Some basic vitamin D issues

The last post on vitamin D raised a number of basic questions among readers. So let me discuss some of these questions one by one. All of them raise important issues surrounding the practical aspects of managing vitamin D in your health.

Anne said:

I think it is important to stress that vitamin D supplementation needs to be continued long term.

I have met too many people who have been prescribed 50,000 IU of D2 for 8-12 weeks and then told to stop because their 23(OH)D went over 30ng/ml. I know one person who's doctor stopped and started the D2 3 times.


Thanks for pointing that out, Anne. Excellent point. I also see doctors do this with statin drugs: start it, check a LDL level which is lower, then think that you're done and stop the drug. What the heck are they thinking?

If vitamin D is not being produced by sun exposure and not obtainable through diet, continued supplementation is necessary, essentially for life.


Twinb asked:

How often you think Vit. D levels should be tested after the initial test is done, especially if the levels are drastically low?

We have used every 6 months in the office. Ideally, levels are in mid-summer and mid- to-late winter in order to gauge the extremes of your seasonal fluctuations. While most adults over 40 fail to fluctuate more than 10 ng/ml in the Wisconsin climate (and this summer, after an initial rainy season early, has been flawlessly bright and sunny, in the high-70s and 80s every single day for months), an occasional person fluctuates more widely. The only way to judge is to check a blood level.


Rich said:

Vitamin D dosage effects appear to be quite idiosyncratic.

Yes, indeed it is. Despite using crude rules-of-thumb, like taking 1000 units of vitamin D per 10 ng/ml desired (a rule I learned from Dr. John Cannell, which he offered fully aware of its inaccuracy), many people will surprise you and have levels that make no sense. Testing is crucial to know your vitamin D level.


Richard asked: Where do we get enough vitamin D wihout worring about laboratory tests?

Well, the entire point of the post was that you absolutely, positively cannot just take vitamin D blindly at any dose and hope that your level is ideal, no more than you can blindly take a dose of thyroid and know you have achieved normal thyroid levels. In my view, vitamin D blood levels are an absolute.


Another simple issue: Don't be afraid of vitamin D. It is, in all practicality, no more dangerous than getting a dark tan. (But, as many of you realize, getting a tan is no assurance of raising vitamin D if you are over 40 years old.)

Wouldn't it be great if someone developed a do-it-yourself-at-home skin test for vitamin D? I know of no effort to develop this, but it would be a huge advantage for all of us.

Comments (7) -

  • Anne

    8/24/2008 2:06:00 PM |

    Ted wrote "I am a 64yr old male living in the UK. My skin is fairly tanned as I try to get as much full body sun exposure as is available here however I have also been taking 5000iu/daily for a couple of years now. When I was last tested my score was 147.5nmol/l 59ng/ml. I wonder if Anne's numbers are the result of a faulty test."

    I said to my endocrinologist that I thought the high test result I had, 384 nmol/L (153 ng/ml), was a lab error, but he was pretty sure it was correct. Maybe it's because I'm slim and can't store the D3 easily so I'll gain serum levels of it easily and lose it equally easily ? I contacted Dr Reinhold Vieth who has done a lot of research into D and he suggested I could have a hypersensitivity to D - if so, this will become apparent when I have my next test.

    Anne

  • Anonymous

    8/24/2008 7:32:00 PM |

    Great post

    If you have been taking 4000iu D3 daily for several months and then suddenly stop taking any, after a week would depression and lethargy be a side effect?

    Thanks

  • rabagley

    8/25/2008 4:14:00 AM |

    The most important thing to realize about Vitamin D is that your body has many ways to deal with excess quantities, and almost no way to deal with a deficiency.

    Once 25(OH)D gets above ~80ng/ml (which takes a LOT of vitamin D over a long period of time), your body begins to store Vitamin D in your fat cells.  The amount that can be safely stored in your fat is almost an order of magnitude larger than what is carried in your blood serum (equivalent of 500-600 ng/ml).  It takes a truly ridiculous amount of Vitamin D3 taken for a long time to saturate your fatty tissue.

    If you have sarcoidosis, which often causes problems with conversion of Vitamin D active forms in your body, supplemented Vitamin D will probably make your condition worse.  For everyone else, it is extraordinarily hard to overdose on oral Vitamin D supplementation.

    40,000 IU's/day for a month might cause problems for a normal person, but almost nobody will recommend more than 10,000 IU's/day (the same amount a young person's skin can make in 30 minutes of low-latitude, noonday sun).  Another number to be aware of is 4000 IU/day, which is the amount of Vitamin D that an average human body with normal levels of 25(OH)D will use up in a day.

    The RDA (at 400 IU's/day) is based on old science.  Completely ignore that number as worthless and dangerously out of date.  That amount will stop rickets and little else.  That's little help for bones, for cancer prevention, for steering calcium away from arterial walls, for all of the other things that Vitamin D will do in your body.

  • Anonymous

    8/25/2008 10:16:00 AM |

    I'm familiar with a couple chemists that tried to make a Vit.D home testing kit.  They looked up older TLC methods for making a Dkit that was similar to the home cholesterol kits.  They spent time on it, and  felt they had a result on one of the tests, but in the end decided it was going to take too much time to do right.  More time than they could offer, so the project was shelved.

  • moblogs

    8/25/2008 10:50:00 AM |

    Because I'm not ill I'm only really allowed vit D tests yearly (I would probably be seen as an NHS pest if I pursued it), but I'm taking 5000IU for the last year to see what this does to my unsupplemented level of 10nmol/L. I was prescribed 400IU and that only raised me by 11nmol/L to 21nmol/L, so in understanding the relative safeness of D, and how other family members respond to it (almost always needing higher), I don't feel like I'm playing Russian Roulette. I'm allowed a blood test late September though.

  • Anonymous

    8/26/2008 3:33:00 PM |

    This could be grist for another post (along the lines of how disastrously low the US RDA is for Vit. D):

    http://www.nytimes.com/2008/08/26/health/research/26rick.html?ref=health

  • Anonymous

    9/1/2008 6:01:00 PM |

    Dr Davis,

    Have you watched this video on vitamin D?

    http://www.youtube.com/watch?v=78CB21mKlXc

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Are Your Cosmetics Safe?

Are Your Cosmetics Safe?



If you are reading The Cureality blog chances are you care about your health. You care about what you eat. You want to remain healthy, free of disease, feel good and possibly even want to look and feel as vibrant as you were when you were 20. Many of us think of food all day long. Many of us love to eat. We plant gardens so we know our food is free of pesticides and other toxic chemicals. Food can be a cause of disease and it can minimize our chances of disease. We try and take care of our insides but did you ever wonder what in the world you apply to your skin on a daily basis? What do these products contain and are they safe? Why are there more endocrine disorders popping up. Could it be that some of things we apply to our skin every single day may be harmful to our insides?

A portion of the skin health section of Cureality will take a look at skincare products and cosmetics. Are the products we apply to our skin gluten-free, paraben-free and free of other harsh chemicals that can cause skin irritations and possible other unwanted diseases. I came across Mirabella cosmetics and I wanted to learn more about this particular product line so I tracked down John Maly, founder and CEO of Mirabella Cosmetics. Mr. Maly was gracious enough to take time out and answer my questions.This is what Mr. Maly has to say about Mirabella:

DD: Tell us about some key features about Mirabella, gluten-free cosmetics. What made you get started in a gluten-free line?

JM: We didn't start as gluten-free. Over time we have continued to make our line more beautiful AND more healthy for women. First we began with a mineral foundation. Then as we introduced new products, we made sure they were as clean and healthy, while still being fashion forward. We saw the benefits to our clients to take out those ingredients that didn't help them look and feel their best such as glutens, parabens and talcs.

DD: Some cosmetic companies carry partially gluten-free cosmetics. Are all of Mirabella products gluten-free, paraben-free and talc-free?

JM: Everything is paraben-free and talc free. And our brand is all gluten-free except our Skin Tint Creme foundation. That is a product that women love and we just cannot make the formula without a wheat protein to perform as well...yet! We will continue to work on it!

DD: Are there other ingredients in cosmetics that women should be cautious of using if they have skin sensitivities or allergies?

JM: Some women are sensitive to fragrance as well.This is another thing that we avoid with our brand. The biggest ingredients that women find that helps with their skin health is mineral products. They are natural and very breathable on a woman's skin.

DD: I think your velvet lip pencils are by far the most extraordinary lip pencil on the market. What are some of your other standout products your customers love?

JM: Pure Press Mineral Foundation is still our #1product. But the fastest growing product is Magic Marker Eyeliner. It is easy to use, doesn't smudge and lasts all day.

DD: Anything new on the horizon for Mirabella that you can share with us?

JM: In August we launch CC crème. This product has all the good for you ingredients to help with Anti-Aging like avocado oil, argan oil and Acai (Assai) berry. Plus it is a mineral formula, gluten-free, and paraben-free. And it has an SPF of 20. One of the biggest issues that women have with aging is lips. That is why we put Litchi Chinesis Fruit Extract in our Colour Vinyl lipstick. Then in your favorite Velvet Lip Pencil, we put Pomegranate Extract, Vitamin C and E in to assist with in Anti-Aging.

DD: Is Mirabella only sold in the US or do you have international distribution as well.

JM: We are sold in Canada, Australia, Finland and Russia.

DD: Where can we purchase your cosmetics?

JM: Our products are available at www.mirabellabeauty.com and at over 1,500 of the finest salons and spas. Go to our salon locator to find a retailer near you.

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