Over the last couple of years or so I have developed quite an interest in vitamin D. It seems like a week doesn’t go by when some study or other has unearthed a potential new benefit for this substance, or some research turns up results that strengthen and support previous work. The evidence as it stands suggests Vitamin D appears to have the capacity to ward off, among other things, cardiovascular disease, cancer, diabetes, multiple sclerosis, muscle pain, osteoporosis and excess weight.
I’ve also been trying to get a handle on what a good level of bodily vitamin D would be. I don’t believe much in ‘reference ranges’ for vitamin D and other things. These, generally are set too wide, and can allow people to be ‘normal’ but with suboptimal levels at the same time. For example, you can read here how ‘normal’ levels of iron in the body can leave individuals compromised in terms of their energy and wellbeing. While there is no consensus on what represents an optimal vitamin D level, there is some agreement among those with a special interest in the area that 40-60 ng/ml (100-150 mmol/l) is worth shooting for.
Usually, most of our vitamin D requirements are met by the action of sunlight on our skin. I am a self-confessed sun-worshiper, and sport a year-round tan. I never (ever) use sunscreen. One of the major dietary sources of vitamin D is oily fish, something that I eat quite regularly. Ever since I became cognisant of the critical role that vitamin D plays in health and wellbeing, I imagined that vitamin D insufficiency or deficiency was something that happened to other people.
In April, more out of idle curiosity than anything else, I decided to have my vitamin D levels checked and these came back at 15 ng/ml (low, and a long way from optimal). From 25th April, to remedy this, I started taking vitamin D (in gelcaps) at a dose of 3000 IU per day. I took these religiously. I also got as much sunshine exposure as possible while avoiding burning. Some people commented on this site that they felt I probably needed a bigger dose of vitamin D to get up into the normal range.
I repeated the test about a week ago and got the results back yesterday: 31 ng/ml.
So, on the plus side, I have doubled my levels. On the other hand, they still remain quite a bit lower than the optimal range. Yesterday, I changed my vitamin D regime, and am now taking 5000 IU units a day. I’m planning to retest again in another 2-3 months.
I was reflecting on all this this morning. Up until recently, there I was, happily believing I was immune to vitamin D deficiency on the basis of my dietary and sun exposure habits. If someone told me that I was likely going to need to supplement with more than 10 times the recommended daily allowance of vitamin D to get my vitamin D into the optimal range I would never have believed them.
And this just got my thinking just how many people may be wandering around with seriously compromised vitamin D levels. Bearing in mind it looks like vitamin D has a quite pivotal role in health, what sort of disease burden may this be causing and/or leading to? And how much unnecessary suffering might be avoided by individuals being educated about what optimal vitamin D levels are, how to have their vitamin D levels tested, and what to do to keep vitamin D levels in their normal range.
Personally, what I think we require for there to be any chance of this happening, is for their to be long-term randomised controlled trials of vitamin D supplementation. And that these should include measurement of vitamin D levels so that the relationship between these and disease risk can be further assessed.
The other thing that needs to happen is for healthcare then to be based on the best available evidence (not on what happens to be most profitable). I sometimes wonder whether the fact that iron is a non-patentable item that so many individuals seem to go short on this vitally important nutrient. Let’s hope that vitamin D does not go the same way on the basis that it too is a naturally occurring substance that cannot be patented and therefore has limited commercial value.
P.S. No blog yesterday as site was down the whole day due to ‘server issues’.
I know that low vitamin D is associated with a variety of diseases, but I haven’t heard if supplementation actually reduces the association or if we just don’t know yet.
Peter
We just don’t know yet, which is why I think we need those randomised controlled trials I specifically mentioned in the blog.
In the meantime, we have a huge and ever-growing pile of epidemiological evidence which is very consistent in its findings (higher vitamin D levels are associated with improved health and lower risk of disease).
William Davis
http://heartscanblog.blogspot.com/
is another champion of Vitamin D. Actually one of many these days.
One wonders how we will get it when the Codex Alimentarius is imposed
UK readers wanting to monitor their 25(OH)D levels twice yearly may be interested in participating in the
Grassrootshealth D Action trial.
You can just have a single test or join for the whole 5yr trial and have 1 or 2 tests each year.
Although the 31ng the Dr Briffa has achieved is an improvement there is good reason to believe that the level at which human breast milk naturally flows replete with D3 is the level our DNA evolved to function best with.
Very interesting to wonder what conditions (illnesses) the low vitamin D levels may be linked to and the efficacy of supplementation. Is much known about the causes of low Levels and how might likely variance of vitamin D levels confound our appreciation of the merits of the Mediterranean diet?
Items in the list of associated conditions, cvd, weight gain, diabetes, and cancer have been linked by some to diets including a high component of refined and high GL carbohydrate sources. Is it possible that high GL and low vitamin D levels are in themselves linked and act as co-factors in the development of these conditions?
Dr. Briffa,
How much of your skin is typically exposed when you get your sun exposure? Just curious if it is often just arms and face or if you make a point to expose as much skin a spossible when out in the sun.
Jack
It depends, but when the sun is shining, I’ll very often be in nothing but a pair of shorts.
Have you been supplementing with vitamin D3 in dry tablet form? If so, you might try oil-based gelcaps instead; that form appears to be more readily absorbed.
Perhaps you simply require a much larger dose than most people. There’s tremendous individual variation in dosage needed to reach ~50 ng/ml.
I have calcium oxalate kidney stones. I have been supplementing with 6000 IU/day over recent months, and have started passing many small stones. I have stopped the vitamin D, and thought I would check my levels in several months. Do you recommend Vitamin D to your kidney stone formers?
Okay, someone told me that after sun exposure you need to avoid washing for a bit to allow the oils to be absorbed, or something like that. I wonder if we are overdoing the showering after sun exposure?
Jen
Yes, I’ve been taking oil-based gelcaps.
Dennis
I don’t actually know if higher vit D levels predispose to calcium oxalate stones, though I appreciate they may because of an effect on blood calcium levels. If this is the case, then I think one needs to balance the potential hazards of supplementation (kidney stones) with the potential benefits (reduced risk of many illnesses and diseases, some of which could prove fatal).
Also, you may consider protecting against stones using an alternative approach. Ensuring a good fluid intake should help, as should avoiding oxalate-containing foods. Nutrient supplementation may help too – I believe magnesium/B6 has been found to be effective at reducing stone formation and you might want to do your own research into this.
That is quite unsettling that after all of the supplementation and sun levels are still not optimal.
Have you ever corresponded with Chris MasterJohn? He has studied vitamin A, D and K quite extensively and might have some insight for you.
His contact page:
http://www.cholesterol-and-health.com/contact-cholesterol-and-health.html
Very interesting feature. How do you get your vitamin D levels tested?
I started taking Vit D3 on the advice of my colleague and before I found Grassroots organisation, so I don’t know my level before I started. It was listed at 35 in May and I will get it repeated about November. Currently I am taking an oil based spray twice a day, under my tongue so will be interested how this differs from tablets. I am not good at swallowing pills.
Do all the Vit D3 supplements come from USA or are any manufactured here in UK? I would like to get some high dosage if possible, to save having to take so many.
Because of what I have read in recent months including in your e-newsletters I have been trying to enhance my Vit D levels by going back to the traditional remedy that I had as a child — cod liver oil (CLO). I have been saddened to read that a lot of CLO is useless for Vit D content nowadays – — see the section entitled Manufacturing and Deodorization in the article http://www.westonaprice.org/modernfood/codliver-manufacture.html (since the article was written the factory which added back the natural vitamins no longer does so). Luckily the author of the article has now turned his hand to making CLO by traditional methods and this can be obtained in the UK — it has both Vit A and Vit D in it and they appear to act synergistically.
where, apart from the grassroots trial above, is the best place to get vit d tested?
thanks
Where can I get my Vit D levels checked – I can’t see my GP being willing without me showing deficiency symptoms?
Where can you get your Vitamin D levels checked? I’ve been taking a supplement for the past six months and would love to see what my level is.
The concern with cod liver oil is the polutants/heavy metals from the sea. My understanding is that fish oils from oily fish are better. I have found a supplement that is guaranteed to be free of contaminants and also has Vit D added. Only 200mg per day but hopefully enough for most people for topping up as long as they are getting out in the sun too. I also get 600mg from my “multi-vit”
@ Lorna Read
The cheapest postal testing is provided by the Grassrootshealth D Action trial.mentioned in post 4 of this discussion. If you have a medical problem that is associated with vitamin d insufficiency then it may be possible to get a 25(OH)D test done on the NHS but it may be simpler and cheaper to just use the link above. Getting mine tested on the NHS involved 3 visits to the surgery and one to the path lab so I now save hassle and petrol money by getting it done in USA by post.
Grassrootshealth are a charity run by a group of eminent vitamin d scientists who have spent their lives working on the subject but who have been studiously ignored by the medical profession.
The trial is looking at the incidence of chronic illness in relation to 25(OH)D levels, supplement intake and medical interventions over a 5 year period. The basic questions you have to answer are pretty simple and take no longer than a few minutes. You are then sent a couple of spring loaded lancets to prick your finger and you then drop 2 drops of blood onto a sample sheet which you post back to them and in a few days you get a link to the result.
At the moment it costs $40 about £24 but that varies with exchange rate. You can sign up for one test or 2 and you can participate for as long as you want. Ideally the more people who sign up for the full 5 yrs either once or twice yearly will provide better data as it takes a while for Vitamin D status to rise and for the body to store a reasonable amount of D3 to have available to deal with emergencies.
Does Vitamin D make the world go round is a useful summary of recent vitamin D research.
I think I’ve said this before, but I used grassrootsforhealth (Ted Hutchinson mentions this above) for my vitamin D testing.
I have asked a lab I used for other tests if they might provide testing at low-ish cost, and they’re thinking about it.
Finally, getting vit D levels checked on the NHS is not straighforward. For example, a patient of mine at high risk of vit D deficiency with symptoms suggestive of it too was refused a test on the basis that her calcium level was normal. Aghhhhh!
I had polyps removed 8 and 10 years ago. About 3 years ago I discovered a company selling a liquid vitamin D, Ddrops,and it’s the one the Canadian researcher, Dr. Reinhold Vieth ,uses in clinical studies.It’s sold under another name in the US. I started taking 1000 IU daily and when tested last fall my 25[OH]D was 92 nmol/L. I’m in Canada.
I also had a colonoscopy last fall and the good news was I didn’t have any polyps. Do I believe Vitamin D prevented them. I sure do.
I find it has reduced my rheumatoid arthritis pain and has made me more stable when walking also.I’m 72 years old and was needing a wheelchair and walker before I started the Vitamin D. I don’t take any medications now either.
Presently I’m taking 4000 IU a day to maximize my level.
I and my wife have taken 50,000 IU of D3 each day for the past two years on the advice of my good friend Dr Joe Prendergast (http://www.endocrinemetabolic.com). Dr Prendergast himself has been taking this amount for ten years and more – with extraordinary effects.
My wife and I no longer get flu infections or throat infections (which used to floor us every year), nor is there any danger of us getting swine flu, given the mega immunity afforded us by our 50,000 IU of D3 daily. Don’t pussy foot around with low doses like 5000 IU. Instead get to 150 ng NOW by taking the dose I’m taking. Remember; you only absorb one tenth of ANY tablet form D3 content. Dr Prendergast now has a mouth spray that provides sublingual ingestion at a far more potent rate. Email him at joe@drjoeweb and he’ll sort you out if you wish.
I get my Vitamin D capsules from the following website in the USA: http://www.bio-tech-pharm.com. People in the UK should only order one batch at a time, otherwise you get hit with taxes and exhorbitant handling charges from the Post Office in the UK.
Vitamin D3 does NOT increase your calcium. When your body has enough it stops absorbing any more and you return to normal healthy levels. The research on this was done at Bangor University Hospital in Wales.
I’m on the Grassroots testing regime now. Prior to this I always got tested on the NHS simply by personally adding a request for one whenever my doctor gave me a test sheet with other routine tests to take to my local hospital – this ploy worked every time! A private test in London now costs £199.
John,
Interesting to see your results.
Ordinarily your vitamin D levels would increase through the summer and fall during the winter: all thing sbeing equal you would expect your vitmain D levels to rise as exposure to sunlight increases over the summer months.
Its very difficult to know what proportion of your increased vitamin D levels are due to increased sunlight and what proportion are due to supplementation. I guess it will take a couple of years to work out how your body responds, and to adjust your intake accordingly.
Looking to nature for clues, two thngs spring to mind. Firstly dietary sources of vitamin D seem to be more significant the further your move from the equator: fish, etc. Secondly, people and animals tended to gain weight prior to winter by taking advantage of seasonal fruits, etc. Vitamin D is fat soluable and would be released as fat was used for energy at the very same time as vitmain D reached its lowest levels.
The problem for most people is that they may well accumualte weight but are less likely to lose it. In additional even if they lost weight its unlikely that they would hvae stored much vitamin D.
Another thought is that skin pigmentation plays a role. Those with pale skins are probably better adapted to produce vitamin D in the UK than those with darker skin pigmentation. That, combined with modern lifestyles means that it couold be very difficult for some to naturally produce optimal levels of vitamin D. If grains/ gluten also interfere with vitamin D absorbtion assome suggest no wonder vitamin D deficiency is so widespread.
I sometimes swonder if current lifesytle guidance is designed to create poor health rather optimal health: limit expsosure to sunlight, eat a low fat diet based upon “healthy” wholegrains, etc.
Paul Anderson.
http://www.vitamindcouncil.org/
Lots of good information on Vitamin D.
VITAMIN D TESTS
You can purchase a vitamin D home testing kit via the Vitamin D Council: http://www.vitamindcouncil.org. It works out at just over £40 or you can purchase a multi test kit which works out even cheaper. You can then test your vitamin D levels as frequently as you require.
I would just like to say that I take my D3 added to Liquid fish oils. It works out at just a tad over 5000 iu per day and I also add 2100 mcg of Vitamin K2 to the mix.
Hi Liz
Is the vitamin D spray available anywhere in the Uk or do you purchase it from America? I have been to all the stores I can think of and no one seems to have heard of it.
I understand as you age you absorb way less Vit D as when younger, need large parts of your bod exposed at peak times of the day, not to use the dry form as isn’t as effective and use it with Vit A.anyone over 39 parallel is not getting enough sun to help the vit d situation.
heartscanblog.com
trackyourplague.com
john
have you read this link- http://articles.mercola.com/sites/articles/archive/2009/05/12/shocking-update-sunshine-can-actually-decrease-your-vitamin-d-levels.aspx
wondered if any of these reasons applied to your low levels?
Jo
Thanks for this, as I hadn’t seen it. The only factor that seems particularly appropriate is the showering issue.
As it happens, I’ve been making a concerted effort to avoid potentially hazardous chemicals in personal care products over the last few months. So, now I’m going to extend that to using soap or soap substitute on only the most needy parts of my body, especially after I’ve been in the sun.
Thanks again for posting the link – very useful.
John
VITAMIN D SPRAYS
Beware, some of the Vitamin D sprays contain nano particles (safety is unproven yet!) and other undesirable ingredients.
Statins and Vitamin D The full text is online if you click the PDF link
Starts with the sentence The diet-cholesterol-heart hypothesis dominated medical thinking for the latter half of the 20th century and it still persists. The diet component has so many inconsistencies that it is unsustainable. It continues in popular folklore and government dietary policies but it seems to have been quietly dropped by most cholesterol-heart researchers
Increased Levels of 25 Hydroxyvitamin D and 1,25-Dihydroxyvitamin D After Rosuvastatin Treatment: A Novel Pleiotropic Effect of Statins? again full text online.
This study has shown an effect of rosuvastatin on vitamin D metabolism, with an increase in both 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. This may be an important pleiotropic effect whereby rosuvastatin reduces mortality in patients with coronary artery disease. Further studies are needed to clarify the relationship between statins and vitamin D metabolism.
I thought this was interesting Grimes the outhor of the first link had the idea that statin’s were acting as vitamin D analogues back in 20006 and has an article in the Lancet that was more or less ignored. It just seems ridiculous to me that if Statins achieve their reputed beneficial effects by hijacking the pleiotropic effects of vitamin D3, the the obvious answer is to use Vitamin D3 in the first place. Thus avoiding all the nasty side effects of statins.
But the problem with this idea is that vitamin D is free from sunshine and dirt cheap from online sources from the USA. I use 5000iu from Iherb using code WAB666 saves you $5. But previously I was using the dry powder filled capsules 5000iu from bio tech mentioned above.
I can see no benefit in using extremely high dose 50,000iu/d capsules for extended periods more than initially to quickly restore a deficiency situation.
If you do go the high dose route then it is more important you get 25(OH)D checked regularly. Most UK readers will find amount around 500~6000iu/daily will, with a bit of extra sunshine keep them around 125~150nmol/l and while I would accept a slightly higher level may be justifiable for people with chronic inflammatory conditions. I do not see any evidence supporting levels higher than 70ng/mL~ 175nmol/l.
With regard to sun exposure it’s my opinion that this is a very important component of vitamin repletion. This paper
Demonstration of UVB-induced synthesis of 1a,25-dihydroxyvitamin D3 (calcitriol) in human skin shows cells in the skin can perform the whole metabolic process from cholesterol through previtamin d to Vitamin D3 to calcidiol and even to the active hormone calcitriol. Knowing your skin is an organ I don’t see the justification in saying that we now know better than the forces driving evolution and can dispense with the organ function skin evolved to provide.
The question Dermatologists should be investigating is why current human skin has so little natural sunscreen protection and I suggest they look at the difference in the ability to withstand UVB between high omega 3 status and high omega 6 status individuals. They may then come to realise why some people burn more easily than others.
http://atoz-naturalhealth.com/
Best/cheapest source I have found to date – reroutes to their ebay shop for the time being
120 gel caps 5000iu @ £11.40 inc P&P
(BrothersNutrition.com don’t ship exUS any more)
Hmmm – didn’t see the iHerb source – same product but cheaper …. $12.80
Got my results for my Vit D 3 today, 58, pleased with this, I have been using a liquid D3 supplement for the past year, never got a test before I started supplementing so have no idea what it might have been, but, I very rarely got out in the sun until last summer, and this summer I am in New Zealand, shame as I hear the summer in UK has been great.
Kristine Ross,
how much do you take?
where you get the liqued from?
thanks,
Matt
I order it from a company in US called NOW, the only other ingredient in it is MCT oil. The only thing is trying to get anything int UK past the post office and their charges, I have been stung quite a few times now and its getting a bit expensive, in saying that, one little bottle lasts a very long time.
Has anyone looked at this site?
http://nadir.nilu.no/~olaeng/fastrt/VitD-ez_quartMED.html
It calculates the UV exposure levels you need for healthy Vitamin D status, according to the time of year and weather and where you live and your skin type. It’s amazing how much time you should spend outdoors in December in the UK!!!
Hi Guys,
First of all, i am suffering from a wierd illness every autumn/winter which has been going on for years now, which takes me from a fit and healthy gym going guy in the summertime to a person that struggles to get out of bed in a morning, suffering from extreme fatigue, aching limbs, poor memory, confusion, chills etc.
Its really upsetting me now as i cant carry on living like this (not that i am going to kill myself or anything like that!) its just debilitating & worrying!
I was wondering why i get like this every year at the same time of year, when all summer i am fine???? So i was wondering if any of you guys think it could be down to a lack of vitamin d3 in my body due to the poor weather in England at this time of year and could this cause the problems i am suffering with??? It gets better when the weather starts to get better, but at the moment, i feel so ill !!!! So……. any ideas of what i should do guys, or where could i buy a test from and some high dosage vitamin d3…… any advice would be greatly appreciated.
Thanks
Rich
Hi Rich,
I’m in no way qualified to answer your question, but it sounds to me like you might be suffering from Seasonal Affective Disorder (SAD) – I have the same problem and found it was greatly improved through the use of a light box – you can find plently of information online about this. I bought my light box about 10 years ago from the SAD Lightbox Company and found them very helpful and professional. Their website is here:
http://www.sad.uk.com/
My children have broken my light box, so I’m unfortunately having to manage without it at the moment and I’m finding it a struggle. I have found some improvement through eating oily fish every day (mackerel), which contains high levels of vitamin D. I’m also considering adding a vitamin D3 supplement.
Hope this helps 🙂
I have autoimmune disorders that get really bad starting November and then get better in spring. When I take vitamin D (anything over 1000 iu) my cholesterol shoots up and my MD gets very alarmed. Should I ignore my MD on this.
Thanks.
Kim,
Your cholesterol SHOULD shoot up. That is what the body needs to process the vitamin D. I came to this conclusion when I learned that cholesterol is what “connects” vitamin D3 to the body. So when I began using vitamin D, I expected my cholesterol levels to rise and they did. Since my cholesterol was relatively low with excellent ratios my doc didn’t even flinch. But I expect my cholesterol to rise even more unless there is a set amount of cholesterol that the body needs for processing vitamin D. I must see this as a good thing.
I was recently diagnosed with pre-diabetes. I have known for years that I was insulin resistant so this diagnosis didn’t really upset me. However, I have not had any noticeable symptoms since beginning my low carb lifestyle. I also do intermittent fasting and once I became used to the fasting, I continued to have no noticeable issues. After that diagnosis I concluded that 10,000 IUs / daily was not enough so I raised my dosage to a gradual 50,000 IUs. My fasting glucose levels seem to be coming down. Although I knew that vitamin D deficiency could interfere with weightloss, I wasn’t sure about me. So if I were truly deficient, I should lose weight, right? I lost 6 lbs in 3 weeks. I take the Carlson’s gel caps that are 10,000 IUs.
This is something else that I concluded…if you are taking vitamin D3 supplements but are still experiencing symptoms of low vitamin d then you are not taking enough. My daughter has asthma. She takes a little bit of vitamin D and concludes that it isn’t working for her. I am trying to convince her that she is not taking enough. After I shared my experience with her she is increasing her dosage.
I have just had mt vut D levels checked and it is :- 75 nmol/L is this a good level? I am not sure what it should be!
Hi, It is quite an interesting article. I am diagnosed with sarcoidosis, stage 1. I got my vitamin D level checked and it was way too low 5.9, and it is supposed to be above 20. Tests for active vitamin D was not available so I couldn’t get it checked. I have read contradictory articles over internet about vitamin D and sarcoidosis. I don’t know should I start taking vitamin d supplement or should I avoid sunlight altogether (as suggested in various articles on sarcoidosis). Any suggestions?
Hi,
I’m an English man living in Seattle and recently underwent a D test and my value was 23 ng/ml my Dr suggested taking 1000IU.
I personally don’t believe this is sufficient to restore D levels,
After contesting this with my dr he said 1000ng/ml is the right dose.
The ignorance of research based evidence seems to be obvious
So under my own guidance I supplement with 4000IU daily.
Hi Last year my dentist basically told me my teeth were coming out my gums were so low and he really didn’t know why..so I looked here on the net and found the vitamin D sites…after a blood test the results came back as 1.1 3 months later they went upto 35 ( I was given high doses)..so now I take a supplement problem is my gums are still low and my dentist will not listen to me…I have been told my oral hygene is great but she won’t listen…she is a new dentist..anyways they want me to have an operation where by they will pull my gums down and glue them back…I don’t think I need it…I honsetly believe my vitamin d level has caused the loss of bone and anchoring type bone…I don’t expect my gums to return but was hoping to stop this going worse…I’m run down with it all noone will listen they think vitamin D is just one big joke..I was also terribly low in calcium and Iron..please help I feel like i’m going crazy.
D~