I've viewed several studies on the subject. Most of them show a target zone of about 26-42 ng/ml for serum vitamin D (25-Hydroxy Vitamin D). Vitamin D status can be easily adjusted upwards by some sun exposure and/or some supplementation. Many of them show an increased mortality risk not only at low values but also at high values (a bathtub curve).
All mortality risk and cardiac risk charts give similar ranges for D.
It's important to pay attention to the units of measure. For example, this NIH metastudy gives results in nmol/l. Most US test results are in ng/ml. To convert simply divide nmol/l by 2.5 to get ng/ml.
My vitamin D is in the 40's. A little high. I live in Phoenix and like to hike and swim so it's easy to get a lot of sun exposure.
It seems to me that there is a "Vitamin D cult" out there with people touting megadoses of Vitamin D. There are many people who are deficient and you definitely want to avoid that, but taking megadoses is also bad.
Between 400-800 IU per day is the recommended amount. Here's what Mayo says about it:
Certainly, nobody needs to be taking more than 4000 IU per day which is considered the upper safe limit for continual supplemental intake.
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Serum D testing isn't very expensive so a couple times a year I have my serum D tested. I was taking 2400IU per day of D but this has me at a serum level in the 40s. A little too high so I stopped the D supplementation completely.
My wife's serum level is in the teens though so I have her take a D supplement.
The normal range of vitamin D is measured as nanograms per milliliter (ng/mL). Many experts recommend a level between 20 and 40 ng/mL. Others recommend a level between 30 and 50 ng/mL.
“Based on all the evidence, at a minimum, we recommend vitamin D levels of 30 ng/mL, and because of the vagaries of some of the assays, to guarantee sufficiency, we recommend between 40 and 60 ng/mL for both children and adults.”
As always, it's best to listen to the experts rather than the random opinions of people on this forum who think they know better.
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Don't listen to random people on the forum. Unless of course the random person is me! Lol!
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It's not the people on the forum that are the problem, it's the opinions of the people on the forum.
We should all try to be neutral and present the facts based on what the science says, not try to reinvent treatment protocols based on our own opinions, andecdotes and unproven conjecture while trying to come off as experts.
I am not presenting my opinion here and trying to pass it off as fact, unlike some others on this forum. It would help if certain people would do more referencing of experts and less pretending that they are the experts.
If anyone wants to criticise me for referencing the Harvard Medical School, go ahead.
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I was joking. Being serious, I agree. If someone gives an opinion, state that it is an opinion and isn't data or science backed.
I attempt to back things up with research. But even if things are backed by research or science I like to test them out myself if possible. Lots of bogus "studies" and "research" on the internet.
You say, "I am not presenting my opinion here" and then state "certainly, nobody needs to be taking more than 4000 IU per day." That sounds an awful lot like an opinion!
I would like to hear the scientific basis for an assertion that dosing below 4,000 IU could be beneficial but that at 4,000 IU no more benefit for ANYONE is possible, and/or the dosage suddenly begins to have some risk that didn't exist at lower levels.
I have provided plenty of references. I don't see many from you.
Here's what Mayo Clinic says:
"Mayo Clinic recommends that adults get at least the RDA of 600 IU. However, 1,000 to 2,000 IU per day of vitamin D from a supplement is generally safe, should help people achieve an adequate blood level of vitamin D,"
"4000 IU is the safe upper limit according to the Institute of Medicine (IOM). Make sure not to take more than that without consulting with a health professional."
"you just make stuff up to suit whatever self-promotion binge you happen to be on today"
"instead just making things up"
That's two accusations of me in just making things up... all in one post! If you cannot quote me to back that up with specifics, guess what? You will be guilty of just making things up.
Usually financial motives that affect all large institutions with large amounts of ongoing salaries, equipment and building costs, utilities. The institution or a corporation financing the research could have a vested interest in the outcome.
My comment was a general one about motive. I didn't say that I knew this particular study was tainted. But I do believe scientific research can be easily slanted. Corporations have been doing it or financing such for years.
"Large doses of vitamin D (such as more than 4,000 IU a day) should be taken only under the advice of your health care provider. Taking too much supplemental vitamin D can be toxic in rare cases. It can lead to hypercalcemia, a condition in which too much calcium builds up in the blood.
I do not mind opinions as long as they aren't stated as fact. We all have opinions. That's one of the primary ways we learn. Hear an opinion and research and analyze.
My opinion is that in general a 30-40 ng/ml range has been shown to be a good range for vitamin D. But I also think that everyone is different. Every situation is different. And what is the optimum for the average person may or may not be optimum for a particular individual at a particular time with a particular hormonal/dietary milieu.
This isn't an opinion it is a trial that resolves the previous uncertainty
"there is currently insufficient scientific evidence to show vitamin D can be beneficial in preventing or treating Covid-19" that statement made may 2020
That can no longer be said after the trial published 9/2020
In the video the doctor describes the study and explains that the trial took 76 consecutive patients that came to the hospital for treatment (no one knew what each persons vitamin D levels were -- they just tookthe next 76 patients that showed up for treatment ) and randomly assigned them to one of two groups at a 2 to 1 ratio regardless of their vitamin D levels it was a double blind study: -- one group of 50 patients received something in the range of 20,000 units and again another approx. 10,000 every other day -- the other group of 26 randomly assigned patients did not receive any vitamin D... the ones that received the large doses of D fared extremely well compared to the group that did not receive the additional dose ... only 2% of the high dose vitamin D group were admitted to ICU compared to 50% of the non supplemented vitamin D group who were admitted to ICU and 2 of them died. As the doctor rightly concluded this test proves the benefit in high dose vitamin D in fighting covid19 (and likely many other diseases) and it answered the question.
No one knows who (if any) of the 76 consecutively admitted patients randomly assigned were deficient Vitamin D - they may have all been taking supplemental vitamin D when they arrived.. ..
Less than an hour in the sun produces 20,000 units of Vitamin D, all at once, every time you do it -- daily
" Exposure of a young adult in a bathing suit to one minimal erythemal dose (MED) of UV radiation in a tanning bed was equivalent to ingesting approximately 20,000 IUs of vitamin D2 (Fig. 40).25 When a healthy 75 y old male in a bathing suit was exposed to UVB radiation in a tanning bed three times a week for 7 weeks he was able to raise and maintain his blood levels of 25(OH)D into the healthy normal range of ~50 ng/ml"
Vitamin D3 is made in large quantities when you are in the sun during peak UV times. In fact it is estimated that 30 minutes in the sun (ideally in a bathing suit), midday in summer can make up to 20,000 IU of Vitamin D.
If you get too much sun, the skin is able to convert the excess Vitamin D to other inactive molecules. In this way the body does not get overdosed with Vitamin D from sun exposure.
Vitamin D3 from the sun (or supplement) makes its way to the liver where it undergoes a process (hydroxylation) turning it into 25D to store in your body. Having optimal stores of 25D in your body is very important, as these stores will enhance your body’s ability to make the best use of Vitamin D’s capabilities. If your body does not store enough Vitamin D in the form of 25D, then you will have low or deficient levels of Vitamin D in the blood. Ideally your Vitamin D levels should be optimal.
Then your body is to sends 25D from your liver to the kidneys where it is transformed into 1,25D3.
1,25D3 is the active and potent form of Vitamin D. As 1,25D3 this form of Vitamin D has the job of circulating in your blood to ensure that you maintain appropriate levels of calcium.
Many people especially those with autoimmune diseases have mutations to the Vitamin D receptor that prevent conversion to the bioactive 25OH vitamin D. As a clinical laboratory scientist I began testing my level when we started running the correct test in the 90’s. Before that all labs ran the wrong assay. I was taking 4,000 IU daily and getting More sun than most people. My level was 18. For adequate levels I have to take 10,000 IU daily and for optimal levels I take 15,000 IU daily. My point is that without a blood test you have no idea what amount of vitamin D3 you need.
You said: "No one knows who (if any) of the 76 consecutively admitted patients randomly assigned were deficient Vitamin D"
That's the problem, I'd say quite a few considering that in Spain where the trial of 76 patients was done: "Overall, adults living in the Córdoba area are relatively vitamin D deficient (16 ng/mL on average) in late winter and early spring."
So if we don't know who was deficient, we don't know who, if anyone had an additional benefit by having more the sufficient amount of Vitamin D.
Don't know what effect this had: All hospitalized patients received as best available therapy the same standard care, (per hospital protocol), of a combination of hydroxychloroquine (400 mg every 12 h on the first day, and 200 mg every 12 h for the following 5 days), azithromycin (500 mg orally for 5 days.
I still do think it's an important finding that demostrates the relationship between Vitamin D and immune response. I suspect that there is some limit at which there is no additional effectivity. It may just be at the level above deficiency, maybe higher.
There are certainly a lot of upcoming clinical trials exploring this so we should learn more about this in the future:
"Many of them show an increased mortality risk not only at low values but also at high values (a bathtub curve)."
I don't recall studies that show a U-shaped PCa mortality curve.
In the meta-analysis of 7 studies that you cited:
"The results calculated from seven eligible studies indicated higher vitamin D level was significantly associated with decreased all-cause mortality and prostate cancer-specific mortality. Further dose–response analysis showed that every 20 nmol/L increment in 25-hydroxyvitamin D level was associated with a 9% lower risk of all-cause mortality and prostate cancer-specific mortality."
Within the range of 25-D levels found in those studies, it was always better to be higher
There is no bath tub effect.....up to a certain level (like 100 ) Vit D helps and after that higher level than that ..the benefit stops.
In India, small time farm laborers who work 8 to 10 hours in Sun in wheat fields ...every day of the week.... were found to have very high Vit D levels (100+) but they were healthy ,with strong bones and muscles . The doctor's explanation was that excessive Vit D from Sunlight gets converted to harmless molecules and/or excreted out of body.
My vitamin D isn't high if it was nmol/l but the lab units are ng/ml (I'm in the states and the lab measurement is typically in ng/ml). If I convert the lab measurement of 47 ng/ml, my vit D level is 117 nmol/l.
(I used to be an electrical engineer and bathtub curve is an engineering statistic term used for a certain curve shape. I believe that I should start using standard English instead of using engineering jargon common in one niche industry.)
And because I am interested in the end point of mortality I don't look only at PCa mortality in exclusion to all else. If I did then perhaps 100g of arsenic would be good? Certainly wouldn't die of PCa.
Most PCa patients die of other causes than PCa. My oncs' new predictions show a very bright outlook. I have aggressive PCa but based on my current status and where I was 2 years ago, the SOC oncs think I'll die of something other than cancer.
Of course you are right on this -- see the 9/2020 trial that proves high dose Vitamin D improves outcomes in covid19 ... just published .. see the link on my post above..
The effect of aging on the cutaneous production of vitamin D3 was demonstrated in a study that exposed healthy young adults and older adults to the same amount of UVB radiation in a tanning bed. The increase in the blood level of vitamin D3 in six young adults aged 20–30 was at least three-fold higher compared with the six older adults aged 62–80 demonstrating that aging significantly decreased the capacity of the skin to produce vitamin D3. 20 to 30 year old outdoor active beach goers have Vitamin D ranging from 60 to 90
A day in the sun on the beach in a bathing suit will amount to 50,000 -- an over dose of what is in effect sunlight is virtually unheard of.
we aren't perfectly healthy people here -debating how many mulit vitamins we should take daily ... we have advanced prostate cancer that tries to get in our bones --- when it does, they have no problem putting you on Zometa or something to strengthen your bones (and maybe wreck your jaw) for $8000 to $10,000 ---
I think I will up my D3 and K1/2 to be sure I have and keep high bone calcium levels to avoid if at all possible the alternative. ADT sapps and weakens bones... Vitamin D has been shown to extend OS ... see the post of pjoshea13 above. If you don't want to then that is fine. I do.
You are right, that is a similar study to the one I was referencing above also ... 9/2020
The recent study I referenced is a randomized double blind study conducted in Spain in a public hospital setting by medical doctors.
They can't keep saying we don't have enough information at this time to know if Vitamin D helps improve outcomes with covid19 "
Once you prove the world in not flat it may take another 20 years for the last ditchers to finally admit it. Some people think we never actually landed on the moon.
I think if any of you get covid19 you should consider getting on what you think is high dose vitamin D -- I have been taking 10,000 daily for 4 years
We have to use all kind of evidence for our comprehensive treatment as we do not have decades to wait for their trial results. Do not let these randomized trial guys limit our options. We don,t have luxury of unlimited time.
Why they do not say to their mothers "I need results of a randomized trial proving this man is my father...otherwise I am not accepting him as my Dad".
Well, in this case we DO have a randomized double blind trial that proves that vitamin D is hugely beneficial in treating covid19 see the video I posted -- on the trial results just out 9/2020
Do NOT start taking supplements unless and until you can be scientifically tested to see what vitamins etc. that your body is exhibiting as being short on, determine exactly how much you should take and when you should stop taking the extra supplement.
These are critical steps that the fake naturopaths FAIL to undertaken in their treatments, thus putting many at risk due to taking too much etc.
Oh come on now. We're adults. We can research and understand what dosages or quantities of supplements are suitable for us. That "always consult your doctor before [fill in the blank]" is just CYA legalese. Are you seriously suggesting I demand that my doctor test me before I take my next K2 / nattokinase supplement capsule? I take a bunch of supplements -- tests for each? Get real.
Another thing to keep in mind. Barring RCTs with thousands of participants of specific ages and health conditions, and various levels of pre/post vitamin D serum levels, much of the data we have is from millions of people in population studies.
But one common issue with drawing conclusions from this type of study is the correlation, causation, or reverse causation issue.
For vitamin D serum studies, most, but not all, population studies show a 30-40 ng/dl sweet spot.
But is it causation? Could be correlation. If you're stuck inside working all day and rarely have an opportunity to get outside your vitamin D level would likely be low. Conversely, if you're stuck laboring on a farm all day your vitamin D level would likely be high. In both of those cases, many of the people in those bins aren't able to afford the best foods and healthcare, and don't have the time to exercise.
An example of reverse causation is if, when you're maybe 5 years away from dying from a certain cause, your vitamin D status goes high (or low). Cholesterol and BMI are good examples of data skews from reverse causation.
I'm looking for data about high dose vitamin D and PCa. Are there logical paths for the destruction of PCa? I've found one research study that suggests that there are. But the studies performed weren't very robust.
This paper discusses the change in gene expression with D3 supplementation, including race-oriented differences, and some of the possible mechanisms at play...
Yes, I had seen Tall_Allen reference that on his blog. Because D3 is a pre-hormone to the active form of D as a steroid hormone in the body, it makes sense to think any number of other hormonal changes may occur when taking high-dose T. Trouble is, of course, we don't know what all those changes might be, and which ones might be good or bad (or both!) for which men with which sub-type of PC.
I was on that program back in 2007 taking high dose Calcitriol while going through docetaxel. I believe it may have been From a Beers’ study which failed to show a benefit in the end But I have no opinion on it so please leave me off the hook! 🐟🤷♂️
It was Rocaltrol oral solution. I believe it was 30 ml/ day for something like 5 days max around each round of chemo - which is a big dose and not to be sustained! This is not typically used anymore so I doubt it was beneficial. Had PSA recurrence 2 years later so who knows?
I don't recall the source but I copied this down some time ago: 1000 IU (25 mcg) per day increases vitamin D blood levels 10 ng/ml (25 nmol/L)
Obviously it isn't exact. I don't think it would be the same for a 75 lb woman and a 300 lb man.
I haven't found good trials or experiments involving SPT and D. This article somewhat goes into the relationship between T and D: systematicreviewsjournal.bi...
That is a great comprehensive review article. I think my treatments corresponded to the reference #113. TMBeer RT al from the ASCENT trial. Though my treatment was outside the trial on suggestion of Dr Beer to my MO at the time.
Here is my thinking -If you are outdoor in direct sunlight 2 or 3 hours a day you are getting upwards of 50,000 whether you want to or not --- - if we spend any time at all in direct sunlight daily as do may people in the southern US, doing everything from work /pleasure /beach goers etc --you cannot help but get 50,000 a day or more -- our skin makes it whether you want it to or not (sun blocker and covering of skin is the exception)-- we were engineered to make it naturally -- almost constantly at high doses. The problem is we are old and not in the sun much and our skin is old and doesn't work like it used to. It's very important and beneficial -- most outdoors people are healthier as a whole -- certainly active young people and athletes are. Their blood levels are 80 to 100 with no supplementing -- whether they like it or not. so whether it is sunbathing 3 or 4 hours daily or supplementing daily -- getting to 80 to 100 is clearly safe .. 50,000 didn't hurt you when you were young and in the sun all day ... ... it is even more important to indoor people and older people and those living in the northern hemisphere.... they can stay out doors all the time and the sunlight is not strong enough to get their blood D levels to anywhere near the levels of active outdoor peoples lifestyle in the southern US.
here is a link to the double blind / randomized study that confirms high dose Vitamin D improves outcome in covid19 patients.
Some here have tried to explain it away by saying maybe they were all deficient in vitamin D when they were admitted for treatment.... NO
It was 76 consecutive patients sick enough to need hospitalization --- 2% of the group treated with high dose Vitamin D needed ICU and 50% of those not given supplemental Vitamin D were admitted to ICU and 2 of them died.
Why would they give extremely ill patients 25,000 Vitamin D day one and 10,000 every other day thee after if such amounts were dangerous even for extremely ill patients..
They know many outdoors people have blood level ranges of 80 to 100 naturally ...
Do you think that supplemental vitamin D and natural D production stimulated via light are the same? I don't know if they are or they aren't.
I hike maybe 3 hours total on the weekend (my main sun exposure). Still that would be 100kIU or so a week. But my unsupplemented baseline serum D levels are only in the low 20s (ng/ml). When I supplemented with 150kIU per week my vitamin D shot up to 90 ng/ml (over 200 nmol/l). But when I decreased my supplement to 16.8kIU per week but started lying out in the sun for 30 minutes a day (in Phoenix), my vitamin D level has dropped to 47 ng/ml. I kept my hiking about the same. Coronavirus quarantining might have a little to do with it since I don't go out as often during the week (yet go to cabins and long hikes more often). I logged most of my supplement use and sun exposure but not the miscellaneous time out in the sun each day.
Sunlight generated vitamin D and oral vitamin D are the same. In combination or all one doesn't matter. Vitamin D is a critical hormone. Your body uses it daily and stores large amounts so it is available in high amounts when you need it -- in short notice -- attack from infection/virus disease etc.. Vitamin D raises calcium levels to ensure the calcium goes to the bones teeth nails etc to strengthen them.. You should take a K1/2 supplemental ... and or eat lots of green vegetables -- which we may not do regularly as we should -- Parsley Spinach, broccoli, cabbage collard greens etc.
I think you are right to keep digging for the truth until you are satisfied (as one can be) you are doing the right thing.
pjoshea13 -- is as knowledgeable as anyone on this -- hopefully he will weigh in -- -- he has done years of research for the truth --- where ever it leads .. not a zealot trying to twist anything to fit a bias .. (It is obvious by the way he reports it)
-- I think we are all looking for the truth so we can have better results and improved outcomes -- it is our lives effected by it.... not the doctors or some annalists giving their opinion or their biases -- we can't afford to be biased.
It is likely D fluctuates a lot -- when you are up north it is hard to get vitamin D naturally ... especially in the winter --- when vacationing in PHX and being outdoors should have increased stores of vitamin D -- it may be that God knew we would have lengthy times in winter months and those living further and further away from the equator would need heavy stores of vitamin D -- thus wide range of variance is normal to allow for times you may not be able to get sunlight -- -- high levels of reserve D for fighting infection / disease / bone strength etc...
I know we all know this -- but -- If we were locked in a dark room and fed like a king -- anything we wanted that doesn't have Vitamin D in it -- in about 2 years we would likely be critically ill -- unable to walk -- bones deformed etc.
The key to us especially as prostate cancer patients is -- vitamin D is the main ingredient that regulates bone health/strength and ADT and prostate cancer wrecks our bones. I'm not shooting for the guaranteed highest range determined to be safe for anyone... especially when most young healthy outdoors people have summer levels at 80 to 100 like we all used to have.
Vitamin D has some very important functions, and after studying this topic for a while I take 4000IU per day.
Partly because of the study below, and other sources.
I the video:
Bruce W. Hollis, PhD, Medical University of South Carolina shares the results of a recent trial including identifying the vitamin D level needed to protect the prostate gland.
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