6 ms·

I am not a Dr (of medicine), and many of my Dr (of medicine) friends tell their patients to take Vitamin D. At one point I asked my GP, hey, why don't you tell

I am not a Dr (of medicine), and many of my Dr (of medicine) friends tell their patients to take Vitamin D. At one point I asked my GP, hey, why don't you tell me to take Vitamin D, you tell your patients and talk about how great it is. He looks at me and says "well, I know you run outside like every day". Years later, I looked at my levels during some blood work and saw my D was elevated. My Dr again said "yea, you run in the sun." Yes, it is a singular data point, but if you are inside all the time, get your D levels checked and see where you stand instead of just taking pills for it. You might be in the normal range, you might not. It is probably genetics, and how much sun you get too.

endless1234 4y ago
But it's also pretty hard to take too much of it - ref eg https://www.health.harvard.edu/staying-healthy/taking-too-much-vitamin-d-can-cloud-its-benefits-and-create-health-risks https://www.health.harvard.edu/staying-healthy/taking-too-mu... - and the supplement doesn't cost much at all
- pydry 4y ago
  I've gotten wildly different estimates about how much to take - including some that overlap with how much is supposed to be harmful. Some people say 500 IU is enough, some say you need 4000 IU per day.
  - knownastron 4y ago
    This says 30,000 to 50,000 IU is fine: https://vers.substack.com/p/doctors-are-idiots-vitamin-d-megadose https://vers.substack.com/p/doctors-are-idiots-vitamin-d-meg...
    - pydry 4y ago
      According to the National Academy of Medicine, formerly known as the Institute of Medicine, 4,000 IU is the safe upper level of daily vitamin D intake. However, doses up to 10,000 IU have not been shown to cause toxicity in healthy individuals (11Trusted Source, 16Trusted Source). Vitamin D toxicity is generally caused by excessive doses of vitamin D supplements, not by diet or sun exposure (17Trusted Source, 18Trusted Source). Although vitamin D toxicity is a very rare condition, recent increases in supplement use may lead to an increase in reported cases. A daily intake ranging from 40,000–100,000 IU (1,000–2,500 mcg), for 1 to several months, has been shown to cause toxicity in humans (15Trusted Source, 19Trusted Source, 20Trusted Source, 21Trusted Source, 22Trusted Source). https://www.healthline.com/nutrition/how-much-vitamin-d-is-too-much#TOC_TITLE_HDR_4 https://www.healthline.com/nutrition/how-much-vitamin-d-is-t...
      - knownastron 4y ago
        Thanks for the additional info!
  - nradov 4y ago
    There's no way to know without testing. The optimal supplement amount for you could be zero, or it could be even more than 4000 IU per day. This depends on genetics, diet, ultraviolet light exposure, body composition, and a variety of other factors. So, the only way to be sure is to get periodic blood tests and titrate the supplements up or down to hit the target level. If you don't want to hassle with testing then something like 600 IU will be adequate (although not necessarily optimal) for most adults. YMMV. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona...
- nextaccountic 4y ago
  Also, there is some evidence that Vitamin D supplementation at higher than natural, higher than usually recommended levels is beneficial to mental health (but not sure if the OP article confirms it)
  - knownastron 4y ago
    Do you know where you heard of this link between high Vitamin D levels and improved mental health? If you do, can you share it?
    - mrguyorama 4y ago
      Like most everything around vitamin D, the causality typically is backward. Vitamin D isn't improving these people's mental health, but it turns out that if you have a healthy life that involves ample outdoor activity, you are mentally healthier. Consider migrant workers, who spend so much time under the hot sun picking veggies, what do their Vitamin D levels and other health metrics look like?
- colechristensen 4y ago
  It's not hard to take too much. They sell 5000 IU vitamin D pills, with regular supplementation my serum levels were at the top of the range which led me to ease off. You can take too much and there are consequences, it screws with your calcium which eventually screws with your nerve firing.
  - jghn 4y ago
    One of the claims is that what's considered normal range is already too low. I'm not personally equipped to tell you if that's right or wrong. But when people are suggesting to take megadoses they're coming from this angle, whether they realize it or not.
  - voldacar 4y ago
    If you look at the literature on cases of D "toxicity" (hypercalcemia), it only really occurs when people take absurd doses like 100k IU per day (often far more) for months. This usually occurs by accident, rather than someone choosing to take that much. And since D toxicity isn't reported that often, I have to assume that there are a lot of people out there unwittingly taking mega doses but without developing toxicity. But everyone thinks that high doses of D are scary because of that idiotic 4000 IU number that gets thrown around. N=1, but I take 50k IU per day and have never had any issues. My calcium is within the normal range.
    - colechristensen 4y ago
      I would really hesitate to give the impression that you were giving medical advice like that, way out of range of that is considered safe.
      - voldacar 4y ago
        The range that is considered safe is much smaller than the range that is actually safe. It also doesn't help that there is misinformation about what "vitamin D toxicity" actually is. Wikipedia states "Vitamin D toxicity, or hypervitaminosis D is the toxic state of an excess of vitamin D. The normal range for blood concentration is 20 to 50 nanograms per milliliter (ng/mL). However, the toxic state is known to be a value of 100 ng/ml or more in a clinical setting." This is wrong because toxicity is not a pure function of vitamin D concentration. I'm above 100 ng/ml and yet my calcium is normal. The toxicity is purely a result of elevated calcium levels. The threshold level of D which causes this elevated level of calcium seems to vary significantly between individuals, and in any case, is much higher than the numbers that google or wikipedia gives you. At any rate the 4000 IU number is unscientific nonsense.
DrThunder 4y ago
There's a lot of data to suggest the "normal range" is still way too low. So, you may be getting the ok on your blood test but still be suffering from the effects of a lower level of vitamin D. Additionally, places that get a lot of cloud cover in different seasons may cause your D level to drop quite a bit in the Winter.... which means you need to test often. Also, your skin color is going to make a difference in how much D you absorb. If you live in a cloudy northern place and are darker skinned you may not get enough even with sun exposure. Anecdotally, I feel better supplementing in the winter.
- nradov 4y ago
  Vitamin D is a fat soluble hormone. During much of recent human evolution, the typical pattern was for people to accumulate body fat during the spring / summer / autumn seasons when food is more plentiful. Then they would survive partially on those fat stores during the winter when food was scarce. Breaking down adipose tissue for energy also releases stored vitamin D (and some other nutrients) into the rest of the body. So, they maintained adequate levels even with minimal sunlight exposure. Now in developed countries we have screwed up that pattern and no longer survive on stored body fat during the winter. If anything we're more likely to gain fat during the winter, which makes vitamin D levels even lower. But we're no longer at risk of starving to death in a hard winter, so that's a positive.
lepus 4y ago
He doesn't know your vitamin D is high enough without testing at least once. Plenty of people who are outside a lot have vitamin D deficiency because we don't actually expose much of our skin to the sun due to clothing.

endless1234 4y ago

But it's also pretty hard to take too much of it - ref eg https://www.health.harvard.edu/staying-healthy/taking-too-much-vitamin-d-can-cloud-its-benefits-and-create-health-risks https://www.health.harvard.edu/staying-healthy/taking-too-mu... - and the supplement doesn't cost much at all

pydry 4y ago
I've gotten wildly different estimates about how much to take - including some that overlap with how much is supposed to be harmful. Some people say 500 IU is enough, some say you need 4000 IU per day.
- knownastron 4y ago
  This says 30,000 to 50,000 IU is fine: https://vers.substack.com/p/doctors-are-idiots-vitamin-d-megadose https://vers.substack.com/p/doctors-are-idiots-vitamin-d-meg...
  - pydry 4y ago
    According to the National Academy of Medicine, formerly known as the Institute of Medicine, 4,000 IU is the safe upper level of daily vitamin D intake. However, doses up to 10,000 IU have not been shown to cause toxicity in healthy individuals (11Trusted Source, 16Trusted Source). Vitamin D toxicity is generally caused by excessive doses of vitamin D supplements, not by diet or sun exposure (17Trusted Source, 18Trusted Source). Although vitamin D toxicity is a very rare condition, recent increases in supplement use may lead to an increase in reported cases. A daily intake ranging from 40,000–100,000 IU (1,000–2,500 mcg), for 1 to several months, has been shown to cause toxicity in humans (15Trusted Source, 19Trusted Source, 20Trusted Source, 21Trusted Source, 22Trusted Source). https://www.healthline.com/nutrition/how-much-vitamin-d-is-too-much#TOC_TITLE_HDR_4 https://www.healthline.com/nutrition/how-much-vitamin-d-is-t...
    - knownastron 4y ago
      Thanks for the additional info!
- nradov 4y ago
  There's no way to know without testing. The optimal supplement amount for you could be zero, or it could be even more than 4000 IU per day. This depends on genetics, diet, ultraviolet light exposure, body composition, and a variety of other factors. So, the only way to be sure is to get periodic blood tests and titrate the supplements up or down to hit the target level. If you don't want to hassle with testing then something like 600 IU will be adequate (although not necessarily optimal) for most adults. YMMV. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona...
nextaccountic 4y ago
Also, there is some evidence that Vitamin D supplementation at higher than natural, higher than usually recommended levels is beneficial to mental health (but not sure if the OP article confirms it)
- knownastron 4y ago
  Do you know where you heard of this link between high Vitamin D levels and improved mental health? If you do, can you share it?
  - mrguyorama 4y ago
    Like most everything around vitamin D, the causality typically is backward. Vitamin D isn't improving these people's mental health, but it turns out that if you have a healthy life that involves ample outdoor activity, you are mentally healthier. Consider migrant workers, who spend so much time under the hot sun picking veggies, what do their Vitamin D levels and other health metrics look like?
colechristensen 4y ago
It's not hard to take too much. They sell 5000 IU vitamin D pills, with regular supplementation my serum levels were at the top of the range which led me to ease off. You can take too much and there are consequences, it screws with your calcium which eventually screws with your nerve firing.
- jghn 4y ago
  One of the claims is that what's considered normal range is already too low. I'm not personally equipped to tell you if that's right or wrong. But when people are suggesting to take megadoses they're coming from this angle, whether they realize it or not.
- voldacar 4y ago
  If you look at the literature on cases of D "toxicity" (hypercalcemia), it only really occurs when people take absurd doses like 100k IU per day (often far more) for months. This usually occurs by accident, rather than someone choosing to take that much. And since D toxicity isn't reported that often, I have to assume that there are a lot of people out there unwittingly taking mega doses but without developing toxicity. But everyone thinks that high doses of D are scary because of that idiotic 4000 IU number that gets thrown around. N=1, but I take 50k IU per day and have never had any issues. My calcium is within the normal range.
  - colechristensen 4y ago
    I would really hesitate to give the impression that you were giving medical advice like that, way out of range of that is considered safe.
    - voldacar 4y ago
      The range that is considered safe is much smaller than the range that is actually safe. It also doesn't help that there is misinformation about what "vitamin D toxicity" actually is. Wikipedia states "Vitamin D toxicity, or hypervitaminosis D is the toxic state of an excess of vitamin D. The normal range for blood concentration is 20 to 50 nanograms per milliliter (ng/mL). However, the toxic state is known to be a value of 100 ng/ml or more in a clinical setting." This is wrong because toxicity is not a pure function of vitamin D concentration. I'm above 100 ng/ml and yet my calcium is normal. The toxicity is purely a result of elevated calcium levels. The threshold level of D which causes this elevated level of calcium seems to vary significantly between individuals, and in any case, is much higher than the numbers that google or wikipedia gives you. At any rate the 4000 IU number is unscientific nonsense.

DrThunder 4y ago

There's a lot of data to suggest the "normal range" is still way too low. So, you may be getting the ok on your blood test but still be suffering from the effects of a lower level of vitamin D. Additionally, places that get a lot of cloud cover in different seasons may cause your D level to drop quite a bit in the Winter.... which means you need to test often. Also, your skin color is going to make a difference in how much D you absorb. If you live in a cloudy northern place and are darker skinned you may not get enough even with sun exposure. Anecdotally, I feel better supplementing in the winter.

nradov 4y ago
Vitamin D is a fat soluble hormone. During much of recent human evolution, the typical pattern was for people to accumulate body fat during the spring / summer / autumn seasons when food is more plentiful. Then they would survive partially on those fat stores during the winter when food was scarce. Breaking down adipose tissue for energy also releases stored vitamin D (and some other nutrients) into the rest of the body. So, they maintained adequate levels even with minimal sunlight exposure. Now in developed countries we have screwed up that pattern and no longer survive on stored body fat during the winter. If anything we're more likely to gain fat during the winter, which makes vitamin D levels even lower. But we're no longer at risk of starving to death in a hard winter, so that's a positive.

lepus 4y ago

He doesn't know your vitamin D is high enough without testing at least once. Plenty of people who are outside a lot have vitamin D deficiency because we don't actually expose much of our skin to the sun due to clothing.