The Optimal Dose of Vitamin D Based on Natural Levels

The Optimal Dose of Vitamin D Based on Natural Levels
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Why do some recommend thousands of units of supplemental vitamin D when the Institute of Medicine set the recommended daily intake at just 600 to 800 units?

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If everyone took 2,000 units of vitamin D a day, it could shift the curve from average blood levels in the mid-50s to about 110 [nanomoles per liter], which some estimate could add years to our life expectancy. Data derived from randomized clinical trials have convinced some influential experts, such as Harvard’s Chair of Nutrition, that we should shoot for this kind of range—levels that about nine out of ten people fail to reach, because it may necessitate taking between 1,800 and 4,000 units a day.

The Institute of Medicine, however, considered blood levels of 50 to be sufficient, and, therefore, only recommended 600 to 800 units a day for those with little or no sun exposure, because they were only considering bone health. But even if you just cared about your bones, and not your lifespan, you’d still probably want to shoot for the 75 threshold, because there’s evidence like this— from hundreds of autopsies of people that like died in car accidents showing osteomalacia (softening of the bones) in between 18 and 39 percent of people that reach the Institute of Medicine target, but fail to make it to 75.

There’s even been a charge that the Institute of Medicine simply just made a mistake in their calculations, and, using their own criteria, they should be recommending thousands of units a day as well. But the mere absence of soft bones can hardly be considered an adequate definition either of health or of vitamin D sufficiency. It’s like saying you only need 10 milligrams of vitamin C to avoid scurvy—yeah, but we need way more than that for optimal health.

The Institute of Medicine took the position that the burden of proof fell on anyone who claimed benefits for intake higher than their minimal recommendations—which is a good approach for drugs. For unnatural substances, less is more, until proven otherwise. But for nutrients, shouldn’t the starting point, at least, be the natural levels to which our bodies have become finely tuned for millions of years?

The target level of 75 only sounds high compared to average levels today. But in modern times, we practice unnatural activities, like working at a desk job, or, sometimes, even wearing clothes. We evolved running around naked in equatorial Africa, getting sun all day long.

If you measure vitamin D levels in those living traditional lives in the cradle of humanity, a normal vitamin D level would be over 100. So, maybe that should be the starting point, until proven otherwise; a concept, regrettably, many guidelines committees seem to have ignored.

Now look, the natural level isn’t necessarily the optimal level. Maybe the body would have thrived with less. So, you still have to look at what levels correspond to the lowest disease rates. And when you do, the highest levels do indeed seem to correlate with less disease.

You know, it always struck me when I was doing pediatrics, that breastfed babies required vitamin D drops. I mean, shouldn’t human breast milk be a perfect food? Of course, for the medical profession, the solution is simple, right? Provide the baby supplements: the drops. But it seems like we shouldn’t have to. It should be perfect. But look, you measure human breast milk these days, and it has virtually no vitamin D, and would cause rickets, unless the mom has vitamin D levels up around, you guessed it, the level natural for our species, which, of course, makes total sense.

So, it’s just like an environmental mismatch, the way we live in our modern world. It helps to think of vitamin D as what is truly is—a hormone, not a vitamin. So, if you think of it like that, then it would be reasonable to have normal levels. We physicians try to maintain blood pressure, and all sorts of parameters, within normal limits, “but why is so little attention paid to the status of the hormone ‘vitamin D’?”

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 skeeze via Pixabay.

If everyone took 2,000 units of vitamin D a day, it could shift the curve from average blood levels in the mid-50s to about 110 [nanomoles per liter], which some estimate could add years to our life expectancy. Data derived from randomized clinical trials have convinced some influential experts, such as Harvard’s Chair of Nutrition, that we should shoot for this kind of range—levels that about nine out of ten people fail to reach, because it may necessitate taking between 1,800 and 4,000 units a day.

The Institute of Medicine, however, considered blood levels of 50 to be sufficient, and, therefore, only recommended 600 to 800 units a day for those with little or no sun exposure, because they were only considering bone health. But even if you just cared about your bones, and not your lifespan, you’d still probably want to shoot for the 75 threshold, because there’s evidence like this— from hundreds of autopsies of people that like died in car accidents showing osteomalacia (softening of the bones) in between 18 and 39 percent of people that reach the Institute of Medicine target, but fail to make it to 75.

There’s even been a charge that the Institute of Medicine simply just made a mistake in their calculations, and, using their own criteria, they should be recommending thousands of units a day as well. But the mere absence of soft bones can hardly be considered an adequate definition either of health or of vitamin D sufficiency. It’s like saying you only need 10 milligrams of vitamin C to avoid scurvy—yeah, but we need way more than that for optimal health.

The Institute of Medicine took the position that the burden of proof fell on anyone who claimed benefits for intake higher than their minimal recommendations—which is a good approach for drugs. For unnatural substances, less is more, until proven otherwise. But for nutrients, shouldn’t the starting point, at least, be the natural levels to which our bodies have become finely tuned for millions of years?

The target level of 75 only sounds high compared to average levels today. But in modern times, we practice unnatural activities, like working at a desk job, or, sometimes, even wearing clothes. We evolved running around naked in equatorial Africa, getting sun all day long.

If you measure vitamin D levels in those living traditional lives in the cradle of humanity, a normal vitamin D level would be over 100. So, maybe that should be the starting point, until proven otherwise; a concept, regrettably, many guidelines committees seem to have ignored.

Now look, the natural level isn’t necessarily the optimal level. Maybe the body would have thrived with less. So, you still have to look at what levels correspond to the lowest disease rates. And when you do, the highest levels do indeed seem to correlate with less disease.

You know, it always struck me when I was doing pediatrics, that breastfed babies required vitamin D drops. I mean, shouldn’t human breast milk be a perfect food? Of course, for the medical profession, the solution is simple, right? Provide the baby supplements: the drops. But it seems like we shouldn’t have to. It should be perfect. But look, you measure human breast milk these days, and it has virtually no vitamin D, and would cause rickets, unless the mom has vitamin D levels up around, you guessed it, the level natural for our species, which, of course, makes total sense.

So, it’s just like an environmental mismatch, the way we live in our modern world. It helps to think of vitamin D as what is truly is—a hormone, not a vitamin. So, if you think of it like that, then it would be reasonable to have normal levels. We physicians try to maintain blood pressure, and all sorts of parameters, within normal limits, “but why is so little attention paid to the status of the hormone ‘vitamin D’?”

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 skeeze via Pixabay.

Doctor's Note

If one is going to make an evolutionary argument for what a “natural” vitamin D level may be, how about getting vitamin D in the way nature intended: sun instead of supplements? That’s the subject of my next video, The Best Way to Get Vitamin D: Sun, Supplements, or Salons?

This is the fourth video of a six-part series on the latest in vitamin D science. If you missed the first three, check out:

After The Best Way to Get Vitamin D: Sun, Supplements, or Salons? I’m going to close out with The Risks and Benefits of Sensible Sun Exposure.

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

183 responses to “The Optimal Dose of Vitamin D Based on Natural Levels

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    1. PCRM’s warning about cancer risk from HRT is in reference to ovarian hormone replacement. In general, HRT (hormone replacement therapy) refers to sex steroid hormone replacement therapy and most of the time it’s estrogen that’s being discussed but sometimes testosterone as well. There are many hormones in the body. PCRM doesn’t have a position against replacing hormones categorically. Conditions like hypothyroidism, type 1 diabetes, Addison’s disease just to name a few can be life threatening without the appropriate hormone replacement (thyroid, insulin, cortisol). They certainly don’t have a position against Vitamin D (hormone) replacement and state that it probably needs to be replaced in people who don’t get regular sun exposure.




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    2. How is it that pill-mongers and their thinking keep keep trying to take over the vegan world? I thought that we were headed for a diet of organic whole foods, not hormone supplements plus whatever? So ALL of the results in these papers discussed keep addressing Vit D as if that were the only thing that we need to be worried about. Let’s remember that correlation does not equal causation. Those folks in Africa are generally eating and living a lot better than the folks in Europe–so it’s a lot more than sun and Vit D that predicts disease. Sorry, I get quite upset when I see a complex issue like health (and blood chemistry) being boiled down to a single component like Vit D. It’s nonsense and you shouldn’t fall for it. Cheers.




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      1. Doctor Dave I eat amazingly 99% of the time. I run/exercise almost daily. However I have a few autoimmune diseases. The data is promising regarding D levels. I wouldn’t through the baby out with the bath water quite yet.




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      2. And as you know if you cover one topic in detail it could appear to be crying wolf but we take the entire accumulated body of research presented on this website.




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      3. DoctorDave, give me a list of foods that will provide me with sufficient vitamin D. I cannot get enough vitamin D from the sun because I am not outside enough due to my job and the only source of vitamin D for me is either food or supplement.

        Also we are talking about optimal health here. Granted there are millions of people who don’t get enough vitamin D from either the sun, foods or supplement and still live well. But there are also millions who get sick or die prematurely.




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        1. If you are not getting outside enough due to your job (apparently you only need somewhere between 5-30 minutes a few times a week depending on latitude and skin tone), then I would recommend a new job. Vitamin supplements are not going to make an overworked person more healthy. It’s like saying my job prevents me from getting exercise, so give me a list of foods that will give me the same benefits of exercise. The irony of all this discussion about vitamin D on nutritionfacts.org is that it’s one vitamin we don’t need in our nutrition/food.




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          1. Well if I lose my current job and cannot find a better job then I cannot afford to buy and eat healthy foods which is worse. The last thing I want to do is to be able to be outside in the sun and then eat hamburger :)

            In order to get vitamin D from the sun then they say in the literature that one has to be outside between noon and 2:00PM if I recall correctly. That’s right during my busy time at work.




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            1. I use an app called dMinder that tell me when I can make vitamin D from the sun. It’s not a perfect app in all it’s features, but it’s very useful for telling you when sun bathing is optimal and for timing your session. If you use the paid version, it keeps track of your sunbathing sessions. Where I live in central coastal California, I can make vit D from the sun10 months a year. Only for a couple hours around noon in November and February, but today I can make it from 8:39 am until 5:45 pm.




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              1. Thanks, I just download dMinder. I didn’t realize that there are a number of apps for vitamin D. I will try them all eventually.




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          2. Not necessarily…I can exercise in a gym (indoors). I leave my home at 5:30 am get home at 7pm. I live in a cold weather city so we only get real sunshine about 6-7 months out of the year. So, should I move to Africa or Arizona? Quit my job or move or take a-single-one-uno supplement.
            The holistic approach to this site explains all the other nutrients etc. Vitamin D supplementation is a small fraction of the overall discussion.




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      4. Yes, but if your hormone-levels are below the hormone-levels of long-living populations you could guess a causation.
        Also you do exactly know why your hormone-levels are lower (clothes, living inside). This strengthens a possible causation.

        After the randomized controlled trial, that shows that Vitamin D levels (supplements) lengthen lifespan the causation is nailed.

        Of course, there are other factors that can cause diseases, But low Vitamin D IS one if them. you are not only headed for a diet of organic wholefoods but also a life outside in the sun around africa…




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      5. Yes, but if your hormone-levels are below the hormone-levels of long-living populations you could guess a causation.
        Also you do exactly know why your hormone-levels are lower (clothes, living inside). This strengthens a possible causation.

        After the randomized controlled trial, that shows that Vitamin D levels (supplements) lengthen lifespan the causation is nailed.

        Of course, there are other factors that can cause diseases, But low Vitamin D IS a factor for preventing disease. You are not only headed for a diet of organic whole foods, but also a life outside in the sun around africa… (or supplements)




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  1. The research and information about the role Vit D plays in autoimmune diseases is fascinating and also exciting for people with autoimmune diseases. Has our aversion to being in the sun caused the uptick in autoimmune diseases?




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  2. I have light-colored skin. More than a few minutes in the sun will cause it to burn. I got a nasty burn on my neck the other day just while wearing a baseball cap instead of my usual hat which drapes around my neck, even though I was wearing sunscreen. ( I have to wear long sleeves and gloves as well). I was only out for a couple of hours. I imagine that the sunburn will eventually cause wrinkles too. I’d much rather live an unnatural life and take supplements than suffer from burns and wrinkles.




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    1. A little bit of fun in the sun is worth a wrinkle or two. Life brings wrinkles, I’m going to have a few more before I’m done.

      I’m fair-skinned and get over-exposed now and then, a few times per year. I work and play out of doors, use hats and sleeves and sunscreens to reduce UV exposure and damage, but not perfectly so. When playing I try to use early and late hours and shade as much as possible, often this is impossible at work. Have faint flip-flop tan lines I need to work on.

      But I’m still not sure if I’m supposed to start taking my D3 again or not.




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      1. Fun in the sun without sunscreen and without covering also brings ugly brown spots and possible skin cancers. Why wasn’t this caveat included and how do we avoid this while getting the prized vitamin D from the sun?




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        1. Friday video — The Best Way to Get Vitamin D: Sun, Supplements, or Salons?
          Next Monday video — The Risks and Benefits of Sensible Sun Exposure.




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    2. Perhaps one of Dr. Greger’s videos has already addressed this, or one of the research papers he’s cited has (but the info wasn’t included in the video): How much does the amount of sun exposure required to attain a certain level of vitamin D (say the whopping 115 nmol/L level) differ by skin tone / melanin concentration?

      I ask this because I had my vitamin D level tested years ago by a keen physician, and found it was really low (can’t recall the level now, think it was 15 nmol/L). He joked about how it was the lowest level he’d seen other than an infirm black woman. He explained that skin pigmentation combined with northern latitude seriously impaired ability to synthesize vitamin D. A short while later, I came across an article that referenced a Canadian study (believe it was UofT) that came to the same conclusion.

      Perhaps half an hour a day is sufficient for someone living in equatorial Africa or S. America with pigmentation close to that of historical native population. Less would be needed for someone lighter skinned living at the equator. Conversely, more would be needed by someone native from that area but lives at a more northern latitude. Would be cool if someone worked out a formula for it.




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      1. Dr Hollick who did many studies on Vitamin D has charts in his book, I have seen them but not sure of the name of the book anymore. HOwever you could look on line.




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    3. Im also very light-skinned but i dont burn easily. May be because i take astaxanthin, get tocotrienols and many other anti-oxidants from food which protect the skin.




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    4. The great thing is you have that choice. Unlike mideastern women who do not. But as a society when we learn valuable information such as this we can make informed decision how to live life and how to vote for and demand changes in society to foster better life.




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  3. Why assume babies need vitamin D from mothers milk and not from the sun? And why point out blacks and hispanics have lower vitamin D and lower health outcomes – They have lower health due to socioeconomic reasons and they have lower vitamin D due to their skin naturally producing less vitamin D (and perhaps also due to their poorer health). I love your work Dr Greger but am disappointed in this video series to be honest. There is still no scientific consensus apart from staying above 20ng/ml.




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    1. If you look at the charts in this video and attached articles it seems pretty convincing to me. Granted this can change with new data but as of today I am going to get my level up. Any down side?

      Since I started supplementing 3 weeks ago I have slept better then I have in years.




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    2. You might die before you find consensus? Best to go with the best available science?

      I’m surprised by Dr Gregers conclusions on vit D…I was expecting a hit piece of sorts. I’ll be thinking of bumping my D level from 60 to 100.




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    3. Dr. Greger makes a very strong, convincing and rational case for the optimal dose of vitamin D based on mostly very recent research papers
      by the foremost vitamin D researchers such as Drs Holick, Vieth, Heaney, Garland and several others … who all agree, for the past 5-10 years,
      that adequate levels should be > 75 nmol/L [> 30 ng/mL, conversion factor 0.4 or 2.5]. There is scientific consensus – except for the strange
      findings and recommendations of the IOM.
      Vitamin D absorption through the skin from the sun (by way of several intermediate steps) is clearly the most natural way of obtaining adequate
      levels (as opposed to insufficient levels < 75 nmol/L and deficient levels < 50 nmol/L [ < 20 ng/mL]).
      The decisive variable is skin pigmentation = melanin content in the skin cells = standardized as skin types I – IV. The variations in inherited basic skin pigmentation is a perfect example of natural selection in relation to geographical latitude … Fast forward: If a person has skin type I with
      poorly pigmented (or freckled ) white skin and red hair, he or she should indeed avoid direct sunshine … and should ideally not be living in a
      low latitude environment. That was the big mistake of colonisation of tropical countries by "fair"-skinned people who suffer and complain
      about the inevitable consequences of intense sunshine (and heat); skin cancers etc. However, any individual with skin type II-IV can adjust
      to direct sun exposure even in the tropics and still derive most of his/her vitamin D needs from (greatly varying) regular sun exposure, such
      as only 10-15 minutes of full body exposure for skin type I-II and II, and as long as 60-120 minutes per day for skin type IV (all without the
      use of sunscreens!). A protective suntan may be slowly built up over weeks and months, and should be supported by polyphenol-rich
      nutrition.
      [ I live in Hawaii, at 19.6 º latitude, skin type I-II, almost daily short direct full-body sun exposure of 12 – max. 20 minutes, and my Vitamin D
      [25(OH)D3] levels vary from min. 45 ng/mL [112 nmol/L] to 65 ng/mL [162 nmol/L]. Years ago I combined long afternoon sun exposures while
      working on my farm without a shirt with vitamin D3 supplementation of 2000 IU/d and found myself with a lab result for 25(OH)D3 of
      105 ng/mL = 262 nmol/L ! I survived … and no adverse effects were noticed. Hypercalcemia may start at/around 150 ng/mL according to
      Prof. Vieth. An average vitamin D, 25(OH)D3, level of 45 ng/mL [112 nmol/L] keeps me healthy at the ripe old age of 82 … living among an
      ethnically very diverse population where the majority "suffers" from either vitamin D insufficiency (<75 ng/mL) or even deficiency (< 50 nmol/L).
      But most of the surfers and lifeguards "are above average" …]
      Dr. Greger has done a great service for Public Health with this post on the optimal dose of vitamin D !




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    4. Several of his sources indicate 75 mol should be considered the target. I have not yet met anyone that comes close to that. I work with patients who get this tested yearly and they range from 8-42. The best source of Vitamin D is from the sun, but for babies.. most mom’s aren’t going to risk other issues by setting their babies in the sun, without sunscreen. I work with a population of predominantly black patients and they tend to have the higher of the vitamin D levels.




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  4. Excellent video!

    Slightly off-topic: has Dr Greger ever talked about the health aspect of becoming a blood donor? Benefits? Risks? I want to know! :)




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    1. Largest risk I assume is from infection due to the need to pierce your skin to draw your blood. Any other risks are likely attached to people which may have health issues that would cause them distress from loosing so much blood so rapidly.




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    2. Yes he has although you’ll have to dig for it. The gist: donating blood is an easy way for one to reduce iron levels if they are excessive




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    1. Maybe, maybe not. But it’s clear that meat eaters have lots of other risks and problems. And if the way meat eaters get D is from vitamins added to animals, I think I’d rather just take the vitamin myself and skip the health problems caused by animal products.




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        1. I haven’t researched it. I believe dr Greger mentions in the series that three level in meat is added, not naturally occurring. Cod liver oil certainly seems to have plenty naturally occurring. I wouldn’t want to touch it; it’s fish and it’s from the liver, a filtering organ.




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  5. Dr Greger needs to talk about taking vitamin K supplement (MK-7 to be exact) or otherwise taking vitamin D alone will cause calcium to be deposited in the wrong place (i.e. kidney stone, arteries plaque instead of bone).




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        1. This is correct. Vitamin K1 cannot be absorbed by the body. Only vitamin K2 is and it comes from a few foods such as fermented foods like you said, notably the natto or Japanese fermented tofu. I tried it but could not do for long so I have to take supplement. Other than natto, there are only a few foods such as egg that have K2 but much less than natto. Other than eating natto, there is not too many foods that give you enough vitamin K2 and then you have to eat a lot of those foods.

          Kale has a lot of vitamin K but that’s K1.




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          1. From what I’ve read, certain fermented cheeses, poultry dark meat, and many poultry livers are high in K2. I just went eat any of those things so I take supplements derived from natto. My endocrinologist has no problem with this.




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              1. Jimmy: What supplement contains the 2700 mcg of K2? And do you have a reference for the ideal dosage of K2 being 2700? And is that MK-4 or MK-7? Thanks! Barry




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            1. Jimmy: Brenda Davis and Vesanto Melina wrote a reference book called Becoming Vegan. They did extensive research into individual nutrients, including vitamin K. On page 119 of the Express Edition, the book says: “If you follow popular health gurus on the Internet, you may wonder if you need supplemental vitamin K2, since little of this form is present in a vegan diet. At this time, there is no scientific evidence to suggest that vegans need to worry about supplementing with Vitamin K2.”

              That’s a trustworthy source. They make note that leafy green veggies are vitamin K superstars. And it is easy to get enough Vitamin K on a whole plant food diet. That seems to be all we need to worry about. There is no (credible) scientific evidence, at least by 2013 that says otherwise.

              You may already know this, but “…intestinal bacteria synthesize forms of this vitamin known collectively as vitamin K2…” Page 119 I interpret that to mean: While I don’t know about our bodies making K2 from K1, it looks like our bodies do make K2, as least in those people who have healthy guts. Perhaps rather than worrying about consuming K2, people should strive for the goal of consuming gut health promoting foods such intact grains.

              I’m aware that the article you linked to had this to say: “Most of the vitamin K2 produced in the intestine are embedded within bacterial membranes and not available for absorption. Thus, intestinal production of K2 likely makes only a small contribution to vitamin K status. (Unden & Bongaerts, 1997, pp. 217-234)”

              Maybe all we need is a small amount. Because I found backup for my understanding of K2 from an article written by another well respected expert, Jack Norris RD: “Menaquin one (K2) is produced by a number of different bacteria species that typically live in the digestive tract of humans, and can be absorbed in the distal part of the small intestine. Unless someone has had significant antibiotic therapy, they shouldhave plenty of such bacteria providing them with menaquinone.” Anyone concerned about vitamin K in any form, may want to check out this article: http://www.veganhealth.org/articles/vitamink (Thank you Darchite for bringing this to my attention!)

              It’s also worth noting that the article you linked to referenced the Weston Price Foundation. Knowing how inaccurate the Weston Price Foundation is about so many things, that tells me that the article you linked to is suspect as well.




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              1. Thanks Thea for the complete explanation. Perhaps vitamin K in general should be the next topic for Dr Greger to explain to us how we can get it.

                In the meantime, I am blown away by all the experts opinion. Vitamin K is actually a family of vitamins which is composed of the long chain K1 and the short chain MK which is contained only in certain fermented foods. So for my own safety, I consume a complex K supplement (which has both K1 and MK vitamins) until I am convinced otherwise. I also eat plenty of plant foods rich in vitamin K1.

                The least I want to have is kidney stone and arteries plaque because I take vitamin D supplement.

                http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321262/




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                1. animal studies have shown that their bodies convert some k1 to mk4, i see no reason why this would be different in humans, if mk4 is even required.




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            2. When looking at his overall believes in high cholesterol being ok, animal products being important to eat, etc, I don’t rely on anything he says.




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          1. From what I’ve read, it makes a very small amount and far down the digestive system, which many say is of little value. This is whole area of K2 seems to be a relatively new area of study.




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        2. Best food source of K2 is natto (fermented soybeans), with a whopping 250mcg an ounce, compared with 7.5-15mcg for cheese, acc to Dr Stephen Sinatra. It takes a lot to get me to eat natto, but the good likelihood of K2 deficiency in a vegan diet & resulting metabolic imbalances are sufficient motivation–and I’ve actually found ways to make the stuff more palatable.
          I look for brands with as few ingredients as possible & no preservatives. The flavoring packets in the refrigerated Japanese varieties are often loaded with MSG, beef extract, hydrolyzed protein, & other questionable ingredients, so I usually toss them & substitute my own mix-ins (mustard, scallions, sriracha, &c).
          At $10 for three 2-oz pkgs, they’re not exactly cheap–but I haven’t yet mustered the moxie to make my own. I’ve been resisting buying Sinatra’s version of MK-7, but it wd actually be more cost-effective than the food form I’m buying at the Asian grocery.




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            1. Dilution is the solution. I mix some natto with rice or quinoa and black beans with a miso-tahini-lemon juice dressing. I also like to add a bit of finely chopped kale, peppers and onion.




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    1. So if you want to understand the vitamin K family and how it works, then read the following scientific article from NCBI, in particular the paragraph titled “Pharmacokinetics and efficacy of different forms of vitamin K”. So vitamin K1 which comes from plant foods and K2 (MK) which comes from fermented foods are 2 different vitamins K and there is no conversion from one to another. Vitamin K2 (MK) is more useful than K1 and has a longer life and circulates throughout the body while K1 is retained by the liver for anti clotting purpose. You need both K1 and K2 with more emphasis on K2.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321262/




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      1. But a healthy gut makes all the K2 we need. Humans did not eat fermented natto in the paleo period or millions of years before when we were apes. Our guts produced it.




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        1. When we were “apes”, we didn’t get to live close to 100 year of age. And our foods were more natural and nutritious than now. Plus we get gut bacteria naturally from nature plus we also got diseases along the way. Today we have sanitation to prevent diseases but we also kill our beneficial bacteria along the way. Our foods are not as diverse as in the past because we can only eat what are sold at the supermarket. And we don’t get to be outside enough because of our job.

          Just take a look at the web sites that list out the amount of nutrients in each food. There are some nutrients that we simply cannot get enough through foods. Just do the math and add them up to see that it’s impossible to get to the optimal range. I am talking about optimal health here, to live disease free to possibly 100 year of age. But if you are happy to leave it to nature then it will be a different expectation.

          I am a big fan of Dr Greger and I have followed him close to 4 years and so I am not new here. Although I follow Dr Greger advice in general by eating a diet rich in vegetables, whole grain, bean, seeds, herbs, etc. exercise regularly, I still supplement myself where it is necessary. And I am glad to see that Dr Greger has lately accepted the idea of supplementation. He started out with Omega-3 although he is not quite clear about it and now Vitamin D. This Friday, he will discuss about getting Vitamin D through sun lamp and I am interested to hear about it.




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          1. Jimmy: Just to set the record straight on Dr. Greger’s recommendations for supplements, this is nothing new. You can see Dr. Greger’s recommendations on the following page, which was originally published in 2011 and which existed in a similar form before 2011. The page has been updated in February 2016, but the recommendations for B12, D, and omega 3 look unchanged to me. In other words, characterizing Dr. Greger as “lately” accepting the idea of supplementation does not jive with what I have seen.

            http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

            Since you are so interested in supplements, you might find the other “nutrients to pay attention to” on that page helpful.




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            1. OK Thea, I stand corrected :)

              Then I don’t understand all the hoopla from people that sometimes supplementation is necessary.




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  6. So – if we are outdoors people – how much do we need to take? And, does our vegan diet help? Is the deficiency from people who eat poorly?




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    1. Completely naked standing outside in the noon sun in middle america and 18 years old, you would get enough vitamin D created in about 10 minutes. 40 years old it would take longer. With clothes on, even longer.




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    2. I’d start by getting your Vitamin D level checked. There are too many variables that impact Vit D levels that each person (diet, skin, kidney function, climate, location…). Then choose how you will manage it. I had my value checked a few years ago and mine was 13!! The PA didn’t bat an eye about it, didn’t see it as a big deal (not cool).. I started supplementing with 5000/day to replete. Unfortunately, I am not a good pill taker… A year later it was 22.1.




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  7. I was surprised to hear that babies get Vitamin D drops because of the inadequacy of breast milk. Was this done in the 1960s, 50s and earlier? I’m wondering about people walking around today who may not have gotten those drops as infants.




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      1. Thanks. Then, I’ll bet the drops go way back. I just found this on the web:”In the 1950s, British physicians identified a condition they named “idiopathic hypercalcemia,” which was associated with increased blood levels of calcium, anorexia, vomiting, wasting, constipation, thirst, excessive urination and, in some cases, kidney stones.29 At its peak, the syndrome was diagnosed at a rate of 100 cases per year. Although the hypercalcemia was never conclusively linked to vitamin D, the liberal enrichment of dried milk powder and infant cereals with crystalline vitamin D2, and the common practice of giving Viosterol (vitamin D2) drops to infants, made it readily possible for an infant to consume 4000 IU per day of vitamin D at that time. The rate at which hypercalcemia was diagnosed declined after the revision of regulations on the fortification of milk products, and most infants with the syndrome recovered after a period of restricting vitamin D and calcium. Source: http://www.westonaprice.org/childrens-health/vitamin-d-in-the-infant-requirements-for-safety/




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    1. The Vitamin D Council is a terrific evidence-based website featuring all kinds of new studies of vitamin D. A must-subscribe site akin to NF.org!




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  8. I do learn much from Dr. Greger’s teaching videos and blogs and am grateful for his work in research on the science of nutrition. However, natural science cannot say anything about how things came about but only observe how things are. Scientific observations based upon the theory of evolution, which is a highly debunked theory because information cannot produce itself but must come from an outside Source, stands upon faulty grounds. I wince when Dr. Greger goes there, because it is opinion and not science. It would be better to say that the levels of Vitamin D that we need can be observed in those who live as their ancestors lived.




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    1. Susan, your statement that the “theory of evolution…is a highly debunked theory…” is rather astonishing. I would like to see just who you believe has done the “high debunking”. The observations of life forms changing and adapting over time is certainly no longer contested by anyone without ideological blinders. The analyses of the processes of these changes is sometimes in the hypothetical range but very often it is shown conclusively to result from know selection processes and has been shown to be more than adequate to give indicators of the general processes. .

      I have personally never seen any debunking of evolution come from any but those claiming credibility for some sort of religious fundamentalism. Perhaps you can correct this?




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    2. Susan, the science of biology and nutrition are completely based on Therory of Evolution (and that is theory in the way that scientist use it to mean an extremely well verified explaination for an observed body of facts, and not the commons usage of theory as a rough idea). So Dr. Greger could be talking about nutritional science if he didn’t also talk about evolutionary science.

      And if information as you say can not come from itself but has to come from an outside source, where then does the information in this outside sources one from? Assuming a creator of information in fact just makes the situation is even worse because the information content of this external source has to greater than what it creates. If it were less, then we would be back to your objection that information in the created would be more than in the creator. You could propose a higher level information creator to explain first level information creator, but then you are in an infinite recursion loop of every higher creators in order to explain where the information content of the lower level creator came from.

      Fortunately information is indeed spontaneously created. By this I mean that the order in matter can increase without external input. We see this every time water freezes into ice. This can happen because the water isn’t a closed system. As heat (ie disorder) is removed from the water the disorder of the larger system it is connected to increases and in fact the total disorder in the full system increases even though a small portion of it spontaneously becomes more ordered. This is the heart of the second law of thermodynamics which unless I miss my guess is what you are thinking about when you say that information can not create itself.

      Evolutionary science is far from debunked. In fact it has been confirmed completely independently lines of evidence as disparate as genetics and geology, radioactive physics and comparative anatomy. In fact evolution has more and better confirmation than any other major scientific theory.

      So I would have immediately consign Dr. Greger to the quack category if he somehow tried to talk about nutritional science outside of the context of evolutionary science since they are, as I said, one and the same.




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    3. I won’t get into the huge body of evidence to the contrary but the simple study of just Darwin’s finches were enough to elucidate my 7 year old grand daughter of the simple concept of a creator wise enough to churn out adaptable species! It does not have to be creationism vs evolution, that is just stunted and ridiculous.




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      1. Number of people who believe in evolution are somewhat different , it depends on age with the younger people at 51% believing in evolution and those older over 50 coming in at about 40%. Creationists seem to come in at 30%. That leaves 30% who don’t know what the heck to believe in.
        Cheers!




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  9. I’m looking forward to the next video. While the studies presented so far correlate vitamin D levels with various health factors, they don’t attempt to control where that vitamin D is coming from (sun exposure, skin tone, whole food vitamin D consumption, vitamin D supplements). Just my opinion, but I personally lean towards vitamin D being only useful if it’s made by your body from sun exposure. Vitamin D consumption from whole food or supplements may make your vitamin D blood level higher but I don’t think you’re getting much of the benefits associated with sufficient vitamin D hormone levels. Vitamin D level is likely just an indicator of the many chemicals produced by the complex physiological processes in your body triggered by moderate sun exposure. Biologists like to tell (and I’ve taught it in my classes) the story that Inuit are darker-skinned than northern Europeans living at similar latitudes because the Inuit eat a diet richer in vitamin D, but we have no real evidence for this. It may just as likely be explained by one or a combination of other factors, such as the fact that Inuit have likely been living in the far north for a shorter period of time, insufficient to finish evolving towards lighter skin-tone, or that very light skin-tone (along with blue eyes and blonde hair) was a rare occurrence that just happened to arise in Europe and not in other northerly populations. So in summary, stop worrying about your vitamin D level or what you’re eating, and simply spend more time enjoying and exercising in the outdoors, while still using some moderate level of sun protection. We’re not evolved to spend hours half-naked lying a beach, but we’re also not evolved to stay inside all day or cover every part of our skin and eyes whenever we go outside.




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  10. Now! How to reply to both Jim and Stewart! Indeed I agree that our Creator is much more than we are! Infinitely so! When we were conceived, the information that created us did not come from us. That is a reasonable statement. There is no “loop” involved. I certainly am not saying that the second law of thermodynamics is faulty. It is evidenced all around us. Perhaps my phrase, “highly debunked” was an unfortunate one. It is apparent that many, and perhaps a majority, do not believe in a Creator and so the theory of evolution is highly believed. But that is just the point – it is “believed.” I guess it must have to do with who we will trust as our authority. Why do we believe in this particular authority and not another? It is true that there are changes in the creatures as time goes on. That is not a false statement. These changes are never upward as in the theory of evolution, but rather devolve. Have you ever seen a fish turn into a man? Or even a monkey into a man? That would be a hard thing to believe! Observational science, however, should not based upon a belief system, but upon its observations. Good science keeps to the known facts.




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    1. Susan: re: “Have you ever seen a fish turn into a man? Or even a monkey into a man?” Those statements (among others) indicate that you don’t know what evolution means. Evolution does not in any way imply or say that you will see a monkey turn into a human. It’s hard to argue against something if you don’t know what it is. In other words, I don’t think it makes sense for you to post about evolution until you understand what it is. Explaining evolution is beyond the scope of this site (or at least, I’m not going there), but I’m sure you could find a good primer easily enough if you wanted to educate yourself. Good luck.




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    2. Susan, If you are interested in taking a look at a well written book which is a great introduction to evolution I would recommend “The Beak of the Finch: A Story of Evolution in Our Own Time” by Jonathan Weiner.




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          1. gen: I got to 5.5 minutes and saw a serious flaw in his talk. So, I gave up. I wasn’t aware of this guy before though. Thanks for the head’s up.




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    3. “Believe” is another one of those confusing words since it can mean nearly diametrically opposite things to different people even when talking about the very same thing. Scientists don’t believe in evolution in the way that you use the word. Perhaps what they should say is that since Evolution has been verified many thousands of times by thousands of researchers working in a dozen different field over a period of time exceeding a century that they have a very very high level of confidence that the Theory of Evolution does indeed represent the mechanism by which life on this planet has come to be in its current state. They have no need to believe the word of any authority on faith alone. The data is public, the analysis of that data has been published, anybody can run their own test and analysis and come to their own conclusion. At this point in time the evidence in favor of the Theory of Evolution is true is so overwhelming that researchers no longer feel any need to do work specifically to verify it any more. Rather, like in the fields of nutrition, researchers are using it to expand our understanding of how living being work. All the advances in biology and related fields like nutrition have been built on top of Evolution. And the fact that the predictions and continued verifications in these fields continues to serve as confirmation of the truth of Evolution.

      Even more important is that confidence or belief is entirely provisional not absolute. If somebody found a bed of fossils that are from a geological layer that can be verified to have been formed in the Jurassic period and it contained fossils of modern day rabbits in it, then scientist would have to conclude that the Theory of Evolution is fatally flawed and begin the search for another theory that still explained all the millions of other observations as well as the current Theory of Evolution does, since any theory still has to explain all the data, but also explains those Jurassic rabbits as well.

      I hope that helps.




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      1. Thank you, Jim, for your well-thought out explanation. It is not through ignorance of the theory of evolution that I decry it. I was taught it also in school and have studied it on my own time. I have no claims to brilliance, but rather must struggle in my understanding, as imagine some of you do also. Some things are beyond the ken of mankind, though I expect now another onslaught of denial and defense. Faith in the Son of God supersedes all science. I used the word “believe” in the sense of what or who we put our trust in; it was no more complicated than that. You trust evolution and I trust Jesus Christ. Please see “The Existence and Attributes of God” by Stephen Charnock for a further elucidation of my faith.




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      2. Thank you, Jim, for your well-meaning explanation. It is not through ignorance of the theory of evolution that I decry it. I was taught it also in school and have studied it on my own time. I have no claims to brilliance, but rather must struggle in my understanding, as I imagine some of you do also. Some things are beyond the ken of mankind, though I expect now another onslaught of denial and defense. Faith in the Son of God supersedes all science. I used the word “believe” in the sense of what or who we put our trust in; it was no more complicated than that. You trust evolution and I trust Jesus Christ. (Please see “The Existence and Attributes of God” by Stephen Charnock for a further elucidation of my faith.)

        You trust in the limited wisdom and power of men; I trust in the infinite wisdom and power of God. That explains precisely why I objected to Dr. Greger basing his work upon the theory of evolution – it is a house built upon sand.




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        1. So many conceptualizations of gods, goddesses, divine spirits, and higher powers by humans over time! So many religions that help people find meaning in this lifetime and give them a sense of security about the afterlife. Yet none of these gods can be proven. Like sand shifting with the winds, they shift with the times and cultures.




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  11. I am so grateful that what I’ve been saying for years about the natural state of being naked should certainly be good for us is being born out by the research. I’m not suggesting spending hours a day naked in the sun, but at least a half hour or an hour. Even other animals for the most part avoid the direct mid-day sun, but move around mostly in shaded areas. Does anyone else want to live boldly in harmony nature? I hope so.




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    1. That would be great, running around naked all the time in the warm sun! However, most of us still need to be able to somehow make a living. Maybe if I had 20 or so acres on the wet side of the Big Island and it was planted through and through with fruit and nut trees and taro everywhere . . .




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  12. I hope that there will be something in the next couple of videos about the use of special narrow spectrum UVB lamps tuned to the frequencies that cause the maximum vitamin D3 to be generated from the precursor in the skin, somewhere around 308 nm if what I read is correct. One has to be careful with these since the total flux per area can be several times that of the UVB portion of the solar spectrum. As such just a minute or two can be enough to get enough UVB to convert all the precursor available. Still if I need to supplement with something, I would like to supplement with what is actually in short supply, and in this case it is insufficient UVB exposure rather than Vitamin D, whose shortage is contingent on the shortage of UVB.

    Also we spent millions of years evolving to regulate vitamin D generation in the presence of an abundance of sunlight. Being able to regulate absorption of large amounts of ingested Vitamin D is a novel experience for our physiology, and so it being as well controlled as internal generation from sun exposure would have to be just a happy coincidence.

    The lamps don’t have much if any UVA, which is the frequencies that penetrate more deeply into the skin and can damage the deeper collagen layers in the dermis that if I understand correctly are largely responsible for wrinkles, while UVB don’t penetrate much deeper than the epidermis. Still my melanoma started right at the surface in the epidermis, so some care has to be take. However, like in everything the poison is in the dose. Research has shown that even a couple of really bad sunburns can substantially increase your chances of developing skin cancer.

    So my hope is that short exposure to carefully controlled amounts of UVB would be the best solution to not being able to run naked in the sun, fun as that might sound (and terrifying to those who might see something that can never be unseen!) rather than popping pills.




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    1. Jim Felder: I’m really glad you did this post. Some time ago, someone else posted that she put a special lightbulb in her bathroom and has it on while her family takes showers. So, they feel they get the vitamin D that way. I thought it sounded like a fantastic idea, but I didn’t know if the light bulbs were legitimate, and I didn’t know if there are any “gotchas”. And I couldn’t find information I felt I could trust. So, I have done nothing to date.
      .
      But I would LOVE to implement this idea as I’m not good about taking pills and just turning on a light when I shower would be a no-brainer. But if only a couple minutes is healthy, then maybe I would have to make sure I turn it off after a couple of minutes???? It seems like this kind of detail would be important. I’d hate to give myself skin cancer while trying to get enough vitamin D…
      .
      I haven’t watched ahead in this video series either. I’m seeing it with everyone else. But like you, I would love to have this topic covered. And/Or if anyone reading these posts have links to some valid sources, that would be great too. Thanks!




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      1. I bought a vitamin D lamp last Fall and used it all Winter. I was totally delighted with the results — although I haven’t had an assay of my D levels since the insurance stopped paying for them. I didn’t get a fancy Sperti lamp, but I got the B2R UVB Sun Lamp which cost me $236.

        The bulbs last for 300 hours, and since each session is five minutes, that makes for twelve sessions per hour of bulb life, or 3,600 DAYS of use. I get vitamin D either from the lamp in the Winter or from the sunbathing during the rest of the year. I figure I need the lamp for an average of 100 days per year. Therefore, it will last for thirty-six years before I need to replace the bulbs!

        The price is only 6.5 cents per dose. That’s WAY cheaper than vegan Vitamin D supplements. One also gets the benefit of an endorphin hit the body emits from getting the light.

        By the way, I can’t see any practical use of the lamp in the shower. There’s the problem of moisture/wetness and there’s also the problem of always needing eye protection — glasses of some sort — when being exposed to a UV-B lamp. Who would want to wear glasses in the shower?




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        1. Allen Crider: Thank you so much for sharing this information. I’m starting to get motivated and excited. :-) Five minutes seems like something I could integrate into my day…




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          1. Interesting – I didn’t realize people were really using UVB lamps in their homes to get their vitamin D. Sounds like a great idea for when I’m stationed in the Arctic over the winter. It reminds me of using LED’s with specific spectra for growing plants – it works and can save electricity but I think most growers believe that the plants would grow better under natural sunlight, all other variables being equal. Me personally, I want more spectra hitting my skin than just a couple minutes of a UVB lamp, and I definitely don’t want to expose myself to something that is dangerous enough that I have to protect my eyes or that I can’t tell when I’ve been overexposed. Vitamin D is just part of the picture, and we really only know so much about it because originally we identified a disease (rickets) caused by its deficiency (and later learned vitamin D’s importance for many other functions). Many other less-easily identifiable components of poor health may be caused by deficiency in other chemicals that our bodies produce when exposed to full spectrum sunlight.




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            1. Ryan Keane: All great points. Thanks for jumping in.
              .
              My reality is that I just don’t get enough sunlight. That’s not going to change any time soon. So, it’s either supplements or a lamp. I think the lamp may be a good option. We can get a full spectrum light bulb that might address your point about not over doing just one spectrum.




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      2. I think it would be important to put it on a timer, and one that was easy to set for a couple of minutes. My thinking is that I will set it up on my bathroom counter and turn it on the morning when I start to brush my teeth when I would be standing in one spot for a couple of minutes anyway. Conveniently my electric toothbrush has a built in two minute timer. So when I am done with my teeth, then I will have also produced my daily vitamin D! And since I am already in my all together prior to taking a shower, this would also be a natural time. Though I think my wife will probably think it a bit odd that I am standing in front of a lamp slowly rotating in place while brushing my teeth in the nude!




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        1. Jim Felder: That’s just a funny image. I think your wife will be completely impressed with your efficiency / ability to multi-task. :-)




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    2. I was treated for PUPP (pregnancy induced rash) with UVB photo therapy. My first session was 32 seconds. I remember leaving after 32 seconds thinking what a crock it was.. until later in the afternoon, I was sunburned. They had to reduce my time to 29 seconds after that!!




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      1. Wow, it’s scary to me that someone could get a sunburn from 32 seconds. That’s clearly a therapy to do only with professionals. Thanks for sharing your experience.




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  13. The body makes Vitamin D3. “Vitamin D” as you recommend is nearly useless, since D2 is not what the body makes or uses. Please do your research. And yes we take 2,000 IU Vitamin D3.




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  14. Gotta tell you I freakin love you Dr Michael! Wish I could know you….thanks for all the info you share so generously.
    Absolutely agree with your position on the HORMONE Vit D.




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  15. Hmm…no mention of race differences. Given IOM and Endocrine Society recommended levels (over 30 ng/ml for sufficiency), majority of black people are found to be deficient or insufficient. HOWEVER, they have higher Bone Mineral Density and lower fracture rates than whites. Also this study – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894250/ – suggests that supplementation may have adverse effects (to bone and cardiovascular health) for blacks in particular. What’s insufficient for a white person may be sufficient for me as a black person.

    Another study – http://www.nejm.org/doi/full/10.1056/NEJMoa1306357#t=articleDiscussion – explains why and also warns against unwarranted supplementation for black people. Here’s an article that was based on that study – http://www.npr.org/sections/health-shots/2013/11/20/246393329/how-a-vitamin-d-test-misdiagnosed-african-americans.

    My recent Vitamin D level was 28.7 ng/ml, (20-30 considered insufficient). I get about 7 hrs of sun exposure per week while cycling and hiking with sleeveless tops and short shorts. I’m at normal weight (116 lbs) and eat a 95% plant-based diet. I’ll try to get a little more sun and will be happy with the low 30s but I don’t think I can get to over 35 without supplementation and with the above studies, I think it could be detrimental to my health and not worth the risk. This is one time I’m not going to take Dr. Greger’s advice.




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    1. Nutritarians isn’t Dr McDougall specifically mentioning a study specially about fractures. Dr. Greger is talking about mortality in today video and earlier in this series about what has been discussed with vit d levels and heart, BP, etc. Are you most concerned with fractures?




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  16. It is also fascinating, or rather sad, that no one in response to my original post, addressed my point of keeping to observational science but immediately began to defend the theory of evolution. That seems a rather “knee-jerk” response.




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    1. The point is that evolution is a scientific theory while a belief in the supernatural is at best an hypothesis. Many of us just regard it as superstition and look politely away when somebody tries to introduce it into a discussion about science.




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  17. Wonder when we are going to quit calling this hormone a vitamin? And when we do, do we call it “Hormone D”?

    Given the historic rate of “updating the system” of western food and drug policy, I estimate the year 2030 or so.




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  18. Sorry Tom, that was unkind of me. I do understand that what is taught in our schools is the theory of evolution, but it is not observational science. I would rather see observational science taught and that is the point I was trying to make, for theories are not proven even experientially. Thank you all for your interest in my post. Now I need to do my work. Have a good evening.




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    1. Thanks for your comment.

      As far as I know, taking into account that 1 IU = 0.025 mcg, then 1 IU = 0.000025 mg.

      And if 2000 IU a day seems to be the optimal level of intake (watch video here), then 2000 IU = 0.05 mg.

      Hope this answer helps.




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  19. My mother in law has some hard news today. She had a nuclear stress test today, there is definitely blockage and because of this, her heart is not working the way it’s supposed to. They need to do an angioplasty on her but can’t because her kidneys are not working properly. (She’s in stage 3 kidney failure) the Dr. wants her to have cardiac rehab but her enzyme levels are not at a level where he thinks Medicare will approve it.
    So now what? I gave her for Dr. Greger’s Book, How Not To Die for Christmas, but I don’t think she took it serious.
    I know a whole foods plant based lifestyle would help, but could it help enough? And how do I get her to understand when for the past 77 years her diet has been mainly meat and potatoes with lots of butter and cheese.




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    1. It’s very difficult in my experience. One meal at a time is how I learned to WFPB. Then a whole day. Then after _three_ days I could feel it. So I don’t know what it will take but SHE has to open up and give it a chance before anything will get better.

      I’d love to know how to help folks make this leap.




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    2. Mike, get her Dr. Caldwell Esselstyns book, How to Prevent and Reverse Heart Disease. Dr. Esselstyn has had more success with seriously ill heart patients than anyone I know See his website. He’s dealt with and saved people in similar positions to your mother in law. Dr Greger would approve, and knows him well.




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    3. MikeOnRaw: I’m so sorry to hear about your mother. So many times we have seen people talk about their worry for their loved ones and the helplessness they feel when they can’t get through to effect change. And sometimes that health news wake-up call does come too late. It is easier to prevent a problem than to reverse it.
      .
      ***However,*** we have also seen stories of people who have made changes to their diet late in life (even in their 70s I think) to remarkable effect. So, it seems to me that it is worth trying if your mother is interested in trying. That last part is key. You can’t force your mother to change and you don’t want this issue to come between you, especially if your time together has become limited.
      .
      I don’t know you or your mother, so this may be off base. But if it were me, I would try one frank talk and if that didn’t work, then I would just let it go and be as supportive as I could given the decisions my loved one was making.
      .
      The frank talk would include statements like, “I love you, and I hate to see you sick. The health problems you are facing are caused by your diet. At this stage, the medical community is unable to help you. I don’t know if it is too late to turn things around or not, but people *have* been able to fix these types of problems by fixing their diet. A new diet is not a guarantee, but we have good reason to believe that a healthy diet will really help. If you want to to try it, I will do everything in my power to make this as easy as possible on you. I will explain what a healthy diet looks like. I will cook for you. I will find recipes that you like. (whatever you feel you can promise) etc.”
      .
      I don’t know if this post is helpful to you or not, but please know that my thoughts are with you.




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    4. There is some great research on early/moderate CKD and the benefit of a plant based diet in preventing further decline of kidney function and possibly reversing it. Dr. Greger states at the end of the video linked below, is “If patients are not going to cut back on animal products, at least they should eat more fruits and vegetables. And they did, and it worked too, and without leading to too much potassium in the blood. And it may even work better, as fruits and vegetables have the additional advantage of helping to lower blood pressure. This study is important because it illustrates a very simple and safe way to treat metabolic acidosis: fruits and vegetables. So, the key to halting the progression of chronic kidney disease might be in the produce market, not in the pharmacy.”

      I love the second part of Dr. Greger’s book where he describes his daily dozen. Maybe going over that and see what she is willing to incorporate into her diet. Encourage her to maybe not take anything out (just yet) but start including daily doses of greens, berries, etc.

      Good luck!

      http://nutritionfacts.org/video/treating-chronic-kidney-disease-with-food/




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  20. It is my understanding that observational science does involve experimentation. That is why it is different from a theory. Good night.




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    1. No. It only includes observation. That is why it is called observational. It is not different from scientific theory. They are both aspects of science.




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  21. I appreciate the site a great deal. I’m a respecter of persons, and of good English, too. So I was dismayed to read this tonight: “there’s evidence like this— from hundreds of autopsies of people that like died in car accidents …” “… people that like died” ??? First change would be “people who …” Second change wold be to delete this second “like” so that writing on the site doesn’t sound like English used by too many poorly-schooled adolescents.




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  22. I think food is harvested early, before its ripe, and these foods are high in Bromine. Plants store bromine to warn animals not to eat them. I think a bromine excess is coming humanity’s way. Bromine is very dangerous.




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    1. Well, you’re talking only about fruit (and in the botanical sense, including nuts and vegetables that are actually fruit) – these are the only foods that ripen. True vegetables store defensive compounds to deter animals from eating them at all times. This includes all dark leafy greens that are the poster-child of nutritious food for Dr. Greger, so I’m not sure if presence of defensive compounds = not nutritious. Older leaves tend to have more defensive compounds than younger leaves; the ones that we eat are normally what we call quantitative defenses, like bitter tannins – the negative effect builds up as you eat more – as opposed to qualitative defenses where they either poison you in small doses or the animal has evolved resistance to it and is unaffected at any quantity.

      But for fruits and nuts, I agree it’s better to wait until they’re ripe before eating. Tree-ripened is usually always better, but some fruits ripen after picking and are only slightly less nutritious once ripe. Fruit that do not ripen after picking should be avoided in stores, unless they’re produced locally and are ripe in the store. But some unripe fruit may still have nutritional benefits that cancel out the negatives. I think another top pick for Greger, indian gooseberries (amla), are always picked unripe and either ground up or canned without ever having the chance to ripen.

      Can you point to any references about bromine in unripe fruit – I hadn’t heard that before.




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      1. I forgot to add that cooking or soaking destroys many of these defensive compounds. Dr. Greger has a video arguing that some foods are more nutritious when cooked, which very well might be the case, but the main reason we cook (or soak, salt cure, ferment, etc.) most vegetables and unripe fruit is to break down the defensive compounds and make the food more edible, in the case of quantitative defenses, or no longer poisonous, in the case of qualitative defenses.




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      2. Sorry this is only my opinion. I think that eating oatmeal, blueberries, and coffee I can feel bromine induced pain in my back. Is that Bromine, the pain in my back and leg? It was a similar sensation to taking Tums. Bromine is very dangerous. I think we are eating older leaves and younger fruits.




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  23. Dr. McDougall says vitamin D supplements are harmful – that they raise LDL (bad cholesterol) , and don’t necessarily increase blood levels of vitamin D. Can you help clear up this conflicting info? Thank you.




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  24. I’m curious if they took the amount of sunlight babies get into account. Human breast milk might cause rickets without very high levels of vitamin D in the mother, but wouldn’t just a few minutes of sunlight a day on a baby’s skin be enough to raise their vitamin D levels regardless of the mom’s vitamin D levels?




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  25. What units are you using for the target level? ng/ml is standard in US but is that what you are using here? Thank you




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  26. It would be helpful if you would convert nmole/L to ng/mL. This unit is used by both LabCorp and Quest. This is where we receive information about our own values.
    On supplement values: Shifting from the minimum value to prevent disease to the optimum value that promotes well being and longevity is one of the most important statements on NutritionFacts.org.




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  27. I notice K2 being discussed along with Natto here. You may like to try Natto (Japanese fermented beans) with a little soy sauce , wasabi on rice with Nori (the sheets of seaweed for sushi), it might be more palatable if you tried natto before and didn’t like it. Having said that it is an acquired taste like liver which I could never eat because of the smell.




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  28. I live in the Tropics in front the ocean and the beach. I tested my vitamin D3 level in 3 different laboratories and it came out around 22 to 27 ng/ml (aroung 60 nmol/L). To bring it up to 150 nmol/L or 60ng/ml which was my preferred target took me around 9000-10000 iu/day of D3 for several months. Now over 12 years supplementing with 10.000iu/day. I hope some study will not come out debunking high doses of Vitamin D3 as I have been doing really well with this amount daily for all these years and for sure will not stop it now. Since starting it I have fund myself much much less prone to any kind of infections like flu and fevers, less pain and faster recovery after couple of surgeries I had where I took 50000 iu just before going into the operating room. Surgeons were stunned when just few hours after my surgery (for them generally a very painful nose surgery) I was sitting at the table and eating merrily 1 chilos of spinach and cucumber salad. May not be only the Vitamin D3 for sure (I also been eating a plant based diet since many years) but I did see a huge difference in my health especially once I started supplementing this miraculous hormone. Thank you so much doctor Greger it is a huge plus to see that you also believe in the benefits of having high level of Vitamin D3 into the blood over 115 nmol/L.




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  29. Hi DOC. Are there ingredients that should be avoided when buying Vitamin B12 or hormone ” vitamin D “? I’m worried about all these chemicals going inside me!! could you please advice us or direct us to a reliable pharmacologist…… thanks a lot for sharing all this knowledge with us, words cannot express how grateful i am.




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    1. What doctors are they talking about? Left the planet? Sounds sort of sensationalism type alternative news feed.Not there’s anything wrong with that.




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  30. I think a serious error was made here in only mentioning the units of measurement, nmoles/liter once. The average vit d level in US seems to be reported in ng/ml. There is a big difference. The average Maasi in the quoted study had levels of 115 nmol/l which is equivalent to 46 ng/ ml. If a lay person read this article they could think their totally adequate level of 40 ng/ ml was insufficient.




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  31. Interesting. One point about the levels in people who get all of their vitamin D from the sun, it’s my understanding that one cannot overdose on vitamin D from the sun. Once your body reaches an optimal level, it will simply stop producing it. Therefore, those who live in nature with few clothes, probably have the optimal levels.




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  32. It would be helpful if you could do a video on how Vitamin K works with Vitamin D, as well as what type of K is best. Vitamin K purportedly keeps calcium from accruing in one’s arteries, something that’s more likely to happen with higher levels of D. This might explain why higher very high levels of D might shorten longevity (if not accompanied with K. Thanks.




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  33. Which Vitamin D3 is recommended? Have any been tested to contain the 2000 units that they are said to contain? I want to get a D3 but I am not sure which one to buy. Advice?




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  34. I love the first-principle evolutionary logic applied here. I love how the breast milk data supported the first-principle logic. I love the complete absence of assumption or oversimplification. We already owned and have read Dr. G’s book. However, his logic applied in this particular video has jettisoned Dr. G to the top of my list of people whose analysis I will seek out.




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  35. I’d like to know what kind of vitamin D to take. Most tablets come with a small amount of calcium… and there there are the gelcaps in oil. Thanks for the help!




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  36. Hello Doctor,
    I have been taking vitamin D3 500 IU for last 3-4 months as my levels for D had been 11. JUst recently I read that you should take vitamin D with K2 else, it causes calcium to be deposited in wrong places and cause problems. What is your opinion on it? I didnt see a mention of K2 in the book. Your help is greatly appreciated!

    Thanks!




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  37. Dr. Greger and Staff:

    Hi – I have a question about supplements.

    I need to take Vitamin D and Vitamin B-12 but am concerned with all of the other ingredients included with most supplements:

    Soybean Oil, Corn Oil, Sunflower Oil, (all kinds of oils), Medium Chain Triglycerides, Gelatin, natural and artificial flavors, etc. These are the oils and animal products (most capsules are gelatin) we are trying to avoid.

    I believe Vitamin D is fat soluble, is this why most supplements include some type of oils?

    Consumer Labs recommendation is a liquid which has ingredients of medium chain triglycerides and orange & essential oils; is this OK?

    Should we only take non-oil, vegan supplements? Note: these seem hard to find and obviously more expensive.

    Or, are these ingredients in such small quantities they are harmless?

    Do you have a brand recommendation for B-12 and for D?

    Or can you please advise on what other ingredients are safe that are added to these supplements, such as cellulose, dicalcium phosphate, magnesium stearate, etc.

    It seems strange to be adding supplements to our health that contain the damaging non-whole plant foods we are trying to avoid.

    Thanks for all the great work you all are doing!

    David




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    1. Hi, DavidG123. What a great question! Dr. Greger and NutritionFacts are not in the practice of endorsing products. That said, I will tell you what I use, but this is in no way intended as a product endorsement or promotion by me, Dr. Greger, or NutritionFacts. I use Garden of Life MyKind sprays for both Vitamin D and Vitamin B12. I find they have few, if any, questionable ingredients, and a spray means no capsule or tablet, so no gelatin, cellulose, carrageenan, etc.! I have no connection whatsoever to companies making or selling these products, and I am sure that there are other products that are just as good. You are correct that vitamin D is a fat-soluble vitamin, and that is why it comes in oil form. Of course, this time of year, you may be able to get all the vitamin D you need through sensible sun exposure, which is free! More information of Dr. Greger’s recommendations may be found here, in case you have not already seen it: https://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/ I hope that helps!




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      1. Hi Christine,

        Thank you so much for your response and the information.

        I truly appreciate all of the work you and your peers are performing at NutritionFacts.Org!

        Please keep up the great work,




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  38. I am a bit confused about Vitamin D supplements. I am reading the Starch Solution(2012) by Dr. John McDougall, another doctor whom I trust, just like Dr. Greger. But this book notes that Vitamin D taken at what is considered “safe doses” has been shown to increase LDL, prostate cancer, pancreatic cancer, immune system suppression, autoimmune diseases, gastrointestinal symptoms, kidney disease and kidney stones. The book also notes:” supplements may actually hurt the bones”. I looked at the references for these statements which are from 1995, 1997, 2004, 2007, 2008, 2009, and 2010, so perhaps these statements are just due to out-of-date sources? I trust both Dr. Greger and Dr. McDougall, but I also want to do the most right thing for my body. I currently take a 2500 IU vegan vitamin D supplement daily and that was based on nutritionfacts.org videos. So, can you please confirm that my suspicion is correct, that true to its purpose, the nutritionfacts.org info is more recent and therefore I should not worry about the harmful effects of vitamin D supplements I read about in The Starch Solution? I look forward to hearing back from you. Thank you! Sheila K.




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  39. Hi Sheila- I’m Dr Anderson, a volunteer with Dr Greger. You’re justified in being confused about Vitamin D! There is a lot of information out there, and it’s not entirely settled what the optimal Vit D level is. I would suggest continuing to follow Dr Greger’s website, as he reviews every published article on this topic and will update as new information arises. The most relevant video he has on your question is this: https://nutritionfacts.org/video/the-best-way-to-get-vitamin-d-sun-supplements-or-salons/ There are pros and cons to both commercial Vit D supplements and getting Vit D from the sun, and he summarizes them here.




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  40. Hi Dr. Anderson and Sheila,

    This video by Dr. Greger directly addresses Sheila’s question – the data referenced was mis-interpreted (specifically with longevity and higher Vitamin D levels):

    https://nutritionfacts.org/video/how-much-vitamin-d-should-you-take/

    Dr. Anderson – if you have a minute, please see my comment which preceded Sheila’s asking about common additives found in supplements. I would appreciate it if you could address this.

    Sheila – this should make you not worry about your 2500 IU dose :-) I take 4000 a day. Note: I am not a doctor.

    Thanks,

    David




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  41. . . . I just wanted to add one more comment to address Sheila’s question.

    Please see this video about Vitamin D from Dr. Greger (which is actually under the IBS thread):

    https://nutritionfacts.org/video/vitamin-d-for-inflammatory-bowel-disease/

    I do not have Crohn’s Disease but this study is indicatory of inflamation in general and the natural level of Vitamin D for our species. If I was of average weight I would take 5,000 IU a day. I am 5′ 7″ male and being that I only eat whole plant foods – only weigh 135 lbs – so I take 4,000 IU a day.

    Again, I am not a doctor. Just an avid researcher who greatly appreciates NutritionFacts.Org!

    Hope that helps,

    David




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    1. Thanks to you both. Much appreciated. I too am so appreciative of nutritionfacts.org and Dr. Greger and all that he and his team does. I had reviewed all these videos first before asking my question but reviewed them again after your messages. I agree that there does not appear to be anything here to suggest that vitamin D supplements can cause harm— it all seems to be good. I will take Dr. McDougall’s words to possibly be a bit out of date, and will remain watchful for more videos in this topic.
      Anyhow, I decided to check and see if Dr. McDougall said anything more recently about this, and in March 31, 2015, there was this which does not seem to change his stance.: https://www.drmcdougall.com/2015/03/31/vitamin-d-supplements-are-harmful-sunshine-and-food-determine-health/

      This below was the analyses noted in the link above.
      https://www.ncbi.nlm.nih.gov/pubmed/24703049

      Any further thoughts?

      I still try to get sunlight on my skin every day that I can to try to get some Vitamin D also the natural way (even though I still take my supplement). I don’t know what “excess” sunlight means exactly, but I cover up when outside 10am-3pm but uncovered the rest of the time.

      Thanks for any further thoughts.
      THANK YOU!




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      1. Hi Sheila,

        What specifically is your true concern about taking vitamin D? What is the bad effect you are worried about?

        McDougall (who I also greatly respect) is only referring to potentially worse fracture rates and calcium levels which are part of your standard blood tests so you can easily monitor if that is your concern.




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        1. Hi, It was this, from the Starch Solution that caught my eye and was in my first post: “But this book notes that Vitamin D taken at what is considered “safe doses” has been shown to increase LDL, prostate cancer, pancreatic cancer, immune system suppression, autoimmune diseases, gastrointestinal symptoms, kidney disease and kidney stones. The book also notes:” supplements may actually hurt the bones”.

          Also, in that latest 2015 Dr. McDougall article, yes bone health is what he talked about but if you go to the Pubmed Abstract he is citing, https://www.ncbi.nlm.nih.gov/pubmed/24703049 its about many other things as well. Not harm noted there— just no help is what I think I recall.

          Thank you




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          1. Hi Sheila,

            I really like Dr. McDougall – he is fantastic. But, from Dr. Greger’s videos it seems his references were studies that could not tease out cause (as Dr. Greger would say) and they have since determined that there are no negative consequences to dosing with vitamin D at higher levels (as recommended by Dr. Greger).

            Dr. McDougall will always recommend the natural way if possible. If you can get the recommended sun exposure – don’t do the supplements, I am sure McDougall is correct that nature provides the ultimate solution.

            If you are concerned you can’t get the proper sun exposure, follow Dr.
            Gregor’s advice for dosing; I live in a northern climate (Minnesota) and take even more – 4000 IU a day as I am comfortable that it is a safe dose even at my low body weight.

            Hope this helps.




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