7 ms·

Vitamin D metabolites and the gut microbiome in older men

88 points by voisin 6y ago

DoofusOfDeath 6y ago
Could someone explain the significance of these findings? It's not remotely my area of expertise, and I'm having trouble seeing if/how this has any current or future clinical significance.
- whalesalad 6y ago
  (I am not a scientist) My interpretation is that your gut bacteria are vital for metabolizing Vitamin D and that you can take a lot of supplements but if your gut aint right it won't help. Slightly related: I keep trying to identifty the recent report that essentially demonstrated a big calculation error in our societal wisdom regarding Vitamin D amounts - and that we need a LOT more than most people think. 2,000 - 5,000 IUD is like a fraction of it. Edit, found it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/ A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. and ....we call all responsible public health authorities to consider designating as the recommended dietary allowance (i.e., the average daily level of intake sufficient to meet the nutrient requirements of nearly all healthy people, presuming minimal sun exposure) intake levels corresponding to those proposed by the Endocrine Society Expert Committee (2011) as safe upper tolerable daily intake doses for patients at risk for vitamin D deficiency (<50 nmol/L): 2000 IU for those <1 year of age, 4000 IU for those aged 1-18 years, and 10 000 IU for those aged >18 years. I wonder how these two concepts could relate. Do you need more Vit-D or do you just need a healthier environment for it to be metabolized? I have been taking 10,000 IU every night for a week or so - going to keep cruising on it for a while to see how I feel.
  - zeku 6y ago
    I would contact a doctor. Vitamin D stores in your body can take a long time to build up, but if you store too much it can be a major problem. You should at least consider an at home vitamin D test, I found a few online(that i didn't order in the end) that were selling for around $50. If you're determined to do this yourself you should periodically use those tests to help keep yourself safe. Source: I'm not a doctor.
  - tenebrisalietum 6y ago
    I was prescribed 50,000 IU Vitamin D and told to take it once a week, and not take any other Vitamin D supplements while taking this. Everyone is different, just sharing my experience.
    - deleted 6y ago
      [deleted]
  - Sunspark 6y ago
    Be careful. "Vitamin" D is actually a hormone that is fat-soluble which means it can build up too much in your body and cause a toxic effect and I know one person who that happened to. The way to know you're ok at your current dosage is to take a blood test, ideally at least twice a year (summer and winter) so you can make sure you're not overdosing. I haven't had a blood test in many years, so currently I am only on 3000 IU. It's a big difference, in one week I have 21,000 IU and you have 70,000 IU, I am only taking 30% of the dose you are. Get a blood test!
    - panorama 6y ago
      Perhaps off-topic but my inner hacker finds it very upsetting that getting blood tests can be so cumbersome, despite being so important. Make an appointment, transit to the doctor's office, pay a bunch of money, wait for labs, wait for your doctor to explain and prescribe stuff to you. It's cumbersome enough to the point where the vast majority of humans aren't testing anywhere near the frequency they should, including myself. I don't think running diagnostics on a human should be this hard, we run diagnostics on our apps, computers, cars more often than ourselves. I wonder if people are working on making this process a lot easier (or if it's even possible, I have zero knowledge of the space).
madrox 6y ago
Lots of interesting details here. I’m struggling somewhat with the language since this isn’t my area, but it seems to be saying a few things. First, this is a study of 80 year old men so YMMV. Second, in that group, they found more sunlight didn’t seem to actually correlate with vitamin D activation. Regardless of how you got vitamin D, you got the benefits if you had the right gut bacteria. This seems like good news, since there’s been some indication for a while that vitamin D supplementation can be hit or miss and sunlight may be better. This could be the missing factor.
andreygrehov 6y ago
What is a _healthy_ gut microbiome? And if it's not healthy, how to make it healthy?
- newlikeice 6y ago
  http://www.gapsdiet.com http://www.gapsdiet.com in my research I was led here. But not sure on the accuracy but they seem to have methods.
  - gerbal 6y ago
    This looks a lot like quackery. A miracle diet that will cure almost all ailments? Sounds too good to be true. The author encourages parents to disregard Physician advice in favor of a vaguely formulated diet advice and expensive supplements, which the author sells. Also lots of enemas and no MMR vaccines.
  - jchrisa 6y ago
    This diet is well regarded in my research as well, and prescribed for people with inflammation problems. It also happens to look like the 1st week or so of any kind of elimination diet / partial fasting. I don't know if they are trying to sell something, but you can get the benefits without buying anything, so they don't seem like quacks to me.
- viburnum 6y ago
  The consensus view is more vegetables and fiber, and less processed food.
  - pujaile 6y ago
    Yes. It seems to be connected with the synthesis of short-chain fatty acids by gut bacteria. Beta-glucan is also helpful in this regard; sources include porridge oats, mushrooms and supplementation.
  - whycombagator 6y ago
    Agreed. Specifically, prebiotic foods & foods that contain cultures (such as yogurt) make most sense to me (as a layperson).
sradman 6y ago
My takeaway is that the widespread measure of serum 25(OH)D represents the total Vitamin D reserve store while the rarely measured 1,25(OH)2D [2 in 2D should be subscript] represents the actual active level. It is low 1,25(OH)2D or a reduced ability to convert storage to active that is associated with a less diverse gut microbiome. We may be over supplementing. To use a car analogy, our gas tank is overflowing and we are obsessed with the gauge reading Full while the gauge reading Empty is the critical measure. What we need is a measure of how fast our 25(OH)D is depleted and what level represents an empty tank.

88 points by voisin 6y ago

Could someone explain the significance of these findings? It's not remotely my area of expertise, and I'm having trouble seeing if/how this has any current or future clinical significance.

whalesalad 6y ago
(I am not a scientist) My interpretation is that your gut bacteria are vital for metabolizing Vitamin D and that you can take a lot of supplements but if your gut aint right it won't help. Slightly related: I keep trying to identifty the recent report that essentially demonstrated a big calculation error in our societal wisdom regarding Vitamin D amounts - and that we need a LOT more than most people think. 2,000 - 5,000 IUD is like a fraction of it. Edit, found it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/ A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. and ....we call all responsible public health authorities to consider designating as the recommended dietary allowance (i.e., the average daily level of intake sufficient to meet the nutrient requirements of nearly all healthy people, presuming minimal sun exposure) intake levels corresponding to those proposed by the Endocrine Society Expert Committee (2011) as safe upper tolerable daily intake doses for patients at risk for vitamin D deficiency (<50 nmol/L): 2000 IU for those <1 year of age, 4000 IU for those aged 1-18 years, and 10 000 IU for those aged >18 years. I wonder how these two concepts could relate. Do you need more Vit-D or do you just need a healthier environment for it to be metabolized? I have been taking 10,000 IU every night for a week or so - going to keep cruising on it for a while to see how I feel.
- zeku 6y ago
  I would contact a doctor. Vitamin D stores in your body can take a long time to build up, but if you store too much it can be a major problem. You should at least consider an at home vitamin D test, I found a few online(that i didn't order in the end) that were selling for around $50. If you're determined to do this yourself you should periodically use those tests to help keep yourself safe. Source: I'm not a doctor.
- tenebrisalietum 6y ago
  I was prescribed 50,000 IU Vitamin D and told to take it once a week, and not take any other Vitamin D supplements while taking this. Everyone is different, just sharing my experience.
  - deleted 6y ago
    [deleted]
- Sunspark 6y ago
  Be careful. "Vitamin" D is actually a hormone that is fat-soluble which means it can build up too much in your body and cause a toxic effect and I know one person who that happened to. The way to know you're ok at your current dosage is to take a blood test, ideally at least twice a year (summer and winter) so you can make sure you're not overdosing. I haven't had a blood test in many years, so currently I am only on 3000 IU. It's a big difference, in one week I have 21,000 IU and you have 70,000 IU, I am only taking 30% of the dose you are. Get a blood test!
  - panorama 6y ago
    Perhaps off-topic but my inner hacker finds it very upsetting that getting blood tests can be so cumbersome, despite being so important. Make an appointment, transit to the doctor's office, pay a bunch of money, wait for labs, wait for your doctor to explain and prescribe stuff to you. It's cumbersome enough to the point where the vast majority of humans aren't testing anywhere near the frequency they should, including myself. I don't think running diagnostics on a human should be this hard, we run diagnostics on our apps, computers, cars more often than ourselves. I wonder if people are working on making this process a lot easier (or if it's even possible, I have zero knowledge of the space).

madrox 6y ago

Lots of interesting details here. I’m struggling somewhat with the language since this isn’t my area, but it seems to be saying a few things. First, this is a study of 80 year old men so YMMV. Second, in that group, they found more sunlight didn’t seem to actually correlate with vitamin D activation. Regardless of how you got vitamin D, you got the benefits if you had the right gut bacteria. This seems like good news, since there’s been some indication for a while that vitamin D supplementation can be hit or miss and sunlight may be better. This could be the missing factor.

andreygrehov 6y ago

What is a _healthy_ gut microbiome? And if it's not healthy, how to make it healthy?

newlikeice 6y ago
http://www.gapsdiet.com http://www.gapsdiet.com in my research I was led here. But not sure on the accuracy but they seem to have methods.
- gerbal 6y ago
  This looks a lot like quackery. A miracle diet that will cure almost all ailments? Sounds too good to be true. The author encourages parents to disregard Physician advice in favor of a vaguely formulated diet advice and expensive supplements, which the author sells. Also lots of enemas and no MMR vaccines.
- jchrisa 6y ago
  This diet is well regarded in my research as well, and prescribed for people with inflammation problems. It also happens to look like the 1st week or so of any kind of elimination diet / partial fasting. I don't know if they are trying to sell something, but you can get the benefits without buying anything, so they don't seem like quacks to me.
viburnum 6y ago
The consensus view is more vegetables and fiber, and less processed food.
- pujaile 6y ago
  Yes. It seems to be connected with the synthesis of short-chain fatty acids by gut bacteria. Beta-glucan is also helpful in this regard; sources include porridge oats, mushrooms and supplementation.
- whycombagator 6y ago
  Agreed. Specifically, prebiotic foods & foods that contain cultures (such as yogurt) make most sense to me (as a layperson).

sradman 6y ago

My takeaway is that the widespread measure of serum 25(OH)D represents the total Vitamin D reserve store while the rarely measured 1,25(OH)2D [2 in 2D should be subscript] represents the actual active level. It is low 1,25(OH)2D or a reduced ability to convert storage to active that is associated with a less diverse gut microbiome. We may be over supplementing. To use a car analogy, our gas tank is overflowing and we are obsessed with the gauge reading Full while the gauge reading Empty is the critical measure. What we need is a measure of how fast our 25(OH)D is depleted and what level represents an empty tank.