"High-dose" Vitamin D

I stumbled on one of the growing number of local media stories on the power of vitamin D.

In one story, a purported "expert" was talking about the benefits of "high-dose" vitamin D, meaning up to 1000, even 2000 units per day.

I regard this as high-dose---for an infant.

Judging by my experiences, now numbering well over 1000 patients over three years time, I'd regard this dose range not as "high dose," nor moderate dose, perhaps not even low dose. I'd regard it as barely adequate.

Though needs vary widely, the majority of men require 6000 units per day, women 5000 units per day. Only then do most men and women achieve what I'd define as desirable: 60-70 ng/ml 25-hydroxy vitamin D blood level.

I base this target level by extrapolating from several simple observations:

--In epidemiologic studies, a blood level of 52 ng/ml seems to be an eerily consistent value: >52 ng/ml and cancer of the colon, breast, and prostate become far less common; <52 ng/ml and cancers are far more likely. I don't know about you, but I'd like to have a little larger margin of safety than just achieving 52.1 ng/ml.

--Young people (not older people >40 years old, who have lost most of the capacity to activate vitamin D in the skin) who obtain several days to weeks of tropical sun typically have 25-hydroxy vitamin D blood levels of 80-100 ng/ml without adverse effect.

More recently, having achieved this target blood level in many people, I can tell you confidently that achieving this blood level of vitamin D achieves:

--Virtual elimination of "winter blues" and seasonal affective disorder in the great majority
--Dramatic increases in HDL cholesterol (though full effect can require a year to develop)
--Reduction in triglycerides
--Modest reduction in blood pressure
--Dramatic reduction in c-reactive protein (far greater than achieved with Crestor, JUPITER trial or no)
--Increased bone density (improved osteoporosis/osteopenia)
--Halting or reversal of aortic valve disease

(I don't see enough cancer in my cardiology practice to gauge whether or not there has been an impact on cancer incidence.)

My colleagues who have bothered to participate in the vitamin D conversation have issued warnings about not going "overboard" with vitamin D, generally meaning a level of >30 ng/ml.

I know of no rational basis for these cautions. If hypercalcemia (increased blood calcium) is the concern, then calcium levels can be monitored. I can reassure them that calcium levels virtually never go up in people (without rare diseases like sarcoid or hyperparathyroidism). Then why any hesitation in recreating blood levels that are enjoyed by tropical inhabitants exposed to plentiful sun that achieve these extraordinary health effects?

For the present, I have applied the target level of 60-70 ng/ml without apparent ill-effect. In fact, I have witnessed nothing but hugely positive effects.

Comments (43) -

  • Anne

    12/30/2008 8:58:00 AM |

    This time last year I started taking 4,000 ius of D3 per day. Four months later I had a 25(OH)D test and the result was 154 ng/ml. I had to stop taking the D immediately as my alkaline phosphatase levels had got too high.

    Two months later with no D3 and no sun my 25(OH)D had dropped to more normal levels and I resumed taking the D3 last August but this time at 2,000 ius per day. I continue to take 2,000 ius per day. I don't get any sun. My last measurement of 25(OH)D was 62 ng/ml. My HDL is 93 and my triglycerides 53. Maybe I'm unusual ? My endocrinologist was very surprised I must say.

    Anne

  • Elise P

    12/30/2008 2:22:00 PM |

    I take 3000 IU's daily and my D level is 52.  I'm also 2 months pregnant.  Is it safe for my pregnancy to continue taking higher levels of Vitamin D and should I up my dosage?  Baby books of course recommend a very low dose citing potential overdose at higher levels. I haven't asked my OB yet.

  • Anonymous

    12/30/2008 3:03:00 PM |

    Dr. Davis,
    Good to know the right dosage for Vitamin D. But if mere addition of it results in all the things you listed, how do you explain the high incidence of CVD in a country like India where the sun shines 12 months a year.

  • BarbaraW

    12/30/2008 3:26:00 PM |

    Thank you Dr. Davis for all the articles on Vitamin D, as well as all the other useful information you provide!  We truly appreciate it.

    Happy New Year!

  • JoeEO

    12/30/2008 8:58:00 PM |

    I primary care physician raised his eye brows when I told him I was supplementing with 8IU of Vitamin D. (Carlson Vitamin D gelcaps)

    I just received my the results of my blood test. My vitamin D level is 25NG/ML - I hate to see what my levels would be like with zero supplementation.

    Joe E O

  • David

    12/31/2008 12:37:00 AM |

    Anonymous,
    Don't forget --exposure to sunlight doesn't guarantee vitamin D activation in the body. This is dependent on several factors, including things like age and darkness of the skin. The darker the skin, the less vitamin D will be made in the body. If those in India are not supplementing with vitamin D, chances are good that they aren't making enough from whatever UVB exposure they have.

    Just my two cents.

    David

  • Wifezilla

    12/31/2008 1:29:00 AM |

    I take 8000IU of D3. So far my head has not exploded nor have I turned in to a newt.

    Why this amount? I am over 40, I am still a little over weight (down over 40 lbs), and I have a family history of heart disease, high blood pressure, stroke and Alzheimer's disease.

    I began supplementing last Winter at 2000IU. I stopped when Summer hit because I actually got some sun. Due to taking the supplements, I could go outside without bursting in to flames for the first time since I was a kid!!!

  • Anonymous

    12/31/2008 6:22:00 AM |

    Elise said:
    I take 3000 IU's daily and my D level is 52. I'm also 2 months pregnant. Is it safe for my pregnancy to continue taking higher levels of Vitamin D and should I up my dosage? Baby books of course recommend a very low dose citing potential overdose at higher levels. I haven't asked my OB yet.

    The baby books are probably very wrong.  A new study in Clinical Endocrinology reports that...women with 25(OH)D <37.5 nmol/L were almost 4 times as likely to have a cesarean than women with 25(OH)D ≥37.5 nmol/L (AOR 3.84; 95% CI 1.71 to 8.62).
    Full link:
    http://tr.im/2rnz

    I also read somewhere that if you breastfeed, your milk will not contain any D3 until your blood levels are above 50 (ie, if you don't supplement enough, your body conserves all D3 for itself, sharing none with your infant.)

    (Unfortunately, I don't have the link to that study.)

  • Anne

    12/31/2008 12:36:00 PM |

    In the first post Anne says that she is able to keep her vitamin D level at 62 with 2000 IU's. I got my level to 42 in the summer, but this fell to 24ng/ml during the winter even though I was using 2000 IU's. I am now supplementing with 5000 IU and will test again soon. My oral supplementation of D needs to be higher in the winter than in the summer.

    Elise ~ congratulations on your pregnancy. There are recent articles showing a possible link between low vitamin D and higher C-section rates and higher risk of pre-eclampsia.

  • Jessica

    12/31/2008 5:16:00 PM |

    Elise- Pregnant women need Vitamin D and your level should be greater than 60 ng/mL.

    Having an optimal Vitamin D level could help prevent preeclampsia. Plus, your baby NEEDS Vitamin D for normal development and has no way of getting it except through you.

    Google "Vitamin D philadelphia pregnancy study" and see about the research done re: Vit D and pregnancy.

    My Primary care doc recommends 6,000 IU/daily for pregnant patients. He draws Vit D and calcium blood levels every 3 months.

    Your OB will likely not recommend much- OBs live in the dinosaur ages. It's by far the slowest specialty to adapt to medical news.

    Google Vitamin D and pregnancy and read up- you'll find that it's perfectly safe (and in fact, will help your infant immensely) to stay on optimal doses of D.

    My sister took 10,000 IU daily during pregnancy, so did a RN at our office.  

    Best wishes for a happy and healthy pregnancy Smile

  • Richard Nikoley

    12/31/2008 9:46:00 PM |

    I just had a very interesting experience, but keep in mind: this is purely anecdotal.

    I've been taking 6k IU per day for a few months and I'll soon get tested to see what my level is. However, week before last was the holiday party week and I was at parties like 5 days in a row, LOTS of drink (scotch, mostly), staying up late, getting up early, etc.

    Predictably, I came down with a cold. On that first day, with that odd scratchy feeling in the back of my throat, I did 18k units of D. Next morning, no symptoms, to the point I though I might be mistaken about a cold coming on. Next morning, bang, the nose starts running, sneezes, but very mild -- like 25% of a cold. 18K units again, and within hours, no more symptoms. Next morning, same thing with the runny nose, so I did another 18K units and within a few hours all symptoms were gone, it's now almost a week later and they have not returned.

    I almost can't wait to catch another cold just to see if I can duplicate.

    BTW, I stumbled on some amazing epidemiological info on D, and did a series of posts on it yesterday:

    http://www.freetheanimal.com/root/2008/12/epidemic-influenza-and-vitamin-d.html

    http://www.freetheanimal.com/root/2008/12/vitamin-d-deficiency-and-type-1-diabetes.html

    http://www.freetheanimal.com/root/2008/12/melanoma-sun-and-its-synthetic-defeat-sunscreen.html

    http://www.freetheanimal.com/root/2008/12/vitamin-d-deficiency-and-all-cancer.html

  • David

    1/2/2009 2:06:00 AM |

    Very interesting indeed, Richard. I had a similar experience recently.

    It was a few days before Thanksgiving, and I felt myself getting sick. Not with a cold, but with the flu. I got a 102 degree fever and felt awful. I remembered Dr. Cannell and Dr. Mercola talking about "stoss" therapy, so I calculated an "influenza dose" based on my body weight. I took around 150,000 IU once per day for three days. On the morning of the third day, I was completely better and was able to eat Thanksgiving dinner with my family. All in all, I had the flu for TWO DAYS. Amazing. I've never recovered from a severe illness that fast. In the past, I have always been very slow to recover. Incredible stuff.

  • Anna

    1/2/2009 10:20:00 PM |

    My experiments last winter and this one with high doses of D at the first sign of a cold have been very similar, though I have been using 8-12,000iU of D3 (Carlson Solar Gems 4000iU x 3 each morning for my husband and I, x 1 for my son).  The past week we were visiting family members some of whom had a cold that was catchy, and so far, we haven't caught the cold.  Of course, they were skeptical of the Vit D boosting the immune system, etc.

  • Anonymous

    1/2/2009 10:23:00 PM |

    Richard,  

    your experience where Vitamin D appears to eradicate cold symptons is similar to my experience.

    In past winters I always experienced major colds - typically three to five during the months of November through April.  Usually they would last a couple of weeks each.

    Late Spring 2008 I learned about the critical importance of vitamin D3.  Now I supplement between 6,000 IU and 8,000 IU per day, and my 25(OH)D level floats in the 60 - 80 ng/ml range.  

    This year, sofar, I have had three experiences where I thought I caught a cold with typical symptoms.   In each case the symptoms seemed to get worse during the first day, but completely resolved within 24 hours.  No additional medication or supplementation of anyting, except the regular 6k - 8k IU D3.

    With research indicating that vitamin D is critical to a strong immune system, my sense is that the cold virus still attacks, but has no change to survive when the immune system is strong, enabled by means of adequate Vitamin D.

    By the way, my four year old son also has no persistent cold symptons this year, no ear infections.  Such relief!

    It is great to see that vitamin D does much more than enusring the cold virus cannot survive.  The strong immune system it allows our bodies to build, appears to reduce all kinds of inflammation (CVD link) and cellular problems.

    Arnoud

  • Anonymous

    1/4/2009 10:52:00 PM |

    Hi Dr. Davis,

    I am having a physical soon, which labs/tests would you recommend that I ask my physician to order?

    Thanks in advance.

    -Patrik

  • Richard Nikoley

    1/5/2009 6:54:00 PM |

    Regarding the epidemiological aspect of 52, check out the last image on my post the other day about vitamin d and all cancer:

    http://www.freetheanimal.com/root/2008/12/vitamin-d-deficiency-and-all-cancer.html

  • moblogs

    1/6/2009 1:21:00 PM |

    I've had a similar experience to Anonymous.
    I'm currently taking 10k a day and I never had the flu in 2008 (and I usually get it without fail once a year minimum).
    However there were times close to the 5th day (I take my D as 50k once every 5 days) where I'd feel I was getting something. But by the time I took the next dose I was fine. The flu didn't really get to develop, but the next dose seemed to get rid of it.

  • Anonymous

    2/17/2009 7:55:00 PM |

    Can taking an oil-based vitamin D-3 supplement
    in the range of 2,000-5,000 IU per day spike liver enzymes AST and/or ALT ???

  • David

    2/18/2009 4:24:00 AM |

    "Can taking an oil-based vitamin D-3 supplement in the range of 2,000-5,000 IU per day spike liver enzymes AST and/or ALT ???"

    Just ran across this study recently, and thought it might have some application here:

    http://www.ncbi.nlm.nih.gov/pubmed/17823429

    These were specifically people with MS, but it's noteworthy that they mention in passing that liver enzymes were unchanged with D3 doses at 28,000 to 280,000 IU per week.

    It seems very unlikely to me that vitamin D at that dose would cause a spike in liver enzymes...

  • Anonymous

    3/22/2009 10:04:00 PM |

    Elise,

    I did not realize that I was pregnant until Week 6 of pregnancy.  During Week 4 and Week 5, I took one 50,000 IU dose of a vitamin D prescription. I can't find much info on whether this overdose is likely to cause birth defects.  I stopped taking it after week 5.  Was your baby healthy after taking your 3,000 IU's during pregnancy?  If anyone has any info, I appreciate it because I am so worried about this!

  • Elise P

    3/23/2009 1:23:00 PM |

    Anonymous said...

        Elise,

        I did not realize that I was pregnant until Week 6 of pregnancy. During Week 4 and Week 5, I took one 50,000 IU dose of a vitamin D prescription. I can't find much info on whether this overdose is likely to cause birth defects. I stopped taking it after week 5. Was your baby healthy after taking your 3,000 IU's during pregnancy? If anyone has any info, I appreciate it because I am so worried about this!

    Anonymous: I'm almost 5 months pregnant now and all tests show the baby is healthy, and I'm still taking D at a dose of 4,000 IU per month.  I'm due to get my blood levels tested again but I'm not worried any more after doing some research specifically on pregnancy and vitamin D supplementation.  I wouldn't do the high doses weekly as you were previously doing but I wouldn't discontinue taking the D if I were you (keep your levels in the high normal range and keep testing). I'm 40 with my first baby and became pregnant after trying for a while - only after I had been supplementing D for a few months and it could be what made the difference in conceiving.  A very nice reply from Mike V. from a related post gave me this link: http://www.direct-ms.org/pdf/VitDGenScience/Hollis%20vit%20D%20pregnacy.pdf
    Hope that helps and good luck!

  • Anonymous

    3/26/2009 10:37:00 PM |

    Elise,  Thank you so much for the response. I feel better. I also visited a prenatal specialist and they put my mind at east as well.  I am not going to take the 50,000 IU dosage during the remainder of pregnancy.

  • Anonymous

    4/8/2009 12:47:00 AM |

    Well, I had posted a while back that I took 50,000 IU doses of vitamin D early in my pregnancy because I had not yet known that I was pregnant.  I had a miscarriage today.  I'm so sad.

  • Elise P

    4/8/2009 6:20:00 PM |

    Anonymous,
    I'm so sorry for your loss.
    Elise

  • mbarnes

    9/9/2009 10:42:17 AM |

    There are good data showing that vitamin D protects against colds and flu. Indeed the Canadians are running studies with vitamin D to determine if it can reduce the indcidence of N1H1, Here is a link a to a recent article that covers these data:
    http://archive.constantcontact.com/fs026/1102452079631/archive/1102685428884.html
    and take a look at www.vitaminD3world.com for some good summaries of the data in general

  • Anonymous

    11/6/2009 4:00:15 PM |

    Everybody should get their Vitamin D level tested, because we are all so different. I was at 40 with 4000 IU of D3 a day. I doubled it to 8000 IU of D3 and, after 6 months, my level is only 52! I read that 10,000 IU per day was the new safe upper limit. I am going up to 10,000 now, but I wonder if it would be safe to take more than that. I really want to get up to the 80ish level. Why settle for 50% less chance of cancer? 90% less sounds much better to me. I wonder why I need so much more D3 than others. I am older and fatter than average; maybe that is the reason.

  • Chris Tucker

    11/25/2009 1:11:54 AM |

    I am going to start taking 4000 IU a day of Vitamin D3 for my Rosacea.

  • DeBorah Beatty

    1/29/2010 7:08:27 AM |

    My doctor wants me to take 10,000 units a day of Vitamin D. But where can I find any in mega doses so I can avoid spending my entire day taking Vitamin D? So far, can't find anything higher than 400 units.

  • Elise P

    1/29/2010 3:02:21 PM |

    I've been buying 5,000 IU caps at vitacost.com for about $17 for 365.

    They're making them stronger these days so it shouldn't be too hard to find.  Probably vitamin shoppe, GNC, etc. carry them as well.

  • Anna

    1/29/2010 5:19:27 PM |

    DeBorah Beatty,

    More stores are starting to carry higher dose Vit D, but I've noticed the supermarkets and drug stores are lagging behind.  I'm seeing 1000iU and 2000iU doses creeping on to those shelves, but frankly, even with the increasing awareness of the need for more Vit D, the options are still quite limited in these retail establishments (and are too often the tablets, which may be cheaper, but may not absorb as well).  Be sure to ask for the higher doses so the managers who order know people are looking for them.  I also have found the chain supermarkets and drug stores don't necessarily have the best prices or brands.

    When shopping at "brick & mortar" stores, I've had the best luck finding better prices and higher dose Vit D3 (2500-5000+iU) at specialty vitamin businesses (such as Vitamin Shoppe, GNC, and independent vitamin shops) and in the vitamin depts of "health food" and "natural food" grocery stores, such as Whole Foods and similar local chains.

    Online shopping will provide you with the best options for both price and selection.  There are many good options.   Ted Hutchinson's Vit D3 blog (http://vitamind3.blogspot.com/) often lists good online sources and deals on Vit D3 in the higher doses you want.  

    Last year I purchased Bio-Tech 5000iU dose D3 from the Drs Eades Protein Power website (www.proteinpower.com) for a great price ($8 for 100 capsules).  These capsules are a dry-powder in a gel cap (not a hard tablet) and I seem to get just a good a 25(OH)D result as when taking an oil gelcap.  The bottles are small and light-weight, so they don't take up much storage or packaging room.  For the same shipping cost as 1 bottle, I bought 10 or 11 bottles before going to a high shipping price - enough D3 for a year for myself (I take 5000iu daily) and some to send to my MIL and SIL in London.  The Eades' Protein Power site also sells Bio-Tech's D3 in 50,000iU (that's equivalent to the Rx dose) capsules, 12 qty for $18, which is a good way to get a low 25(OH)D up fast.

  • Anonymous

    2/4/2010 1:08:09 PM |

    My 2 year old and I had the same experience with taking larger amounts of Vitamin D and staying well while exposed to sickness. My husband came home with the Swine flu a few months ago. I was 7 weeks pregnant at the time. My Dr. told me to take Tamiflu immediately. I was concerned about taking a Cat C drug while pregnant so, instead I started to take around 10,000 IU of Vitamin D. My daughter took about 5,000 IU (cherry chew-ables). We got the common cold out of it but we never got a fever above 98.8 and that only lasted 1.5 days. My husband was out for days and the two people who, theoretically have the lower immune systems stayed well! I owe it all to taking Vitamin D. We continue to take it daily to prevent getting any flu that comes around, especially since I'm more pregnant and I'm not planning on getting my H1N1 vaccine.

  • Anonymous

    2/21/2010 4:43:09 PM |

    I inquired with a Vitamin D researcher regarding megadoses of Vitamin D (e.g. 50,000) and he informed me those are usually D2 not D3, one's slower acting and the other faster acting.  Be sure you're comparing apples to apples.

  • vitamin D

    5/17/2010 5:26:19 AM |

    After read this post I think that it is good to take high dose of vitamin D?

  • hoosierdaddy

    5/17/2010 4:03:20 PM |

    I live at latitude 38.72 just south of Annapolis, MD. On Nov. 10,2009 my 25(OH)D test revealed my D level at 50 ng/ml. I'm a blonde, light skinned, 58 year old male, weight 137, height 5'7".
    Immediately after the test I began to supplement with 10,000 IU D3 per day in addition to the 400 IU in my multivitamin. I took this high-D3 dosage every day through the winter and on March 19,2010 my 25(OH)D test revealed my result as 64 ng/ml. On this date I decreased my D3 to 5,000 IU per day (+ 400 IU from multi) and intend to stay at that dosage until my next test, which I plan to take in mid August. I do not sunbathe and I go swimming maybe once a week. I get an average amount of exposure during the warm months while mowing the lawn and just going outdoors to go to the store or walking my dogs.
    I also get 1,000 mg of calcium and 500 mg magnesium per day - my calcium level is 2.45 mmol/L and my total cholesterol is 147 mg/dL. I do not follow any speial diet other than eating everything in moderation and balancing veggies, fruits, grains, meats and seafoods. I do however avoid trans-fats and instead use coconut and palm oils as well as butter and olive oils. I also supplement with a complete EFA and 1200 mg of Lecithin daily.
    I hope this helps others make a determination where to start with their high dose D3 supplementation.

  • Maddy

    6/22/2010 2:45:55 AM |

    Dr. Davis,
    I am 21 years old and have a level of vitamin D of 25. My doctor told me that was very low and put me on 2 pills a week of 50,000 units of supplements and also 5,000 units a day. Is this normal or safe? I just really need a second opinion because I feel like it is a lot.

    Thanks, Maddy

  • jfwysong

    9/14/2010 1:22:53 AM |

    I had low D (14).  My doc put me on 50000/mo (D2??).  After 2+ years, little effect.  Found www.vitamindcouncil.org and got educated.  For every 1000iu (D3) intake, you should see a 7-10 ng/ml serum increase.  So I started (again) at 18ng/ml and am taking an extra 5000iu/day.  It is all going as expected.  After 6 months I am up to 38ng/ml.  On the liver enzyme issue, I drink alcohol and have noticed NORMAL enzyme levels now after my D3 intake...even when drinking the night BEFORE my blood test.  Interesting.  Hope this helps somebody.....

  • Anonymous

    9/15/2010 2:59:02 PM |

    Here's my experience regarding testing:

    I test my D3 level twice a year, at the end of winter (April) and the end of summer (October) and then adjust the amount of D3 I take depending on the results.

    Living in a northern state (WIS) and getting outdoors in shirtsleeves in the summer a lot, I find that I need about 5,000 IU in the winter months and 1,000 IU in the summer months to maintain a level around 70 ng/ml.

    So far, I've tested four times over two years and I may adjust both the summer dose and the winter dose just a bit after another year of tests, but I think I'm homing in on the amount I need. Everyone is different and everyone should attempt similar testing, in my opinion. Each test costs about $70 and I pay it myself.

    Side note: It's also supposed to help with psoriasis. For 25 years or so, I've had a psoriasis-like itching/redness develop almost monthly in my moustache and hairline that one application of Head & Shoulders would bring under control for about a month. Obviously it's not a serious case of psoriasis. Nevertheless, I started the vit D3 supplementation three years ago and haven't used the Head & Shoulders since.

  • Anonymous

    10/21/2010 6:10:38 AM |

    So is a vitamin d level of 85 ng/mL something to worry about? Should one continue taking 2000 IU a day of vitamin d3?

  • buy jeans

    11/3/2010 3:05:29 PM |

    -Young people (not older people >40 years old, who have lost most of the capacity to activate vitamin D in the skin) who obtain several days to weeks of tropical sun typically have 25-hydroxy vitamin D blood levels of 80-100 ng/ml without adverse effect.

  • Helen BC

    12/26/2010 5:37:29 PM |

    Fall 2009 I had done 25(OH) D-test which revealed my D level at 32 ng/ml (36 y/o Female). My “old school “doctor told me that there is a little that I can do about it since we live in Canada and during Fall/Winter we have almost no exposure to sun. I was not satisfied with answer that there is little that we can do and did some research on line about it.
    As of today I am taking about 15,000 IU/day of D3 (3 tiny gel pills – Spring Valley brand @ Wal-Mart $6.00 per 100 pills) and my D level is barely 45 ng/ml.
    I am also working with public at Major International Airport, so we are constantly exposed disease (like TB, HEP-C, N1H1 on daily basis). First year working I managed to get Kidney infection, 3x cold, 1x flue and  weeks long cough. Now I am working with gloves and when I am feeling that I may get flu I will double dosage to 30,000 IU/Day + 400 IU Ginseng. In 2010 I was not sick all.
    I must say I can see Significant improvement on my skin (suffering from Psoriasis). Also good prevention for breast, colon cancer, hypoglycemia and development of Type 1 Diabetes that is in my family history.
    However, since some articles suggesting that high dosage of D3 may assist with weight lost finding difficult locate this bottle (5,000 IU) and be available on shelf, but I can order it on-line from Wal-Mart at any time.

  • Anonymous

    1/8/2011 12:22:41 AM |

    I'm 32 weeks pregnant and when my doctor heard that I am supplementing with vitamin D3, she was very concerned and advised against it. I had my D3 levels checked about a month ago and they were 25 ng/mL, which makes me vitamin D3 deficient. I had been taking 4000 IU of vitamin D3 for about 3 months by then, and decided to take 6000 IU from that day on, because I was concerned that 4000 IU is too low for me and that my baby and that I needed more so that my D3 levels could reach the optimum of 50-80 ng/mL). In the meantime I've read more on the subject because I got a cold and am worried a bit about the flu (didn't want to get vaccinated), so now I'm taking 10000 IU/day. Is that too much?! I don't have anyone else to seek advice from, my doctors have no idea about the new research and would freak out if I told them how much I'm taking. Smile I plan to breastfeed and I want to do what's best for my baby... 4000 IU was obviously not an adequate dose for me since after 3 months of taking it my levels were 25 ng/mL, right? Thank you in advance. Smile

  • Elise P

    1/11/2011 2:28:30 AM |

    Anonymous,
    I took 3000 while pregnant and my level was 52, but I had been taking that level for a while before I became pregnant - not sure how long you've been supplementing.  Anyway, my advice to you would be to find a doctor who is well versed in vitamin d supplementation (call around or search the internet) and is willing to help you monitor your levels, and you could keep your current doctor as well (I'm assuming the one you're referring to is your OB).  Also, get retested now to make sure your levels are really that low, as lab results are sometimes wrong.  I don't know if it was the vitamin d, but after I started taking it I was able to get pregnant, had an uneventful pregnancy and vaginal birth - (no need to be induced).  I've had a couple of colds that were over more quickly than they used to be, but no flu.  My son who is now 1 1/2 takes about 1200 IU's of D - they come in drops that are easy to mix in food.  He's had one short cold that lasted for 24 hours and roseola but no flu and bounced right back. Vitamin D has helped us so much but it doesn't mean you'll never get sick - a lot less and a lot less severe though.  If you're getting leg cramps at night, try pickle juice. Good luck!

  • Benjamin

    2/25/2011 2:12:57 PM |

    Brilliant blog.

    More people need to be aware theat suggested doagsages are often well short of the mark.

    A recent publication suggestes that doses of 4000-8000 IU are required daily to amintain optimal levels.

    check out the study, and video here:
    http://www.timeforwellness.org/blog-view/you-need-a-lot-more-vitamin-d-than-you-think-178

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Trains, planes, and heart scans

Trains, planes, and heart scans

A Heart Scan Blog reader posted the following question:

It is not clear to me why getting a cardiac scan is the necessary first step, if in fact the next step would be to bring down small LDL particles which is revealed on a NMR lipoprofile or VAP test. Why isn't the NMR or VAP test the first thing?

Good question. Think of it this way:

Lipoproteins, as measured via VAP (Vertical Auto Profile) or NMR (Nuclear Magnetic Resonance), provide a snapshot of risk from a metabolic viewpoint at that moment. Lipoproteins shift with the tides of age, menopause, weight changes, even what you ate last evening for dinner (especially small LDL). There are also other factors that cause coronary plaque, as well, not revealed through lipoprotein testing, such as vitamin D deficiency, smoking, high blood pressure, phosopholipase A2, lipoprotein(a), inflammatory factors, thyroid dysfunction, omega-3 fatty acid deficiency, etc.

A heart scan, providing a coronary calcium score, provides an indirect measure of coronary plaque that is the sum total of lipoprotein and other plaque-causing factors that have accumulated up to the time of your scan--regardless of the cause.

It means that two females, each 60 years old, with 70% small LDL, HDL 42 mg/dl, triglycerides 150 mg/dl, and mild hypertension, have identical markers for potential coronary risk, but can have widely different heart scan scores. One might have a score of zero, while the other might have a score of 300.

Why would the same panel of causes measured at one moment yield wildly different quantities of plaque? Several reasons:

1) The lifestyles, eating habits, and weight of each woman differed during their earlier years, not currently reflected in this moment's lipid or lipoprotein patterns. Perhpaps one experienced several years of extraordinary stress from a failed marriage, or suffered through two years of depression that caused her to smoke and overeat.

2) There are hidden factors that affect coronary plaque growth that we are presently not able to detect, e.g., vitamin D receptor genotype, cholesteryl-ester transfer protein variants, variation in inflammatory factors. If we can't measure it, we won't know whether it might influence coronary plaque risk.


With all the changes that occur over a person's life, with the uncertainties of yet-to-be-identified causes for coronary plaque, how can you possible know what your risk for heart disease truly is? Yup--a heart scan. Do it and you will know.

Comments (10) -

  • Anonymous

    9/6/2009 6:22:50 PM |

    So now the question is, how would your treatment differ for these two women?

    BTW I had thought the NMR/VAP were the lipoprotein equivalent of the HbA1c for blood sugar -- oh well!

  • Lou

    9/6/2009 10:38:43 PM |

    Hi Dr Davis

    I have just discovered your brilliant site.

    I saw on another post that you have some Track you plaque members from other countries. Do you have any idea if the blood tests you recommend are available to patients outside of the States (specifically in the UK or Europe)?

    Thanks
    Lou

  • Anonymous

    9/7/2009 1:45:12 AM |

    Hi Dr. Davis,

    Do you find an earlobe crease to be a reliable determinant of coronary calcium?  I have one and notice you have one as well (on your pic).

    Thanks,
    Dan

  • Heart Scan

    9/7/2009 6:12:51 AM |

    Isn’t it natural for us to believe we are healthy and not suffering from any disease? I had a similar thought process until my physician asked me to get a heart scan done after he found that my basic cardiograms were not perfect. I discovered that there were calcium deposits in my coronary arteries and I was at a serious risk of a heart attack. I was shocked and went ahead with the Cardiologist's suggestion of an advanced diagnostic scan. Though it’s always tough to undergo such experiences, I was not at any kind of discomfort at the Elitehealth.com advanced heart scan facility. I am not an expert in medical appliance and machines but could feel that the equipment was world-class and I was in safe hands. That feeling is really very important for me and that’s how it actually went on. The facilities for Full Body Scan were as good as they can get.

  • Dr. William Davis

    9/7/2009 2:13:21 PM |

    Anony--

    Easy. A woman with a zero score might make some efforts to correct her lipid/lipoprotein patterns to less strict endpoints, though she should still supplement vitamin D, iodine, and omega-3 fatty acids. The other woman should follow our Track Your Plaque endpoints if her goal is to stop plaque growth.


    Lou--

    Sorry, but I am not familiar with the availability of lipoproteins worldwide. I do know that people from outside the U.S. have managed, but it differs in every country. Please let us know if you have any success.

  • Anonymous

    9/7/2009 3:21:15 PM |

    I had a heart scan 7 years ago at  Hopkins, how often should it be done? I didn't have any calcium- I  was 49 at the time but I have high levels of small particle LDL and HDL.

    Incidentally they called a week after reporting the results of the heart scan and said I had a bunch of 'spots' on my liver which requires CAT scans and Ultra sounds to further investigate. Turned out to be something rather normal- I forget what they are called- just it involved a bunch of tests during a four week period and a lot of worrying.

    Anytime you do a body scan be prepared to find other stuff- which may or may not be a good thing depending on your frame of mind and it you are the type of person who needs to know everything.

    C'est la vie

  • Anonymous

    9/9/2009 1:42:12 PM |

    Actually, I can think of at least one scenario where getting a VAP or similar test WOULD be the first step... youth.


    I am inelligible for a heart scan because of my age (female under 40), yet I have a strong family hx of heart disease and have already presented with some signs of risk.  IMO, a VAP test would be the best thing for someone under 40 who is concerned about heart disease.

  • Materialguy

    9/15/2009 5:21:02 PM |

    I'm looking at "The New Heart Disease Handbook" by Christopher Cannon MD and Elizabeth Vierck 2009. They mention calcium score and calcium scan a few times. Their wording focuses on the calcium scan being useful in identifying areas of plaque buildup. There are probably only a total of 300 words on the subject all totaled. Sounds like progress slowly inching along.

  • Carolyn

    9/23/2009 6:11:03 PM |

    Wheat bran and any other dry whole grain puts my digestive tract in acid overdrive.

  • Female heart attack

    9/24/2009 10:06:31 AM |

    We all have heard of heart attacks. Among women, menopausal women are more prone to heart attacks due to lower levels of estrogen. Some symptoms of female heart attacks are: pressure felt in the chest area, feeling weak, low energy, uncommon symptoms are: nauseous sensation, giddiness, etc. Women often put themselves in the last list because they have many responsibilities, but as soon as any women notice such symptoms, should go for checking.

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