Should you be taking vitamin D3?

[drewab]

Here is a very interesting critique of Dr. Greger's vitamin D videos on nutritionfacts.org.

 

 

I'm such a huge Dr. Greger fan and have traditionally not been a fan of some of the critics of him around here (i.e. Michael Rae), but this one really caught my attention.

[TomBAvoider]

All vitamin and mineral (and other kinds of) supplements, follow a kind of graph, where there is initial high enthusiasm for a given supplement, seemingly convincing studies, a ton of hype, strong personalities involved in pushing (eg. Dr. Sinclair), money flooding in, supplement makers making a mint, and then the second phase where the supplement is shown to be basically worthless (except for perhaps cases of frank extreme deficiencies), and then often a third phase where the supplement is shown to actually be deleterious. At that point the hype dies down, but supplement sales continue, even if at a lower rate than before for that particular nutrient. That's also the story of vit. D. (for vit. C, the strong personality was Nobel prize winner L. Pauling).

 

What is more treacherous, is when the supplement in question is more obscure, so there simply are not enough studies being performed, but small groups of people have allegiance. Because the supplement is relatively obscure, there are not enough followup studies to go into the second phase of the process - the debunking, and worse, no third phase showing actual harm. That way, the partisans of the supplement experience real harm. One possible example might be vit. K2 - there are fanatical groups (such as perhaps a subset of CRONies), who are strong partisans. But K2 is still relatively obscure, so not enough debunking studies are undertaken, and the folks who take K2 supplements never find out if they are actually being harmed - as pretty much every other single vit. in megadoses has transpired to be.

 

That is particularly true for herbal supplements - the super popular ones eventually get enough research to move to the debunking and warning stages, but there are thousands of supplements that are obscure enough not to experience that life cycle, and so the users are never warned.

 

I guess the vit. D phase has firmly moved into the debunking phase, which took a few years. I think fish oil supplements are having their debuking phase at the moment. Which one of our favorites is next, and which ones will never be big enough to experience the benefits of research? Look at your supplement list, and wonder.

[drewab]

Tom,

 

You make some interesting points. Can I ask if you take any supplements?

[TomBAvoider]

I take the following, based on my own research, although I am under no illusion that in time, these might be - or should be - debunked.

 

Zinc

Grape Seed Extract

Curcumin

Iodine

Aged Garlic Extract

 

I am not promoting or recommending these for others - this is based upon my personal situation. F.ex. according to my promethease SNP readings, I am at relatively high risk of prostate cancer - hence grape seed extract, higher LDL cholesterol than I'd like, hence aged garlic extract etc. Plus, I monitor my bloodwork, and would not hesitate if f.ex. I was low in B12, I'd supplement with B12 for a limited time (though my B12 status is higher than normal). On the other hand, all my prostate readings, such as PSA are very low, and yet I take preventive measures in so far as I can. 

 

After all my supplement talk, here I am, taking a bunch - ok, so I contradict myself, I am large, I contain multitudes :)

[Sibiriak]

I don't think Jeff Nelson's question --should I be taking Vitamin D?--is the correct one.

 

Instead the question should be:   should I get  a 25(OH)D test , and if  I do and  the level is  seriously sub-optimal,  should I do something about it?

 

That question leads to a number of other questions, such as:

 

What is the evidence regarding the associations/causal relationships of  25 (OH) D  levels and various diseases/mortality?  Are  25 (OH) D tests reliable?   What is an optimal 25 (OH) D level?  What low or high levels  are seriously problematic?     What is the best way to increase levels--  sun exposure, vitamin D supplementation, diet ?  Is it necessary to take vitamin K2 along with Vitamin D?  How often should I be tested?  Etc.

 

See the Vitamin D Recommendations thread here:   https://www.crsociety.org/topic/11678-vitamin-d-recommendations/   (Michael Rae's input is on page 3.)

 

Note:  those questions are posed on the individual level.  There is also the society-level question of who should be tested as part of standard medical practice, taking in to consideration society-level cost-effectiveness issues.  See my post about the mainstream position on Vitamin D testing in the Basic Blood Tests thread:  https://www.crsociety.org/topic/16821-basic-blood-tests/?do=findComment&comment=29274

 

Toward the end of his video, Jeff Nelson  approvingly quotes Dr. McDougall:

 

There is no level of Vitamin D discovered by a blood test that would cause me as a medical doctor to prescribe vitamin D supplements to one of my patients.

 

That seems to me to be an extreme, ideology-driven position.  McDougall's answer to low vitamin D levels is simple:

 

I recommend people expose themselves to as much sun as tolerated. That may mean to let their skin become slightly reddish at times. Skin damage, however, must be avoided because serious precancerous conditions (actinic keratosis), skin cancers, and accelerated aging come from over exposure.

 

However, I don't think that prescription will work for everyone.   It certainly doesn't for me.

[mccoy]

Mc Dougall's position on all supplements represents one extreme of the whole gamut of opinions. 

Again, we have to gamble here and this is a personal decision.

Valter Longo's position is one of maximum entropy: as he hints at, since the literature is so divided and there is about 50% probability that taking supplements is good and 50% that it is bad, he proposes to take them 2 or 3 times per week.

A couple of years ago I was against all supplements. Now I revised my thoughts and include D3 supplements when the sunbathing season is over.

[Saul]

A wise decision; much more turu where I live, where due to lake effect, we get less sunshine than almost any other part of North America.  (But our abundant rainfall makes the area look like a lovely forest.)

  --  Saul

[Gordo]

Decent read:

Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It

The doctor most responsible for creating a billion-dollar juggernaut has received hundreds of thousands of dollars from the vitamin D industry.

[mccoy]

On the other side, impartial observators like Rhonda Patrick have supported the use of D3 supplements and the adoption of higher optimal values like 40-60 ng/ml.

While a consultancy position with the interested parties sure would suggest a lack of objectiveness, the figures (monetary gains) cited by the Kaiser Permanente study seem not to be so much elevated. I mean, after taxes, dr. Holick really did not take an obscene amount of money in relationship to the purported industry gains.

All other objections are of course sensible. A randomized controlled study like the one cited in the article is needed, we'll see the results.

[Todd Allen]

On 8/7/2018 at 3:17 PM, mccoy said:

A couple of years ago I was against all supplements. Now I revised my thoughts and include D3 supplements when the sunbathing season is over.

I try to take a mid-day 20+ minute daily walk with good skin exposure and I take D3 in the winter, roughly October-March here in Chicago, when there is less sun and sometimes less skin.   I also supplement K2.   Last  Sunday I inadvertantly got a full day of bright sun in shorts and a tank top, no hat or sunscreen (never use it anymore) and didn't burn.  Unimaginable a few years ago when I had to meticulously reapply SPF 60+ sunscreen every couple hours and would still get fiercely burnt patches that I failed to keep adequately slathered.

[mccoy]

3 hours ago, Todd Allen said:

I try to take a mid-day 20+ minute daily walk with good skin exposure and I take D3 in the winter, roughly October-March here in Chicago, when there is less sun and sometimes less skin.   I also supplement K2.   Last  Sunday I inadvertantly got a full day of bright sun in shorts and a tank top, no hat or sunscreen (never use it anymore) and didn't burn.  Unimaginable a few years ago when I had to meticulously reapply SPF 60+ sunscreen every couple hours and would still get fiercely burnt patches that I failed to keep adequately slathered.

Todd, interestingly, I've been suffering that same problem, oversensitivity to UV rays, for many years. Up to a couple of years ago, when I started changing my dietary habits. It may have been lack of optimum pyridoxine and niacine, or some other nutrients.  I still wonder what it may have been. The cited main ingredients for melanine production AFAIK are tyrosine, copper, B6.

Also, this year I've been working at home and had a chance to sunbathe in swimtrunks out in the garden at midday almost every day across the solstice, up to 2 hours. Plus weekends at the beach. The fact that this intense exposure to UVB rays resulted in a modes 30 ng/l blood D3 suggests that the high optimum values often suggested in the internet are mere theoretical speculation. My present thought is that, since the body by photosynthesis produces only the needed amount of D3, nothing in excess, that's my optimum amount, no less, no more. Individual rvariability in requirements must be very high.

[Saul]

Hi Mccoy!

Most of us probably eat a lot of vegetables rich in carotenoids -- examples are romaine lettuce, bell peppers, carrots -- in fact, most of the color in vegetables comes from carotenoids.

Carotenoids protect the vegetables from the sun.  If you consume enough caretonoids (and many of us do), your skin will be discolored with an orange-like hugh -- often mistaken by non-CR knowledgeable physicians as jaundice. 

Your ingested carotenoids may be protecting your skin from the sun. 

  --  Saul

[Sibiriak]

Mccoy,  studies of lifeguards an other  outdoor workers  have shown that it is in fact possible to get very high D3 levels without taking supplements.  30 ng/l  is a very reasonable level,  given the uncertainties involved. 

Chris Masterjohn has discussed D3 levels in several articles,  emphasizing the impact of calcium intake.  (I'm not a great fan of CM's  dietary preferences, and I believe he has a propensity to cherry-pick evidence ala Greger-- I'm linking the articles/podcast out of convenience,  not having time to pull up the studies myself and produce some  coherent commentary.)

An Ancestral Perspective on Vitamin D Status, Part 1: Problems With the “Naked Ape” Hypothesis of Optimal Serum 25(OH)D [2013]

https://www.westonaprice.org/an-ancestral-perspective-on-vitamin-d-status-part-1-problems-with-the-naked-ape-hypothesis-of-optimal-serum-25ohd/

An Ancestral Perspective on Vitamin D Status, Part 2: Why Low 25(OH)D Could Indicate a Deficiency of Calcium Instead of Vitamin D [2013]

https://www.westonaprice.org/an-ancestral-perspective-on-vitamin-d-status-part-2-why-low-25ohd-could-indicate-a-deficiency-of-calcium-instead-of-vitamin-d/

The Evolution of Diverse Vitamin D Requirements [2016]

https://chrismasterjohnphd.com/2016/08/20/the-evolution-of-diverse-vitamin-d-requirements/

 

 

[mccoy]

@ Saul: yes, carotenoids and probably other synergistic protecting molecules might do the difference. Previously I was consuming vegetables but not so many green and red leaves. I believe that might be the main difference, due to I don't know which compounds. Together with more B complex vitamins. Copper was not the most likely problem.

@Sibiriak: thanks for the links, going to study them, as much as I noticed, CM appears to support an omnivore diet but has no problems in suggesting a vegan diet for cancer prevention for example. He's apparently more into biochemistry, metabolism and objectivity than advocacy (except his sponsoring of organ meats!).  In a few words, he's a nutritional consultant and caters to all tastes, no clients left behind. Maybe he evolved into a more objective outlook...

[Genny]

just as a FWIW....

I don't know what else curcumin does, but as a selective COX2 inhibitor, it works.  It's not FABULOUS, but it's better than aspirin.

Aspirin at even baby doses makes my blood vessels leak like a sieve at the slightest bump, so I don't like taking it daily.  It seems like a good idea for people who might benefit more directly than for me.  I'm seriously concerned about the raised chances of stroke on low dose aspirin given my reaction.  At higher doses, it also trashes my GI tract.  So curcumin is the perfect mild daily pain reliever for me.

It is also the only thing that I've every taken that dramatically reduces my DOMS.  Shockingly so.

[Clinton]

Hi Genny -

What brand of curcumin are you using?  Is it Webber (which contains Meriva) ??

I can get this for a decent price at Costco ;-) 

Thanks,

Clinton