too) and iron, and the things improved remarkably, in particular RLS is gone and i can exercise without hitting almost immediately that fatigue ceiling. >Or do we even need supplements at all if we just ate well and had an active lifestyle? Speaking as someone who just had yogurt and a banana: "Let thy food be thy medicine and thy medicine be thy food." you're enjoying condition which can be summed up as confirmation bias of a healthy person. It is a really great condition - i've enjoyed it myself for about the first 40 years of my life.
- baccheion 6y ago
  There are 2 tests (a few months apart) needed to calibrate vitamin D dose. One could even go through the Coimbra protocol induction (though they don't have MS) to find the optimal amount for them.

ErikAugust 6y ago

As a Vermonter, I have to ask - does the locale have anything to do with the low Vitamin D levels, any more than most of the rest of the northern United States? Would 5000 - 10000 IU/day be toxic?

mod 6y ago
Your body makes its own vitamin D in response to sunlight exposure.
- ErikAugust 6y ago
  Well, yes. But does the region have significantly less sunlight than others? Or is it just the people in question didn't get nearly as much exposure?
  - liability 6y ago
    Latitude, local geography and weather will all play a role in how much sunlight you get. If you're living in a valley you can have much shorter days than your latitude would suggest. And if the weather is shitty enough to keep you inside much of the year that will obviously have an impact.
    - mixmastamyk 6y ago
      Yes, age and skin color also have a large influence on whether your body can utilize the sunlight you receive.
      - trhway 6y ago
        Yep, there were studies that Somali refugee populations in MN and Sweden have very low vitamin D levels (and associated high rate of children autism)
        selimthegrim 6y ago

devaboone 6y ago

I'm the physician who wrote the article. And I agree with you. Vitamin D deficiency is a problem because it leads to bone loss (see part 1: https://www.devaboone.com/post/vitamin-d-part-1-back-to-basics https://www.devaboone.com/post/vitamin-d-part-1-back-to-basi...). And Vitamin D supplements can be very helpful for those with a deficiency. The point that I am trying to make is that Vitamin D should not be thought of as a dietary supplement. I am seeing more and more people with high calcium levels from being on high-dose Vitamin D. If you treat Vitamin D like the steroid hormone that it is, you will treat it like a medicine, and not take outrageous doses because someone online suggested it. At least, that's what I'm trying to get across.

mrfusion 6y ago
How do you feel about vitamin k2 (and magnesium) for lowering the risk of high calcium?
- velox_io 6y ago
  As far as I'm aware it's only B vitamins that aren't toxic in high volumes. I take 1,500ug of B12 (60,000% nrv - B12 has fairly poor adoption) for a nervous system disorder, seems to stops my toes going purple...
  - nowandlater 6y ago
    I dose a similar amount of B12 as you and likewise see real benefits, but I recently stumbled across some research that claims vitamin B6 and B12 supplemenation show increased incidence of lung cancer in men [1]. I'm wondering if any of the above physicians can comment on this research. 1. https://examine.com/nutrition/vitamin-b-cancer/ https://examine.com/nutrition/vitamin-b-cancer/
    - velox_io 6y ago
      ">55 mcg/day [B12] was associated with a 98% greater risk" Wow, that is quite a staggering increase! Luckily it was men who smoke; "As for never-smokers, the paper states they “were excluded from the smoking-stratified analysis because of the low number of participants with incident lung cancer in that group.” It's interesting how woman weren't affected, but I am all too aware of the link between smoking and lung cancer as the two go hand in hand. My father died of lung cancer and we didn't part on the best of terms as he had a bad cough for a over a decade before being diagnosed, I lacked sympathy as it was virtually a given. Seeing patients needing to go outside to smoke (often with an IV attached) as they are dying is something I'll never get my head. I would name it the Darwin ward, but that is probably insensitive... (ASD) It makes me angry that medics won't even condon, let along recommend smokers switch to vaping due to politics. They could save 100,000's of lives per year in the US alone (480k smokers die per year).

jonnycomputer 6y ago

This actually reinforces for me the idea that people need individualized expert advice on this. I know that lay people (and I include myself here) tend to think if x is good for you then more x is even better. So you see vitamins marketed with extreme %s over daily recommended levels. Supplementation really seems it should be last resort. This reminds me somewhat of how people are so concerned about the health effects of too much salt that they end up getting too little, which is also detrimental.

DoreenMichele 6y ago
If you are a lay person, as I am, you can still make judgements symptomatically. If you have good reason to believe you are probably deficient, you can conservatively experiment with taking supplements and see if it helps. If your status improves, adjust doses downward as needed. Keep a journal. Keep a journal. Keep a journal. If you can't manage it yourself in that manner, yes, seek testing and so forth. Don't ever take supplements of any kind for any reason if you don't have reason to believe you in particular actually need the supplement. Period.
- treeman79 6y ago
  Journal is huge. I also keep a log of every medication and supplement and notes on how it affects me. Doctors like being handed a 2 Page document with everything listed and the results. I also got diagnosed with a rare condition from this. Doctor saw more to the reactions then I had.
  - DoreenMichele 6y ago
    People don't realize it, but journaling doesn't have to be hard. If you are talking to yourself, really brief notes can help jog your memory about "That was the day I had two eggs instead of one and otherwise did everything the same" and you don't necessary need to write down every single morsel of food to let yourself know next week "That was the day I had an extra egg with that meal." You know what your "usual" is. "My usual, but with an extra egg" is something that will mean something to future you next week, even if it means nothing ten years from now. Journaling as a health management tool doesn't have to be complicated and burdensome. Write down what you feel you will need help remembering in a few days when you are wondering "What truck ran me over this time???" and as you get value out of it, you may feel like writing more because you can see it isn't a waste of time. Just start, no matter how pathetically.

mrfusion 6y ago

I’m thinking of flagging this since it seems to overweight the risk of high vitamin d vs the more common risk of low vitamin d?

floatingatoll 6y ago
It came across to me as a warning that we wouldn’t be so cavalier about any other hormone, so we shouldn’t be with Vitamin D either. In that context it’s fine.
not2b 6y ago
Please don't, unless your expertise is comparable to that of the physician who wrote the article.
devaboone 6y ago
I'm the one who wrote the article. I would actually argue that the risk of low Vitamin D has been overplayed. There are very alarmist articles out there about this epidemic of Vitamin D deficiency - which causes people to go out and buy supplements. But there is very little actual data showing that healthy people should take Vitamin D. This is where you get into the large human trials of Vitamin D supplementation, which I want to get into for part 3.
- EvanAnderson 6y ago
  Thank you for writing these articles. Even more thanks for coming here and participating in the discussion.
exhilaration 6y ago
Your average HN reader has probably seen enough articles posted here about vitamin D deficiency that we are in fact the perfect audience to read about the dangers of taking too much of it.

jjcon 6y ago

Funny question I know but how effective are D supplements at improving low D levels?

deleted 6y ago
[deleted]
cactus2093 6y ago
As I understand it, very effective. But most of the research that correlates low vitamin D levels with various diseases is from observational studies, so there's always a question of whether a low vitamin D level is the causal problem or if it's more complicated, for example maybe lack of sunlight causes other effects in addition to low vitamin D levels and those other effects are the real problem rather than the low vitamin D levels. IFAICT, most doctors will still prescribe supplements for low vitamin D though. It certainly doesn't seem to hurt, as long as the levels don't get too high as discussed in this article.
spfzero 6y ago
There is a site with some data on supplementation's effect on serum D3 levels. Short version, they are effective. https://www.grassrootshealth.net https://www.grassrootshealth.net

cbanek 6y ago

I totally agree. Right now I'm actually very vitamin D deficient (10 ng/ml) and on 50,000 IU Rx dosage weekly, and I'm in Arizona! I just don't get enough sunlight and wear sunblock all the time due to being extremely fair and feeling like meat in a frying pan when the sun is on me. Also staying indoors due to Corona! But I wouldn't have guessed Vitamin D deficiency. I haven't had any bone fracture issues (thankfully) since I'm still young, but low vitamin D levels can also apparently give you brain fogginess and depression, which I'm suffering from. But it does seem like Vitamin D testing isn't on most normal testing regimes, it was only when I presented with depression that I got tested.

gojomo 6y ago
Important news from the future: use shade not sunscreen whenever possible. And, as long as you're not often getting peeling-levels of sunburn, don't fear the sun, or the feeling of the hot sun, so much. Sun exposure is sufficiently correlated with so many health benefits that it is almost certainly causative for those benefits – especially lower rates of heart disease. Endogenous Vitamin-D production is just one mechanism/signal of the sun's influence, not the full story, so supplementation of Vitamin-D can't reproduce all the sun's benefits. And, other than preventing sunburns, the health benefits of sunscreen are suspiciously under-proven, and the potential effects of long-term exposure-to/blood-absorption-of their ingredients under-studied. In another decade or two, the current levels of sunscreen use, and recommendation by expert bodies that should know better, will likely be considered a public health failure up there with "use margarine not butter" or "replace fats with sugars" or "masks don't help against respiratory epidemics". Use shade not sunscreen whenever possible.
- cbanek 6y ago
  I would normally be with you but I burn in just a couple of minutes, and I've unfortunately had some really bad burns in the past (where my skin is still very freckled). I'm totally with you on shade over sunscreen though, I only put sunscreen on my face, and just try to shade everything else. Sadly my skin hates sunscreen too!
  - 6y ago

DNtBlVtHhYp 6y ago

What’s your opinion on K2? K2/D3 ratio and how would age affect the ratio?

duncanawoods 6y ago

> low Vitamin D levels are endemic in temperate and northern latitudes When this last came up, jusssi commented about the actual counter-intuitive distribution of D deficiency: > under 20% in Northern Europe, 30-60% in rest of Europe, up to 80% in Middle East. https://eje.bioscientifica.com/view/journals/eje/180/4/EJE-18-0736.xml https://eje.bioscientifica.com/view/journals/eje/180/4/EJE-1... https://news.ycombinator.com/item?id=23255533 https://news.ycombinator.com/item?id=23255533

SamBam 6y ago
We probably wouldn't even expect it to be a straight correlation with "the higher your latitude, the lower your vitamin D." Skin color is very tightly coupled with latitude, with melanin concentrations evolved to let in a small window of sunlight that (1) allows enough production of vitamin D and (2) prevents destruction of folic acid. (A few exceptions can be found in communities that have historically eaten large amounts of fish, such as Inuits, who tend to have skin color slightly darker than "expected" because they are getting more vitamin D from diet, and so the the folic acid side of the fitness function "wins.") Given that, we shouldn't necessarily expect populations whose ancestors have been at one latitude for hundreds/thousands of years, and who get plenty of out-door time, to necessarily be vitamin D deficient. What is more likely to contribute to higher vitamin D deficiencies in a population would be (1) immigration/expatriation of people to higher latitudes (even over the course of hundreds or thousands of years) and (2) living indoors more. Naturally, this may result in a hodge-podge of communities with vitamin D deficiencies, which may not be clearly correlated with latitude (although may still show correlation).

zzz61831 6y ago

> So please don't interpret this story as a reason to avoid any vitamin D supplementation. 1-2000 IU/day has been shown to be safe with long term use I'll give you a more regular story. Some time ago I thought I needed to take D3 supplements after being exposed to all this PR pushing it and given that I don't eat food rich in it, rarely get sunlight, don't go outside in daylight (densely populated area, supermarkets work 24/7, etc.). So I bought some and took 2000 IU/day for a few days. Suddenly I started feeling numbness on the tip of my toes. After a bit of research I attributed it to D3, immediately stopped taking it, but numbness went away only after a few weeks. It's hard to see how taking it longer could have been safe. So please don't generalize that 2000 IU is safe just because something showed that it was for some people in certain circumstances given certain country-specific lifestyle, foods, etc. I don't think a decent study on D3 safety even exists.

ping_pong 6y ago
No offense, but this sounds like a bad diagnosis on your part. It takes more than a few days for Vitamin D problems to arise. The fact that the numbness took a few weeks to go away after taking Vitamin D for only a couple of days means it was most probably some other thing causing the problem.
- zzz61831 6y ago
  It took a few weeks to go away completely, but got noticeably better just after a couple of days. I'm pretty confident in that diagnosis, as nothing else have changed.

sizzle 6y ago

Do you recommend vitamin D3 or D2 and why? Please advise.

amai 6y ago

Explain that: Low vitamin D is also common in Africa! https://theconversation.com/think-vitamin-d-deficiency-is-not-common-in-africa-think-again-140080 https://theconversation.com/think-vitamin-d-deficiency-is-no...

slim 6y ago
Because too much clothes maybe? Western clothing style was introduced by colonization

ysavir 6y ago

Thanks for your input. I think a valuable thing that can be added to the conversation is a rough evaluation of how long vitamin D takes to leave the body. It's easy for us to look at a bottle and control how much we're putting in, the tricky part is managing that we're only putting in enough to compensate for what has been used or lost since the last dosage. If people were given a vague idea of the Vitamin D "burn rate", and what factors might increase or decrease that number, I believe your and Dr. Boone's points may be significantly better received by others.

baccheion 6y ago

Before adding supplemental vitamin D, first ensure nutrient sufficiency and that all RDAs are being met (with just food). For example, low magnesium impairs vitamin D conversion and is a more common problem. Further, hGH/IGF-1 also pushes for conversion of vitamin D. Insufficient potassium, insulin resistance, and some other things clip hGH/IGF-1. In some cases, fixing diet and sleep (ZMA for males) normalizes vitamin D. After other steps are taken, then add some amount of D3 if necessary. It's been said it's better gotten from red light (one of those special lamps/light) on the skin, as the body is able to regulate/limit absorption. Either way, some supplementation is likely to be needed with age. Response of the skin to sunlight declines over time, especially due to rising cortisol.