lol, well written doc. i miss pizza and naan.

i have been grain free for almost 4 years now.  just got my LDL particle size tested and was surprised to see i was predominately small particle.  i eat pretty low carb with very little sugar.

Hi, my name is Marie-Anne.  I am a carbivore - a whole grain junkie with a sweet tooth to boot.  Changing is hard but your blog is very helpful and informative, thank you!  Now if only I could get the rest of my household on board.

We tested einkorn flour to see how it would elevate blood sugar.

Einkorn wheat bread:

Blood sugar pre: 154.8 mg/dl (8.6 mmol/L)

Blood sugar post: 160.2 mg/dl (8.9 mmol/L)

Convention wheat bread:

Blood sugar pre: 149.4 mg/dl (8.3 mmol/L)

Blood sugar post: 190.8 mg/dl (10.6 mmol/L)

Post was based on 1 hour 15 minutes.  Quanity was about 1 oz.  (a slice of white bread)

Has anyone tried using Einkorn in any of the other ways
that wheat flour is commonly employed,
like as a thickener for sauces or in making noodles?

By the way, has Barley also gone through the mutations that wheat has?

Regards,

Scott

I would be curious if this were true of the "ancient" grains showing up in the bread aisle.

Thank you for cotinuing to remind us why wheat is not healthful.  I have been trying to give it up completely for about a year.  Gluten-free foods tasty gritty and chalky, not spongy and chewy like wheat, so wheat-free means no pastries or breads.  I picked the most challenging time, the month of December, to try again to banish wheat from my diet.  If I can get past Christmas without eating a cookie or cranberry-walnut scone, I'll have unacquired my acquired taste for wheat.  As an added bonus, my consumption of added sugars in any form will be zero since most of it came from pastries and sweet snacks.

Where do I find einkorn?  I've not been eating grains for about 3 months now, but I'd like to have something occasionally.

Re:  According to Dr. Allan Fritz, Professor of Wheat Breeding at Kansas State University, and Dr. Gary Vocke at the USDA,...

Have they got any hard data (and willing to make it public) that would allow statistically correlating the rate of coronary heart disease with the spread of this breed of wheat, historically and across various areas of the Earth?  

I wonder if they use the same variety in France and in other low heart diase countries?

If that dwarf variety of wheat is really more harmfull than the old wheat, that could perhaps explain the sudden onset of heart disease among the population of the UK and USA in the 1920-ties, and in other countries after 1945?

Stan (Heretic)

Would you add beer to this list?

http://www.stltoday.com/news/local/obituaries/article_3af7cf24-af69-50f6-8d70-20ac78da15e9.html

Thought you might have something to say about his "egg white and granola" diet.

Chuck...what were the specific test results that you received?

Hi, Vick--

That's what I would have expected, though I'm a bit surprised that the standard wheat didn't send blood glucose even higher.

Experiences like yours make me more hopeful that einkorn may indeed be a reasonable alternative for some people.

Judy-

Try the Jovial brand pasta at Whole Foods.


Stan--

Great question, though I doubt it. We would probably have to perform the correlation ourselves, since their focus is not health, but agriculture.

I have finally found a substitute for toast/ bread at breakfast--organic green beans with organic butter from grass-feed cows. So far, I am not missing the wheat and the beans are very satisfying.

I will have unacquired my acquired taste for wheat. As an added bonus, my consumption of added sugars in any form will be zero since most of it came from pastries and sweet snacks.

some nit-picking: traditional pumpernickel is made from rye exclusively (at least in my part of the world where it originates). So, this has been dwarved, too, I am aware, but it ain't wheat. Period.

I tried the jovial "spirals" last week. Starting blood sugar  86. 2 hours later blood sugar 91. Gluten destroys my digestion but several days later no noticeable change in digestion. I plan on testing it again this week. One year of grain free lowered my average blood sugar from 124 to 86. our blog was a great resource. Thanks Doc!

I worked on a wheat farm in the early 70's. The shorter varieties raised the yield per acre because they put less energy into building stalk, and were less likely to fall over during high winds and become difficult or impossible to harvest. Nothing nefarious, just practical. Also around that time the Russians, who were huge importers of wheat, started paying for the protein content rather than just by volume. High protein yield became important as a result.

Other than the dwarfing mutation, which seems to be a symptom rather than a cause, what changes have taken place in the dwarf mutant wheat, especially chemically and nutritionally?

Speaking of costs ...
my own CEO of my own HMO (I live in this quite stupid country now) "made" in 2007 over 1 BILLION and nobody investigated the deaths.

Wow, a miraculous disappearance of intelligent posts.

Anonymous--

I didn't think that penis enlargement ads were "intelligent." I can forward them to you if you'd like.

Also, I think you meant "curious," not miraculous.

Even organic whole wheat suffers from "genetic manipulations"? Really?

Dr Davis, interesting study. But both links go to the same study, Nilsson 2004, shouldn't the second link go to second study?

Hi, Prague-

Absolutely right. Thanks for catching that.

Actually, both observations were best made in the same study. While the effect of milk on insulin secretion is firm, the question of cheese has not been as well explored. There's also the possibility that, because cheese is like wine in that there are thousands of variations (organism chosen for fermentation, fat content, etc.), there might even be variation from cheese to cheese.

I would assume that heavy cream devoid of proteins and carbohydrates would result in less area under the curve?  Are there any studies of this?

How can you have a test meal of cod which contains the same carbohydrate count as a reference bread meal when cod has no carbohydrates?

But I'm not sure why they used reconstituted milk. Why not normal (3.5%) milk, or perhaps normal and skim? They do say, "Interestingly, there is epidemiologic evidence suggesting that overweight subjects with a high intake of milk and dairy products are at a lower risk of developing diseases related to the insulin resistance syndrome" Perhaps because the SFA content?

I know that a tall glass of milk can surprisingly jack up blood sugar, and they say that "The insulin response to milk products does not relate solely on the lactose component." Interesting. Still, much better a glass of milk than a glass of apple juice.

Hi, Stephen--

Yes, crucial distinction. To my knowledge, that has not been done, though I would fully expect that there is no effect.

Hi, Brent--

The cod must have been breaded. The cod they used was purchased in a grocery store.

What about the recent information on trans-palmetic (spc) acid formation being BENEFICIAL to diabetes? More so, forms from raw, full fat dairy?

It would be interesting to see how different sources of milk influence insulin secretion. Aside from the distinct breeds of cattle many pastoralists use goat & sheep; plowmen milk  buffalo and some artic milking of reindeer (it takes 2 people, one to hold the horns).

My dairy consumption is in the form of Kefir "Quark". This is cultured milk that is then drained of it's whey. In the Mediterranean & Mid-east regions they use yogurt "quark"; but named differently by each culture in their own vernacular. In India it would be "curd", and usually from water buffalo milk.

"Quark" is a fermentation process byproduct and the minerals in milk are lost (soluble) in the whey. In other words, there is minimal calcium in "quark".(A few Posts back readers may recall Doc restricting calcium for reducing aortic calcification. Elsewhere, some men may recall having seen prostate studies suggesting excess calcium is not ideal.)

What about full-fat kefir? I no longer consume grains and eat raw cranberries as my small daily portion of fruit. But I will not give up my kefir even if it takes 10 years off my life! So be it.

Heck, no more yoghurt.I'll have to grind flaxseeds or eat eggs for breakfast.

What about heavy whipping cream?  It has low carbohydrate content and high fat.  Did the study differentiate between the different fat contents of milk/cream?

Don't forget "Butter and Insulin".

It was one of Dr. Davis' more controversial blog posts, especially among us butter lovers...

I'm also not quite so eager to throw out my whey protein and BCAA supplements either. Not when they provide the most bio-available protein that has long been proven to be beneficial for human muscle synthesis.  Why eliminate a dietary source that can help tip the balance toward a favorable muscle to fat composition ratio?... that in turn actually improves fat metabolism and insulin sensitivity?

Study used 28 gr. spray dried whey (among other items) that was reconstituted in 550 gr. water. It showed that whey had fastest uptake of insulin-otrophic (secretagogue) amino acids (namely leucine, valine, isoleucine, lysine and theonine).

Compared over 1.5 hours to same gr. weight of white bread (studies reference food) whey's insulin reaction was 90% greater. It's blood glucose however rose notably less than the reference food's blood sugar did.

I'd like to understand better the way insulin "spikes" have beneficial functions in non-diabetics. It seems to me that there may be times of day (circadian) when elevated insulin serves a signalling purpose; late night in front of the TV seems unlikely. Anybody?

Pretty damn depressing. Is it safe to breathe still? Can someone explain what the observed danger of eating Whey Protein actually is. This seems to be quite speculative.

Someone please correct me if I am mistaken - but I think that what this boils down to is the amount of lactose in a particular dairy product and would that not explain the difference between, for example, the effects of milk v.s cheese?

Hi Terry,
Cheese doesn't have the whey any more; it gets drained off. The whey proteins are the insulin spiker (Doc's post is on how insulin reacts). Milk's lactose (milk sugar) apparently has more to do with the way blood glucose (sugar)reacts to milk, irregardless of the milk still containing it's whey.

Did anyone actually read the study.  The cod was not breaded, they added lactose to each product to bring the carb count up to 25g, including the cod.

Also, yogurt is not mentioned at all in this study, so not sure why you are lumping it in here.

It would be difficult to design a diet using the II of these two papers, because their insulin index (II) is based on equal carb portions. Some foods do not have much carbs, so they add carb (lactose) to them.  A better table for a variety of foods is given in this  paper * where II is calculated based on equal calorie portions, so we know the weight of each portion (from Table 2).  In this paper the values for GI (glucose index) and II are (from Table 4)

Food
Weight gr
GI
II
White bread
Yogurt
Cheese
Eggs
Beef
94
241
59
159
158
100
62
55
42
21
100
115
45
31
51

(how do you paste atable here???)

Some of the GI of the protein-rich foods is due to  glucagon  which raises blood sugar levels by gluconeogenesis.  The GI and II of cheese, eggs and beef are not much different,  but for yogurt II is almost double of its GI.

* An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods
http://www.ajcn.org/content/66/5/1264.full.pdf+html

Don't forget they are testing isolated products for blood sugar impact. The impact will be blunted if combined with something that has that effect. Like adding eggs to a whey protein shake.

So the whey protein isolate (100%) protein that I add to my morning smoothie is causing an insulin spike?

My greek yogurt as well? (high protein, low carb)

I always understood that milk was high carb and would cause a spike, but these others are bewildering.

Bodybuilders favor whey protein for its insulin spiking properties. Their idea that the insuin drives creatine and amino acids to muscle tissue Ne c'est pas?

Could they be engaging in diabetogenic behavior?

These insulin-boosting properties of some foods (especially dairy, and yes, fish) appear to have been well known for awhile:

http://www.mendosa.com/insulin_index.htm

The site lined below suggests eating carbs in the morning before and immediately after working out, to help achieve the holy grail of nearly all who work out -- that is, lose fat, build muscle. Can't vouch for the validity of this, but here it is:

http://shadowfit.com/articles/index.php/archives/794

So, the fundamental question remains. Is it the spike or the area under the curve that is the worst? Kind of like radiation, now back in the news because of Fukishima

Mike

Hi Terry,
Greek yogurt is reduced whey (they drain some off); that's how they make it thicker.
Yogurt's carb level is less than milk because the fermentation bacteria mainly fed on the milk sugar(lactose).

Bodybuilders favor whey protein for its insulin spiking properties. Their idea that the insuin drives creatine and amino acids to muscle tissue Ne c'est pas?

Could they be engaging in diabetogenic behavior?

These insulin-boosting properties of some foods (especially dairy, and yes, fish) appear to have been well known for awhile:

http://www.mendosa.com/insulin_index.htm

The site lined below suggests eating carbs in the morning before and immediately after working out, to help achieve the holy grail of nearly all who work out -- that is, lose fat, build muscle. Can't vouch for the validity of this, but here it is:

http://shadowfit.com/articles/index.php/archives/794

So, the fundamental question remains. Is it the spike or the area under the curve that is the worst? Kind of like radiation, now back in the news because of Fukishima.

Mike

Right thats dairy of the list now. Not much left to eat!

@Jason R. lol too right... there will be an epidemic of malnourished dead people with perfect arteries !

Just don't understand (other than water and air) what's ok to eat...

It appears we can safely conclude that just eating (anything!) will spike your insulin!

I am not sure what's left that hasn't been found to be problematic to health in some way

It all makes for good news stories though!

praguestepchild gives us the money quote which I shamelessly repeat here:

"Interestingly, there is epidemiologic evidence suggesting that overweight subjects with a high intake of milk and dairy products are at a lower risk of developing diseases related to the insulin resistance syndrome"

We are left to conclude that with dairy you look bad on paper but turn out to look pretty darn good in real life.  Especially considering that overweight would be associated with higher risk of insulin resistance syndrome indicating, potentially, that dairy actually has a powerful protective effect.

So Terry, Jason cheer up!

It would be difficult to design a diet using the insulin index (II) given in these two papers, because their  II values are based on equal carb portions. Some foods do not have much carbs, so the studies of both papers add carb (lactose) to them and that creates unrealistic foods (but proves their point).   A better table for a variety of foods is given in the paper * below where II is calculated based on equal calorie portions, so we know the weight of each portion (see Table 2). See Table 4  for the values for GI (glucose index) and II.

I think, some of the high GI of the protein-rich foods is not due to their high carb content, but their release of glucagon,  which raises blood sugar levels by gluconeogenesis.  The GI and II of cheese, eggs and beef are not much different, but for yogurt, II is almost double of its GI.

* An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods
Susanne HA Holt, Janette C Brand Miller, and Peter Petocz
http://www.ajcn.org/content/66/5/1264.full.pdf+html

Is it not possible whey's sustained insulin response indicates it is part of a feed back loop? For active people (ex: body builders, herdsmen) the dynamic is more valuable than for the sedentary; modern sedentary lifestyle & insulin spike are a different dynamic.  

Many crucial cells must get their glucose diffused to the extra-cellular spaces; blood doesn't get to touch every cell.
Insulin "spike" and steady reign may be evolutionary to give crucial cells chance to sip some glucose. The spike is a signal
there's plenty for every cell; it prevents first come first served cells from going into overdrive and pulling in all the blood glucose.

"By conventional wisdom, this may be a good thing, but not in my book."

Well dear doctor we are all entitled to opinions, but in this particular case your book needs revision:

A population-based prospective study (CARDIA) revealed that dairy consumption was inversely associated with the incidence of all components of the insulin resistance syndrome (IRS) among overweight individuals (BMI>=25kg/m2).

*** Each daily occasion of dairy consumption was associated with 21% lower odds of IRS. ***

These associations were similar for blacks and whites and for men and women.


If you believe this to wrong, please direct us to what bases your conclusion.

Hi Annon.,
? Insulin resistance decreased by dairy in what form; ie:
hard cheese (essentially no whey), klabbered (yogurt/kefir) with bacteria, fluid w/or w/o "x" % milk fat ...? My reply to you on "Smoothies" thread got lost, so am pleased you posted again here.

BMI is a ratio of proportionality to the persons height. A tall and thin individual can score a higher BMI than a short and fat one. BMI doesn't tell ratio of lean:fat in our body mass.

One day I'd like to see all studies use their subject's "Ponderal" proportion. This is the individual weight (in kilograms) divided by their height cubed (in meters).

It is superior for assesing what's happening with obesity. The "ponderal" change will reflect basal inflammation and can be cross-referenced to previous C Reactive Protein measurements to track if any complication are occuring.

Is there a home insulin meter, like the home glucose meter? It would help a lot.

We tend to over think things latching on to this isolated nutrient or that. Your overall diet is what counts. People have been drinking milk/yoghurt/kefir and eating cheese for thousands of years. Dairy is a pretty damned good food (especially cheese).

It seems to me that Weston Price (the man and organization) has it just about right.

This time last year I started taking 4,000 ius of D3 per day. Four months later I had a 25(OH)D test and the result was 154 ng/ml. I had to stop taking the D immediately as my alkaline phosphatase levels had got too high.

Two months later with no D3 and no sun my 25(OH)D had dropped to more normal levels and I resumed taking the D3 last August but this time at 2,000 ius per day. I continue to take 2,000 ius per day. I don't get any sun. My last measurement of 25(OH)D was 62 ng/ml. My HDL is 93 and my triglycerides 53. Maybe I'm unusual ? My endocrinologist was very surprised I must say.

Anne

I take 3000 IU's daily and my D level is 52.  I'm also 2 months pregnant.  Is it safe for my pregnancy to continue taking higher levels of Vitamin D and should I up my dosage?  Baby books of course recommend a very low dose citing potential overdose at higher levels. I haven't asked my OB yet.

Dr. Davis,
Good to know the right dosage for Vitamin D. But if mere addition of it results in all the things you listed, how do you explain the high incidence of CVD in a country like India where the sun shines 12 months a year.

Thank you Dr. Davis for all the articles on Vitamin D, as well as all the other useful information you provide!  We truly appreciate it.

Happy New Year!

I primary care physician raised his eye brows when I told him I was supplementing with 8IU of Vitamin D. (Carlson Vitamin D gelcaps)

I just received my the results of my blood test. My vitamin D level is 25NG/ML - I hate to see what my levels would be like with zero supplementation.

Joe E O

Anonymous,
Don't forget --exposure to sunlight doesn't guarantee vitamin D activation in the body. This is dependent on several factors, including things like age and darkness of the skin. The darker the skin, the less vitamin D will be made in the body. If those in India are not supplementing with vitamin D, chances are good that they aren't making enough from whatever UVB exposure they have.

Just my two cents.

David

I take 8000IU of D3. So far my head has not exploded nor have I turned in to a newt.

Why this amount? I am over 40, I am still a little over weight (down over 40 lbs), and I have a family history of heart disease, high blood pressure, stroke and Alzheimer's disease.

I began supplementing last Winter at 2000IU. I stopped when Summer hit because I actually got some sun. Due to taking the supplements, I could go outside without bursting in to flames for the first time since I was a kid!!!

Elise said:
I take 3000 IU's daily and my D level is 52. I'm also 2 months pregnant. Is it safe for my pregnancy to continue taking higher levels of Vitamin D and should I up my dosage? Baby books of course recommend a very low dose citing potential overdose at higher levels. I haven't asked my OB yet.

The baby books are probably very wrong.  A new study in Clinical Endocrinology reports that...women with 25(OH)D <37.5 nmol/L were almost 4 times as likely to have a cesarean than women with 25(OH)D ≥37.5 nmol/L (AOR 3.84; 95% CI 1.71 to 8.62).
Full link:
http://tr.im/2rnz

I also read somewhere that if you breastfeed, your milk will not contain any D3 until your blood levels are above 50 (ie, if you don't supplement enough, your body conserves all D3 for itself, sharing none with your infant.)

(Unfortunately, I don't have the link to that study.)

In the first post Anne says that she is able to keep her vitamin D level at 62 with 2000 IU's. I got my level to 42 in the summer, but this fell to 24ng/ml during the winter even though I was using 2000 IU's. I am now supplementing with 5000 IU and will test again soon. My oral supplementation of D needs to be higher in the winter than in the summer.

Elise ~ congratulations on your pregnancy. There are recent articles showing a possible link between low vitamin D and higher C-section rates and higher risk of pre-eclampsia.

Elise- Pregnant women need Vitamin D and your level should be greater than 60 ng/mL.

Having an optimal Vitamin D level could help prevent preeclampsia. Plus, your baby NEEDS Vitamin D for normal development and has no way of getting it except through you.

Google "Vitamin D philadelphia pregnancy study" and see about the research done re: Vit D and pregnancy.

My Primary care doc recommends 6,000 IU/daily for pregnant patients. He draws Vit D and calcium blood levels every 3 months.

Your OB will likely not recommend much- OBs live in the dinosaur ages. It's by far the slowest specialty to adapt to medical news.

Google Vitamin D and pregnancy and read up- you'll find that it's perfectly safe (and in fact, will help your infant immensely) to stay on optimal doses of D.

My sister took 10,000 IU daily during pregnancy, so did a RN at our office.  

Best wishes for a happy and healthy pregnancy

I just had a very interesting experience, but keep in mind: this is purely anecdotal.

I've been taking 6k IU per day for a few months and I'll soon get tested to see what my level is. However, week before last was the holiday party week and I was at parties like 5 days in a row, LOTS of drink (scotch, mostly), staying up late, getting up early, etc.

Predictably, I came down with a cold. On that first day, with that odd scratchy feeling in the back of my throat, I did 18k units of D. Next morning, no symptoms, to the point I though I might be mistaken about a cold coming on. Next morning, bang, the nose starts running, sneezes, but very mild -- like 25% of a cold. 18K units again, and within hours, no more symptoms. Next morning, same thing with the runny nose, so I did another 18K units and within a few hours all symptoms were gone, it's now almost a week later and they have not returned.

I almost can't wait to catch another cold just to see if I can duplicate.

BTW, I stumbled on some amazing epidemiological info on D, and did a series of posts on it yesterday:

http://www.freetheanimal.com/root/2008/12/epidemic-influenza-and-vitamin-d.html

http://www.freetheanimal.com/root/2008/12/vitamin-d-deficiency-and-type-1-diabetes.html

http://www.freetheanimal.com/root/2008/12/melanoma-sun-and-its-synthetic-defeat-sunscreen.html

http://www.freetheanimal.com/root/2008/12/vitamin-d-deficiency-and-all-cancer.html

Very interesting indeed, Richard. I had a similar experience recently.

It was a few days before Thanksgiving, and I felt myself getting sick. Not with a cold, but with the flu. I got a 102 degree fever and felt awful. I remembered Dr. Cannell and Dr. Mercola talking about "stoss" therapy, so I calculated an "influenza dose" based on my body weight. I took around 150,000 IU once per day for three days. On the morning of the third day, I was completely better and was able to eat Thanksgiving dinner with my family. All in all, I had the flu for TWO DAYS. Amazing. I've never recovered from a severe illness that fast. In the past, I have always been very slow to recover. Incredible stuff.

My experiments last winter and this one with high doses of D at the first sign of a cold have been very similar, though I have been using 8-12,000iU of D3 (Carlson Solar Gems 4000iU x 3 each morning for my husband and I, x 1 for my son).  The past week we were visiting family members some of whom had a cold that was catchy, and so far, we haven't caught the cold.  Of course, they were skeptical of the Vit D boosting the immune system, etc.

Richard,  

your experience where Vitamin D appears to eradicate cold symptons is similar to my experience.

In past winters I always experienced major colds - typically three to five during the months of November through April.  Usually they would last a couple of weeks each.

Late Spring 2008 I learned about the critical importance of vitamin D3.  Now I supplement between 6,000 IU and 8,000 IU per day, and my 25(OH)D level floats in the 60 - 80 ng/ml range.  

This year, sofar, I have had three experiences where I thought I caught a cold with typical symptoms.   In each case the symptoms seemed to get worse during the first day, but completely resolved within 24 hours.  No additional medication or supplementation of anyting, except the regular 6k - 8k IU D3.

With research indicating that vitamin D is critical to a strong immune system, my sense is that the cold virus still attacks, but has no change to survive when the immune system is strong, enabled by means of adequate Vitamin D.

By the way, my four year old son also has no persistent cold symptons this year, no ear infections.  Such relief!

It is great to see that vitamin D does much more than enusring the cold virus cannot survive.  The strong immune system it allows our bodies to build, appears to reduce all kinds of inflammation (CVD link) and cellular problems.

Arnoud

Hi Dr. Davis,

I am having a physical soon, which labs/tests would you recommend that I ask my physician to order?

Thanks in advance.

-Patrik

Regarding the epidemiological aspect of 52, check out the last image on my post the other day about vitamin d and all cancer:

http://www.freetheanimal.com/root/2008/12/vitamin-d-deficiency-and-all-cancer.html

I've had a similar experience to Anonymous.
I'm currently taking 10k a day and I never had the flu in 2008 (and I usually get it without fail once a year minimum).
However there were times close to the 5th day (I take my D as 50k once every 5 days) where I'd feel I was getting something. But by the time I took the next dose I was fine. The flu didn't really get to develop, but the next dose seemed to get rid of it.

Can taking an oil-based vitamin D-3 supplement
in the range of 2,000-5,000 IU per day spike liver enzymes AST and/or ALT ???

"Can taking an oil-based vitamin D-3 supplement in the range of 2,000-5,000 IU per day spike liver enzymes AST and/or ALT ???"

Just ran across this study recently, and thought it might have some application here:

http://www.ncbi.nlm.nih.gov/pubmed/17823429

These were specifically people with MS, but it's noteworthy that they mention in passing that liver enzymes were unchanged with D3 doses at 28,000 to 280,000 IU per week.

It seems very unlikely to me that vitamin D at that dose would cause a spike in liver enzymes...

Elise,

I did not realize that I was pregnant until Week 6 of pregnancy.  During Week 4 and Week 5, I took one 50,000 IU dose of a vitamin D prescription. I can't find much info on whether this overdose is likely to cause birth defects.  I stopped taking it after week 5.  Was your baby healthy after taking your 3,000 IU's during pregnancy?  If anyone has any info, I appreciate it because I am so worried about this!

Anonymous said...

    Elise,

    I did not realize that I was pregnant until Week 6 of pregnancy. During Week 4 and Week 5, I took one 50,000 IU dose of a vitamin D prescription. I can't find much info on whether this overdose is likely to cause birth defects. I stopped taking it after week 5. Was your baby healthy after taking your 3,000 IU's during pregnancy? If anyone has any info, I appreciate it because I am so worried about this!

Anonymous: I'm almost 5 months pregnant now and all tests show the baby is healthy, and I'm still taking D at a dose of 4,000 IU per month.  I'm due to get my blood levels tested again but I'm not worried any more after doing some research specifically on pregnancy and vitamin D supplementation.  I wouldn't do the high doses weekly as you were previously doing but I wouldn't discontinue taking the D if I were you (keep your levels in the high normal range and keep testing). I'm 40 with my first baby and became pregnant after trying for a while - only after I had been supplementing D for a few months and it could be what made the difference in conceiving.  A very nice reply from Mike V. from a related post gave me this link: http://www.direct-ms.org/pdf/VitDGenScience/Hollis%20vit%20D%20pregnacy.pdf
Hope that helps and good luck!

Elise,  Thank you so much for the response. I feel better. I also visited a prenatal specialist and they put my mind at east as well.  I am not going to take the 50,000 IU dosage during the remainder of pregnancy.

Well, I had posted a while back that I took 50,000 IU doses of vitamin D early in my pregnancy because I had not yet known that I was pregnant.  I had a miscarriage today.  I'm so sad.

Anonymous,
I'm so sorry for your loss.
Elise

There are good data showing that vitamin D protects against colds and flu. Indeed the Canadians are running studies with vitamin D to determine if it can reduce the indcidence of N1H1, Here is a link a to a recent article that covers these data:
http://archive.constantcontact.com/fs026/1102452079631/archive/1102685428884.html
and take a look at www.vitaminD3world.com for some good summaries of the data in general

Everybody should get their Vitamin D level tested, because we are all so different. I was at 40 with 4000 IU of D3 a day. I doubled it to 8000 IU of D3 and, after 6 months, my level is only 52! I read that 10,000 IU per day was the new safe upper limit. I am going up to 10,000 now, but I wonder if it would be safe to take more than that. I really want to get up to the 80ish level. Why settle for 50% less chance of cancer? 90% less sounds much better to me. I wonder why I need so much more D3 than others. I am older and fatter than average; maybe that is the reason.

I am going to start taking 4000 IU a day of Vitamin D3 for my Rosacea.

My doctor wants me to take 10,000 units a day of Vitamin D. But where can I find any in mega doses so I can avoid spending my entire day taking Vitamin D? So far, can't find anything higher than 400 units.

I've been buying 5,000 IU caps at vitacost.com for about $17 for 365.

They're making them stronger these days so it shouldn't be too hard to find.  Probably vitamin shoppe, GNC, etc. carry them as well.

DeBorah Beatty,

More stores are starting to carry higher dose Vit D, but I've noticed the supermarkets and drug stores are lagging behind.  I'm seeing 1000iU and 2000iU doses creeping on to those shelves, but frankly, even with the increasing awareness of the need for more Vit D, the options are still quite limited in these retail establishments (and are too often the tablets, which may be cheaper, but may not absorb as well).  Be sure to ask for the higher doses so the managers who order know people are looking for them.  I also have found the chain supermarkets and drug stores don't necessarily have the best prices or brands.

When shopping at "brick & mortar" stores, I've had the best luck finding better prices and higher dose Vit D3 (2500-5000+iU) at specialty vitamin businesses (such as Vitamin Shoppe, GNC, and independent vitamin shops) and in the vitamin depts of "health food" and "natural food" grocery stores, such as Whole Foods and similar local chains.

Online shopping will provide you with the best options for both price and selection.  There are many good options.   Ted Hutchinson's Vit D3 blog (http://vitamind3.blogspot.com/) often lists good online sources and deals on Vit D3 in the higher doses you want.  

Last year I purchased Bio-Tech 5000iU dose D3 from the Drs Eades Protein Power website (www.proteinpower.com) for a great price ($8 for 100 capsules).  These capsules are a dry-powder in a gel cap (not a hard tablet) and I seem to get just a good a 25(OH)D result as when taking an oil gelcap.  The bottles are small and light-weight, so they don't take up much storage or packaging room.  For the same shipping cost as 1 bottle, I bought 10 or 11 bottles before going to a high shipping price - enough D3 for a year for myself (I take 5000iu daily) and some to send to my MIL and SIL in London.  The Eades' Protein Power site also sells Bio-Tech's D3 in 50,000iU (that's equivalent to the Rx dose) capsules, 12 qty for $18, which is a good way to get a low 25(OH)D up fast.

My 2 year old and I had the same experience with taking larger amounts of Vitamin D and staying well while exposed to sickness. My husband came home with the Swine flu a few months ago. I was 7 weeks pregnant at the time. My Dr. told me to take Tamiflu immediately. I was concerned about taking a Cat C drug while pregnant so, instead I started to take around 10,000 IU of Vitamin D. My daughter took about 5,000 IU (cherry chew-ables). We got the common cold out of it but we never got a fever above 98.8 and that only lasted 1.5 days. My husband was out for days and the two people who, theoretically have the lower immune systems stayed well! I owe it all to taking Vitamin D. We continue to take it daily to prevent getting any flu that comes around, especially since I'm more pregnant and I'm not planning on getting my H1N1 vaccine.

I inquired with a Vitamin D researcher regarding megadoses of Vitamin D (e.g. 50,000) and he informed me those are usually D2 not D3, one's slower acting and the other faster acting.  Be sure you're comparing apples to apples.

After read this post I think that it is good to take high dose of vitamin D?

I live at latitude 38.72 just south of Annapolis, MD. On Nov. 10,2009 my 25(OH)D test revealed my D level at 50 ng/ml. I'm a blonde, light skinned, 58 year old male, weight 137, height 5'7".
Immediately after the test I began to supplement with 10,000 IU D3 per day in addition to the 400 IU in my multivitamin. I took this high-D3 dosage every day through the winter and on March 19,2010 my 25(OH)D test revealed my result as 64 ng/ml. On this date I decreased my D3 to 5,000 IU per day (+ 400 IU from multi) and intend to stay at that dosage until my next test, which I plan to take in mid August. I do not sunbathe and I go swimming maybe once a week. I get an average amount of exposure during the warm months while mowing the lawn and just going outdoors to go to the store or walking my dogs.
I also get 1,000 mg of calcium and 500 mg magnesium per day - my calcium level is 2.45 mmol/L and my total cholesterol is 147 mg/dL. I do not follow any speial diet other than eating everything in moderation and balancing veggies, fruits, grains, meats and seafoods. I do however avoid trans-fats and instead use coconut and palm oils as well as butter and olive oils. I also supplement with a complete EFA and 1200 mg of Lecithin daily.
I hope this helps others make a determination where to start with their high dose D3 supplementation.

Dr. Davis,
I am 21 years old and have a level of vitamin D of 25. My doctor told me that was very low and put me on 2 pills a week of 50,000 units of supplements and also 5,000 units a day. Is this normal or safe? I just really need a second opinion because I feel like it is a lot.

Thanks, Maddy

I had low D (14).  My doc put me on 50000/mo (D2??).  After 2+ years, little effect.  Found www.vitamindcouncil.org and got educated.  For every 1000iu (D3) intake, you should see a 7-10 ng/ml serum increase.  So I started (again) at 18ng/ml and am taking an extra 5000iu/day.  It is all going as expected.  After 6 months I am up to 38ng/ml.  On the liver enzyme issue, I drink alcohol and have noticed NORMAL enzyme levels now after my D3 intake...even when drinking the night BEFORE my blood test.  Interesting.  Hope this helps somebody.....

Here's my experience regarding testing:

I test my D3 level twice a year, at the end of winter (April) and the end of summer (October) and then adjust the amount of D3 I take depending on the results.

Living in a northern state (WIS) and getting outdoors in shirtsleeves in the summer a lot, I find that I need about 5,000 IU in the winter months and 1,000 IU in the summer months to maintain a level around 70 ng/ml.

So far, I've tested four times over two years and I may adjust both the summer dose and the winter dose just a bit after another year of tests, but I think I'm homing in on the amount I need. Everyone is different and everyone should attempt similar testing, in my opinion. Each test costs about $70 and I pay it myself.

Side note: It's also supposed to help with psoriasis. For 25 years or so, I've had a psoriasis-like itching/redness develop almost monthly in my moustache and hairline that one application of Head & Shoulders would bring under control for about a month. Obviously it's not a serious case of psoriasis. Nevertheless, I started the vit D3 supplementation three years ago and haven't used the Head & Shoulders since.

So is a vitamin d level of 85 ng/mL something to worry about? Should one continue taking 2000 IU a day of vitamin d3?

-Young people (not older people >40 years old, who have lost most of the capacity to activate vitamin D in the skin) who obtain several days to weeks of tropical sun typically have 25-hydroxy vitamin D blood levels of 80-100 ng/ml without adverse effect.

Fall 2009 I had done 25(OH) D-test which revealed my D level at 32 ng/ml (36 y/o Female). My “old school “doctor told me that there is a little that I can do about it since we live in Canada and during Fall/Winter we have almost no exposure to sun. I was not satisfied with answer that there is little that we can do and did some research on line about it.
As of today I am taking about 15,000 IU/day of D3 (3 tiny gel pills – Spring Valley brand @ Wal-Mart $6.00 per 100 pills) and my D level is barely 45 ng/ml.
I am also working with public at Major International Airport, so we are constantly exposed disease (like TB, HEP-C, N1H1 on daily basis). First year working I managed to get Kidney infection, 3x cold, 1x flue and  weeks long cough. Now I am working with gloves and when I am feeling that I may get flu I will double dosage to 30,000 IU/Day + 400 IU Ginseng. In 2010 I was not sick all.
I must say I can see Significant improvement on my skin (suffering from Psoriasis). Also good prevention for breast, colon cancer, hypoglycemia and development of Type 1 Diabetes that is in my family history.
However, since some articles suggesting that high dosage of D3 may assist with weight lost finding difficult locate this bottle (5,000 IU) and be available on shelf, but I can order it on-line from Wal-Mart at any time.

I'm 32 weeks pregnant and when my doctor heard that I am supplementing with vitamin D3, she was very concerned and advised against it. I had my D3 levels checked about a month ago and they were 25 ng/mL, which makes me vitamin D3 deficient. I had been taking 4000 IU of vitamin D3 for about 3 months by then, and decided to take 6000 IU from that day on, because I was concerned that 4000 IU is too low for me and that my baby and that I needed more so that my D3 levels could reach the optimum of 50-80 ng/mL). In the meantime I've read more on the subject because I got a cold and am worried a bit about the flu (didn't want to get vaccinated), so now I'm taking 10000 IU/day. Is that too much?! I don't have anyone else to seek advice from, my doctors have no idea about the new research and would freak out if I told them how much I'm taking. I plan to breastfeed and I want to do what's best for my baby... 4000 IU was obviously not an adequate dose for me since after 3 months of taking it my levels were 25 ng/mL, right? Thank you in advance.

Anonymous,
I took 3000 while pregnant and my level was 52, but I had been taking that level for a while before I became pregnant - not sure how long you've been supplementing.  Anyway, my advice to you would be to find a doctor who is well versed in vitamin d supplementation (call around or search the internet) and is willing to help you monitor your levels, and you could keep your current doctor as well (I'm assuming the one you're referring to is your OB).  Also, get retested now to make sure your levels are really that low, as lab results are sometimes wrong.  I don't know if it was the vitamin d, but after I started taking it I was able to get pregnant, had an uneventful pregnancy and vaginal birth - (no need to be induced).  I've had a couple of colds that were over more quickly than they used to be, but no flu.  My son who is now 1 1/2 takes about 1200 IU's of D - they come in drops that are easy to mix in food.  He's had one short cold that lasted for 24 hours and roseola but no flu and bounced right back. Vitamin D has helped us so much but it doesn't mean you'll never get sick - a lot less and a lot less severe though.  If you're getting leg cramps at night, try pickle juice. Good luck!

Brilliant blog.

More people need to be aware theat suggested doagsages are often well short of the mark.

A recent publication suggestes that doses of 4000-8000 IU are required daily to amintain optimal levels.

check out the study, and video here:
http://www.timeforwellness.org/blog-view/you-need-a-lot-more-vitamin-d-than-you-think-178

Dr D:
I take up to 4000 IU per day depending on season and have recently had a zero CTA scan, so I personally have high confidence in vitamin D3.
From time to time I see references to the possibility that excessive D can produce soft tissue/arterial calcification in some people. I understand of course that Vitamin K2 menaquinone is an essential partner in proper calcium homeostasis.
Are you completely without concern at the blood levels discussed?, or should people with marginal kidney performance or other moderate metabolic conditions be cautious?
Would appreciate your thoughts.
MikeV

Where does one get 10,000 IU caps?

I take 4000 IU capsules from Carlson Labs (called "Solar Gems")--the oil in the caps is fish oil, so that's a plus, and my multivitamin has 1,000 IUs.


P.S. Thanks for the blog, I'm a big fan!

There are clearly groups of people who should work with their doctor when it comes to vitamin D, particularly people with kidney disease or dysfunction; history of kidney stones; glandular diseases like hyperparathyroidism; a history of high calcium.

If taking 4,000 IU of Vitamin D a day increases one's HDL by a relatively small number -- say, 10 -- but it's still low, what do you think is the likelihood hiking the amount will further increase HDL?

Also, do you take calcium with your Vitamin D?

I have never seen 10,000 capsules. I'm hoping somebody comes out with such a preparation. I wasn't aware of the 4000 unit capsules. Thanks for the tip!

I would not advise taking more vit D just to raise HDL.

Blood level of vit D is the parameter to assess vit D adequacy. I would regard a rise in HDL as a fortuitous side phenomenon.

“…and I no longer experience colds nor winter "blues."

Careful, this sort of personal testimonial lends to sounding more like a “nutritional guru” instead of medical professional examining scientific evidence.

I’m not saying you’re incorrect, it may be your experience and it may be absolutely true, but a stick to the clinical facts. You’re talents are better suited to being a “medical watchdog” than a “dietary duck.”

Dear Dr. Davis,
I would love your opinion of my doctor's protocol regarding my recent diagnosis of osteopenia in my hips (t-scores -1.1 and -1.2 femoral neck, my spine was normal, -0.2).  I'm a 56 year old woman, 115 pounds, just went through menopause, taking Zocor and Lotrel (high cholesterol and hypertension both run in my family), I exercise regularly.  My doctor said he wanted to see how well I absorb Vit D, so he ordered a blood test, however, he ordered the D1,25 test (results 35 pg/mL), NOT D25 which I understand is a truer biomarker.  He prescribed Vitamin D, Calcitriol, one 0.025 capsule per day for one month, with no restrictions on my Calcium/Vit D intake through supplements, after which he said to return for another Vitamind D blood test (another D1,25).  I've read that Calcitriol can cause hypercalcemia.  I've also read that D1,25 will not tell you how well you're absorbing Vitamin D.  Based on that, I felt I was wasting my time and risking hypercalcemia, so I stopped taking the Calcitriol.  Should I tell my doctor that he ordered the wrong blood test?  Also, which prescription Vit D should I be taking? I have no other health issues.  Thank you, Dr. Davis.
Ruthie

Thank you, but I disagree.

I add my experiences to that of probably over 1000 patients in the last two years who have shared similar effects.

Hi, Ruthie-

Lots of issues. However, it sounds like your doctor is simply toeing the conventional line of prescription drugs. It may be time to either prod your doctor to get up to date on vitamin D, or to find a doctor willing to engage in the discussion.

Do you know if any one is making or developing an at home vitamin D3 testing product?

Wouldn't that be wonderful?!

Unfortunately, I do not know of any such commercially available product. However, it would be a tremendous boon to this movement of self-empowerment in health care that I see coming for the future.

I am taking vitamin D3 two softgels of 2000 IU each daily, one in the morning and one in the evening. I want to know if I get the same effect if I take two softgels together instead of taking one twice a day. Thanks.

Hi Ruthie,

I'm 54 and diagnosed with osteoporosis (T scores -3.7 in hips and -3.1 lumbar spine). I've been prescribed calcium supplements (as well as Strontium Ranelate) but I've found that I'm very intolerant to the calcium, no matter whether I try calcium citrate, calcium carbonate or calcium amino acid chelate, so since Christmas I've stopped all calcium supplements and upped my vitamin D3 intake to 4000iu per day (not prescription, I wish it was then it wouldn't be so expensive...vitamin D costs a lot in the UK, much more than the US) so that I absorb my dietary calcium as well as possible. I feel very confident that this will work, especially in view of a previous blog from Dr Davis about calcium:http://heartscanblog.blogspot.com/2008/01/calcium-chaos_22.html

Plus logic tells me that it is not lack of calcium that causes osteoporosis but other factors. People in third world countries such as Africa on suboptimal diets have very low levels of dietary calcium but they don't usually get osteoporosis...they get more sunshine (vitamin D) and do much more physical work. I'm doing plenty of weight resistance exercise now !

bw's
Anne

Yes, no difference.

bio-tech-pharm.com supply D3 in 1k, 5k and 50k capsules, and with delivery rates that are reasonable for those out of the US.
I've been taking 5k for the past 2 weeks and don't feel bad on it, but will be getting blood levels checked within a season to see if I'm personally responding correctly.
The 400IU average was just based on preventing rickets.

Dr. Davis,
I've had great results from increasing my vitamin D intake with regards to my lung capacity. I'm a recovering smoker with moderate copd and, after being hospitalized for pneumonia, am finally recovering to a point where I can almost run up and down steps. I attribute this to my "D" supplements which I began taking about a month ago. I can take deep breaths for the first time in years.

My question is about the supplements themselves. I see very expensive D3 tablets and then I see the regular vitamin D. Is one better than the other? Is there a great deal of difference? Thanks.

I am surprised to see how many people are gettingtheir their Vitamin D requirements with supplements.  Go out into the sun WITHOUT sunscreen for 10-15 minutes a day and then supplement the rest.  Remember it also takes about 40 glasses of milk to equal 4000 iu's of Vitamin D.  You can get that from about 15 minutes of sun exposure depending on your age and ethnicity.  The more melanin in your skin, the longer you need to expose it.

The capsules I take (the Solar Gems) are 6 cents a 4000 IU softgel:

http://www.vitacost.com/Carlson-Solar-D-Gems-Vitamin-D

Jabs,
I live in Indiana. It's going to be 6 degrees out in just a few minutes. We haven't seen the sun in weeks. What do you suggest, tanning beds? I'll do it but not until I hear that they're safe. Be reasonable, not everyone lives where they can get natural sunlight. I think that's part of the Vitamin D deficiency problem.

I have been taking the same 5000iu Biotech capsules Moblogs uses.
I was 147.5nmol - 59ng when tested at the end of summer (UK latitude 53) although I did not take a D3 on days when I knew I would be able to get near full body sun exposure at midday.

As others have reported, I also have not had a cold or flu over the winter (so far and still touching wood) others I am regularly in contact with have been unlucky.
(I also did not need to get my SADLIGHT down from the attic this winter)

Something in the my 7 month TYP program (6000iu D3 gelcap, Slo-Niacin 1.5g, 3g+ fishoil, low wheat-suger) has really helped with joint pain I have had for 8 years.  This has allowed me to lift weights 3 times per week and thus reduced my bodyfat from 27 to 19 percent.  I look and feel much better.  I am 51, male at 215 lbs.

Oh, is it because I take vitamin D3 that even with people dropping like flies around me (with colds, flu, etc) I never get sick? I have always thought it surprising that I tend not to get these things, given that I do have a number of autoimmune conditions. I have only ever used tablets (1000IU 1/day) and my vitamin D3 (250H) level is 52ng/mL.

However, my vitamin D2 (250H) level is <4ng/mL and my vitamin D (1,25) level is only 24pg/mL (normal range 22-67). Should I (and is it possible to?) do anything to increase those levels?

* * D2 v. D3 * *
http://www.medicalnewstoday.com/articles/92952.php

* * D2 vs. lupus vulgaris * *
("administered in alcoholic solution is key" to success of therapy)
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1583253&blobtype=pdf

Very interesting article. I find myself concerned about the side effects of vitamin D supplements, as opposed to sunlight-derived vitamin D.

I'd love to hear your thoughts on this article, which appears to be quite well cited:

http://www.raw-food-health.net/Vitamin-D-Toxicity.html

In my practice and in the Track Your Plaque program, we routinely use doses of 2000-10,000 units per day, occasionally more. We are guided by blood levels of 25(OH) vitamin D3. I have personally never witnessed vitamin D toxicity.

Thank you for posting so much about cholesterol.  Do you have Dr's that you know of that think this way that I can find in Seattle??

Dr. Davis, I'd like to invite you to visit ad comment on my blog: http://wordworks2001.blogspot.com

Thanks,

Jeff Brailey

Hi, Jeff-
I took a look at your Blog and congratulate you on takin the time and effort to talk about the bizarre state of affairs in heart disease. We know that the principle that explains much of what happens is "follow the money". I see it as my role to facilitate this conversation.

Dr. Davis - I have been trying to follow your recomasmendations on diet and supplements and am really confused today as the new studies on Women and Heart Disease have contridicted the use of folic acid.  I take 2mg a day and it has brought my homocysteine down below 7 for the first time.   Do you think Women should be treated entirely differently than men as far as heart disease and plague is concerned.   Do you find a difference in the genders in your studies?   If so, how and what?   Thanks so much,
Noreen Boles