Dear Subscriber,
Here is a very recently published report on the use of vitamin D supplements. There has been a hot controversy in the medical world about vitamin supplements. Most orthodox doctors will tell you that vitamins are a waste of money – just eat a good diet, and without telling you what is a righteous diet. I am bringing this forward as a hard example not to believe anything the orthodox doctors tell you about medicine being a science. Medical thought changes all the time. What we believe today could be tossed out tomorrow. Doctors like me, who have practiced the medicine of tomorrow have often been disciplined, even loss of license, for being ahead of our time. In the case of vitamin D, the integrative doctor has been far ahead of his time.
Conventional medical DOGMA says the RDA of this essential substance is some 800 IU daily. The conventional doctor is happy if your blood level is, say, 30 ng/ml. The “reference range” can be as low as 20. If you are at 25, your doctor is “not concerned”. That is how medicine has been practiced in the West for scores of years. And, if the doctor wants you to take D, he recommends the paltry RDA, which is not “optimal” range.
I am pasting a report on vitamin D that defies decades of conventional dogma on the subject. It appears now that the recommendation for vitamin D will be bumped to 2000 IU daily. That said, I’ll add that I’ve written over the years that I have regularly used a minimum of 5000 IU daily, and often 50,000 IU twice weekly. I like our clients to have a level AT LEAST 40, and prefer levels of 60-80. Vitamin D is not just a vitamin. It is a hormone that bears very significant effects on bone strength, calcium absorption, but perhaps even more misunderstood – effects your immune system significantly, your vascular system.
Now the matter boils down to logic. Our vitamin D comes from natural sunlight striking our exposed skin and activating cholesterol, a sterol, in your blood to vitamin D also a sterol. Problem is, in the winter, the sun is not high enough in latitudes north of Boston, or even San Francisco, to contain enough ultraviolet frequency to make any vitamin D for months. Hence, your blood levels will gradually fall into spring. This can have detrimental effects on much of your physiology.
Vitamin D issues are very individual. Dark skinned people will make less, obviously because the increased melanin in the skin will absorb the UV rays of the sun which does the cholesterol conversion to vitamin D. Most people (especially African Americans) I’ve measured, including myself, will be on the low end by early spring. Is it any coincidence that flu and cold illnesses frequent the winter, when sun is low and vitamin D plunges?
I have measured before and after vitamin D supplementation on scores of patients taking 5000 IU per day. Levels typically rise from an initial 30 or lower to the range I prefer: 60-80. I am talking with colleagues now who prefer a level closer to 90-100. As I mentioned, we often give 50,000 units twice weekly. Again, I’ve not seen issues with overdosage at that level either. If you are African American or darker skinned, vitamin D can be a real issue. Most I have checked in late winter/early spring are significantly lower than I’d like, and even lower than the low end of lab reference range.
If you are interested in ordering the vitamin D3 I use, you can get it from Pure Encapsulations. It is suitable for me as a vegetarian. The vitamin D3 is not from fish oil but from sheep lanolin. That is the oils that sheep secret onto their wool where it reacts with the sun and the sheep lick it to get their vitamin D, and the oils harvested for us from their wool. The sheep are not injured, unless you consider shearing their wool a problem. (I wear a lot of wool clothing). This product is then placed in vegetarian capsules. You can get a 10% discount on any Pure Encapsulation product by going here: https://patientdirect.pureencapsulationspro.com/patients/sign_up. Then enter code 856612. That will give you discount access not just to vitamin D but to any of their products. We do not recommend any vitamin D2 product.
Please enjoy this report and consider what is right for you. And don’t forget, medicine is not a “science” as your brainwashers would have you believe. It is an “applied science”. Every one of us is different from the next, and that includes identical twins.
To Your Excellent Health,
Robert Jay Rowen, MD
https://www.news-medical.net/news/20240131/New-study-recommends-2000-IU-daily-vitamin-D-supplementation.aspx
New study recommends 2000 IU daily vitamin D supplementation
By Neha MathurJan 31 2024Reviewed by Lily Ramsey, LLM
In a recent narrative review published in Nutrients, researchers discuss the evidence arguing for the efficiency and safety of 2000 international units (IU), i.e., 50 micrograms (µg) of vitamin D supplementation per day to prevent and treat vitamin D deficiency in the general adult population.
Study: Vitamin D Supplementation: A Review of the Evidence Arguing for a Daily Dose of 2000 International Units (50 µg) of Vitamin D for Adults in the General Population. Image Credit: FotoHelin/Shutterstock.com
Background
Vitamin D deficiency has many adverse clinical consequences, including poor musculoskeletal health, manifesting as diseases like rickets and osteomalacia.
Moreover, vitamin D may be crucial for preventing extra skeletal diseases like cancer and diabetes.
Vitamin D is biologically inactive in the human body; thus, in laboratory detection of vitamin D deficiency, they measure serum concentrations of 25-hydroxyvitamin D (25(OH)D), a vitamin D metabolite utilized by the body and that reflects the overall supply from different sources, including ultraviolet-B (sunlight) and food sources, such as fish or mushrooms.
Worldwide, the prevalence of low serum levels of 25(OH)D, i.e., below 25-30 nmol/L and 50 nmol/L, occurs in ~5-18% and 24-49% of people, respectively, underscoring the need for prompt action to reduce vitamin D deficiency burden globally.
At a dosage of 50µg per day, the whole 25(OH)D distribution of a given population could rise to higher levels; however, there are safety concerns with such dosage as it may also increase the risk of vitamin D overdosing for those at the higher end of the distribution.
Moreover, given the extra skeletal health effects of vitamin D, it is crucial to focus on the attainment of 25(OH)D levels needed to prevent them rather than safety concerns for targeting 75 nmol/L (30 ng/mL), which are optimal target serum 25(OH)D concentrations for skeletal health.
So, researchers additionally investigated whether attaining serum 25(OH)D levels ≥50 nmol/L should be the target.
Current Vitamin D supplementation guidelines
Guidelines for vitamin D intake establish target serum 25(OH)D concentrations and recommend the required doses to achieve those levels, assuming adequate intake of other nutrients and seasons (winters or summers).
Accordingly, current guidelines recommend a daily vitamin D intake of 400-800 IU; however, individuals from different ethnicities or regions may require even higher intakes of 2008-2672 IUs for attaining 25(OH)D serum levels of ≥50 nmol/L.
What should be the target serum 25(OH)D levels: 75 nmol/L (30 ng/mL) or 2000 IU (50 µg)?
Many observational studies have suggested that while ≥50 nmol/L serum 25(OH)D levels can prevent rickets and osteomalacia, concentrations ≥75 nmol/L are needed for improved health outcomes in diabetes and cancer.
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The optimal concentration needed may also vary depending on the study population and outcome of interest.
Further, the authors noted that randomized controlled trials (RCTs) testing 25(OH)D needs may be biased towards healthy people who may not accurately represent the general population, especially those with obesity.
In fact, optimal serum 25(OH)D concentrations for most chronic diseases are slightly above 75 nmol/L (30 ng/mL).
Thus, obese individuals, individuals with higher body mass index (BMI), and patients with malabsorption syndromes may require higher doses of vitamin D to increase their serum 25(OH)D levels.
Some may not meet the threshold even after supplementing with daily 2000 IUs of vitamin D, like patients with inflammatory bowel disease during episodes of high disease activity.
Even medications, like antiepileptic drugs, can affect lower serum 25(OH)D concentrations by modulating its metabolism.
When serum 25(OH)D concentrations exceed 150 ng/mL, vitamin D toxicity may lead to hypercalcemia; thus, clinicians advise caution for those on vitamin D supplements.
Recent RCTs like the Vitamin D and OmegA-3 Trial (VITAL) gathered safety data on using 2000 IU of vitamin D/day in general adult populations who showed no signs of vitamin D toxicity for 5.3 years, indicating the safety of this daily dosage.
Further, a meta-analysis of 15 vitamin D RCTs found no increase in kidney stones when supplementing with ≥70 µg of vitamin D for at least one year.
Another meta-analysis found that daily vitamin D supplementation of 3200-4000 IUs for six months increased the risk of hypercalcemia, hospitalizations, and falls; however, this did not occur in chronic kidney disease patients.
Conclusions
Adherence to conservative dosing regimens not exceeding 800 IU (20 µg) of vitamin D per day may not sufficiently treat vitamin D deficiency, considering the heterogeneity in inter-individual dose-response and accounting for the multiple clinical factors involved, such as obesity, malabsorption syndromes, and medications that impair vitamin D metabolism.
This review revealed that daily vitamin D supplementation was more effective than intermittent bolus dosing in adults. However, precaution is needed for older and diseased individuals, who are more prone to adverse effects of vitamin D overdosing.
In real-world settings, clinicians should consider tailoring the vitamin D dosage according to the patient's needs and characteristics.
Instead of following the 'one-size fits all' approach, they may adopt a personalized treatment approach and prescribe a dosing range from 800-2000 IUs (20-50 µg).
It is a narrative review lacking a pre-registered systematic review. Yet, based on the evidence outlined in this review, the authors argue in favor of a daily vitamin D supplement dose of 2000 IU (50 µg) to raise and maintain serum 25(OH)D concentrations >50 nmol/L (20 ng/mL) and >75 nmol/L (30 ng/mL) in >99% and >90% of the general adult population, respectively.
Furthermore, they found no significant safety concerns in supplementing such a dose for several years, even in individuals with a sufficient vitamin D status at baseline.
This could be the perfect remedy for addressing the vitamin D pandemic in the general adult population.
Journal reference:
Pludowski, P., Grant, W. B., Karras, S. N., Zittermann, A., & Pilz, S. (2024). Vitamin D Supplementation: A Review of the Evidence Arguing for a Daily Dose of 2000 International Units (50 µg) of Vitamin D for Adults in the General Population. Nutrients, 16(3), 391. doi: https://doi.org/10.3390/nu16030391. https://www.mdpi.com/2072-6643/16/3/391
Pure Encapsulations also makes a combined D/K2 product: https://www.pureencapsulationspro.com/vitamin-d3-with-k2.html
All these should be taken with food, in my opinion, as they are fat soluble and best fat absorption is with a meal when your gall bladder kicks in.
Thank you. I agree. K2 is important as is vitamin A. A and D compete for absorption. There is a product that has them all from Allergy Research Group called Full Spectrum K. I like it. You can get a discount from the company on all their products using 10-0051. It has all the fat soluble vitamins. I also take micellized vitamin A specifically for my eyes.
There are other products containing D and K2. This post was devoted to just D due to the recent report. Many people will need to have individualized doses depending on their underlying conditions.