4 ms·

High‑dose Vitamin D reduces disease activity in early multiple sclerosis onset

91 points by pseudolus 2y ago

evrimoztamur 2y ago
Question to HN: To what extent do we understand vitamin D's activity in our body? A lot of the focus seems to be on the bone, muscle, teeth, etc. components, but I also hear often about headlines like in the OP or its significance in improving mood. I would like to know if there's potential that we know little about its complete set of effects.
- jaitsu 2y ago
  https://examine.com/supplements/vitamin-d/ https://examine.com/supplements/vitamin-d/ This is a good place to get that kind of information
VladVladikoff 2y ago
I’ve personally been taking 7500 IU daily for many years now. Anecdotally (yes, I know, N=1) I have noticed I get sick less. I just did the math and apparently I’m taking the same dose as the participants in this article. I firmly believe the RDA is wrong, and the “high dose” of this article is closer to what the RDA should be. I can’t find the article which caused me to originally start my 7500 IU regiment but there are many similar papers out now, such as: >Soccer players that supplemented with 6,000 IU of vitamin D significantly improved their blood vitamin D levels, increased their free and total testosterone, and performed better on the 5 m sprint test compared to the placebo group. https://pmc.ncbi.nlm.nih.gov/articles/PMC7284423/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7284423/
- j_w 2y ago
  The linked study uses a daily dose of 6,000IU, and references two studies (13,26) which also tout the benefit of supplementing Vitamin D at a 3,000IU dose and a 3,332IU dose, both daily. The two studies which are referenced (27,28) that do not find any significant benefits followed a different dosing strategy: 20,000IU and 60,000IU, weekly. It seems like daily, large doses is the best method for supplementing vitamin D. I've seen it suggested to pair vitamin D supplementation with calcium and magnesium [1]. [^1]: https://pubmed.ncbi.nlm.nih.gov/32972636/ https://pubmed.ncbi.nlm.nih.gov/32972636/
- Tade0 2y ago
  > I’ve personally been taking 7500 IU daily for many years now. And here I am debating whether increasing to 4000 was pushing my luck. I am also reporting less illnesses - or actually - no instances of being bedridden, which is an improvement over the previous flu seasons.
  - OutOfHere 2y ago
    It depends on your sun exposure and kidney health. In the elderly with a compromised kidney, 4000 can push them over a sane limit. For most people though with minimal sun exposure, 4000-5000 is pretty good, and certainly will make them less sick. For optimal effect, stack with calcium and magnesium as citrate or better.
- trevorkoob 2y ago
  Did a masters on Vit D. Multiple overdoses of over 1 million IU have been recovered from without obvious long-term damage present in near term follow up. Out of vitamin D’s many potentially clinically positive effects some of the clearest and best evidence is for increased muscle strength. Personally I take between 5000-10000 IU D3 daily depending on exposure to sun intensity.
  - elric 2y ago
    Care to share your thesis? Sounds interesting! What was your degreee in?
    - trevorkoob 2y ago
      The hypothesis was: is it beneficial to supplement vitamin D to reach the maximum levels achieved through sun exposure year-round? Conclusion: these types of studies did not exist at the time, but the risks of doing such studies would be minimal, and such studies would be able to test for the effects of higher dose supplementation that were lacking at the time. Potential benefits include increased muscular strength and bone strength.
tuesdaynight 2y ago
I got a prescription for vitamin D deficiency and started researching about it. On the way, I found the Coimbra Protocol[1], which evolves around giving high doses of vitamin D (40000-200000 IU) to multiple sclerosis patients. [1]: https://www.coimbraprotocol.com/the-protocol-1 https://www.coimbraprotocol.com/the-protocol-1
- nbk_2000 2y ago
  Same here, and with good results, but a note of warning, according to my doctor 10,000 - 20,000 are considered in the protocol a normal daily supplement for adults with vitamin D issues. Dosages above that require medical supervision (in the form of regular blood and urine analysis). Also at those high doses there are potential negative side effects that must be mitigated (osteoporosis being among them). So please don't just YOLO massive doses of vitamin D.
adamgordonbell 2y ago
I've tried taking vitamin D bc heard it was so great. After taking 1000 ui a day for a week or two, I will start to experience mood issues like increased anger and anxiety which will go away after a couple days of stopping. I have heard of others with this complaint as well, but I do not know why. ChatGPT suggests something about magnesium and calcium levels, but it's certainly not a commonly talked about side effect. Anyone have an answer? I assume I'm deficient but I'm not sure its worth the benefits. ( I'm not saying Vit D is bad, I'm just curious if others have had difficulties with it )
- bruce343434 2y ago
  I don't think there's an easy answer as we all have differently tuned bodies with different known/unknown beningn/malevolent conditions. It's probably good to do some short term experimenting, try eating more magnesium and calcium rich foods and see how you feel. If you really want to be objective, get your blood contents measured. (Although blood levels don't show everything, like calcium stores in the bones.)
  - adamgordonbell 2y ago
    Yeah, experimentation makes sense. I've had it happen twice, with two different dosages. First time was at a higher dosage than 1000 and I think it happened sooner. I'm just calling it out here, because sometimes you get lucky and someone else had the same issue and has the answer and will resolve the mystery. I'm not saying Vit D is bad, I'm just curious if others have had difficulties with it. My doctors opinion on it is everyone is low on Vit D, so just take some.
    - canucker2016 2y ago
      Never had/heard of your problem with Vitamin D. A web search brings up - https://www.reddit.com/r/Biohackers/comments/1ia6yyb/update_vitamin_d_anger_issues/ https://www.reddit.com/r/Biohackers/comments/1ia6yyb/update_... tl;dr - some Vit D supplements are based on lanolin. if you're sensitive to it, you may switch to a supplement that doesn't use lanolin. also one response talks about taking a multi-Vitamin B supplement for anger issues with Vit.D
saos 2y ago
I’ve been toying with idea of upping vitamin D Iu. Currently its 1000 and that was what was prescribed to me a while back.
- SOLAR_FIELDS 2y ago
  I take 5000 daily as a maintenance dose. Bloodwork has been basically perfect since I started doing that. If you are deficient doctors often prescribe a massive daily dose like 20000-30000 to get back to normal then drop down to a maintenance dose. The nice thing with vitamin D is that you can actually check its level in bloodwork. The normal range is often considered to be between 50-125 ng/mL with below 30 considered deficient and above 120 or so considered too much. I highly recommend people stay on top of this particular vitamin. In addition to evidence that a deficiency significantly affects your immune system functionality, it’s also uncomfortable. My spouse has been deficient in the past and experienced hand cramps, back spasms, muscle aches etc. It’s fat soluble so it takes a few weeks to get it back to normal after supplementation
  - y33t 2y ago
    Vitamin D deficiency has also been linked to cancer, specifically colorectal IIRC. Also people who had D deficiency were more likely to have problems with COVID.
  - trevorkoob 2y ago
    Adding on this point, in my research I found blood serum testing to be wildly imprecise. The conclusion of my study was that we should do more studies where we take regular blood level samples and adjust dosage to achieve a certain average level (near the upper level of the range). 5000IU D3 (D2 is about 1/3-1/2 as effective at raising blood serum levels) is a good starting point.
  - Sunspark 2y ago
    Muscle cramps/spasms are a lot more than just vitamin D.. electrolytes are important.. If they have been deficient in vitamin D, chances are they are also deficient in electrolytes as well.
armedpacifist 2y ago
On a sidenote, for everyone looking into vit d, this talk with Stasha Gominak was very informative: https://www.youtube.com/watch?v=74F22bjBmqE https://www.youtube.com/watch?v=74F22bjBmqE As for the criticism against vit d supplements because of the extreme variability of actual vit d between brands, regardless of the supposed IU they advertise (there is very little objective, independent quality control being done, which makes it a bit of a wild west, but I guess that goes for _all_ supplements). I don't think it's necessarily a problem. Ignore the prescribed dosage by the brand. This sounds like bad advice, but it's not reliable cfr. the variability. Just get your bloodwork done first. Then start experimenting with consistent dosages and stick to one brand. Get your bloodwork checked again after a month and proceed from there. Aim at a value between 40 and 70 (according to Gominak, which I concur doing my own research/experimenting). Disclaimer: I am not a doctor, please do your own research and preferably consult with a medical advisor
- trevorkoob 2y ago
  Other than the value you are aiming for (I personally aim for the upper edge of the normal range), I agree with the immense variability in dosage, and also would like to mention imprecision in vitamin D bloodwork tests as well. Thankfully throughout my Vitamin D research, I found low risk of overdose, and cases of immense accidental overdose that appear to have been treated successfully (mainly by stopping the over-intake).
- JumpCrisscross 2y ago
  > Get your bloodwork checked again after a month and proceed from there As someone who's had a vitamin D deficiency, your serum vitamin d levels will almost certainly vary month to month as a result of the weather.
chasebank 2y ago
I remember reading about how the current recommended dose of Vitamin D was a statistical error in a study and has since been corrected to the tune of 10-11x higher. "The recommended daily intake of vitamin D has a long history, originally set at 400 IU/day in the early-to-mid 20th century, including the 1970s, primarily to prevent rickets in children and bone disease in adults. In 2010, the Institute of Medicine (IOM) updated the recommendation to 600 IU/day for most adults and 800 IU/day for those over 70. However, a major statistical error in the IOM’s analysis was later uncovered by researchers, who showed that the calculation underestimated the amount needed to achieve sufficient blood levels of vitamin D in 97.5% of the population. Their corrected analysis suggested a required intake closer to 7,000 IU/day, an order of magnitude higher. Despite this, most official health organizations have not revised the RDA, and the 600–800 IU/day guideline remains standard." [chatgpt summary] https://www.grassrootshealth.net/blog/iom-miscalculated-rda-vitamin-d/ https://www.grassrootshealth.net/blog/iom-miscalculated-rda-...
- vlovich123 2y ago
  I thought follow up work also showed it's questionable whether dietary vitamin D actually has any of the benefits that you get through solar vitamin D?
  - nostrebored 2y ago
    Yes, 90% of the world’s population does not absorb dietary vitamin D well, which should make people skeptical of this result.
    - kpfleger 2y ago
      Nonesense. It's well established that dietary D3 (or D2, but D3 is better) clearly incleases 25(OH)D serum levels. It is that serum biomarker whose deficiency (levels below 20ng/ml or 30ng/ml) that has the largest association with higher risk of dozens of diseases as well as all-cause mortality. You can defend your phrasing by saying that "not well" just means one has to take a lot of it. Yes, there is a wide variety of dose response, which is why it's best to test blood levels to titrate supplementation amount.
GrantMoyer 2y ago
Too much Vitamin D can calcify your soft tissues, so be cateful following some of the reccomendations in these comments. https://en.wikipedia.org/wiki/Vitamin_D#Excess https://en.wikipedia.org/wiki/Vitamin_D#Excess
- OutOfHere 2y ago
  Up to 5000 IU per day is unlikely to result in a concerningly high level of D3 or calcium in someone with minimal sun exposure. Also, caffeine drains nutrients like calcium away. Those with compromised kidneys will have to be more careful.
deleted 2y ago
[deleted]

91 points by pseudolus 2y ago

Question to HN: To what extent do we understand vitamin D's activity in our body? A lot of the focus seems to be on the bone, muscle, teeth, etc. components, but I also hear often about headlines like in the OP or its significance in improving mood. I would like to know if there's potential that we know little about its complete set of effects.

jaitsu 2y ago
https://examine.com/supplements/vitamin-d/ https://examine.com/supplements/vitamin-d/ This is a good place to get that kind of information

VladVladikoff 2y ago

I’ve personally been taking 7500 IU daily for many years now. Anecdotally (yes, I know, N=1) I have noticed I get sick less. I just did the math and apparently I’m taking the same dose as the participants in this article. I firmly believe the RDA is wrong, and the “high dose” of this article is closer to what the RDA should be. I can’t find the article which caused me to originally start my 7500 IU regiment but there are many similar papers out now, such as: >Soccer players that supplemented with 6,000 IU of vitamin D significantly improved their blood vitamin D levels, increased their free and total testosterone, and performed better on the 5 m sprint test compared to the placebo group. https://pmc.ncbi.nlm.nih.gov/articles/PMC7284423/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7284423/

j_w 2y ago
The linked study uses a daily dose of 6,000IU, and references two studies (13,26) which also tout the benefit of supplementing Vitamin D at a 3,000IU dose and a 3,332IU dose, both daily. The two studies which are referenced (27,28) that do not find any significant benefits followed a different dosing strategy: 20,000IU and 60,000IU, weekly. It seems like daily, large doses is the best method for supplementing vitamin D. I've seen it suggested to pair vitamin D supplementation with calcium and magnesium [1]. [^1]: https://pubmed.ncbi.nlm.nih.gov/32972636/ https://pubmed.ncbi.nlm.nih.gov/32972636/
Tade0 2y ago
> I’ve personally been taking 7500 IU daily for many years now. And here I am debating whether increasing to 4000 was pushing my luck. I am also reporting less illnesses - or actually - no instances of being bedridden, which is an improvement over the previous flu seasons.
- OutOfHere 2y ago
  It depends on your sun exposure and kidney health. In the elderly with a compromised kidney, 4000 can push them over a sane limit. For most people though with minimal sun exposure, 4000-5000 is pretty good, and certainly will make them less sick. For optimal effect, stack with calcium and magnesium as citrate or better.
trevorkoob 2y ago
Did a masters on Vit D. Multiple overdoses of over 1 million IU have been recovered from without obvious long-term damage present in near term follow up. Out of vitamin D’s many potentially clinically positive effects some of the clearest and best evidence is for increased muscle strength. Personally I take between 5000-10000 IU D3 daily depending on exposure to sun intensity.
- elric 2y ago
  Care to share your thesis? Sounds interesting! What was your degreee in?
  - trevorkoob 2y ago
    The hypothesis was: is it beneficial to supplement vitamin D to reach the maximum levels achieved through sun exposure year-round? Conclusion: these types of studies did not exist at the time, but the risks of doing such studies would be minimal, and such studies would be able to test for the effects of higher dose supplementation that were lacking at the time. Potential benefits include increased muscular strength and bone strength.

tuesdaynight 2y ago

I got a prescription for vitamin D deficiency and started researching about it. On the way, I found the Coimbra Protocol[1], which evolves around giving high doses of vitamin D (40000-200000 IU) to multiple sclerosis patients. [1]: https://www.coimbraprotocol.com/the-protocol-1 https://www.coimbraprotocol.com/the-protocol-1

nbk_2000 2y ago
Same here, and with good results, but a note of warning, according to my doctor 10,000 - 20,000 are considered in the protocol a normal daily supplement for adults with vitamin D issues. Dosages above that require medical supervision (in the form of regular blood and urine analysis). Also at those high doses there are potential negative side effects that must be mitigated (osteoporosis being among them). So please don't just YOLO massive doses of vitamin D.

adamgordonbell 2y ago

I've tried taking vitamin D bc heard it was so great. After taking 1000 ui a day for a week or two, I will start to experience mood issues like increased anger and anxiety which will go away after a couple days of stopping. I have heard of others with this complaint as well, but I do not know why. ChatGPT suggests something about magnesium and calcium levels, but it's certainly not a commonly talked about side effect. Anyone have an answer? I assume I'm deficient but I'm not sure its worth the benefits. ( I'm not saying Vit D is bad, I'm just curious if others have had difficulties with it )

bruce343434 2y ago
I don't think there's an easy answer as we all have differently tuned bodies with different known/unknown beningn/malevolent conditions. It's probably good to do some short term experimenting, try eating more magnesium and calcium rich foods and see how you feel. If you really want to be objective, get your blood contents measured. (Although blood levels don't show everything, like calcium stores in the bones.)
- adamgordonbell 2y ago
  Yeah, experimentation makes sense. I've had it happen twice, with two different dosages. First time was at a higher dosage than 1000 and I think it happened sooner. I'm just calling it out here, because sometimes you get lucky and someone else had the same issue and has the answer and will resolve the mystery. I'm not saying Vit D is bad, I'm just curious if others have had difficulties with it. My doctors opinion on it is everyone is low on Vit D, so just take some.
  - canucker2016 2y ago
    Never had/heard of your problem with Vitamin D. A web search brings up - https://www.reddit.com/r/Biohackers/comments/1ia6yyb/update_vitamin_d_anger_issues/ https://www.reddit.com/r/Biohackers/comments/1ia6yyb/update_... tl;dr - some Vit D supplements are based on lanolin. if you're sensitive to it, you may switch to a supplement that doesn't use lanolin. also one response talks about taking a multi-Vitamin B supplement for anger issues with Vit.D

saos 2y ago

I’ve been toying with idea of upping vitamin D Iu. Currently its 1000 and that was what was prescribed to me a while back.

SOLAR_FIELDS 2y ago
I take 5000 daily as a maintenance dose. Bloodwork has been basically perfect since I started doing that. If you are deficient doctors often prescribe a massive daily dose like 20000-30000 to get back to normal then drop down to a maintenance dose. The nice thing with vitamin D is that you can actually check its level in bloodwork. The normal range is often considered to be between 50-125 ng/mL with below 30 considered deficient and above 120 or so considered too much. I highly recommend people stay on top of this particular vitamin. In addition to evidence that a deficiency significantly affects your immune system functionality, it’s also uncomfortable. My spouse has been deficient in the past and experienced hand cramps, back spasms, muscle aches etc. It’s fat soluble so it takes a few weeks to get it back to normal after supplementation
- y33t 2y ago
  Vitamin D deficiency has also been linked to cancer, specifically colorectal IIRC. Also people who had D deficiency were more likely to have problems with COVID.
- trevorkoob 2y ago
  Adding on this point, in my research I found blood serum testing to be wildly imprecise. The conclusion of my study was that we should do more studies where we take regular blood level samples and adjust dosage to achieve a certain average level (near the upper level of the range). 5000IU D3 (D2 is about 1/3-1/2 as effective at raising blood serum levels) is a good starting point.
- Sunspark 2y ago
  Muscle cramps/spasms are a lot more than just vitamin D.. electrolytes are important.. If they have been deficient in vitamin D, chances are they are also deficient in electrolytes as well.

armedpacifist 2y ago

On a sidenote, for everyone looking into vit d, this talk with Stasha Gominak was very informative: https://www.youtube.com/watch?v=74F22bjBmqE https://www.youtube.com/watch?v=74F22bjBmqE As for the criticism against vit d supplements because of the extreme variability of actual vit d between brands, regardless of the supposed IU they advertise (there is very little objective, independent quality control being done, which makes it a bit of a wild west, but I guess that goes for _all_ supplements). I don't think it's necessarily a problem. Ignore the prescribed dosage by the brand. This sounds like bad advice, but it's not reliable cfr. the variability. Just get your bloodwork done first. Then start experimenting with consistent dosages and stick to one brand. Get your bloodwork checked again after a month and proceed from there. Aim at a value between 40 and 70 (according to Gominak, which I concur doing my own research/experimenting). Disclaimer: I am not a doctor, please do your own research and preferably consult with a medical advisor

trevorkoob 2y ago
Other than the value you are aiming for (I personally aim for the upper edge of the normal range), I agree with the immense variability in dosage, and also would like to mention imprecision in vitamin D bloodwork tests as well. Thankfully throughout my Vitamin D research, I found low risk of overdose, and cases of immense accidental overdose that appear to have been treated successfully (mainly by stopping the over-intake).
JumpCrisscross 2y ago
> Get your bloodwork checked again after a month and proceed from there As someone who's had a vitamin D deficiency, your serum vitamin d levels will almost certainly vary month to month as a result of the weather.

chasebank 2y ago

I remember reading about how the current recommended dose of Vitamin D was a statistical error in a study and has since been corrected to the tune of 10-11x higher. "The recommended daily intake of vitamin D has a long history, originally set at 400 IU/day in the early-to-mid 20th century, including the 1970s, primarily to prevent rickets in children and bone disease in adults. In 2010, the Institute of Medicine (IOM) updated the recommendation to 600 IU/day for most adults and 800 IU/day for those over 70. However, a major statistical error in the IOM’s analysis was later uncovered by researchers, who showed that the calculation underestimated the amount needed to achieve sufficient blood levels of vitamin D in 97.5% of the population. Their corrected analysis suggested a required intake closer to 7,000 IU/day, an order of magnitude higher. Despite this, most official health organizations have not revised the RDA, and the 600–800 IU/day guideline remains standard." [chatgpt summary] https://www.grassrootshealth.net/blog/iom-miscalculated-rda-vitamin-d/ https://www.grassrootshealth.net/blog/iom-miscalculated-rda-...

vlovich123 2y ago
I thought follow up work also showed it's questionable whether dietary vitamin D actually has any of the benefits that you get through solar vitamin D?
- nostrebored 2y ago
  Yes, 90% of the world’s population does not absorb dietary vitamin D well, which should make people skeptical of this result.
  - kpfleger 2y ago
    Nonesense. It's well established that dietary D3 (or D2, but D3 is better) clearly incleases 25(OH)D serum levels. It is that serum biomarker whose deficiency (levels below 20ng/ml or 30ng/ml) that has the largest association with higher risk of dozens of diseases as well as all-cause mortality. You can defend your phrasing by saying that "not well" just means one has to take a lot of it. Yes, there is a wide variety of dose response, which is why it's best to test blood levels to titrate supplementation amount.

GrantMoyer 2y ago

Too much Vitamin D can calcify your soft tissues, so be cateful following some of the reccomendations in these comments. https://en.wikipedia.org/wiki/Vitamin_D#Excess https://en.wikipedia.org/wiki/Vitamin_D#Excess

OutOfHere 2y ago
Up to 5000 IU per day is unlikely to result in a concerningly high level of D3 or calcium in someone with minimal sun exposure. Also, caffeine drains nutrients like calcium away. Those with compromised kidneys will have to be more careful.

deleted 2y ago

[deleted]