Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Vitamin D: the New Covid-19 Chloroquine?

berthub.eu

Post reply on HN
Print view View original

121–130 of 156 posts

Re: Vitamin D: the New Covid-19 Chloroquine?

#121

Post by gregwebs »

cachestash wrote: post #118
gregwebs wrote: post #109

Earlier quoted context omitted.

The NIH states that 4000 IU is the tolerable upper intake: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona... If you are rounding down your vitamin D status then it is currently at what the NIH say should be avoided. Have you consulted with a medical professional about your vitamin d status? 10k IU/day can be great when someone's level is 12, but it's not a maintenance dosage once at healthy levels.

https://pubmed.ncbi.nlm.nih.gov/28768407/ "A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was neede…

It is pretty easy to cherry pick a paper advocating whatever you want to advocate for vitamin D. The paper you cite is entirely founded on another paper about fixing the daily estimate. That paper states about its improved estimate: "As this dose is far beyond the range of studied doses, caution is warranted when interpreting this estimate."

I have no doubt that the mainstream NIH advice is not optimal. The best thing for everyone to do though is not to recommend high dosages for everyone but instead to recommend getting vitamin D levels tested.

Re: Vitamin D: the New Covid-19 Chloroquine?

#122

Post by trevorkoob »

elric wrote: post #85
travisoneill1 wrote: post #78

Earlier quoted context omitted.

The point is that being outside naked at noon every day for 15 minutes wouldn't hurt you. Therefore, a daily dose of 20,000 IU / day won't hurt you. Therefore, a 5000 IU supplement every day won't hurt you either.

One does not follow the other. Maybe taking 5000 IU orally has a vastly different effect to letting it acculumate through skin? That's purely speculation on my part though, just trying to illustrate that these two are not necessarily equivalent.

It is certainly a different mechanism. There are inactive isomers of pre-Vitamin D (tachysterol and lumisterol) that prevent over-production of Vitamin D from continued UV exposure.

I list these numbers to give a general idea of the levels of Vitamin D that people experience without oral supplementation.

My conclusion was that too many studies were being done to determine the correct or safe amount to supplement rather than testing regularly to determine a safe/optimal blood concentration.

Very excited for good prospective studies of Vitamin D.

Re: Vitamin D: the New Covid-19 Chloroquine?

#123

Post by trevorkoob »

Barrin92 wrote: post #106
travisoneill1 wrote: post #78

Earlier quoted context omitted.

The point is that being outside naked at noon every day for 15 minutes wouldn't hurt you. Therefore, a daily dose of 20,000 IU / day won't hurt you. Therefore, a 5000 IU supplement every day won't hurt you either.

is this just an extrapolation or does my body actually constantly produce the same amount of vitamin D if i sit in the sun even if I don't have a deficit? Because usually phisiological processes are in some kind of equilibrium and regulated, so it's not straightforward to compare it to supplements.

7-dehydrocholesterol is photolyzed by UV to previtamin D. There is then spontaneous isomerization between this previtamin D, vitamin D and 2 inactive isomers. As vitamin D is used by the body, and the inactive isomers remain in the skin, there is an equilibrium - as vitamin D is used by the body it is drawn from the skin, leading to more conversion of inactive isomers to active vitamin D.

Re: Vitamin D: the New Covid-19 Chloroquine?

#124

Post by trevorkoob »

AnonC wrote: post #86
trevorkoob wrote: post #43

Did my masters on Vitamin D - It is very difficult to extract CLINICALLY RELEVANT information from retrospective epidemiological studies. However, there a a few things that are clear: 1. Calcium absorption from the intestine increases with vitamin D supplementation dose up to around 8-10,000 IU D3 daily. 2. 15 minutes of full body exposure in noon sun is equivalent to a dose of ~20,000 IU D3 3. There are few cases of…

> 2. 15 minutes of full body exposure in noon sun is equivalent to a dose of ~20,000 IU D3 For someone who claims to have done a masters on Vitamin D, I find this generalized statement disturbing. What skin tone the person has, what season it is, what latitude the person lives at, age of the person etc., are factors in how much Vitamin D is produced by the body on exposure to sunlight. I’m afraid I can’t take the oth…

Yes, this was overly brief and a tilde is not enough to qualify this statement, and I should have said noon equatorial sun.

My point here was meant to be about how this is essentially the daily maximum dose from UV radiation due to the isomerization of previtamin D into inactive isomers, and to give context to a dose of 10,000 IU D3 seeming large when it is half the amount a person might receive from sun exposure.

Re: Vitamin D: the New Covid-19 Chloroquine?

#125

Post by trevorkoob »

mrfusion wrote: post #59
trevorkoob wrote: post #43

Did my masters on Vitamin D - It is very difficult to extract CLINICALLY RELEVANT information from retrospective epidemiological studies. However, there a a few things that are clear: 1. Calcium absorption from the intestine increases with vitamin D supplementation dose up to around 8-10,000 IU D3 daily. 2. 15 minutes of full body exposure in noon sun is equivalent to a dose of ~20,000 IU D3 3. There are few cases of…

Will your body make vitamin d from sunlight if you already have a enough from a supplement? I’m worried about overdosing if I take 5000 UI and get a lot of sun.

I personally aim for 10,000 IU D3 daily from either sun or supplement. In normal times, living in New York, I would supplement 10,000 IU D3 from November through March, and then I would make sure to be outside 1 hour a day with at least arms and face exposed.

Shots of 250,000 IU are given clinically and the therapeutic dose was traditionally 50,000 IU D2 weekly - corresponding to a dose of about 3,500 IU D3 daily.

I highly recommend getting tested for kidney disease if you are worried and get multiple vitamin D tests - the tests are imprecise but will give you a general idea of what your levels are.

Re: Vitamin D: the New Covid-19 Chloroquine?

#126

Post by trevorkoob »

gregwebs wrote: post #121
cachestash wrote: post #118

Earlier quoted context omitted.

https://pubmed.ncbi.nlm.nih.gov/28768407/ "A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was neede…

It is pretty easy to cherry pick a paper advocating whatever you want to advocate for vitamin D. The paper you cite is entirely founded on another paper about fixing the daily estimate. That paper states about its improved estimate: "As this dose is far beyond the range of studied doses, caution is warranted when interpreting this estimate." I have no doubt that the mainstream NIH advice is not optimal. The best thin…

I noted the levels needed to maximize intestinal calcium absorption because this is the best studied aspect of Vitamin D. Rickets was the main reason Vitamin D was discovered and supplemented.

Vitamin D level blood testing is imprecise - I would not consider any one test of Vitamin D levels to be accurate.

This person's cited paper corresponds with the calcium absorption data that suggests around 8,000 IU D3 is where calcium absorption begins to plateau and more vitamin D leads to minimal additional calcium absorption.

Since I haven't been going outside, I take vitamin D 10,000 IU daily. You are correct in that one shouldn't just take the advice of random internet strangers - I should be more careful in posting. My personal experience with Vitamin D has been extremely positive and so I get excited about sharing what I know - of course I had to work and couldn't actively respond to this thread as much as I would like.

Re: Vitamin D: the New Covid-19 Chloroquine?

#127

Post by jungletime »

trevorkoob wrote: post #43

Did my masters on Vitamin D - It is very difficult to extract CLINICALLY RELEVANT information from retrospective epidemiological studies. However, there a a few things that are clear: 1. Calcium absorption from the intestine increases with vitamin D supplementation dose up to around 8-10,000 IU D3 daily. 2. 15 minutes of full body exposure in noon sun is equivalent to a dose of ~20,000 IU D3 3. There are few cases of…

I knew people that would go for a walk during lunch around the office building with a friend. Ate a packed sandwich, got a walk in, a conversation, and apparently got a much needed dose of D3.

Seems like such a low effort, high reward thing to do.

Depending on the latitude and skin complexion that may be all thats needed for D3.

Re: Vitamin D: the New Covid-19 Chloroquine?

#128

Post by trevorkoob »

Abishek_Muthian wrote: post #69
trevorkoob wrote: post #43

Did my masters on Vitamin D - It is very difficult to extract CLINICALLY RELEVANT information from retrospective epidemiological studies. However, there a a few things that are clear: 1. Calcium absorption from the intestine increases with vitamin D supplementation dose up to around 8-10,000 IU D3 daily. 2. 15 minutes of full body exposure in noon sun is equivalent to a dose of ~20,000 IU D3 3. There are few cases of…

>this excludes people with kidney disorders. Can increased calcium absorption lead to kidney disorders? This is my biggest worry when taking Vitamin D3 supplements, I have Vitamin D deficiency but when I take supplements it quickly reaches to toxicity levels (> 80 ng/mL) and so I have the revert to monthly supplement of 60,000 IU of Cholecalciferol. PSA: I'm a dwarf, possibly Achondroplasia, but during childhood (4 -…

There are many cases of kidney disorders causing issues in vitamin D metabolism - the majority of literature examples I read involved genetic kidney disorders which would not be be caused by increased calcium absorption.

I hope you are receiving the treatment you need.

Re: Vitamin D: the New Covid-19 Chloroquine?

#129

Post by trevorkoob »

didgeoridoo wrote: post #51
trevorkoob wrote: post #43

Did my masters on Vitamin D - It is very difficult to extract CLINICALLY RELEVANT information from retrospective epidemiological studies. However, there a a few things that are clear: 1. Calcium absorption from the intestine increases with vitamin D supplementation dose up to around 8-10,000 IU D3 daily. 2. 15 minutes of full body exposure in noon sun is equivalent to a dose of ~20,000 IU D3 3. There are few cases of…

Interesting, I've always heard of the calcium absorption effect as a negative aspect of D over-supplementation — I guess the theory is that it raises your blood calcium level too high, leading to arterial calcification? Is that effect overblown in your opinion?

In acute hypervitaminosis D, there can be organ calcification that has to be treated. These cases are rarely reported - one case occurred when the patient ingested crystalline vitamin D - dosing themselves in the range of 1-2 million IU D3 per day for weeks, and although there was not an extensive follow-up to determine the long-term effect on the patient, the acute calcification was reversed with treatment.

Vitamin D is involved with calcium in the body in many different ways, specifically I was talking about a measure of the absorption of calcium into the body from food as promoted by vitamin D.

Organ calcification is extremely serious and a very understandable reason why doctors have been hesitant to recommend higher doses of vitamin D, however most medical thinking about vitamin D until recently has focused on the prevention of Rickets, which requires only a small amount of constant supplementation (500 IU D3) to avoid serious effects. In context, 10,000 IU seems like an enormous dose. However if you look at the blood serum levels of people who receive consistent UV exposure, they have much higher levels than someone who is being supplemented with 500 IU D3 and no UV. So much of this debate is around trying to find out what the "optimal" vitamin D level is rather than what level is "sufficient" to prevent Rickets.

Re: Vitamin D: the New Covid-19 Chloroquine?

#130

Post by trevorkoob »

AlexanderNull wrote: post #68
dehrmann wrote: post #63

Earlier quoted context omitted.

When my vitamin D levels tested a little low, I asked my doctor about it, and he said studies don't show any benefit for supplementing vitamin D deficiencies that are asymptomatic. At the time, I looked up the study, though I can't seem to find it now.

The studies I've seen relaying the same sentiment of no appreciable benefit only looked at a single outcome, normally bone density or bone fracture occurrence. Vitamin D levels affect expression of almost 300 different genes in humans ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3604145/ ) so looking at a single outcome to gauge the entire efficacy of that vitamin is absurd and disappointing that so many other doct…

My thesis argued that we should not be testing supplementation levels, instead we should be testing the effects of maintaining people at various serum levels of vitamin D year-round.
Post reply on HN