10,000 units of vitamin D

Joanne started with a 25-hydroxy vitamin D level of 23 ng/ml--severe deficiency.

What made this starting value even worse was that it was drawn in August after a moderately sunny summer spent outdoors. (Last summer, not this summer.) It therefore represented her high for the year, since vitamin D levels trend lower as fall and winter set in. This suggests that her winter level was likely in the teens or even single digits. In addition, note that, at age 43, Joanne has lost much of her ability to activate vitamin D in the skin.

So I advised that she take 6000 units of an oil-based gelcap per day, a dose likely to generate the desired blood level, which I believe is 60-70 ng/ml.

Four months later, her 25-hydroxy vitamin D level: 39.9 ng/ml--still too low. So I advised her to increase her dose to 10,000 units per day. Several months later, her 25-hydroxy vitamin D level: 63.8 ng/ml--perfect.

However, on hearing that she was taking 10,000 units vitamin D per day, Joanne's primary care physician was shocked: "What? Stop that immediately! You're taking a toxic dose!" So Joanne called me to find out if this was true.

No, of course it's not true. It's not the dose that's toxic, but the blood level it generates. Although it varies, vitamin D toxicity, as evidenced by increased blood calcium levels, generally does not even begin to get underway until at least 120-130 ng/ml, perhaps higher. Rarely, a dose of 2000 units per day will generate a level this high. In others, it may require 24,000 or more units per day to generate such a high level.

So it's not the dose that's toxic, but the blood level of 25-hydroxy vitamin D it generates.

Provided you and/or your doctor are monitoring 25-hydroxy vitamin D blood levels, the dose is immaterial. It's the blood level you're interested in.

You can always count on Dr. John Cannell for unique perspectives on vitamin D. I reprint here his unfailingly entertaining and informative Vitamin D Newsletter on whether vitamin D replacement enhances physical performance.

The whole vitamin D "discovery" sometimes worries me. Vitamin D has proven to be an unbelievable, remarkable, dramatic boon to health, including facilitation in dropping CT heart scan scores. Yet the answer was always right in front of us. It worries me that you and I might have the answer to important questions right within our grasp all along--but don't know it. What if the same were true, say, for cancer? That is, a profound answer is right there, but our eyes just pass right over it.

Anyway, we should all keep our eyes open and perhaps you and I will continue to identify the most powerful tools available that return control over heart disease to us and take it away from the perverse, procedural hospital formula that still reigns.

If you haven't done so already, be sure to visit Dr. Cannell's website, www.vitamindcouncil.com.

The Vitamin D Newsletter
March, 2007

Peak Athletic Performance and Vitamin D

"No way doc." I had just finished telling my patient about the benefits of vitamin D, telling him he should take 4,000 IU per day, using all the techniques I had learned in 30 years of medical practice to convince someone proper treatment is important. But, he knew the U.S. government said he only needed 200 IU per day, not 4,000. He also knew the official Upper Limit was 2,000 IU a day. "What are you trying to do doc, kill me?" I told him his 25(OH)-vitamin D blood test was low, only 13 ng/ml. He had read about that too, in a medical textbook, where it said normal levels are between 10 and 40 ng/ml. "I'm fine doc;" adding "Are you in the vitamin business?" I explained I was not; that the government used outdated values; that recent studies indicate ideal 25(OH)D levels are about 50 ng/ml; and that they indicated that he needed about 4,000 IU per day to get his level up to 50. "No thanks doc, I'm fine."

So I tried a different tact. I brought him copies of recent press articles. "Look," I said, "look at these." Science News called vitamin D the Antibiotic Vitamin. The Independent in England says vitamin D explains why people die from influenza in the winter, and not the summer. U.S. News and World Report says almost everyone needs more. Newsweek says it prevents cancer and helps fight infection. In four different recent reports, United Press International says that: it reduces falls in the elderly, many pregnant women are deficient , it reduces stress fractures, and that it helps heals wounds.

He glanced at the articles, showing a little interest in stress fractures. Then he told me what he was really thinking. "Look doc, all this stuff may be important to old guys like you. I'm 22. All I care about are girls and sports. When I get older, maybe I'll think about it. I'm too young to worry about it. I'm in great condition." I couldn't argue. He was in good health and a very good basketball player, playing several hours every day, always on indoor courts.

What could I do to open his eyes? As an African American, his risk of early death was very high, although the risk for blacks doesn't start to dramatically increase until their 40's and 50's. Like all young people, he saw himself as forever young. The U.S. government was no help, relying on a ten-year-old report from the Institute of Medicine that is full of misinformation.

I tired to tell him that the 200 IU per day the U.S. government recommends for 20-year-olds is to prevent bone disease, not to treat low vitamin D levels like his. I pointed out the U.S. government's official current Upper Limit of 2,000 IU/day is the same for a 300 pound adult as it is for a 25 pound toddler. That is, the government says it's safe for a one-year-old, 25-pound, child to take 2,000 IU per day but it's not safe for a 30-year old, 300-pound, adult to take 2,000 and one IU a day. I mean, whoever thought up these Upper Limits must have left their thinking caps at home. Nevertheless, nothing worked. My vitamin D deficient patient was not interested in taking any vitamin D.

What are young men interested in? I remembered that he had told me: "Sex and sports." Two years ago I had researched the medical literature looking for any evidence vitamin D enhanced sexual performance. Absolutely nothing. That would have been nice. Can you imagine the interest?

Then I remembered that several readers had written to ask me if vitamin D could possibly improve their athletic performance? They told me that after taking 2,000 to 5,000 IU per day for several months, they seemed just a little faster, a little stronger, maybe had a little better balance and timing. A pianist had written to tell me she even played a better piano, her fingers moved over the keys more effortlessly! Was vitamin D responsible for these subtle changes or was it a placebo effect? That is, did readers just think their athletic performance improved because they knew vitamin D was a steroid hormone precursor (hormone, from the Greek, meaning "to set in motion")?

The active form of vitamin D is a steroid (actually a seco-steroid) in the same way that testosterone is a steroid and vitamin D is a hormone in the same way that growth hormone is a hormone. Steroid hormones are substances made from cholesterol, which circulate in the body, and work at distant sites by "setting in motion" genetic protein transcription. That is, both vitamin D and testosterone regulate your genome, the stuff of life. While testosterone is a sex steroid hormone, vitamin D is a pleomorphic (multiple function) steroid hormone.

All of a sudden, it didn't seem so silly. Certainly steroids can improve athletic performance although they can be quite dangerous. In addition, few people are deficient in growth hormone or testosterone, so when athletes take sex steroids or growth hormone they are cheating, or doping. The case with vitamin D is quite different because natural vitamin D levels are about 50 ng/ml and, since almost no one has such levels, extra vitamin D is not doping, it's just good treatment. I decided to exhaustively research the medical literature on vitamin D and athletic performance. It took me over a year.

To my surprise, I discovered that there are five totally independent bodies of research that all converge on an inescapable conclusion: vitamin D will improve athletic performance in vitamin D deficient people (and that includes most people). Even more interesting is who published this literature, and when. Are you old enough to remember when the Germans and Russians won every Olympics in the 60's and 70's? Well, it turns out that the most convincing evidence that vitamin D improves athletic performance was published in old German and Russian medical literature.

With the help of my wife and mother-in-law, both of whom are Russian, and with the help of Marc Sorenson, whose book Solar Power is a must read, I finally was able to look at translations of much of the old Russian and German literature. When one combines that old literature with the modern English language literature on neuromuscular performance, the conclusion is inescapable. The readers who wrote me are right.

If you are vitamin D deficient, the medical literature indicates that the right amount of vitamin D will make you faster, stronger, improve your balance and timing, etc. How much it will improve your athletic ability depends on how deficient you are to begin with. How good an athlete you will be depends on your innate ability, training, and dedication. However, peak athletic performance also depends upon the neuromuscular cells in your body and brain having unfettered access to the steroid hormone, activated vitamin D. In addition, how much activated vitamin D is available to your brain, muscle, and nerves depends on having ideal levels of vitamin D in your blood - about 50 ng/ml, to be precise.

Why would I write about such a frivolous topic like peak athletic performance when cancer patients all across this land are dying vitamin D deficient? Like many vitamin D advocates, I have been disappointed that the medical profession and the public don't seem to care about vitamin D. Maybe people, like my young basketball player, will care if it makes better athletes. So, Hey! You jocks! Listen up! I'm talking speed, balance, choice reaction time, muscle mass, muscle strength, squats, reps, etc. Important stuff. Here's the Vitamin D Council's first ever sports quiz.

1. Vitamin D-producing UVB radiation improves athletic performance and may have been widely practiced by German and Russian Olympic athletes in the 1960's and 70's.

True. I found tantalizing evidence the Russians and especially the Germans were on to this during the 60's and 70's when those two nations took turns placing number one and number two in the Olympics every year?

For example, in 1938, Russian researchers reported that a course of ultraviolet irradiations improved speed in the 100-meter dash in college students compared to matched controls, both groups undergoing daily training. Average 100-meter dash times decreased from 13.51 seconds to 13.28 seconds in the non-irradiated controls, but from 13.63 seconds to 12.62 seconds in the irradiated students. Here we see training improved times but training and irradiation improved times much more. Obviously, irradiation or vitamin D would not render the same magnitude of improvements in world-class sprinters, but they would be happy with a few milliseconds.

Gorkin Z, Gorkin MJ, Teslenko NE. [The effect of ultraviolet irradiation upon training for 100m sprint.] The Journal of Physiology of the USSR [Fiziol, z. (RSSR)] 1938; 25: 695-701. (In Russian)

If you want to know what early German thinking was on this, read this summation of the German literature:

"It is a well-known fact that physical performance can be increased through ultra-violet irradiation. In 1927, a heated argument arose after the decision by the German Swimmers' Association to use the sunlamp as an artificial aid, constituting an athletic unfairness, doping, so to speak. In 1926, Rancken had already reported the improving effect of sunlamp irradiation on muscle work with the hand-dynamo-graph. Heib observed an improvement in swimming times after repeated irradiations. In thorough experiments, Backmund showed that a substantial increase in muscle activity happens after radiation of larger portions of the body with an artificial sunlamp; that this performance increase is not caused through local - direct or indirect - effects on the musculature, but through a general effect. This general effect, triggered by ultra-violet irradiation, is caused by a systemic effect on the nervous system." (p. 17)

Parade GW, Otto H. Die beeinflussung der leistungsfahigkeit durch Hohensonnenbestrahlung. Zeitschrift fur Klinische Medizin (Z Klin Med),1940;137:17-21 [In German]

In 1945, two Americans measured the cardiovascular fitness and muscular endurance of 11 male Illinois subjects undergoing training in an indoor physical education class, comparing them to 10 matched controls. Both groups underwent similar physical training. Treatment consisted of ultraviolet irradiation, given in the nude, up to two minutes per session, three times per week, for ten weeks in the late fall and winter. After ten weeks, the treatment group had a 19% standard score gain in cardiovascular fitness compare to a 2% improvement in the control students. To regular readers of this newsletter, it should come as no surprise that the un-irradiated control group reported twice as many viral respiratory infections as the treatment group.

Allen R, Cureton T. Effects of Ultraviolet Radiation on Physical Fitness. Arch Phys Med 1945: 10: 641-44.

In 1952, the German sports medicine researcher, Spellerberg, reported on the effects of wholesale irradiation of athletes studying and training at the Sports College of Cologne - including many elite athletes - with a "central sun lamp." He irradiated the athletes in their bathing suits, on both sides of their bodies, for up to ten minutes, twice a week, for 6 weeks. He reported a "convincing effect" on athletic performance and a 50% reduction in sports injuries. Results were particularly impressive for swimmers, soccer, handball, hockey, and tennis players, as well as for boxers and most track and field athletes. He reported that irradiation leading to burns, further irradiation of athletes having achieved peak performance, and irradiation within 24 hours of competition, all impaired athletic performance. Their results were so convincing, the Sports College of Cologne officially notified the "national German and International Olympic committee." (p. 570)

Spellerberg AE. [Increase of athletic effectiveness by systematic ultraviolet irradiation.] Strahlentherapie 1952; 88: 567-70. [In German]

In 1952, Ronge exposed 120 German schoolchildren to UV lights installed in classrooms and compared them to 120 un-irradiated control children. Over a two-year period - excluding summer vacations - he tested both groups with a series of six cardiovascular fitness tests using a bike ergometer. Un-irradiated children showed a distinct seasonality in fitness, with the highest values right after summer break and the lowest values in the spring. Treated children showed no seasonal differences in physical performance. Differences in work performance between the irradiated and un-irradiated children were most conspicuous in the spring with 56% difference between the two groups. In a final experiment, he gave 30 children in the control classrooms 6.25 mg (250,000 IU) of vitamin D as a single dose in February and found their performance had "increased considerably," one month later but did not report the actual numbers. He concluded that vitamin D, either as a supplement or induced via UV irradiation, improved physical performance.

Ronge HE. [Increase of physical effectiveness by systematic ultraviolet irradiation.] Strahlentherapie 1952; 88: 563-6. [In German]

In 1954, another researcher, at the Max-Planck Institute for Industrial Physiology in Dortmund, Germany, administered three different wavelengths of UV light over 8 weeks to university students. He found that ultraviolet light in the vitamin D-producing UVB range was consistently effective in reducing resting pulse, lowering the basal metabolic rate, and increasing athletic performance. UVA had no effect; interestingly, artificial UVC irradiation (the atmosphere normally completely filters out UVC radiation and thus it's not naturally present on earth) also gave some positive results.

Lehmann G. [Significance of certain wave lengths for increased efficacy of ultraviolet irradiation.] Strahlentherapie. 1954 Nov;95(3):447-53. [In German]

In 1956, Hettinger and Seidel irradiated seven subjects in two different experiments: athletic performance on bike-ergometers and forearm muscle strength. They found that UV radiation induced a significant improvement in both muscle strength and athletic performance.

Hettinger T, Seidl E. [Ultraviolet irradiation and trainability of musculature.] Internationale Zeitschrift für angewandte Physiologie, einschliesslich Arbeitsphysiologie 1956; 16: 177-83. [In German]

Another German researcher, at the Institute for Medical Physics and Biophysics at the University of Gottiingen, studied reaction times (the time needed to recognize a light and switch it off) during October and November in a series of controlled experiments on 16 children and an unspecified number of adults. He first controlled for practice effects (getting better by practicing) and then administered nine full-body UV radiation treatments over three weeks to the two treatment groups, using placebo radiation in the two control groups. UV radiation improved choice reaction time by 25% in children and 20% in adults while reaction time worsened in controls. The improvements in the irradiated groups peaked at the end of the three weeks of UV treatments and reverted to baseline levels three weeks later. In the two control groups, he found distinctly improved reaction times in the sunnier months.

Sigmund R. [Effect of ultraviolet rays on reaction time in man.] Strahlentherapie. 1956; 101: 623-9. [In German]

The next study threw me because it was very well conducted, meticulously designed, and completely negative. In 1963, Berven reported on the effects of ultraviolet irradiation and vitamin D supplementation in a group of 30 Stockholm schoolchildren, aged 10 -11, comparing them to appropriate controls. He found no seasonality of fitness in the control group and no effect from either irradiation or two different vitamin D supplementation protocols (1500 IU of cholecalciferol daily for two months and a single dose of 400,000 IU of ergocalciferol) on performance on a bike ergometer.

Berven H. The physical working capacity of healthy children; seasonal variations and effect of ultraviolet irradiation and vitamin-D supply. Acta paediatrica. Supplementum 1963; 148: 1-22.

However, two things were not right and got me thinking. One, Berven found no seasonality of physical fitness and was the only author who found no such seasonal variations in athletic performance. Second, he found no effect from irradiation, again, the only author. Then I realized he was working with Swedish children in the late 1950's. Supplementation of children with high doses of vitamin D - often as cod liver oil - was routine in Scandinavia in the past, particularly in children. For example, in neighboring Finland, the official recommended daily dose of vitamin D for children - including infants - was 4,000 IU per day until 1964, when authorities reduced it to 2,000 IU/day. (That's right, you read that correctly, 4,000 IU per day for infants, which is too much by the way.)

In 1975, Finnish authorities reduced it to 1,000 IU per day, and, in 1992, to 400 IU per day. I emailed Professor Elina Hypponen who confirmed that the Swedish recommendations were similar to the Finnish ones. Therefore, it seems highly unlikely that many of Berven's Swedish children, studied in 1958 and 1959, all from "families with a good standard of living," were vitamin D deficient. Therefore, this study showed that vitamin D will not improve athletic ability in vitamin D replete people. That's very important because it indicates more is not necessarily better. More is only better if you are not taking enough.

Hypponen E, et al. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001 Nov 3;358(9292):1500-3.

In the 1960's, three American researchers conducted experiments with university students. Rosentswieg studied the effects of a single six-minute dose of UV light on each side of the trunk in 23 college women, recording changes in various tests of muscle strength at one and five hours. He found a trend towards significance after five hours in white but not African American students. In 1968, Cheatum found that a six-minute administration of UV light, on each side of the trunk, increased the speed of 15 college women in the 30-yard dash. In 1969, Rosentswieg found a six-minute dose of UV light, on each side of the trunk, finding improved performance on a bicycle ergometer in college women. However, unlike the Germans and Russians, I could find no evidence that any of these American findings interested any American professionals involved in the care or training of athletes.

Rosentsweig J. The effect of a single suberythemic biodose of ultraviolet radiation upon the strength of college women. J Assoc Phys Ment Rehabil. 1967 Jul-Aug;21(4):131-3.

Cheatum BA. Effects of a single biodose of ultraviolet radiation upon the speed of college women. Res Q. 1968 Oct;39(3):482-5.

Rosentswieg J. The effect of a single suberythemic biodose of ultraviolet radiation upon the endurance of college women. J Sports Med Phys Fitness. 1969 Jun;9(2):104-6.

2. Athletic performance peaks in the summer when vitamin D levels peak, and is at its lowest in the winter when vitamin D levels are at their lowest.

A. True
B. False

True. The studies below - all I could find in the literature - show tests of physical performance peak in the summer, when vitamin D levels peak, start to decline in early autumn, as vitamin D levels decline, and athletic performance reaches its lowest point in late winter, when vitamin D levels bottom out. However, it is reasonable to assume that any associations between athletic performance and summer season may be due to "reverse causation." That is, improved athletic performance in the summer might be secondary to increased outdoor physical and recreational activity in the warmer weather with an indoor sedentary lifestyle during the colder months. Maybe people have better athletic ability in the summer because they exercise more. If that is true - and using the same logic - athletic performance should not begin to decline until late autumn, because at most temperate latitudes early fall weather is ideal for outdoor physical activities.

However, some of the studies below controlled for seasonal variations in time spent exercising. Furthermore, besides a consistent positive association of summer season with improved athletic performance, the below studies found an abrupt - and unexplained - reduction in athletic performance beginning in the early fall - when vitamin D levels decline - but when the weather is ideal for outdoor activities.

For example, in 1956, German researchers found a distinct seasonal variation in the trainability of musculature, studying wrist flexor strength in 21 German subjects undergoing daily training. They found highly significant seasonal differences with peak performance during the later part of the summer, nadirs in the winter, and an unexplained sharp autumn decline beginning in October.

Hettinger T, Muller EA. Seasonal course of trainability of musculature. Int Z Angew Physiol. 1956;16(2):90-4.

A study of Polish pilots and crew found physical fitness and tolerance to hypoxia were highest in the late summer with an unexplained sharp decline starting in September. The authors hypothesized that seasonal variations in an unidentified hormone best explained their results.

Kwarecki K, Golec L, Klossowski M, Zuzewicz K. Circannual rhythms of physical fitness and tolerance of hypoxic hypoxia. Acta Physiol Pol. 1981 Nov-Dec;32(6):629-36.

Cumulative work ability among 1,835 mainly sedentary Norwegian men during bicycle exercise tests showed an August peak, a sharp decline starting in the autumn, and a wintertime nadir. There were no seasonal changes in body weights, as might be expected if more caloric-demanding recreational activity during the sunnier months explained their results.

Erikssen J, Rodahl K. Seasonal variation in work performance and heart rate response to exercise. A study of 1,835 middle-aged men. Eur J Appl Physiol Occup Physiol. 1979 Oct;42(2):133-40.

Koch and Raschka reviewed the mostly German literature on the seasonality of physical performance, discussing studies indicating that muscle strength and stamina peak in the late summer. The authors then attempted to control for seasonal variations in the time spent exercising by instituting a controlled yearlong training regimen, beginning in December. The training regimen consisted of at least 20 push-ups per day and 2 or 3 long-distances races per week for the entire year. They found the both the number of push-ups and muscle strength peaked in late summer followed by a rapid decline in the fall, and a nadir in the winter, despite continued training. They concluded that seasonal variations in an unidentified hormone best explained their results. In addition, by now we all know that vitamin D is a seasonal hormone, and a steroid hormone precursor to boot.

Koch H, Raschka C. Circannual period of physical performance analysed by means of standard cosinor analysis: a case report. Rom J Physiol. 2000 Jan-Dec;37(1-4):51-8.

3. Vitamin D has direct muscle-building (anabolic) effects.

A. True
B. False

True, but only in vitamin D deficient subjects. Both animal and human studies have found that vitamin D directly affects muscle. That is, vitamin D increases muscle mass.

For example, Birge and Haddad found that vitamin D caused new protein synthesis in rat muscle.

Birge SJ, Haddad JG. 25-hydroxycholecalciferol stimulation of muscle metabolism. J Clin Invest. 1975 Nov;56(5):1100-7.

What about humans? In 1981, Young performed muscle biopsies on 12 severely vitamin D deficient patients before and after vitamin D treatment. They found type-II (fast-twitch) muscle fibers were small before treatment and significantly enlarged after treatment. Sorensen performed muscle biopsies on eleven older patients with osteoporosis before and after treatment with vitamin D. The percentage and area of fast twitch fibers increased significantly after treatment, despite the lack of any physical training.

Young A, Edwards R, Jones D, Brenton D. Quadriceps muscle strength and fibre size during treatment of osteomalacia. In: Stokes IAF (ed) Mechanical factors and the skeleton. 1981. pp 137-145.

Sorensen OH, Lund B, Saltin B, Lund B, Andersen RB, Hjorth L, Melsen F, Mosekilde L. Myopathy in bone loss of ageing: improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium. Clin Sci (Lond). 1979 Feb;56(2):157-61.

Sato reported that two years of treatment with 1,000 IU of vitamin D per day significantly increased muscle strength, doubled the mean diameter, and tripled the percentage of fast-twitch muscle fibers, in the functional limbs of 48 severely vitamin D deficient elderly stroke patients. The placebo control group suffered declines in muscle strength, and in the size and percentage of fast-twitch muscle fibers.

Sato Y, Iwamoto J, Kanoko T, Satoh K. Low-Dose Vitamin D Prevents Muscular Atrophy and Reduces Falls and Hip Fractures in Women after Stroke: A Randomized Controlled Trial. Cerebrovasc Dis. 2005 Jul 27;20(3):187-192 [Epub ahead of print]

These studies clearly show that vitamin D when administered to vitamin D deficient people stimulates the growth and number of those muscle fibers critical to athletic ability, type-2, or "fast twitch," muscle fibers.

4. Many studies have found direct associations between physical performance and vitamin D levels. That is, the higher your vitamin D level, the better your athletic performance.

A. True
B. False

True. I found 13 positive studies of associations between vitamin D levels and various parameters of neuromuscular performance. However, they were all in old people. Of course, old people can be athletes too. Furthermore, age differences in physiology and pharmacology are quantitative, not qualitative. That is, what is true in old people will be true in young people, although the magnitude might be different. Higher vitamin D levels are associated with a wide variety of athletic performance but appear to have the strongest associations with balance, timing, and timed tests of physical performance.

The three largest studies had more than 7,000 elderly subjects. All found evidence of a vitamin D threshold of between 30 - 50 ng/ml, above which further improvements in athletic performance were not seen. Wicherts and her colleagues found a linear correlation between vitamin D and neuromuscular performance; scores were 78% better for those with vitamin D levels greater than 30 ng/ml compared to those with levels less than10 ng/ml.

Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB, Zhang Y, Karlson EW, Dawson-Hughes B. Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr. 2004 Sep;80(3):752-8.

Gerdhem P, Ringsberg KA, Obrant KJ, Akesson K. Association between 25-hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA Study of Elderly Women. Osteoporos Int. 2005 Nov;16(11):1425-31.

Wicherts IS, et al. Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab. 2007 Mar 6; [Epub ahead of print]

Professor Heike Bischoff-Ferrari, now in Switzerland, did the largest study. She and her colleagues found a strong positive correlation and suggestion of a U-shaped curve with athletic performance on one test peaking with vitamin D levels of 50 ng/ml but deteriorating at higher levels. It is interesting to speculate that levels around 50 ng/ml may be optimal for athletic performance as such levels are common in humans living in a "natural" state of sun-exposure, such as lifeguards or tropical farmers.

Bischoff HA, Stahelin HB, Urscheler N, Ehrsam R, Vonthein R, Perrig-Chiello P, Tyndall A, Theiler R. Muscle strength in the elderly: its relation to vitamin D metabolites. Arch Phys Med Rehabil. 1999 Jan;80(1):54-8.

Interestingly, all three studies that looked for an association between mental abilities and vitamin D levels found one. A fourth study, unrelated to athletic function, also found an association. The obvious explanation for these findings is that cognitively impaired patients do not go outdoors as often as higher functioning patients and thus have lower vitamin D levels. However, Dhesi found the association after excluding all but mildly demented patients, making such an explanation more difficult. Flicker and - more recently - Przybelski and Binkley, found the association after controlling for outdoor activities, raising the possibility that the association of vitamin D levels with cognitive abilities is casual. Both the vitamin D receptor and the enzyme necessary to activate vitamin D are present in a wide-variety of human brain tissue. If vitamin D deficiency impairs cognitive abilities, it is likely that such deficiencies will also impair the brain's ability to process the complex circuits needed for peak athletic performance.

Dhesi JK, Bearne LM, Moniz C, Hurley MV, Jackson SH, Swift CG, Allain TJ. Neuromuscular and psychomotor function in elderly subjects who fall and the relationship with vitamin D status. J Bone Miner Res. 2002 May;17(5):891-7.

Kenny AM, Biskup B, Robbins B, Marcella G, Burleson JA. Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men. J Am Geriatr Soc. 2003 Dec;51(12):1762-7.

Flicker L, Mead K, MacInnis RJ, Nowson C, Scherer S, Stein MS, Thomasx J, Hopper JL, Wark JD. Serum vitamin D and falls in older women in residential care in Australia. J Am Geriatr Soc. 2003 Nov;51(11):1533-8.

Przybelski RJ, Binkley NC. Is vitamin D important for preserving cognition? A positive correlation of serum 25-hydroxyvitamin D concentration with cognitive function. Arch Biochem Biophys. 2007 Jan 8;

There can be no doubt that higher vitamin D levels are associated with improved athletic performance in the elderly. From what we know of physiology and pharmacology, the same associations should hold true in young people, including young athletes.

5. Numerous studies have found that vitamin D improves physical performance.

A. True
B. False.

True, but, again, most all the studies are in old persons, not young ones, and none of the studies are in world-class athletes. However, there is no medical reason why vitamin D would improve the athletic performance of vitamin D deficient old people but not vitamin D deficient young ones. Eleven studies found vitamin D improved physical performance, mainly on measures of balance and reaction time. The one study of younger subjects showed dramatic physical performance effects in 55 severely vitamin D deficient women.

Sorensen OH, Lund B, Saltin B, Lund B, Andersen RB, Hjorth L, Melsen F, Mosekilde L. Myopathy in bone loss of ageing: improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium. Clin Sci (Lond). 1979 Feb;56(2):157-61.

Gloth FM 3rd, Smith CE, Hollis BW, Tobin JD. Functional improvement with vitamin D replenishment in a cohort of frail, vitamin D-deficient older people. J Am Geriatr Soc. 1995 Nov;43(11):1269-71.

Glerup H, Mikkelsen K, Poulsen L, Hass E, Overbeck S, Andersen H, Charles P, Eriksen EF. Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement. Calcif Tissue Int. 2000 Jun;66(6):419-24.

Prabhala A, Garg R, Dandona P. Severe myopathy associated with vitamin D deficiency in western New York. Arch Intern Med. 2000 Apr 24;160(8):1199-203.

Verhaar HJ, Samson MM, Jansen PA, de Vreede PL, Manten JW, Duursma SA. Muscle strength, functional mobility and vitamin D in older women. Aging (Milano). 2000 Dec;12(6):455-60.

Pfeifer M, Begerow B, Minne HW, Abrams C, Nachtigall D, Hansen C. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res. 2000 Jun;15(6):1113-8.

Bischoff HA, Stahelin HB, Dick W, Akos R, Knecht M, Salis C, Nebiker M, Theiler R, Pfeifer M, Begerow B, Lew RA, Conzelmann M. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003 Feb;18(2):343-51.

Dhesi JK, Jackson SH, Bearne LM, Moniz C, Hurley MV, Swift CG, Allain TJ. Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing. 2004 Nov;33(6):589-95.

Sato Y, Iwamoto J, Kanoko T, Satoh K. Low-Dose Vitamin D Prevents Muscular Atrophy and Reduces Falls and Hip Fractures in Women after Stroke: A Randomized Controlled Trial. Cerebrovasc Dis. 2005 Jul 27;20(3):187-192 [Epub ahead of print]

In summary, five converging - but totally separate - lines of scientific evidence leave little doubt that vitamin D improves athletic performance. (I actually left out a sixth line of evidence, something a little more complicated, studies of muscle strength and vitamin D receptor polymorphisms; the two studies I could find were both positive.) Anyway, the scientific evidence that UVB radiation, either from the sun or from sunbeds, will improve athletic performance is overwhelming and the mechanism is almost certainly vitamin D production. Peak athletic performance will probably occur with 25(OH)D levels of about 50 ng/ml, whether from sun, sunbeds, or supplements.

All that is missing is a big-time professional or college team identifying and then treating their elite athletes who are vitamin D deficient. Can you imagine what such performance-enhancing effects would do for basketball players, most of who are African American and who practice and play indoors all winter? Or gymnasts? Or weight lifters?

However, a word of caution. The above studies suggest that taking too much vitamin D (more than 5,000 IU per day) may actually worsen athletic performance. Take the right amount, not all you can swallow. Take enough to keep your 25(OH)D levels around 50 ng/ml, year round. Easier yet, regularly use the sun in the summer and sunbeds in the winter - with care not to burn. Once a week should be about right.

When you think about it, none of this should surprise anyone. Every body builder knows that steroid hormones can improve athletic performance, certainly increase muscle mass. Barry Bonds knows they increase timing and power. Moreover, activated vitamin D is as potent a steroid hormone as exists in the human body. However, unlike other steroids, levels of activated vitamin D in muscle and nerve tissue are primarily regulated by sun exposure. That's right, the rate-limiting step for the cellular function (autocrine) of activated vitamin D is under your control. It depends on how much you put in your both or go into the sun. It's ironic that many athletes now avoid the sun, organized baseball is even promoting sun avoidance and sunblocks. The ancient Greeks knew better; they had there elite athletes train on the beach and in the nude.

The medical literature indicates vitamin D levels of about 50 ng/ml are associated with peak athletic performance. Of course, recent studies show such levels are ideal for preventing cancer, diabetes, hypertension, influenza, multiple sclerosis, major depression, cognitive impairments, etc. But who cares about all that disease stuff old people get, we're talking about something really important: speed, balance, reaction time, muscle mass, muscle strength, squats, reps, etc. And guess who's now taking 4,000 IU/day? Yes he is, and he tells me his timing is better, he can jump a little higher, run a little faster, and the ball feels "sweeter," whatever that means.

John Cannell, MD

This is a periodic newsletter from the Vitamin D Council, a non-profit trying to end the epidemic of vitamin D deficiency. If you don't want to get the newsletter, please hit reply and let us know. We don't copyright this newsletter. Please feel free to reproduce it and post it on Internet sites and blogs. Remember, we are a non-profit educational organization. Our pathetic finances are available for public inspection. We rely on donations to publish our newsletter and maintain our website. Send your tax-deductible contributions to:

The Vitamin D Council (www.vitamindcouncil.com)
9100 San Gregorio Road
Atascadero, CA 93422

Pater_Fortunatos
8/2/2010 8:06:19 PM |

There is a romanian guy that promotes healthy life style with low carb and other paleo ideas.

http://www.cristianmargarit.ro/

On his forum, a schizo girl was asking about suplemments, but she was really amazed by Dr Davis prescriptions, 6000 UI/zi, she said that NowFoods recomand a 5000 UI gelcap /3 days.

But Cristian (the body builder from the link) replies:

"It happened that I had once 100.000 UI on a day of vitamin D. Yes, one hundred thousands! When you try to adjust the level for certain deficencies, the therapeuthical doses can be a lot higher than the usual doses, that look like jokes for healthy people."

Readind the article that Dr Davis just published, I assume he has a point, but 100.000 on a day!?!

Anonymous
8/2/2010 8:16:33 PM |

hi Dr. Davis

could you sum up the benefits of vitamin d for non heart patients?

im in early twenties and have my vit d at 18!

i feel normal. what can i expect with higher blood levels of this vitamin?

i have some source naturals 2000 ui powdered caps is that effective?

Thanks

enliteneer
8/2/2010 8:49:12 PM |

There is evidence to suggest a correlation between high circulating Vitamin D blood levels (>40ng/ml) and rare cancers (pancreatic, etc):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892544/?tool=pmcentrez&report=abstract

http://cancerres.aacrjournals.org/cgi/content/full/66/20/9802

http://cancerres.aacrjournals.org/cgi/content/abstract/69/4/1439

http://aje.oxfordjournals.org/cgi/content/abstract/kwq114

Anonymous
8/2/2010 9:05:48 PM |

My Vit. D level 2 years ago was 42, I started supplementing with 6K per day. I retested this spring and had decreased to 41.

I was amazed and confused.

After some communications with the Vit. D council, I found out that the Tretinoin Cream I was using for my splotching skin was interfering with absorption of Vit. D.

I have since stopped the cream, increased to 12K per day and get 1 hour of sun without any sunscreen.
I am sure my Dermatologist won't be happy with my tan.

aurelia
8/2/2010 11:22:05 PM |

Did you call her PCP?

steve
8/3/2010 12:54:59 AM |

2 questions about vitamin d. Should I take it in the summer months. I work outside all day long? Whats the differences between vitamin d with cod liver oil and without ? thanks...

Tommy
8/3/2010 1:11:35 AM |

What about taking Vitamin A to counter balance Vitamin D?

Patricia Dillavou
8/3/2010 3:45:24 AM |

It has been determined that toxicity concerns for VD3 occur somewhere around 200 ng/ml.  (www.grassrootshealth.net)

Vitamin D experts recommend between 70-90 ng/ml depending on the doctor.  Some even higher. For instance - Dr. Cannell of The Vitamin D Council (www.vitamindcouncil.org) recommends at least 90-100 ng/ml for cancer survivors.

Dr. Cannell is also on the board of GRH - both non-profit advocacy groups promoting the health benefits of VD3.

Grassroots Health is running a five year study on VD3 that is well worth joining.  Anyone can join - find the details at their website.

Patricia Dillavou
8/3/2010 3:54:18 AM |

Dr. Cannell warns that vitamin A "antagonizes the action" of VD3. He says you don't need to supplement with vitamin A outside of a good diet.

Not quite halfway down in this newsletter post:
http://www.vitamindcouncil.org/newsletter/2008-june.shtml

Sara
8/3/2010 4:07:00 AM |

I read a study recently where they measured the actual amount of vit. D present in various name brands. They varied in strength from 1% to 82%.
That's very weak on the mfgs. part and would only encourage the use of prescription D.
Here is the link:
http://www.medpagetoday.com/MeetingCoverage/CMSC-ACTRIMS/20522

Pat D.
8/3/2010 4:08:36 AM |

Enliteener - a quote from the study at the second link you provide:
( 7). Ecologic data are not supportive of a strong positive association between vitamin D and pancreatic cancer as sunnier regions do not have higher rates of pancreatic cancer. In fact, the opposite is true, in the United States, relatively high pancreatic cancer rates are observed in states where UV exposure is low.

vlado2020
8/3/2010 11:46:08 AM |

as much I respect dr. Davis he is like all the docs obsessed with numbers and stability and "safety". Unfortunatelly it ignores the basic properties of vitamin D which is an essential , perhaps most important hormone in all the living beings. First of all , vitamin D gets activated in kidneys first and if kidneys get saturated in tissues where all the healing properties of vitamin D occur. Second of all , there is a reason why oral supplementation is possible throughout life as opposed to simple skin synthesis. Then our bodies can absorb much more orally at once than through the skin which leads me to believe that we are designed to take much larger doses at once to correct deficiencies. Lastly vitamin D is fat soluble so it stays with you for 2 months at least. Having said all that , it doesn't make any sense to supplement every day with lesser doses than you can synthesize in the skin or to follow some magical numbers.
I have dealt with a very stubborn case of psoriasis for 3 years but in a few days I am taking a big vitamin D experiment, 30 days / 500 000 IU daily, 15 million in a month. Indeed if you search google archives you can find newspaper clippings from 30's and 40's when doctors were more liberal and less obsessed with money of such doses reversing psoriasis and arthritis and other auto immune conditions.

MissPkm
8/3/2010 2:16:13 PM |

Dr Davis, A great post yet again. I guess that is the one single line I have forgotten to tell people "it is not the dose, it is the blood level that matter"!! GREAT! Thank you.

Sara,
There is a big concern for supplements on the market as they are not being checked by any agencies, and just like Dr Davis previous have been reporting on - some Vitamin D3 over the counter are not what they say they are. However in this study that you refer to (the part that I was able to read) they do not list the name brands or the type of Vitamin D (pill, gel cap, liquid) as that also plays a big role. I think it is a big separation from the message in the report of saying to only take Vitamin D2 (which is the prescription vitamin D) when we know D2 is not natural to us humans nor is it better. I suggest you read a little bit more about D2 and D3 before deciding what is best for you.

Ned Kock
8/3/2010 5:00:11 PM |

Hello Dr. Davis.

Let me point out a few things based on research on vitamin D. Not all agree with what you said in your post, but then again you may well be right and the research wrong:

- Indeed, toxicity signs do not seem to occur until one reaches the 50,000 IU/d level of intake.

- Among the elderly (i.e., those aged 65 or above) pre-sunburn full-body exposure to sunlight is equivalent to an oral vitamin D intake of 218 Âµg (8,700 IU). That is close to 90 percent of what a 20-year-old would produce.

- People on average will plateau at 130 nmol/L, after months of 10,000 IU/d supplementation. That is 52 ng/mL. Assuming a normal distribution with a standard deviation of about 20 percent the peak mean (a rough guesstimate), one would expect 68 percent of the population to be in the 42 to 63 ng/mL range. That might be the range most of us should expect to be in at an intake of 10,000 IU/d.

As we know, some people are outliers. A person who is two standard deviations above the mean would be at around 73 ng/mL. Three SDs above the mean would be 83 ng/mL. These are outliers; non-average people.

There are other factors that may have affected the results for this patient. Being overweight tends to reduce D levels. Sunscreen also does that. Excess cortisol may also be affecting D levels.

Below are two links with more details:

http://healthcorrelator.blogspot.com/2010/02/vitamin-d-levels-sunlight-age-and.html

http://healthcorrelator.blogspot.com/2010/01/vitamin-d-deficiency-seasonal.html

stop smoking help
8/3/2010 6:56:15 PM |

I wonder what levels are found in smokers? I know smokers aren't supposed to supplement with beta-carotene as it statistically increases their risk of developing lung cancer.

What about vitamin D? Is there any data on this as it relates to people who smoke cigarettes or other tobacco products?

Anonymous
8/3/2010 9:57:45 PM |

This is so off topic, but for some reason I cannot find the Pharmax website for fish oil. Can anyone help? Thank you
From an old person who is not tech savvy.

Matthew
8/3/2010 11:01:03 PM |

There is a graph of vitamin D blood levels on the video by Dr. Michael Holl+
ick that shows the knee of the runaway blood levels is around 10,000 IU per day, and he recommends no more than that on an ongoing basis.

For me, 5000 iu per day stopped my gums from bleeding when I brushed, and ended decades of dysthymia.

http://www.youtube.com/watch?v=Cq1t9WqOD-0
http://www.uvadvantage.org/

Anonymous
8/5/2010 6:21:19 PM |

Dr Davis,
You are absolutely right that "it is not the dose, it is the blood level that mattersâ€. But, what about the blood level of calcium? One of the causes of the toxicity of Vit D is that it may cause high calcium levels in blood. So, should we not measure also the calcium level, and if it is high then should we not stop taking D, even though its blood level may be normal or low? Thank you.

Ganesh
8/6/2010 8:17:05 AM |

How does a dosage of Vitamin D3 supplementation totaling 2,260,000 IU over 56 days averaging daily to about 40,000 IU sound?? Resulting in a blood level of 239.0 ng/mL?? This is no fiction...but my personal experience...and I have never felt more better since then! I got rid of my pre-diabetes, Metabolic Syndrome and other fancy new-age potential diseases... Read all about it at gkwellness.wordpress.com.

TedHutchinson
8/6/2010 9:16:15 AM |

Perhaps it would be well for others to read what Dr Cannell has to say about massive doses of vitamin D.

Warning: If you intend to take massive doses of vitamin D based on this newsletter, which I highly recommend you do not, read the entire newsletter. In addition, accurate determination of side effects of massive doses of vitamin D was not available in the early 1930s, nor was accurate determination of the true amount in each pill possible.

You'll find the Vitamin D Council newsletter at this link.
Gary Null and Vitamin D Toxicity

Josh
8/6/2010 12:44:21 PM |

I've been taking 10,000 IUs a day for the last 3 months. Got my results back today: I went from 51ng/dL to 65 ng/dL. I eat strictly paleo and I also get regular sun. I expected a greater increase. I also had a CMP run to check for hypercalcemia - all good.

Anonymous
8/7/2010 1:03:50 AM |

I recently went to a doctor for pre-diabetes and high cholestrol and found my vitamin d level is 17 and I am breastfeeding. Does anyone know what a safe amount would be for me to take. I am taking 5000 d3, liquid dropper full. I am very tan, and out in the sun...why am I not absorbing or making the hormone? My crp level was 24, they said that wasn;t normal. Could this be a effect of this wheat allergy I am reading about? What do you think Dr. Davis?

Jimmy Moore
8/7/2010 11:12:16 AM |

I too got the same reaction from my doctor when I told him I take 10,000IU daily. But I HAVE to in order to reach that optimal level you're talking about. Two years ago my D3 was 42, so I went on a 6-month Vitamin D3 gelcaps regimen to get it up to 68. Wanting to find the balance of how much to take, I backed off to 6,000IU for about 8 months and my D3 level dropped back down to 50. So I've been on 10,000IU daily again for the past 8 months and look forward to seeing my levels return into the 60s where they need to be. THANK YOU Dr. Davis for leading the way on this important issue. My wife Christine had a D3 level of 9 before starting 10,000IU herself--today her D3 is 54 and she's completely off of her Paxil medicine. WOO HOO!

Anonymous
8/8/2010 6:57:56 PM |

I can't find the link but I recall reading something, possibly by Dr. Cannell urging people who are taking higher quantities of vitamin D to ALSO take extra Magnesium and Potassium to prevent kidney stones(which may occur with higher dosing of Vitamin D).

If this is the case, how much mag and potassium should one take to prevent stones?

Neonomide
8/11/2010 9:58:48 PM |

Vitamin D3 decreased relapse rate by 50% in Crohn's disease patients in a 12 month randomized controlled trial:

http://www.ncbi.nlm.nih.gov/pubmed/20491740

I knew this for almost two years already and got to ditch my meds, just by taking enough Vitamin D3. If everything in healthcare was this simple we would not have major healthcare problems, yes ?

mike V
8/21/2010 4:56:17 PM |

Dr D.
It has probably by now come to your attention that there is some evidence for a U shaped mortality curve with vitamin D in elderly men, esp cancer.

Here is one report:
*Plasma vitamin D and mortality in older men: a community-based prospective cohort study.*

MichaÃ«lsson K, Baron JA, Snellman G, Gedeborg R, Byberg L, SundstrÃ¶m J, Berglund L, ArnlÃ¶v J, Hellman P, Blomhoff R, Wolk A, Garmo H, Holmberg L, Melhus H.

Am J Clin Nutr. 2010 Aug 18. [Epub ahead of print]PMID: 20720256 [PubMed - as supplied by publisher]Related citations

My suspicion is that it may be related to insufficent vitamin K2, which of course may relate to typical elderly diets.

Please comment, and/or refer us to earlier comments you may have made.
Thank you
Mike V

TedHutchinson
8/21/2010 10:39:36 PM |

How to Optimize Vitamin D Supplementation to Prevent Cancer, Based on Cellular Adaptation and Hydroxylase Enzymology
At the most northerly latitudes such as Sweden, where the study Mike V linked to was done and Finland where P Tuohimaa has reported similar findings, we have to appreciate the people with the highest vitamin D status probably have the largest changes in status over the year.
Vieth provides a hypothesis that explains how people with extreme changes in status experience longer periods of imbalance between the forces controlling cell proliferation.
Vieth suggests keeping 25(OH)D BOTH HIGH and STABLE is the safest option that way there is little or no CHANGE in status through the year, so no periods where dis-regulation of the counterbalancing forces could occur.

Anonymous
8/22/2010 11:50:44 PM |

Ted,

If I'm reading what you posted correctly, Vieth is indicating that one should maintain higher serum d-levels year round as opposed to allowing them fluctuate?

Anonymous
8/22/2010 11:53:29 PM |

I'm sure this has been asked before but what's a suitable dosing strategy for someone who just flat out refuses to get their 25(OH)D3 levels checked? My brother is 28, I've convinced him to start supplementing with vitamin D but her refuses to go to the doctor to get blood drawn and when I suggested he order a kit online and do it himself he looked at me like I was crazy.

I have him on average taking 5000 to 6000 units per day.

Mike

TedHutchinson
8/23/2010 9:39:52 AM |

@ Vieth is indicating that one should maintain higher serum d-levels year round as opposed to allowing them fluctuate?

Vieth says so long as serum 25(OH)D concentrations are in a phase of decline, there can be no full achievement of tissue 1,25(OH)2D to match its ideal set-point concentration.

There have been a couple of papers recently showing ANNUAL vitamin D supplementation (raising status with high intakes before winter) only makes matters worse because it creates a longer period of declining 25(OH)D.

Note also that because Ergocalciferol has a shorter half life than D3 it amplifies this problem so should be avoided.

Supplementing DAILY or WEEKLY reduces the potential for fluctuation so are ideal but fortnightly or even monthly supplementation with D3 probably avoid the periods of declining status, if the person concerned really isn't capable of more regular dosing.

The amount of vitamin D made in the skin varies with 25(OH)D status This reduces the summer rise in status but if you get lots of sun in summer (unlike the UK)it may be sensible to REDUCE (but not stop) vitamin D supplements while you are also getting near full body sun exposure, and then resume the full amount of supplementation as soon as sun exposure reduces.

I think people who live furthest from the equator have to be particularly careful when taking winter sun holidays in the tropics.
As Vitamin D is itself photoprotective it's worth supplementing with vitamin D before a winter sun break rather than relying on the holiday sun to raise status. Then reduce intake while sunning in the tropics but resume supplementation as soon as you return. Careful supplementation increases serum 25(OH)D concentrations and reduces the effect of the seasonal amplitude in 25(OH)D on the tissue fluctuations in 1,25(OH)2D.

TedHutchinson
8/23/2010 10:11:13 AM |

@ Mike
Grassrootshealth graph of typical responses to various vitamin D intakes

Startling Findings About Vitamin D Levels in Life ExtensionÂ® Members

The graphs at the above links show 5000~6000iu/daily gets most people above insufficiency status and doesn't raise status above a safe amount.

The range of response to regular D3 supplements is about 100ng/ml so without a few 25(OH)D tests it's impossible for anyone to say if you're at the lowest or highest end of that response scale.

If you're diabetic or celiac then it's likely you're a poor responder but there are people reading this with inflammatory conditions who've taken very modest vitamin D3 amounts but had extremely high 25(OH)D test results.

It's so simple to put a couple of drops of blood on a test strip and post if off that I'm surprised everyone doesn't get it done.

Once you've had a few tests done you can more or less predict what the result will be, but there have been instances where people have changed brands of D3, been tested and discovered problems.

Only if you've had a test can you be certain the brand/batch/amount/dosing regime of D3 you are taking is working for you.

mike V
8/23/2010 1:30:20 PM |

Thanks for the helpful posts, Ted.
Is it your interpretation that variability still remains important, even if one's 25(OH)D does not fall below say 30 or 40 ng/mL over the year, or do you think the the lower excursion limit would have to drop to a deficient level at least for a part of the year? It would seem to me that storage in body fat would be a consideration in minimizing variability.
Have you come across any studies on U curve effects performed at lower latitudes, or perhaps on those supplementing?

I am a vintage Brit, living in the "Deep South", and whose last readings were between 60 and 70 ng/ml so I have no personal concerns.
Last winter I was using 8000iu, but I drop back to 4-6000 in the Summer months, when we typically have highs between 90 and 100F.
FWIW I have been gradually escalating my dose over a period of more than 10 years. Now in 75th year.
regards
Mike V

TedHutchinson
8/23/2010 2:01:16 PM |

@ It would seem to me that storage in body fat would be a consideration in minimizing variability. I agree.
Bear in mind we don't see significant stored D3 reserves below 40ng/ml but at 50~60ng/ml reserves are measurable.
I stay around 60ng/ml with 5000iu/d + regular full body UVB/SUN exposure.
I'm not aware of any data on Ushaped curve at lower latitudes or with people maintaining a steady state 25(OH)D by avoiding declines in 25(OH)D.
I'd be more than willing to participate in any trial, providing I'm assured of remaining on the high end arm of the study.

mike V
8/23/2010 2:56:12 PM |

Thank you.
One more question.
It appears that UVB/sun exposure is useful way to 'top off' supplementation in a natural or controlled way.
Seems we evolved our African metabolisms getting a heavy daily full body dose.

Are you aware of any data suggesting that UVB sourced D has any other advantages over presumingly well managed supplementation?
Thanks again
I appreciate your awareness of, and facility at quoting relevant studies.
Mike V

TedHutchinson
8/23/2010 4:42:12 PM |

UVR is likely suppressing disease independent of vitamin D production, and that vitamin D supplementation alone may not replace the ability of sunlight to reduce MS susceptibility.

Cholesterol levels are lower in summer than winter so it's reasonable to suppose some of the benefit of UV exposure is the reduction of cholesterol when converted into vitamin D.

I suspect it's also possible that the conversion of cholesterol to vitamin D3 Cholecalciferol alone may be simplistic.

It could be that other types or subtypes of the vitamin D family or its analogues are created that, at the moment, we are not aware of and which may provide benefits that are greater than those provided just by vitamin D3 alone. That is one of the reasons why I prefer to get my basic D3 needs met from supplements but also use sunlight/uvb exposure to top up my stores as naturally as possible.
Sorry no time at the moment to provide supporting links for that hypothesis.

Anonymous
8/23/2010 6:42:53 PM |

Ted, you bring up an interesting point regarding different dosing methods. Here's a study comparing daily vs. weekly vs. monthly dosing of D3.

http://jcem.endojournals.org/cgi/content/full/93/9/3430

Anonymous
8/23/2010 7:28:43 PM |

Seasonal fluctuations may be of importance but the overall 25(OH)D levels still seem most important.

The Framingham Study data and other papers have already pointed out that not only total mortality, but also bone health seems best in about 35-40 ng/ml, not more. Similarly, not-so-rare cancers like in prostate and pancreas (kills practically everyone) may well increase in susceptiple populations ie in smokers.

There are also racial differences that may be of huge importance. Not only CHD risk and 25(OH)D does follow the skin color pretty closely, but native Africans also have rather low 25(OH)D levels which perhaps explains the association. Even doctor Cannell wrote previously about this:

"Dr. Freedman and his Wake forest colleagues measured vitamin D levels and plaque (the build-up in your arteries) on 340 diabetic, obese (BMI 35) African Americans and found higher vitamin D levels were associated with more plaque build up in the arteries."

http://www.vitamindcouncil.org/newsletter/vitamin-d-race-and-cardiovascular-disease.shtml

Infants in Nigeria have much higher 25(OH)D levels, yet as Nigerian people get older, their 25(OH)D levels drop a lot.

I'd imagine that tremendous UVB exposure for decades makes it progressively harder to make Vitamin D and that seems to be the simplest explanation. Elderly white-skinned people may on the other hand make a lot more Vit D as a recent study shows. I'd die to know if the same works out for native Africans as well - which I very much doubt.

Vitamin D has tens of metabolites that form only in the skin. This may be the single biggest challenge to the claim that Vitamin D supplementation fixes "everything".

A quick googling on a wide array of problems people have had when supplementing more than 2000 IU a day is dazzling. So D3 may be a wonder vitamin, but it's benefits are dose dependent and probably highly dependent of other nutriotional factors as well, since D3 affects the absorption of minerals, expression of hundreds of genes and so on.

Food rep

TedHutchinson
8/23/2010 10:47:56 PM |

@ you bring up an interesting point regarding different dosing methods ...Comparison of Daily, Weekly, and Monthly Vitamin D3
Perhaps that is because I regard the natural level at which humans produce vitamin D replete breast milk, achieve 25(OH)D equilibrium and maintain a stored reserve of vitamin d3 as ideal, not the level used in that study that barely ever provides sufficient even for basic daily needs.

Health professionals may aim for a level that maximises health service interventions. I want a level that minimises my need to use those services.

Bankers make more money from people who frequently use overdraft and loan services. I prefer to save up, keep a reserve of cash in an instant access savings account, only every pay cash and get discounted prices.

You may be happy to manage your Vitamin D account without ever having any spare reserves available for emergency use but IMO that is neither prudent or safe.

Why on earth would your skin produce 10~20000iu in a relatively short time if only 1500iu were required?

mike V
8/24/2010 1:39:15 AM |

Food Rep:
Suggest you take as a baseline levels that are thought to be closer to the equatorial 25(OH)D blood levels we evolved with. Not minimal levels to mitigate some particular symptom or disease.
Yes, achieving this goal largely by supplements, can be complicated depending on skin color, genetics, latitude, age, body fat, but in my judgment it is well worth achieving, and it will become easier as time goes on.

IMHO, Ted and Dr Davis have it about right.

Do you visit www.grassrootshealth.net?
If not I recommend you do so... soon. IMHO there is not a more authoritative resource on this topic.
Mike V
By the way, vitamin D does not *cause* calcification. It does enable homeostasis.

Anonymous
8/24/2010 2:51:38 PM |

Ted,

I only posted that study above to show that different dosing schedules (daily, weekly, monthly) all seem like viable approaches in maintaining 25(OH)D3 levels granted you are consistent with it. I wasn't trying to suggest that the actual doses they were administering were adequate.

Anonymous
8/25/2010 4:45:49 PM |

I just trying to have ripped abs. I am not taking any supplements or anything like that but the literature here suggests that taking some substances could actually have an adverse affect on your body even though they are supposed to be healthy.

mike V
8/26/2010 6:29:59 PM |

Ted, Dr D.
I suggest that vitamin 2K should be considered in association with Vitamin D where the cancer mortality curve is in question.
**
http://www.lef.org/magazine/mag2009/jan2009_Vitamin-K-Protection-Against-Arterial-Calcification-Bone-Loss-Cancer-Aging_03.htm
**
note: I believe I am right insaying that the first 15 references cited in this article relate to cancer.
Mike

Mike V

max
9/25/2010 7:50:35 AM |

good article.

Anonymous
10/30/2010 4:40:15 PM |

I recently did the Vitamin D Council blood spot test. It cost $70.00 including shipping I think. It was painful and two weeks later, my finger still hurts. If I ever do another blood spot test, I'll try to draw blood from my forearm, although the test requires at least 2 large blood drops. I have no results yet. I am 114 lbs and take 2400 IU a day (softgels). I don't really plan to test ever again, especially on my finger, so I'll play it safe and keep my level around 40. Obviously, I'll have to adjust accordingly, once I get the results. I don't have the luxury of a good doctor. Doctors around here are virtually useless.

Anonymous
1/21/2011 5:19:23 PM |

Hi there,
Been researching Vit D here on the heartscan blog and others such as Vit D counsil, Dr. Ben Kims' site,getting good info to stay away from D2 of course.
But this site, "The Peoples Chemist"- Shane Ellison and blog poster "Chuck" say we all should stay away from any man-made D3(sheep wool) included. They back it up stating specific chemical biological changes in the body. They say it just isn't the same and can do more harm in the long run. The site states basically that we should be using only food for Vit D3. meats, eggs, cod-liver oil(w/o the vitamins depleted or added)ect...
This is real important for all of us if this is true. Please Heart scan Bloggers/Dr. Davis read the info @ Vit D on Shanes site... Thanks

Anonymous
1/21/2011 5:19:47 PM |

Hi there,
Been researching Vit D here on the heartscan blog and others such as Vit D counsil, Dr. Ben Kims' site,getting good info to stay away from D2 of course.
But this site, "The Peoples Chemist"- Shane Ellison and blog poster "Chuck" say we all should stay away from any man-made D3(sheep wool) included. They back it up stating specific chemical biological changes in the body. They say it just isn't the same and can do more harm in the long run. The site states basically that we should be using only food for Vit D3. meats, eggs, cod-liver oil(w/o the vitamins depleted or added)ect...
This is real important for all of us if this is true. Please Heart scan Bloggers/Dr. Davis read the info @ Vit D on Shanes site... Thanks

Lynn D
9/20/2012 10:32:05 PM |

If our vite D levels show up low 20every year ,even when take 4000/day, then
are we not absorbing or are we using it up. It sounds like some websearch showed up maybe
additional testing such as also 1,25 OH in additon to the 25OH
Thanks for any info

Eric
7/21/2011 1:53:59 AM |

Isn't there some bacteria that grows in sun tea?

Shreela
7/21/2011 2:41:53 AM |

I believe Eric is correct, although sinus problems tell me not to search for it right now LOL
Try overnight tea in the fridge instead.
http://www.theyummylife.com/blog/2010/08/22/How+to+Make+Refrigerator+Iced+Tea

Againstthegrain
7/21/2011 6:46:21 AM |

I have to agree with Shreela, as I have had the misfortune of drinking sun tea that had been at room temp for too long during warm weather. Steep and store the tea cold in the fridge and discard it after two or three days if it isn't consumed, or at the first sign of anything floating in the tea. The bacteria that grows in tea brewed at room temp (or warmer) can cause an unpleasantly strong attack of the "runs".

More info about this issue:
http://www.snopes.com/food/prepare/suntea.asp

Joe E O
7/21/2011 11:28:19 AM |

Dr. Davis care to comment:

Study: Boosting Good Cholesterol With Niacin Did Not Cut Heart Risks:
http://www.npr.org/blogs/health/2011/05/28/136678665/study-boosting-good-cholesterol-with-niacin-did-not-cut-heart-risks?ft=1&f=1001

Peace
Joe E O

Kent
7/21/2011 3:10:50 PM |

Joe E O, I would investigate the numerous other studies that have proven the effectiveness and benefits of Niacin, before dicounting it due to skewed and flawed study you reference. Keep in mind that anytime something shows benefit over the Statin Machine, it is going to have a full out assault launched against it.

Randy
7/21/2011 3:18:29 PM |

Also good with a couple of mint tea bags thrown with the green tea. Safeway Select is very good.

Randy
7/21/2011 3:19:55 PM |

Is a warm or cold extraction as effective at pulling the antioxidants out of the tea and into the water?

Chris B
7/21/2011 5:58:35 PM |

I would second the refrigerator tea suggestion over sun tea.
Also, the reason green tea can be bitter so often is that does not like water as hot as black tea and if it is brewed with the same boiling water, that is too hot for it. If you try letting it cool just a little first or not quite get to boiling, you will get a better brew. There are sites out there that will tell you proper temperatures, but I generally don't feel like pulling out the thermometer so I usually just wing it.

Dr. William Davis
7/22/2011 3:11:46 AM |

Gee. I sure enjoyed it--without any runs!

Againstthegrain
7/31/2011 9:41:24 PM |

Dr. Davis,

Most of the time, brewing tea in the sun will probably be fine, especially if the tea is consumed quickly and stored in the refrigerator. But there definitely is *potential* for problems, especially when brewing during warmer weather or prolonged storage time out of the refrigerator. That's what happened with one batch I made a couple summers ago - I kept the pitcher on the counter for a few days due to lack of refrigerator space, adding ice to chill the tea when I filled my glass (or just drinking the tea at room temp). I had at least three tea refills before I connected the tea consumption to the frequent "just-in-time" trips to the loo that day. Upon further inspection, the tea had a slightly cloudy appearance, with a large thing floating in it. The runs stopped after I dumped the tea and switched to drinking water.

Now when I "cold-brew" tea I either make it in on the counter during cooler weather or in the refrigerator during warmer weather, never in the sun where the water will become warm. I dump leftover tea after a few days if it isn't consumed, and I thoroughly wash the container.

Yvonne
8/2/2011 9:38:14 AM |

I think I'll make the sun tea the same way Dr. Davis did, so as to get that smooth green tea flavor; but I'll add the lemon to the brewed tea after I remove it from the sun (to boost its natural acidity), and decant it in smaller jars in the refrigerator. Thanks for this recipe, Dr. Davis!

Anonymous
3/19/2007 6:02:00 PM |

D looks like the answer to a lot of problems and I have heard also it can reduce arteial build up of plaque and calcium. True or False

Dr. Davis
3/19/2007 9:53:00 PM |

My view is that vitamin D replacement to 50 ng/ml is a powerful facilitator of plaque regression.

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