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Vitamin D: Setting the Record Straight

By:

Posted Tuesday, May. 3rd, 2011

vitamin d

On Wednesday, November 30, 2010, the Institute of Medicine’s Food and Nutrition Board issued a report saying, in essence, that taking more than 800 IU of supplemental vitamin D was unnecessary and could even be harmful (more on this in a minute).

Should you ignore this report?  Simply put, yes.  It lacks any basis in the latest scientific research, ignores the “real world” findings of medical practitioners who routinely prescribe higher doses of vitamin D and see dramatic results in their patients, and it fails the common sense “sniff” test.  Let me explain.

The Smart Nutrient…

The committee only looked at the amount of vitamin D known to be needed for strong bones.  That’s like evaluating an iPhone based solely on the ability of its built-in calculator to add and subtract.  The calculator is one tiny feature of the iPhone, but it’s hardly a complete picture of what a good smartphone can do.

Similarly, vitamin D is important for strengthening bones, but that’s only one of the many important things this miraculous “smart” nutrient does.

Vitamin D expert William Grant, PhD, puts it this way:

The health benefits of vitamin D extend to at least 100 types of disease, with the strongest evidence for many types of cancer (breast, colon, ovarian, pancreatic, prostate, and rectal), cardiovascular disease, diabetes types 1 and 2, respiratory infections such as type A influenza and pneumonia, other infections such as sepsis, and autoimmune diseases such as multiple sclerosis1.”

The Many Faces of Vitamin D…

There is a massive amount of research showing that low levels of vitamin D increase the risk for with every disease mentioned by Dr. Grant (above).  What’s more, when people are low in vitamin D, it affects their mood, ability to lose weight, physical performance, immune system function and even their chances of dying.

A 2008 study found that low levels of vitamin D increased the risk for death from any cause — called the mortality risk — by a whopping 26 percent compared to those who had “optimal” levels in their blood2.

Which brings us to the question of “optimal” levels, and the related question of toxicity.

Vitamin D Research…

Dietitians and doctors are mired in a culture that looks at vitamin needs solely in terms of what’s needed to prevent deficiency diseases.  The “recommended daily allowance” for vitamin C is the amount you need to prevent scurvy.  The recommended daily allowance for vitamin B1 (thiamine) is the amount you need to prevent beriberi.  I call this “minimum wage nutrition” and consider it utterly irrelevant to those interested in optimal health and well-being.

If you’ve got enough vitamin D in your system, taking more won’t necessarily make you faster or stronger, or give you the energy to run a marathon.  Problem is, many people are very far from having “enough” of it.  And when you don’t have enough of it, it can cost you dearly in terms of energy, health and physical performance.

We first began to notice the connection between vitamin D and physical performance when a pair of studies—one published in the Journal of Clinical Endocrinology and Metabolism3 and another by the Gerontological Society of Amercia4 both reported on the relationship between vitamin D, physical performance and disability in older people.

In a third study, Netherlands researchers at the American Society of Mineral and Bone Research’s annual meeting in 2005 also found that low levels of vitamin D are associated with low physical performance.  In their study5, 1238 older men and women with low serum levels of vitamin D performed significantly worse than controls on basic tests of balance and strength such as a basic walking test, having to get up from a seated position on a chair, or having to stand balanced with one foot in front of the other.

Scores for all three tests showed significant improvement with increased levels of vitamin D.  “Persons with low serum vitamin D had a higher risk for low physical performance,” Ilse Wicherts, PhD told Medscape Medical News at the time.  “The strongest effects were found in persons with a major deficiency.”

But that deficiency might be more common than anyone thought.  A couple of years later, in 2007, researchers at the Wake Forest University of Medicine found that, in a sample of 976 adults 65 years of age or older, a whopping 75 percent of women and 51 percent of men had insufficient vitamin D levels6.  And, in testing the participants physical performance using such measures as handgrip strength, the researchers once again confirmed that those with lower levels of vitamin D performed much worse than those who weren’t deficient.

The literature on vitamin D is enormous, and the above studies are only the tip of the iceberg.  Three more examples concern the immune system, cognitive decline, and weight loss.

According to Oregon State University researchers7, vitamin D induces the expression of a gene that’s actually antimicrobal.  The gene is called cathelicidin, and the researchers believe that it may be responsible for vitamin D’s capacity to function as one’s primary immune response.  They nicknamed cathelicidin “nature’s antibiotic,” and they believe that in the future the cathelicidin gene may form the basis for new immune-based therapies.  Vitamin D “turns on” this gene.

Since an estimated 70 percent of Americans have far less than optimal levels of vitamin D, and nearly a billion people worldwide are vitamin D deficient, the Oregon State researchers warn of an impending public health problem, in both developed and developing nations.

The second example has to do with cognitive decline.  Recently, a study in the prestigious Archives of Internal Medicine found that adults with the lowest levels of vitamin D were most likely to have higher levels of cognitive decline as they age8.  Does this mean vitamin D supplementation will protect you from memory loss?  We don’t know for sure, but we do know that not having enough D in your system increases the risk for just such problems.

The third example connects optimal vitamin D levels with greater success on a weight-loss program.  Researchers measured circulating blood levels of vitamin D in overweight women and men both before and after they followed an 11-week diet plan consisting of extreme calorie reduction (750 calories a day!).  You would expect just about everyone to lose on such a restrictive number of calories, and most did.  But the researchers found that “pre-diet” levels of vitamin D predicted weight loss success.  For every increase of 1 ng/mL (a tiny amount) in blood levels of vitamin D, folks ended up losing almost a half-pound more on their calorie-restricted diet9.

In addition, higher baseline values of vitamin D in the blood predicted greater loss of abdominal fat!

Finding the Right Dose…

 

So what is the optimal level of vitamin D anyway? Well — not surprisingly — there’s some dispute about this.  Dr. Grant says it should be “at least 40-60 ng/mL.”

According to Dr. Grant’s research10, raising serum vitamin 25(OH)D levels to 40 ng/mL could reduce mortality rates by 15 percent in the United States, corresponding to a two-year increase in life expectancy.

The vitamin D council thinks 50 ng/ml is the minimum acceptable level, and that optimal levels are between 50 ng/ml and 70 ng/ml.*  (This is in line with what most experts I know believe to be ideal.  Many of them use 70 ng/ml or 80 ng/ ml as the optimal goal.)

It’s impossible to get anywhere near that number without supplements.  And there’s virtually no chance of achieving it with the paltry 600 IUs a day recommended by the Food and Nutrition Board (FNB).

According to vitamin D expert Zoltan Roma, MD, MSc, author of “Vitamin D: The Sunshine Vitamin”:  Research now indicates that the correct figure for the minimum daily requirement is 4,000 IUs,” adding that “it will probably take another decade before the government nutritional authorities acknowledge this fact and recommend higher vitamin D intakes for the population.

The Question of Toxicity…

 

This brings us to the issue of toxicity.

The FNB also reported that vitamin D toxicity might occur at an intake of 10,000 IU/day (250 micrograms/day), although they could produce no reproducible evidence that 10,000 IU/day has ever caused toxicity in humans. Also, only one poorly conducted study indicated 20,000 IU/day may cause mild elevations in serum calcium, but not clinical toxicity.

In an excellent review of all the literature on vitamin D, Reinhold Vieth, PhD, professor in the Departments of Nutritional Sciences, Laboratory Medicine and Pahtobiology of the University of Toronto, had this to say:

Throughout my preparation of this review, I was amazed at the lack of evidence supporting statements about the toxicity of moderate doses of vitamin D.”  He added: “If there is published evidence of toxicity in adults from an intake of 250 ug (10,000 IU) per day, and that is verified by the 25(OH)D concentration, I have yet to find it11.”

Vieth reports human toxicity probably begins to occur after chronic daily consumption of approximately 40,000 IUs a day (about 100 of the typical 400 IU capsules).  Dr. Rona says, “Real toxicity begins at 40,000 IUs a day after only many weeks of use.

Let’s remember that the body itself will easily make 10,000 IUs a day in a few hours in the sun.  As one cynic commenting on the new report put it, “I guess they think God doesn’t know what she’s doing.”

It’s very disheartening that this report, which has been horribly reported by the mainstream media with headlines like “vitamin D can be dangerous,” will probably scare off many people who would benefit enormously from supplementing with this important nutrient.

I consider vitamin D right up there with fish oil as one of the most important supplements to take on a daily basis. I strongly suggest you pay no attention to this report, especially if you’re reading about it second hand from the mainstream media who have demonstrated a shocking indifference to its limitations (if indeed, they even understand what those limitations are to begin with).

This is yet one more sad example of the “conventional wisdom” being anything but wise.

*Remember that there are two ways to measure vitamin D in the blood; don’t confuse the measurements.  In the U.S., we usually use ng/ml, but the international measure is nmol/ mL.  So if someone tells you their level is “50,” be sure to ask which measurement they’re using.  (A measurement of 50 ng/ml is equal to 124.8 nmol/L.)

Jonny Bowden, PhD, CNS
Also known as “The Rogue Nutritionist,” Bowden is a board-certified nutritionist with a master’s degree in psychology; the best-selling author of twelve books including Unleash Your Thin, The 150 Healthiest Foods on Earth, Living L...[ read more ]

References:

1http://www.vitamindcouncil.org/grant-statement-fnb-vitamin-d-report.shtml

2http://archinte.ama-assn.org/cgi/content/abstract/168/12/1340

3http://jcem.endojournals.org/cgi/content/full/92/6/2058

4http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645652/

5http://www.medscape.com/viewarticle/513634

6http://www.ncbi.nlm.nih.gov/pubmed/17452740?ordinalpos=28&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

7http://www.medscape.com/viewarticle/712847_3

8http://archinte.ama-assn.org/cgi/content/abstract/170/13/1135

9http://www.medicalnewstoday.com/articles/153669.php

10Grant, WB.  In defense of the sun: An estimate of changes in mortality rates in the United States if mean serum 25-hydroxyvitamin D levels were raised to 45 ng/mL by solar ultraviolet-B radiance.  Dermato-Endocrinology.  2009;1(4):207-14

11http://www.ajcn.org/content/69/5/842.full

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  • Hope Damon

    I thoroughly agree with the article’s conclusions but as a registered dietitan, strongly disagree with your statement that dietitians only evaluate nutrient intake to prevent deficiency states. Most dietitians are far more proactive than you believe – we routinely help people to act to be well, not just be absent of disease. We do value getting as much nutrition from whole food sources as possible but I certainly recommend supplements when it is not reasonable to get an adequate nutrient intake from food. I have many discussions a day recommending that people get their D level checked and supplement accordingly. Hope Damon RD, CDE, LD

  • Jnkingwood

    I thought the controversy was the use of vit d with calcium

  • Rhoda Lerman

    I keep hearing that vit D is dangerous if you don’t take calcium with it. Do you know anything about that warning?

  • Kathyldb

    Thank you for this information. I have Fibro and a few other things and the rheumatologist said to take 12,000 IU’S so I feel better now knowing that there would be no toxicity at that level.

  • Jim Callas

    Rhoda, it’s the other way around – need VitD to absorb Calcium otherwise tissues/organs may become calcified.

  • Willy C

    This article is quite misleading. Vitamin D from sunshine is never toxic. The body uses only the amount it needs and the rest is discarded. Vitamin D from pills add vitmain D to the metabolic process regardless of whether the body needs it or not. And even small amounts (over 600 IU in some people) can cause calcium to increase excessively in soft tissues, which is one of the precursors to cancer, arthritis, heart disease and most other degenerations. Certainly I’m all for people using 5000 IUs for a short period of time, but if used persistantly over many months and years, the health risks can increase dramatically. Note also that without vitamin K2, sufficient magnesium, and a host of other nutrients, none of the calcium that vitamin D puts in the blood makes it into the bones. All these people who are being encouraged to take massive Vitamin D nowadays without the necessary cofactors of metabolism may encounter surprisingly unhealthful results.

  • Guest

    In the last comment, you use nmol/mL and nmol/L. Which one is it? (I’m a chemist, and can figure this out, but others may not be able to–you should clarify.)

  • http://naturalhealthsherpa.com Natural Health Sherpa

    The correct dosage is nmol/mL. Thanks for asking…sorry for the typo.

    Naturally yours,

    The Sherpa

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Hope,

    Thank you for your amazing service to your clients!

    Naturally yours,

    The Sherpa

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Vitamin D, calcium, and magnesium (as well as vitamin K2) are all needed for optimal bone health.

    Naturally yours,

    The Sherpa

  • Steve

    I want to take vitamin D but I form kidney stones, and have been told that vitamin D promotes stone formation. What do scientific studies show about this?

  • Roijb

    If you are going to refute information presented in an article then at least provide credentials that show you are qualified to do so or provide research to verify your statements. Otherwise it is merely your opinion or hearsay that you are repeating with no foundation.

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Dear Willy,

    We have not been able to find a single, peer-reviewed study indicating toxicity in humans taking supplemental vitamin D at up to 10,000 IUs a day. If you have or can point us to a study that shows how “health risks can increase dramatically,” we would be very interested to read it.

    As to your other point, that vitamin D should (like so many other nutrients) be taken in combination with other, supportive nutrients is entirely correct. When it comes to bone health, vitamin D should be taken with calcium, vitamin K, magnesium, boron, etc.

    Naturally yours,

    The Sherpa

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Kathy,

    You are welcome. If you are worried about the 12,000 IU, start with 10,000 IU and see how you feel.

    Naturally yours,

    The Sherpa

  • Ted

    thank you for a wonderful article.

    As far as calcium is concerned, Google Vitamin K2 mk 7.

    It will point to studies that with sufficient K2 supplementation (or via Natto, a fermented food) the calcium will be removed from arteries and used in the bones. Of course, this assumes adequate magnesium, strontium and manganese intake from food. Bottom line, a processed food diet short of micro-nutrients leaves you vulnerable.

    Please be aware that when articles mention vitamins like D, K, E and others, these are a “grouping classification”, like the word dog. And just like a Poodle is a different animal than a German Sheppar though both are dogs, so too vitamin K1 and K2 are different and perform different functions. Likewise, D2 and D3 are different. Again, there are many different forms of vitamin E, which perform differently inside a human body. Even with vitamin K2, the mk2 and mk7 sub categories perform differently in a human body. Beware oversimplification!

    Ted

  • Dovelaugh

    Hope…..I wish we had a dietitian like you at our Cancer Center. No mention was ever made of checking Vitamin D levels or any other nutrient level for that matter. Now, I will know to ask next time we are there. None of the doctors, including the Naturopath, in our “Circle of Care” mentioned or offered this testing either, despite their direction, knowledge & support (of some) of my husband’s supplement intake. Thanks for your direction, Joyce

  • Loumi

    I wish you would specify the difference between Vitamin D and D3. Many recommends Vitamin D3 which is of much better quality and efficiency.

  • Mary

    One of the physicians who disparages the taking of Vitamin D (Dr. Jones) is one of the designers of a synthetic Vitamin D in Canada that will be aimed at people on dialysis. Those people on dialysis are commonly given 50,000 IUs of D so maybe we should rethink 800 IUs being harmful.

    I will probably stick with my 2,000 IUs of D3 plus other supplements.

  • Heather

    First off, great article. Timely and important. A few comments:

    -A-

    Be careful with the units for circulating 25-hydroxyvitamin D. You have used ng/mL in the article and have noted that the other unit of measure that is commonly used is nmol/L. You correctly also state that they are not equivalent – 1ng/mL = 2.496 nmol/L but you have incorrectly stated some recommendations by using them interchangeably.

    You wrote: “The vitamin D council thinks 50 ng/ml is the
    minimum
    acceptable
    level, and that optimal levels are between 50 ng/ml and 80 ng/ml.*
    (This is in line with what most experts I know believe to be ideal.
    Many of them use 70 ng/ml or 80 ng/ ml as the optimal goal.)”

    However, expert consensus papers typically cite 75-100 nmol/L (30-40ng/mL) as the target dose for minimum circulating 25(OH)D concentrations (1-3). I know of absolutely no experts who have published recommendations of 70 or 80 ng/mL (which would be as a target of 175 – 200 nmol/L). Rather, 70-80ng/mL would be better thought of as the upper limit of the “normal” physiological range of 25(OH)D.

    ——————————

    References:

    1. Dawson-Hughes et al., Osteoporosis Int 2005

    2. Bischoff-Ferrari et al.
    J Steroid Biochem Mol Biol 2007

    3. Souberbielle et al. Autoimmune Rev 2010

    4. Bischoff-Ferrari et al., Osteoporosis Int 2010

  • Heather

    There is absolutely no published, per-reviewed evidence to support any toxicity of supplemental vitamin D (in doses described by the Sherpa) taken without calcium. Both vitamin D and Calcium are essential nutrients and by optimizing your vitamin D intake, you will optimize you body’s absorption and utilization of dietary Calcium.

    When it comes to safety of supplemental Calcium, note that the jury is still out with regards to its safety in doses above 500 mg. At this point, taking supplemental vitamin D while trying to optimize dietary intakes of Calcium is the safest bet.

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Heather,

    Thank you for your great insight. We will check with Mr. Bowden for his thoughts and either post here or amend that sentence in the article.

    Naturally yours,

    The Sherpa

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Loumi,

    Yes, D3 is the way to go.

    Naturally yours,

    The Sherpa

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Ted,

    Thank you for your very well-explained comment. Indeed there are differences within each vitamin type and we will be sure to clarify in future articles.

    Naturally yours,

    The Sherpa

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Ted,

    Thank you for your very well-explained comment. Indeed there are differences within each vitamin type and we will be sure to clarify in future articles.

    Naturally yours,

    The Sherpa

  • http://twitter.com/healthpls Dave’s Grand Babies

    Cardio Protegen™ – A Foundation of Good NutritionLook at the ingredients and see why this premium product attracts customers for life. Has 5000 iu of  Vitamin D3

  • Patricia143

    Loved this artical, I am a 67 year old female and have been taking 10,000 IU of vitamin D on a daily basis in 2 divided doses. 5000 IU in the morning and 5000 IU before bed. I feel great have good energy, and have not seen any evidence in mental decline or any adverse symptoms. I have taken this dose for a few years. I also take fish oil every day along with other good nutrients to prevent declining health.

    Patricia 

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Patricia,

    Fantastic! Congratulations for taking control of your health!

    Naturally yours,

    The Sherpa

  • Dr. James Flannick

    Excellent article — thank you so much! I particuarly liked how well-written and researched it is.

    Two winters ago I took 2600 IU / day of vitamin D, and last winter bumped that to 4600 IU. I had no major illness either winter, which is very unusual, as I teach large classes at a university where many of the students are coughing and sneezing.

    I also noticed my mood was significantly better both winters. Given this personal experience, I have become convinced of vitamin D’s benefits. One can read all the research one wants, but when you experience the benefits first-hand as I have, you become a believer and advocate.

    In addition to teaching full-time at the university, I also am a licensed psychologist in clinical practice. I put many of my clients on supplements (especially fish oil, the B and C vitamins, the minerals calcium, magnesium, and zinc, iron for women), and now have begun to include vitamin D in their regimens in winter. This past year I noticed in one client in particular — whose mood had responded very nicely to fish oil — that she got additional signficant benefit from vitamin D.

    So again, thank you for this report, and for saving us from Effexor, Paxil, Zoloft, Prozac, Celexa, et al.!

    God’s blessings,

    Dr. James Flannick

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Thank YOU Dr. Flannick! And keep up the great work.

    Naturally yours,

    The Sherpa

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Thank YOU Dr. Flannick! And keep up the great work.

    Naturally yours,

    The Sherpa

  • Anonymous

    Wow …. This one is really mind blowing tips regarding Vitamins D. It is a great for Boosts the immune system,provides calcium balance in the body and Normalizes insulin secretion. It recommended in the treatment of several diseases.

  • Anonymous

     I like this post regarding Vitamin D. Vitamin D is really good for health. It boost our immunity,good for metabolism,one of the only vitamins produced naturally by the body.It is most famous for muscles and bones contribution. 

  • http://naturalhealthsherpa.com Natural Health Sherpa

    We are glad you liked the article. We are big fans of vitamin D ourselves!

    Naturally yours,

    The Sherpa

  • bookworm worm

    Zinc helps build proteins and it is also needed to help keep the immune system running smooth.Zinc is one of a number of important mineral. Zinc supplement

  • http://www.angstrom-mineral.com Iron Mineral

    It can be very hard to get enough vitamin D from food sources alone. As a result, some people may need to take a vitamin D supplement. 

  • http://naturalhealthsherpa.com Natural Health Sherpa

    Iron,

    Yes, that’s correct. This is one of those cases where supplementation is likely needed to get the needed amount.

    Naturally yours,

    The Sherpa

  • Bevg33

    I have my blood work checked for thyroid maintenance every 3 months and always have Vit D levels checked, along w/other levels; my Vitamin D levels used to be really low, long story short increased dosage to over 10K I.U.’s/day and my levels are now where they are supposed to be; I currently take 9000 I.U.’s a day and my functional doctor (M.D.) says to keep it up. If I decide to spend a day in the sunshine I’ll decrease it for that day. I know someone who thought she was getting enough D from her foods and her multi (what a joke) and ended up w/breast cancer. My MD had known of the link between low D levels and breast cancer way before it became public knowledge…so take your D (make sure it shows it as D3 on the label) and take enough!!!

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