Low vitamin D levels linked to premature death

[haidut]

Another way to phrase the findings of the study is that vitamin D deficiency increases the risk of death from any cause. Another important finding of the study is that it was the levels of 25-OH-D (calcifediol, a biomarker of of cholcalciferol (vit. D3) supplementation) and not 1,25-OH-D (calcitriol), which had inverse correlation to all-cause mortality and premature death. The fact that about 30% of US adults have vitamin D deficiency and another ~10% have vitamin D insufficiency, may be a major cause behind the recent drop in expected lifespan of US adults.

https://www.jacc.org/doi/abs/10.1016/j.jacc.2008.08.050
ACP Journals
Vitamin D Deficiency Is Linked To Premature Death, New Study Says | mindbodygreen

"...New research reveals that improving your vitamin D levels can be a matter of life or death. A new population study from Annals of Internal Medicine shows mortality risk increases with vitamin D deficiency, which is defined as a 25(OH)D serum level of 20 ng/ml or lower. Considering 29% of U.S. adults1 are deficient in vitamin D, this new research is a bit alarming. The study also found an association between low vitamin D status and mortality from cancer, cardiovascular disease, and respiratory diseases. This means the 60% of U.S. adults2 living with at least one chronic disease and 40% that have two or more chronic diseases could be at even higher risk of mortality if they're also deficient in vitamin D."

 

[Rinse & rePeat]

I am reposting this. People don’t realize how important getting outdoors is.

 

[philalethes]

I am reposting this. People don’t realize how important getting outdoors is.

Well, in many places getting outdoors won't be anywhere close to sufficient to meet the amount of vitamin D we've evolved to be optimized for. We did after all evolve for tens of millions of years as primates in the equatorial tropics, and would have had intense UVB radiation beating down on us every single day (sheltered by the rainforest for most of our evolutionary history, but we'd certainly still have a lot of exposure to it).

At extreme latitudes there really isn't any substitute for supplementation as far as I'm aware, since no foods contain anywhere close to the amounts necessary to sustain optimal human health; and in that I include pretty much the entirety of the US and Europe, even the southernmost parts of both, all the inhabitants of which I'd recommend supplementing every day, even during the summer months.

 

[Rinse & rePeat]

Well, in many places getting outdoors won't be anywhere close to sufficient to meet the amount of vitamin D we've evolved to be optimized for. We did after all evolve for tens of millions of years as primates in the equatorial tropics, and would have had intense UVB radiation beating down on us every single day (sheltered by the rainforest for most of our evolutionary history, but we'd certainly still have a lot of exposure to it).

At extreme latitudes there really isn't any substitute for supplementation as far as I'm aware, since no foods contain anywhere close to the amounts necessary to sustain optimal human health; and in that I include pretty much the entirety of the US and Europe, even the southernmost parts of both, all the inhabitants of which I'd recommend supplementing every day, even during the summer months.

With people being primarily indoors nowadays I would agree with you. Good egg yolks have 10% vitamin D, some mushrooms have more than 50%, clam juice has even more and chlorella has more 100% vitamin D needed. It is out there.

 

[philalethes]

With people being primarily indoors nowadays I would agree with you. Good egg yolks have 10% vitamin D, some mushrooms have more than 50%, clam juice has even more and chlorella has more 100% vitamin D needed. It is out there.

Egg yolks don't contain anywhere close to sufficient amounts of vitamin D. You'd need to eat a kilogram of egg yolks alone every single day just to hit ~2000 IU, and that's not even coming close to the ~20,000+ IU we'd get naturally from sunlight in our natural habitat. It really doesn't have anything to do with being more indoors these days, but with living at extreme latitudes where we didn't evolve for tens of millions of years.

As for mushrooms and chlorella, they contain vitamin D2, which is known to not have the same beneficial effects as D3 does (and mushrooms have to be exposed to UVB themselves to make it in any case). I can't find a single source corroborating the claim that clam juice has any vitamin D of any kind at all (and even if it did I strongly doubt it'd be enough based on the small amounts found in all other foods).

There really are no two ways about it: either you live somewhere with adequate Solar exposure to UVB or you supplement, otherwise you'll get deficient; the only third option to break this dichotomy is to use artificial UVB with lamps like those used for keeping lizards and other sunlight-loving animals.

 

[Chad_Catholic]

For these winter months, how many drops of Calcirol would you recommend we typically administer per day?

 

[Runenight201]

Egg yolks don't contain anywhere close to sufficient amounts of vitamin D. You'd need to eat a kilogram of egg yolks alone every single day just to hit ~2000 IU, and that's not even coming close to the ~20,000+ IU we'd get naturally from sunlight in our natural habitat. It really doesn't have anything to do with being more indoors these days, but with living at extreme latitudes where we didn't evolve for tens of millions of years.

As for mushrooms and chlorella, they contain vitamin D2, which is known to not have the same beneficial effects as D3 does (and mushrooms have to be exposed to UVB themselves to make it in any case). I can't find a single source corroborating the claim that clam juice has any vitamin D of any kind at all (and even if it did I strongly doubt it'd be enough based on the small amounts found in all other foods).

There really are no two ways about it: either you live somewhere with adequate Solar exposure to UVB or you supplement, otherwise you'll get deficient; the only third option to break this dichotomy is to use artificial UVB with lamps like those used for keeping lizards and other sunlight-loving animals.

Do those UVB lamps work? Thinking about getting some for my room so I can hole up like an animal in a dungeon to morph into a superhuman like creature.

 

[philalethes]

Do those UVB lamps work? Thinking about getting some for my room so I can hole up like an animal in a dungeon to morph into a superhuman like creature.

I don't see any reason why they wouldn't. UVB therapy using lamps is well-established to raise serum vitamin D levels significantly. You'd have to take a bit of care measuring the dosage, though, but at those frequencies you'd notice pinkness and burn if you overdo it, just like with real sunlight. Roughly 5% of the spectrum of sunlight reaching the ground is UVB, and the Solar irradiance is ~1 kW/m^2, so you'd have to approximate ~50 W/m^2 of UVB if you'd want to match that.

 

[philalethes]

For these winter months, how many drops of Calcirol would you recommend we typically administer per day?

If you're talking about calcitriol, I'm not sure what an ideal dosage would be, since this is the final form of the vitamin after conversion in both liver and kidneys; normally you'd take cholecalciferol, which is the result of the spontaneous isomerization of the previtamin D3 that forms in the skin when UVB radiation hits 7-dehydrocholesterol there. This is then allowed to be converted in the liver to calcifediol, whose circulating levels is what is measured in blood tests. The body then converts this as needed to calcitriol in the kidneys. Bypassing the body's own regulatory mechanisms is something I try to avoid whenever possible (which is why I also try to avoid heme-iron and preformed retinol/retinal as well).

The "official" recommended dosage of cholecalciferol (what's typically known as vitamin D3) is typically quite low (~500-1000 IU), and it's generally recognized that such a dosage doesn't effectively raise serum levels if low. As mentioned above this is however far from what we'd achieve naturally, and what is typically achieved in UVB therapy with light, which is rather 20,000+ IU. I would recommend at least ~2000 IU daily, but more is probably optimal (I personally do ~5000 IU daily all year at 60 degrees north, and unless you live within ~30 degrees of the equator I'd recommend supplementing most of the year, if not all of it). I've read that people also regularly supplement with much higher doses without any problems at all, up to as much as ~50,000 IU.

I see there's also a pharmaceutical product called "Calcirol", in case that's what you were referring to. That appears to be sachets containing ~60,000 IU of cholecalciferol designed to be taken weekly, probably to correct deficiency. I see they have some equivalent products using drops instead, so perhaps that's what you were asking about. I'm not sure what the dosage per drop is, but as mentioned above you should probably aim for at least ~2000 IU each day).

 

[Ben.]

noone of this matters when supplemental vitamin d acts like poision in certain individuals.

 

[Runenight201]

I don't see any reason why they wouldn't. UVB therapy using lamps is well-established to raise serum vitamin D levels significantly. You'd have to take a bit of care measuring the dosage, though, but at those frequencies you'd notice pinkness and burn if you overdo it, just like with real sunlight. Roughly 5% of the spectrum of sunlight reaching the ground is UVB, and the Solar irradiance is ~1 kW/m^2, so you'd have to approximate ~50 W/m^2 of UVB if you'd want to match that.

Thank you so much for the information and even breaking down the math for me. Much appreciated

 

[Rinse & rePeat]

Egg yolks don't contain anywhere close to sufficient amounts of vitamin D. You'd need to eat a kilogram of egg yolks alone every single day just to hit ~2000 IU, and that's not even coming close to the ~20,000+ IU we'd get naturally from sunlight in our natural habitat. It really doesn't have anything to do with being more indoors these days, but with living at extreme latitudes where we didn't evolve for tens of millions of years.

As for mushrooms and chlorella, they contain vitamin D2, which is known to not have the same beneficial effects as D3 does (and mushrooms have to be exposed to UVB themselves to make it in any case). I can't find a single source corroborating the claim that clam juice has any vitamin D of any kind at all (and even if it did I strongly doubt it'd be enough based on the small amounts found in all other foods).

There really are no two ways about it: either you live somewhere with adequate Solar exposure to UVB or you supplement, otherwise you'll get deficient; the only third option to break this dichotomy is to use artificial UVB with lamps like those used for keeping lizards and other sunlight-loving animals.

I agree with you, that the UVB lamps sound like a logical best next option.

 

[philalethes]

I agree with you, that the UVB lamps sound like a logical best next option.

That's an interesting claim on the nutritional label. From what I can find it appears that the amount of vitamin D in clams and other shellfish has previously been overestimated based on poor methodology:

https://www.ars.usda.gov/ARSUSERFILES/80400535/DATA/PUBLICATIONS/AMR/1-S2.0-S0889157513000100-MAIN.PDF

As seen from the above comparisons, the values for almost all fishes from the present study were within the ranges previously reported in databases and in the literature. There were differences, however, between our determined values and tabulated values for shellfish. Specifically, we found very little vitamin D in oysters, mussels, clams, scallops, and shrimp. For these comparisons, the values calculated from RFs are used, since the values are well below the LODs calculated from the calibration curves.

Based on the fact that values determined from multiple and duplicate analyses using UV with confirmation by MS, and use of methodology validated by analysis of SRM 1849, the higher vitamin D value for some shellfish in some literature reports appear to be overestimates. Every analysis of mollusks (clam, mussel, oyster and scallop) (Table 1) gave results of less than 0.25 mg/100 g vitamin D3, showing mollusks to be consistently low in this nutrient. The tabulated value from Bourre and Paquotte (2008) for mussel was 2.4 mg/100 g. Since our data are validated and supported by multiple mutually confirmatory detection techniques, we believe that further analyses will confirm the low levels of vitamin D in mollusks, especially oysters.

In other words, there's a good chance that label isn't necessarily accurate if it's based on such unreliable previous findings. That being said, even if it were accurate, 2.3 µg of vitamin D corresponds to ~100 IU, so even if it turns out to actually contain that amount it's still way too little to cover what's optimal for humans as far as I'm aware.

But yes, lamps are definitely the only alternative to supplementation if you live somewhere with limited exposure to natural UVB (based on estimates of UV index by latitude, I'd say that applies anywhere outside of ~30 degrees of the equator). I personally find it easier and more reliable to supplement, but I know there are handheld devices one can buy to use for UVB therapy. You can also install lamps somewhere, but then you'd be tied down to spend a certain amount of time in the light of those lamps throughout the day; might be perfectly fine for some, but not reliable enough for me personally.

 

[Rinse & rePeat]

That's an interesting claim on the nutritional label. From what I can find it appears that the amount of vitamin D in clams and other shellfish has previously been overestimated based on poor methodology:

https://www.ars.usda.gov/ARSUSERFILES/80400535/DATA/PUBLICATIONS/AMR/1-S2.0-S0889157513000100-MAIN.PDF

In other words, there's a good chance that label isn't necessarily accurate if it's based on such unreliable previous findings. That being said, even if it were accurate, 2.3 µg of vitamin D corresponds to ~100 IU, so even if it turns out to actually contain that amount it's still way too little to cover what's optimal for humans as far as I'm aware.

But yes, lamps are definitely the only alternative to supplementation if you live somewhere with limited exposure to natural UVB (based on estimates of UV index by latitude, I'd say that applies anywhere outside of ~30 degrees of the equator). I personally find it easier and more reliable to supplement, but I know there are handheld devices one can buy to use for UVB therapy. You can also install lamps somewhere, but then you'd be tied down to spend a certain amount of time in the light of those lamps throughout the day; might be perfectly fine for some, but not reliable enough for me personally.

The clam juice amount was for 1 tablespoon. I use a whole bottle or two for whatever I am making which serves 4 to 6 people.

Fortunately I live in California so I don’t worry too much about vitamin D.

 

[philalethes]

The clam juice amount was for 1 tablespoon. I use a whole bottle or two for whatever I am making which serves 4 to 6 people.

Fortunately I live in California so I don’t worry too much about vitamin D.

I see. Well, taking it at face value that'd be roughly ~1600-3200 IU divided by however many people consume what is being made, ~260-800 IU per person depending on whether one or two bottles is used and the people sharing being 4-6. That would still be way too little to rely upon in my view, and one would have to be in the upper range of this (2 entire bottles divided by as few people as possible) every day to make a dent in the requirements at all; and if that value is indeed exaggerated it would naturally be even worse, since if there's actually only 1/10 of the vitamin D in there, or even less, then you'd have to essentially guzzle down liters of clam juice every day.

Living in California on the other hand will generally mean you probably won't need much supplementation if you frequently get exposure to sunlight near Solar noon, although even there there will be very limited UVB during the winter months. It would also depend a bit on where in California one lives, since it spans 10 degrees of latitude from 30 to 40 degrees north, and there's significantly more UVB near 30 than 40. The body also does store it, so being able to have plenty of exposure for a larger part of the year makes it more doable to get through the winter months, and the months bordering winter as well, using stores. I'd definitely be checking my levels to make sure they're good, but I assume you're doing this already.

 

[Rinse & rePeat]

I see. Well, taking it at face value that'd be roughly ~1600-3200 IU divided by however many people consume what is being made, ~260-800 IU per person depending on whether one or two bottles is used and the people sharing being 4-6. That would still be way too little to rely upon in my view, and one would have to be in the upper range of this (2 entire bottles divided by as few people as possible) every day to make a dent in the requirements at all; and if that value is indeed exaggerated it would naturally be even worse, since if there's actually only 1/10 of the vitamin D in there, or even less, then you'd have to essentially guzzle down liters of clam juice every day.

Living in California on the other hand will generally mean you probably won't need much supplementation if you frequently get exposure to sunlight near Solar noon, although even there there will be very limited UVB during the winter months. It would also depend a bit on where in California one lives, since it spans 10 degrees of latitude from 30 to 40 degrees north, and there's significantly more UVB near 30 than 40. The body also does store it, so being able to have plenty of exposure for a larger part of the year makes it more doable to get through the winter months, and the months bordering winter as well, using stores. I'd definitely be checking my levels to make sure they're good, but I assume you're doing this already.

If I were struggling in some way maybe I would supplement or feel the need to dive into the matter, but I am in excellent health and don’t have a need to worry about it.