And here's another "I agree wholeheartedly". It can be hard to find a doctor on the same page though. Anyone have suggestions?

Amen brother!    One of the big problems with self directed care is the lack of true knowledge for the public to help them make choices.  For example  The dietary advice given from our government and other health agencies (ADA,  AHA, food pyramid etc) to cut the fat and red meat, eat whole grains and lots of fruit.

Agreed. I've thought something like this would be very nice. In my mind, I've been calling it 'distributed medicine', but 'self-directed health' sounds more empowering.

Hi StephenB,

This is the future of medicine!!

I suggest Dr. Kenneth Tourgeman. He is definitely on the same page as Dr. Davis.  He is a nephrologist who preaches a hunter gatherer lifestyle and practices scientific nutritional medicine with high dose vitamin D3 and high dose omega 3 fish oil. His blog is nephropal.blogspot.com

This is one of the wisest suggestions I have heard in a long time. If other medical practitioners would accept this advice, it could revolutionize our healthcare system.

Not that I disagree, but just how realistic is this.  Most people cannot even manage to keep their own computer running properly, how can they be expected to manage their health to the extent I suggest.

Not that I approve of paternalistic "do as I say" doctors, but I don't see a system such as yours work for the majority of people.  I'd like to see a system that encourages patients to take charge of their health care, instead of considering them trouble maker when when they do.  But that will always be a minority.  Most people want to be told what to do.

This is amazing. I was just thinking the same thing about one hour ago after doing some reading on my own health issues.

Thank you for putting this forward, this idea will indeed revolutionize the health care "industry" for the better, when people start taking it upon themselves to manage their own tests, results, medications, supplements, etc. outcomes will improve dramatically.

Mark my words.

I know a handful of doctors who are like this, and they seem to make a psychological difference as well as a physical one.
However, most might be worried that you'll think for yourself - in the wrong or right direction. They can't be having that.

Dr. David Grimes (who once proposed that statins work by somehow activating the vitamin D receptor) published a book on the vitamin D/cholesterol connection this April.
http://www.vitamin-d-deficiency.co.uk/
A very nice man as well. I've had an email conversation with him.

I agree that healthcare should be largely self-directed, and I absolutely agree that the public should be allowed to make more informed decisions about their own health. However, I think that to assume that all Americans have the discipline and intelligence to truly take charge of their own care is very misguided.  Our health problems go far beyond the misinformation from the ADA and AHA.

This change can't come too soon. I recently went to the VA hospital to get bloodwork done. I wanted any sort of test to give me a baseline on which I could monitor improvements from changes in my diet.

The nurse refused several tests because they cost money, said with mild scorn, "You apparently don't want anything from the VA other than testing" and later chastised me for refusing a mammogram and pap smear. (Aren't those costly, too?)

This is my body. I call the shots. Please, just answer my questions and help me help myself.

StephenB

>It can be hard to find a doctor on the same page though.

Absolutely. And in the UK, with its large General Practice centres, it is hard to see the same doctor twice. 'First consult you doctor' is written everywhere these days, but one doesn't have *a* doctor, so there can't be a relationship established on trust. It is also getting harder to buy simple non-prescription drugs like aspirin over here, due to nannying by pharmacists.

Hello Dr Davis,

I just found this article about Type-1 Diabetes and wheat; thought you would like it, unless you already red it.

http://diabetes.diabetesjournals.org/content/58/8/1789.abstract

Let me post a hypothetical question: What if your health were tracked, if online interactions were truly interactive, and you could be prompted/reminded/coached to consider various strategies for health using your individual health data?

That is what we are working on here using Track Your Plaque as the prototype.

Congratulations! Our selection committee compiled an exclusive list of the Top 100 heart disease Blogs, and yours was included! Check it out at http://thedailyreviewer.com/top/heart-disease

You can claim your Top 100 Blogs Award Badge at http://thedailyreviewer.com/blog/9076

Cheers!

Angelina...

billye

Sorry to be off topic -- I love the nephropal blog but wonder if anyone else is having problems with it?  Everytime I log on it knocks out my wireless connection.

Dont know where else to put this but I voted on your thyroid question. I answered "questioned why but ordered the tests"

But the rest of the story is he said the results were fine although my TSH was High "normal" and my T4 was OUT of range low.

Went to see a new doc this week.

Nick,

I have not heard anything about connection problems from anyone.  Leave a comment for Dr T at nephropal.blogspot.com and I am sure that he will look into it.

Dr. Davis, i agree with you what you just said. but, there is even bigger issue to deal with here. the FDA. for example: FDA is going after natural thyroid hormons. which have been selling safely in the market for 100 years now. talk about pure money muscle power. FDA have no problem approving dangrous drugs for cholstrol. it confuses the issue further for the people who are trying to learn about their own health.
http://thyroid.about.com/b/2009/08/26/end-natural-thyroid.htm?nl=1#commentform

Dr. Davis said: Let me post a hypothetical question: What if your health were tracked, if online interactions were truly interactive, and you could be prompted/reminded/coached to consider various strategies for health using your individual health data?

Well that would be just great, IF one didn't have to worry some about an insurance company accessing such data and using it against one to deny coverage or prevent one from obtaining future coverage. Such info would have to be COMPLETELY private.

Until there are no "pre-existing condition" exclusions in health insurance, and it doesn't matter if such information could possibly be accessed by insurance, I will just "do it myself".

Technology can be a two-edged sword.  I had a heart scan and my insurance wouldn't pay for it... but they apparently were interested enough in the results to make it damn near impossible to obtain life insurance, health insurance, and long term care insurance on the open market, due to my "pre-existing condition".

Luckily we will have "lifetime medical insurance" through an employer's generous retirement plan and eventually Medicare.  Not so lucky about the long tern care coverage, though.

Until technology can guarantee complete privacy, and no possible controverted use of information, I have great reservations, no matter how well intentioned and valuable the information.

madcook

Hi, Mad--

Yes, indeed.

I believe that, while imperfect, online security is the solution. Only you (or those you designate) can access your info. This is how Google Health, Microsoft Health Vault, and Revolution Health's health archiving services work.

It's happening. And it will change healthcare for the better by putting more information and control into the hands of the consumer. This is a GOOD thing.


Kris--

Yes, this is very worrisome.

The FDA is threatening to "clamp down" on thyroid preparations and "bioidentical hormones," two areas in which most of us agree no action is required and in fact will be destructive.

I've written my letters to the FDA expressing my objection to their policies. Everyone else should, too.

Just saw my doc for annual physical (I'm 49).  Mentioned the heart scan blog and he said calcium score tests are "bogus".  "insurance companies don't pay for them so they must not mean much, plus if the plaque doesn't reduce flow, it's not a problem".  And he's young (early 40's).  Kept quiet after that; no use trying to convince him to open his mind.

Hi Dr. Davis (and readers),

I have conceptualized this movement to the 'Patient of One' healthcare system in a few essays:

http://epistemocrat.blogspot.com/2008/12/health-care-sans-primary-care.html

and then, more recently, through many of my recent blog postings:

http://epistemocrat.blogspot.com/

(feedback welcomed)

Cheers to fostering an inviting and respectable community of self-directed self-experimenters.

Thanks,

Brent

To a degree I've had something like that for a while now. Our local surgery uses nurses, prescribing nurses etc. for routine stuff, which frees up the doctors' time for serious stuff. For example when mother is ill I can always get a doctor to call (or paramedics/ambulance) or take her to the surgery where she is seen by a triage nurse and a GP is called immediately if required.

My GP (In fact all the GPs) are comparatively clueful BUT limited by accountants as to what they are and are not permitted to do - and here's the problem, when the doctor is cut out of the loop then even the receptionist is permitted to refuse tests or refuse to give out the results and otherwise hinder my looking after myself. The not-doctors are even more limited as to what they are and are not permitted to do and it still needs a real doctor to override these restrictions, for example to get a full lipid panel rather than TChol, and then be given the actual numbers.

If these relatively recent financial restrictions were lifted again (some hope!) it'd be an ideal system, I get the tests I need and the prescriptions I need and as much or as little support as I require to work on the results. Reversing this back to a patronising  "eat up your carbs yum yum and we'll weigh you again in six months and check for statin deficiency once a year" may "save" money but only in the short term.

The doctors themselves aren't happy about Big Brother - but they realise that opposing it will lead to loss of their employment

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. Davis, first, thanks for one of the best blogs on the net.

I'd suggest testing krill oil to see if it offers an advantage over plain fish oil.

I'd also consider testing the rather extreme diet followed by the guy who does the Hyperlipid blog.  (Extreme high fat, moderate protein, essentially zero carb.)

(By the way, he has an interesting post where he argues that in the presence of dietary sugar and/or excess alcohol intake, that fish oil is actually very dangerous.
http://high-fat-nutrition.blogspot.com/2008/08/familial-hypercholesterolaemia-and.html

http://www.ajcn.org/cgi/content/full/69/3/419

I got this from the Wikipedia page on Lp(a). Subjects were fed casein, safflower oil, and cornstarch, or the same but with soy replacing the casein. With soy, Lp(a) levels were slightly decreased, with casein, they were radically decreased. (By as much as 65 percent.)

Those fish-eating Bantu Islanders from the Kitiva study--they weren't just eating more omega 3's, they were also eating a lot more protein, and better quality protein at that.

Hi Dr. Davis,

Doxycycline works to reduce Lp(a) in some patients...

Doxycycline inhibits the production of Leukotrienes produced through the 5-Lipoxygenase inflammatory pathway.

I think you've hit the nail on the head here with the question of whether it would be better to hit Lp(a) with every weapon in the arsenal right from the start...

So, all the inhibitors of the 5-LO pathwy would be used from the start including High dose EPA/DHA, Boswellia, Curcumin, Pycnogenol, Resveratrol, Quercetin, etc.

Hit it with everything right from the start...

wccaguy

Forgot another possibly significant angle on this "kitchen sink" idea...

Include the new software tools/devices in the Virtual Clinical Trial to increase Heart Rate Variability to reduce the inflammation that most likely drives Lp(a) level.

Re: the concept of the kitchen sink...

It can take years to cycle through all the potential supplement and other solutions to high Lp(a) in the difficult cases.

Why not throw the kitchen sink right from the start for the TYP program "high risk" members?

8-)

wccaguy

Regarding diet....

I am increasingly more impressed with the essential argument of the PaleoDiet that G keeps bringing up...

Why is it that study after study finds the "nuts, berries, leaves, bark, and meat" which are central to the paleo diet to reduce risk?

It seems to me that the essential argument of the paleo diet makes scientific sense and that the detailed studies of the nuts, berries, bark, and meat are supportive as well.

wccaguy

Dr. Davis,
My two-cent suggestion for a full-frontal assault would include the followings:
1. Drastically lower basal and total insulin production through ketogenic diet (the anabolic hormone that promotes inflammation). In this context, intermittent fasting and/or a high-fat diet is a component of this approach.
2. Promote cell membrane flexibility/suppleness with fish-oil and simultaneously cut back on omega-6 intake.
3. L-Arginine and/or nasal-breathing aerobic/anaerobic physical activities to promote nitric oxide production by the endothelial cells - vasodilation
4. Potassium supplement from spices, vegetables and fruits (low fructose) to help lower blood pressure.
5. Correct other nutritional deficiencies (vitamins D, A, niacin, magnesium, etc.)
6. Treating the root cause of Lp(a) production. I'm partial to the Pauling's hypothesis which asserts that (a) the small, dense and sticky Lp(a) is the body's first response to patch the cracked coronary arteries that break down due to constant high pumping pressure; and (b) Lp(a) production is unique to primates who have lost the ability to synthesize ascorbic acid. Therefore, high dose vitamin C to cure scurvy of the heart and Lysine and Proline to bind to and remove Lp(a) that forms plaque.

If all of that fail to produce the desire outcome after 6 months or so then it's time to get naked and carry a sharpened stick to the woods to did up some tubers and kill your own meat.

Dr. Davis, thanks for an a great blog.

I'd suggest testing the following:


After one year, arterial plaque decreased 30% for those patients who consumed 8oz Pomegranate Juice daily, compared to a 9% worsening for patients who drank a placebo:

Blood flow to the heart improved approximately 17% for those patients who consumed 8oz Pomegranate Juice daily but worsened approximately 18% in the comparison group:

http://tinylink.com/?OUFOIe3yo6  
same as:
http://www.pompills.com/health_benefits/health_heart.aspx

Statin dosage may need to be reduced because pomegranate acts like grapefruit.


Seaweed sushi wrap for increased iodine.

Daily Japanese iodine consumption vary from 5,280 mcg to 13,800 mcg; by comparison the average U.S. daily consumption is 167 mcg. It has been hypothesized the amount of iodine in the Japanese diet has a protective effect for breast and thyroid disease:

http://tinylink.com/?Q1Gfu8LFxO  
same as:
http://findarticles.com/p/articles/mi_m0FDN/is_2_13/ai_n27943644/pg_

HeartHawk (blog) thinks his hypothyroidism has caused some of his Lp(a) problems.


Matt W

Apparently some people in the Netherlands believe in Doxy as well, enough to warrant a trial.

The effects of doxycycline treatment on inflammation and endothelial function in advanced atherosclerosis

My mother-in-law has fibromyalgia and host of viral infections, one bacterial, along with Lpa around 240, and of course elevated CRP. She is starting on Doxy for the bacterial infection.  Maybe we can hit two birds???

Thanks Dr Davis for an excellent blog.  Hopefully with info from you blog we can slow down her PAD (100% blocked carotid + 4 blocked arteries below the knee) and keep her legs!

Matt made a mention of Iodine.

Dr. Guy Abraham has been doing all sorts of studies with and Iodine/Iodide combination. It has proven to be very effective in treating fibrocystic breast/ovarian disease, which are also responsive to estrogen. From looking at many of the studies he's published (http://www.optimox.com/pics/Iodine/opt_Research_I.shtml) he seems to like to collaborate with physicians with a clinical practice. Perhaps he would be interested in working with you to look at the Lp(a) problem and see if iodine/iodide has any affect.

I love my kitchen,when i bought my house through costa rica homes for sale i expected to have a big kitchen and now i am really happy.

I love my kitchen,when i bought my house through costa rica homes for sale i expected to have a big kitchen and now i am really happy.

While many people might find this unpalatable and overwhelming from the starting gate of their program, I do believe it may be a strategy we should consider adopting for full and more immediate plaque control in the Track Your Plaque program. Something to chew on.