Is Vitamin D Supplementation Even Neccessary

[Travis]

Interesting Travis. How does Vitamin D modify the Ca/Mg ratio? Is there a difference if it is taken oral or transdermal? Interesting about not taking at night.

The classic effect of vitamin D is to increase intestinal calcium absorption, which it does by transcribing for Ca²⁺-binding proteins. But vitamin D also seems to be involved in the circadian rhythm. which would make sense considering how it's formation is controlled diurnally (and also dianually, to a degree). Of course melatonin is a more powerful molecular signal yet is the signal for night, not the day like vitamin D is—or was millions of years ago (and still perhaps could be in more primitive species). We also do have cortisol negatively-controlled by melatonin, so this could also be perhaps considered a 'daylight' hormone (a signal, an indicator, or at least a huge confounder).

Bone is best mineralized piezoelectrically—this has been proven—so can only occur under load. This observation fully conforms with Wolff's Law and also the observation that 'astronauts' (actornauts?) will lose bone mass in lower gravity. Calcium is also very involved in muscle contraction so it would make sense why we'd want to increase calcium during the day.

And strangely, there is even more melatonin in the bone marrow than in the pineal gland. This hormone is also involved in bone formation and I think it could be involved in the reverse process, the demineralization (our bones would outgrow us if there wasn't also a catabolic cycle). Since sunlight is correlated with activity and this forms the hydroxyapatite of bone, it would only make sense for our circadian hormones to be regulate calcium influx and also bone proteins—and they do.

 

[Amazoniac]

Q: “Was tested low in vitamin D. Would supplementing 8,000 units a day be too much?”
“If you figure that being in a bathing suit in the sun for 20 or 30 minutes enough to just start turning pink, that can make 10,000 or 15,000 units. So 5,000 or 10,000 units is never gonna be harmful. I've never heard of 10,000 a day being harmful.” - Ray Peat

Mito, I had a glass of the hours running knowning that this quote would eventually pop up. From Figure Ein on the link #1 you'll notice that even 1000 IU is enough to increase 25(O and H)D by 10 ng/mL, so for the average values it goes from 30 ng/mL to 40 ng/mL in a lot of people. With 2000 IU it doubles. And then as you increase, it starts to level, so when people supplement 10000 IU, their curve gives the impression that the average values is around 75 ng/mL, but it looks lower, close to 50 ng/mL, yet the tendency to increase the values is still there. It's considered safe because toxicity is when levels go above 150 ng/mL (if I'm not wrong), and while no one reached those levels with 10000 IU supplemented, it appears that at this point the body is trying to do something with the excess. But regardless of what it's trying to do, this amount can be more than needed:
Calcirol - Liquid Vitamin D3

Considering that members ingest plenty of calcium, have multiple persistent deficiencies (B vitamins, C, magnesium, boron, etc), 2000 IU is probably a safer amount for maintenance if you're already getting some from sun and diet (they believe these provide about 3000 IU). But for 10000 IU daily supplementation, it's worth monitoring through tests.

Please let me know if I'm wrong because I haven't confirmed this information on anesthesiology book yet

 

[Cirion]

A little side tracking here, but how does one know for sure if they are deficient in a vitamin or mineral? There doesn't seem to be an easy test to check all of your vitamin and mineral levels... or is there? I am getting a little burned out on just trying to "guess" and experiment... would be nice to know for certainty where my nutritional gaps are.

 

[HDD]

J Steroid Biochem Mol Biol. 2016 Dec 21. pii: S0960-0760(16)30356-9.

Results of daily oral dosing with up to 60,000 international units (iu) of vitamin D3 for 2 to 6 years in 3 adult males.

McCullough P1, Amend J2.

In the 1930's and 1940's, vitamin D was reported to be an effective treatment for a number of diseases, including asthma, psoriasis, rheumatoid arthritis, rickets and tuberculosis. High doses were used, 60,000 to 300,000 IU a day for asthma, and 200,000 to 600,000 IU a day for rheumatoid arthritis. Toxicity from hypercalcemia occurred after prolonged oral dosing with these supraphysiologic doses. Assays for measuring vitamin D in the blood were not available, and blood levels of vitamin D associated with hypercalcemia were unknown. A 2011 report on vitamin D toxicity showed that hypercalcemia resolved when 25-hydroxyvitamin D (25OHD) blood levels dropped below 400ng/ml in 2 patients with blood levels ranging from 645ng/ml to 1220ng/ml after accidental ingestion of massive doses of vitamin D. We now know that vitamin D is made in the skin in amounts ranging up to 25,000 IU a day with exposure to UVB radiation. There is little data on the safety and blood levels of 25OHD and calcium after prolonged daily intake of amounts of vitamin D in this range. In this report, one subject took increasing daily doses of vitamin D3 for 6 years starting in April 2009: 6500 IU for 6 months; increasing to 10,000 IU for 13 months; 20,000 IU for 24 months; 40,000 IU for 12 months; 50,000 IU for 10 months, and 60,000 IU since October 2014. 25OHD blood levels were 28, 81, 204, 216, 225, 166, and 218ng/ml. Subject 2 began 10,000 IU in Nov 2011, increased to 20,000 IU in Feb 2014, 25,000 IU in June 2014, and 30,000 IU in Oct 2014, and then decreased to 20,000 IU in June 2015. 25OHD blood levels were 96.6, 161.1 and 106.9ng/ml. He reported marked clinical improvement in his asthma. Subject 3 started on daily 10,000 IU in Sept 2013, increasing to 20,000 IU on Nov 2013. 25OHD blood levels were 31.4, 102, 164, 148, and 143ng/ml. No one developed hypercalcemia or any adverse events. The major finding of this case series is prolonged daily dosing of vitamin D3 with doses of 10,000 to 60,000 IU was safely tolerated.

 

[Amazoniac]

https://www.sciencedaily.com/releases/2018/02/180226122548.htm

A review published in The Journal of the American Osteopathic Association found Vitamin D can't be metabolized without sufficient magnesium levels, meaning Vitamin D remains stored and inactive for as many as 50 percent of Americans.

"People are taking Vitamin D supplements but don't realize how it gets metabolized. Without magnesium, Vitamin D is not really useful or safe," says study co-author Mohammed S. Razzaque, MBBS, PhD, a professor of pathology at Lake Erie College of Osteopathic Medicine.

Razzaque explains that consumption of Vitamin D supplements can increase a person's calcium and phosphate [?] levels even if they remain Vitamin D deficient. The problem is people may suffer from vascular calcification if their magnesium levels aren't high enough to prevent the complication.

Patients with optimum magnesium levels require less Vitamin D supplementation to achieve sufficient Vitamin D levels. Magnesium also reduces osteoporosis, helping to mitigate the risk of bone fracture that can be attributed to low levels of Vitamin D, Razzaque noted.

Deficiency in either of these nutrients is reported to be associated with various disorders, including skeletal deformities, cardiovascular diseases, and metabolic syndrome."

"By consuming an optimal amount of magnesium, one may be able to lower the risks of Vitamin D deficiency, and reduce the dependency on Vitamin D supplements," says Razzaque.

 

[dbh25]

Patients with optimum magnesium levels require less Vitamin D supplementation to achieve sufficient Vitamin D levels.

What is the value of this optimum magnesium level?

 

[Cirion]

Interesting. Thanks for this information. It might explain many things that I've experienced going on with me lately.

 

[Amazoniac]

What is the value of this optimum magnesium level?

Magnoil - Liquid Magnesium
Although as soon as you start adding vit D to the story, it can complicate things, so you'll have to go by feel or keep testing along with vit D.

 

[HDD]

Me: Do some people have a chronic vitamin D deficiency problem?


RP: Yes, some people seem to metabolize it faster than normal. It’s involved in energy metabolism.

 

[Mito]

Mito, I had a glass of the hours running knowning that this quote would eventually pop up. From Figure Ein on the link #1 you'll notice that even 1000 IU is enough to increase 25(O and H)D by 10 ng/mL, so for the average values it goes from 30 ng/mL to 40 ng/mL in a lot of people. With 2000 IU it doubles. And then as you increase, it starts to level, so when people supplement 10000 IU, their curve gives the impression that the average values is around 75 ng/mL, but it looks lower, close to 50 ng/mL, yet the tendency to increase the values is still there. It's considered safe because toxicity is when levels go above 150 ng/mL (if I'm not wrong), and while no one reached those levels with 10000 IU supplemented, it appears that at this point the body is trying to do something with the excess. But regardless of what it's trying to do, this amount can be more than needed:
Calcirol - Liquid Vitamin D3

Considering that members ingest plenty of calcium, have multiple persistent deficiencies (B vitamins, C, magnesium, boron, etc), 2000 IU is probably a safer amount for maintenance if you're already getting some from sun and diet (they believe these provide about 3000 IU). But for 10000 IU daily supplementation, it's worth monitoring through tests.

Please let me know if I'm wrong because I haven't confirmed this information on anesthesiology book yet

It’s interesting that Peat doesn’t seem to hesitate recommending Vitamin D supplementation to callers considering he is so cautious about many other supplements. When people email him about most any condition, a common response is “Have you checked your Vitamin D level?”.

 

[Mito]

“Inspite of having so much sunshine, Saudi Arabian population is suffering from the deficiency of the ‘sunshine vitamin’, vitamin D, measured in the serum as 25-OHD level. According to a recent report, about 83.6% of Saudi population is vitamin D deficient. 31.9% have severe, 32% have moderate and 19.7% have mild vitamin D deficiency (VDD). The severity of VDD differs with age, gender and region. Females are more severely vitamin D deficient than males. Various factors contributing towards it deficiency are linked to their housing designs, religious practices, lifestyle choices and dark skin color. The increasing incidences of breast, prostate and colon cancer among this society are also raising an alarm. The presence of vitamin D receptor (VDR) and the enzyme responsible for conversion of the 25(OH)D in its active metabolite 25(OH)2D3 in extra renal tissue shows the involvement of vitamin D in other diseases like cancer, diabetes, multiple sclerosis etc. About 2000 genes related to various types of diseases are found to be regulated by VDRs. These genes possess vitamin D responsive elements (VDREs) in their promoters. Studies on population of other regions also have shown correlation with low serum levels of 25(OH)D and certain diseases So, we hypothesized that vitamin D deficiencies might cause a higher prevalence of these diseases in the Kingdom.”
https://www.medical-hypotheses.com/article/S0306-9877(15)00149-8/pdf

Background: Whether dark skin produces less vitamin D after UVB radiation than fair skin remains controversial. Objective: To compare 25-hydroxyvitamin D [25-(OH)-D] levels after a single UVB exposure in fair (phototype II-III) and black-skinned (phototype VI) volunteers. Methods: Fair-skinned volunteers (n = 20, 4 males/16 females, mean age: 23.2 years) and black-skinned (n = 11, 6 males/5 females, mean age: 23.8 years) received a single total body UVB exposure (0.022 J/cm2). The 25-(OH)-D levels were measured on days 0, 2 and 6. Results: On day 0, all volunteers were severely vitamin D deficient. On day 2, 25-(OH)-D levels of fair-skinned volunteers increased significantly (median: 11.9-13.3 ng/ml, p < 0.0001), but not in black-skinned people (median: 8.60-8.55 ng/ml, p = 0.843). Again, on day 6, 25-(OH)-D levels of fair-skinned volunteers increased significantly (median: 11.9-14.3 ng/ml, p < 0.0001), but not in black-skinned people (median: 8.60-9.57 ng/ml, p = 0.375). Conclusion: This study suggests that skin pigmentation negatively influences vitamin D synthesis.
Skin color is relevant to vitamin D synthesis. - PubMed - NCBI

 

[crestind]

NO. Supplementation of vitamin D is generally the supplementation of preformed vitamin D. In nature this substance is rare and available in small quantities considering the amount people actually need. If humans had evolved to need preformed vitamin D, it would be difficult for people to populate the world due to the rarity of it. The skin produces vitamin D for a reason. You're supposed to be outside in the sun. Get your sun time. You won't get myopia, your mood will improve, you will get your vitamin D, all for free. People these days act like sunlight will kill them. Their loss.

 

[Amazoniac]

NO. Supplementation of vitamin D is generally the supplementation of preformed vitamin D. In nature this substance is rare and available in small quantities considering the amount people actually need. If humans had evolved to need preformed vitamin D, it would be difficult for people to populate the world due to the rarity of it. The skin produces vitamin D for a reason. You're supposed to be outside in the sun. Get your sun time. You won't get myopia, your mood will improve, you will get your vitamin D, all for free. People these days act like sunlight will kill them. Their loss.

But this is the problem:

Spoiler: Cloudiest cities in the US and A

 

[Dave Clark]

I live in the NorthEast of USA, and theoretically, if I had to go outside and expose 75% of my body to the sun for a given amount of time during the day, and required that I do that for good health, it would not be possible most of the year for several reasons. There are only three, maybe four months of the year that the temperatures are comfortable enough to sunbath. This isn't a modern day phenomena, I am sure ancient man did not walk around freezing his butt off just to get vitamin D. I am not against the theory of getting vitamin D from sun (I own a vitamin D sunlamp), but the logistics just don't work out for most of the world that lives a considerable distance above the equator. Somehow I think our storage forms of vitamin D. plus what we would get via food is supposed to last us through the winter months, maybe by design, otherwise, perhaps most of the world had tropical climates in our evolution and that wasn't the case.

 

[benaoao]

Which is why I think tanning once a week should be sufficient. 6-9 minutes doubles vitamin D levels in Canadians who don’t take oral D.

Canadian Study Finds Tanning Salon Sunbeds Effective for Raising Vitamin D Levels - GrassrootsHealth

Looks like blood levels of 40-60 ng/ml is somewhat of a consensus. Whatever the Canadian government says about sun being the worst enemy.

 

[Obi-wan]

Just looked at the various suppliers of Vit. D. Many are packaged in PUFA oil. Some in olive oil. Cheap olive oil can have a considerable PUFA content. Buyer beware.

 

[Obi-wan]

Vitamin D3 is produced photochemically from 7-dehydrocholesterol in the skin of most vertebrate animals, including humans.[148] The precursor of vitamin D3, 7-dehydrocholesterol is produced in relatively large quantities. 7-Dehydrocholesterol reacts with UVB light at wavelengths between 270 and 300 nm, with peak synthesis occurring between 295 and 297 nm.[149] These wavelengths are present in sunlight, as well as in the light emitted by the UV lamps in tanning beds (which produce ultraviolet primarily in the UVA spectrum, but typically produce 4% to 10% of the total UV emissions as UVB). Exposure to light through windows is insufficient because glass almost completely blocks UVB light.[150][151]

Adequate amounts of vitamin D can be produced with moderate sun exposure to the face, arms and legs, averaging 5–30 minutes twice per week, or approximately 25% of the time for minimal sunburn. The darker the skin, and the weaker the sunlight, the more minutes of exposure are needed. Vitamin D overdose is impossible from UV exposure; the skin reaches an equilibrium where the vitamin degrades as fast as it is created.[24][152][153] -The natural way!

Sunscreen absorbs or reflects ultraviolet light and prevents much of it from reaching the skin.[154] Sunscreen with a sun protection factor (SPF) of 8 based on the UVB spectrum decreases vitamin D synthetic capacity by 95%, and SPF 15 decreases it by 98%.[155] - This is the problem!

Vitamin D3 (cholecalciferol) is produced industrially by exposing 7-dehydrocholesterol to UVB light, followed by purification.[161] The 7-dehydrocholesterol is a natural substance in fish organs, especially the liver,[162] or in wool grease (lanolin) from sheep. Vitamin D2 (ergocalciferol) is produced in a similar way using ergosterol from yeast or mushrooms as a starting material.[ -Wikipedia

Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and multiple other biological effects. In humans, the most important compounds in this group are vitamin D3 (also known as cholecalciferol) and vitamin D2 (ergocalciferol).[1] Cholecalciferol and ergocalciferol can be ingested from the diet and from supplements.[1][2][3] Only a few foods contain vitamin D. The major natural source of the vitamin is synthesis of cholecalciferol in the skin from cholesterol through a chemical reaction that is dependent on sun exposure (specifically UVB radiation). Dietary recommendations typically assume that all of a person's vitamin D is taken by mouth, as sun exposure in the population is variable and recommendations about the amount of sun exposure that is safe are uncertain in view of the skin cancer risk.

Vitamin D from the diet or skin synthesis is biologically inactive; enzymatic conversion (hydroxylation) in the liver and kidney is required for activation. As vitamin D can be synthesized in adequate amounts by most mammals exposed to sufficient sunlight, it is not an essential dietary factor, and so not technically a vitamin.[3] Instead it could be considered as a hormone, with activation of the vitamin D pro-hormone resulting in the active form, calcitriol, which then produces effects via a nuclear receptor in multiple different locations.[3] Cholecalciferol is converted in the liver to calcifediol (25-hydroxycholecalciferol); ergocalciferol is converted to 25-hydroxyergocalciferol. These two vitamin D metabolites (called 25-hydroxyvitamin D or 25(OH)D) are measured in serum to determine a person's vitamin D status.[4][5] Calcifediol is further hydroxylated by the kidneys to form calcitriol (also known as 1,25-dihydroxycholecalciferol), the biologically active form of vitamin D.[6] Calcitriol circulates as a hormone in the blood, having a major role regulating the concentration of calcium and phosphate, and promoting the healthy growth and remodeling of bone. Calcitriol also has other effects, including some on cell growth, neuromuscular and immune functions, and reduction of inflammation.[7]

Vitamin D has a significant role in calcium homeostasis and metabolism. Its discovery was due to effort to find the dietary substance lacking in children with rickets (the childhood form of osteomalacia).[8] Vitamin D supplements are given to treat or to prevent osteomalacia and rickets, but the evidence for other health effects of vitamin D supplementation in the general population is inconsistent.[9][10] The effect of vitamin D supplementation on mortality is not clear, with one meta-analysis finding a small decrease in mortality in elderly people,[11] and another concluding no clear justification exists for recommending supplementation for preventing many diseases, and that further research of similar design is unneeded in these areas.[ -Wikipedia

So why supplement Vitamin D if you do not have osteomalacia or rickets and do not live underground or use sunscreen every time you walk outdoors...Also supplemental Vitamin D is made from fish organs...mostly encapsulated in PUFA oil...

 

[Braveheart]

Great thread so far Obi, thanks

 

[Obi-wan]

Just checked a bottle of NOW Vitamin D3. It is made from Lanolin (sheep wool grease) and encapsulated in extra virgin olive oil. But it is 5,000 IU. RDA upper limit is 4000 IU. Maybe a winter product not on a daily basis.

 

[CLASH]

Why not just apply the vit D3 supplement to the skin as opposed to ingesting it, assuming adequate light exposure isnt available (I’m pretty sure the skin synthesizes cholecalciferol)? Perhaps applying enough to maintain serum levels and then get sunlight or light exposure as much as you can when you can would be a decent idea. Blood tests may also be a good idea.