His opinion was that the increase in sunscreen usage and the push to avoid skin cancer by staying covered up was likely to blame. I find it interesting when articles such as this pop up, because it directly reflects his concerns from those years ago.
For reference, this was the late Dr Geoffrey Mews (who I only just realised has passed on while I was looking for a reference to post. That's made me a bit sad now)
Related: I found the old measure (burn time) much easier to use than the new UV index, and while having it standard across countries is good, it’s not straight forward to convert.
Not sure what the health qualms are with lack of Vitamin D bit I'm certain I don't want to advocate in favour of potentially harming people as much as my girlfriend experienced.
Rickets and Osteomalacia are the big ones, I think. Both are a form of softening of the bones. Vitamin D apparently helps regulate the absorption and use of calcium, magnesium, and phosphate in the body.
My sunbathing policy is to go without sunscreen but only for 20-30 minutes daily around noon.
I think this must be cultural. Certainly in my experience in the United States, the lust is for tanned skin. There are even tanning salons, where one can lie down in a machine which floods one's skin with UV.
Now, I personally love fair skin, and have never understood why others seem to love a tan so much.
If most people work outside for a living, then the sign of wealth is that you don't have a tan. If most people work in offices, then the sign of wealth is that you have a tan, implying that you went on vacation or otherwise have the available leisure time.
When most people do manual labor, having impractically long fingernails demonstrates that you don't have to do that.
When most people have two or three sets of clothing, changing clothes several times a day demonstrates your wealth.
When most people eat a subsistence diet, being fat is demonstrating wealth. when most people eat fast food, being thin demonstrates your superior resources.
If most people need to pay attention to what they are wearing at their jobs, dressing in a way which signals that you don't have to pay attention is a status marker.
If everybody drives a car, picking an unusual vehicle can be a status marker. What's the difference between a Chevy Silverado 2-door and a Ford F-150 SVT Raptor? They demonstrate different spending priorities.
1 - https://www.bloomberg.com/features/2016-tanning-salon-indust...
1 - https://www.bloomberg.com/features/2016-tanning-salon-indust...
I burn in front of a monitor, I have fair skin because factor 50 and covering everything I can are simply required.
It's not particularly clearly worded but to me that seems to suggest that tanning increases melanin and that melanin helps prevent cancer regardless of whether your dark skin is natural or tanned.
You clearly get more than SPF 3 with a deep tan as you can spend 8 hours in direct sun without obvious problems. Without any tan you get a burn in under an hour suggesting ~SPF 10+.
For a fixed amount of sun exposure, spreading out the duration is better both to establish a tan and to allow more time for skin recovery. But there isn't really a case where tanning increases safety, because you get the tan via exposure.
It's like saying pilots who practice a lot are safer; for any given flight it might be true, but cumulative risk can only rise.
So think about it this way:
If you're genetically predisposed to having very dark skin, you will be able to tolerate more UV exposure without significantly increasing your risk of cancer. And by continuing to be exposed to high UV levels, your body will continue to produce melanin to keep you protected. It's a feedback loop.
If you're genetically predisposed to having pale skin, but then expose your skin to higher levels of UV than your low melanin levels can guard against, you will sustain significant sunburn, and if you do this repeatedly you'll significantly increase your risk of skin cancer. But if you gradually expose yourself to moderate levels of UV you can gradually increase your melanin levels more safely, but only as far as your genetics allow. (This is theoretical of course; we know very well that it's very hard for fair-skinned people to expose themselves to UV light from the sun or tanning beds without overdoing it, hence the widespread occurance of skin cancer.)
My educated guess about the notion that dark skinned people are experiencing higher levels of cancer would be that if a dark-skinned person keeps avoiding UV for long enough, their melanin levels start to decline (due to it not being an optimal use of resources), but then if/when sun exposure happens, the protection isn't as strong and the risk of cancer is higher.
I'm curious as to whether your educated guess derives from a clinical background, or reddit?
I know, I acknowledged that in my comment.
My main point was only about the extent to which people with genetically high melanin levels are at much lower risk of cancer (which your first link confirms), but how their risk might increase if their melanin levels drop.
I don't dispute that it's a complex and dangerous topic. And as someone with genetically very pale skin, I most certainly steer well clear of direct sunlight and make no efforts to develop a tan.
That's a low blow :)
I rarely go anywhere near Reddit, certainly not for anything to do with health. I have spent 10+ years researching health topics for reasons to with serious, chronic, illnesses I've endured, and have now largely overcome thanks to what I've learned.
And even last year I heard girls talk about building up a 'base tan' before summer. Roasting like rotisserie chickens under the solarium lamps.
> people who were previously were at lower risk of cancer due to their skin pigmentation/higher melanin
My dad died of malignant melanoma. He wore sun screen all the time. He didn't swim. He would wear sun hats. He was paranoid, and likely had premonition of it. Unfortunately, his prevention methods might have actually exacerbated his odds even further because he was depriving his skin of one of its few natural healing modalities.
Anyway, please wear shades and a hat.
My point is that moderate sun exposure is healthy and good melanoma prevention. From what I've seen, there is quite a bit of research to back this up.
I think that better education about this would encourage people to develop healthy relationships with the sun at a young age. Right now the conventional wisdom seems to be "just throw sunscreen at it" / "stay out of the sun unless you are wearing sunscreen" and I think this totally misses the point.
My caution is that it's unwise to tell people to avoid sun exposure in total. While sunscreen does seem to be helpful in slowing sun damage, it'd also be unwise to suggest that sunscreen will protect people from overexposure, there isn't really evidence for that. There is a whole body of research. Take a look at some of the studies cited in this article http://m.jabfm.org/content/24/6/735.full
Talk to some people in the southern hemisphere (australia and nz). There is a LOT of awareness of sun damage in these countries.
It's a complex, dynamical issue and there is conflicting evidence about the effectiveness of sunscreen to just blanket reduce melanoma: https://www.ncbi.nlm.nih.gov/pubmed/22994908
Not only that, there have been some controversies about sunscreens themselves containing questionable ingredients, some of which might actually be carcinogenic. If you're going to market your product as cancer preventative, but go and put carcinogens into that very same product, my trust level in your industry has been reduced by somewhere in the range of 25%-75%.
Somehow, in all this, there are people who think any raw sun exposure is going to cause cancer. That's actually misinformation. Melanin is known to be a protective. How can one go about increasing melanin? By tanning in moderation, letting your skin adapt to the sun. Of course there are people who simply don't tan easily, and yes, they should be cautious. But I'm fortunate to have skin that tans, and I'm going to let it do that!
If you have concerns about the chemical sunscreens, please use zinc oxide. It is totally non reactive.
Sun damage is cumulative, a tan is a reaction to damage. People with a tan have sun damaged skin.
Naturally very dark skinned people are different, and also have enhanced mechanisms to allow damaged cells to self-euthanize.
Ah! Research, gotta love it. UVA darkens directly as a result of action on the melanin. UVB damages DNA resulting in long-lasting production of more melanin.
Here's another study arguing that sunscreen might inhibit the inflammatory response without actually reducing the burn. Their abstract concludes "As such, sunscreens might promote instead of protect against melanoma." : http://journals.lww.com/melanomaresearch/Abstract/2005/02000...
SPF is actually measured by reduction of redness. That study points out that reduction of redness doesn't necessarily come with a reduction of damage!
If people are preventing their body from expressing its natural sun defenses and going out and overexposing themselves to the sun, believing themselves to protected... If that protection is illusory, that's kind of a recipe for disaster. People could be getting burned and not even know it... They won't even know to put aloe on.
Take that one with this one, which postulates that sun exposure isn't what causes malignant melanoma, sunburns are:
> Although there is convincing evidence that nonmelanoma skin cancer is related to cumulative sun exposure, there is less evidence of that association with CMM. If CMM were related to cumulative sun exposure, one would expect that outdoor workers would have a greater incidence of CMM than indoor workers. However, that is not the case. The incidence of CMM is actually increasing among indoor workers who receive three to nine times less solar UV radiation than outdoor workers. Furthermore, there is a higher incidence of CMM among whites living in northern states such Delaware, Vermont, and New Hampshire (>30 per 100,000), which enjoy less year-round sunlight and UV radiation than southern states such as Texas, Florida, Arizona, and New Mexico (<25 per 100,000). In California, whites living in San Francisco had a CMM incidence of 30.5 per 100,000, whereas those living in Los Angeles had an incidence of 24.9 per 100,000.
There are a few studies that suggest that chronic, low-grade exposure to sunlight may be protective against CMM. In one Austrian study, those with chronic sun exposure without sunburn had a reduced incidence of CMM compared with those with recreational sun exposure. In Germany, outdoor activities during childhood, in the absence of sunburn, were associated with a lower risk of melanoma. Chronic, repeated sun exposure may allow the skin to accommodate to UV radiation by increasing melanin production, thereby reducing the risk of sunburn. An English study published in 2011 showed that regular weekend sun exposure had a protective effect against CMM, and the researchers postulated that this may be mediated by photo-adaptation or higher vitamin D levels.
Check out JoeAltmaier's comment.
If you spend some time in the sun without getting a tan, it's still good for you even if you don't tan, as long as you're not burning.
do some product research and pick a reputable brand. but don't try to scare people off sunscreen by implying that it causes cancer!
It's like avoiding eating food altogether because you might became obese, or worse (given the odds) choke on it.
Sun lotion can only prolong your safe time, but 0 times whatever is still zero, as in her case. So there is a difference.
On good old Earth, one can sit in the sun for hours on end without a burn. In fact people frequently do, like all the time.
More exposure to UV (eg sun exposure) leads to a greater chance of developing skin cancer.
If they did, we would know, because workers compensation would be paying for it.
Yes, they do.
> If they did, we would know, because workers compensation would be paying for it.
While state workers comp laws vary in ways which make this different from state to state, workers comp is paying for it for some subset of people who work outside.
"However, compared with the general population, the rates for certain diseases, including some types of cancer, appear to be higher among agricultural workers, which may be related to exposures that are common in their work environments. For example, farming communities have higher rates of leukemia, non-Hodgkin lymphoma, multiple myeloma, and soft tissue sarcoma, as well as cancers of the skin, lip, stomach, brain, and prostate."
This is believed to be due to sun exposure of the left side while driving.
Science is trying to work this out, it is complex. We know that sun exposure both protects from and causes skin cancer depending on the study. This is a complex subject, the only thing I think I can safely say is don't get a sunburn.
It is estimated that around 200 melanomas and 34,000 non-melanoma skin cancers per year are caused by occupational exposures in Australia.
The 2006 Report on indicators for occupational disease
highlights there was an increase in skin cancer claims per million
employees/persons over a six-year period to 2004. The report
says that given the long latency period associated with exposure
and the onset of skin cancer, it is also likely that compensation
claims greatly understate the real incidence of occupational
That's a bit of a blasé thing to say... I have lost direct family members through melanoma due to their work requiring them to be in the sun all day, and clearly many other people here have too. I can't fathom how you would form such an opinion.
My father, who worked outdoors most of his life, always wore long pants and long sleeves even on the hottest summer days. I did not understand why when I was younger. I now get it.
Which is good because if I remember correctly the human skin has quit a bit natural sun protection, but is only fully developed in the twenties.
If I got that mixed up with something else please correct me if I'm wrong.
I obtained this book while studying clinical nutrition in Australia in 2005.
Clinical nutrition as taught by at least a handful of teaching practitioners in Australia that I'm aware of has been using mega-dose therapy to re-establish nutritional deficiencies since at least before I became aware of it twelve years ago.
This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency.
So 8000 IU for adults
I have been deficient for a few years now and I take ~6000 IU per day, but it doesnt seem to make a big difference in my blood tests. I already thought 6K was a lot...
The normal doctor prescription to increase levels is a 50k pill once a week for a couple months. The previous recommended level was 20ng/ml, but they increased it to 30ng/ml.
When I got tested mine was 11ng/ml (and this is in the sunny bay area). To have the recommended value from normal sun exposure you'd need face/legs/arms exposed to sunlight for ~30-45 minutes a day which most people don't get. It's very hard to increase D from food.
I'm also not sure how they determine the recommended amount and there seems to be a ton of pseudoscience around all of this stuff so it's hard to tell what's true.
If you're going to do high doses, stay away from anything with significant amount of calcium in your food (dairy, nuts etc)
I also eat a lot of eggs. My girlfriend will be pleased to know that I'll be upping our egg intake!
Get your current nmol/L value and decide based on that data.
In Germany, you have to pay around €30 for that test. It's not covered by insurance for some reason. Anyhow, if they ask for significantly more than that, they are ripping you off.
edit: Just having checked I misread the dosages completely. Right now it's much less.
Multivitamin - 400IU
D3 Supplement - 400IU
One thing that I was not expecting, when I was on that prescription at first I noticed a marked improvement in my hearing (which I had not noticed being degraded at all previously...). I thought I was imagining it but upon doing some research it turns out that hearing loss is one of the possible complications of vitamin D deficiency.
Check out the map: https://www.health.harvard.edu/staying-healthy/time-for-more...
This is an honest question -- if it is the first, I am not too concerned. I grew up in a colder climate and, while living far in the shaded area today, routinely wear short sleeves and walk a lot outside from early spring to late fall. If it is the second, I would love to learn the underlying causes at least as a scientific curiosity (and start thinking about vitamin D supplements).
Argentina and Southern Chile in it. Buenos aAires looks ok. Bu
If you do need supplementation, then Vitamin D3 (specifically Cholecalciferol) is vastly better absorbed than Vitamin D2. If you want a specific recommendation, buy this: https://www.amazon.com/gp/product/B07234TTCC and take it twice per week (Sunday & Thursday for example), that'll average to about 1400 IU per day.
This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter.
Milk is high in vitamin D because it's intentionally added. Like iodine in table salt, or fluoride in drinking water. Obviously these things had no role in human evolution before they started in the 20th century.
I have observed 'seanmcdirmid to be a thoughtful commentator. It would be uncharitable to suggest that he thinks that USDA has regulated milk drinking for millennia.
Most "1st-hand" nutritional research is also wrong. That has been the case for decades, which explains the field's relative lack of progress. The reason is that most nutritional research is funded by large commercial food interests.
Hard cheeses are generally very low in lactose, by the way, but I guess lactose intolerant societies are unlikely to discover this on their own.
2. UVB do pass through clouds. (But not through glass windows.)
3. Arms and face exposure are sufficient if you spend 10, 20, or 30 minutes a day depending on UV index of the day (the higher the UV index the less time you need to trigger vitamin D production) and on your skin color. There is some kind of "reservoir" effect that limits production of vitamin D to a maximum, so sun exposure time beyond the above does not have any benefit in terms of vitamin D production.
The average where I live for Nov is about an hour of sunlight per day, but to catch that you'd have to spend all the light hours of day outside (and for sure, November sunshine isn't quite the same as summer sunshine).
They calculate to 1000 UD if I see that right, I assume it's linar over time so just multiply that.
This seems like such low-hanging fruit that it was extremely surprising to me that this is at the cutting edge. Causes and cures for IBS are not clear and one third of patients find current treatments unsuccessful . But the above doesn't seem to be well known in online discussion because it's so new, and my gastroenterologist didn't bring it up at all either.
4000 UI vitamin D a day, and about four weeks in it magically goes away 90%. I've gotten thanks from other people I passed the tip to.
Incidentally, the symptoms started abruptly about a year and a half before my diagnosis of melanoma; another disease with a vitamin D link.
However, I can't get a good colonoscopy - my GI doc says the prep is always bad, even if I extend it for an additional day. He attributes that to a chronic simmering inflammatory state preventing things from cleaning out well. That puts me at a much higher risk of colon cancer, and so I'm also doing Entyvio infusions prophylactically.
Pubmed is sort of like arxiv.org and the fact this has an nih.gov base url should not be taken as an endorsement of it by the NIH.
That said I do actually believe that more then the recommended amount of vitamin D can be beneficial and the recommendations are in need of reevaluation.
I don't really know anything about the medical publishing world, but I would have expected a top journal to be cited much more?
If you are done with the "undergrad level" of Popper and Kuhn it is worth reading Imre Lakatos's work on philosophy of science. It contains a moment where one realizes that research programs live or die by this "impact factor" and that this living or dying is a key part of the overall methodology of science. The gist is that science is actually participating in a survival-of-the-fittest evolution with certain foundational ideas as the "genes" which "reproduce". So scientific ideas are actually good or bad in no small part due to their ability to create further scientific research along similar lines. A low impact-factor therefore directly says "along this particularly important-to-science axis, this journal sucks."
1. Imre Lakatos and maturity are great, both implying that you should not apply the aforementioned rule of thumb to an individual paper - an individual in the population - whether it was published in Nature or an insignificant contender.
2. Your memetic approach is also good, but incomplete: the objective function in case of these journals is maximizing the impact factor - so we can conclude that "PrevMed is less successful in maximizing the impact factor than some competitors, or it is a younger journal, or ..." Yes, imact factor and quality correlate in the long run, but we are not at undergrad level.
3. "A low impact-factor ... directly says" - Not directly. Also, most of the journals - not to mention conferences - do not even have an impact factor.
4. "...this journal sucks" - Most of the people writing in these kind of journals have given up a lot to contribute something modest. The editor of this journal is probably emailing with reviewers at 1am or so. Just saying...
Yes impact factor matters to current science as practiced but there is plenty of good criticism to show (at least as it is currently calculated) that it is a lousy measure of what is likely to end up being true, reproducible and useful.
If I read every PoS article vaguely related to my research, I'd never get anything done. In practice, I don't pay attention to impact factor. But I do pay attention to who's publishing. And that's basically the same as impact factor, in practice.
> that it is a lousy measure of what is likely to end up being true, reproducible and useful.
I don't think so.
High impact factor publications are MUCH more likely to be quality science than low impact factor publications (at least in my area).
The major venues would have to get at least two orders of magnitude worse before they became bad indicators of quality.
Of course, and obviously, that does not entail that all work published in high impact factor journals is high-quality.
I think the fundamental problem is just that you vastly under-estimate the enormous volume of utter crap there is out there.
What? It's nothing of the sort. Pubmed is not a preprint server. The paper in question was accepted by a journal. The quality may not have been great - I agree - but it is not like the archive at all.
It’s very much like arxiv in that regard.
So this recommending 4000 IU/d is not too far fetched.
So semantics, I guess. Just felt compelled to mention it, probably more because it frustrates me to see health researchers use pubmed as their only gateway to scholarly lit.
After seeing no improvement whatsoever in vitamin D levels, and after talking with others with the same issue, I self medicated to 10000 IU / day.
Lo and behold my vitamin D levels went back up and my auto-antibodies went back down.
Prior to diagnosis, I learned that the numbness is also a symptom of Vitamin D deficiency and found that taking supplements helped.
Look into r-lipoic acid, low dose 100mg (take one per day, with food), from the Doctor's Best brand (available on Amazon). You might consider that for the peripheral neuropathy, it does wonders for some people.
> Nearly all quinolone antibiotics in modern use are fluoroquinolones ... One example is ciprofloxacin (Cipro), one of the most widely used antibiotics worldwide.
If you've taken it in the last year or two, I'd suggest taking high absorbtion magnesium (citrate etc). Some of the particularly bad effects from Cipro seem to be caused - if not entirely, at least in part - by low magnesium levels. It strips magnesium out of various tissue and leaves it necrotic, which is how it destroys tendons for example (one of the FDA labels is for spontaneous tendon rupture). If you had low magnesium levels before taking it, the concern is that much greater. The earlier you take the magnesium after completing Cipro, the better.
The other compounding action on fluoros, including Cipro, is NSAIDs and steroids, they dramatically increase the damage from the antibiotic (the instructions you get with Cipro properly warn against taking NSAIDs with it, but how many people don't realize how dangerous taking Advil around the same time might be?).
Cipro is being implicated in all sorts of interesting things:
If you spend even a few minutes digging, you'll find a large array of high quality sources now discussing it. 20 years ago it was mostly fringe sources discussing it. The FDA though, was warned as far back as the early 1990s, for example by a paper out of UCLA med circa 1994 that perfectly laid out how dangerous it was. The FDA's behavior was either malicious (protecting pharma revenue), or they were scared to pull such a valuable broad spectrum antibiotic.
Cipro was force fed to soldiers during the first Iraq Gulf War (on a non-proven claim that it could protect against anthrax). The last few years, since the FDA slapped a warning on it for peripheral neuropathy (and seeing as it's being implicated in two dozen other major health problems), veterans groups have been looking into it as a possible source of gulf war syndrome. 
There are increasing links suggesting the huge increase in women being diagnosed with Fibromyalgia, may in fact be effects due to how common Cipro has been prescribed for things like urinary tract infections. If you get injured by Cipro, doctors will often immediately jump to diagnosing you with one of three things (typically ignoring the blatant Cipro tie): lactic acidosis, rheumatoid arthritis, or fibromyalgia.
It's merely my opinion, but I think Bayer is probably due a trillion dollar lawsuit. Anyone that has ever taken Cipro has likely suffered serious damage from it, which may not show up for many years (the FDA says the damage from Cipro may continue for several years). At least in the US, millions of people are prescribed it every year.
I looked up the list of those drugs (-floxacins?) and I don't recall having taken one of those. I was actually prescribed Ciprofloxacin earlier this year, merely as a prophylactic after a very minor surgery, and after looking into it I decided to not fill the prescription.
I don't want to give any kind of medical advice especially without knowing the situation of others. If you are concerned though, it doesn't hurt to get blood work done. Following are the common things to test for if you think you may have Hashimoto's or thyroid issues.
Vit D, Ferritin, Thyroid peroxidase antibody (TPO), Thyroglobulin antibody (TGAb), Thyroid-stimulating hormone (TSH), Free T4 Test
How much low, in ng/ml or nmol/L?
I was prescribed vitamin D3 10,000 IU/day.
If you're taking little green footballs of oil-based D2, I suggest dry D3. I had much better response.
>it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality, demolishing the previously presumed U-shape curve of mortality associated with vitamin D levels.
What is IU/d? What is nmol/L? Could someone ELI5 the entire abstract for me? Well, maybe a little more than 5, I get that there was an error estimating recommended levels and we're not getting enough.
nmol/L = nanomoles per litre (a measure of resultant blood concentration of vitamin D)
The ELI5 is:
1. Trials indicate that vitamin D deficiency (possibly below a blood concentration of 75 nmol/L) is a bad thing and is associated with a higher risk of death (from any cause) and also other health problems (risk of development of type I diabetes is given as an example)
2. The current recommended daily allowance (RDA) of vitamin D (https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona...) is currently lower than the intakes that studies have found are needed for most people to provide the blood concentrations which may be needed for good health (possibly due to a previous calculation error in determining the RDA)
3. Therefore, the author recommends to increase the RDA for vitamin D
IU/d is "IU per day of Vitamin D", and nmol/L is "nmol per liter of blood". Vitamin D is measured in IU rather than grams like most other supplements for medical reasons I'm not familiar with. nmol is an unfamiliar unit, but I can help clarify why this paper is so stunning anyways.
https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona... is a summary of the NIH's position on Vitamin D for US citizens. The research linked by this post differs in two key ways, approximately:
First, "<75 nmol/L may be too low for safety", vs. the NIH statement ">50 nmol/L generally considered adequate" (for adults).
Second, "8895 IU was needed to reach >50 nmol/L", vs. the NIH statement "600 IU sufficient with minimal sun exposure" (for adults).
So, in summary, for healthy adults, they assert that 10-20x the current RDA-indicated IU of vitamin D consumption is necessary to achieve the recommended blood saturation level of 50-75 nmol/L in all adults.
Two notes: These precise figures are for grown adults, NOT children; and, I strongly encourage getting a vitamin D blood test before starting or modifying your vitamin D supplement intake, especially if attempting to reach the 15x RDA levels described here.
1 IU of cholecalciferol is 0.025 micrograms. If you supplement vitamin D at hogh doses, make sure you use cholecalciferol rather than ergocalciferol. The former is naturally synthesized in your own skin, whereas the latter is produced mainly in mushrooms, and can result in unpleasant side effects. Maximum-dose recommendations from nutritionists may include the assumption that the consumer does not know the difference, therefore reflect the highest safe dose of the least-safe vitamer.
It is similar to the issues with vitamin A, when someone may safely supplement with carotenes and unsafely supplement with retinol. You can eat sweet potato and carrots until you turn orange, but you cannot eat a single bite of polar bear liver. But because we are mostly idiots, nutritionists cannot recommend a high-dose supplement for vitamin A, with carotene in mind, because someone will inevitably overdose themselves with retinol. So if you can certify yourself as not-a-moron, you will be able to figure out when those recommendations may be safely ignored.
That said, the only way to measure a safe dose of a vitamin is to perform medical tests before and during a dosing regimen to ensure that you are neither under nor over the target levels of the vitamin in your body.
Medical science is not yet reliable when it comes to defining target levels of vitamins in any individual's body.
In general, for all body dosing regimens, the goal is to survive the dosing changes without dying first, and to produce the desired result second. If you are not treating a specific symptom and instead wish to simply calibrate your blood levels to "optimum", be warned: There is no optimum, period full stop.
For example, if you increase your vitamin D levels precisely to a target amount with careful blood testing and supplement regimes, then your risk of death from sunlight exposure may increase if/when the levels of sunlight you're exposed to shift significantly (due to work, weather, or travel). Some will immediately object that the increase in risk is vanishingly small. You are irreplaceable. What level of risk of death of acceptable to you?
Soylent calibrates their food product to 100% of all doses specified by the US RDA for healthy adults. It's generally assumed to be a safe set of targets, though some would say that it is too low in many respects (while missing the bigger picture of the 'pick one' conflict between society-level dosing and individual-specific dosing), and others would say that it is too high in many respects (while missing the bigger picture of the 'pick one' conflict between increased risk of side effects vs. increased risk of malnutrition).
There's a good reason why everyone ends up at the same sentence, and I'm going to provide it now:
Seek advice from a medical professional before consuming supplements. If you are unwilling to do so, get a med-alert bracelet and keep a summary of the past year of dosing changes in your wallet. It may someday save your life. If you are unwilling to wear a med-alert bracelet and keep a log of your self-alteration efforts, consciously accept that you risk death if unintended consequences occur.
Many of the remainder are constrained by politics or medical malpractice law. For instance, USRDA recommendations and USDA gimmicks like the food pyramid are heavily influenced by agricultural businesses. Minimum daily requirements are mostly based on the amounts needed to avoid showing symptoms of known deficiency diseases, rather than to actually be healthy.
The actual scientific research is rather sparse. I am aware of a study performed in the 1960s that completely replaced all meals with a nutrient slurry with the texture of corn syrup, which was partially spoiled because subjects were convincing accomplices to smuggle real food to them. Thanks to subject compliance issues, most long-term research is done on analysis of food-diary observations and surveys. Short-term research, such as for satiety and glycemic response, is more controllable.
You will have to do a lot of your own digging.
Start with professional athletes like swimmers, cyclists, and bodybuilders, but beware the "broscience". Look at the life extension people that use caloric restriction and intermittent fasting. Check out the Soylent people. Look at the practice of geophagy. Listen to some vegans. Study some biochemistry, especially the Krebs cycle and the known DNA repair and disease-fighting mechanisms. Do a lot of Wikipedia walks.
Be aware that your nutrient requirements will vary from others as a result of your personal genetic quirks, but mostly can be expressed as a ratio of mass to ingested kcal.
Learning the biochemistry is key. You have to know that omega-3 and omega-6 fatty acids use some of the same enzymes at particular steps in their metabolic chains, so those fats will compete with one another in your body, meaning that those nutrients must be in a balanced ratio to each other, regardless of your absolute consumption. What's the best ratio? I don't know. Cursory analysis suggests that 6 parts omega-6 to 1 part omega-3 is too high. Supplementing with krill oil, algae oil, chia seed, or flax meal would therefore be as warranted as cutting the amount of omega-6 from vegetable oils.
If you look at Na+/K+-ATPase, it actively transports sodium and potassium across the cell wall until the interior is mostly K and the exterior is mostly Na. Your dietary requirements are likely related to the homeostasis mechanisms for regulating the ionic concentrations. What's the best ratio? I don't know. Cursory analysis suggests that your body requires overall 2.25 times as much K+ as Na+ at any given time, but the K+ is more strongly conserved, being mainly inside your cells. So you should probably eat a ratio similar to that found in your extracellular fluid, which is 33.5:1 Na+:K+, which indicates that your table salt should probably be at least 1:24 KCl:NaCl by mass. Sea salt provides some K, but not that much--about 1:200. And it also shouldn't be more than 3:1 KCl:NaCl by mass, even if you are severely deficient, because your body needs the Na+ to be present to pump K+ into the cells.
It's all guessing, and the signal-to-noise ratio is very low.
"IU" is a measurement common in pharmacology, and has to do with trying to standardize how much mass/volume of a substance will give a particular biological effect. The "/d" is per day.
In summary, the article is saying that, based on a meta analysis of previous research, we have misunderstood or misreported some of these measurements. They suggest both the safe dosage and the effective dosage for Vitamin D should be much higher, and argue that this is a cheap and effective way of treating problems associated with Vitamin D deficiency.
(edited for spelling)
nmol/L Nano Mols per liter.
The abstract is basically saying previous work was mistaken and we need to take a lot more vitamin D than we've been suggesting, and calling on regulatory authorities to change their guidelines.
Anecdotally, it was a game changer for me personally. I got less sick during the winter, and my overall wellbeing improved greatly.
A word of advice, increase Vitamin K intake aswell. Vitamin D helps calcium absorption, but Vitamin K directs it to where it needs to go (skeleton).
I know it sounds downright crazy, but it's possible that someone who's studied medicine and practiced it for years, actually knows better than random anonymous forum users.
As the link in the OP actually denotes, no, that's not always the case.
Bodybuilders and performance trainers - as well as Soviet Union sports scientists - have known for decades that Vitamin D supplementation is vital. This has been rejected by a significant number of general practitioners and other medical experts who are and were anti-supplement simply out of rote thinking.
Yes, people should be tested for their levels. But this simply isn't feasible for poor people, and telling them to get serum tests for Vitamin D before taking a lower-bound amount of the cheap supplement from the grocery store is ridiculous.
It is always possible to arrive at a correct conclusion through entirely incorrect reasoning.
Or, as the saying goes, a broken clock is right twice a day.
Homeopathy is crap. But bodybuilding/powerlifting/athletic training often finds the answers well ahead of peer-reviewed science.
Truth be told, doctors still don't know much about IBS and/or Crohn's. Or even conditions like rosacea and/or dermatitis. Mark my words, better gut flora/microbiome will be the cure for these conditions in the near future and doctors will contest this up until the evidence is too loud to ignore.
A fruit or vegetable that have traveled thousand of miles before being delivered to you has almost no vitamins left in it and probably didn't have much to start with considering soil depletion.
I believe (emphasis on believe) that supplementation is necessary even if you "eat right".
For instance, overdose quantities may be different among the various vitamers of a specific vitamin. Your physician will advise you not to supplement ADEK because people have overdosed on retinol or ergocalciferol, whereas you can eat carotene until you literally turn orange, and 15-30 minutes of daily midday sunlight can make 10000 to 20000 IU each time.
The danger of vitamin D oversupply (even as cholecalciferol) is calcium related, which is why you have to balance it with vitamin K (as menatetrenone), but it's called vitamin K from the German for "clotting factor", so then your doctor worries about clots. But vitamin E (as RRR-alpha-tocopherol) is also an anticoagulant. It's almost as if you have to consider every vitamin as just one part of a balanced system of nutrition...
So in order to give you good advice, your doctor would have to have detailed and intimate knowledge of your current nutritional state and your physiology, but we only have 15 minutes and I don't want a malpractice suit for giving you the wrong advice, so just f' it and give 'em the boilerplate: "You don't need to supplement. Just eat a balanced diet with plenty of dark green vegetables, and get some exercise."
So there you go. I just saved you a copay, unless your particular physician has an interest in nutrition-based medicine.
Don't get your vitamins from the corner pharmacy or the grocery store. Most of them will use the cheapest chemical that technically qualifies as a particular vitamin. You need specific vitamers if you intend to exceed the general recommendations. Do your own research, and remember that you can damage your own body by doing something stupid with it. If you consult a physician, make sure they have enough training and education to be credible with respect to nutrition and biochemistry before you fork over money for an office visit. You can read the same articles and papers that they read, if you are motivated enough to do so.
If you want to safely increase vitamin K, just eat more dark green vegetables like spinach. There's no need to overdo it with K or it could be a regrettable error.
Natto is not "normal". It is an acquired taste. The acquisition of said taste is a difficult, nauseating, and extremely stinky path. Besides that, most of the vitamin K from natto is as MK-7.
Animal-sourced vitamin K is mostly menatetrenone (aka menaquinone MK-4) whereas vitamin K from fermentation bacteria is various lengths of menaquinone, of which only MK-4 and MK-7 have good vitamin K activity in humans, and the MK-4 form is usually nearly absent. Plant-sourced K is as phylloquinone, which has to be converted to menatetrenone in the body.
So also-good sources are egg yolks from free-ranging, pastured laying hens and butter from free-ranging, pastured dairy cows. Basically, you need to eat parts of animals that were raised by traditional, non-battery farming, particularly the livers and adipose tissue. Poultry animals such as geese, chickens, and ducks are good for this. Apparently, the oil from rendered emu fat is also high in vitamin K.
Cheeses have some MK-4 from the milk and some MK-7 from the bacteria, but a lot of their K is in less easily assimilated forms. That's probably good enough unless you have some rare and nigh-undetectable enzymatic deficiency that interferes with conversion of MK-9 to MK-4, or something.
I suppose that if you force-fed some geese a bunch of natto, and then mashed up their livers into a paste, that would be a great vitamin K pate. I think I'd rather just swallow a pill.
Most pills/drops you would prefer over foie gras are mostly made from Natto (MK-7) btw.. there are some supplements with MK-4 but those are rare and quite expensive.
Foie gras is nauseating for a completely different reason than natto. As actual food goes, I'd rather eat the pastured eggs and butter, even though they are also rare and expensive in US supermarkets.
It doesn't help that the supplement industry is loaded to the rafters with hucksters and scammers, but you can get a year's supply of pills labeled as 5 mg MK-4 for $90. It'd be hard to tell whether that's really what's in them without engaging a testing lab at additional expense.
You may not like the taste, but trying it is an interesting experiment.
Just out of curiosity, did you work out regularly in a gym before taking those pills?
I think I will talk to my doctor about trying some Vitamin D supplementation in the next months. Generally I try to avoid supplements, but in this case I don't know what else to try.
Remember to keep them on during the _daytime_ only, though, to keep your body clock on the appropriate schedule!
Some people (including me) find that they stay indoors most of the time in the winter. Doing your workout outside gets you out there, which gives you not only sunlight (speaking of Vitamin D) but also a change of scenery that can cut down on cabin fever.
With the proper gear, the cold is tolerable (except maybe in extreme climates). And, especially if the exercise is vigorous, it's more tolerable being outdoors in the cold than it would be if you just went stood or sat around outside.
Just take half a pound of spinach and boil it, when you eat it, it'll be about the size of a medium bowl. That will be about 50 calories and contain 1200% of your daily vitamin K needed!!
It really isn't that simple. One issue is that it doesn't matter how much is in spinach if you don't absorb it.
>...Circulating phylloquinone levels after spinach with and without butter were substantially lower (7.5- and 24.3-fold respectively) than those after taking the pharmaceutical concentrate. Moreover, the absorption of phylloquinone from the vegetables was 1.5 times slower than from Konakion.
And while those vegetables will get you some K1, they won't get you K2 which is important for how calcium is handled in the body.
>...We examined whether dietary intake of phylloquinone (vitamin K-1) and menaquinone (vitamin K-2) were related to aortic calcification and coronary heart disease (CHD) in the population-based Rotterdam Study.
>...The relative risk (RR) of CHD mortality was reduced in the mid and upper tertiles of dietary menaquinone compared to the lower tertile [RR = 0.73 (95% CI: 0.45, 1.17) and 0.43 (0.24, 0.77), respectively]. Intake of menaquinone was also inversely related to all-cause mortality [RR = 0.91 (0.75, 1.09) and 0.74 (0.59, 0.92), respectively] and severe aortic calcification [odds ratio of 0.71 (0.50, 1.00) and 0.48 (0.32, 0.71), respectively]. Phylloquinone intake was not related to any of the outcomes.
These findings suggest that an adequate intake of menaquinone could be important for CHD prevention.
Just a counter-point. Vitamin D didn't help me with SAD. SAD seems only addressed for me by a proper full spectrum lamp for 30 minutes a day in the winter.
Search on that page for: "Skeleton and Bone Metabolism".
K1 and K2 work differently. We know a lot but there is still a lot more we don't know. Hell, looks like even different versions of K2 (from MK-4 to MK-13) works for different stuff in body. Only because MK-7 stays in blood for longer than MK-4 doesn't mean that it better. It could also mean that body is better in utilizing MK-4, or even that it's using it for different stuff.
More here: https://chrismasterjohnphd.com/2016/12/03/start-here-for-vit...
Here is a university page with information:
They collect and analyze available research, and the result of that process is their product (in the form of guides etc).
Personally I don't know better source with information about different supplements than examine.com, more how they are working here: https://examine.com/about/
If you know better source point it to me, please. This university page you provided is short and old.
Just one question: what's wrong with using dotcom domain?
i guess to respond to your question: most biomedical research today is eminating from universities and university-affiliated entites. page for page, i generally wouldn't expect a .com web site -- the majority of which are probably just attempting to generate advertising revenue -- to be on par in terms of accuracy etc with a .edu site. generally, I've found one of the best ways to improve the signal-to-noise ratio is to filter to a specific set of domains (e.g., ,edu, .gov) when searching online.
They are important cofactor for many proteins, including one called osteocalcin, needed for bone calcification.
I specifically use Life Extension for vitamin D because they're the cheapest one I'm aware of.
Quest-only: DirectLabs, Personalabs
Choice of Quest or DirectLabs: Walk-in Lab (switch the radio button to Quest on the category pages, and make sure a "QD" icon shows up next to it in your cart), TrueHealthLabs (make sure the tests you look at say Quest is an option), HealthTestsDirect (make sure the test list page is toggled to Quest at the top)
DirectLabs and Walk-in are generally cheaper than the others I mentioned.
I just recently have been struggling with coverage of Vitamin D test for kid with Celiac.
I went in, the nurse drew some blood and charged me $150. A week later, they mailed me the results.
None of this was done online, and insurance never was involved. I found a lab in town, asked their cash price, and they told me, and it was fine. Specifically the lab was associated with a larger medical facility, so call around to any local hospitals to see what they quote you.
The "Vitamin D 25 Hydroxy Blood Test" was $47. I got a blood draw order signed by a doctor that I had to take to a LabCorp - so make sure you've got one near you.