It's particularly important if you have dark skin and live in the northern hemisphere. Several of my family were diagnosed with Vitamin D deficiency and had a tangible increase in quality of life from supplements.
Their advice hasn't been updated for a long time, and is for 400 IU. During Covid, plenty of medics in the media were recommending about 2000 IU, perhaps a bit more.
This was the dose that my doctor recommends as well. I didn't start taking them until doc said "your vit d levels are pretty low". They wanted to give me some of those megadoses but I just agreed to start supplementing. I took 5000IU daily for about a month and then switched over to 2000 and everything has been normal since.
Vitamin d accumulates. You can actually take it all at once, but most people take dailies. Fat soluable vitamin...unlike water soluable that leave the body almost immediately.
>> Does the NHS say all other vitamin supplements are a waste; or is vit-d the only one they actively endorse?
I need to look for docs around this, but the message in the US (not sure about UK) is usually not that stark. Doctors usually say - "if you are eating a balanced diet, you dont need any supplements except Vitamin D".
There’s a strong evidence base for correlation, the base for causation is much worse. Only few things like bone health in the elderly have been shown to be improved by supplementation.
This very post references a randomized, double blind, placebo controlled trial. It's an intervention over 5+ years that showed 22% reduction in autoimmune disease, not a correlative study.
What you see here is that combing through the data to see wether anything shows a publishable correlation. It’s better than a correlation in the general population, but can be also spurious.
Here is the article: https://pubmed.ncbi.nlm.nih.gov/35082139/
It’s important to observe that “omega 3 fatty acid supplementation with or without vitamin D reduced the autoimmune disease rate by 15% (not statistically significant)”. If vitamin D reduced autoimmune diseases you would expect omega 3 + vitamin D to have similar results than just vitamin D
> Here is the article: https://pubmed.ncbi.nlm.nih.gov/35082139/ It’s important to observe that “omega 3 fatty acid supplementation with or without vitamin D reduced the autoimmune disease rate by 15% (not statistically significant)”.
There are two endpoints measured, and you chose to quote the statistically insignificant result, rather than the significant one. Though I agree, p-hacking is always an issue. OTOH, plenty of biological discoveries come from unintended observations. As long as they replicate, nothing's off limits -- you wouldn't disbelieve penicillin because it wasn't discovered in a pre-registered trial.
> If vitamin D reduced autoimmune diseases you would expect omega 3 + vitamin D to have similar results than just vitamin D
It did. D only hazard ratio: .68, D+omega3 hazard ratio .69
i have had some sort of psoriasis in my feet and palm of my hands for the almost 16 odd years now. the feet used to have wide gashes that took years to heal. i would spend months lubricating with vaseline and a sarin wrap style plastic covering to keep the grease in contact with the skin...
over time, the feet started to heal, one foot is completly fine, the second one still has a 2 inch square size piece below the ankle that gets super dry, starts to break and super exfoliation making me go "scratch scratch scratch".
left hand, well same thing. i would get a gash in the palm and it would stay an open wound for 2-3 years, get better and then again on its own.
for the past 6-9 years the hands had been pretty much fine but this year i am seeing signs for skin getting "patches" like you get if you just burn the top skin layer, just a tad bit dark. it gets scratchy very easily and so is the urge.
for the first time in my life my right hand palm is showing "patches" which is totally new to me.
i was diagnosed with "hyperhidrosis" back in 2012, got that aluminum chloride or whatever antiperspirant but that never worked. it made my skin super dry and the base problem got worse with it...
they had told me that this is an autoimmune disease so "you gotta weather it out"...
i will definitely try VitD because improvement in my hands and feet would definitely be a quality of life improvement for me personally. its been to a point i have a slight tilt in my left foot because of all the tip toe i had to walk for years because i could not put my heel down in school/road/etc ...
For hyperhidrosis, if you can tolerate the discomfort, I highly suggest using Iontophoresis. It really changed my social life after trying many other solutions that did not work.
There are now plenty of commercial machines available
Not everyone is going to get those benefits, though.
I've been so deficient that I literally hurt. I had trouble sleeping due to the back/neck pain and had to take breaks while cooking food. Supplements took care of the pain and the extreme lack of energy, but I've never been "energetic".
The best way to describe this, really, is that if I had taken supplements before, I'd have prevented undue lethargy and tiredness. What actually made me get sick less often was not working with the public nor with children, and I never really had trouble shaking off disease when I did get sick. (I ended up deficient due to moving to a northern climate).
At best, supplements help me keep a level of normal.
That was My experience. Was stuck in bed 22 hours a day for a year, unable to even look at phone or tv.
Few months after lots of Vit D I was kayaking every weekend.
There is extremely solid evidence that 4000 IU or 100 mg a day is completely safe for all adults. There are some recent large studies that back this up.
Don't listen to this. Just talk to your doctor and supplement. The main way that humans get vitamin D is sunlight. If you aren't outdoors a lot or live far north it's even more likely you need it. It would be good to get tested by your doctor, maybe with your current lifestyle you are just fine and your vitamin D levels are normal. Mine weren't, taking supplements got it back up to normal.
I read an interesting theory that people near rivers ate fish and were able to be healthier than the people inland. And also tended to retain the darker complextion of their southern ancestors.
I read that years ago it's in my brain but no idea where it comes from.
1 gram of Lovaza contains 465 mg EPA and 375 mg DHA [4] and note that "Prescription medications may contain up to 90% omega-3 fatty acids, whereas over-the-counter fish oil supplements contain roughly between 30% and 50% omega-3 fatty acids" [3] so you should look at the label on your Omega-3 supplement to see how much EPA and DHA it contains. And finally, note that the ratio of EPA to DHA might matter too [5].
Before people get all excited... Prescription strength EPA can cause heart arrhythmia once you start crawling above 4g a day. No idea if it can happen at doses lower.
I still think 1G-2G of fish oil, with more of a lean to EPA, is probably beneficial over the long run. I, personally, take about 1-1.5G a day of a third-party tested brand but only do so 4 days a week. I give myself a break from supplements over Fri-Sun.
Here's a fantastic talk between Dr Rhonda Patrick and Dr. Bill Harris. From the YT Description, he is the author of more than 300 scientific papers on fatty acids and health. He is a professor in the Department of Medicine in the Samford School of Medicine at the University of South Dakota, the co-inventor of the Omega-3 Index, founder of OmegaQuant Analytics, and president and founder of the Fatty Acid Research Institute.
Why are you taking your supplements for fours days, followed by a three day break? If you are concerned about accumulating dosages couldn't you reduce the dose of fish oil, or take you supplements every other day? I am curious about the four days on, three days off regimen.
I have no real science to back it. I've just seen too many supplements hailed over the years only to be found out to have a problem at large, prolonged doses.
Zinc creates copper imbalance.
Excessive b vitamins may contribute to insomnia and nervous excitability
Omega3s may cause heart arrhythmia but also prevent most cardiac issues, has positive impacts on mood, cognition and autoimmune status.
VitD may cause stones. Not enough raises infection and autoimmune risk.
All electrolytes and metals (copper iron, etc) can create problems when in excess or shortage.
D without adequate k2 (which is hard to get without supplements or natto) , magnesium or vit-a or even b2 can raise risk of kidney stones. Sun exposure is enough to raise stone risk, alone.
Everything needs to be in a balance that you don't have monthly insight into.
Maybe I'm falling back to a naturalistic fallacy, but in nature most early man would not be highly exposed to any supplement 365 days a year.
And maybe I'm falling back to aphorisms of "everything in moderation"
But I'm doing so to err on the side of caution.
I just do it most of the time if I find it to be a relatively positive addition.
I also find it better for my mental health. Having a neuroticism that I must do and take a list of things every day, I just feels produces stress. Especially if I feel like my routine is being broken by an outside force I can't control. And what better time for a break than a weekend.
I do a 18/6 or 20/4 fast M-Fri. I eat 3 meals a day Sat and sun.
I don't drink Sun-thurs
I sauna M-Fri.
I exercise M-Sat.
My supplements are m-Thurs, except anything meant for sleep. Even then I cycle between substances for 6 weeks on and 6 weeks off.
The only thing I do about 95% of the time or more is I go to bed at 9:30-10pm.
I have health anxiety/ocd and without boundaries and creating ebbs and flows in my behavior, I create problems for myself.
If I remember correctly, vitamin D is produced by the body when it gets sunlight.
Sounds logical to me that we have more and more problems with lack of vitamin D as we are more and more in the house and not in the sun due to how labour and our daily life changes.
At least for me that's a reminder to get out sometimes and get some light.
> Plus intense sunlight carries the risk of cancer.
Not the whole truth. Broad spectrum sun exposure is correlated with a decreased risk of death from melanoma. The presence of solar elastosis (basically sun damaged skin) was associated with a 60% lower hazard ratio for death from melanoma, with a 0.009 P value in a 5 year study of 500+ women: https://pubmed.ncbi.nlm.nih.gov/15687362/ (cited almost 300 times)
On the flip side, avoiding sun exposure was found to double (!) the risk of all cause mortality in a 20 year (!) Swedish study of 29k people (!): https://doi.org/10.1111/joim.12251
Categorizing people from lowest to highest sun avoidance behavior (self reported), those who sought out sun exposure the most (sunbathing throughout the year) had a statistically significant 40-50% lower hazard ratio for all cause mortality.
I will still use sunscreen, but given that we evolved to be diurnal on a planet orbiting a sun, I would be more worried about not getting enough sun than getting too much sun.
Where I live we had 14 hours of sunlight per entire January of last year. 14 hours. FOR ENTIRE MONTH. And sunrise is past 9 in the morning where entire population is already indoors working, sunset is about 3 in the afternoon.
So yeah, I maybe got 15 minutes of sun for entire January, but this is my generous guess.
I play tennis in the Greek sun four hours a week (plus whatever other exposure) and I'm still deficient. I don't know who these levels were designed for, maybe my ancestors who were in the sun so often that they looked 50 in their thirties.
I regularly go outside with my shirt off at -10C, as long as there's no wind and the sun's beaming, I'm nice and warm. Got a bit of a suntan last week. Wife thinks I'm crazy :)
Doesn't that vary with the skin color (aka melanin content in the skin)? I presume as a brown person I need more exposure for an equivalent dose compared to a Caucasian person.
Yes it does, darker skinned persons in northerly climes are at higher risk of lower vit D than we pale skins with the equal level of exposures to the sun.
Completely uneducated guess: Dark skin is an adjustment for areas that take on more sunlight, and even migrating a little north can mean that you are not getting enough sunlight (oh you already mentioned this but I missed it or was added later, anyway...)
For people who have light skin and still have deficiency: Office life probably means you must be proactively chasing sun in your free time, or get the damn supplements and be done with it :)
Because for a lot of people just 15-20 minutes a day with bare arms and face is more than enough sunlight. Also the body stores vitamin D in fat cells as well, it's not like vitamin C that goes through you pretty quickly. On those nice sunny days you can build up your stores so to speak if you're out for a long time. However I can name plenty days I never even go outside during the sunlight. I prefer evening and night activities. I do take a supplement as a result of my doctor finding I had low vit-d level, now I take a 2000IU supplement every day.
I don't think pre-modern humans were prancing around naked in the midday sun. They probably stuck to the shade when sunlight was particularly intense, the same way many animals do. Given that we mostly evolved in pretty sunny areas, we would have gotten plenty of sun exposure even if we avoided direct sunlight for a large part of the day.
Given that we're prancing around naked in the midday sun on beaches for a large part of the year, I wouldn't doubt it. Even as late as a few decades ago, my grandparents were in the fields all day, and there's no shade there. Sure they took a midday break to eat, but that was probably only in the height of the summer.
Anecdotal evidence: my extremely effective anti psoriasis spray contains a vitamin D derivative (calcipotriene) and since I started shaving my head (more uv on the skin so more vitamin D is produced where needed) I had no need for that expensive spray.
“Sensible sun exposure” is the practice of obtaining the minimum sun
exposure required for adequate vitamin D synthesis followed by application of sunscreen or clothing
coverage; and is often characterized as sun exposure of 5–30 min, two–three times per week to the arms,
legs and torso during 10:00 h to 15:00 h [2,30]. The specific duration required within this time frame is
dependent on skin type, previous tanning, latitude, season and environmental conditions. The minimal
erythemal dose (MED), or the minimum quantity of UVB that induces a slight erythema 16–24 h post
exposure, is a common dosage employed for sensible sun exposure guidelines [31]. The standard
erythemal dose (SED) is a standardized method for quantifying erythemal UV radiation (UVR) dose
and is becoming more commonly used because the MED varies from person to person even within
the same skin type. The SED is defined as 100 J/m2
[32]. For adults with a fair complexion, one MED
is equal to about 10–12 min of full body exposure during peak summer sun for all skin types [33].
One MED may be considered equivalent to ~2.5 to 3.5 SEDs depending on skin type [34].
As other comments say, duration of exposure depends on time of year, distance from equator, level of skin pigmentation, etc.
One other factor I didn't see mentioned (or I just missed it) is amount of skin area exposed to sunlight. Generally it's recommended to protect sensitive skin of face/neck. Exposed limbs, trunk are somewhat less vulnerable to sunlight injury (but varies with skin type). When sunlight has little penetration of layers of clothing it obviously doesn't cause Vit D synthesis in skin.
In northern US/Canada, European countries, vit D supplementation is more reliable, possibly safer re: cancer risk. However a lot about Vit D remains controversial. It's still unclear what the optimum target range is (as measure by blood level), and just how much Vit D is too much. As it is now, lots of expert opinions but no consensus in in sight.
Finally Vit D accumulates/declines gradually. High doses (50k units) are used in deficiency states, normalization of blood level typically takes a few months. Well worth doing for sake of bone health, and other body systems too. In Vit D insufficiency (low but not as low as deficiency) OTC Vit D is probably enough, but people should ask their healthcare providers about what form and dose are best.
Nobody really knows, but the general advice is to get "10-15 minutes of sun every day, when your shadow is shorter than you".
The above is probably enough if you're caucasian, but add a bit of color and you'll need more time.
Also, UV-B rays needs to be able to penetrate the atmosphere, which is why the shadow part is there. I live at 56 degress north, and the shadow thing becomes a problem from around September to April. First of all, the sun doesn't rise above 50 degress until late april, and it also needs to be visible, which it usually isn't for long.
2000 IU is an almost arbitrary number anyways. The precise input is obviously less important than the resulting serum levels, quantifiable by a simple blood test measuring 25-hydroxy D. A recent meta-analysis of 32 studies (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103214/) recommended >30 ng/mL 25(OH)D for lower all-cause mortality risk. Just get a blood panel in the summer/winter.
It's not that simple. The angle of the sun needs to be such that the UV B isn't absorbed by the atmosphere. I believe the dminder app can track this and account for other things like altitude.
You should get tested first, chances are you don't need supplements if you live in the tropics and spend much time at all out in the sun. If you're a vampire like me (I rarely go out much during the day, my car is even in the garage :) ) you might need supplementation though. If you're an active person outdoors a lot the chances you need supplements are unlikely. Go to a doctor and get some blood tests, they can spot all kinds of deficiencies and tell you how normal things look
This is complex to evaluate. Another issue is that absorbing UV to create Vitamin D happens not within the body but at the skin. Because of this washing and scrubbing thoroughly just after sun exposure can reduce or eliminate generation of Vitamin D. What is considered ideal is to get sun exposure during the day and then avoid showering until the next morning to allow the skin to do its work.
Keep in mind the only thing tested is Vitamin D3 supplementation, it's not the same as synthesizing Vitamin D3 through sunlight. It might be worth reading the paper to see if sunlight exposure was even controlled for.
To answer your question, though, it depends on your skin tone and your location. It could be about 5 minutes if you're very fair skinned.
Of course it's not the same. However people are people for the most part. I was low, and I'm sensitive to the sun and don't like being out in it, so I supplement with D and my doc tells me I'm perfectly healthy and vitamin D levels are normal. Supplements can work too.
If you're supplementing vitamin D, might be worth checking out riboflavin (vitamin B2) too:
> Flavin-dependent monooxygenases and oxidoreductases are located at critical branch points in the biosynthesis and metabolism of cholesterol and vitamin D
In our modern lifestyle, there's a good argument for a vitamin D supplement, but it's also important not to take too much - the suggested dose in the article is IMHO the max I'd take (I am very far from being a medical authority - this is just based on my readings of such articles).
An overlarge supplement of vitamin D will create kidney stones[1] and may be harmful to bones[0] - a rather unexpected result.
This isn't something a regular person can easily decide using test results. Because vitamin D accretes over time, it's possible to overshoot.
A possible scenario: you get a test, take the supplement, take another test, see no difference, take a bigger dose, and the test after that shows the effect of the first dose. Then you decide to keep the bigger dose even though it's unnecessary.
The moderate dosages are safe according to most studies. However, I agree with what dragonwriter below wrote: people who think they need the bigger dosages better consult a doctor before making a decision.
You can get blood tests for $50 (and indeed <$40 with sales/discounts) around much of the world, e.g. from OmegaQuant. Once every 6 months instead of once every 2 months is fine for most when doing initial calibration.
Eat your natto while sunbathing. (Seriously, I prefer natto to k2 supplements - you get high dose of K2 through natto and you get nattokinase which lowers BP https://pubmed.ncbi.nlm.nih.gov/18971533/ )
Here's a great video about K2, well sources in the description:
The best thing is if you think you need more than a moderate dose, work with your doctor to monitor whether you are actually deficient or not. I take a very high daily dose, but I was deficient until I did.
It's funny you say that. I just went through that process and I was immensely annoyed at our healthcare system.
I've been suspecting low vitamin D for my quite some time. Felt very lethargic, and on the weekend without setting an alarm I just straight up slept 15+ hours. (and a few other issues, which I am not sure whether they are related to that, time will tell)
I've been complaining about that for some time, even mentioned the possibility of a deficit to my doctor, but he never agreed to look into that direction.
I finally went around my doctor and got a blood drawn and sent to a lab for a vitamin D test, and the results were what I expected: 4ng/ml (which is extremely low).
I went to my doctor with those results, they just told me to "go out more".
I called two other offices, both of which didnt take me as a patient and one even just told me to look at the internet.
I was infuriated by all those three offices. After some research I now ordered supplements myself and made a treatment plan and I am planning to get another blood test in 2 months to check in on my levels and adjust accordingly.
This seems more like an issue where the Dr was giving you correct advice but you weren't hearing what you wanted to hear?
Why would you infuriated by a Dr telling you to go outside more to increase Vitamin? That's exactly what they should be suggesting in the first instance.
Well, first of all it is early march and the sun is at an too low angle.
Secondly I working from home for over 2 years now, and during most months of the year it is already dark outside when I am done with work.
Thirdly, I already have symptoms which correlate to a deficit, so the doctor not even wanting to look into it baffled me. And well, I never managed to talk to a doctor with my actual test results, but from looking at papers/official resources, 4ng/ml seems to be extremely low as a vitamin d level.
Well in the end I obviously don't know if those symptoms are the result of my vitamin d deficit, but time will tell.
> I've been complaining about that for some time, even mentioned the possibility of a deficit to my doctor, but he never agreed to look into that direction.
Working your network to find a better primary care physician in your insurer’s network (blind change tends to have poor results) may be worthwhile, but, yeah, this is a way too common problem.
> VITAL is a […] study […], conducted to investigate whether taking daily dietary supplements of vitamin D3 (2000 IU) or omega-3 fatty acids (Omacor fish oil, 1 gram) could reduce the risk for developing cancer, heart disease, and stroke in people who do not have a prior history of these illnesses.
Would be interesting to hear the results for their original research goal. Autoimmune diseases not being in that list kind of makes you wonder wether they didn’t get any results and then went hunting for any correlations they could find and publish.
I wonder how much of the effect is because of people not being outdoors as much as they used to be.
It would be interesting to see the groups broken down that way, as i expect the numbers would be even more striking (IE that it has huge effect on people who are inside a lot, and almost no effect on people who are outdoors a lot).
The words "prevent" and "reduce risk" to me are confusing. Prevent is obvious but to reduce the risk would that mean ifyou have an autoimmune disease now it reduces health effects?
The article has a population point of view and risk means the ensemble probability of a given sample of people having said disease. It’s correct that risk is confusing from a single person point of view where probabilities do not make sense.
https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...
It's particularly important if you have dark skin and live in the northern hemisphere. Several of my family were diagnosed with Vitamin D deficiency and had a tangible increase in quality of life from supplements.