Vitamin D Supplements May Be Necessary

Vitamin D Supplements May Be Necessary
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To reach the circulating (25-hydroxy) vitamin D levels associated with the lowest overall mortality, one may need to take supplements, given data suggesting suboptimal production from sun—even under optimal circumstances.

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How much sun exposure might one need to get their target vitamin D level to that found associated with the lowest total mortality rate? Well, it depends. It depends on our age, how long we’re exposed, the time of day, the time of year, our latitude, our skin color, our use of sunscreen, and how much of our body we’re exposing.

Even in Boston, though, all it takes is 10-12 minutes of midday summer sun, without sunblock—if, you’re a young, pale, naked Caucasian. But then, you’re golden! Actually, you’d be a little pink. Note, though, if you’re some old white guy prancing around naked on the Commons, you’re not going to make it.

As I hope you’re beginning to appreciate, it’s not easy to make a one-size-fits-all recommendation for how much sun exposure one might need. And “Low vitamin D Status despite Abundant Sun Exposure” has been found even in the best of circumstances: young, half-naked skateboarders in Honolulu, mostly Caucasian, averaging 30 hours of sun a week—and 51% didn’t even make it to 30. If they can’t, who can?

And these days, even if we’re an albino nudist at the Equator, how often might we be getting outside in the middle of the day with a desk job?

So, if we’re really interested in getting to the vitamin D level associated with the lowest mortality rates, and our lifestyle or latitude won’t allow us the necessary sun exposure, then one needs to take vitamin D supplements. The piddly amount added to soy milk, calf milk, margarine, or mushrooms would simply not be enough.

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 veganmontreal.

Please consider volunteering to help out on the site.

Image thanks to Tony Alter / Flickr

How much sun exposure might one need to get their target vitamin D level to that found associated with the lowest total mortality rate? Well, it depends. It depends on our age, how long we’re exposed, the time of day, the time of year, our latitude, our skin color, our use of sunscreen, and how much of our body we’re exposing.

Even in Boston, though, all it takes is 10-12 minutes of midday summer sun, without sunblock—if, you’re a young, pale, naked Caucasian. But then, you’re golden! Actually, you’d be a little pink. Note, though, if you’re some old white guy prancing around naked on the Commons, you’re not going to make it.

As I hope you’re beginning to appreciate, it’s not easy to make a one-size-fits-all recommendation for how much sun exposure one might need. And “Low vitamin D Status despite Abundant Sun Exposure” has been found even in the best of circumstances: young, half-naked skateboarders in Honolulu, mostly Caucasian, averaging 30 hours of sun a week—and 51% didn’t even make it to 30. If they can’t, who can?

And these days, even if we’re an albino nudist at the Equator, how often might we be getting outside in the middle of the day with a desk job?

So, if we’re really interested in getting to the vitamin D level associated with the lowest mortality rates, and our lifestyle or latitude won’t allow us the necessary sun exposure, then one needs to take vitamin D supplements. The piddly amount added to soy milk, calf milk, margarine, or mushrooms would simply not be enough.

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 veganmontreal.

Please consider volunteering to help out on the site.

Image thanks to Tony Alter / Flickr

Doctor's Note

This is the fifth video in a nine-part series on vitamin D. Be sure to check out yesterday’s video: Vitamin D and Mortality May Be a U-Shaped Curve.

Also, check out my associated blog posts for additional context: Eating To Extend Our LifespanVitamin D: Shedding some light on the new recommendations; and Vitamin D from Mushrooms, Sun, or Supplements?.

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

21 responses to “Vitamin D Supplements May Be Necessary

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    1. Hi Doctor,
      I noticed that since I started taking Vitamin D3 supplements, I feel really itchy all over. Could that be related to the D3 supplements? The onset is usually within an hour of taking it and it takes a few hours for me to stop itching. If it is related to the D3, what are the alternatives in winter?
      Thanks for your help.

  1. In some European countries, Vit D supplements prescription to adults over 70 years of age, with ostheoporosis, consists of monthly dosages of 25.000 IU (=820 IU/d considering 30.5 days/mo).

    IOM Upper Level is 4000 IU/d.

    Question: any study about the possible toxicity for such a large monthly dosages?

    NB: I recall similar questioning about Vit A mega doses in large national campaigns in developing countries in the last decade.

    I could not find anything so far on PubMed for Vit D.

    Thanks Dr Greger.

    Filippo

  2. Hi filippodibari, I do not think a single monthly dose of 25,000 would lead to toxicity based on information at this time. Your concern is well placed though… since we have a history of making recommendations only having to change them after finding out about toxicities later.

    1. Based on their current pricing, supplementing with that product would cost hundreds of dollars a year. Given the fact that at the preferred daily dosing D2 and D3 appear to be equivalent, I would suggest choosing a less expensive option (D2 is easily 10 times cheaper). Just think about how much kale you could buy with all the money you save!

      1. im guessing from the above comment that you feel D2 is just as effective as D3?  i’m vegan and recently found out im very deficient in D.  from what i’ve read, i got the impression that D3 is more absorbable and d2 could be toxic.  I would much rather take D2 b/c of my moral concerns..but i was scared into taking D3!  what is your opinion on this matter?  thanks so much in advance.

  3. Dear Dr. Greger,

    Thank you for this interesting video!

    Could you provide us with a list of the best oils/butters to use as a sunscreen (including a range)?

    Thank you so much!

  4. Hi. thanks for the videos. What about dosing for children? I started giving my 9 & 11 year old children 1000iu/day. Is this safe for them?

  5. I try to follow a whole food, plant-based diet and I favor Dr. McDougall’s starched based diet. I watch Dr. Gregor’s videos frequently and I find myself conflicted regarding the efficacy of using Vitamin D supplements. It seems Dr. Gregor recommends the use of them; whereas, Dr McDougall does not. See https://www.drmcdougall.com/misc/2015nl/mar/vitamind.htm . Dr. McDougall states that these supplements do not have benefit at least as far as bone fractures are concerned and may have negative side effects. Dr. Gregor emphasizes studies regarding overall mortality and the level of vitamin D to be at that optimal level (2000 iu daily). I live in the Seattle area where many days may go by without sunshine. Questions: 1. Does the body produce vitamin D if outdoors even with cloud cover? 2. Are there studies that demonstrate the negative side effects of vitamin D supplements? 3. Dr Gregor’s video seems to suggest that there is no natural means of maintaining an adequate level of vitamin D without supplements so that suggests that perhaps the levels recommended are inflated. Does this seem plausible from available research?

    1. Hey Tim, Thanks for reposting this question. Vitamin D seems complex and doctor’s may have varying opinions based on the populations they serve. The choice is yours, as there is not a perfect answer. Know that there will be many more vitamin D videos from Dr. Greger to come, so stay tuned…

      Here is Dr. Greger’s take on vitamin D. Perhaps there is more to vitamin D beyond bone health? Dr. Greger mentions if vitamin D supplements are necessary in this video (the one above) and whether we should obtain vitamin D from sunshine, mushrooms or supplements here. You can also see his video on cancerous tanning beds.

  6. Apparently my vitamin D level is 13. My doctor wants me to take 50,000 iu? a week for 15 weeks and then 2000 a day. This seems excessive to me. What is your take on this? I’m 73 and very overweight.

    1. I am also interested in this, living in Britian we don’t get to see much sun. I returned from the doctors with a low level Vit D (12) and have been prescribed 3000 IU each day, for a few weeks…then i need to go for another blood test as i have painful hands and the Doc wants to rule out its not my lack of Vit D first.

      Is this ok to do, is there any other way to get Vit D, i know sun exposure is the best, but like i said we don’t see too much of it here. Would it be ok to still expose self to sun with cloud cover?

      any help would be of benefit
      Thanks
      Claire

      1. Hi thanks for your great question. I live in Wisconsin and we spend most of our winters indoors. So I have to supplement too. In the clinic I used to work in, I think EVERY vitamin D level we checked was very very low. It just may not be possible to get enough some exposure.
        You do want to get your level corrected and it may not be possible without supplements if your level is already low and you have limited sun exposure. In some areas of the world, even with sun exposure, the sunlight is not direct enough to make adequate Vitamin D. Once your level is corrected, I think adequate sun exposure, weather permitting, may be able to help you maintain it, but may not correct a deficiency. If you are eager to stop or decrease your supplements once your level is corrected, I would make sure to continue to get it checked to make sure it doesn’t get depleted again. I try to get all the sun I can during our summers and then when the weather forces us indoors, I start taking a maintenance dose of vitamin D and my level always tests adequate.
        Good luck.
        NurseKelly

  7. I found this advice useful. I am also interested to know if there is any science comparing ‘mushrooms grown in sunlight’ vs ‘DIY sunlight added to ordinary mushrooms’, as described below.

    Increase the vitamin D in your mushrooms.

    Over the past decade, sci­entists have found that it takes only a modest amount of UV from the sun or special lamps to produce significant levels of vitamin D in mushrooms. Just 15 minutes of direct sun­light can produce 200 to 800 IU in 3 ounces of mushrooms (the daily RDA is 600 to 800 IU), regardless of type or season. At least 90 per­cent of the vitamin is retained after storage and cooking. Whole button mushrooms syn­thesize the least D; sliced buttons, however, are proficient D producers. If you do this your ­self, place the mushrooms with the “gills” (also called lamellae, under the caps) facing the sun to increase D production. The mush­rooms may discolor or dry out a little.

    Bottom line: If you like mushrooms, those that have been exposed to UV can help you get more vitamin D, but it’s easier and cheaper to take a vitamin D supplement, if you need one.

    Source:
    http://www.berkeleywellness.com/healthy-eating/nutrition/article/mushrooms-and-vitamin-d

  8. Hi, i’m a 6″2 male, about 250lbs, i take 10,000 iu a day which i bought from Amazon (seems like a lot to me) . Is this safe? i have been diagnosed with low levels of vitamin D, i don’t go out much and i live in the UK where there’s no sun.

  9. The optimal level to take can vary considerably from one person to the next. Just be sure to check your levels periodically until you reach an optimal level of vitamin D in your blood. See this video for reference: https://nutritionfacts.org/video/the-optimal-dose-of-vitamin-d-based-on-natural-levels/

    There is an entire series of vitamin D videos, which can be found here: https://nutritionfacts.org/?fwp_search=vitamin+d&fwp_content_type=video

    Dr. Jamie Koonce

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