Vitamin D disappointment ahead

Anyone following the Track Your Plaque conversation know that we are rabid fans of normalizing blood vitamin D blood levels (25-OH-vitamin D3).

A wonderful report on vitamin D was aired this morning on the NBC Today show. The interviewed guests did a good job of describing the health effects of vitamin D, thought the focus was on some new data on the use of vitamin D for breast and prostate cancer.

I learned that shiitake mushrooms have some vitamin D--I didn't know that! (They contain 260 units per 4 mushrooms.)

Unfortunately, the closing comments from the guests, among whom was nutritionist and author, Joy Bauer,MS, was that you should get vitamin D from your multivitamin or your calcium with vit D.

That is absolutely wrong. When you check blood levels of vitamin D, as we do in everybody we see, you quickly learn what works and what doesn't.

Vitamin D in multivitamins is very poorly absorbed, if at all. Likewise, about 90% of the D in most calcium preparations is not absorbed. The vast majority of tablet or powder preparations, such as those in calcium tablets, are not absorbed to any significant extent. Take all you want and you remain vit D-deficient with osteoporosis, growing coronary plaque, low HDL, and exposed to risk for prostate and colon cancer.

If you take vitamin D in supplement form, it must--MUST--be in an oil-based capsule. The tablets are simply much too poorly and erratically absorbed to be reliable. There's nothing more frustrating to take, for instance, 4000 units of vitamin D in tablet form, only to have a blood level of 12 ng/ml--severe deficiency. Take the same 4000 unit dose in capsule form and blood level skyrockets to 58 ng/ml. And it's no more expensive.

One other thing: If you want to waste time and money, take the prescription vitamin D prescribed by many doctors. This is vitamin D2, also known as "ergocalciferol". Why use the synthetic vitamin D2 when D3 is the form your body needs? Because the D2 is patent-protectable and profitable to the drug manufacturer, similar to using Premarin (horse estrogens) when human preparations would suffice--or be superior. I saw a woman today taking 50,000 of prescription D2 once per week. Her blood level of 25-OH-vitamin D3? 17 ng/ml--severe deficiency. Don't waste your time with this garbage.

Comments (9) -

  • Ortcloud

    6/5/2007 4:50:00 PM |

    I am often disappointed with "experts" that you see being interviewed on tv. It makes you wonder where they get these people. Do you think they would ever interview you if you offered? Maybe you could get on their list of experts to refer to.

  • Anonymous

    6/5/2007 5:13:00 PM |

    Dr. Davis, Thank you for this posting!  My vitamin D levels were tested in early April at 17.  I have been taking citrical with vit. D.  From your post, this sounds like a bad idea!  Can you recommend a good brand of oil-based D3 capsules?  Also, how long should it take for my vit. D levels to normalize?  Thank you!

  • Dr. Davis

    6/5/2007 8:20:00 PM |

    Ortcloud--
    Thanks for the vote of confidence.

  • Dr. Davis

    6/5/2007 8:21:00 PM |

    We've used Carlson's and Vitamin Shoppe's 2000 unit vitamin D3 (cholecalciferol) capsules with great results. It takes about 4 weeks to fully reflect the dose.

  • Anonymous

    6/30/2007 12:34:00 PM |

    How about co-administering an oil along with a powdered vitamin D tablet or capsule? I would be curious to see absorption rates using this method vs. oil-based vitamin D.

    Also does this low absorption apply to all fat soluble vitamins? In other words, must vitamin A, E, and K also be in an oil or oil-based to maintain optimal bioavailability? Thanks.

  • Dr. Davis

    6/30/2007 1:51:00 PM |

    Including oil with a powder form of D does enhance absorption though in my experience it remains erratic.

    I'm uncertain about the E and A, though I suspect the same remains true. I would really like to know how important this phenomenon is with K2, but I am not unaware of any real data, nor do I have sufficient experience to say at this point. With time.

  • Anonymous

    8/13/2007 12:51:00 PM |

    After taking Prescription Vitamin D ( oil ) capsule for
    3 month my levels were up to 50.
    Now I am taking 1ooooIU's daily and my levels are down to 29. Does fish oil capsule interfere with the asboprtion of Vitamin D?
       Maria

  • Dr. Davis

    8/13/2007 2:51:00 PM |

    Hi, Maria--

    No, in fact fish oil should do the opposite and can increase D absorption. It might therefore be variation in your preparation.

  • Doug

    4/7/2009 6:21:00 PM |

    I live in Canada and am on a perpetual 50,000 iu/week dose of Vitamin D due to low blood levels.

    AFAIK only D2 is available in Canada, and the endo dismissed any negative comparison with D3.

    What can I do ?

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More catheterizations would make me happy!

More catheterizations would make me happy!

I received this fax today from a cardiologist seeking a position:

"I would prefer to perform as many interventions [stents, angioplasties, etc.] as possible..."

That about sums it up, doesn't it? The goal of this young man, trained in major universities including Columbia University, Harvard, and Emory, is not to pursue an avenue of investigation or healthcare that yields real answers. His goal is to perform as many procedures as possible.

This attitude is deeply ingrained in cardiologists. It's also shared by all procedural medical specialties: the drive to do more and more procedures. It's not because it does more good for the public, but it fulfills a primitive impulse to spread your influence, enlarge your territory, and--of course--make more money.

Personally, I find this impulse repulsive. The fact that this young cardiologist looking for a position is willing to make this statement out in the open demonstrates how widely accepted this attitude is. Imagine your cancer surgeon, looking for a new job, said, "I'm looking to remove as many tumors as I can."

My colleagues have lost sight of the fact that we're trying to reduce or eliminate disease, not enrich our pockets or service some primitive impulse to beat others at our game.
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