another question: Was this miscalculation deliberate? Pharma makes a lot more money off of a population that is chronically ill than a population that is healthy.
Vitamin D is rodenticide . Rat poison. What is your problem? People know it and avoid it . Oh your buddies are loosing money. Oh only in very high dosage. Ok Than even cyanide is ok for human consumption in small dosage..
Vitamin D3 is a poor substitute for sunshine itself and sunshine provides so many more benefits than just Vitamin D3 itself, but it cannot be a poison for us as Vitamin D3 is contained in so many foods we eat, like eggs, almost entirely in the yolks.
Having said that, rats are opportunistic feeders, like squirrels, and both will eat bird eggs when they find them in the wild, so if Vitamin D3 in eggs is purely rodent poison, that would kill the rats and squirrels, but it does not. Maybe that is because the D3 is accompanied by other compounds in the eggs to render it safe to eat, a bit like eating natural sources of aspirin in herbal form will not cause stomach bleeding, whereas pharmaceutically isolated aspirin will cause stomach bleeding, and even damage microcapillaries in the ears and eyes, leading to varying degrees of deafness and eye damage, and if I take aspirin even once for instance, I start to hear a tinnitus sound, and that is damage to the ears occurring.
You are supposed to eat K2 with D3 or you are just asking for high calcium in the blood,
K2 reverses high calcium in the blood. And the free book online: 'Why Animals Don't get Heart Attacks But Humans Do' by Dr Matthias Rath says that just 500 mg Vit C a day and a few other vits clears 50% of arterial deposits in 3 years, I take 4 grams Vit C a day and have done for years. He reckons heart disease is often (though not always) a symptom of actual scurvy from Vitamin C deficiency.
I can eat plenty of bitter apricot seeds, and I absolutely love crunching up apple seeds for the delightful marzipan taste, the very mild compound called amygdalin containing cyanide is activated only by an enzyme specifically released only from cancer cells, so any cyanide is only released due to the presence of a cancer cell, and the cyanide homes in precisely on a cancer cell and neutralizes it.
From 'the internet':
Vitamin D3 kills rats by causing toxic hypercalcemia, which leads to kidney failure, organ damage, and death.
Mechanism of Toxicity
Vitamin D3, also known as cholecalciferol, regulates calcium and phosphorus in the body. At rodenticide doses, it dramatically increases calcium absorption from the gut, releases calcium from bones, and reduces calcium excretion via the kidneys. This results in severely elevated blood calcium (hypercalcemia) and phosphorus (hyperphosphatemia), which can damage soft tissues including the kidneys, heart, lungs, and gastrointestinal tract, ultimately leading to organ failure and death if untreated.
In addition to its positive effects on blood clotting and strong bones, vitamin K helps keeps your heart healthy. That’s because of the way it acts to clear out calcium from your blood vessels.
When calcium builds up in your body, it can lead to hardening (or calcification) of your tissues, organs and blood vessels. Calcium deposits in your arteries can lead to high blood pressure, kidney disease and more.
“Vitamin K has been shown to help activate a protein that helps prevent calcium from depositing in your arteries,” Zumpano explains. “Calcium deposits contribute to the development of plaque, so vitamin K does a lot of good for your heart health.”
Some early research has shown that vitamin K2 may be more effective at clearing out calcium than vitamin K1.
The house doctor on Fox News many, many years ago decided to test all of his patients for vitamin D deficiency. He found that significantly more than half of them were deficient close to half were severely deficient!
I asked my doctor to test mine and he said he was going to test all his patients. I told him that I figured he was a Fox News viewer and he just grinned.
It turns out that I was mildly deficient and my wife was severely deficient. Our indoor lifestyle is the culprit, I believe. I try to get out in the sun as much as possible these days.
I was an early adopter of vitamin D supplementation. My multiple disciplinary care provider at that time had been testing patients and found that so many were deficient that it was safe to assume all were deficient. Due to the low toxicity of vitamin D, his policy was to supplement first, and then test after three months to see who might need more.
The fact that the IOM's RDA is far too low does not mean that we should respond with a higher RDA. The whole concept of RDA is broken in general, and in particular with vitamin D3 supplementation.
The real question is how much supplemental vitamin D3 should each person take, on average, per day, to attain at least the level of circulating 25-hydroxyvitamin D required for good health.
This question is not about "adults" in a particular country - it is about everyone, of any race, age or location.
The answer is Prof. Sunil Wimalawansa's recommendations, the only peer-review journal published vitamin D3 supplemental quantity recommendations which apply to people of all ages, races and body weights and which are calculated as ranges of ratios of body weight, with higher ratios for those suffering from obesity.
The only people who need much less supplemental vitamin D3 than this are infants substantially breast fed from 25-hydroxyvitamin D replete mothers and people whose UV-B skin exposure is so high that they are, in the long-term, at much elevated risk of skin cancer.
(Human breast milk from mothers who are replete in 25-hydroxyvitamin D contains both 25-hydroxyvitamin D and a variable amount of vitamin D3 cholecalciferol, depending on how much supplemental vitamin D3 or UV-B skin exposure the mother has had recently. Only about 1/4 of ingested or skin-produced vitamin D3 winds up as circulating 25-hydroxyvitamin D after it has been hydroxylated in the liver. Measurements are tricky, but this means that the breast milk levels of the two compounds found by Tsugawa et al. 2021 https://www.mdpi.com/2072-6643/13/2/573 each contribute about equally to the infant's 25-hydroxyvitamin D level, even though the average 25-hydroxyvitamin D level was about 1/4 that of vitamin D3.)
Expressed in IUs (for vitamin D3, 1/40,000,000th of a gram), the average daily intakes Prof. Wimalawansa recommends are
70 to 90 IU / kg body weight for those not suffering from obesity (BMI < 30).
100 to 130 IU / kg body weight for obesity I & II (BMI 30 to 39).
140 to 180 IU / kg body weight for obesity III (BMI > 39).
For 70 kg (154 lb) without obesity, this is about 0.125 milligrams (5000 IU) a day = a gram every 22 years. This takes several months to attain the desired > 50 ng/mL circulating 25-hydroxyvitamin D. See: https://vitamindstopscovid.info/00-evi/#00-how-much.
In 2022, Prof. Wimalawansa published an article with proper vitamin D3 supplementation recommendations, as ratios of body weight, with higher ratios for those suffering from obesity, since obesity reduces the rate of hydroxylation in the liver to 25-hydroxyvitamin D and because the excess adipose tissue absorbs 25-hydroxyvitamin D and vitamin D3: https://vitamindstopscovid.info/00-evi/#obesity- deficit. He later simplified these recommendations somewhat to those in the three lines above, in an FLCCC (now IMA) webinar in 2023: https://odysee.com/@FrontlineCovid19CriticalCareAlliance:c/Weeekly_Webinar_Aug16_2023:d?t=3386.
Prof. Wimalawansa repeated these simplified recommendations in an article co-written by two other professors - one of medicine and the other of pediatrics: Integrating Endocrine, Genomic, and Extra-Skeletal Benefits of Vitamin D into National and Regional Clinical Guidelines Sunil J. Wimalawansa, Scott T. Weiss and Bruce W. Hollis, Nutrients 2024-11-20 https://www.mdpi.com/2072-6643/16/22/3969.
This is the answer to the only question that matters. Just say No to RDAs for vitamin D3.
Here is what is wrong with the RDA approach. But first, we need a proper target level of circulating 25-hydroxyvitamin D
The RDA can only be calculated for a particular level of circulating 25-hydroxyvitamin D which is believed to be required for good health. The IOM aimed for 20 ng/mL (50 nmol/L = 1 part in 50,000,000 by mass. This is roughly what the kidneys need to maintain whatever, very low - ~~ 0.05 to 0.1 ng/m - level of circulating calcitriol (1,25-dihydroxyvitamin D) the body needs to properly regulate calcium-phosphate-bone metabolism.
The IOM did not consider the needs of the immune system. They didn't know - and many vitamin D researchers to this day still do not know - that immune cells are not significantly affected by this very low, stable, level of circulating calcitriol, which is the only hormonal function of the three compounds.
Many types of immune cell rely on a good supply of 25-hydroxyvitamin D as raw material for their 25-hydroxyvitamin D to calcitriol intracrine (within a single cell) and paracrine (to nearby cells, typically of different types) *signaling* systems. These are crucial to the ability of cells of many types to respond to their changing circumstances. These signaling systems are only activated when a cell detects a cell-type specific condition. Their successful operation - which can only occur with much greater than 20 ng/mL circulating 25-hydroxyvitamin D - is essential for the immune system to mount rapid, strong, responses to bacterial and viral pathogens and to malignant cells, and to properly limit self-destructive, indiscriminate cytotoxic, inflammatory responses. Successful operation changes gene transcription - and so the cell's behavior - in cell-type specific ways.
There being no peer-reviewed tutorial on these signaling systems, and since immunologists and even many vitamin D researchers do not understand them (or have even heard of them), I wrote my own tutorials: https://vitamindstopscovid.info/00-evi/#02-compounds - or, in greater detail: https://vitamindstopscovid.info/02-intracrine/. Every medical professional, endocrinologist, virologist, vaccinologist, epidemiologist and of course every vitamin D researcher in the world needs to understand these signaling systems.
We should aim for 50 ng/mL or more circulating 25-hydroxyvitamin D. The most specific evidence for this as the minimum level for full health comes from Quraishi et al. 2014, in which the risk of post-operative infections was found to be stable at about 2.5%, separately for hospital acquired and for surgical site infections, for pre-operative 25-hydroxyvitamin D levels of 50 ng/mL or more. At levels below that, the risk of post-operative infection rises rapidly, such as to 25% for each of the two types, at 20 ng/mL. It is reasonable to assume that a similar pattern of immune system failure occurs with responses to viruses and cancer, the further below 50 ng/mL the level of circulating 25-hydroxyvitamin D is.
The amount of supplemental vitamin D3 required to attain 50 ng/mL circulating 25-hydroxyvitamin D depends directly on body weight and is elevated even further for any given body weight by obesity.
This means that or any given target level of circulating 25-hydroxyvitamin D, to calculate the RDA for a given population, such as residents of the USA, we need to run extensive vitamin D3 supplementation trials on a substantial sample of people whose body weights are just below the range of body weights of the heaviest 2.5% of the population.
The body weights and the responses to vitamin D3 supplementation of the other 97.5% of the population do not affect the RDA.
Properly researched, the U.S. vitamin D3 RDA for a target of 20 ng/mL circulating 25-hydroxyvitamin D would be some figure well in excess of 125 micrograms (5000 IU). This is already more than children, many adolescents and a substantial fraction of adults need.
The RDA for the proper target of 50 ng/mL circulating 25-hydroxyvitamin D would be very much higher. Since 2.5% of the U.S. population are suffering from obesity 3, using Prof. Wimalawansa's recommendation backwards, with my 120 kg guesstimate of the body weight border of the 2.5% of the population who respond most weakly to any given quantity of supplemental vitamin D3 (those adults who are the most obese), reversing Prof. Wimalawansa's third line, means 16,800 to 21,600 IUs a day.
Such intakes would be far too high for many adults. The whole concept of the RDA is fundamentally broken.
Even if there was a good RDA for "adults", lighter (including especially elderly) adults would be supplementing too much vitamin D3 by following the RDA - and the RDA doesn't specify anything for infants, children and adolescents.
Prof. Wimalawansa's recommendations work for everyone - in every country - without the need for the extensive research which would be required to calculate an actual RDA.
(1 of 2) Perhaps the RDA for vitamin D3 should be ca. 18,620 IU/day.
Here is an attempt to estimate the RDA for supplemental vitamin D3 in the United States adult (20 years and over) population, for two target levels of 25-hydroxyvitamin D:
20 ng/mL, as used by the IOM and many other health authorities
I guess the RDA for 20 ng/mL is probably in the 4000 to 8000 IU/day range. Below I show how I estimated the RDA for 50 ng/mL circulating 25-hydroxyvitamin D in the U.S. adult population (not counting pregnant women and those in institutions), is, very approximately, 18,620 IU/day.
The whole concept of the RDA is wrong due to wide variations in obesity. This is especially so for vitamin D3, due to the ill-effects of obesity.
Professor Wimalawansa's recommendations for supplemental vitamin D3 intakes, as a range of IUs per day per kg body weight, with higher ranges for those suffering from obesity, should be adopted by health authorities worldwide https://vitamindstopscovid.info/00-evi/#00-how-much. These apply to all people, of all ages and body weights, including those suffering from obesity, without being specific to any race, sex or country. They apply to people who are not subject to medical advice to the contrary and they will reliably attain at least the 50 ng/mL level of circulating 25-hydroxyvitamin D the immune system needs to function properly, without the need for blood tests or medical monitoring.
Extensive research of these recommendations in practice, in populations of millions of people, might refine the exact figures slightly, but this would make only a marginal difference to the recommendation's safety and health benefits.
Best regards
Robin
The amount of any nutrient an individual needs to attain a given level of sufficiency scales directly with bodyweight. In addition, with the amount of supplemental vitamin D3 required to attain any given level of circulating 25-hydroxyvitamin D, obesity increases the amount of vitamin D3 required, in proportion to the severity of the obesity, due to at least two mechanisms. Firstly, obesity reduces the rate at which the liver produces 25-hydroxyvitamin D for any quantity of supplemental or UV-skin produced vitamin D3, for any given body weight. Secondly, the excess adipose tissue seems to absorb more circulating 25-hydroxyvitamin D (and vitamin D3 too, I recall) than in people not suffering from obesity, without giving it back to the circulation if the circulating levels fall. See detailed references at: https://5nn.info/temp/250hd-obesity/.
The RDA is the amount of supplemental nutrient which, if given to an entire population, would result in 97.5% of that population receiving what is judged to be an adequate intake.
Because the relationship between circulating 25-hydroxyvitamin D level and vitamin D3 supplemental intake quantity falls off so strongly with high bodyweight and obesity, and since all the individuals with the highest (20% or more) body weights are suffering from obesity, it suffices to assume that if we could find a testable subset of the population whose body weight was around the 97.5th percentile of the whole population's body weight distribution, we could test those individuals with different quantities of supplemental vitamin D3 in order to find, in general, on average, for such people, how much was required to attain any given target level of circulating 25-hydroxyvitamin D.
To proceed, we want estimates of the body weight and the obesity status of these people.
I could not find an exact data on this 97.5th percentile, but we can guesstimate the body weights from data contained in: Anthropometric Reference Data for Children and Adults: United States, 2015–2018 https://stacks.cdc.gov/view/cdc/100478. This data does not cover pregnant women or those who are institutionalized. It is corrected for sampling biases to represent the general United States population 20 years and over.
Tables 3 and 5 report the body weight at various percentiles of the distribution, separately for women and men. Averaging these two sets of body weights results in:
50th 74.2 kg
75th 85.2 kg (1.1)
85th 104.4 kg (4.8)
90th 112.3 kg (4.0)
95th 125.0 kg (6.4)
(This mixes the body weights from two separate distributions, one for men and the other for women, but it is a reasonable estimate of what the body weights would be for these percentiles of a single distribution for men and women combined. Likewise the BMI figures below.)
The values in parentheses are the average kilogram increment per 2.5% span of the population distribution, from the previous percentile to this one.
The long tail of this distribution beyond the 95th percentile can only be known accurately from sampling bias corrected individual observations. I could find no such analysis or graph, so I guesstimated that the body weight at the 97.5th percentile is 133 kg, by assuming the 2.5% span from the 95th percentile to the 97.5th has an increment of 8 kg. It is probably more, so this is a conservative guess based on the pattern of increase in the numbers in parentheses.
Tables 14 and 15 report the average BMI for women and men, the 1st and 2nd figures below, with the 3rd being the average. Women have higher BMIs, but this could be due to BMI's simplistic nature, rather than being based on actual metabolic health.
50th 28.5, 28.4 = 28.5 Overweight
75th 33.9, 32.8 = 33.5 Obesity I
85th 37.5, 35.3 = 36.4 Obesity II
90th 40.3, 37.1 = 38.7 Obesity II
95th 44.6, 41.0 = 42.8 Obesity III
On the basis of 133 kg body weight with obesity III, we can apply Prof. Wimalawansa's vitamin D3 supplemental intake recommendation in the reverse direction to estimate what the RDA would be for the United States adult population to attain at least 50 ng/mL circulating 25-hydroxyvitamin D. I will use the lower figure of Prof. Wimalawansa's range, which is 140 IU/kg.
(133 * 140) = 18,620 IU / day = 465 micrograms / day, on average.
I am not sure how to scale this to an RDA for the target of 20 ng/mL circulating 25-hydroxyvitamin D. I was going to use Fig 3 from Ekwaru et al. 2014 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0111265. This depicts the relationship between supplemental vitamin D3 intake and long-term 25-hydroxyvitamin D levels, with separate curves for self-described (by the adult fitness-pursuing participants in the study) body morphologies of underweight, normal weight, overweight and obese. However these lines are all above 20 ng/mL (50 nmol/L in the graphs) at the 0 IUs per day intercept.
The self-limiting nature of higher 25-hydroxyvitamin D (due to the activity of the 23-hydroxy enzyme irreversibly degrading the 25-hydroxyvitamin D, at a rate roughly proportional to the circulating 25-hydroxyvitamin D level) is clearly evident in the curves flattening out at higher 25-hydroxyvitamin D levels from their initial steep rise from lower levels.
If the RDA is defined on the assumption that the people are getting minimal UV-B skin exposure, little or no vitamin D3 (or 25-hydroxyvitamin D) in food, and the RDA specifies how much vitamin D3 they must supplement in total, then it can easily be seen from the graph that halving any given amount of supplemental vitamin D3 will result in reduction in circulating 25-hydroxyvitamin D of less than 50%. I can't estimate with any precision what fraction of 18,620 IU/s a day would attain, in this set of 97.5 percentile bodyweight people, all suffering from obesity III, would be required to attain just 20 ng/mL circulating 25-hydroxyvitamin D, but I am sure the figure is well over 600 IU a day.
I guess it is in the 4000 to 8000 IU/day range. But who cares? We know the IOM was mistaken and therefore that the government recommendations all around the world for how much vitamin D3 to supplement are also mistaken, because they are based on the IOM's recommendations and whatever even lower recommendations were current before the IOM's 1100 page 2010 report. For instance, here in Australia, since 2005 https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-d, the recommended daily vitamin D3 supplemental intake is 5 micrograms (200 IU) a day, from birth to 50 years, 400 IU/day for 51 to 70 years and 600 IU/day for 71+ years. (The highest capacity vitamin D3 capsule which can legally be sold here without prescription is 25 micrograms 1000 IU.)
The IOM recommendation of 600 or 800 IU/day isn't just wrong because the miscalculated.
A proper calculation for their 20 ng/mL circulating would probably be an RDA of 4000 to 8000 IU/day. This would still be wrong because it is only raising the circulating 25-hydroxyvitamin D level of the 30% or so of the population who suffer from obesity to around 20 ng/mL, when the target should be at least 50 ng/mL.
If the RDA was set correctly to ca, 18,000 IU a day, it would still be wrong, since this is a vast overestimate of what most of the population need to be healthy. The 10th percentile body weights are 53.9 kg for women and 66.9 kg for men. (At 70 years of age, I am at that percentile.) I supplement about 250 micrograms 10,000 IU of vitamin D3 a day, with 200 micrograms of vitamin K2. My circulating 25-hydroxyvitamin D level is ca. 90 ng/mL, which I am happy with. If I took 18,000 IU a day, the level would probably go to 140 ng/mL. I might be super-healthy, but no health professional in their right mind would issue a blanket, adult population wide, recommendation for 18,000 IU of vitamin D3 a day.
The whole concept of RDA is unfit for purpose. It is a simplistic administrative convenience which persists due to the convenience of stating it, or a percentage of it, in a few square millimetres on the back of a supplement bottle. It also persists because whole committees of supposed experts are unwilling to admit that they - and their predecessors - were wrong to ever use it.
The only system which properly meets the need of people is to specify supplemental quantities as ratios of body weight. In the case of vitamin D3, a sliding scale or separate recommendations need to be made for varying degrees of obesity. Prof. Wimalawansa's recommendations have a modest range of IUs per day per kilogram body weight for most people, with two higher sets of figures for those suffering from obesity I or II and obesity II. It is easy to interpolate between these if people are borderline obese or are unsure if they are suffering from obesity II or III.
The RDA should be to abandonned, and urgently so in the case of vitamin D3.
I stopped drinking store-bought whole milk after discovering that it was giving me bone spurs. Store-bought whole milk always comes fortified with vitamin D, but no vitamin K. I have had zero problems with bone spurs ever since I stopped drinking the vitamin D fortified milk..
another question: Was this miscalculation deliberate? Pharma makes a lot more money off of a population that is chronically ill than a population that is healthy.
Vitamin D is rodenticide . Rat poison. What is your problem? People know it and avoid it . Oh your buddies are loosing money. Oh only in very high dosage. Ok Than even cyanide is ok for human consumption in small dosage..
Vitamin D3 is a poor substitute for sunshine itself and sunshine provides so many more benefits than just Vitamin D3 itself, but it cannot be a poison for us as Vitamin D3 is contained in so many foods we eat, like eggs, almost entirely in the yolks.
Having said that, rats are opportunistic feeders, like squirrels, and both will eat bird eggs when they find them in the wild, so if Vitamin D3 in eggs is purely rodent poison, that would kill the rats and squirrels, but it does not. Maybe that is because the D3 is accompanied by other compounds in the eggs to render it safe to eat, a bit like eating natural sources of aspirin in herbal form will not cause stomach bleeding, whereas pharmaceutically isolated aspirin will cause stomach bleeding, and even damage microcapillaries in the ears and eyes, leading to varying degrees of deafness and eye damage, and if I take aspirin even once for instance, I start to hear a tinnitus sound, and that is damage to the ears occurring.
You are supposed to eat K2 with D3 or you are just asking for high calcium in the blood,
K2 reverses high calcium in the blood. And the free book online: 'Why Animals Don't get Heart Attacks But Humans Do' by Dr Matthias Rath says that just 500 mg Vit C a day and a few other vits clears 50% of arterial deposits in 3 years, I take 4 grams Vit C a day and have done for years. He reckons heart disease is often (though not always) a symptom of actual scurvy from Vitamin C deficiency.
I can eat plenty of bitter apricot seeds, and I absolutely love crunching up apple seeds for the delightful marzipan taste, the very mild compound called amygdalin containing cyanide is activated only by an enzyme specifically released only from cancer cells, so any cyanide is only released due to the presence of a cancer cell, and the cyanide homes in precisely on a cancer cell and neutralizes it.
From 'the internet':
Vitamin D3 kills rats by causing toxic hypercalcemia, which leads to kidney failure, organ damage, and death.
Mechanism of Toxicity
Vitamin D3, also known as cholecalciferol, regulates calcium and phosphorus in the body. At rodenticide doses, it dramatically increases calcium absorption from the gut, releases calcium from bones, and reduces calcium excretion via the kidneys. This results in severely elevated blood calcium (hypercalcemia) and phosphorus (hyperphosphatemia), which can damage soft tissues including the kidneys, heart, lungs, and gastrointestinal tract, ultimately leading to organ failure and death if untreated.
https://health.clevelandclinic.org/vitamin-k2
In addition to its positive effects on blood clotting and strong bones, vitamin K helps keeps your heart healthy. That’s because of the way it acts to clear out calcium from your blood vessels.
When calcium builds up in your body, it can lead to hardening (or calcification) of your tissues, organs and blood vessels. Calcium deposits in your arteries can lead to high blood pressure, kidney disease and more.
“Vitamin K has been shown to help activate a protein that helps prevent calcium from depositing in your arteries,” Zumpano explains. “Calcium deposits contribute to the development of plaque, so vitamin K does a lot of good for your heart health.”
Some early research has shown that vitamin K2 may be more effective at clearing out calcium than vitamin K1.
Could you explain this a little bit more?
Har har
All vitamins taken without the necessary cofactors can cause problems.
Sola dosis facet venenum. Eat your apricot pits!
I gave it to the squerels. Memento Mory.
Dosis?
I wrote the VITAMIN D PARADIGM SHIFT in 2004 https://pubmed.ncbi.nlm.nih.gov/15478784/. The rest is intentional obfuscation to keep people sick and weak https://healthythinking.substack.com/p/usas-18000-member-endocrine-society
The house doctor on Fox News many, many years ago decided to test all of his patients for vitamin D deficiency. He found that significantly more than half of them were deficient close to half were severely deficient!
I asked my doctor to test mine and he said he was going to test all his patients. I told him that I figured he was a Fox News viewer and he just grinned.
It turns out that I was mildly deficient and my wife was severely deficient. Our indoor lifestyle is the culprit, I believe. I try to get out in the sun as much as possible these days.
I was an early adopter of vitamin D supplementation. My multiple disciplinary care provider at that time had been testing patients and found that so many were deficient that it was safe to assume all were deficient. Due to the low toxicity of vitamin D, his policy was to supplement first, and then test after three months to see who might need more.
I wonder if he saw it on Fox News like me and my doctor did?
Thank you for setting up and holding this event. It is as important as smoking and lung cancer.
[ https://deepd1ve.substack.com/p/the-vitamin-d-rda-should-be-10x-higher ]
The fact that the IOM's RDA is far too low does not mean that we should respond with a higher RDA. The whole concept of RDA is broken in general, and in particular with vitamin D3 supplementation.
The real question is how much supplemental vitamin D3 should each person take, on average, per day, to attain at least the level of circulating 25-hydroxyvitamin D required for good health.
This question is not about "adults" in a particular country - it is about everyone, of any race, age or location.
The answer is Prof. Sunil Wimalawansa's recommendations, the only peer-review journal published vitamin D3 supplemental quantity recommendations which apply to people of all ages, races and body weights and which are calculated as ranges of ratios of body weight, with higher ratios for those suffering from obesity.
These recommendations are intended to ensure everyone attains at least 50 ng/mL circulating 25-hydroxyvitamin D, without the need for blood tests or medical monitoring. They are based on the work of Iranian doctors in Dubai (UAE) https://www.researchgate.net/publication/346136330_Suggested_role_of_Vitamin_D_supplementation_in_COVID-19_severity, Ekwaru et al. 2014 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0111265, the 2010 Endocrine Society Recommendations (Holick et al.) https://academic.oup.com/jcem/article/96/7/1911/2833671 and Prof. Wimalawansa's long clinical and research experience.
The only people who need much less supplemental vitamin D3 than this are infants substantially breast fed from 25-hydroxyvitamin D replete mothers and people whose UV-B skin exposure is so high that they are, in the long-term, at much elevated risk of skin cancer.
(Human breast milk from mothers who are replete in 25-hydroxyvitamin D contains both 25-hydroxyvitamin D and a variable amount of vitamin D3 cholecalciferol, depending on how much supplemental vitamin D3 or UV-B skin exposure the mother has had recently. Only about 1/4 of ingested or skin-produced vitamin D3 winds up as circulating 25-hydroxyvitamin D after it has been hydroxylated in the liver. Measurements are tricky, but this means that the breast milk levels of the two compounds found by Tsugawa et al. 2021 https://www.mdpi.com/2072-6643/13/2/573 each contribute about equally to the infant's 25-hydroxyvitamin D level, even though the average 25-hydroxyvitamin D level was about 1/4 that of vitamin D3.)
Expressed in IUs (for vitamin D3, 1/40,000,000th of a gram), the average daily intakes Prof. Wimalawansa recommends are
70 to 90 IU / kg body weight for those not suffering from obesity (BMI < 30).
100 to 130 IU / kg body weight for obesity I & II (BMI 30 to 39).
140 to 180 IU / kg body weight for obesity III (BMI > 39).
For 70 kg (154 lb) without obesity, this is about 0.125 milligrams (5000 IU) a day = a gram every 22 years. This takes several months to attain the desired > 50 ng/mL circulating 25-hydroxyvitamin D. See: https://vitamindstopscovid.info/00-evi/#00-how-much.
In 2022, Prof. Wimalawansa published an article with proper vitamin D3 supplementation recommendations, as ratios of body weight, with higher ratios for those suffering from obesity, since obesity reduces the rate of hydroxylation in the liver to 25-hydroxyvitamin D and because the excess adipose tissue absorbs 25-hydroxyvitamin D and vitamin D3: https://vitamindstopscovid.info/00-evi/#obesity- deficit. He later simplified these recommendations somewhat to those in the three lines above, in an FLCCC (now IMA) webinar in 2023: https://odysee.com/@FrontlineCovid19CriticalCareAlliance:c/Weeekly_Webinar_Aug16_2023:d?t=3386.
Prof. Wimalawansa repeated these simplified recommendations in an article co-written by two other professors - one of medicine and the other of pediatrics: Integrating Endocrine, Genomic, and Extra-Skeletal Benefits of Vitamin D into National and Regional Clinical Guidelines Sunil J. Wimalawansa, Scott T. Weiss and Bruce W. Hollis, Nutrients 2024-11-20 https://www.mdpi.com/2072-6643/16/22/3969.
This is the answer to the only question that matters. Just say No to RDAs for vitamin D3.
Here is what is wrong with the RDA approach. But first, we need a proper target level of circulating 25-hydroxyvitamin D
The RDA can only be calculated for a particular level of circulating 25-hydroxyvitamin D which is believed to be required for good health. The IOM aimed for 20 ng/mL (50 nmol/L = 1 part in 50,000,000 by mass. This is roughly what the kidneys need to maintain whatever, very low - ~~ 0.05 to 0.1 ng/m - level of circulating calcitriol (1,25-dihydroxyvitamin D) the body needs to properly regulate calcium-phosphate-bone metabolism.
The IOM did not consider the needs of the immune system. They didn't know - and many vitamin D researchers to this day still do not know - that immune cells are not significantly affected by this very low, stable, level of circulating calcitriol, which is the only hormonal function of the three compounds.
Many types of immune cell rely on a good supply of 25-hydroxyvitamin D as raw material for their 25-hydroxyvitamin D to calcitriol intracrine (within a single cell) and paracrine (to nearby cells, typically of different types) *signaling* systems. These are crucial to the ability of cells of many types to respond to their changing circumstances. These signaling systems are only activated when a cell detects a cell-type specific condition. Their successful operation - which can only occur with much greater than 20 ng/mL circulating 25-hydroxyvitamin D - is essential for the immune system to mount rapid, strong, responses to bacterial and viral pathogens and to malignant cells, and to properly limit self-destructive, indiscriminate cytotoxic, inflammatory responses. Successful operation changes gene transcription - and so the cell's behavior - in cell-type specific ways.
There being no peer-reviewed tutorial on these signaling systems, and since immunologists and even many vitamin D researchers do not understand them (or have even heard of them), I wrote my own tutorials: https://vitamindstopscovid.info/00-evi/#02-compounds - or, in greater detail: https://vitamindstopscovid.info/02-intracrine/. Every medical professional, endocrinologist, virologist, vaccinologist, epidemiologist and of course every vitamin D researcher in the world needs to understand these signaling systems.
We should aim for 50 ng/mL or more circulating 25-hydroxyvitamin D. The most specific evidence for this as the minimum level for full health comes from Quraishi et al. 2014, in which the risk of post-operative infections was found to be stable at about 2.5%, separately for hospital acquired and for surgical site infections, for pre-operative 25-hydroxyvitamin D levels of 50 ng/mL or more. At levels below that, the risk of post-operative infection rises rapidly, such as to 25% for each of the two types, at 20 ng/mL. It is reasonable to assume that a similar pattern of immune system failure occurs with responses to viruses and cancer, the further below 50 ng/mL the level of circulating 25-hydroxyvitamin D is.
See the two graphs at the end of the HTML article at: https://jamanetwork.com/journals/jamasurgery/fullarticle/1782085.
The PDF can be found at: https://www.researchgate.net/publication/258957847_Association_Between_Preoperative_25-Hydroxyvitamin_D_Level_and_Hospital-Acquired_Infections_Following_Roux-en-Y_Gastric_Bypass_Surgery.
I combined the two graphs and added some annotations: https://vitamindstopscovid.info/00-evi/#00-50ngmL.
The amount of supplemental vitamin D3 required to attain 50 ng/mL circulating 25-hydroxyvitamin D depends directly on body weight and is elevated even further for any given body weight by obesity.
This means that or any given target level of circulating 25-hydroxyvitamin D, to calculate the RDA for a given population, such as residents of the USA, we need to run extensive vitamin D3 supplementation trials on a substantial sample of people whose body weights are just below the range of body weights of the heaviest 2.5% of the population.
The body weights and the responses to vitamin D3 supplementation of the other 97.5% of the population do not affect the RDA.
Properly researched, the U.S. vitamin D3 RDA for a target of 20 ng/mL circulating 25-hydroxyvitamin D would be some figure well in excess of 125 micrograms (5000 IU). This is already more than children, many adolescents and a substantial fraction of adults need.
The RDA for the proper target of 50 ng/mL circulating 25-hydroxyvitamin D would be very much higher. Since 2.5% of the U.S. population are suffering from obesity 3, using Prof. Wimalawansa's recommendation backwards, with my 120 kg guesstimate of the body weight border of the 2.5% of the population who respond most weakly to any given quantity of supplemental vitamin D3 (those adults who are the most obese), reversing Prof. Wimalawansa's third line, means 16,800 to 21,600 IUs a day.
Such intakes would be far too high for many adults. The whole concept of the RDA is fundamentally broken.
Even if there was a good RDA for "adults", lighter (including especially elderly) adults would be supplementing too much vitamin D3 by following the RDA - and the RDA doesn't specify anything for infants, children and adolescents.
Prof. Wimalawansa's recommendations work for everyone - in every country - without the need for the extensive research which would be required to calculate an actual RDA.
(1 of 2) Perhaps the RDA for vitamin D3 should be ca. 18,620 IU/day.
Here is an attempt to estimate the RDA for supplemental vitamin D3 in the United States adult (20 years and over) population, for two target levels of 25-hydroxyvitamin D:
20 ng/mL, as used by the IOM and many other health authorities
50 ng/mL, which is widely accepted among vitamin D researchers and which is the threshold below which immune system failure against primarily bacterial post-operative infections rises dramatically, from a base risk of ~2.5% for 50 ng/mL and higher pre-operative levels of circulating 25-hydroxyvitamin D. See Quraishi et al. 2014 https://www.researchgate.net/publication/258957847_Association_Between_Preoperative_25-Hydroxyvitamin_D_Level_and_Hospital-Acquired_Infections_Following_Roux-en-Y_Gastric_Bypass_Surgery, discussed at: https://vitamindstopscovid.info/00-evi/#00-50ngmL.
I guess the RDA for 20 ng/mL is probably in the 4000 to 8000 IU/day range. Below I show how I estimated the RDA for 50 ng/mL circulating 25-hydroxyvitamin D in the U.S. adult population (not counting pregnant women and those in institutions), is, very approximately, 18,620 IU/day.
The whole concept of the RDA is wrong due to wide variations in obesity. This is especially so for vitamin D3, due to the ill-effects of obesity.
Professor Wimalawansa's recommendations for supplemental vitamin D3 intakes, as a range of IUs per day per kg body weight, with higher ranges for those suffering from obesity, should be adopted by health authorities worldwide https://vitamindstopscovid.info/00-evi/#00-how-much. These apply to all people, of all ages and body weights, including those suffering from obesity, without being specific to any race, sex or country. They apply to people who are not subject to medical advice to the contrary and they will reliably attain at least the 50 ng/mL level of circulating 25-hydroxyvitamin D the immune system needs to function properly, without the need for blood tests or medical monitoring.
Extensive research of these recommendations in practice, in populations of millions of people, might refine the exact figures slightly, but this would make only a marginal difference to the recommendation's safety and health benefits.
Best regards
Robin
The amount of any nutrient an individual needs to attain a given level of sufficiency scales directly with bodyweight. In addition, with the amount of supplemental vitamin D3 required to attain any given level of circulating 25-hydroxyvitamin D, obesity increases the amount of vitamin D3 required, in proportion to the severity of the obesity, due to at least two mechanisms. Firstly, obesity reduces the rate at which the liver produces 25-hydroxyvitamin D for any quantity of supplemental or UV-skin produced vitamin D3, for any given body weight. Secondly, the excess adipose tissue seems to absorb more circulating 25-hydroxyvitamin D (and vitamin D3 too, I recall) than in people not suffering from obesity, without giving it back to the circulation if the circulating levels fall. See detailed references at: https://5nn.info/temp/250hd-obesity/.
The RDA is the amount of supplemental nutrient which, if given to an entire population, would result in 97.5% of that population receiving what is judged to be an adequate intake.
Because the relationship between circulating 25-hydroxyvitamin D level and vitamin D3 supplemental intake quantity falls off so strongly with high bodyweight and obesity, and since all the individuals with the highest (20% or more) body weights are suffering from obesity, it suffices to assume that if we could find a testable subset of the population whose body weight was around the 97.5th percentile of the whole population's body weight distribution, we could test those individuals with different quantities of supplemental vitamin D3 in order to find, in general, on average, for such people, how much was required to attain any given target level of circulating 25-hydroxyvitamin D.
To proceed, we want estimates of the body weight and the obesity status of these people.
(2 of 2)
I could not find an exact data on this 97.5th percentile, but we can guesstimate the body weights from data contained in: Anthropometric Reference Data for Children and Adults: United States, 2015–2018 https://stacks.cdc.gov/view/cdc/100478. This data does not cover pregnant women or those who are institutionalized. It is corrected for sampling biases to represent the general United States population 20 years and over.
Tables 3 and 5 report the body weight at various percentiles of the distribution, separately for women and men. Averaging these two sets of body weights results in:
50th 74.2 kg
75th 85.2 kg (1.1)
85th 104.4 kg (4.8)
90th 112.3 kg (4.0)
95th 125.0 kg (6.4)
(This mixes the body weights from two separate distributions, one for men and the other for women, but it is a reasonable estimate of what the body weights would be for these percentiles of a single distribution for men and women combined. Likewise the BMI figures below.)
The values in parentheses are the average kilogram increment per 2.5% span of the population distribution, from the previous percentile to this one.
The long tail of this distribution beyond the 95th percentile can only be known accurately from sampling bias corrected individual observations. I could find no such analysis or graph, so I guesstimated that the body weight at the 97.5th percentile is 133 kg, by assuming the 2.5% span from the 95th percentile to the 97.5th has an increment of 8 kg. It is probably more, so this is a conservative guess based on the pattern of increase in the numbers in parentheses.
Tables 14 and 15 report the average BMI for women and men, the 1st and 2nd figures below, with the 3rd being the average. Women have higher BMIs, but this could be due to BMI's simplistic nature, rather than being based on actual metabolic health.
50th 28.5, 28.4 = 28.5 Overweight
75th 33.9, 32.8 = 33.5 Obesity I
85th 37.5, 35.3 = 36.4 Obesity II
90th 40.3, 37.1 = 38.7 Obesity II
95th 44.6, 41.0 = 42.8 Obesity III
On the basis of 133 kg body weight with obesity III, we can apply Prof. Wimalawansa's vitamin D3 supplemental intake recommendation in the reverse direction to estimate what the RDA would be for the United States adult population to attain at least 50 ng/mL circulating 25-hydroxyvitamin D. I will use the lower figure of Prof. Wimalawansa's range, which is 140 IU/kg.
(133 * 140) = 18,620 IU / day = 465 micrograms / day, on average.
I am not sure how to scale this to an RDA for the target of 20 ng/mL circulating 25-hydroxyvitamin D. I was going to use Fig 3 from Ekwaru et al. 2014 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0111265. This depicts the relationship between supplemental vitamin D3 intake and long-term 25-hydroxyvitamin D levels, with separate curves for self-described (by the adult fitness-pursuing participants in the study) body morphologies of underweight, normal weight, overweight and obese. However these lines are all above 20 ng/mL (50 nmol/L in the graphs) at the 0 IUs per day intercept.
The self-limiting nature of higher 25-hydroxyvitamin D (due to the activity of the 23-hydroxy enzyme irreversibly degrading the 25-hydroxyvitamin D, at a rate roughly proportional to the circulating 25-hydroxyvitamin D level) is clearly evident in the curves flattening out at higher 25-hydroxyvitamin D levels from their initial steep rise from lower levels.
If the RDA is defined on the assumption that the people are getting minimal UV-B skin exposure, little or no vitamin D3 (or 25-hydroxyvitamin D) in food, and the RDA specifies how much vitamin D3 they must supplement in total, then it can easily be seen from the graph that halving any given amount of supplemental vitamin D3 will result in reduction in circulating 25-hydroxyvitamin D of less than 50%. I can't estimate with any precision what fraction of 18,620 IU/s a day would attain, in this set of 97.5 percentile bodyweight people, all suffering from obesity III, would be required to attain just 20 ng/mL circulating 25-hydroxyvitamin D, but I am sure the figure is well over 600 IU a day.
I guess it is in the 4000 to 8000 IU/day range. But who cares? We know the IOM was mistaken and therefore that the government recommendations all around the world for how much vitamin D3 to supplement are also mistaken, because they are based on the IOM's recommendations and whatever even lower recommendations were current before the IOM's 1100 page 2010 report. For instance, here in Australia, since 2005 https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-d, the recommended daily vitamin D3 supplemental intake is 5 micrograms (200 IU) a day, from birth to 50 years, 400 IU/day for 51 to 70 years and 600 IU/day for 71+ years. (The highest capacity vitamin D3 capsule which can legally be sold here without prescription is 25 micrograms 1000 IU.)
The IOM recommendation of 600 or 800 IU/day isn't just wrong because the miscalculated.
A proper calculation for their 20 ng/mL circulating would probably be an RDA of 4000 to 8000 IU/day. This would still be wrong because it is only raising the circulating 25-hydroxyvitamin D level of the 30% or so of the population who suffer from obesity to around 20 ng/mL, when the target should be at least 50 ng/mL.
If the RDA was set correctly to ca, 18,000 IU a day, it would still be wrong, since this is a vast overestimate of what most of the population need to be healthy. The 10th percentile body weights are 53.9 kg for women and 66.9 kg for men. (At 70 years of age, I am at that percentile.) I supplement about 250 micrograms 10,000 IU of vitamin D3 a day, with 200 micrograms of vitamin K2. My circulating 25-hydroxyvitamin D level is ca. 90 ng/mL, which I am happy with. If I took 18,000 IU a day, the level would probably go to 140 ng/mL. I might be super-healthy, but no health professional in their right mind would issue a blanket, adult population wide, recommendation for 18,000 IU of vitamin D3 a day.
The whole concept of RDA is unfit for purpose. It is a simplistic administrative convenience which persists due to the convenience of stating it, or a percentage of it, in a few square millimetres on the back of a supplement bottle. It also persists because whole committees of supposed experts are unwilling to admit that they - and their predecessors - were wrong to ever use it.
The only system which properly meets the need of people is to specify supplemental quantities as ratios of body weight. In the case of vitamin D3, a sliding scale or separate recommendations need to be made for varying degrees of obesity. Prof. Wimalawansa's recommendations have a modest range of IUs per day per kilogram body weight for most people, with two higher sets of figures for those suffering from obesity I or II and obesity II. It is easy to interpolate between these if people are borderline obese or are unsure if they are suffering from obesity II or III.
The RDA should be to abandonned, and urgently so in the case of vitamin D3.
All that reading and still not sure how much to take
I stopped drinking store-bought whole milk after discovering that it was giving me bone spurs. Store-bought whole milk always comes fortified with vitamin D, but no vitamin K. I have had zero problems with bone spurs ever since I stopped drinking the vitamin D fortified milk..