How Much Vitamin D Should You Take?

How Much Vitamin D Should You Take?
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The safe dose of vitamin D supplementation to get most of the population to the optimal level is 2,000 IU a day, but the elderly and overweight may need more.

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Randomized, controlled clinical trials have found that vitamin D supplements extend one’s lifespan. What is the optimal dose? What blood level is associated with living longest? In my nine-part video series on vitamin D back in 2011, I noted that the relationship between vitamin D levels and mortality appeared to be a U-shaped curve—meaning low vitamin D levels were associated with increased mortality. But so were levels that were too high, with the apparent sweet spot around 75 or 80 nanomoles per liter [nmol/L], based on individual studies like this one.

Why might higher D levels be associated with higher risk? Well, this was a population study; so, you can’t be sure which came first. Maybe the vitamin D led to higher risk. Or maybe higher risk led to the vitamin D, meaning maybe those who weren’t doing as well were prescribed vitamin D. Maybe it’s because these were Scandinavian studies, where they tend to take a lot of cod liver oil as the vitamin D supplement, one spoonful of which could exceed the tolerable upper daily limit of intake for vitamin A—which could have negative consequences, even if you don’t inject it into your penis.

I was surprised to see cod liver oil listed among the long list of things men have tried to inject into themselves because they felt they were coming up short, though may have ended up shorter after all the reconstructive surgery.

Anyways, the U-shaped curve is old data. An updated meta-analysis has shown that as population vitamin D levels go up, mortality appears to go down, and stay down—which is good, because then we don’t have to test to see if we’re hitting just the right level.

Routine testing of vitamin D levels is not recommended. Why? Well, it costs money, and in most people, levels come right up to where you want them with sufficient sun, or supplementation. So, they figure what’s the point?

But also because the test is not very good—results can be all over the place. What happens when you send a single sample to a thousand different labs around the world? You maybe expect a little variation, but not this. Results from the same sample ranged anywhere from less than 20 to over 100. So, depending on what lab your doctor sent your blood sample to, the results could have placed you here, or here; so, not necessarily very helpful.

So, what’s a safe dose that will likely get us to the purported optimal level? 1,000 units a day should get most people up to the target 75 nmol/L (which is 30 ng/mL). But by most people, they mean 50%. To get around 85% of the population up to 75 would require 2,000 a day. 2,000 international units a day would shift the curve from here to here. That way, we can take the average person into the desired range without fear of toxicity. You can take too much vitamin D, but you don’t tend to see problems until blood levels get up around 250, which would take consistent daily doses in excess of 10,000.

Note that if you’re overweight, you may want to take 3,000, or if obese, even more than that. If you’re over age 70, and not getting enough sun, it may take 3,500 units to get that same 85% chance of bumping your levels past the target. Again, no need for the average person to test and retest, since a few thousand a day should bring almost everyone up without risking toxicity.

Okay, but then why did the Institute of Medicine set the Recommended Daily Allowance at 600 to 800 units? In fact, official recommendations are all over the map—ranging from just 200 a day, all the way up to 10,000 a day. I’ll try to cut through the confusion, next.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Image thanks to Peter Rosbjerg via flickr.

Randomized, controlled clinical trials have found that vitamin D supplements extend one’s lifespan. What is the optimal dose? What blood level is associated with living longest? In my nine-part video series on vitamin D back in 2011, I noted that the relationship between vitamin D levels and mortality appeared to be a U-shaped curve—meaning low vitamin D levels were associated with increased mortality. But so were levels that were too high, with the apparent sweet spot around 75 or 80 nanomoles per liter [nmol/L], based on individual studies like this one.

Why might higher D levels be associated with higher risk? Well, this was a population study; so, you can’t be sure which came first. Maybe the vitamin D led to higher risk. Or maybe higher risk led to the vitamin D, meaning maybe those who weren’t doing as well were prescribed vitamin D. Maybe it’s because these were Scandinavian studies, where they tend to take a lot of cod liver oil as the vitamin D supplement, one spoonful of which could exceed the tolerable upper daily limit of intake for vitamin A—which could have negative consequences, even if you don’t inject it into your penis.

I was surprised to see cod liver oil listed among the long list of things men have tried to inject into themselves because they felt they were coming up short, though may have ended up shorter after all the reconstructive surgery.

Anyways, the U-shaped curve is old data. An updated meta-analysis has shown that as population vitamin D levels go up, mortality appears to go down, and stay down—which is good, because then we don’t have to test to see if we’re hitting just the right level.

Routine testing of vitamin D levels is not recommended. Why? Well, it costs money, and in most people, levels come right up to where you want them with sufficient sun, or supplementation. So, they figure what’s the point?

But also because the test is not very good—results can be all over the place. What happens when you send a single sample to a thousand different labs around the world? You maybe expect a little variation, but not this. Results from the same sample ranged anywhere from less than 20 to over 100. So, depending on what lab your doctor sent your blood sample to, the results could have placed you here, or here; so, not necessarily very helpful.

So, what’s a safe dose that will likely get us to the purported optimal level? 1,000 units a day should get most people up to the target 75 nmol/L (which is 30 ng/mL). But by most people, they mean 50%. To get around 85% of the population up to 75 would require 2,000 a day. 2,000 international units a day would shift the curve from here to here. That way, we can take the average person into the desired range without fear of toxicity. You can take too much vitamin D, but you don’t tend to see problems until blood levels get up around 250, which would take consistent daily doses in excess of 10,000.

Note that if you’re overweight, you may want to take 3,000, or if obese, even more than that. If you’re over age 70, and not getting enough sun, it may take 3,500 units to get that same 85% chance of bumping your levels past the target. Again, no need for the average person to test and retest, since a few thousand a day should bring almost everyone up without risking toxicity.

Okay, but then why did the Institute of Medicine set the Recommended Daily Allowance at 600 to 800 units? In fact, official recommendations are all over the map—ranging from just 200 a day, all the way up to 10,000 a day. I’ll try to cut through the confusion, next.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Image thanks to Peter Rosbjerg via flickr.

Doctor's Note

After all that work plowing through the new science, the same 2,000 IU/day recommendation I made in 2011 remains: https://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

If you missed the first two videos in this series, see:

And I wrap up with:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

118 responses to “How Much Vitamin D Should You Take?

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  1. I don’t get it ? If the lab results can go any where from 20 to a 120 from the same blood sample, how the heck do you know any of the studies were correct?
    Mcdougall got the right idea, don’t take Vitamin D, now if you’ll excuse me I need to go out in the canadian sunshine while it’s still here. Happy 4th USA!




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    1. What a great idea! Its a beautiful day just across the border from Vermont, I am getting my Vitamin D while moderating for the next couple of hours, enjoy the holiday and the sun




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      1. Well I’m going to get tested this winter several times just to see , I am not planning on supplementing.
        It will be my own “We didn’t know until now” lol
        Cheers




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          1. I was going to get tested in late January, pretty sure I’m not getting much D from the sun here now , even though I still spend several hours outside each day. I will post my results.




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    2. Trial on Vitamin D is underway (lead by Dr Manson) and we will know the result in one year by 2017.

      http://www.ncbi.nlm.nih.gov/pubmed/25864623

      http://www.vitalstudy.org/

      In the meantime, personally I am taking 5000 IU of Vitamin D supplementation + vitamin K as a precaution. There are days in the summer that I cannot get outside around noon because of work and I live in a region where there isn’t too much sun in the winter. Other than that, I eat and exercise well.




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    3. Is it true that Canada only has two seasons, July and winter? =0
      Just a little neighborly kidding.

      Cheers, from sunny California.
      Mark G.




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      1. yeah that makes sense lol
        When I was in high school our ag teacher would comment on how foolish some of the farmers in the area were trying to grow cob corn , didn’t everyone know we were way to far north to grow anything other than immature silage? I have been following a little story not far from here, well actually a little further north , about what has been found out about the native Indian population in these parts BEFORE european’s came to these parts. To everyone”s surprise they had huge crops of corn , I mean 100’s of acres using at least 1500 lbs a day ! 62% of their diet was corn. You can read it for yourself at Wikipedia “Mantle Site Wendat Ancestral village”
        Was my teacher ever wrong , they grew cob corn pre 1600’s , maybe much further back, for God’s sake they can grow corn in Manitoba now.
        Cheers from too hot Canada




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    4. There are many methods of measuring Vit D. Here are a few categories: competitive protein binding assay, immunoassay (radioimmunoassay, enzyme immunoassay), high performance liquid chromatography, liquid chromatography-tandem mass spectrometry. Within each category there are many variations in sample preparation, reactivity of the detection molecule, the type of marker, etc. Presumably, but not certainly, a clinic or individual that sends out a sample for testing is going to have that done by an automated, inexpensive, and imprecise methodology. A research lab that cares about the accurate determination of Vit D and has sufficient funding and expertise will use the best method available at the time.




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    5. The late great epidemiologist Dr. Agatha Thrash said just 10 to 20 minutes in the sun baring a forearm would do your daily Vitamin D for most folks (people of African descent, due to pigmentation need more). Dr. Zane Kime, author of “Sunlight Can Save Your Life” reminds us that Vitamin D is a hormone produced from cholesterol through the sun acting on the skin (thereby lowering cholesterol). He suggested Vit. D supplements might cause a reduction of the body ‘s ability to produce it adequately (just as testosterone supplementation causes us men to lose our ability to produce adequate amounts of that hormone eventually).




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    6. Esben Andersen, I wouldn’t get too frustrated yet. Let’s wait until the video comes out regarding Vit D through sun, supplements, or salons.




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    7. We still have these 3 videos to go before making any decision.
      The Optimal Dose of Vitamin D Based on Natural Levels
      The Best Way to Get Vitamin D: Sun, Supplements, or Salons?
      The Risks and Benefits of Sensible Sun Exposure




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  2. Here I am, thinking I’m going the right thing getting my VitD level tested, only to find out the results may not be accurate aaaarrrrrrrrrrgggghhhhh, still banging my head on the wall !!!!!!!!!




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    1. HI Gumbootgoddess, I would suggest getting your test locally, and relying on your local lab if the results seem to make sense (if you get a reasonable amount of sun and are in the normal range, for example.) If a result really seems not to make sense, I would suggest repeating the test with the same or different lab, and if you get the same result twice, it is probably reliable. In my case personally results had been inexplicably low despite lots of sun during a good part of the year, confirmed with a test at another lab, and came up with supplementation. Hope that is helpful!




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      1. Dr Miriam, I wonder if an indirect vitamin D test can be done indirectly through a calcium blood test which is more accurate? Granted a low calcium reading may be due to low intake of calcium itself, but since calcium can be easily obtained through foods, it is assumed that one eats a diet rich in calcium first and then take a calcium blood test. If the calcium reading is low then one can deduct that it is due to low vitamin D.

        https://www.nlm.nih.gov/medlineplus/ency/article/003477.htm




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        1. It won’t work well because the calcium level in the blood is tightly regulated. If you don’t get enough calcium from food then the body will liberate calcium from your bones to increase calcium levels. At the same time the body will increase the production of certain enzymes that help to absorb calcium from food and other enzymes that help to absorb calcium to the bone better. These latter two processes require the body to use calcitriol which is derived from vitamin D, to switch on the genes that code for these enzymes.

          A sign of low vitamin D affecting the calcium regulation process can be higher parathyroid hormone levels.




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        2. Hi Jimmy, Low vitamin d in the blood can and often does coexist with normal or even high calcium levels, so this won’t really work. Calcium levels are regulated tightly by the body and other influential mechanisms include parathyroid hormone secretion which will cause calcium to be taken from bone in order to maintain normal levels (something we don’t want to be happening chronically and one of the reasons to TAKE vitamin d if blood levels are low). Calcium levels can also depend on the albumin levels (if low for example in severe malnutrition) High calcium levels can be a sign of cancer, without any connection to vitamin d levels. So unfortunately, “it’s complicated….” Hope that was helpful!




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    2. Well we don’t necessarily take vitamin test for other vitamins such as vitamin A, B, C, E, K, minerals such as magnesium, zinc, iron, etc, cancer biomarker, etc, etc. So my point is that why do we have to worry so much about taking vitamin D test? Since there are sufficient evidence that there are benefits by having vitamin D intake via the sun, foods or supplements then we need to feed our body with vitamin D. Ideally you want to get through the sun and foods but if you can’t then you need to take supplementation.

      By the way, it was shown that there is no difference in the body between vitamin D through synthesis from the sun than through foods or supplementation.

      Since we don’t necessarily take lab test for other vitamins and minerals but we know that they are beneficial, so we still want to eat the right types of foods that provide those vitamins and minerals without taking a test. Same goes with vitamin D.




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    1. Attached is a link to the systematic review looking at all cause mortality from Dr Greger’s reference list in NF’s sources cited. When looking at the full article, the plain language summary including the results and author’s conclusion is the easiest way to get the highlights of this review. Note what population seemed to benefit according to the authors and as Dr Greger mentioned how many people needed to take D3 and for how long

      http://onlinelibrary.wiley.com.proxy3.library.mcgill.ca/doi/10.1002/14651858.CD007470.pub3/full




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  3. Since uptake is very dependent on whether Vitamin D is taken with food or not, I wonder whether the studies took this into account and whether this would affect the recommendation.




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  4. I thought I’d take a minute to share a very interesting little experiment that some researchers performed. I read this piece of research years ago so I can’t provide a link, but here’s the info. The researchers took a group of people and measured their blood levels of VitD to get the individual baseline. Then they put the individuals out in the mid-day sun. After 20 minutes the individuals were taken out of the sun and the VitD level taken again. The question was: How much VitD does the body make for itself when it has the opportunity to do so in 20 minutes in the sun? The answer is that in that 20 minutes the VitD levels in the group, individually, went up by 40,000 Units. So that gives us an idea as to how much the body makes and how much the body can perhaps use, or store, or whatever it chooses to do. The paper I read did not provide information as to the ages of the individuals and/or the number in the study. Or at least I don’t recall that information. I believe these were healthy individuals and probably not elderly. But I thought this little study was interesting given this topic by Dr. G.




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      1. You look up the UV Index on the web for the location that you want to know about. Type in “UV Index Cleveland, OH” for example and the index will come up for that area.




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    1. In the Certification course for Plant-based nutrition thru the T. Colin Campbell Foundation they have a handy chart for figuring out how much sun one needs based on skin type and the UV Index. For example if you occasionally burn and slowly tan and in your area at the moment there is a UVI of 6-7, then 15 to 20 minutes of sun a day is enough to get adequate Vit D. Of course it’s problematic if you’re in the higher latitudes and don’t get consistent sun. I’m in AZ and that’s the least of our worries! The point is, I’ve heard both from Campbell and McDougall, that if sun is available we can get all we need.




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    2. You said, “… The answer is that in that 20 minutes the VitD levels in the group, individually, went up by 40,000 Units.” Do you mean went up BY 40,000 “units” (ng/dl?) for each person? Or that the (resultant) level was 40,000 “units”?




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        1. Ginger stated “by”, so I read her comment with some amazement. But I wanted to be sure, particularly since individual D3 production rates vary considerably by individual.




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  5. How funny, I just got 2 emails. 1-this one on Vit D3 and the other, about using enough sunscreen to protect me from the sun! I’m taking 1,000 a day because I’m only 100lbs and I take Vit k.




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  6. I congratulate everyone commenting here whether the comments be positive or negative doesn’t matter you’re aware which unfortunately most people arent they haven’t a clue!




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  7. I have found that 2000 units a day is not enough for the elderly people in my community. Almost everyone I check in my practice has a low level of Vit. D and many have severe deficiency. I find that 5000 units are well tolerated in this group, boosting the level to 45-65ng




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  8. Thanks, Dr. G, as always, for cutting through the confusion with solid information and simple, easily-implemented recommendations.




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  9. I would like to know more about those lab results, like what was the full spread of responses and also the mean, median and mode forms of averages, while showing the full range. And I’d like to know if there were different methods of testings and the different types of machines their ages and even where the different manufacturers of the machines. It would also be important if the results were coming up different from the same sample tested on the same equipment. In short, I’d like to know possible reasons for the variations. I assume this info isn’t available, but it seems like it’s an important question.

    I note that my range always comes back right around 40, except in those instances when I go in with symptoms of low D, like a lot of fatigue, slowed thinking, and otherwise feeling like crap. Those times my range has been in the low 20s. So, it might be that my results every few months tends to be similar because my doctor is using the same lab and it’s being processed on the same equipment. It’s just a guess, but it seems reasonable.

    I have to be tested often because of calcium issues. Otherwise, I’d only be tested in my annual physical. I’d still want to be tested since some brands are just oil and contain little or no Vit D.

    Mark G




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    1. Hi Mark G. In the video at around 2:32 there is a graph, which gives me the impression that something like 90% of the results cluster around 40-60, with a few outliers at either end. It would be interesting to know which labs were the outliers, and indeed how the labs were selected. As you say, it would be useful to know if the same sample were tested repeatedly at the same lab, would the result be pretty much the same? As well as the other concerns that you mention. When I first read the transcript, I found the statement that results vary so much to be alarming, but looking at this graph, I was somewhat reassured, since the vast majority of the results from different labs did cluster within the range I noted above. As I mentioned in an earlier comment this evening, if one were to get a lab result that did not make sense, if one repeats the test at the same or at a different lab, and it comes back the same, it is probably reliable. Again, with vitamin D levels, in the vast majority of cases one is not aiming clinically for pinpoint accuracy but for a state of sufficiency. Hope this is helpful. Happy 4th!




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      1. Hi Dr. Maisel:
        Hey, thanks for that reply. It was really interesting and helpful. I think I’ll go back and look at things again a little closer.

        Mark




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  10. In the 1920s and early 1930s, when vitamin D was discovered, people went crazy for it. They were taking 20 mg, or what works out to over a million IU of D2. Doctors went out of business, pharmacies closed, hospitals went bankrupt. The pharmacies came up with International units in an effort to cut consumption. It worked and brought back sickness. Some doctors and Vitamin D experts believe that we need ten times as much D3 as 1,200 iu. To me, it is the one vitamin. This story is told in “The Miraculous Results Of Extremely High Doses Of The Sunshine Hormone Vitamin D3 My Experiment With Huge Doses Of D3 From 25,000 To 50,000 To 100,000 Iu A Day Over A 1 Year” by Jeff T Bowles, Asthma, MS, and many other diseases yield to D3 supplementation. Life was engineered to make use of what is cheapest and most available. What was more available than sunlight? How much sun do you think you would get based on human evolution? An hour at noon might work out to tens of thousands of units of D3. The vitamin is safe and effective at many diseases, and could be a major deficiency.




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    1. Could it simply be that vitamin D pills are suppressing the immune system, and lots of people’s diseases are being caused by an overactive immune system. So yeah, the D pill helps in one regard, but maybe it sets them up to come down with a future illness due to a suppressed immune system.




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      1. I personally think D3 activates the immune system. D3 activates a large percentage of the genome. It might even be a backbone to some kinds of genes. D3 to me is the master vitamin. In the book by Bowles, he asks if healthcare costs could be reduced by 90 percent with D3. another doctor says $18 billion.




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      2. Not true.

        This is the same argument they use on cancer patient not to take antioxidant food or supplement during chemo treatment because antioxidant “suppresses” the chemo.




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  11. Pretty sure I read that they had standardized these Vitamin D tests across the country a few years ago precisely due to the fact that they hadn’t been standardized before and the results could be all over the map from the same blood sample. I don’t think that’s the case anymore (not sure if the same standards were put in place in other countries), and it’s possible that the article featured here was drawing on that old data. If you’re considering getting tested and are shying away because you think the results won’t mean anything, this is worth looking into further before opting out.




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  12. I was taking 2,000 IU/day and at only 33.1 ng/Dl, so I bumped this up to 4,000IU/day am still at only 40.7 ng/dl. Dr Greger is saying we shouldn’t trust our labs, but its awfully tempting to use these labs as helpful pointers. If so, I would go for 6,000-8,000 IU/day — I’ve read that some MDs are suggesting that these higher intakes are essential for some people to get into the right range. The alternative is to get sun exposure as some people have recommended here, but with a history of melanoma, my dermatologist is very insistent that intentionally getting sun exposure for the Vitamin D is the wrong approach.




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    1. are you sure you don’t mean ng/ml ??
      i’m on weekly standing order bloodwork and last Monday my D3 was 57 ng/ml.
      I take 2 drops, 2000 iu sublingually.
      my D3 one week prior was 47 ng/ml so either the labs are not consistent or the blood levels fluctuate quite a bit.




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      1. Oops, you’re right. Just checked and it is 40.7 ng/ml. I’m going to edit that above to be accurate. As for your labs, maybe you got more sun the week prior to your reading of 57. Anyway, I think the answer may be to cross-check with different laboratories to eliminate variability in testing. I use LabCorp, but I could also do Quest Labs…




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  13. Up North here in New Hampshire, not much sun much of the year between clouds and latitude. We take 2,000 IU of Vitamin D3. Vitamin D3 is what the skin makes. Many supplements and additives are Vitamin D2 some of which is slowly converted to D3. FDA hasn’t done their homework. How much to take? Get your blood tested. There’s a lot more in Dr. George Jelinek’s book “Overcoming MS”. MS is much more prevalent the further away from the equator. It’s an amazing parabolic curve.




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  14. OMG I wasn’t expecting the punchline at 1:22, LOL! Great delivery. I think that one tops the 8 pounds of raspberries into the rectum (See “How not to die”, p. 69). Dr. Greger performs therapy with food and… laughter :-)




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    1. isn’t he amazing?
      we listened to the audio book on a 20 hour ride to salt lake city.
      it’s like he was in the back seat talking the whole way, LOL.
      loved it.




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      1. Good idea for a long trip, but based on the audio quality of older videos on this website, the question arose whether you could hear Dr. Greger clearly. Fortunately, audio on more recent videos has improved immensely.

        Could hearing Dr. Greger as though he were talking from the back seat mean the entire original series of individual segments was reprocessed to standardize / reset audio levels?

        Maybe that is an inducement for others to buy the audio book– so which one was it?




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        1. I never meant the AUDIO quality was bad at all but it FELT like Dr Greger was personally WITH us along the entire trip talking to us from the back seat (front seat, between us seat, whatever).

          the audio is top notch, studio quality.

          no worries about that, I was just sayin it was like he was with us the entire trip.

          not sure how you got anything else from my comment.

          donald.
          .




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          1. I understood what you said about your audio book, but based on the audio quality of older videos on this website, I wondered how at least some videos could be heard clearly. For example, some website videos of 2008-2010 require significant changes in volume to be heard.

            So, if every video in your audio book was such high quality that no adjustment of volume was necessary, perhaps Dr. Greger and/or staff had re-recorded the video for the less audible segments– but this time with better audio control.

            And that could only help sell more audio books.




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            1. alphaa10: Before there was a NutritionFacts website, Dr. Greger produced annual DVDs (“volumes”) which were meant to watched on a DVD player all the way through at once. Those early, pre-NutritionFacts annual DVDs covers something like volumes 1 thru 4 or 5. When NutritionFacts came to life, those annual DVDs were broken up in the video-of-the-day segments that you are referring to now. And yes, that set of videos has both volume and some editing issues.
              .
              Since that original set, all new videos produced for this website have the volume problem solved.
              .
              The audio book in question is a completely different animal that has nothing to do with those earlier volumes. The audio book is a brand new recording of Dr. Greger’s new book, How Not To Die. The audio book was produced by professionals in relationship to publishing the book. It’s not surprising to hear that it was well done, but the resources that went into producing the audio book are separate from what happens here on the website.
              .
              If you are making the request that the early videos on this website be re-recorded in order to fix sound problems, I’m sure the NutritonFacts staff will see your post. I have no inside information on this project. It’s my *guess* that Dr. Greger would rather spend resources just producing new videos rather than re-recording old videos. Re-recording old videos opens up a can of worms, because the older videos do not have the detail that the newer videos have. So, if we are going to re-record, then do we bring the older videos up to current video standards in terms of content? And what if the science has changed? We are basically talking a large number of brand new videos. In that case, why not just produce that brand new video as a new video of the day rather than trying to replace an old one. In fact, you will notice that when it comes to vitamin D, Dr. Greger is doing a new series now. The point is that Dr. Greger is already addressing old topics again if he feels that there is something new worth saying. I’m guessing we just don’t have time to replace all the old ones.
              .
              I’m also guessing you already know that if you have trouble hearing those early videos, you can read the transcript. I mention it just in case you did not know about the Transcript button to the right of each video.




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              1. Thea– Thanks for the background. I had presumed the website selections were the original content, but in fact, the DVDs are. In any case, when I see a website video publication date of 2008-2010, I know to adjust my volume. And yes, I have used the transcript option to discern what Dr. Greger said– with many thanks to the volunteers who spend hours transcribing.




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  15. I have read that Vitamin A inhibits the absorption of Vitamin D. I was taking an eye supplement with Vitamin A in it and also taking Vitamin D2. A blood test showed I was low in D. I will no longer take the supplement with Vitamin A and see if that makes a difference. I know, I know. The test for D is not reliable.




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    1. Hi Terri,
      Most “eye supplements” contain beta-carotene (and/or other carotenoids) rather than pre-formed vitamin A. Carotenoids should not have any interaction with Vitamin D (to my knowledge, anyway), but in any event if you’re taking a D supplement I’d recommend D3 instead of D2.




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  16. I live in South Texas and I practice sun tanning in my bathing suit for about 20 to 30 minutes per day. And, I wear a hat. I think anything over that and you might start getting skin damage. But, you get more than vitamin D from sun exposure you also get a build up of nitric oxide which helps to promote vasodilitation. I imagine there are many more benefits besides these two benefits. Obviously sun exposure on your skin probably has some bactericidal effects also. I have been watching these videos now for about 5 months. I did a search on this website on the topic of fasting. I am really surprised that Dr Greger has not presented any information of fasting since research shows that the fewer calories you take in the longer you are going to live. Intermittent fasting on a whole plant food diet has been shown to rapidly bring down total cholesterol levels, IGF-1 levels come plunging down, hypertension becomes normal, and obviously weight loss becomes really easy. The trick is to maintain MOTIVATION to do intermittent fasting. And, the only way you can stay motivated is to read the research of how fasting helps the brain to grow new neurons, helps the immune system, and many more postive biological gains. So, am I missing something, has Dr. Greger touched upon this super important health topic?




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  17. I get a level of ~60 when taking 7,000 D3 per day year round….(Labcorp)…tested in spring…early summer…not a lot of sunbathing…




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  18. With such limited effects from the clinical trials (and with their risk of reporting bias), I think the causality confusion remains on whether D supplementation has any effect on longevity. In better controlled experiments, mutations that disable the vitamin D receptor or induce hypervitaminosis D both cause premature aging, which alas mostly says that hormonal signalling networks work more poorly when wires are ripped out.

    A possible mechanism for how adequate vitamin D might slow aging is autophagy, the damaged organelle & protein aggregate “spring cleaning” that appears to play an essential role in life extension. Vitamin D3 induces autophagy in immune cells, inhibiting infection by HIV and tuberculosis bacteria. Some have argued that autophagy induction is a major benefit of vitamin D.




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  19. I haven’t seen this posted elsewhere, but does anyone have a recommendation on the best D3 supplement (specific brand)? I’m having trouble finding a vegan source without oil (coconut, sunflower, etc.). Looking at all the options is enough to make my head spin! Had Dr. Greger ever said what he brand he takes?




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    1. Matthew: I just Googled “Vegan Vitamin D3”, which at least cuts out those products with gelatin (collagen, mostly from animal sources). There is still a wide variety available. You can get drops, chewable gummies, capsules, and tablets. Capsules can be a little easier to swallow than tablets, if that’s a concern. Many of them don’t have a full ingredient list. A few that DO list all the ingredients are:
      Tablets:
      1) MegaFood brand, Vit D3, 2000 IU; “Other ingredients: plant cellulose, vegetable lubricant, silica”; certified gluten free, dairy free, soy free. Costs $26.98 for 90 tabs, from “iHerb”
      2) Solgar brand, Vit D3 1000 IU; “Other ingredients”: microcrystalline cellulose, vegetable cellulose, vegetable stearic acid, silica, vegetable magnesium stearate, vegetable glycerin, riboflavin. Costs $10.16 for 180 tabs, from “iHerb”.
      Capsules:
      1) MRM brand, Vit D3 2,500 IU; derived from lichen; “Other ingredients: rice flour, cellulose capsule, modified starch, maltodextrin, sucrose, silicon dioxide and antioxidants (d-alpha tocopherol and ascorbyl palmitate).” Contains no dairy, egg, soy, wheat, or gluten. Costs $8.77 for 60 capsules, from PureFormulas.com.
      Hope this helps.




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  20. Note that negative health effects won’t start at 10,000 IU/day (with typical calcidiol levels of 250 nmol/l). This level has been argued as a safe upper limit because it is about the maximum level you can get from Sun exposure on the long term, and it is much lower than the estimated minimum level of about 40,000 IU/day that you need to get into the danger zone where you can get hypercalcemia. As pointed out here:

    http://ajcn.nutrition.org/content/88/2/582S.full

    “…the wealth of animal studies and human anecdotal reports of vitamin D intoxication indicate that plasma 25(OH)D3 is a good biomarker for toxicity, and the threshold for toxic symptoms is ≈750 nmol/L. This threshold value implies that 25(OH)D concentrations up to the currently considered upper limit of the normal range, namely 250 nmol/L, are safe and still leave a broad margin for error because values significantly higher than this value have never been associated with toxicity.”




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  21. This is going to be a little lengthy, but I really need some plant based medical advice. I am 54. I have had osteopenia in my spine and hips for several years. It runs in my family and I have just gone through menopause. I started eating plant based about 18 months ago. I had bone density scans in 2010, 2013, and 2016. The first and last ones were on the same machine and the middle one was on a different machine. Evidently, they can’t compare my results on different machines. This last scan showed that I went into osteoporosis in my spine and my hips have decreased in bone density but not to the osteoporosis stage. I was really hoping that my 18 months of plant based eating would be correcting the low bone density. I can’t know for sure if the decrease was before the 2013 scan and my plant based eating or after that scan, because of the different machine. My doctors is concerned and would like to put me on medication. She is supportive of my plant based eating and is willing to wait for 2 more years to see how things look then, since my bone fracture ratio isn’t in a bad range yet. She wants me to take vitamin D and Calcium though. I do take vitamin D. I have been taking 1,000 IU a day but plan to up that to 2,000 after watching this video. I have to be careful with sun exposure since I have already had a few rounds of skin cancer. I quit taking calcium supplements about a year ago.

    I have loved plant based eating and the optimistic outlook on aging that it has given me. I am fairly active and would like to stay that way. I don’t want bone fractures to be a part of my future. So my question is – should I wait the 2 more years before another scan, increase vitamin D to 2,000 a day, take calcium supplements, do more weight resistant exercise, and see if there is further decrease in my bone density? Or is there something else I should do? I really don’t want to start taking the medication, but don’t want any bone fractures either!




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    1. Alena: From my research, there are two keys to having healthy bones, proper diet and proper exercise. For diet, I highly recommend the book, Building Bone Vitality. https://www.amazon.com/Building-Bone-Vitality-Revolutionary-Osteoporosis–Without/dp/0071600191/ref=sr_1_1_twi_pap_1?ie=UTF8&qid=1467768483&sr=8-1&keywords=building+bone+vitality That book will help you understand all the nutrients necessary for bone health, including putting calcium into perspective. The book would help you understand that calcium is just one of many substances which make up our bones. It might help you plug some holes in your diet??? And it might help you decide if supplementing with calcium is really a good idea or not.
      .
      Also for diet, I highly recommend Dr. Klaper’s talk on healthy bones. I heard him speak live, so I don’t know if the following talk would include all of the information or not, but hopefully it covers the same basic information, including which foods add to bone health and which foods to stay away from: http://doctorklaper.com/webinars/healthy-bones-preventing-reversing-osteoporosis/ This talk includes some information about foods to stay away from that the above book misses.
      .
      These sources are also great compliments for each other in exercise area. Not just any exercise will help your bones. The book explains about that. But Dr. Klaper goes into some specific suggestions on how to walk to help your bones.
      .
      In the talk I heard, Dr. Klaper also went into what is wrong with the osteoporosis drugs. They increase bone density, but not necessarily stop fractures! If you watch the talk and he doesn’t cover the drugs, let me know an I’ll try to summarize the information.
      .
      Good luck to you!




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      1. I meant to add: You doctor is right on target and gets good credit for recognizing that bones are “slow moving organs”. So, it makes sense to do some interventions and give it time to take effect. I’m glad she is giving you a couple of years to work on it.




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        1. jj: I agree. But if the talk covers the information I heard live, it is worth it (in my opinion) for someone in Alena’s situation.




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    2. You mention your “first and last (scans) were on the same machine”, 2010 and 2016 respectively, so your concern is whether the last 18 months on a WFPB diet has improved matters for you, despite the overall decline in bone density. The only way to isolate the effect of your dietary change 18 months ago is to compare your 2016 scan with one next year or even as late as 2018.




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    3. Alena – Thea has given you some good advice and resources. I would add that Brenda Davis has a you tube clip on this topic and her books cover it too – she has been religious about getting ample calcium from food and supplements and doing weight bearing exercise and credits her good bone density to these practices. My experience is very similar to yours and I am the same age. I think that plant based eating has the potential to make bone density worse due to the drop in calcium and protein, although this way of eating it good for other things. However, as Brenda Davis’s experience shows, if you can get plenty of calcium, protein and exercise, everyday, then bone density can be preserved on a plant based diet and perhaps even improved.




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    1. There’s not a lot of long term research comparing dosing methods. Also, optimum dosing methods may be different depending on your objective. The Mayo Clinic website has a lot of info on doses used in research.
      However, as far as I know, whether you supplement daily, weekly or monthly does not make a big difference.




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  22. This study says there may be no real benefit to supplementing vitamin-D. And a 60-Minutes news (video) article that tested supplements bought from a random array of stores showed that few supplements contain what they claim on the label. I stopped taking Vitamin-D a month or two ago. I guess I’ll try to get a little more sun exposure (not mid-day, of course) find out if I’m deficient on my next blood test.

    https://www.thestar.com/news/canada/2016/06/17/vitamin-d-has-few-medical-benefits-edmonton-study-says.html




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  23. I’m a 60 year-old vegan. I live on the coast and walk on the beach everyday. 12 years ago I was diagnosed with malignant melanoma so I cover up and wear sunscreen. I’m 5’5″ 115 lbs. I’ve have joint pain and lethargy so had blood levels checked. Everything looked great except my D – it was down at 11 which I was told is critically low. The doctor prescribed 3,000 units a day but a friend who does health coaching suggested 12,000 units a day for a month to 6 weeks and then dropping down to 2,000 to 3,000 per day. I’m not sure what is optimum. I’m taking a vegan D3 derived from lichen in liquid form sublingualy then follow with a squeeze of lemon (for better absorption). Given what you’ve said here I’m not sure where I should be given my extreme low level (and now wondering if it’s even accurate!). Thanks so much for any input. You SO helped me a few years back with my young son . . .




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  24. Totally confused with all the units. nmol/litre, ng/ml?? What are IU’s? I wanted to know HOW I get my vitamin D. What foods etc. HELP!! British government now saying we need to eat more eggs and tuna. Is this rubbish? Ben




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  25. It seems like there is so much conflicting information about topics such as this, even from doctors that support plant based diets, etc. It’s very frustrating. For example, I saw this article regarding Vitamin D that say such supplements and unnecessary, can be harmful and should be avoided: http://www.forksoverknives.com/vitamin-d-supplements-are-harmful-sunshine-and-food-determine-health/ I seriously no longer know what to do…




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    1. Thanks for your comment Shrewby.

      I understand your point as a health professional myself, sometimes it is hard to keep up with what’s the latest science on any given topic. I just read the article shared & it is written by a very good physician (Dr John McDougall). This is solely based on my opinion.

      While I certainly do agree with Dr McDougall, I think his article was focusing more on fracture risk and therefore I personally find the information presented here by Dr Greger is more to do with the benefits in helping the average person live longer.

      I think this summary really points out the main take away points.

      Hope this answer helps.




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  26. Just had blood work done. I am severely low on Vitamin D, my doctor told me the same, take 2,000 IU/day until my next blood work which is in 6 mos. 1) I am outside for an hour + a day at times walking or running 2) I live in a City that has endless sunshine year around




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    1. Michael,

      Actually, the amount of vitamin d will vary dependent on a number of factors including your genetics. As an example, those from equatorial areas have different efficiencies for vitamin D and may need less. The literature seems to be suggesting somewhere between 50-70 is the current consensus, for the progressives, with anything above 32 as acceptable ,conventionally. You might want to view some of Dr. Greger’s videos regarding vitamin d at:
      http://nutritionfacts.org/?fwp_search=vitamin+d&fwp_content_type=video Dr. Alan Kadish Moderator for Dr. Greger




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  27. I’m an ethical and practical vegan, eating as much WFPB as possible. On a fixed budget, vegan D-3 supplements are too expensive, but I have many, many bottles of lanolin based D-3. What are the possible damaging effects of taking an animal based D-3?




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  28. What s the latest with Vitamin D and multiple sclerosis. Do MS patients need more D?I was taking SUPPLIMENTS W D3 and finally got tested. I don’t spend much time outside. I eat lower carb items- no milk. The total I was taking ended up 7600IU/day. I felt very good. Finally got tested a month ago and my D level was way too high for my internist at 104 ng/ml. So til next test in 6mo.For now I’m taking 800iu/day in my Calcium pill of which I am also taking ½ the amount or 500mg. The label says 1serving(=2tabs) twice a day which was 1600IU Vit. D. and 1000mg Calcium. I assume this is the recommended amount for the public. I don’t know if I was ever deficient but I worry about taking less than 1000IU considering some new evidence that it helps those with MS. Doesn’t seem to be a consensus of opinion on this. I am over 68yrs of age.




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    1. Please see http://www.overcomingms.org for evidence based recommendations,

      Summary here:

      The Overcoming Multiple Sclerosis Recovery Program in Summary:

      Diet and supplements
      • A plant-based wholefood diet plus seafood, with no saturated fat, as far as is practical
      • Omega-3 fatty acid supplements: Take 20-40mls of flaxseed oil daily; fish oil can be used instead if desired
      • Optional B group vitamins or B12 supplement if needed

      Vitamin D
      • Sunlight 15 minutes daily 3-5 times a week as close to all over as practical
      • Vitamin D3 supplement of at least 5000IU daily, adjusted to blood level
      • Aim to keep blood level of vitamin D high, that is between 150-225nmol/L (may require up to 10,000IU daily)

      Meditation
      • 30 minutes daily

      Exercise
      • 20-30 minutes around five times a week, preferably outdoors

      Medication
      • In consultation with your doctor, if a wait and see approach is not appropriate, take one of the disease-modifying drugs (many may not need a drug, and drug selection should be carefully weighed against side effects)
      • Steroids for any acute relapse that is distressing
      • One of the more potent drugs if the disease is rapidly progressive




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  29. Hello,

    To Dr Greger,

    I have been wondering if you have thought about doing a video detailing which supplement type is best… Capsule, gel, liquid or tablet. Just recently I have decided to switch to an gel based supplement that has the following ingredients … INGREDIENTS: Vitamin D3 10,000 IU, Sunflower oil, Capsule Shell (Gelatine, VITAMIN D3 Glycerine), Vitamin D3 (Cholecalciferol).

    As you can see there is oil in there but only a small amount. I know this is bad but when you compare it to my previous tablet based supplement well look for yourself… Vitamin D3 5000IU, Bulking Agents – Dicalcium Phosphate, Microcrystalline Cellulose, Magnesium Stearate, Silica.
    Surely in this case the latter is the worse of the two? I mean eating silica?!
    If you could reply I would be very appreciative.
    Many thanks!




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    1. Harry,

      Not so sure you’re going the right direction. First there is no ideal format for all supplements. The differences should be based on numerous factors including, where the product is absorbed, sublingual such as B 12 or the intestinal tract, with an enteric coating or…… it’s the rest of the story that counts and this is a huge consideration.

      The sunflower oil, if not organic can be a processed issue with both solvents and pesticides….. Silica is considered very safe and inert and not an issue for fillers in tablets and capsules.

      On the other hand the magnesium stearate may be a slight issue and is being debated in supplement circles. With all that…the best approach is use the least excipients necessary to maintain the quality of the ingredients.. The big take away is that to get the benefits of vitamin D it NEEDS to be taken with a meal that contains oil for it to be absorbed at meaningful quantity.

      I would suggest that you have your vitamin d levels when your taking the d with oily meals for 4-6 weeks and see if you need 10Kiu to get into the 50 range.

      Dr. Alan Kadish moderator for Dr. Greger




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      1. hello alan,

        I agree with your post but am not too sure about the part where vit D “needs” to be taken with fat. that may be more of a theoretical idea rather than one where double blind, placebo controlled trials have been done.

        i’m a NO FAT Vegan for 6 years now, have been taking 2000 IU Vit D3 Drops for several years and have always been in the mid 40’s-mid 80’s range depending, I guess, on the season and maybe even my activity level. who knows. I would like to take more but I’m very averse to oils if you have followed my history so I limit it to two drops.

        for the last year, I was on weekly routine bloodwork so I’ve got a pretty good idea of where my levels are at and now am going to more of a 2-4 week routine bloodwork schedule.

        my blood level on 12/06/16 was 43 and I haven’t been in the sun at all recently so that’s a good idea of where i’m at in the winter. I remember prior to taking vit D3 that I was actually in the low range so the 2 drops has, let’s say, ‘doubled’ my levels.

        just some food for thought.

        donald.

        .




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  30. Hello,

    In regards to supplementing vitamin d3, which is best daily or weekly? I have heard some people take daily doses whilst others take the weeks supply on (for example) Monday and then wont take it again till next Monday, is this okay? So instead of taking 2000iu 7 days a week you would take 14000iu one day per week and not have to think about it again till next week.

    Any info on this would be greatly appreciated!




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  31. Hi James: Dr. Greger recommends 2,000 IU of vitamin D3 supplement each day for people who are unable to get sufficient sun. Ideally, this is taken with the largest meal of the day. Hope this helps!




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  32. I think a lot of people would love if the doctor publish a book with plant based complete meal plans (detailing breakfast, lunch and dineer for each day) and including recipes, both for geting a plant based diet without nutritional deficiencies and for knowing how to complete daily dozens every day at a practical level. Thank you




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