Absolutely - but will the govt ever recommend sunshine? Probably not. This is the best way to absorb Vitamin D, as supplements may give our bodies a false signal that we have enough:
In Canada, we don’t get enough sunshine and weather warm enough to expose our bodies in order to synthesize vit d. Most people I know are slathering their bodies with toxic sunscreens, wearing hats, sunglasses and protective clothing when they actually go out in the sun. And now our blue sunny skies are frequently being sprayed with substances which we are not allowed to ask what is in it because we are told that what we are seeing with our own eyes is not happening. Vit D supplementation is crucial. The fact that one cannot get a Vit D test without a doctor’s prescription and in most cases the individual will have to pay for that themselves is proof enough that public health does NOT want to address this issue. I have been saying for years now that a study should be done to test vit D for all elderly in care homes. My suspicion is that we would find that virtually everyone of them is extremely deficient- but that would mean that then something would have to be done-which might mean the elderly actually had better health outcomes with less pharmaceuticals -not a great business model to have people living longer with less pharmaceuticals. Convince me that this “mistake” in calculating optimum vit d dosing is not by design!
If a person relied primarily or solely on UV-B skin exposure, year after year, to generate enough vitamin D3 for their liver to maintain at least 50 ng/mL circulating 25-hydroxyvitamin D (https://vitamindstopscovid.info/00-evi/#00-50ngmL) then they would be at very high risk for skin cancer.
"Surfers and swimmers had consistently higher rates of PSC (pre-skin cancer: actinic keratosis), NMSC (non-melanoma) and MSC (melanoma skin cancers) than the general Australian population. Point prevalence of MSC (groups combined) was 76-fold higher than the general Australian population."
The pattern of locations on the bodies of surfers shows that this is due to the UV-B exposure - mainly the face, arm and back.
Except in the tropics it is not possible to get enough UV-B to attain 50 ng/mL or more circulating vitamin D3 from natural sunlight all year round, and even there the monsoon months prevent this from being achieved.
Generally it would only possible to do this all year round with special UV-B lamps which emit around the ideal 293 nanometre wavelength range. Eye protection would be mandatory.
There's very little vitamin D3 in food. Fortunately supplemental vitamin D3 is inexpensive and readily obtainable.
If there was no supplemental vitamin D3, the optimal approach would be some level of UV-B exposure all year round, to raise 25-hydroxyvitamin D levels to 25 or 30 ng/mL or so. This is still not enough to run the immune system properly, but it would reduce the skin damage and risk of skin cancer.
Exposure to sunlight, though not large amounts of UV-B, is surely healthy. Despite the title of your article https://romanshapoval.substack.com/p/why-vitamin-d-supplements-dont-work, vitamin D3 supplements do work. They raise the level of 25-hydroxyvitamin D and so greatly improve numerous health outcomes.
Do you think that article cites evidence or arguments which contradict anything I wrote in this discussion, at https://vitamindstopscovid.info or at https://nutritionmatters.substack.com? The same ~293 nm UV-B light which generates vitamin D3 in the skin also damages DNA, kills cells, causes sunburn, long-term skin damage and increases the risk of skin cancer.
If there was no vitamin D3 supplementation, a modest amount of UV-B exposure would be optimal, and would generally reduce the incidence of cancer and probably skin cancers, by significantly improving the immune system's performance due to a substantial rise in circulating 25-hydroxyvitamin D, such as to 20 or 30 ng/mL from levels as low as 5 ng/mL.
See the graphs at the end of Quraishi et al. 2014 https://jamanetwork.com/journals/jamasurgery/fullarticle/1782085 also at: https://vitamindstopscovid.info/00-evi/#00-50ngmL. With 50 ng/mL or more circulating, pre-operative, 25-hydroxyvitamin D, the risk of surgical site and, separately, of hospital acquired, infections were both about 2.5%. At 25 ng/mL, the risk of each rose a factor 6 to about 15%. This is frank immune system dysfunction compared to 2.5%, but much better than the 40% risk of each of these two types of bacterial post-operative infection with 10 ng/mL, which is a typical level for someone who gets little or no UV-B skin exposure and does not supplement vitamin D3 at all.
To rely largely or solely on UV-B skin exposure to achieve the 50 ng/mL circulating 25-hydroxyvitamin D the immune system needs to function properly would, year-after-year, lead to darker (so requiring more UV-B exposure) and damaged skin, with much higher levels of skin cancer than would be the case with modest or no UV-B exposure and proper vitamin D3 supplementation.
People with black or brown skin would need to be out in high elevation sunlight, most days, like our African ancestors, with little in the way of clothing, to attain 50 ng/mL or more circulating 25-hydroxyvitamin D. See the grey histogram at the left of https://vitamindstopscovid.info/00-evi/1-Dror-Israel-14-framed.png. This represents the observations of Luxwolda et al. 2012 https://doi.org/10.1017/S0007114511007161. These are the only 25-hydroxyvitamin D measurements ever made of traditionally living Africans - of Maasai pastoralists and Hadzabe hunter gatherers. The mean level was 46 ng/mL. So half of these people probably have immune system dysfunction, according to the Quraishi et al. graphs.
The Quraishi et al. study was of 770 morbidly obese people who all underwent the same Roux-en-Y gastric bypass surgery at Massachusetts General Hospital. Although people suffering from obesity have greater difficulty raising their circulating 25-hydroxyvitamin D level than normal weight and overweight people, for vitamin D3 supplementation quantities which are any given ratio of body weight, I know of no reason to believe that their immune systems require more circulating 25-hydroxyvitamin D in order to function properly. So those graphs are the best, most specific, guide we have to how the immune system depends on the circulating level of 25-hydroxyvitamin D.
The blue histogram in that infographic is from Israel at al. 2020 (preprint) https://www.medrxiv.org/content/10.1101/2020.09.04.20188268v1 - see also https://vitamindstopscovid.info/00-evi/#israel. The lowest bar is significantly higher (to the right) since it represents the number of Arab women in sunny Israel whose 25-hydroxyvitamin D level is below the 5 ng/mL detection limit. I met a late-twenties African woman, a nurse, here in Melbourne Australia, who told me her level was 7 ng/mL. She greatly appreciated my vitamin D3 pep-talk and link to the most pertinent research cited and discussed at: https://vitamindstopscovid.info/00-evi/. Regarding low circulating 25-hydroxyvitamin D being a huge risk factor for neurodegeneration: https://vitamindstopscovid.info/00-evi/#3.3 and (in pregnancy and early childhood) preeclampsia, pre-term birth and mental retardation, ADHD and autism in the children: https://vitamindstopscovid.info/00-evi/#3.2.
I am not arguing against the benefits of sunlight - just against the common notion that UV-B skin exposure is the best way to attain the 50 ng/mL circulating 25-hydroxyvitamin D we need to be healthy.
I don't know what to think about HHS and ACIP after reading this on Dr. Exley's sub stack this morning? "A number of weeks prior to the ACIP meeting I was asked by Health and Human Services (HHS) to prepare a talk on aluminum adjuvants for presentation at the December ACIP meeting. I recommended to HHS that several other highly qualified individuals be asked to join me to form a working group to prepare the talk. The group was formed and a thorough review of the safety of aluminum adjuvants used in vaccination was prepared and submitted to HHS for final review before the scheduled ACIP meeting. Imagine our surprise and indeed annoyance when just one week before the meeting we received an email from the ACIP Secretary, not HHS, telling us that our presentation at the December ACIP meeting had been cancelled. No explanation was offered at that time. Indeed, we learned just prior to the meeting that an ACIP member would give a brief presentation on aluminum adjuvants at the end of the meeting, if there was time. ...I concluded that the decision not to vaccinate against Hep B at birth was correct. Neonates are especially vulnerable to intoxication by aluminum as I have written about in this Substack on a number of occasions. Not injecting them with aluminum at birth will undoubtedly save the lives of some infants and may also reduce the number of infants that develop profound autism over subsequent weeks, months and years. However, it is only delaying infant intoxication by aluminum and is a half measure at best. If I had been allowed to present to ACIP I would have asked for an immediate moratorium on the use of vaccines that include an aluminum adjuvant." Why would the world's leading expert have been cut with his colleagues from the ACIP meeting. No explanation was given.
Perhaps you did not notice that this is NOT Dr Exley’s Substack, is NOT about the HHS or ACIP recommendations, and NOT about the Hep B vaccine or its aluminum adjuvants. How hard is it to confine your comments to the subject matter presented in THIS article?
After taking a peekaroo at the MSDS (material safety data sheet) for vitamin D's components, namely Cholecalciferol, I do not want this in my body. Every vitamin D pill has this ingredient and it mostly comes from China or India, not from "Sunny"ville USA.
The same with the food additives for vitamin D. There are no standards for supplements and many supplement companies are run by big pharma. The trust factor for me is zero. The trust factor for the HHS is zero...they still love mRNA poisons to death.
There is no way this is the same "stuff" you might get from sun exposure (and I am doubting that is even vitamin D), although sun exposure is very healthy in other ways.
If supplements are real, then DVs, MDAs or RDAs are never a one-size-fits-all. I no longer believe the chemically made vitamin D is nearly the same as what might be naturally in foods...if it even is.
There's far too little vitamin D in food, fortified or not, to attain the 50 ng/mL circulating 25-hydroxyvitamin D the immune system needs to function properly: https://vitamindstopscovid.info/00-evi/#00-50ngmL.
Supplemental vitamin D3 cholecalciferol is identical in every respect to the vitamin D3 cholecalciferol which is created in the skin when UV-B light ca. 293 nanometre wavelength breaks one of the bonds in one of the carbon rings in 7-dehydrocholesterol, with the resulting molecule changing its shape of its own accord (due to thermal vibrations) and settling down in its new shape, with all the same atoms which were in the 7 dehydrocholesterol, which is vitamin D3 cholecalciferol.
You can read about the industrial production of vitamin D3 cholecalciferol in "Industrial Aspects of Vitamin D" by Arnold L. Hirsch in 2010: https://sci-hub.se/10.1016/B978-0-12-381978-9.10006-X . The process involves creating 7-dehydrocholesterol by chemically transforming cholesterol from wool fat. This is purified and dissolved in a hydrocarbon solvent,such as ether. This is exposed to UV-B light from special, multi-kilowatt, high pressure mercury vapour lamps which are water cooled, with the light being further filtered by compounds in the cooling water jacket, to optimise conversion of 7-dehydrocholesterol to the molecule which settles down to become vitamin D3, minimising other wavelengths which break down this product.
This is then purified. The ether solvent is nothing to worry about. It is highly volatile and not very toxic. For a 70 kg body weight non-obese person to attain 50 ng/mL circulating 25-hydroxyvitamin D, it only takes a gram of vitamin D3 every 22 years (5000 IU = 125 micrograms a day, on average).
The multinational pharmaceutical companies do not make vitamin D3. The margins are far too low. The production process is exotic and hard to master. Several companies in India set up to do it, and failed. A gram of pharma-grade vitamin D3 costs about USD$2.50 a gram, ex-factory, in 1 kg quantities. A lot of this price would go into the electricity for the massive mercury vapour lamps.
The Chinese manufacturers, as far as I know produce vitamin D3 in an unpurified form for agricultural purposes.
I guess there are multiple companies worldwide who produce pharma-grade vitamin D3 with all the necessary accreditation for use in various countries. The only one I know of is Fermenta Biotech in India: https://fermentabiotech.com, who have been making vitamin D3 since 1967. You can see photos of the outside and inside of their main vitamin D3 plant at: https://aminotheory.com/cv19/#Maharashtra-police.
I agree that, especially for vitamin D3, single values for adults for "daily values" and Recommended Daily/Dietary Allowance, are wrong. I will write more about this in another comment. See https://vitamindstopscovid.info/00-evi/#00-how-much for New Jersey based Professor of Medicine Sunil Wimalawansa's recommendations for how much vitamin D3 to supplement, on average, per day. It applies to people of all ages and body weights and is calculated according to body weight, with higher ratios for those suffering from obesity.
Unrefined vitamin D3 cholecalciferol is used as a rodent poison. Rats can be induced to each such large quantities of it, in proportion to their body weight, which (after hydroxylation mainly in the liver) raises their circulating 25-hydroxyvitamin D levels far beyond what is healthy. This raises the level of circulating calcitriol (1,25-dihydroxyvitamin D) which the kidneys maintain (imagine the upwards slope of the graph of Fig 1b of Tang et al. 2009: https://www.nature.com/articles/s41598-019-43462-6 extending much further to the right, and so going much higher. This causes the level of circulating calcium ions to rise far beyond what is tolerable, and this kills the rat. Also, I suspect, the very high level of 25-hydroxyvitamin D also causes significant binding to the VDR molecules in the cells which sense the very low levels of circulating calcitriol and which are involved in calcium-phosphate-bone metabolism, with the same deadly effects.
If a human ingested the same amount of cholecalciferol as a ratio of their bodyweight, the same processes would occur.
None of this contradicts the fact that we need to maintain at least 50 ng/mL circulating 25-hydroxyvitamin D in order to be healthy. Please see my other comments here, or more importantly, the research cited and discussed at: https://vitamindstopscovid.info/00-evi/.
This is what you say… You know what else is toxic to rats? Baking soda... Oh No! Also chocolate, caffeine, alcohol, avocados, onions, garlic, blue cheese, licorice and citrus fruits,.... all are poisonous to rats. Oh Dear…. look at all that rat poison we’re ingesting! LOL! https://exoticnutrition.com/blogs/blog/unsafe-food-for-rats#
(1 of n) The HHS proposal you mention is an incremental step in roughly the right direction, but falls far short of what is needed to ensure that most or all Americans attain at least the 50 ng/mL (125 nmol/L = 1 part in 20,000,000 by mass) level of circulating 25 hydroxyvitamin D which the immune system needs to function properly.
Rather than explain everything in these comments, I will refer to my own web pages where you can read proper explanations and follow links to the most pertinent research. Many aspects of the way the three "vitamin D" (using the term broadly) compounds are discussed and understood are completely inadequate. For instance, the notion that "vitamin D" is a hormone, and the tendency to refer to all three compounds as being vitamin D, rather than identifying them clearly by name. See: Reinhold Vieth, 2004: "Why “Vitamin D” is not a hormone, and not a synonym for 1,25-dihydroxy-vitamin D, its analogs or deltanoids" https://www.sciencedirect.com/science/article/abs/pii/S0960076004000858 (paywalled) PDF from Sch-Hub: https://sci-hub.se/10.1016/j.jsbmb.2004.03.037.
The most important failure of the medical profession, immunologists and many or most people who write journal articles about the vitamin D compounds is that they have not heard of, and do not understand, that the immune system uses these compounds in very different ways to the hormonal system, which everyone understands, by which the kidneys play their role, with osteocytes and the parathyroid gland, in regulating calcium-phosphate-bone metabolism. The immune system does not use hormonal signalling. Many types of immune cell, and other cell types such as some which are involved in neurodevelopment, rely on a good supply of 25-hydroxyvitamin D in order that their 25-hydroxyvitamin D -> calcitriol intracrine and paracrine signaling systems can function properly. These operate within a single cell (intracrine) and between nearby cells, typically of different types (paracrine). These are unrelated to hormonal (endocrine) signalling. A hormone is a long-distance, blood-borne (also in the CSF) signaling molecule.
Calcitriol operates as a hormone when it exists in the bloodstream, at a very low, stable, level ca. 0.05 to 0.1 ng/mL. The kidneys maintain this and the level of circulating calcitriol affects the behavior of cells of several types, all over the body, which are involved in calcium-phosphate-bone metabolism. The immune system is not significantly affected by, and does not significantly affect, this very low level of circulating, hormonal calcitriol.
In the above mentioned intracrine and paracrine signaling systems, individual cells hydroxylate 25-hydroxyvitamin D on the number 1 carbon to produce calcitriol, only when a cell-type-specific condition is detected by that cell. In intracrine signaling, this calcitriol functions as an intracrine agent: Calcitriol binds to a VDR molecule (the so-called "vitamin D" receptor, best thought of as the calcitriol receptor, since its affinity for vitamin D3 and 25-hydroxyvitamin D is much lower) much more strongly than does vitamin D3 or 25-hydroxyvitamin D. The bound complex finds its way to the nucleus where it binds with a retinol X molecule and the triple complex up- and down-regulates the copying of dozens to hundreds of genes to mRNA molecules, in a cell-type specific manner. This alters this individual cell's behavior in a cell-type specific manner. The above mentioned paracrine signaling system involves some of this intracellularly produced calcitriol diffusing to nearby cells, where it functions as a paracrine agent and alters the behaviour of nearby cells of one or more types, again in a cell-type specific manner.
It is absolutely critical that all doctors, immunologists, virologists, vaccinologists, epidemiologists, public health officials etc. understand these two signaling systems, because the are completely different from the kidney-based hormonal system which everyone understands.
Most people who write vitamin D research articles have never heard of these signaling systems. Immunologists have generally never heard of them, despite them playing a crucial role in the ability of individual immune cells to alter their behavior in response to their changing circumstances.
The only practical, safe, way for Americans can be be healthy is for them* to follow the recommendations of New Jersey based Professor of Medicine, Sunil Wimalawansa, for how much vitamin D3 cholecalciferol to supplement, on average, per day. These recommendations depend on body weight and obesity status. It is fine to take larger amounts every week to ten days, as long as the average daily amount falls within the ranges Prof. Wimalawansa recommends.
To see why 50 ng/mL (125 nmol/L) is the minimum level of 25-hydroxyvitamin D everyone* should seek to attain, please see this section on Massachusetts General Hospital research from 2014 (Quraishi et al.) which shows, more clearly and directly than any other research, that levels above this provide strong protection against post-operative infections, and the further the level is below this, the greater the risk: https://vitamindstopscovid.info/00-evi/#00-50ngmL.
* The first important exception is infants substantially breast-fed by vitamin D3 and so 25-hydroxyvitamin D replete mothers. The short half-life vitamin D3 and the longer half-life 25-hydroxyvitamin D are both transferred in breast milk. Since 25-hydroxyvitamin D is more easily absorbed into the bloodstream than vitamin D3 (it is more water soluble, due to having two rather than one hydroxyl groups) and since it does not require hydroxylation to raise circulating 25-hydroxyvitamin D, it plays an important role in meeting the 25-hydroxyvitamin D needs of the infant. Measurements of vitamin D3 and 25(OH)D levels in human breast milk vary widely, in part due to the difficulties in measuring such low levels: https://www.frontiersin.org/journals/nutrition/ articles/10.3389/fnut.2023.1229445. One recent study https://www.mdpi.com/2072-6643/13/2/573 found approximately equal amounts of vitamin D3 and 25-hydroxyvitamin D in human breast milk. Since (at least in adults) the liver only coverts about 1/4 of ingested vitamin D3 into circulating 25-hydroxyvitamin D, this means that the bulk of the benefit to the breast-fed child's 25-hydroxyvitamin D comes from the 25-hydroxyvitamin D component of breast milk. This depends on the mother's 25-hydroxyvitamin D level.
The second important exception is people who generate sufficient vitamin D3 in their skin, via UV-B exposure, to attain most or all of the vitamin D3 they need to attain at least 50 ng/mL circulating 25-hydroxyvitamin D all year round. Except in equatorial regions (and even then, there is too little sun in the monsoon season) this can only be achieved with special, dangerous to the eyes and skin, UV-B lamps. While sunlight, including on the skin, is surely important to health via multiple mechanisms, the UV-B required to provide for most or all of our vitamin D3 needs is inherently damaging, since it damages DNA. To rely on this all year, every year, would greatly raise the risk of skin cancer.
(2 of n) Prof. Wimalawansa's recommendations were most recently published in an article with a professor of pediatrics and another professor of medicine: "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.
Please see this section: https://vitamindstopscovid.info/00-evi/#00-how-much. 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. Prof. Wimalawansa's recommended daily vitamin D3 supplemental intake quantities scale directly with body weight, with higher ratios for those suffering from obesity. There is no need for blood tests or medical monitoring if these quantities are adhered to.
There is very little vitamin D in food, including that which is fortified with vitamin D3 cholecalciferol or the less effective vitamin D2 ergocalciferol. Fortification can help improve on disastrously low 25-hydroxyvitamin D levels in ways which reduce the incidence of rickets, but it can never do more than make a slight contribution to attaining at least 50 ng/mL circulating 24-hydroxyvitamin D. (U.S. doctors can only prescribe vitamin D2, for some obscure historical reason. This is less effective at attaining a good level of circulating 25-hydroxyvitamin D2 than vitamin D3 is at attaining a good level of 25-hydroxyvitamin D3. The third natural compound, 1,25-dihydroxyvitamin D3 calcitriol is more effective at binding to the "vitamin D receptor" VDR molecule than 1,25-dihydroxyvitamin D2. There is no reason to use vitamin D2 for any purpose in place of vitamin D3.)
Below, and in subsequent comments, I use the term "25-hydroxyvitamin D" to mean 25-hydroxyvitamin D3 specifically. Likewise 1,25-dihydroxyvitamin D calcitriol, is slightly short for the full term "1,25-dihydroxyvitamin D3".
I argue that every government and/or commercial effort which could be put into supporting vitamin D fortification of food would be better applied to supporting proper vitamin D3 supplementation, as Prof. Wimalawansa recommends: https://vitamindstopscovid.info/00-evi/#07-fortif.
These recommendations 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. This takes several months to attain the desired > 50 ng/mL circulating 25-hydroxyvitamin D from typical baselines of 20 ng/mL or less.
One IU (International Unit) of vitamin D3 is 1.40,000,000th of a gram. (This unit was chosen about a century ago, before anyone the chemical structure of vitamin D3 or D2 was known, and long before the discovery of 25-hydroxyvitamin D and calcitriol. One IU of vitamin D3 approximates the amount of vitamin D3 a baby rat needs to consume to avoid developing rickets. Until about the 1960s, the only way the vitamin D3 or D2 content of a substance could be determined was to feed varying amounts of the substance to baby rats and then to detect, with X-rays, which of them developed rickets.)
0.125 mg = 126 micrograms = 5000 IU a day is 8 or more times what most governments recommend. "5000 IU" sounds like a lot, but it is a gram every 22 years - and pharma grade vitamin D costs about USD$2.50 a gram ex-factory. This will safely attain at least 50 ng/mL 125 nmol/L 25-hydroxyvitamin D over several months, without the need for blood tests or medical monitoring.
I’m trying so hard to understand conflicting information. Vitamin D is cholecalciferol. Look at your bottle. This is manufactured using sheep’s hair. Nothing about the manufacturing process seems healthy to me. I quit Vit D 2 weeks ago. Ask your AI of choice, preferably not Google, What is the manufacturing process for Cholecalciferol. I’m shocked at what I found. Please tell me if I am wrong.
Thank you for replying, I’m at a loss trying to understand this information. I hadn’t seen these articles, but I’ve heard/seen rumblings in the background that I didn’t pay attention to. The conflicting information doesn’t help at all. There’s also a book “Take Daily” by Robyn Openshaw. I would be very interested in your opinion about her conclusions on B vitamins and magnesium. What is going on here?
A quick look at the summary of "Take Daily: How Supplements Hijack Your Health" by Robyn Openshaw and Mike Fairclough https://www.amazon.com.au/Take-Daily-Supplements-Hijack-Health-ebook/dp/B0FTC6CLSV makes me think it is largely ill-informed, alarmist, click-bait like the Unbekoming article I mentioned in my previous comment.
Mike Fairclough has written a number of books on important social controversies. One of Robyn Openshaw's books is entitled "Vibe: Discover Your Energetic Frequency for Health, Love & Success".
I am an electronic technician and computer programmer. Don't take my word for anything regarding nutrition. I am writing to encourage people to read the best research for themselves.
From the intro to "Take Daily": "We believe nature is able to provide all our remedies". I guess they are against all supplements.
If you read the research cited at https://vitamindstopscovid.info/00-evi/ and follow my arguments there, and in these comments regarding the dangers of relying on UV-B skin exposure to attain 50 ng/mL or more circulating 25-hydroxyvitamin D (responding to Sunlover and AlsoMe), I believe you will conclude that the romantic notion of natural foods and natural sources of vitamin D3 (UV-B skin exposure) are inadequate (food) and both impractical and dangerous (UV-B) for attaining the 50 ng/mL circulating 25-hydroxyvitamin D the immune system needs to function properly.
Fortunately we now have bio-identical vitamin D3 cholecalciferol. For 70 kg (154 lb) body weight without obesity, all you need to attain 50 ng/mL or more circulating 25-hydroxyvitamin D all year round is a gram every 22 years (125 micrograms a day, on average): https://vitamindstopscovid.info/00-evi/#00-how-much.
There surely are supplements which cause harm. Greatly exceeding the quantities in these recommendations would likely cause harm to some people. However, it is best to take large quantities of vitamin D3, while reducing calcium intake, ideally with vitamin K2 and under medical supervision, to boost 25-hydroxyvitamin D levels over 150 ng/mL for the purpose of suppressing a wide range of auto-immune inflammatory conditions. This is the Coimbra protocol - see the research cited and discussed at: https://vitamindstopscovid.info/06-adv/.
Magnesium is a very common deficiency. See the work of Patrick Chambers MD: https://www.researchgate.net/profile/Patrick-Chambers-4. Magnesium citrate is a common supplement, but it is also a laxative . . . . Magnesium chelate/orotate is a highly bioavailable alternative. However, for people at risk of kidney stones, magnesium citrate is a source of citrate, which is generally protective against most kidney stones, as is calcium citrate and especially potassium citrate. It is important not to take too much potassium at once: https://aminotheory.com/cv19/kna/.
Vitamin C can increase the risk of kidney stones, but has many benefits.
I haven't got a magic shortcut through these controversies. You can't necessarily "trust the experts" since any one or several chosen, apparent, experts, may be completely mistaken. There's no substitute for reading the research yourself, and searching widely for alternative perspectives. It is a lot of work and many people don't have the interest to skills to do a proper job of it. As long as mainstream medicine is so avoidant of new information, because they are so unwilling to admit they might have been wrong in the past, the whole field will progress at a snail's pace, such as the incremental improvement the HHS is currently considering for vitamin D policy. This would fall far short of what should occur, in the light of the best current research, as I argue here and elsewhere.
So the choice is between relying on mainstream "expert" opinion which might take decades to reflect reality, being scared off by clueless alarmists and doing your own research. Researching these fields can be time-consuming, but it it interesting and can be very rewarding. If you pursue this seriously you might like to join the Nutrition for Immune System Health email discussion group: https://nish.groups.io.
Most D3 is from lanolin which is collected after they shear sheep. Which is why it is so dirt cheap. You can also get plant based D3 from Lichen. But that’s usually 4x the costs.
There are a number of people using as much as 30,000 IU or even 45,000 IU a day as an alternative therapy for multiple sclerosis. I'm not recommending such levels -- they are risking side effects because they're between a rock and a hard place, with their illness. But, they seem to do well for long periods even at those levels -- for anyone who's fearing 10,000 IU / day.
While these very high 25-hydroxyvitamin D levels can suppress the autoimmune inflammatory (indiscriminate cell destroying) immune responses which are the central mechanism in many chronic diseases, the lack of such levels is not the cause of these diseases, or of this excessive level of inflammation.
The cause is surely genetic variations on a general theme of the base level inflammatory responses having evolved to be unhealthily strong, to counter the compounds emitted by helminths (intestinal worms) which downregulate these responses. These inflammatory responses evolved primarily to target multicellular parasites such as helminths, since ordinary antibodies and macrophages are no use against multicellular organisms.
Helminthic therapy - the deliberate introduction of relatively benign helminths - suppresses much the same set of inflammatory conditions as the Coimbra et al. protocol: https://www.helminthictherapywiki.org.
I have tried since about 2021 to get leading vitamin D3 researchers and clinicians interested in helminths, and how humans evolved overly strong inflammatory responses to counteract our ancestors' ubiquitous helminth infections, which down modulated these responses. So far, no-one has taken an interest. They are very busy.
There are excellent prospects for understanding and treating these numerous inflammatory disorders, especially if one or more of the helminthic compounds can be regularly administered to suppress this excessive inflammation. Please see all the sections of: https://vitamindstopscovid.info/06-adv/.
JWL, this time yuo have it all wrong. Corrleation is not causation. And there is also reverse causation. The literature much mroe strongly supports that diseases causes low 25D. And some of the reasons for this are protective. Taking D3 can pour fuel on a fire. Chronic infectious diseases especially tend to dysregulate vitamin D metabolism leading to low 25D but high 1,25D. The 1,25D is high because your body is not geting enough VDR activation because the infections are clogging up the VDRs. If you raise 25D more you start competing with 1,25D for VDRs. 25D does not activate VDRs to the same extent as 1,25D. And you also end up increasing circulating 1,25D (not bound) which is where toxicity happens. There is also zero literature that shows raising 25D considerably increases 1,25D levels. All the conventionally claimed benefits fo D3 come from raising 1,25D, not 25D. You can't even measure 25D properly anyway as most of it is in bones, organs, and muscles. And when your body makes it is is protein bound. If that all were not bad enough, there are more than 70 types of vitamin D and there is enzyme competition and you will probably mess up the levels of many other metabolites that have real health-promoting effects. There are three major branches of the metabolic tree, and D3 - even in theory - only supplies one of them.
There is no such thing as epidemic 25D deficiency. It is a mythical entitity. D3 is a drug. Some feel better or get better taking it. Some get sicker. It's an experiment. Experiment if you want. But just do so knowing hte reaon situation, not the rosy narrative.
Almost everything you wrote here is just plain wrong. You cite no sources. If what you say is valid, you should be able to point out research which disproves pretty much everything you can read about the vitamin D compounds in the research cited and discussed at: https://vitamindstopscovid.info/.
Reverse causation - disease lowering 25-hydroxyvitamin D - is a marginal process which is not very significant, except perhaps in gross infections such as sepsis or granulomatous disorders such as sarcoidosis, and boosting 25-hydroxyvitamin D levels helps with both. Read research cited in the above page in full to see what I mean. Also, https://vitamindstopscovid.info/01-supp/#sarc - Kamphius et al. 2014 https://sci-hub.se/10.1002/jbmr.2262 report that sarcoidosis patients do better with vitamin D3 supplementation.
See Quraishi et al. 2014: https://vitamindstopscovid.info/00-evi/#00-50ngmL who show, conclusively, that low 25-hydroxyvitamin D _causes_ much higher rates of post-operative infections, with 50 ng/mL or more leading to a very low risk: 2.5% for surgical site infections and 2.5% for hospital-acquired infections. At 20 ng/mL, a level people will have if they follow your advice to avoid vitamin D3 supplementation and do not get much UV-B skin exposure, the risk for each of these two types of post operative infection is about 25%. This is a tenfold increase - the result of immune system failure. There is no reverse causation in this research since these are pre-operative 25-hydroxyvitamin D levels.
You wrote: "All the conventionally claimed benefits fo D3 come from raising 1,25D, not 25D." You - or perhaps other people - mistakenly assume that the very low level of circulating calcitriol (1,25-dihydroxyvitamin D) significantly affects the immune system. It does not.
You are right to imply ("here is also zero literature that shows raising 25D considerably increases 1,25D levels") that raising 25-hydroxyvitamin D at most only marginally raises circulating calcitriol. See the gentle rise in the scatterplot graph of Fig 1b of Tang et al. 2009: https://www.nature.com/articles/s41598-019-43462-6.
This, and the much smaller affinity 25-hydroxyvitamin D has for the VDR molecule, does mean that very high levels of 25-hydroxyvitamin D can raise circulating calcium levels to cause hypercalcemia. This is why it is vital to understand 25-hydroxyvitamin D -> calcitriol intracrine and paracrine signaling. Without this understanding, many clinicians and researchers assume that the immune system can somehow be boosted by raising circulating calcitriol levels. This is not the case.
- I have no obligation to compose a literature review, just as you have no obgliations to read it
- kamphius is a small retrospective study where the groups were clearly not comparable (e.g. steroid use). The dose of vitamin D was 400IU which is a trival dose that couldnt produce the presumed benefits. Even if it did it scarcely addresses what I am arguing.
- Qurashi is just one of another endless correlation studies. You misunderstand what i mean by reverse causation. I mean pervasively in chronic disease contexts too, not just in specific acute contexts. Your point about presurgery is incoherent.
- Tang provides singificant evidence for what I am saying. Look at figure 1 again...
i) 24,25D is a marker of 25D catabolism. If 25D were a true marker of deficiency, we would expect that at low levels of 25D, the ratio of 25D to 24,25D would be elevated, reflecting reduced catabolism as the body tries to preserve 25D. Instead, the ratio remains roughly constant across the observed range of 25D, indicating that catabolism scales proportionally with substrate. This finding does not support the claim that circulating 25D is a marker of deficiency.
ii) Figure 1D shows that when 25D is low, the body preserves 1,25D relative to 24,25D (high ratio), and as 25D rises, the ratio drops quickly, then plateaus. That's tight feedback. The body adjusts the balance of activation vs. catabolism to maintain 1,25D levels. By extension, your body can be expected to resist the effects of vitamin D supplementation, as it recognizes no need for it.
YOu have the burden of proof backwards. Prove 25D is a market of deficiency. I'd say in about 80% of conditions for which vitamin D has been tested, the results are a flop. Since low 25D is associated with all of them, if it were a market of deficiency, trials would be far more successul. The balance of 20% of trials or so that are positive can still be explained by a drug effect.
I strongly favor sun exposure with correction of dysfunctional lifestyle and environment that has reduced UV-reslience.
(a) Hi David, The "mostly" 10 micrograms (400 IU) daily vitamin D3 supplementation quantity in Kamphuis did significantly increase the level of circulating 25-hydroxyvitamin D, from 16.8 ng/mL (42 nmol/L, page 2500) to 28 ng/mL (114 + 28 nmol/L). This is a material change. In the Quraishi et al. graph https://vitamindstopscovid.info/00-evi/ of risk of each of the two kinds of post-operative infection, this corresponds to a baseline risk of about 28% being reduced to about 14%. Kamphuis et al. reported that those who took this vitamin D supplement, with calcium (which I think is not required and is probably a bad idea) did better than those who did not take these supplements. This wasn't an RCT, but it was a substantial set of observations.
There probably is reverse causation in that the disease depletes the 25-hydroxyvitamin D. It surely does this more strongly in the affected areas of the body. This does not mean that supplementing vitamin D3 to boost the level is not helpful. The depletion locks the condition in. The supplementation enables the body to get out of its low 25-hydroxyvitamin D state, which enables the immune system to properly regulate itself.
I have not had time to look at the articles which turn up from https://scholar.google.com.au/scholar?hl=en&as_sdt=0%2C5&q=%22Calcium+and+vitamin+D+in+sarcoidosis%22&btnG=. However, a 2025 review https://repozytorium.ur.edu.pl/bitstreams/2cb93d34-9572-409a-bc29-3a444a3f27fc/download notes that "25-hydroxyvitamin D deficiency and insufficiency are virtually universal among sarcoidosis patients.". This alone is an argument for vitamin D3 or calcifediol supplementation to increase the level, despite concerns that this would at least transiently increase the risk of hypercalcemia. Kamphuis et al. report that no such increase occurred. The review article concludes: "Despite the increased risk of hypercalcemia, vitamin D supplementation in patients with sarcoidosis should be considered."
Are you suggesting that the relationship between pre-operative 25-hydroxyvitamin D and the risk of post-operative infection is only to a small extent, or not at all, due to the higher levels enabling the immune system to respond more effectively to bacterial infections? If you are, then I think you mean that the Quraishi et al. 2014 wide variation in post-operative infection risk, which strongly anti-correlates with pre-operative circulating 25-hydroxyvitamin D levels, is largely or entirely due to some kind of confounding, including to some degree, or entirely, due to the high proclivity of of some individuals to this risk being closely associated with those individuals having long-lasting infections before the operation, and it is those infections and/or the inherent immune system weakness which allows them to continue which both causes the lower 25-hydroxyvitamin D levels and which correlate with a higher risk of post-operative infection.
The anti-correllation is so clear and strong in these observations that in order for your hypothesis to be largely or entirely true, there would need to be an extraordinary level of infection in those, with the higher post operative infection risk, such that it greatly lowered the circulating 25-hydroxyvitamin D level by some process such as the infection causing very large amounts of immune system activity which depleted 25-hydroxyvitamin D.
There are at least two problems with this. Firstly, all these people were judged well enough to undergo a complex and risky surgery which radically alters their digestive tract, including removing most of their stomach from the digestive pathway. Secondly, every patient whose pre-operative 25-hydroxyvitamin D level was above about 20 ng/mL had this higher level due to significant vitamin D3 supplementation.
I - and I think most other people - look at this dramatic anti-correlation, recognise it can't be caused by the post-operative infections themselves, and instantly recognise that even if half the anti-correlation is due to some kind of confounding, the half that remains still shows an extremely strong relationship with the causation flowing from the pre-operative 25-hydroxyvitamin D level to the degree of immune system proficiency, and so an anti-correlation with the incidence of post-operative infection.
I am trying to understand exactly what mechanisms of confounding you think could account for most or all of the observed anti-correlation. Can you be more specific?
I don't understand what you mean by "Your point about presurgery is incoherent.".
i) As best I understand it, the non-linear relationship between vitamin D3 ingestion, which presumably roughly linearly drives production of 25-hydroxyvitamin D which goes into circulation, and the actual level of circulating 25-hydroxyvitamin D is a self-limiting mechanism which evolved to limit 25-hydroxyvitamin D levels which would otherwise occur due to very high levels of UV-B skin exposure and/or, I guess, ingesting large amounts of liver from animals who store significant amounts of 25-hydroxyvitamin D (and/or vitamin D3) there. As best I understand this, the mechanism is that the activity of the 24-hydroxylase enzyme is increased at higher 25-hydroxyvitamin D levels, resulting in the rolled off-curves in graphs such as: https://vitamindstopscovid.info/00-evi/Heaney-2015-GRH-distribution-11-.png from Heaney et al. 2015 https://www.mdpi.com/2072-6643/7/3/1688. Once hydroxylated at the 24th carbon, 25-hydroxyvitamin D and, I recall, the other two compounds - vitamin D3 cholecalciferol and calcitriol - cannot have this hydroxylation reversed and the resulting molecules are broken down into compounds which are excreted.
On this basis, I agree that we would expect to see the ratio of 24,25-dihydroxyvitamin D higher for the higher 25-hydroxyvitamin D levels, which graph 1c shows is not the case. I don't have an explanation for this.
ii) All this indicates is that the whole calcium-phosphate-bone regulation system (osteocytes and the parathyroid both signalling to the kidneys resulting in the very low, but important, level of circulating calcitriol) has evolved to respond to the conditions in much the same way no matter what level of circulating 25-hydroxyvitamin D is, with the system generally working fine when the circulating 25-hydroxyvitamin D level is 20 ng/mL or more. (These kidney cells have an active transport system to get 25-hydroxyvitamin D into the cells - a mechanism not found in immune cells.) Ideally, from an engineering point of view, the circulating calcitriol level would not be affected at all by the circulating 25-hydroxyvitamin D level. However, this is not entirely achieved, as the non-level line in Fig 1b shows.
iii) The notion that the circulating 25-hydroxyvitamin D level is a marker for anything is a result of the mistaken belief that all three compounds, vitamin D3 cholecalciferol, 25-hydroxyvitamin D and calcitriol are all somehow "vitamin D", with calcitriol being "fully activated vitamin D". The reality is that these are three different compounds with different roles. Vitamin D3's role is primarily or solely to be converted to circulating 25-hydroxyvitamin D. Circulating 25-hydroxyvitamin D's roles are to supply the kidneys and to supply multiple types of cells, outside the kidney, which need it in their cytosols to supply their 25-hydroxyvitamin D -> calcitriol intracrine and paracrine signaling systems, which are only turned on when a particular cell-type-specific condition is detected in that cell.
The mild upward slope in Fig 1b is due to the influence of osteocytes (via circulating fibroblast growth factor 23) and the parathyroid (via circulating parathyroid hormone) both altering the activity of the 1-hydroxylase enzyme in the kidneys, with the resulting calcitriol output and so level being proportional to both this activity level and the level of 25-hydroxyvitamin D in this part of the kidneys. The resulting increased circulating calcium ion level is detected by the parathyroid, resulting in reduced 1-hydroxylase activity in the kidneys, but the negative feedback gain is not so high as to totally control the circulating calcitriol level, and so the circulating Ca++ level, so they remain exactly the same when the level of 25-hydroxyvitamin D in the kidneys vary.
There isn't really such a thing as "vitamin D sufficiency", except in the mistaken notion that 25-hydroxyvitamin D is somehow vitamin D. It is not. It is a separate compound, as is calcitriol. 25-hydroxyvitamin D sufficiency is what matters.
I know from personal experience and the experience of friends and family that supplementing vitamin D3, to raise circulating 25-hydroxyvitamin D, such as to 50 ng/mL or more (but not, without good reason, above 100 ng/mL, with actual toxicity being possible above the still harder to attain 150 ng/mL level) directly causes much better health outcomes. This is a pervasive experience and correlates with numerous published observations and the mechanism of immune cells needing a good supply of 25-hydroxylvitamin D to run their intracrine and paracrine signaling systems https://vitamindstopscovid.info/02-intracrine/.
Some vitamin D RCTs fail to show a clear positive result due to inadequate supplemental quantities and/or inadequate time-frames, since it takes months for the 25-hydroxyvitamin D level to stabilize at a higher level.
One RCT which had no such problems was Castillo et al. 2020 - see https://vitamindstopscovid.info/00-evi/#castillo for the link and for the Jungreis and Kellis commentary. A single oral dose of 0.532 milligrams of calcifediol, which _is_ 25-hydroxyvitamin D, boosted circulating 25-hydroxyvitamin D levels in a few hours, safely over 50 ng/L, from typically low baselines, reasonably assumed to be in the 10 to 20 ng range. This reduced hospitalised COVID-19 patients rate of admission to ICU from 50% to 2%, and deaths from 8% to zero. Some of this enormously positive effect, as J&K note, was due to the control group happening to have more comorbidities. The rest - the great majority of the effect - must have been due to the boosted 25-hydroxyvitamin D level.
Think an write what you like. For the benefit of others, I am arguing against what I understand to be your position, that the 25-hydroxyvitamin D level doesn't have much effect on general health or on the performance of the immune system.
I had a friend who died at 66 from multiple system atrophy, which is much the same as Parkinson's disease and dementia with Lewy bodies. He had never supplemented vitamin D. It took me a few minutes with Google Scholar to find that the risk of both multiple system atrophy and PD are very strongly correlated with the lowest 25-hydroxyvitamin D levels. See https://vitamindstopscovid.info/00-evi/#3.3 for all the details. I know a 97 year old who has no trace of dementia - who has been taking about 4000 IU a day of vitamin D3 for the last 25 years. I am 70 years old, weigh 65 kg and supplement ~250 micrograms (10,000 IU) vitamin D3 a day (with 200 micrograms K2 and other nutrients). My 25-hydroxyvitamin D level is in the 80 to 90 ng/mL range. Maybe it doesn't need to be over 50 ng/mL, but I want my level to be hell-and-gone from the low level which I am sure condemned my friend to serious disability, and then a horrible death, in his early 60s.
1. Very weak, confounded data. Just more correlation getting assumed to be causation. For one, steroid use could affect both disease outcome and 25D levels. Even if D3 both raised 25D levels and was responsible for disease improvement, that still does not particularly support that there was such a thing as a deficiency. Plus the level of 25D rise is more than what one would typically expect from such a small dose.
2. So what if 25D levels correlates with surgery outcomes? 25D levels correlates every outcome imaginable. A good chunk of your reply reads like circular logic. 25D is in general just a marker of baseline health. It can however be possible that in some specific contexts – especially acute infections, D3 supplements might help. Some trials are like that. But a correlation study does not prove that. Nor would a positive RCT prove that raising 25D levels is the same thing as correcting a deficiency.
3. Noting sarc patients have low 25D and calling it deficiency is not evidence. It’s a logical leap. More likely the body is lowering 25D according to its known feedback mechanisms when 1,25D is high. Overriding that feedback with supplements could just as easily be argued to make people sicker. In fact, anecdotally autoimmune patients go both ways with D3 pills. They can feel much better or get much sicker. Trevor Marshall cured himself of sarcoidosis using a protocol that involves severe 25D depletion.
4. As some patients had extraordinary risk of infection, that kind of self-refutes the claim that they were all healthy enough for surgery. And being fit enough for surgery is hardly a high health bar to cross. Plus the very fact they are getting a weight loss surgery means they are on a spectrum of unhealthiness.
5. Not sure I understand one of your points, but if you are describing patients already coming down with some acute infection prior to surgery, then that infection just not being diagnosed until after surgery, that could be one more confounder as well. 25D is a “negative acute phase reactant” that can plummet during respiratory infections and maybe other infections. It’s plausible infection was setting in and dropped 25D, but I wouldn’t hang my hat on that as they would probably need to be symptomatic for that to happen, and if they were symptomatic they might not have done surgery. Also, that would relate to hospital acquired infections and not surgical site infections, as surgical sites did not yet exist prior to surgery.
6. Another example of confounding is that obesity causes 25D to be stored so less is in blood. This was a weight loss surgery. Fatter patients will be both sicker and have lower 25D. They adjusted for BMI but that is only a partial fix.
7. “Secondly, every patient whose pre-operative 25-hydroxyvitamin D level was above about 20 ng/mL had this higher level due to significant vitamin D3 supplementation.”
[This is yet another confounder. They could be taking supplements because they are healthy / health conscious. Healthy user bias.]
8. “I don't understand what you mean by "Your point about presurgery is incoherent.".”
[I meant your argument was nonsensical. “There is no reverse causation in this research since these are pre-operative 25-hydroxyvitamin D levels.” That is not a coherent statement.]
9. “I don't have an explanation for this.”
[Everything starts making sense once you realize correlation is not causation]
10. “The notion that the circulating 25-hydroxyvitamin D level is a marker for anything is a result of the mistaken belief”
[You’ve claimed it’s a marker of deficiency]
11. “The reality is that these are three different compounds with different roles.”
[I consider the entire vitamin D metabolome of at least 70 metabolites to be important. Many of them are “active”. In fact, 25D appears to be “active” in itself. It’s not just a substrate.]
12. I believe your positive anecdotes. I have encountered many of the exact reverse. Myself included. My chronic bartonella infection was made much worse after raising 25D to 100 ng/ml with 2 weeks of emulsified D3. I feared for my life. It took one year to fully recover, and only because I knew to take Benicar (i.e. the Marshall Protocol). FYI, I was against D pills even before this happened, but I let a practitioner pressure me into taking it against my better judgement. Positive anecdotes do not support the existence of a deficiency. It’s a drug and can do things, positive or negative.
13. I do think that respiratory infections may have a balance of positive vitamin D RCTs at adequate dose. I am not sure however and plan to systematically review it someday. I posit a drug effect, not a deficiency. But it is possible in some contexts 25D levels may be a predictor of response, which is not the same thing as saying it’s a market of deficiency. The use of supplemental 25D instead of D3 is new and may have different effects. I’m planning to do a brief probe with it myself.
I don’t find the strength of association argument to be compelling. Way too many things that could be going on. Long-story short, if 25D was a marker of deficiency, at minimum RCTs of D3 would show it works for just about everything. They don’t.
I consider D3 to be a drug and 25D a marker of background health and/or sun exposure, and occasionally a predictor of response, but never a marker of deficiency. D3 supplementation could have powerful effects on the immune system that leads to treating many conditions. Or conversely it could make them worse. Or even both in the same person at different points on time. Nowhere does a presumed deficiency fit into anything.
I think a beneficial exercise for you would be to make a list of observations that one would logically require to establish that there is such a thing as widespread 25D deficiency, as well as a list of observations that would be logically requirde to be absent. That may help you see the dearth of evidence of a deficiency. Other than that, reading Amy Proal’s papers on Microbe Minded or the files section on Secosteroid Hormone D facebook group would be helpful. But note that if you came with this kind of correlation argument there you would get quickly banned. So download the files before considering that.
How do you think immune cells, or at least many types of immune cell, use these three compounds: vitamin D3 cholecalciferol, 25-hydroxyvitamin D(3) calcifediol AKA "calcidiol" and calcitriol 1,25-dihydroxyvitamin D(3)?
What level or range of levels of circulating 25-hydroxyvitamin D do you think is needed for good health?
1) I have no clue, really. I only point out the many inconsistencies in the mainstream story. Don't need to be an expert to note some obvious fallacies.
2) D3 I have no clue if it does anything on its own, but they said hte same thing about 25D being purely a storage form. One thing that is for sure is that if you don't look, you won't find. It could in theory at least compete for enzymes and affect any number of neglected metabolites levels.
3) Here are some random wtf's for you, possible having to do with enzyme competition:
Vitamin D2 supplementation actually seems to lower 25D3 levels.
This is believed to be a result of: “either competition by D2 for the 25-hydroxylase or increased metabolic degradation of 25OHD3 by the mechanisms up-regulated to metabolize vitamin D2 and its metabolites (or both).”
Moreover, one study reported that a single dose of D2 not only led to decreased 25D3, but to decreased total 25D (i.e. 25D3 decreased more than 25D2 increased).
Though definitive literature appears to be lacking, this raises the question of if D2 supplements might actually cause a rebound effect upon discontinuation.
4) Regarding 25D activities, I have several references, but here are some that that chatGPT recently spit out at me:
"A recent review argues that at the high circulating concentrations typical for 25‑D vs 1,25‑D, even the lower‑affinity binding might suffice to activate VDR in some contexts, and thus 25‑D could have direct hormone‑like activity”
“But such evidence remains controversial and not universally accepted; many sources still consider 25‑D’s VDR affinity too low and its occupancy insufficient under physiological conditions to drive significant genomic effects.”
5) Healthy 25D levels... I don't think there is such a thing. Just fix all environmental inputs (e.g. remove any disease states like chronic infections, remove obesity, get sunlight) and whatever your number is, it's correct. On the whole, I would expect 25D levels to go up on thier own if that is all done. But even if it remains "low" at that point, it's not inherently bad.
At most, a high ratio of 1,25D to 25D might indicate a disease state. People often quote a ratio greater than 2, but I recently now think a ratio greater than 3 is a fair guideline for having a possible health issue, among which I place infectious disease as hte first suspect.
Insults are not replies. I read your video transcript and one of your rapid responses. You don't seem to venture anywhere near actually adressing my argument. These kinds of exchanges just keep convincing me I must be right.
I agree that broad-brush negative character and/or motivation assessments are useless or worse. That is why I am discussing these matters in detail.
I believe, as does Bill Grant PhD (personal conversation), that human ill-health would be, very approximately, halved if everyone had the 50 ng/mL or more circulating 25-hydroxyvitamin D their immune systems need to function properly.
You seem to think that above some much lower level, increasing the level of circulating 25-hydroxyvitamin D provides little or no difference. Unlike clueless, wannabe-know-it-alls who rant about rat poison or vitamin D being made from dirty wool, you have a deep knowledge of the field in general, and some personal experience.
If you observe that you keep getting such insults, this doesn't mean that your arguments are correct. I think everyone gets some of this. To establish causality as your last sentence implies you would need some kind of fancy trial in which multiple individuals or pseudo-individuals argued a variety of perspectives in a given contentious field with a suitably variegated audience of potential commeners, with only one of them, however judged, being right. Then you would need to find that that individual copped most of the unreasonable flak after somehow identifying and attempting to correct for any confounders.
This would probably work as you expect arguing that mRNA and adenovirus vector injections for COVID-19 were reckless, ineffective and dangerous amongst a left-woke, vaccinophile audience, especially ca. 2021.
The Government getting so much wrong, so much of the time, just highlights for me the concept of, to heck with the "experts!" Those turkeys have steered us wrong, have "approved" so many deadly drugs, have demonized so many healthy &/or neccessary things- from sunlight, to salt, butter to beef, from NAC to TCM, herbalism to Homeopathy.
I'm just ready to be done with them all & let Mother Nature take her course.
My grandparents lived into their 90s. My friends have family over 100 years of age, with minds intact!
Those who know how to be healthy will thrive, those who do not will not.
It's tough medicine but honestly, there has been enough Government intervention. We are not the better for it.
By the results you see the truth. By their fruits you shall know them.
May like to include testing for DHEA which is relevant to immunosenescence of macrophages by alpha-fetoprotein to infection, cancer & CVD risks. Clinical labs only test for DHEAS the inactive form of DHEA. DHEA levels decrease with aging so there is an increase in chronic disease. Can keep DHEA high with heathy lifestyles, lowering stress, yoga, walks outside etc. In Canada only specialized DHEA labs (endocrinology) do the testing on blood. Need to make 7-keto-DHEA available over the counter in Canada.
Any possibility that BP is behind the “delay” in fixing this “error”? Allowing it to stand seems like more “remedies” could/would be sold…?
British Petroleum?
Absolutely - but will the govt ever recommend sunshine? Probably not. This is the best way to absorb Vitamin D, as supplements may give our bodies a false signal that we have enough:
https://romanshapoval.substack.com/p/why-vitamin-d-supplements-dont-work
In Canada, we don’t get enough sunshine and weather warm enough to expose our bodies in order to synthesize vit d. Most people I know are slathering their bodies with toxic sunscreens, wearing hats, sunglasses and protective clothing when they actually go out in the sun. And now our blue sunny skies are frequently being sprayed with substances which we are not allowed to ask what is in it because we are told that what we are seeing with our own eyes is not happening. Vit D supplementation is crucial. The fact that one cannot get a Vit D test without a doctor’s prescription and in most cases the individual will have to pay for that themselves is proof enough that public health does NOT want to address this issue. I have been saying for years now that a study should be done to test vit D for all elderly in care homes. My suspicion is that we would find that virtually everyone of them is extremely deficient- but that would mean that then something would have to be done-which might mean the elderly actually had better health outcomes with less pharmaceuticals -not a great business model to have people living longer with less pharmaceuticals. Convince me that this “mistake” in calculating optimum vit d dosing is not by design!
If a person relied primarily or solely on UV-B skin exposure, year after year, to generate enough vitamin D3 for their liver to maintain at least 50 ng/mL circulating 25-hydroxyvitamin D (https://vitamindstopscovid.info/00-evi/#00-50ngmL) then they would be at very high risk for skin cancer.
Climetein et al. 2022 https://peerj.com/articles/13243/ includes the statement:
"Surfers and swimmers had consistently higher rates of PSC (pre-skin cancer: actinic keratosis), NMSC (non-melanoma) and MSC (melanoma skin cancers) than the general Australian population. Point prevalence of MSC (groups combined) was 76-fold higher than the general Australian population."
The pattern of locations on the bodies of surfers shows that this is due to the UV-B exposure - mainly the face, arm and back.
Except in the tropics it is not possible to get enough UV-B to attain 50 ng/mL or more circulating vitamin D3 from natural sunlight all year round, and even there the monsoon months prevent this from being achieved.
Generally it would only possible to do this all year round with special UV-B lamps which emit around the ideal 293 nanometre wavelength range. Eye protection would be mandatory.
There's very little vitamin D3 in food. Fortunately supplemental vitamin D3 is inexpensive and readily obtainable.
If there was no supplemental vitamin D3, the optimal approach would be some level of UV-B exposure all year round, to raise 25-hydroxyvitamin D levels to 25 or 30 ng/mL or so. This is still not enough to run the immune system properly, but it would reduce the skin damage and risk of skin cancer.
Exposure to sunlight, though not large amounts of UV-B, is surely healthy. Despite the title of your article https://romanshapoval.substack.com/p/why-vitamin-d-supplements-dont-work, vitamin D3 supplements do work. They raise the level of 25-hydroxyvitamin D and so greatly improve numerous health outcomes.
You might want to read this :) https://substack.com/@amidwesterndoctor/p-145752278
Do you think that article cites evidence or arguments which contradict anything I wrote in this discussion, at https://vitamindstopscovid.info or at https://nutritionmatters.substack.com? The same ~293 nm UV-B light which generates vitamin D3 in the skin also damages DNA, kills cells, causes sunburn, long-term skin damage and increases the risk of skin cancer.
If there was no vitamin D3 supplementation, a modest amount of UV-B exposure would be optimal, and would generally reduce the incidence of cancer and probably skin cancers, by significantly improving the immune system's performance due to a substantial rise in circulating 25-hydroxyvitamin D, such as to 20 or 30 ng/mL from levels as low as 5 ng/mL.
See the graphs at the end of Quraishi et al. 2014 https://jamanetwork.com/journals/jamasurgery/fullarticle/1782085 also at: https://vitamindstopscovid.info/00-evi/#00-50ngmL. With 50 ng/mL or more circulating, pre-operative, 25-hydroxyvitamin D, the risk of surgical site and, separately, of hospital acquired, infections were both about 2.5%. At 25 ng/mL, the risk of each rose a factor 6 to about 15%. This is frank immune system dysfunction compared to 2.5%, but much better than the 40% risk of each of these two types of bacterial post-operative infection with 10 ng/mL, which is a typical level for someone who gets little or no UV-B skin exposure and does not supplement vitamin D3 at all.
To rely largely or solely on UV-B skin exposure to achieve the 50 ng/mL circulating 25-hydroxyvitamin D the immune system needs to function properly would, year-after-year, lead to darker (so requiring more UV-B exposure) and damaged skin, with much higher levels of skin cancer than would be the case with modest or no UV-B exposure and proper vitamin D3 supplementation.
People with black or brown skin would need to be out in high elevation sunlight, most days, like our African ancestors, with little in the way of clothing, to attain 50 ng/mL or more circulating 25-hydroxyvitamin D. See the grey histogram at the left of https://vitamindstopscovid.info/00-evi/1-Dror-Israel-14-framed.png. This represents the observations of Luxwolda et al. 2012 https://doi.org/10.1017/S0007114511007161. These are the only 25-hydroxyvitamin D measurements ever made of traditionally living Africans - of Maasai pastoralists and Hadzabe hunter gatherers. The mean level was 46 ng/mL. So half of these people probably have immune system dysfunction, according to the Quraishi et al. graphs.
The Quraishi et al. study was of 770 morbidly obese people who all underwent the same Roux-en-Y gastric bypass surgery at Massachusetts General Hospital. Although people suffering from obesity have greater difficulty raising their circulating 25-hydroxyvitamin D level than normal weight and overweight people, for vitamin D3 supplementation quantities which are any given ratio of body weight, I know of no reason to believe that their immune systems require more circulating 25-hydroxyvitamin D in order to function properly. So those graphs are the best, most specific, guide we have to how the immune system depends on the circulating level of 25-hydroxyvitamin D.
The blue histogram in that infographic is from Israel at al. 2020 (preprint) https://www.medrxiv.org/content/10.1101/2020.09.04.20188268v1 - see also https://vitamindstopscovid.info/00-evi/#israel. The lowest bar is significantly higher (to the right) since it represents the number of Arab women in sunny Israel whose 25-hydroxyvitamin D level is below the 5 ng/mL detection limit. I met a late-twenties African woman, a nurse, here in Melbourne Australia, who told me her level was 7 ng/mL. She greatly appreciated my vitamin D3 pep-talk and link to the most pertinent research cited and discussed at: https://vitamindstopscovid.info/00-evi/. Regarding low circulating 25-hydroxyvitamin D being a huge risk factor for neurodegeneration: https://vitamindstopscovid.info/00-evi/#3.3 and (in pregnancy and early childhood) preeclampsia, pre-term birth and mental retardation, ADHD and autism in the children: https://vitamindstopscovid.info/00-evi/#3.2.
I am not arguing against the benefits of sunlight - just against the common notion that UV-B skin exposure is the best way to attain the 50 ng/mL circulating 25-hydroxyvitamin D we need to be healthy.
It was and still is, a policy based on depopulation. The push for "sunscreen" tells you all you need to know.
Great article!
I don't know what to think about HHS and ACIP after reading this on Dr. Exley's sub stack this morning? "A number of weeks prior to the ACIP meeting I was asked by Health and Human Services (HHS) to prepare a talk on aluminum adjuvants for presentation at the December ACIP meeting. I recommended to HHS that several other highly qualified individuals be asked to join me to form a working group to prepare the talk. The group was formed and a thorough review of the safety of aluminum adjuvants used in vaccination was prepared and submitted to HHS for final review before the scheduled ACIP meeting. Imagine our surprise and indeed annoyance when just one week before the meeting we received an email from the ACIP Secretary, not HHS, telling us that our presentation at the December ACIP meeting had been cancelled. No explanation was offered at that time. Indeed, we learned just prior to the meeting that an ACIP member would give a brief presentation on aluminum adjuvants at the end of the meeting, if there was time. ...I concluded that the decision not to vaccinate against Hep B at birth was correct. Neonates are especially vulnerable to intoxication by aluminum as I have written about in this Substack on a number of occasions. Not injecting them with aluminum at birth will undoubtedly save the lives of some infants and may also reduce the number of infants that develop profound autism over subsequent weeks, months and years. However, it is only delaying infant intoxication by aluminum and is a half measure at best. If I had been allowed to present to ACIP I would have asked for an immediate moratorium on the use of vaccines that include an aluminum adjuvant." Why would the world's leading expert have been cut with his colleagues from the ACIP meeting. No explanation was given.
Perhaps you did not notice that this is NOT Dr Exley’s Substack, is NOT about the HHS or ACIP recommendations, and NOT about the Hep B vaccine or its aluminum adjuvants. How hard is it to confine your comments to the subject matter presented in THIS article?
Mind your own business.
After taking a peekaroo at the MSDS (material safety data sheet) for vitamin D's components, namely Cholecalciferol, I do not want this in my body. Every vitamin D pill has this ingredient and it mostly comes from China or India, not from "Sunny"ville USA.
The same with the food additives for vitamin D. There are no standards for supplements and many supplement companies are run by big pharma. The trust factor for me is zero. The trust factor for the HHS is zero...they still love mRNA poisons to death.
There is no way this is the same "stuff" you might get from sun exposure (and I am doubting that is even vitamin D), although sun exposure is very healthy in other ways.
If supplements are real, then DVs, MDAs or RDAs are never a one-size-fits-all. I no longer believe the chemically made vitamin D is nearly the same as what might be naturally in foods...if it even is.
There's far too little vitamin D in food, fortified or not, to attain the 50 ng/mL circulating 25-hydroxyvitamin D the immune system needs to function properly: https://vitamindstopscovid.info/00-evi/#00-50ngmL.
Supplemental vitamin D3 cholecalciferol is identical in every respect to the vitamin D3 cholecalciferol which is created in the skin when UV-B light ca. 293 nanometre wavelength breaks one of the bonds in one of the carbon rings in 7-dehydrocholesterol, with the resulting molecule changing its shape of its own accord (due to thermal vibrations) and settling down in its new shape, with all the same atoms which were in the 7 dehydrocholesterol, which is vitamin D3 cholecalciferol.
You can read about the industrial production of vitamin D3 cholecalciferol in "Industrial Aspects of Vitamin D" by Arnold L. Hirsch in 2010: https://sci-hub.se/10.1016/B978-0-12-381978-9.10006-X . The process involves creating 7-dehydrocholesterol by chemically transforming cholesterol from wool fat. This is purified and dissolved in a hydrocarbon solvent,such as ether. This is exposed to UV-B light from special, multi-kilowatt, high pressure mercury vapour lamps which are water cooled, with the light being further filtered by compounds in the cooling water jacket, to optimise conversion of 7-dehydrocholesterol to the molecule which settles down to become vitamin D3, minimising other wavelengths which break down this product.
This is then purified. The ether solvent is nothing to worry about. It is highly volatile and not very toxic. For a 70 kg body weight non-obese person to attain 50 ng/mL circulating 25-hydroxyvitamin D, it only takes a gram of vitamin D3 every 22 years (5000 IU = 125 micrograms a day, on average).
The multinational pharmaceutical companies do not make vitamin D3. The margins are far too low. The production process is exotic and hard to master. Several companies in India set up to do it, and failed. A gram of pharma-grade vitamin D3 costs about USD$2.50 a gram, ex-factory, in 1 kg quantities. A lot of this price would go into the electricity for the massive mercury vapour lamps.
The Chinese manufacturers, as far as I know produce vitamin D3 in an unpurified form for agricultural purposes.
I guess there are multiple companies worldwide who produce pharma-grade vitamin D3 with all the necessary accreditation for use in various countries. The only one I know of is Fermenta Biotech in India: https://fermentabiotech.com, who have been making vitamin D3 since 1967. You can see photos of the outside and inside of their main vitamin D3 plant at: https://aminotheory.com/cv19/#Maharashtra-police.
See my comment above https://popularrationalism.substack.com/p/it-is-time-for-hhs-to-update-its/comment/185986461 on why it is impractical - and would be dangerous if it was practical - to rely on UV- from sunlight or any other source to produce most or all of the vitamin D3 we need to be healthy.
I agree that, especially for vitamin D3, single values for adults for "daily values" and Recommended Daily/Dietary Allowance, are wrong. I will write more about this in another comment. See https://vitamindstopscovid.info/00-evi/#00-how-much for New Jersey based Professor of Medicine Sunil Wimalawansa's recommendations for how much vitamin D3 to supplement, on average, per day. It applies to people of all ages and body weights and is calculated according to body weight, with higher ratios for those suffering from obesity.
Fatty fish > cod liver oil. All natural, except I would test for radiation if it came from the Pacific. As I do, but so far so good.
What do you say to the people who claim Vit D is rat poison 🤣?
Sola dosis facit venenum
This is "The dose alone makes the poison", in Latin.
Unrefined vitamin D3 cholecalciferol is used as a rodent poison. Rats can be induced to each such large quantities of it, in proportion to their body weight, which (after hydroxylation mainly in the liver) raises their circulating 25-hydroxyvitamin D levels far beyond what is healthy. This raises the level of circulating calcitriol (1,25-dihydroxyvitamin D) which the kidneys maintain (imagine the upwards slope of the graph of Fig 1b of Tang et al. 2009: https://www.nature.com/articles/s41598-019-43462-6 extending much further to the right, and so going much higher. This causes the level of circulating calcium ions to rise far beyond what is tolerable, and this kills the rat. Also, I suspect, the very high level of 25-hydroxyvitamin D also causes significant binding to the VDR molecules in the cells which sense the very low levels of circulating calcitriol and which are involved in calcium-phosphate-bone metabolism, with the same deadly effects.
If a human ingested the same amount of cholecalciferol as a ratio of their bodyweight, the same processes would occur.
None of this contradicts the fact that we need to maintain at least 50 ng/mL circulating 25-hydroxyvitamin D in order to be healthy. Please see my other comments here, or more importantly, the research cited and discussed at: https://vitamindstopscovid.info/00-evi/.
This is what you say… You know what else is toxic to rats? Baking soda... Oh No! Also chocolate, caffeine, alcohol, avocados, onions, garlic, blue cheese, licorice and citrus fruits,.... all are poisonous to rats. Oh Dear…. look at all that rat poison we’re ingesting! LOL! https://exoticnutrition.com/blogs/blog/unsafe-food-for-rats#
Excellent! thank you
(1 of n) The HHS proposal you mention is an incremental step in roughly the right direction, but falls far short of what is needed to ensure that most or all Americans attain at least the 50 ng/mL (125 nmol/L = 1 part in 20,000,000 by mass) level of circulating 25 hydroxyvitamin D which the immune system needs to function properly.
Rather than explain everything in these comments, I will refer to my own web pages where you can read proper explanations and follow links to the most pertinent research. Many aspects of the way the three "vitamin D" (using the term broadly) compounds are discussed and understood are completely inadequate. For instance, the notion that "vitamin D" is a hormone, and the tendency to refer to all three compounds as being vitamin D, rather than identifying them clearly by name. See: Reinhold Vieth, 2004: "Why “Vitamin D” is not a hormone, and not a synonym for 1,25-dihydroxy-vitamin D, its analogs or deltanoids" https://www.sciencedirect.com/science/article/abs/pii/S0960076004000858 (paywalled) PDF from Sch-Hub: https://sci-hub.se/10.1016/j.jsbmb.2004.03.037.
The most important failure of the medical profession, immunologists and many or most people who write journal articles about the vitamin D compounds is that they have not heard of, and do not understand, that the immune system uses these compounds in very different ways to the hormonal system, which everyone understands, by which the kidneys play their role, with osteocytes and the parathyroid gland, in regulating calcium-phosphate-bone metabolism. The immune system does not use hormonal signalling. Many types of immune cell, and other cell types such as some which are involved in neurodevelopment, rely on a good supply of 25-hydroxyvitamin D in order that their 25-hydroxyvitamin D -> calcitriol intracrine and paracrine signaling systems can function properly. These operate within a single cell (intracrine) and between nearby cells, typically of different types (paracrine). These are unrelated to hormonal (endocrine) signalling. A hormone is a long-distance, blood-borne (also in the CSF) signaling molecule.
Calcitriol operates as a hormone when it exists in the bloodstream, at a very low, stable, level ca. 0.05 to 0.1 ng/mL. The kidneys maintain this and the level of circulating calcitriol affects the behavior of cells of several types, all over the body, which are involved in calcium-phosphate-bone metabolism. The immune system is not significantly affected by, and does not significantly affect, this very low level of circulating, hormonal calcitriol.
In the above mentioned intracrine and paracrine signaling systems, individual cells hydroxylate 25-hydroxyvitamin D on the number 1 carbon to produce calcitriol, only when a cell-type-specific condition is detected by that cell. In intracrine signaling, this calcitriol functions as an intracrine agent: Calcitriol binds to a VDR molecule (the so-called "vitamin D" receptor, best thought of as the calcitriol receptor, since its affinity for vitamin D3 and 25-hydroxyvitamin D is much lower) much more strongly than does vitamin D3 or 25-hydroxyvitamin D. The bound complex finds its way to the nucleus where it binds with a retinol X molecule and the triple complex up- and down-regulates the copying of dozens to hundreds of genes to mRNA molecules, in a cell-type specific manner. This alters this individual cell's behavior in a cell-type specific manner. The above mentioned paracrine signaling system involves some of this intracellularly produced calcitriol diffusing to nearby cells, where it functions as a paracrine agent and alters the behaviour of nearby cells of one or more types, again in a cell-type specific manner.
It is absolutely critical that all doctors, immunologists, virologists, vaccinologists, epidemiologists, public health officials etc. understand these two signaling systems, because the are completely different from the kidney-based hormonal system which everyone understands.
Most people who write vitamin D research articles have never heard of these signaling systems. Immunologists have generally never heard of them, despite them playing a crucial role in the ability of individual immune cells to alter their behavior in response to their changing circumstances.
Since there are no peer-reviewed tutorials on 25-hydroxyvitamin D -> calcitriol intracrine (sometimes mistakenly called "autocrine"_ and paracrine signaling, I wrote a tutorial in late 2020: https://vitamindstopscovid.info/02-intracrine/. A simpler version is at: https://vitamindstopscovid.info/00-evi/#02-compounds.
The only practical, safe, way for Americans can be be healthy is for them* to follow the recommendations of New Jersey based Professor of Medicine, Sunil Wimalawansa, for how much vitamin D3 cholecalciferol to supplement, on average, per day. These recommendations depend on body weight and obesity status. It is fine to take larger amounts every week to ten days, as long as the average daily amount falls within the ranges Prof. Wimalawansa recommends.
To see why 50 ng/mL (125 nmol/L) is the minimum level of 25-hydroxyvitamin D everyone* should seek to attain, please see this section on Massachusetts General Hospital research from 2014 (Quraishi et al.) which shows, more clearly and directly than any other research, that levels above this provide strong protection against post-operative infections, and the further the level is below this, the greater the risk: https://vitamindstopscovid.info/00-evi/#00-50ngmL.
* The first important exception is infants substantially breast-fed by vitamin D3 and so 25-hydroxyvitamin D replete mothers. The short half-life vitamin D3 and the longer half-life 25-hydroxyvitamin D are both transferred in breast milk. Since 25-hydroxyvitamin D is more easily absorbed into the bloodstream than vitamin D3 (it is more water soluble, due to having two rather than one hydroxyl groups) and since it does not require hydroxylation to raise circulating 25-hydroxyvitamin D, it plays an important role in meeting the 25-hydroxyvitamin D needs of the infant. Measurements of vitamin D3 and 25(OH)D levels in human breast milk vary widely, in part due to the difficulties in measuring such low levels: https://www.frontiersin.org/journals/nutrition/ articles/10.3389/fnut.2023.1229445. One recent study https://www.mdpi.com/2072-6643/13/2/573 found approximately equal amounts of vitamin D3 and 25-hydroxyvitamin D in human breast milk. Since (at least in adults) the liver only coverts about 1/4 of ingested vitamin D3 into circulating 25-hydroxyvitamin D, this means that the bulk of the benefit to the breast-fed child's 25-hydroxyvitamin D comes from the 25-hydroxyvitamin D component of breast milk. This depends on the mother's 25-hydroxyvitamin D level.
The second important exception is people who generate sufficient vitamin D3 in their skin, via UV-B exposure, to attain most or all of the vitamin D3 they need to attain at least 50 ng/mL circulating 25-hydroxyvitamin D all year round. Except in equatorial regions (and even then, there is too little sun in the monsoon season) this can only be achieved with special, dangerous to the eyes and skin, UV-B lamps. While sunlight, including on the skin, is surely important to health via multiple mechanisms, the UV-B required to provide for most or all of our vitamin D3 needs is inherently damaging, since it damages DNA. To rely on this all year, every year, would greatly raise the risk of skin cancer.
(2 of n) Prof. Wimalawansa's recommendations were most recently published in an article with a professor of pediatrics and another professor of medicine: "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.
Please see this section: https://vitamindstopscovid.info/00-evi/#00-how-much. 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. Prof. Wimalawansa's recommended daily vitamin D3 supplemental intake quantities scale directly with body weight, with higher ratios for those suffering from obesity. There is no need for blood tests or medical monitoring if these quantities are adhered to.
There is very little vitamin D in food, including that which is fortified with vitamin D3 cholecalciferol or the less effective vitamin D2 ergocalciferol. Fortification can help improve on disastrously low 25-hydroxyvitamin D levels in ways which reduce the incidence of rickets, but it can never do more than make a slight contribution to attaining at least 50 ng/mL circulating 24-hydroxyvitamin D. (U.S. doctors can only prescribe vitamin D2, for some obscure historical reason. This is less effective at attaining a good level of circulating 25-hydroxyvitamin D2 than vitamin D3 is at attaining a good level of 25-hydroxyvitamin D3. The third natural compound, 1,25-dihydroxyvitamin D3 calcitriol is more effective at binding to the "vitamin D receptor" VDR molecule than 1,25-dihydroxyvitamin D2. There is no reason to use vitamin D2 for any purpose in place of vitamin D3.)
Below, and in subsequent comments, I use the term "25-hydroxyvitamin D" to mean 25-hydroxyvitamin D3 specifically. Likewise 1,25-dihydroxyvitamin D calcitriol, is slightly short for the full term "1,25-dihydroxyvitamin D3".
I argue that every government and/or commercial effort which could be put into supporting vitamin D fortification of food would be better applied to supporting proper vitamin D3 supplementation, as Prof. Wimalawansa recommends: https://vitamindstopscovid.info/00-evi/#07-fortif.
These recommendations 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. This takes several months to attain the desired > 50 ng/mL circulating 25-hydroxyvitamin D from typical baselines of 20 ng/mL or less.
One IU (International Unit) of vitamin D3 is 1.40,000,000th of a gram. (This unit was chosen about a century ago, before anyone the chemical structure of vitamin D3 or D2 was known, and long before the discovery of 25-hydroxyvitamin D and calcitriol. One IU of vitamin D3 approximates the amount of vitamin D3 a baby rat needs to consume to avoid developing rickets. Until about the 1960s, the only way the vitamin D3 or D2 content of a substance could be determined was to feed varying amounts of the substance to baby rats and then to detect, with X-rays, which of them developed rickets.)
0.125 mg = 126 micrograms = 5000 IU a day is 8 or more times what most governments recommend. "5000 IU" sounds like a lot, but it is a gram every 22 years - and pharma grade vitamin D costs about USD$2.50 a gram ex-factory. This will safely attain at least 50 ng/mL 125 nmol/L 25-hydroxyvitamin D over several months, without the need for blood tests or medical monitoring.
More comments to follow.
I’m trying so hard to understand conflicting information. Vitamin D is cholecalciferol. Look at your bottle. This is manufactured using sheep’s hair. Nothing about the manufacturing process seems healthy to me. I quit Vit D 2 weeks ago. Ask your AI of choice, preferably not Google, What is the manufacturing process for Cholecalciferol. I’m shocked at what I found. Please tell me if I am wrong.
Perhaps you have been reading pages such as https://unbekoming.substack.com/p/the-vitamin-d-paradox-what-they-dont. People who deliberately write torrents of BS like this are not interested in being corrected, so I didn't try. Please see two of my comments here: https://popularrationalism.substack.com/p/it-is-time-for-hhs-to-update-its/comment/185986461 and https://popularrationalism.substack.com/p/it-is-time-for-hhs-to-update-its/comment/186005348.
Thank you for replying, I’m at a loss trying to understand this information. I hadn’t seen these articles, but I’ve heard/seen rumblings in the background that I didn’t pay attention to. The conflicting information doesn’t help at all. There’s also a book “Take Daily” by Robyn Openshaw. I would be very interested in your opinion about her conclusions on B vitamins and magnesium. What is going on here?
A quick look at the summary of "Take Daily: How Supplements Hijack Your Health" by Robyn Openshaw and Mike Fairclough https://www.amazon.com.au/Take-Daily-Supplements-Hijack-Health-ebook/dp/B0FTC6CLSV makes me think it is largely ill-informed, alarmist, click-bait like the Unbekoming article I mentioned in my previous comment.
Mike Fairclough has written a number of books on important social controversies. One of Robyn Openshaw's books is entitled "Vibe: Discover Your Energetic Frequency for Health, Love & Success".
I am an electronic technician and computer programmer. Don't take my word for anything regarding nutrition. I am writing to encourage people to read the best research for themselves.
From the intro to "Take Daily": "We believe nature is able to provide all our remedies". I guess they are against all supplements.
If you read the research cited at https://vitamindstopscovid.info/00-evi/ and follow my arguments there, and in these comments regarding the dangers of relying on UV-B skin exposure to attain 50 ng/mL or more circulating 25-hydroxyvitamin D (responding to Sunlover and AlsoMe), I believe you will conclude that the romantic notion of natural foods and natural sources of vitamin D3 (UV-B skin exposure) are inadequate (food) and both impractical and dangerous (UV-B) for attaining the 50 ng/mL circulating 25-hydroxyvitamin D the immune system needs to function properly.
Fortunately we now have bio-identical vitamin D3 cholecalciferol. For 70 kg (154 lb) body weight without obesity, all you need to attain 50 ng/mL or more circulating 25-hydroxyvitamin D all year round is a gram every 22 years (125 micrograms a day, on average): https://vitamindstopscovid.info/00-evi/#00-how-much.
There surely are supplements which cause harm. Greatly exceeding the quantities in these recommendations would likely cause harm to some people. However, it is best to take large quantities of vitamin D3, while reducing calcium intake, ideally with vitamin K2 and under medical supervision, to boost 25-hydroxyvitamin D levels over 150 ng/mL for the purpose of suppressing a wide range of auto-immune inflammatory conditions. This is the Coimbra protocol - see the research cited and discussed at: https://vitamindstopscovid.info/06-adv/.
Magnesium is a very common deficiency. See the work of Patrick Chambers MD: https://www.researchgate.net/profile/Patrick-Chambers-4. Magnesium citrate is a common supplement, but it is also a laxative . . . . Magnesium chelate/orotate is a highly bioavailable alternative. However, for people at risk of kidney stones, magnesium citrate is a source of citrate, which is generally protective against most kidney stones, as is calcium citrate and especially potassium citrate. It is important not to take too much potassium at once: https://aminotheory.com/cv19/kna/.
Vitamin C can increase the risk of kidney stones, but has many benefits.
Recently, here in Australia, there has been an investigation into people suffering permanent neurological damage due to taking very large amounts of vitamin B6 pyridoxine. It seems that numerous non-prescription vitamin supplements have this added - I am not sure why - and that the total daily intakes can be completely excessive: https://www.abc.net.au/news/2025-01-28/vitamin-b6-toxicity-cases-rise-vitamins-supplements-tga-review/104863232. There is now going go be tighter regulation of supplements containing vitamin B6: https://www.abc.net.au/news/2025-11-26/tga-confirms-removal-of-toxic-vitamin-b6-from-shelves/106052270.
I haven't got a magic shortcut through these controversies. You can't necessarily "trust the experts" since any one or several chosen, apparent, experts, may be completely mistaken. There's no substitute for reading the research yourself, and searching widely for alternative perspectives. It is a lot of work and many people don't have the interest to skills to do a proper job of it. As long as mainstream medicine is so avoidant of new information, because they are so unwilling to admit they might have been wrong in the past, the whole field will progress at a snail's pace, such as the incremental improvement the HHS is currently considering for vitamin D policy. This would fall far short of what should occur, in the light of the best current research, as I argue here and elsewhere.
So the choice is between relying on mainstream "expert" opinion which might take decades to reflect reality, being scared off by clueless alarmists and doing your own research. Researching these fields can be time-consuming, but it it interesting and can be very rewarding. If you pursue this seriously you might like to join the Nutrition for Immune System Health email discussion group: https://nish.groups.io.
Most D3 is from lanolin which is collected after they shear sheep. Which is why it is so dirt cheap. You can also get plant based D3 from Lichen. But that’s usually 4x the costs.
https://futurism.com/study-ai-search-wrong
There are a number of people using as much as 30,000 IU or even 45,000 IU a day as an alternative therapy for multiple sclerosis. I'm not recommending such levels -- they are risking side effects because they're between a rock and a hard place, with their illness. But, they seem to do well for long periods even at those levels -- for anyone who's fearing 10,000 IU / day.
This is the Coimbra / McCullough / Batchelor high 25-hydroxyvitamin D protocol: https://vitamindstopscovid.info/06-adv/#01-higher.
While these very high 25-hydroxyvitamin D levels can suppress the autoimmune inflammatory (indiscriminate cell destroying) immune responses which are the central mechanism in many chronic diseases, the lack of such levels is not the cause of these diseases, or of this excessive level of inflammation.
The cause is surely genetic variations on a general theme of the base level inflammatory responses having evolved to be unhealthily strong, to counter the compounds emitted by helminths (intestinal worms) which downregulate these responses. These inflammatory responses evolved primarily to target multicellular parasites such as helminths, since ordinary antibodies and macrophages are no use against multicellular organisms.
Helminthic therapy - the deliberate introduction of relatively benign helminths - suppresses much the same set of inflammatory conditions as the Coimbra et al. protocol: https://www.helminthictherapywiki.org.
The helminth researchers seem to known nothing of the vitamin D compounds and how they are used in the immune system. (See my comments here and https://vitamindstopscovid.info/00-evi/#02-compounds.)
I have tried since about 2021 to get leading vitamin D3 researchers and clinicians interested in helminths, and how humans evolved overly strong inflammatory responses to counteract our ancestors' ubiquitous helminth infections, which down modulated these responses. So far, no-one has taken an interest. They are very busy.
There are excellent prospects for understanding and treating these numerous inflammatory disorders, especially if one or more of the helminthic compounds can be regularly administered to suppress this excessive inflammation. Please see all the sections of: https://vitamindstopscovid.info/06-adv/.
JWL, this time yuo have it all wrong. Corrleation is not causation. And there is also reverse causation. The literature much mroe strongly supports that diseases causes low 25D. And some of the reasons for this are protective. Taking D3 can pour fuel on a fire. Chronic infectious diseases especially tend to dysregulate vitamin D metabolism leading to low 25D but high 1,25D. The 1,25D is high because your body is not geting enough VDR activation because the infections are clogging up the VDRs. If you raise 25D more you start competing with 1,25D for VDRs. 25D does not activate VDRs to the same extent as 1,25D. And you also end up increasing circulating 1,25D (not bound) which is where toxicity happens. There is also zero literature that shows raising 25D considerably increases 1,25D levels. All the conventionally claimed benefits fo D3 come from raising 1,25D, not 25D. You can't even measure 25D properly anyway as most of it is in bones, organs, and muscles. And when your body makes it is is protein bound. If that all were not bad enough, there are more than 70 types of vitamin D and there is enzyme competition and you will probably mess up the levels of many other metabolites that have real health-promoting effects. There are three major branches of the metabolic tree, and D3 - even in theory - only supplies one of them.
There is no such thing as epidemic 25D deficiency. It is a mythical entitity. D3 is a drug. Some feel better or get better taking it. Some get sicker. It's an experiment. Experiment if you want. But just do so knowing hte reaon situation, not the rosy narrative.
Almost everything you wrote here is just plain wrong. You cite no sources. If what you say is valid, you should be able to point out research which disproves pretty much everything you can read about the vitamin D compounds in the research cited and discussed at: https://vitamindstopscovid.info/.
Reverse causation - disease lowering 25-hydroxyvitamin D - is a marginal process which is not very significant, except perhaps in gross infections such as sepsis or granulomatous disorders such as sarcoidosis, and boosting 25-hydroxyvitamin D levels helps with both. Read research cited in the above page in full to see what I mean. Also, https://vitamindstopscovid.info/01-supp/#sarc - Kamphius et al. 2014 https://sci-hub.se/10.1002/jbmr.2262 report that sarcoidosis patients do better with vitamin D3 supplementation.
See Quraishi et al. 2014: https://vitamindstopscovid.info/00-evi/#00-50ngmL who show, conclusively, that low 25-hydroxyvitamin D _causes_ much higher rates of post-operative infections, with 50 ng/mL or more leading to a very low risk: 2.5% for surgical site infections and 2.5% for hospital-acquired infections. At 20 ng/mL, a level people will have if they follow your advice to avoid vitamin D3 supplementation and do not get much UV-B skin exposure, the risk for each of these two types of post operative infection is about 25%. This is a tenfold increase - the result of immune system failure. There is no reverse causation in this research since these are pre-operative 25-hydroxyvitamin D levels.
You wrote: "All the conventionally claimed benefits fo D3 come from raising 1,25D, not 25D." You - or perhaps other people - mistakenly assume that the very low level of circulating calcitriol (1,25-dihydroxyvitamin D) significantly affects the immune system. It does not.
The immune system uses 25-hydroxyvitamin D -> calcitriol intracrine and paracrine signaling, which are per cell and inter-cell signaling systems which are unrelated to the hormonal signaling use of calcitriol in the bloodstream: https://vitamindstopscovid.info/02-intracrine/ and, in a simpler form: https://vitamindstopscovid.info/00-evi/#02-compounds.
You are right to imply ("here is also zero literature that shows raising 25D considerably increases 1,25D levels") that raising 25-hydroxyvitamin D at most only marginally raises circulating calcitriol. See the gentle rise in the scatterplot graph of Fig 1b of Tang et al. 2009: https://www.nature.com/articles/s41598-019-43462-6.
This, and the much smaller affinity 25-hydroxyvitamin D has for the VDR molecule, does mean that very high levels of 25-hydroxyvitamin D can raise circulating calcium levels to cause hypercalcemia. This is why it is vital to understand 25-hydroxyvitamin D -> calcitriol intracrine and paracrine signaling. Without this understanding, many clinicians and researchers assume that the immune system can somehow be boosted by raising circulating calcitriol levels. This is not the case.
- I have no obligation to compose a literature review, just as you have no obgliations to read it
- kamphius is a small retrospective study where the groups were clearly not comparable (e.g. steroid use). The dose of vitamin D was 400IU which is a trival dose that couldnt produce the presumed benefits. Even if it did it scarcely addresses what I am arguing.
- Qurashi is just one of another endless correlation studies. You misunderstand what i mean by reverse causation. I mean pervasively in chronic disease contexts too, not just in specific acute contexts. Your point about presurgery is incoherent.
- Tang provides singificant evidence for what I am saying. Look at figure 1 again...
i) 24,25D is a marker of 25D catabolism. If 25D were a true marker of deficiency, we would expect that at low levels of 25D, the ratio of 25D to 24,25D would be elevated, reflecting reduced catabolism as the body tries to preserve 25D. Instead, the ratio remains roughly constant across the observed range of 25D, indicating that catabolism scales proportionally with substrate. This finding does not support the claim that circulating 25D is a marker of deficiency.
ii) Figure 1D shows that when 25D is low, the body preserves 1,25D relative to 24,25D (high ratio), and as 25D rises, the ratio drops quickly, then plateaus. That's tight feedback. The body adjusts the balance of activation vs. catabolism to maintain 1,25D levels. By extension, your body can be expected to resist the effects of vitamin D supplementation, as it recognizes no need for it.
YOu have the burden of proof backwards. Prove 25D is a market of deficiency. I'd say in about 80% of conditions for which vitamin D has been tested, the results are a flop. Since low 25D is associated with all of them, if it were a market of deficiency, trials would be far more successul. The balance of 20% of trials or so that are positive can still be explained by a drug effect.
I strongly favor sun exposure with correction of dysfunctional lifestyle and environment that has reduced UV-reslience.
(a) Hi David, The "mostly" 10 micrograms (400 IU) daily vitamin D3 supplementation quantity in Kamphuis did significantly increase the level of circulating 25-hydroxyvitamin D, from 16.8 ng/mL (42 nmol/L, page 2500) to 28 ng/mL (114 + 28 nmol/L). This is a material change. In the Quraishi et al. graph https://vitamindstopscovid.info/00-evi/ of risk of each of the two kinds of post-operative infection, this corresponds to a baseline risk of about 28% being reduced to about 14%. Kamphuis et al. reported that those who took this vitamin D supplement, with calcium (which I think is not required and is probably a bad idea) did better than those who did not take these supplements. This wasn't an RCT, but it was a substantial set of observations.
There probably is reverse causation in that the disease depletes the 25-hydroxyvitamin D. It surely does this more strongly in the affected areas of the body. This does not mean that supplementing vitamin D3 to boost the level is not helpful. The depletion locks the condition in. The supplementation enables the body to get out of its low 25-hydroxyvitamin D state, which enables the immune system to properly regulate itself.
I have not had time to look at the articles which turn up from https://scholar.google.com.au/scholar?hl=en&as_sdt=0%2C5&q=%22Calcium+and+vitamin+D+in+sarcoidosis%22&btnG=. However, a 2025 review https://repozytorium.ur.edu.pl/bitstreams/2cb93d34-9572-409a-bc29-3a444a3f27fc/download notes that "25-hydroxyvitamin D deficiency and insufficiency are virtually universal among sarcoidosis patients.". This alone is an argument for vitamin D3 or calcifediol supplementation to increase the level, despite concerns that this would at least transiently increase the risk of hypercalcemia. Kamphuis et al. report that no such increase occurred. The review article concludes: "Despite the increased risk of hypercalcemia, vitamin D supplementation in patients with sarcoidosis should be considered."
Are you suggesting that the relationship between pre-operative 25-hydroxyvitamin D and the risk of post-operative infection is only to a small extent, or not at all, due to the higher levels enabling the immune system to respond more effectively to bacterial infections? If you are, then I think you mean that the Quraishi et al. 2014 wide variation in post-operative infection risk, which strongly anti-correlates with pre-operative circulating 25-hydroxyvitamin D levels, is largely or entirely due to some kind of confounding, including to some degree, or entirely, due to the high proclivity of of some individuals to this risk being closely associated with those individuals having long-lasting infections before the operation, and it is those infections and/or the inherent immune system weakness which allows them to continue which both causes the lower 25-hydroxyvitamin D levels and which correlate with a higher risk of post-operative infection.
The anti-correllation is so clear and strong in these observations that in order for your hypothesis to be largely or entirely true, there would need to be an extraordinary level of infection in those, with the higher post operative infection risk, such that it greatly lowered the circulating 25-hydroxyvitamin D level by some process such as the infection causing very large amounts of immune system activity which depleted 25-hydroxyvitamin D.
There are at least two problems with this. Firstly, all these people were judged well enough to undergo a complex and risky surgery which radically alters their digestive tract, including removing most of their stomach from the digestive pathway. Secondly, every patient whose pre-operative 25-hydroxyvitamin D level was above about 20 ng/mL had this higher level due to significant vitamin D3 supplementation.
I - and I think most other people - look at this dramatic anti-correlation, recognise it can't be caused by the post-operative infections themselves, and instantly recognise that even if half the anti-correlation is due to some kind of confounding, the half that remains still shows an extremely strong relationship with the causation flowing from the pre-operative 25-hydroxyvitamin D level to the degree of immune system proficiency, and so an anti-correlation with the incidence of post-operative infection.
I am trying to understand exactly what mechanisms of confounding you think could account for most or all of the observed anti-correlation. Can you be more specific?
I don't understand what you mean by "Your point about presurgery is incoherent.".
(b)
i) As best I understand it, the non-linear relationship between vitamin D3 ingestion, which presumably roughly linearly drives production of 25-hydroxyvitamin D which goes into circulation, and the actual level of circulating 25-hydroxyvitamin D is a self-limiting mechanism which evolved to limit 25-hydroxyvitamin D levels which would otherwise occur due to very high levels of UV-B skin exposure and/or, I guess, ingesting large amounts of liver from animals who store significant amounts of 25-hydroxyvitamin D (and/or vitamin D3) there. As best I understand this, the mechanism is that the activity of the 24-hydroxylase enzyme is increased at higher 25-hydroxyvitamin D levels, resulting in the rolled off-curves in graphs such as: https://vitamindstopscovid.info/00-evi/Heaney-2015-GRH-distribution-11-.png from Heaney et al. 2015 https://www.mdpi.com/2072-6643/7/3/1688. Once hydroxylated at the 24th carbon, 25-hydroxyvitamin D and, I recall, the other two compounds - vitamin D3 cholecalciferol and calcitriol - cannot have this hydroxylation reversed and the resulting molecules are broken down into compounds which are excreted.
On this basis, I agree that we would expect to see the ratio of 24,25-dihydroxyvitamin D higher for the higher 25-hydroxyvitamin D levels, which graph 1c shows is not the case. I don't have an explanation for this.
ii) All this indicates is that the whole calcium-phosphate-bone regulation system (osteocytes and the parathyroid both signalling to the kidneys resulting in the very low, but important, level of circulating calcitriol) has evolved to respond to the conditions in much the same way no matter what level of circulating 25-hydroxyvitamin D is, with the system generally working fine when the circulating 25-hydroxyvitamin D level is 20 ng/mL or more. (These kidney cells have an active transport system to get 25-hydroxyvitamin D into the cells - a mechanism not found in immune cells.) Ideally, from an engineering point of view, the circulating calcitriol level would not be affected at all by the circulating 25-hydroxyvitamin D level. However, this is not entirely achieved, as the non-level line in Fig 1b shows.
iii) The notion that the circulating 25-hydroxyvitamin D level is a marker for anything is a result of the mistaken belief that all three compounds, vitamin D3 cholecalciferol, 25-hydroxyvitamin D and calcitriol are all somehow "vitamin D", with calcitriol being "fully activated vitamin D". The reality is that these are three different compounds with different roles. Vitamin D3's role is primarily or solely to be converted to circulating 25-hydroxyvitamin D. Circulating 25-hydroxyvitamin D's roles are to supply the kidneys and to supply multiple types of cells, outside the kidney, which need it in their cytosols to supply their 25-hydroxyvitamin D -> calcitriol intracrine and paracrine signaling systems, which are only turned on when a particular cell-type-specific condition is detected in that cell.
The mild upward slope in Fig 1b is due to the influence of osteocytes (via circulating fibroblast growth factor 23) and the parathyroid (via circulating parathyroid hormone) both altering the activity of the 1-hydroxylase enzyme in the kidneys, with the resulting calcitriol output and so level being proportional to both this activity level and the level of 25-hydroxyvitamin D in this part of the kidneys. The resulting increased circulating calcium ion level is detected by the parathyroid, resulting in reduced 1-hydroxylase activity in the kidneys, but the negative feedback gain is not so high as to totally control the circulating calcitriol level, and so the circulating Ca++ level, so they remain exactly the same when the level of 25-hydroxyvitamin D in the kidneys vary.
There isn't really such a thing as "vitamin D sufficiency", except in the mistaken notion that 25-hydroxyvitamin D is somehow vitamin D. It is not. It is a separate compound, as is calcitriol. 25-hydroxyvitamin D sufficiency is what matters.
I know from personal experience and the experience of friends and family that supplementing vitamin D3, to raise circulating 25-hydroxyvitamin D, such as to 50 ng/mL or more (but not, without good reason, above 100 ng/mL, with actual toxicity being possible above the still harder to attain 150 ng/mL level) directly causes much better health outcomes. This is a pervasive experience and correlates with numerous published observations and the mechanism of immune cells needing a good supply of 25-hydroxylvitamin D to run their intracrine and paracrine signaling systems https://vitamindstopscovid.info/02-intracrine/.
Some vitamin D RCTs fail to show a clear positive result due to inadequate supplemental quantities and/or inadequate time-frames, since it takes months for the 25-hydroxyvitamin D level to stabilize at a higher level.
One RCT which had no such problems was Castillo et al. 2020 - see https://vitamindstopscovid.info/00-evi/#castillo for the link and for the Jungreis and Kellis commentary. A single oral dose of 0.532 milligrams of calcifediol, which _is_ 25-hydroxyvitamin D, boosted circulating 25-hydroxyvitamin D levels in a few hours, safely over 50 ng/L, from typically low baselines, reasonably assumed to be in the 10 to 20 ng range. This reduced hospitalised COVID-19 patients rate of admission to ICU from 50% to 2%, and deaths from 8% to zero. Some of this enormously positive effect, as J&K note, was due to the control group happening to have more comorbidities. The rest - the great majority of the effect - must have been due to the boosted 25-hydroxyvitamin D level.
Think an write what you like. For the benefit of others, I am arguing against what I understand to be your position, that the 25-hydroxyvitamin D level doesn't have much effect on general health or on the performance of the immune system.
I had a friend who died at 66 from multiple system atrophy, which is much the same as Parkinson's disease and dementia with Lewy bodies. He had never supplemented vitamin D. It took me a few minutes with Google Scholar to find that the risk of both multiple system atrophy and PD are very strongly correlated with the lowest 25-hydroxyvitamin D levels. See https://vitamindstopscovid.info/00-evi/#3.3 for all the details. I know a 97 year old who has no trace of dementia - who has been taking about 4000 IU a day of vitamin D3 for the last 25 years. I am 70 years old, weigh 65 kg and supplement ~250 micrograms (10,000 IU) vitamin D3 a day (with 200 micrograms K2 and other nutrients). My 25-hydroxyvitamin D level is in the 80 to 90 ng/mL range. Maybe it doesn't need to be over 50 ng/mL, but I want my level to be hell-and-gone from the low level which I am sure condemned my friend to serious disability, and then a horrible death, in his early 60s.
1. Very weak, confounded data. Just more correlation getting assumed to be causation. For one, steroid use could affect both disease outcome and 25D levels. Even if D3 both raised 25D levels and was responsible for disease improvement, that still does not particularly support that there was such a thing as a deficiency. Plus the level of 25D rise is more than what one would typically expect from such a small dose.
2. So what if 25D levels correlates with surgery outcomes? 25D levels correlates every outcome imaginable. A good chunk of your reply reads like circular logic. 25D is in general just a marker of baseline health. It can however be possible that in some specific contexts – especially acute infections, D3 supplements might help. Some trials are like that. But a correlation study does not prove that. Nor would a positive RCT prove that raising 25D levels is the same thing as correcting a deficiency.
3. Noting sarc patients have low 25D and calling it deficiency is not evidence. It’s a logical leap. More likely the body is lowering 25D according to its known feedback mechanisms when 1,25D is high. Overriding that feedback with supplements could just as easily be argued to make people sicker. In fact, anecdotally autoimmune patients go both ways with D3 pills. They can feel much better or get much sicker. Trevor Marshall cured himself of sarcoidosis using a protocol that involves severe 25D depletion.
4. As some patients had extraordinary risk of infection, that kind of self-refutes the claim that they were all healthy enough for surgery. And being fit enough for surgery is hardly a high health bar to cross. Plus the very fact they are getting a weight loss surgery means they are on a spectrum of unhealthiness.
5. Not sure I understand one of your points, but if you are describing patients already coming down with some acute infection prior to surgery, then that infection just not being diagnosed until after surgery, that could be one more confounder as well. 25D is a “negative acute phase reactant” that can plummet during respiratory infections and maybe other infections. It’s plausible infection was setting in and dropped 25D, but I wouldn’t hang my hat on that as they would probably need to be symptomatic for that to happen, and if they were symptomatic they might not have done surgery. Also, that would relate to hospital acquired infections and not surgical site infections, as surgical sites did not yet exist prior to surgery.
6. Another example of confounding is that obesity causes 25D to be stored so less is in blood. This was a weight loss surgery. Fatter patients will be both sicker and have lower 25D. They adjusted for BMI but that is only a partial fix.
7. “Secondly, every patient whose pre-operative 25-hydroxyvitamin D level was above about 20 ng/mL had this higher level due to significant vitamin D3 supplementation.”
[This is yet another confounder. They could be taking supplements because they are healthy / health conscious. Healthy user bias.]
8. “I don't understand what you mean by "Your point about presurgery is incoherent.".”
[I meant your argument was nonsensical. “There is no reverse causation in this research since these are pre-operative 25-hydroxyvitamin D levels.” That is not a coherent statement.]
9. “I don't have an explanation for this.”
[Everything starts making sense once you realize correlation is not causation]
10. “The notion that the circulating 25-hydroxyvitamin D level is a marker for anything is a result of the mistaken belief”
[You’ve claimed it’s a marker of deficiency]
11. “The reality is that these are three different compounds with different roles.”
[I consider the entire vitamin D metabolome of at least 70 metabolites to be important. Many of them are “active”. In fact, 25D appears to be “active” in itself. It’s not just a substrate.]
12. I believe your positive anecdotes. I have encountered many of the exact reverse. Myself included. My chronic bartonella infection was made much worse after raising 25D to 100 ng/ml with 2 weeks of emulsified D3. I feared for my life. It took one year to fully recover, and only because I knew to take Benicar (i.e. the Marshall Protocol). FYI, I was against D pills even before this happened, but I let a practitioner pressure me into taking it against my better judgement. Positive anecdotes do not support the existence of a deficiency. It’s a drug and can do things, positive or negative.
13. I do think that respiratory infections may have a balance of positive vitamin D RCTs at adequate dose. I am not sure however and plan to systematically review it someday. I posit a drug effect, not a deficiency. But it is possible in some contexts 25D levels may be a predictor of response, which is not the same thing as saying it’s a market of deficiency. The use of supplemental 25D instead of D3 is new and may have different effects. I’m planning to do a brief probe with it myself.
I don’t find the strength of association argument to be compelling. Way too many things that could be going on. Long-story short, if 25D was a marker of deficiency, at minimum RCTs of D3 would show it works for just about everything. They don’t.
I consider D3 to be a drug and 25D a marker of background health and/or sun exposure, and occasionally a predictor of response, but never a marker of deficiency. D3 supplementation could have powerful effects on the immune system that leads to treating many conditions. Or conversely it could make them worse. Or even both in the same person at different points on time. Nowhere does a presumed deficiency fit into anything.
I think a beneficial exercise for you would be to make a list of observations that one would logically require to establish that there is such a thing as widespread 25D deficiency, as well as a list of observations that would be logically requirde to be absent. That may help you see the dearth of evidence of a deficiency. Other than that, reading Amy Proal’s papers on Microbe Minded or the files section on Secosteroid Hormone D facebook group would be helpful. But note that if you came with this kind of correlation argument there you would get quickly banned. So download the files before considering that.
Thanks for your reply. It may be a day or two before I respond.
How do you think immune cells, or at least many types of immune cell, use these three compounds: vitamin D3 cholecalciferol, 25-hydroxyvitamin D(3) calcifediol AKA "calcidiol" and calcitriol 1,25-dihydroxyvitamin D(3)?
What level or range of levels of circulating 25-hydroxyvitamin D do you think is needed for good health?
1) I have no clue, really. I only point out the many inconsistencies in the mainstream story. Don't need to be an expert to note some obvious fallacies.
2) D3 I have no clue if it does anything on its own, but they said hte same thing about 25D being purely a storage form. One thing that is for sure is that if you don't look, you won't find. It could in theory at least compete for enzymes and affect any number of neglected metabolites levels.
3) Here are some random wtf's for you, possible having to do with enzyme competition:
Vitamin D2 supplementation actually seems to lower 25D3 levels.
https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuaf166/8256613?login=false
This is believed to be a result of: “either competition by D2 for the 25-hydroxylase or increased metabolic degradation of 25OHD3 by the mechanisms up-regulated to metabolize vitamin D2 and its metabolites (or both).”
https://pismin.com/10.1210/jc.2004-0360
Moreover, one study reported that a single dose of D2 not only led to decreased 25D3, but to decreased total 25D (i.e. 25D3 decreased more than 25D2 increased).
https://pismin.com/10.1210/jc.2004-0360
Though definitive literature appears to be lacking, this raises the question of if D2 supplements might actually cause a rebound effect upon discontinuation.
4) Regarding 25D activities, I have several references, but here are some that that chatGPT recently spit out at me:
"A recent review argues that at the high circulating concentrations typical for 25‑D vs 1,25‑D, even the lower‑affinity binding might suffice to activate VDR in some contexts, and thus 25‑D could have direct hormone‑like activity”
https://www.sciencedirect.com/science/article/pii/S0003986123001388?utm_source=chatgpt.com
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.910601/full?utm_source=chatgpt.com
“In vitro, in prostate cancer cells, 25‑D3 exposure produced gene regulatory changes via VDR even without conversion to 1,25‑D.”
https://www.nature.com/articles/s41598-018-27441-x?utm_source=chatgpt.com
https://www.oncotarget.com/article/6493/text/?utm_source=chatgpt.com
“But such evidence remains controversial and not universally accepted; many sources still consider 25‑D’s VDR affinity too low and its occupancy insufficient under physiological conditions to drive significant genomic effects.”
https://www.mdpi.com/2072-6643/14/14/2847?utm_source=chatgpt.com
https://pubmed.ncbi.nlm.nih.gov/21872797/
https://pubmed.ncbi.nlm.nih.gov/26323657/
A couple more:
https://pubmed.ncbi.nlm.nih.gov/34959778/
https://academic.oup.com/ejendo/article/189/4/448/7289400
5) Healthy 25D levels... I don't think there is such a thing. Just fix all environmental inputs (e.g. remove any disease states like chronic infections, remove obesity, get sunlight) and whatever your number is, it's correct. On the whole, I would expect 25D levels to go up on thier own if that is all done. But even if it remains "low" at that point, it's not inherently bad.
At most, a high ratio of 1,25D to 25D might indicate a disease state. People often quote a ratio greater than 2, but I recently now think a ratio greater than 3 is a fair guideline for having a possible health issue, among which I place infectious disease as hte first suspect.
You can tell he doesn’t understand the pharmacology and he’s apparently never read a clinical trial to understand directionality. https://healthythinking.substack.com/p/vitamin-d-cholecalciferol-pharmacology
Insults are not replies. I read your video transcript and one of your rapid responses. You don't seem to venture anywhere near actually adressing my argument. These kinds of exchanges just keep convincing me I must be right.
I agree that broad-brush negative character and/or motivation assessments are useless or worse. That is why I am discussing these matters in detail.
I believe, as does Bill Grant PhD (personal conversation), that human ill-health would be, very approximately, halved if everyone had the 50 ng/mL or more circulating 25-hydroxyvitamin D their immune systems need to function properly.
You seem to think that above some much lower level, increasing the level of circulating 25-hydroxyvitamin D provides little or no difference. Unlike clueless, wannabe-know-it-alls who rant about rat poison or vitamin D being made from dirty wool, you have a deep knowledge of the field in general, and some personal experience.
If you observe that you keep getting such insults, this doesn't mean that your arguments are correct. I think everyone gets some of this. To establish causality as your last sentence implies you would need some kind of fancy trial in which multiple individuals or pseudo-individuals argued a variety of perspectives in a given contentious field with a suitably variegated audience of potential commeners, with only one of them, however judged, being right. Then you would need to find that that individual copped most of the unreasonable flak after somehow identifying and attempting to correct for any confounders.
This would probably work as you expect arguing that mRNA and adenovirus vector injections for COVID-19 were reckless, ineffective and dangerous amongst a left-woke, vaccinophile audience, especially ca. 2021.
The Government getting so much wrong, so much of the time, just highlights for me the concept of, to heck with the "experts!" Those turkeys have steered us wrong, have "approved" so many deadly drugs, have demonized so many healthy &/or neccessary things- from sunlight, to salt, butter to beef, from NAC to TCM, herbalism to Homeopathy.
I'm just ready to be done with them all & let Mother Nature take her course.
My grandparents lived into their 90s. My friends have family over 100 years of age, with minds intact!
Those who know how to be healthy will thrive, those who do not will not.
It's tough medicine but honestly, there has been enough Government intervention. We are not the better for it.
By the results you see the truth. By their fruits you shall know them.
Just my 2 cents worth.
May like to include testing for DHEA which is relevant to immunosenescence of macrophages by alpha-fetoprotein to infection, cancer & CVD risks. Clinical labs only test for DHEAS the inactive form of DHEA. DHEA levels decrease with aging so there is an increase in chronic disease. Can keep DHEA high with heathy lifestyles, lowering stress, yoga, walks outside etc. In Canada only specialized DHEA labs (endocrinology) do the testing on blood. Need to make 7-keto-DHEA available over the counter in Canada.