Higher Vitamin D Levels Improve Weight Loss and Health

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September 18th, 2009 Leave a comment Go to comments





Worldwide Vitamin D Deficiency Epidemic

Helping maintain healthy weight is just one of many uses of vitamin D in the human body. Yet despite its importance, it is generally recognized that somewhere around half or more of the population is grossly deficient in vitamin D, leading to a variety of serious health problems:

(from Scientists’ Call to D*action: The Vitamin D Deficiency Epidemic)

40-75% of the world’s population is vitamin D deficient.

The causal link between severe vitamin D deficiency and rickets or the bone disease of osteomalacia is overwhelming, while the link between vitamin D insuffiency and osteoporosis with associated decreased muscle strength and increased risk of falls in osteoporotic humans is well documented by evidence-based intervention studies.

There are newly appreciated associations between vitamin D insufficiency and many other diseases, including tuberculosis, psoriasis, multiple sclerosis, inflammatory bowel disease, type-1 diabetes, high blood pressure, increased heart failure, muscle myopathy, breast and other cancers which are believed to be linked to the non-calcemic actions of the parent vitamin D and its daughter steroid hormone. However a causal link has yet to be proven by appropriate vitamin D intervention studies.

It is projected that the incidence of many of these diseases could be reduced by 20%-50% or more, if the occurrence of vitamin D deficiency and insufficiency were eradicated by increasing vitamin D intakes. The appropriate intake of vitamin D required to effect a significant disease reduction depends on the individual’s age, race, lifestyle, and latitude of residence. New evidence indicates that the intake should be in the range of 2000 IU per day for adults. Intake of 2000 IU/day is the current no adverse event level of the National Academy of Sciences, Institute of Medicine, Food and Nutrition Board.

Current research suggests that vitamin D blood serum levels as measured by the 25(OH)D test are optimal around 50 to 80 ng/mL. The medical activists backing the D*Action Project advocate an optimal level of 40 to 60 ng/mL. Either way, there is a lot of room for increases in vitamin D levels for most people. The majority of adults and children in Western nations (and likely most other nations, too) have 25(OH)D levels far below the optimal range.

D*Action’s recommendation for vitamin D intake of 2000 IU per day is in my personal view unwisely low due to antiquated mainstream medicine bias and is likely to result in many people still having deficient vitamin D levels. Significant research shows that long-term supplementation of 10,000 IU per day is likely a more reasonable safe upper limit. Even studies of much higher levels for a couple of months (50,000 IU per day for 8 weeks) showed no significant adverse effects. Innovative hospitals routinely give cardiac patients 50,000 IU or 100,000 IU doses of vitamin D upon intake, some for multiple days. While I have no doubt that hospitals do kill people through their incompetence, it’s not likely this dosing of vitamin D would became standard operating procedure if it were truly dangerous.

Death by Vitamin D Overdose? Not Likely!

A few months ago, I ran across a story of a woman who attempted murder of her husband and father-in-law by putting vitamin D powder in the family sugar bowl. This resulted in outrageously high vitamin D dosages of millions of IU per day for months until they started to notice adverse health effects and figured out what was going on. In case that sounds like a huge amount that might be noticed, realize that 1 gram of vitamin D3 is 40,000,000 IU. One gram of table sugar (granulated sugar) has about 4 calories, far less sugar than what’s in even small quantities of many foods. One teaspoon of sugar weighs about 4.2 grams. So you can see how tainting the sugar bowl with even as little as a 10% mix of tasteless vitamin D3 might not be easily noticed yet could result in intakes of several million IU from simply sprinkling some vitamin D3 laced granulated sugar on your toast or cereal. Despite these chronic massive overdoses, neither of her victims died or suffered incurable effects aside from some understandable persistent anger over her actions.

While I couldn’t find that story again while Googling and web surfing today, I did run across a Vitamin D Council newsletter from 2005 that suggests how one mother made her toddler sick by feeding him 600,000 IU per day of vitamin D for four days because she fed him one bottle of medicine per day rather than one drop per day. As Dr. Cannell, the newsletter’s author, writes:

Anyway, mom was giving her 32-lb son a liquid preparation of ergocalciferol made in Latin America. The direction stated adults should take one drop (2,500 units) per day but mom mistakenly gave junior four bottles (2,400,000 units or 60 mg) over four days. The child developed abdominal pain, mild high blood pressure, and high blood calcium but made an uneventful recovery once the correct diagnosis was made.

That same newsletter also suggested you could murder your husband with vitamin D if you give him about 200,000 vitamin D pills, and suggests you’ll have “start lacing his beer early in the day” to accomplish that.

Obviously this risk of murder by vitamin D is a clear and present danger that warrants extreme caution. Everybody I know downs millions of pills per day so they might not notice a couple hundred thousand extras. 😉

Consider if each pill weights a relatively small 100 mg, not unusual considering ingredients typically added into pills to make them stick together and to be big enough to handle despite very tiny amounts of active ingredients. That’s 20,000 grams, or 20 kilograms, or 44 pounds for those Yanks uninitiated in the metric system. I’m doubtful you could get anybody to voluntarily or otherwise swallow 20 kg of pills in one day. But if somebody drops a 20 kg bulk pack of pills on your unsuspecting head from the next floor above you, it might cause some damage.

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Vitamin D Default Dosage of 5000 IU for Adults

Morbid humor aside, consider these observations of how difficult it is to seriously injure or kill somebody with excess vitamin D and how people who take 2000 IU per day still often fail to achieve even 40 ng/mL blood serum 25(OH)D levels. I’d suggest that supplementation of 5000 IU per day for adults is a more reasonable default level than 2000 IU and that fine-tuning should be done up or down from that 5000 IU per day based upon blood tests. Once a stable optimal level is attained, then further blood tests can be done infrequently to verify continued optimal blood levels. This might be once per year or two, or more often if weight, diet, and sun exposure change significantly.

At the core of this argument for higher dosages is the realization that the risks of not getting enough vitamin D appear to vastly outweigh the risks of getting too much. Further, too much vitamin D intake causing obvious problems means you have to be taking ridiculously large dosages that nobody is suggesting are safe for long-term use or are failing to do any testing whatsoever to ascertain if your dosage is in the realm of reasonable.

If you are getting too much vitamin D at 5000 IU per day when other people have no observable adverse affects on twice that amount for months or years, you should be able to detect the exceedingly small chance of an overdose at 5000 IU per day with a periodic 25(OH)D blood test long before you can even detect anything wrong with your health. If you did happen to find 5000 IU is too much, the treatment is simple — skip vitamin D for a few days and then continue on with a lower dosage based upon your blood test results. But the treatment for vitamin D deficiency related diseases such as heart attacks, strokes, cardiovascular disease, multiple sclerosis, various cancers, and so forth are far more complicated and costly. Consequently, it’s better to err on the side of getting too much vitamin D than too little.

People With Dark Skin More Likely to be Vitamin D Deficient

Dark-skinned people, particularly those with African or Asian Indian ancestry, have much less vitamin D production by their skin because the higher levels of melanin pigment in their skin blocks some of the UV light that causes vitamin D production. This is also an issue for Hispanics and Asians from China, Vietnam, Japan, and elsewhere, too.

If your skin has more melanin than that of your pale Caucasian friends, then all other things equal you’re more likely to have vitamin D deficiency than they are. This becomes particularly problematic when people with darker skin live far away from intense sunlight near the equator and/or spend much of the day indoors. While socially we like to think that “all men and women are created equal”, genetically it is far from true. Darker skin is tuned for sunnier climates and lighter skin for darker climates. If you’ve got dark skin, compensating for the lack of those sunnier climates with vitamin D supplements is probably the only realistic way to attain optimal vitamin D levels.

However, what might be adequate vitamin D supplementation for a light-skinned person may be grossly inadequate for the melanin-gifted among us. Backing this concern up, a study of approximately 3000 American women, about half African and half Caucasian, showed that vitamin D deficiency was 10 times more common for African Americans than Caucasian Americans. Typical strength vitamin D supplements with 200 IU to 400 IU, common in multivitamins and many vitamin D supplements, didn’t raise vitamin D blood serum levels enough to resolve these deficiencies.

Vitamin D Levels Vary By Many Factors

Since people’s sun exposure, skin tone, diet, and weight vary significantly and it is conceivable that presently unknown genetic factors could play a role in vitamin D absorption and utilization, it’s probably not adequately reliable to guess at a vitamin D dosage based upon factors that may be difficult to ascertain or measure. Consequently, it’s more reliable to start supplementing with dosage sufficient to attain optimal vitamin D levels in many people (such as 5000 IU per day) and then test and adjust as necessary.

Time of Year Affects Vitamin D Levels

If you had to pick an ideal time of the year to test for vitamin D, it likely would be during the late winter. This is when sun exposure for most people has been at its minimum for a couple of months and therefore vitamin D levels should generally be at their lowest at this time of year, too. Achieving optimal levels at this time of year is especially important as it corresponds to the cold and flu season that is believed to be related to increased seasonal vitamin D deficiency.

Now if you spent 2 months in the Bahamas sunbathing on a beach over the holiday season, this reasoning may not apply to you. Fortunately, if you could afford that long sunny vacation then you probably have enough money to get another one or two 25(OH)D blood tests at other times to catch any low vitamin D periods and to adjust your vitamin D supplements accordingly.

Health Care Costs May Be Lowered by Better Nutrition

Given the current American political debate about medical care costs and who will bear them, an obvious point that should be raised loudly but instead is being largely ignored is that nutrient supplementation and fortification can result in vast improvements to health and reductions in health care costs at very small increases in food supply costs. In particular, vitamin D supplementation is extremely inexpensive. Yet the diseases with risks raised by vitamin D deficiency are often chronic and expensive to treat long-term and too often result in acute illness episodes such as heart attacks and strokes that can cost far more to treat than an entire lifetime of optimal vitamin D supplementation would have cost.

A year’s supply of 5000 IU of vitamin D3 per day for an adult can cost less than $2 per month if you shop carefully from reputable yet inexpensive web-based dietary supplement manufacturers or discount wholesalers. For instance, Puritan’s Pride Vitamin D3 5000 IU softgels can cost as little as $13.99 for 300 capsules, nearly a year’s supply, when on sale. If you prefer brick-and-mortar stores, Costco sells Kirkland Signature Vitamin D3 2000 IU softgels in a bottle of 600 for $13.99 plus tax. That’s a little more expensive per unit of vitamin D3, but it is still clearly an inexpensive supplement even without any sale pricing.

We’re clearly not talking about major sacrifices here. Skipping dinner out once per month is likely enough savings to pay for sufficient vitamin D, a good quality multivitamin, and a few other basic dietary supplements for your family. Take lunch to work one more day per week rather than eating out and you’ll be able to pay for the vitamin D tests to verify you’re taking the right amount.

Inexpensive dietary supplements and related inexpensive tests to verify their efficacy can quickly and realistically pay for themselves even if all you care about is the bottom line on your budget. If it saves you a few medical visits and prescription drug copays typically at $10 to $30 each or a couple of out-of-pocket visits to a doctor at $100 or more each, the savings add up to a couple of hundred dollars or more per year rather quickly. If it saves you one hospitalization for anything, it’s probably enough of a savings to pay for a decade or more vitamin D supplementation even if you have good medical insurance coverage. If you care about quality of life for you and your family, your perceived payback is likely even faster.

US Government Health Care Debate Ignores Nutrition Impact

Responsible politicians should be pointing out that health care costs could be significantly reduced by modifications in diet and nutrient fortification and supplementation that would result in a healthier population with fewer people needing drastic conventional medicine style interventions to solve the health care crises caused by long-term poor nutrition. If food manufacturers were required to add more significant amounts of vitamin D3 to common products containing enough fat to dissolve vitamin D well, the cost would likely come down even further as there would be little expense for packaging, shipping, and marketing associated with vitamin D3 used to fortify foods.

Life Extension’s William Faloon recently wrote an editorial entitled Why American Healthcare is Headed for Collapse. He points out a study of Intensive Care Unit patients that examined vitamin D blood serum levels that showed a shocking correlation between deaths and low vitamin D levels. The study involved 42 ICU patients and is described in further detail in Low Vitamin D Causes Problems For Acutely Ill Patients. A summary of some of the results is:

Vitamin D Status Mortality Percentage
ICU patients with sufficient vitamin D 16%
ICU patients with insufficient vitamin D 35%
ICU patients with deficient vitamin D 45%

Lower blood serum vitamin D levels translate into higher mortality (death) rates in these ICU patients. The study authors plan to run further studies to see if vitamin D supplementation in ICU patients can reduce mortality rates. While the answer to that question may not be available for some time, the implications of the results above are enough that government health policy analysts should be seriously considering that the cost savings from vitamin D supplementation could create substantial savings in acute health care costs. The failure to consider such implications is part of why Faloon believes that the American health care system is doomed to financial collapse if health care cost efficiency is not improved significantly.

Canada’s government is looking into the possibility of improving their population’s health and reducing medical care costs based upon growing research showing widespread vitamin D deficiencies there. Paying another penny or two per container of milk or block of cheese could pay for drastic increases to vitamin D content in common foods, enough to significantly reduce the severity and prevalence of vitamin D deficiency at very low cost. Unfortunately, in the United States it seems such opinions are largely ignored or nonexistent.

While it seems unrealistic to even hope for responsible health policy to prevail in nations dominated by sound bites, special interest groups, distortions, lies, and personal political power plays, fortunately for you this is an issue you can address easily for you and your family. Attaining optimal vitamin D levels is a very realistic and affordable goal regardless of what the fool politicians in your homeland are likely to do with their latest debacles at mangling national health care and food policies.

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Medical Activists Backing Vitamin D Supplementation and Testing

Some in the medical and biological sciences establishments whose priorities have not been perverted by big government, big money, and big pharma are banding together to push for improved vitamin D nutrition. The GrassrootsHealth organization is backed by numerous scientists and doctors from across the US and Canada. They are sponsoring the D*Action Project which offers $40 vitamin D blood serum tests and surveys as we’ve previously mentioned in our article Adjusting Your Vitamin D Intake to Optimal Levels. This group’s goal is universal 2000 IU vitamin D3 supplementation to attain 40 ng/mL to 60 ng/mL 25(OH)D blood serum levels.

As I’ve mentioned, D*Action’s goals look to be overly conservative when viewed in light of other research suggesting that long-term supplementation of up to 10,000 IU of vitamin D3 per day is safe and effective, optimum blood serum levels may be a little higher at 50 to 80 ng/mL versus 40 to 60 ng/mL, and 2000 IU per day is likely not enough to achieve this for some people. But their work is definitely a step in the right direction. Perhaps more importantly, they are gathering a significant amount of data that may help intelligently shape guidelines for vitamin D dosages and testing.

D*Action Vitamin D Test Results

The data the group has collected via its blood testing through August 25, 2009, is fascinating for those interested in the vitamin D deficiency public health crisis:

  • 54% of participants have 25(OH)D blood serum levels below 40 ng/mL
  • Average age of participants is 50 years, range is from infants under 1 year old to adults up to 92 years old
  • Average vitamin D intake per day is 2300 IU, range is from 0 to 50,000 IU per day.
  • Participants are 89% from US, 5% from UK, 4% from Canada, and 2% from other nations including Australia, Denmark, Finland, Ireland, and Japan
  • Open survey/test participants are 56% female and 44% male

Through chatting with Alison, author of our article on optimizing your vitamin D levels, I’ve become aware of examples of people who are reasonably aware of their vitamin D intake and have been tested yet still are suboptimal despite vitamin D3 supplement intakes of between 2000 IU to 6000 IU per day. While a few anecdotal examples obviously aren’t enough to draw any population-wide conclusions, they are enough to point again to the reasonable hypothesis that the 2000 IU of vitamin D3 per day recommendation is probably not adequate for a significant number of people for a variety of reasons, be they skin color, time spent outdoors, body mass, or other factors.

While I don’t have the D*Action Project data set, from their published results to date it appears to me that the D*Action test statistics appear consistent with this perspective, too. You can see this in their graph (click on the graph to open up a window with a larger version on their web page):

Only about 20% of the participants have 25(OH)D levels in the range I’d consider optimal from my understanding, that being 50 to 80 ng/mL. There are about 5% of participants with 25(OH)D levels above 80 ng/mL, higher than the optimal range.

Although the underlying data from the D*Action Project necessary to independently consider what the data really shows hasn’t been published for viewing by the public, it seems reasonable to surmise that the few people who are taking 50,000 IU per day or other very high amounts of vitamin D3 are probably skewing the results and thereby misleadingly raising the “average D intake” to 2300 IU. If this is true as I suspect it may be, eliminating these outliers would likely cause the average to fall significantly, thereby exposing how the typical daily intake of vitamin D really is likely much lower than 2300 IU per day. That could explain why the majority of study participants are vitamin D deficient even though they are taking supplements.

As an example of this using hypothethical data, consider if there were 100 people in the study with vitamin D intakes like this:

People IU / day
5 0
15 400
20 600
10 800
15 1,000
15 1,200
10 2,000
5 5,000
3 10,000
2 50,000

Using this hypothetical data, the average daily intake of vitamin D is 2340 IU per day, close to what is shown by the D*Action data. Yet consider what happens by dropping out the two people taking 50,000 IU, a dosage which is not even viewed as a safe for long-term use. Then the average falls to only 1367 IU per day! Clearly the outliers can significantly bias the data. Hopefully the D*Action Project researchers will make their underlying data public and re-evaluate their goals to account for unreasonably high vitamin D3 dosages skewing their results and confusing the issue of just how much vitamin D3 supplementation is sufficient to attain optimal blood serum levels.

It would also be helpful for D*Action to publish some results based upon skin color. If it turns out that Caucasians generally can attain optimal vitamin D levels with 2000 IU per day but Hispanics and Asians need 4000 IU and Africans need 6000 IU, this would be very helpful to know up front. After all, we don’t want a US-dominated study with relatively small percentages of people with dark skin to be used to set dietary intake guidelines for populations to which the data does not apply well.

Interim Conclusion: 5000 IU Daily, Adjust by Testing

Until better data is available, I’m in agreement with the suggestions in the Adjusting Your Vitamin D Intake to Optimal Levels article that recommends adults going through a “loading phase” of 10,000 IU per day to even out any gross deficiencies, then taking 5000 IU per day for a month or two and taking a 25(OH)D blood test to determine whether to raise or lower the dosage. The need for a test to adjust dosage is of course not ideal, but with these tests widely available for less than $50 and being needed only infrequently, this level of cost should not be a big obstacle if you really care about the health of you and your family.

For suggestions specific to children and ideas about how to get them to consume vitamin D supplements even if they will not or cannot swallow pills, please see the Adjusting Your Vitamin D Intake to Optimal Levels article. It outlines how vitamin D3 dosages vary based upon age and size of children, whereas the dosages I’ve mentioned in the article you are reading now have focused entirely upon adults.

Get Started Soon — Flu Season is Arriving Soon!

Given the impending cold and flu seasons in the Northern Hemisphere and how low vitamin D levels are suspected to be tied to cold and flu infections, I’d suggest you and your family start your vitamin D3 loading soon. You want to be sure to avoid vitamin D deficiency during this season, especially with concerns about the H1N1 Swine Flu this year.

If you have the financial means or medical insurance for getting two or more vitamin D tests in the next six months, consider getting tested after your loading phase and a couple of months at 5000 IU per day, before the height of the flu season. This will give you a chance to add more vitamin D if you need it.

If your budget is too tight to test your levels a couple of times before Spring 2010, then continue 5000 IU per day for adults during the winter and get tested once around February or March 2010 to get a good idea of whether you need to adjust your dosage upwards or downwards.

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Further Reading

D is for dieting

Successful Weight Loss with Dieting is Linked to Vitamin D Levels

New Vitamin D3 Products Address Vitamin D Deficiency Crisis

Adjusting Your Vitamin D Intake to Optimal Levels

Vitamin D Supplementation: Helpful or Hazardous?

Guarding Against the Dangers of Vitamin D Deficiency


Canada examines vitamin D for swine flu protection

Vitamin D deficiency in black and white

Vitamin D Insufficiency in North America

Why American Healthcare is Headed for Collapse

Low Vitamin D Causes Problems For Acutely Ill Patients


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