Vitamin D levels (Chat GPT)

[PCaWarrior]

The recommendations mirror my own, most major studies I've seen, my primary care physician's and my medical oncologist's.

The optimal ("sweet spot") vitamin D blood level for general health is typically 30-50 ng/mL (75-125 nmol/L).

Key Ranges for Vitamin D (25-hydroxyvitamin D) Blood Levels:

Vitamin D Status Blood Level (ng/mL) Effects

Deficient <20 ng/mL (50 nmol/L) Increased risk of bone loss, fractures, weak immunity, fatigue

Insufficient 20-29 ng/mL (50-74 nmol/L) Mild deficiency, possible health risks

Optimal (Sweet Spot) 30-50 ng/mL (75-125 nmol/L) Best balance for bone, immune, and overall health

High but Safe 50-80 ng/mL (125-200 nmol/L) May be beneficial in some cases (e.g., cancer, autoimmune disease)

Toxic >100 ng/mL (250 nmol/L) Risk of hypercalcemia, kidney damage

Factors Affecting Your Ideal Level:

Bone & Immune Health: 30-50 ng/mL supports strong bones and immune function.

Cancer & Chronic Disease Prevention: Some studies suggest 40-60 ng/mL may help, but more research is needed.

Prostate Cancer & ADT Patients: If on ADT (androgen deprivation therapy), maintaining above 30 ng/mL is crucial to prevent bone loss.

Personalized Needs: People with autoimmune conditions, obesity, or limited sun exposure may need levels on the higher end (40-60 ng/mL).

I used trial and error to find how much I needed to supplement (approx 5000 IU/day). I take K2 (quinones MK-4 and MK-7) with the D. If I had osteopenia or osteoporosis I might supplement with calcium and make sure to take vitamin D3 and K2 with it (otherwise I'd just get my calcium from food). And the bone maintenance properties of D3 in conjunction with ADT are being trialed today.

(Note for the BATmen: when I am high T I tend to go higher on hydroxy levels (50-100 ng/ml). Not much good study data. Just some theories I've seen.)

This calculator can streamline things a bit:

23. Handy calculator for loading dose or maintenance dose: Vitamin D*calculator™ - GrassrootsHealth grassrootshealth.net/projec...

Chat GPT:

Taking vitamin K and vitamin D along with calcium is important for bone health and cardiovascular protection because these nutrients work together to properly regulate calcium in the body.

Why Take Vitamin K and D with Calcium?

Vitamin D Enhances Calcium Absorption

Vitamin D (especially D3) increases calcium absorption in the intestines.

Without vitamin D, only ~10-15% of dietary calcium is absorbed; with adequate D, absorption can reach 30-40%.

Vitamin K Directs Calcium to Bones & Prevents Artery Calcification

Vitamin K (especially K2, MK-7) activates osteocalcin, a protein that helps deposit calcium into bones.

K2 also activates Matrix Gla Protein (MGP), which prevents calcium from depositing in arteries and soft tissues (reducing heart disease risk).

Calcium Alone Can Be Harmful Without Proper Regulation

Excess calcium without K2 can increase the risk of arterial calcification, raising heart disease risk.

Vitamin K2 helps ensure calcium goes to bones, not arteries.

Synergy for Stronger Bones & Fracture Prevention

Vitamin D + Calcium: Increases bone mineral density (BMD).

Vitamin K2 + Calcium: Ensures proper bone formation and reduces fracture risk.

Who Benefits Most?

People at risk for osteoporosis (especially postmenopausal women, older adults, or those on ADT for prostate cancer).

Anyone taking calcium supplements to avoid calcium buildup in arteries.

People with vitamin D or K deficiencies due to poor diet, low sun exposure, or gut malabsorption.

Recommended Combination:

Vitamin D3: 1,000-4,000 IU/day

Vitamin K2 (MK-7): 90-200 mcg/day

Calcium: 500-1,200 mg/day (preferably from food, with supplements only if needed)

A small nit: there is also evidence that some K1 helps with health and that the MK-4 form of K2 might be helpful.

Thanks a lot Koko. This is going to have me up all night. I just asked Chat GPT about quinones.

Vitamin K2 Quinones:

Vitamin K2 is a form of menaquinone (as opposed to phylloquinone, or vitamin K1, found in plants), and it comes in several forms, denoted as MK-n, where "n" refers to the number of isoprenoid units in the side chain. The two most studied forms are MK-4 and MK-7.

MK-4 (Menaquinone-4):

Structure: Has a 4-unit isoprenoid side chain (hence "MK-4").

Source: Primarily found in animal products (e.g., meat, liver, eggs, and dairy), and also made in the body from vitamin K1, especially in the liver.

Absorption: MK-4 is rapidly absorbed and used by tissues, but it has a short half-life in the blood, meaning it doesn't stay in circulation as long as MK-7.

Bioavailability: While MK-4 is effective, its short half-life means it needs to be taken more frequently to maintain consistent blood levels.

Function: Plays a key role in activating osteocalcin (for bone health) and Matrix Gla Protein (MGP) (for vascular health). It may have specific uses in bone metabolism and cardiovascular protection.

MK-7 (Menaquinone-7):

Structure: Has a 7-unit isoprenoid side chain (hence "MK-7").

Source: Primarily found in fermented foods like natto (fermented soybeans) and also available as a supplement.

Absorption: MK-7 has a longer half-life in the bloodstream compared to MK-4, which means it stays in circulation longer and may require less frequent dosing.

Bioavailability: Due to its long half-life, MK-7 provides more stable and sustained vitamin K2 levels in the blood.

Function: Similar to MK-4, MK-7 activates osteocalcin and MGP for bone and cardiovascular health, but due to its longer duration of action, it is often preferred for supplementation.

Differences Between MK-4 and MK-7:

Feature MK-4 MK-7

Isoprenoid Units 4 7

Source Animal products, body synthesis Fermented foods (e.g., natto)

Half-Life Short (hours) Long (up to several days)

Supplementation Frequency Requires more frequent dosing Requires less frequent dosing

Absorption & Bioavailability Rapidly absorbed but less stable Slowly absorbed, long-lasting effect

Primary Function Bone health, cardiovascular protection Bone health, vascular health, less frequent dosing

Which Is Better?

MK-4 may be more effective in immediate tissue activation but requires more frequent doses due to its shorter half-life.

MK-7 provides a more stable and sustained effect with less frequent dosing, making it ideal for long-term supplementation.

Both MK-4 and MK-7 play essential roles in bone metabolism and vascular health, so the choice between them can depend on dietary preferences, absorption rates, and individual health needs.

When asked about K1:

Vitamin K1 (phylloquinone) is important, particularly for blood clotting and overall health, though it functions differently from vitamin K2.

Key Roles of Vitamin K1 (Phylloquinone):

Blood Clotting (Coagulation):

Vitamin K1 is essential for the activation of clotting factors (such as Factor II, VII, IX, and X) in the liver. These proteins are crucial for the formation of blood clots to stop bleeding.

K1 deficiency can lead to bleeding disorders, such as easy bruising or excessive bleeding.

Bone Health:

While vitamin K2 is more directly involved in bone mineralization, vitamin K1 also plays a role in bone health by supporting the activation of osteocalcin, a protein involved in calcium regulation and bone strength.

Vitamin K1 has some impact on bone density, though it's less potent for bone health compared to vitamin K2.

Cardiovascular Health:

Vitamin K1 is involved in the regulation of calcium in the arteries. By activating certain proteins, vitamin K1 helps prevent calcium buildup in blood vessels, reducing the risk of arterial calcification and cardiovascular diseases. However, vitamin K2 is more efficient in this regard.

Antioxidant Properties:

There is evidence suggesting that vitamin K1 may have antioxidant properties, protecting cells from oxidative stress and helping to manage inflammation.

[Derf4223]

As a case study of one, I was osteopenic early on in my 21 month ADT arc. My MO said I had no chance of denting it via supplements etc. Prolia for 2 years worked great. I also religiously take D3, K2, Magnesium and Calcium, and exercise daily. YRMV GLTA.

[cigafred in reply to Derf4223]

GLTA?

[PCaWarrior in reply to cigafred]

Either Gay Lesbian Tennis Association or Good Luck To All.

[GreenStreet]

Thanks .What a very helpful post pulling it all together in one place. I hand n't seen the calulator before. I am aiming between 70 to 90 based on what Nal and Patrick previously posted and also reading what the late Dr Myers said. I too take K2 (from Life Extension). After I had BCR post my RP I had a fairly level PSA of 0.06 for a number of months but when I ramped up my Vitamin D3 it dropped to 0.03 and stayed there for quite a bit. No proof I realise. I generally take c 7000 IU a day. Your post has reminded me it is time to test my blood levels

[PCaWarrior in reply to GreenStreet]

70 to 90 ng/ml? Unfortunately, I never discussed it with them but I think they set the target based on some old studies. That's high. And Patrick was doing a long-cycle BAT program.

I target a little higher than the cancer outcomes in this study. They suggest 20-40 ng/ml (50-100 nmol/L) is optimum. I've looked at other studies and shoot for 30-50 ng/ml.

If you're doing BAT, then during the high T phase, then maybe higher. Sketchy theories, but I doubled my D target. I might adjust that down. Hard to yank it around. Takes weeks. So a real pain to manage and the benefit is only theoretical (steroidal hormone acting on VDRs).

[GreenStreet in reply to PCaWarrior]

I have a note that Patrick was aiming for 70-80 I would have to go back and look for Nal but I dont really have time right now but as I recall it was in the ball park. I am not doing BAT at the moment

[PCaWarrior in reply to GreenStreet]

Patrick was aiming for 70-80. 74 was supposedly the sweet spot. But in at least one of the studies that was nmol/L - units are critical. Are you ng/ml or nmol/L?

74 nmol/L is 24 ng/ml. I think 24 ng/ml is low - not much more than the FDA recommended LL.

[PCaWarrior in reply to GreenStreet]

I'm just concerned if you are targeting ng/ml that it might lead to issues. Here is another Patrick post about D3 and PCa aggressiveness. He states that there is a bathtub curve and the optimum levels are even less than what I target.

If your levels are nmol/L you are close to what this post concludes.

healthunlocked.com/advanced....

25-D ng/mL ... relative risk

<17.67 ... 1.00 (reference)

17.67 - <23.32 ... 0.68

23.32 - <29.21 ... 0.36

29.21 - <36.34 ... 0.85

36.34 & up ... 0.78

So, the optimum is only 23.32 - <29.32 ng/ml. That's barely above the FDA range. Most studies show higher than this.

[cigafred in reply to GreenStreet]

I agree with your memory of what Nal said, and have done accordingly ever since.

[cigafred in reply to cigafred]

Found an old (5/2019) comment on HealthUnlocked from Patrick saying target is 80 to 100, or 50 to 100, certainly not over 100. On the other hand, in 2018 Tall mentioned a New Zealand study showing no benefit from high levels of D. Mine is steady in the low 70s.

[PCaWarrior in reply to cigafred]

I heard from him yesterday.

"I was influenced by The Vitamin D Council’s recommendation of 50 ng/mL as the target. I saw a suggestion elsewhere that we should aim higher when fighting serious illness. I know of no evidence for that. Dr Myers, at one point advised shooting for up to 100 ng/mL, but I think he was merely saying not to go higher. He brought that down to 70, I think, after a while. I saw no reason to go higher than 70.

Frankly, I’m OK with it being anywhere in the 50-70 range. You take your daily dose (in my case, I need 5,000-7,000 daily) and test infrequently, so I like to see it closer to 70 than 50 because most of the time I don’t know what it is."

Looking at mortality curves I target lower, except, like I said, when my T is high. Hopefully my D levels look kind of like a sine wave; I'll tell over time. I take 10K IU half the time and zero the other half.

[PCaWarrior in reply to GreenStreet]

I found one of Patrick's old posts about vitamin D. He used one of the studies I used. But the mortality curves only go up to 110 nmol/L - that is 44 ng/ml. You shouldn't extrapolate further out. D levels vs. mortality is a bathtub curve...

Study: pubmed.ncbi.nlm.nih.gov/303...

Post: healthunlocked.com/advanced....

D - hydroxy vs. mortality

[GreenStreet in reply to PCaWarrior]

ok I will have to relook I believe Patrick and Nal were targetting 70 ng/ml and Myers was looking for 65 ng/ml

[PCaWarrior in reply to GreenStreet]

Sounds about right. I respect all of them but disagree on some things. Some of their theories have been upheld. Some have been overturned by later research.

If I had a nickel for every time I changed my opinion....

[GreenStreet in reply to PCaWarrior]

You may find this post interesting if you have not seen it already from the same person

healthunlocked.com/fight-pr...

[PCaWarrior in reply to GreenStreet]

Thanks. I think I saw this one. The fructose in coffee rings a bell.

So many variables so what I usually do is just look at the results of studies and then try to replicate them. If the optimum measurement vs. PCa mortality is an average blood level of 30 ng/ml I shoot for 30 ng/ml. Otherwise I end up going down a rabbit hole. How much do I undershoot based on my increased utilization and absorption? You get the drift. Very unlikely that the majority of the people in the studies are taking fructose in coffee for example...

Very nice explanation though and sometimes knowing the details makes a difference. He's a very smart guy and was doing BAT way before most of us were even researching it.

[PCaWarrior in reply to GreenStreet]

Do you know how to contact Patrick? I'd love to ask him why he set his target so high. Maybe it was because he uses BAT. That makes sense to me.

His posts have lots of references like this:

"Was the team unaware of the Nordic papers showing a U-shaped risk curve, with lowest risk below 30 ng/mL? Perhaps they disregarded them. Some would consider it risky (unethical) to treat those already D-sufficient."

[petabyte in reply to PCaWarrior]

Do you know how to use the chat function or tagging him in a post? If you do he will only get a notification if these are not disabled.

[PCaWarrior in reply to petabyte]

Thanks. I sent him a message.

[MateoBeach]

Good info, Russ. Thank you