KMUD: 11-18-16 Vitamin D

Dan Wich

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Direct MP3 link | Podcast setup

The majority of the show is about vitamin D, but it also touches on calcium and urine analysis. And most importantly, I think someone in the studio stubs their toe at around 37 minutes.

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Gl;itch.e

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Thanks again Dan!

Good show. Liked that there was less time devoted to callers. Wish Andrew would just ditch the callers or at least screen them a little better.
 

haidut

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One of the more important statements by Peat in this show was that the actions of vitamin D and thyroid hormone cannot really be separated from each other. They affect each other positively and each can fill in for a deficiency of the other. So, given how often Peat seems to recommend checking blood levels of vitamin D and also supplement with vitamin D, I suspect that it can also serve as thyromimetic for the people who don't feel like taking thyroid or can't for whatever reason.
 

Agent207

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If you do your homework you'll find why it doesn't look a very good idea taking d3 other than from uvb exposure. Specially if you have not calcitriol levels checked previously.
 

haidut

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If you do your homework you'll find why it doesn't look a very good idea taking d3 other than from uvb exposure. Specially if you have not calcitriol levels checked previously.

I hear you, but Peat made it very clear in this show that derangements of vitamin D metabolism are likely due to calcium and vitamin D deficiency, not due to supplementation. One caller said she was taking 8,000 IU daily and he said he has never heard of anybody has any issues with 10,000 IU daily. I think his rationale was that 15min exposure to the sun results in 15,000 IU vitamin D being synthesized so taking much smaller amounts than that (especially during the winter) is not likely to cause issues.
 

paymanz

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If you do your homework you'll find why it doesn't look a very good idea taking d3 other than from uvb exposure. Specially if you have not calcitriol levels checked previously.
You think body adjust vitamin d production rate according to calcitriol?!
 

Agent207

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I hear you, but Peat made it very clear in this show that derangements of vitamin D metabolism are likely due to calcium and vitamin D deficiency, not due to supplementation. One caller said she was taking 8,000 IU daily and he said he has never heard of anybody has any issues with 10,000 IU daily. I think his rationale was that 15min exposure to the sun results in 15,000 IU vitamin D being synthesized so taking much smaller amounts than that (especially during the winter) is not likely to cause issues.

I know, I listened the show the other day and it called my attention when Peat approved what the caller said about the units he was taking. From what I've read its not about the units, but about the way they reach the system. 25OH and 1.25 don't always correlate each other in a linear way, and sometimes it's the opposite. Unlike pre-d3 formation from uvb, taking oral d3 when calcitriol is in the upper range can seriously mess with vdr, and that is no joke.


You think body adjust vitamin d production rate according to calcitriol?!

Yep, and that feedback becomes pointless when you load yourself with high amounts of d3 (I mean higher than what you'd get from a normal diet).

So I think its wise to check 1.25 levels to be on the safe side, before any oral d3.
 
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paymanz

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@Agent207 good point.

But 1.25 has a high turn over rate and short half life.body adjust it according to requirements ,I'm not sure how reliable is its measurements.but mayby in stressful situations , or inflammatory diseases its level be up all the time!Idk maybe it needs multiple test at various times.

Vitamin A is good at antagonizing it,at least it prevents the hypercalcemia.

I personally had very bad time when few years ago reached my 25 level to aroud 110 ng,but at that time I has very bad diet regarding vitamin A and k intake.probably it was the 1.25 that caused problems.while many experts doesn't consider 100 ng to be toxic.

But again vitamin A is so important.
 

haidut

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I know, I listened the show the other day and it called my attention when Peat approved what the caller said about the units he was taking. From what I've read its not about the units, but about the way they reach the system. 25OH and 1.25 don't always correlate each other in a linear way, and sometimes it's the opposite. Unlike pre-d3 formation from uvb, taking oral d3 when calcitriol is in the upper range can seriously mess with vdr, and that is no joke.




Yep, and that feedback becomes pointless when you load yourself with high amounts of d3 (I mean higher than what you'd get from a normal diet).

So I think its wise to check 1.25 levels to be on the safe side, before any oral d3.

Oh by all means, I agree. In other posts I mentioned that vitamin D should always be done as a set of tests for vitamin D3, calcitriol, phosphorus, calcium and PTH. Otherwise an isolated test for any of these does not make much sense.
 

raypeatclips

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Uploaded the clips from this talk. I think I really underestimated how important Vitamin D is and how important Ray thinks it is. Some very important and interesting segments in this one.
 

Giraffe

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This is my take on this:
  • 25(OH)D is the best marker for vitamin D storage.
  • 1,25 (OH)2D is influenced by PTH and chronic infections, has a short half-life and is difficult to interpret.
  • The intake of up to 10,000 IU vitamin D3 daily is generally safe.
  • You want to maximally suppress PTH. What minimum serum levels of 25(OH)D are necessary seems do differ between individuals. Dietary factors that lower PTH are adequate intake of calcium, magnesium and proteins: all those should spare vitamin D. High dietary phosphate increases PTH. Sugar, niacinamide, vitamin A and K help to handle the calcium and balance the ratio of calcium to phosphorus.
......

The article below discusses the safety of vitamin D supplementation.

Vitamin D Toxicity, Policy, and Science
The classic symptoms of vitamin D toxicity are entirely attributable to hypercalcemia, and they include nausea, dehydration, and lethargy. Without laboratory testing, these signs of hypercalcemia have been mistaken for gastroenteritis.
Recent evidence in men shows that 8 wk of supplementation with 275 μg (12,500 IU)/d of vitamin D does not affect circulating calcium concentration (urine results were not reported). In other words, the dose is noncalcemic and safe by the criteria applied both to drug studies of vitamin D analogs and to nutrient recommendations.
Concentrations of 1,25(OH)2D are not increased much by vitamin D intoxication. This reflects the high level of regulation of the circulating concentrations of this hormone through both synthesis and catabolism. Nonetheless, vitamin D toxicity is the result of excessive levels of “free” 1,25(OH)2D displaced from its carrier protein, vitamin D–binding protein (DBP), when there is a vast excess of other vitamin D metabolites.
People with abundant exposure to sunlight can easily exhibit a serum 25(OH)D >150 nM (60 ng/ml), which would be a physiologic presupplement input of vitamin D equivalent to >100 μg (4000 IU)/d. An additional oral intake of 100 μg/d of vitamin D would still be less than the dose of 1250 μg (50,000 IU)/d vitamin D shown to be noncalcemic.
CONCLUSION

The absence of hypercalcemia and hypercalciuria in well-conducted trials of vitamin D leads to the conclusion that the current UL of 50 μg (2000 IU)/d has been excessively conservative. The overwhelming bulk of clinical trial evidence supports the conclusion that a prolonged intake of 250 μg (10,000 IU)/d of vitamin D3 likely poses no risk of adverse effects in almost all individuals in the general population. These conclusions are more fully supported in a formal risk assessment for vitamin D by Hathcock et al.
.....

This is a multinational study of 18 countries at various latitudes. Participants were postmenopausal women with osteoporosis. A strength of this study is that all their tests were done in the same laboratory.

The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation
The prevalence of vitamin D insufficiency according to various threshold levels is displayed in Table 3. Overall, 63.9% of women had serum 25(OH)D levels <30 ng mL−1.
As shown in Fig. 3, lower serum 25(OH)D levels were associated with higher levels of PTH. Based on mathematical modelling using a quadratic fit, PTH reached a plateau at 33.9 ng mL−1; that is, serum PTH increased as serum 25(OH)D levels declined below 33.9 ng mL−1, but remained stable for serum 25(OH)D levels above that value.
 
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paymanz

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i dont know how 10k vitamin d supplement can be totally safe.(not pointing to giraffe's post.. giraffe mentioned it is "generally" safe which i agree..short term and blood tested its fine.)but a lot of people promote it as totally safe even up to 40k a day!its not safe in long term.

in my experience and my relatives who used vitamin d supplement , just 5k a day was enough to bring the levels up to 70-80 ng after 6-7 months.

80ng might not be toxic but it is too much for sure, and i can imagine if they kept supplementing like that for longer time without testing it could go toxic range too.

just sharing my thought and personal experience..
 

DaveFoster

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"The media is dying. The trust rate is 6% at this point." True! I really like this guy; he's very humble and well-read.

First caller didn't want to give her weight. Wow.
Seriously. She wanted the whole show to be dedicated to her personal health profile as well.

The insanity of not saying your weight though, even in person! No one's going to look at you and say. "Wow! I'm sure glad I don't know your weight, or I'd think you were fat." Just ridiculous.
 
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