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Comment by rapsey | Hacker News Reader

> Those concerned about low vitamin D levels can get more of the vitamin through foods.

As someone who had a number of health issues whose underlying cause was a vitamin D deficiency I do not agree.

There is no substitute for light. Supplementing with D3 had very limited effect. Using a vitamin d lamp however was a world changer within days.

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Was your supplement dosage enough though? In the order of 10000 IU per day?

The problem with vitamin D was that up until about a year ago, official recommendations in many countries were mistakenly low (500-1000 IUs), which as it turned out, was not enough for many people. It was even hard to find proper pills that has high enough dosages, because when you got to your local farmacist which was going by the official recommendations, all they had were 200-500 IU pills, because they were not expecting that anyone would need more. So as an average citizen who does not do their research properly, if they just went into a farmacist and took the first Vitamin D supplement they saw, the chances were that they were getting one which had basically no effect.

When the dosage is right, many people experience positive effects and dormant Vitamin D levels really do go up. The sun is not required.

It was 6000+

Just another anecdote, a friend of mine with Lyme Disease has serious problems absorbing vitamin D (and other nutrients) via food, his doctor has him on 10K per day.

If I recall correctly, such a treatment is not yet evidence based, though clinical trials are ongoing.

Was it gelcaps or dry tablets? Vitamin D is fat-soluble so much better absorbed in gelcap format (and taken with a meal).

Personally, I've been taking 5000 IUs/day and recently started stepping that closer to 10,000 IUs. I use the liquid drops which are in oil, and I always try to take them with some sort of meal. The liquid is a lot cheaper and seems like the ideal way to absorb it to me.

This is in cloudy wintertime Seattle. In sunny times it may be completely unnecessary.

I would be very careful with liposoluble vitamines, they can aggregate in your fat tissue and cause toxic effects

Do you have a source for the 10000 IU per day guideline? If that's D3, that's 25 times to "recommended" amount, well above what is considered safe for long-term use. Now, I realize that our understanding of these things are in a state of (often violent) flux, but I would like to know who's recommended such a high amount. The problem with Vitamin D is that it is fat-soluble, not water-soluble, so your body doesn't expel the excess very quickly and it builds up. Too much can be harmful, particularly to your bones and kidneys[1].

[1] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...

Mark Hyman made post on it(he is Hillary Clinton’s doctor): https://drhyman.com/blog/2010/08/24/vitamin-d-why-you-are-pr...

That's a good read. He says you can go high (10000 IU/day) for 6-10 months, under doctor's supervision, then cut back down 2000-4000/day. This also makes sense from the perspective that it's fat-soluble, so you should be able to "fill up the tank" as he puts it.

> well above what is considered safe for long-term use.

The Mayo clinic article says:

> Taking 60,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity.

So 10,000, while it's well above the "recommended" dosage, is nowhere near the toxic level. Although when I was looking around the toxic level was 20,000, still, I've seen no guidance regarding Vitamin D that suggests 10,000 IUs/day can be toxic. (Especially if your BMI is over 25, and you're not getting much sunlight.)

Mayo clinic article concerns excessive supplementation, isolated on vitamin D, specifically.

A hypothesis exists that increasing vitamin K consumption in proportion to the vitamin D, and restricting calcium intake, would eliminate the main symptoms of excessive vitamin D supplementation. Nonhuman animal experimentation confirms, but it has not been tested in humans (likely due to the obvious ethical concerns).

Vitamin D, vitamin K, and calcium are all related.

I have seen guidance specifically for vitamin D2 (ergocalciferol), indicating that adverse symptoms may be observed at lower levels of supplementation than for vitamin D3 (cholecalciferol), but it was quite some time ago, and I don't know if the claim was confirmed or refuted scientifically.

I'm always worried about how easy it would be for manufacturers to accidentally put more in a pill than the label says.

10,000 IU is only 1.25 mg, and vitamins aren't well regulated. It's not like you'd notice if your supplement contained 100,000 IU.

USP and other certifications are supposed to address this, but the onus is on the consumer to seek out the certification label.

http://www.usp.org/verification-services/verified-mark

Others include NSF, UL, and consumerlab

https://www.consumerreports.org/vitamins-supplements/what-us...

There's still the chance that a manufacturing mistake could result in bad dosage but that applies to all products including medicine.

Vitamin D is particularly worrisome to me because a few milligrams is the difference between therapeutic and toxic.

... and in fact it has happened. With drops for infants that had a 75 times too high concentration:

http://cphpost.dk/news/danish-health-authority-warns-of-toxi...

That happens all the time. Please check https://labdoor.com/ before buying any unregulated drug.

Oh dammit! I wish I had seen this before I went to the drug store...

Remember that 60,000 was chosen so that toxicity could be very reliably demonstrated. It does not mean that lower doses are not also toxic.

I know you have faith that taking large doses of vitamin d isn't dangerous, but there is very little evidence supporting its value. We all have to make serious decisions every day without scientific support, so I don't begrudge you the right to do what you believe is best for you. But don't you think it's a little irresponsible to try to convince people that this belief of yours is actually effective? AFICT, there's as good a change that your advice will take ten years off of a life as it has of improving life. And you want to push this on others?

Thankfully it was posted to HN so I could find it. Google search has a truly become useless for this stuff. It's early in the morning, but I think I'm reading the abstract right. [1]

1. https://www.ncbi.nlm.nih.gov/m/pubmed/28768407/

Try google scholar next time instead of regular google search.

To add some anecdotal info, those numbers are much more closer to my own personal experience. I've been experimenting with various dosages, with regular blood tests by a doctor, for a few years now. Currently I've setteled at 4000 IU/day to stay at 75 nmol/L, which is the lower end of what is considered normal.

Excellent! Thank you!

The problem with Vit D3 supplement is that you don’t absorb most of it. It is well known, than the bioavailability of the supplements is not the same and that even the molecule itself is not the same as the one your organism produces.

Also, the science is starting to question the supplementation. It’s too early to tell, but one hypothesis is that it is a biomarker at the end of a pathway and not at the beginning of it, i.e. as a consequence of a proper diet and sunlight, and not a cause of a healthy system.

So the vitamin D might be there due to a healthy system instead of the system being healthy due to vitamin D.

An analogy would be the analysis of car exhaust, finding certain levels of CO2, and trying to fix cars with "bad exhaust" by throwing more CO2 into the intake (except maybe this would even have a negative effect by hindering combustion).

> An analogy would be the analysis of car exhaust, finding certain levels of CO2, and trying to fix cars with "bad exhaust" by throwing more CO2 into the intake (except maybe this would even have a negative effect by hindering combustion).

This is an hilarious (and fitting) analogy for nutrition sciences.

There was a classic TV ad by an oil company that said that CO2 is great because it is plant food. It's still an argument used by folks who oppose CO2 controls.

> It is well known, than the bioavailability of the supplements is not the same and that even the molecule itself is not the same as the one your organism produces.

Reputed and trustworthy citations from scientific sources required, please.

No it’s not required. This is a discussion board not a thesis paper review board. Do your own googling. If he or she is wrong then call bullshit.

IMO "Reputed and trustworthy citations from scientific sources required, please." is just a more elegant way of calling bullshit

It's an elegant way of covering noise with more noise.

It is required. Just claiming something is well-known to counter someone’s suggestion without providing any evidence isn’t very productive.

No other suggestion was offered in the post I am referring to, just a "sources pl0x" ask. Here is the simplest counter example I can think of.

"Gravity is real."

"Reputed and trustworthy citations from scientific sources required, please."

You can get less and less ridiculous from here ad nauseam, but the point is made.

"It is well known" is a weasel word, and hence requires more substantiation when asked. If one has to rely on Googling on these matters, one can find so many contradictory views. So I wanted to know what reputed sources the GP was relying on to use "It is well known" for that claim.

Every cholecalciferol molecule is the same. This is chemistry. Chemicals that are not the same cannot have the same chemical name. Every animal (without a genetic defect specific to the precursor chemicals) produces the same 7-dehydrocholesterol molecules, and every 7-dehydrocholesterol will, under UVB light, convert to cholecalciferol.

Industrial production of vitamin D3 irradiates the 7-dehydrocholesterol extracted from sheep's lanolin with UVB light.

There is some question as to whether ergocalciferol--a chemical mainly found in fungi that produce ergosterol and have been exposed to UVB light--is biologically equivalent to cholecalciferol in humans. It can alleviate vitamin D deficiency symptoms, but it is not known with certainty whether it can produce a sufficiency. As far as I am aware, the known cases of hypervitaminosis D have resulted from ergocalciferol supplementation, rather than from cholecalciferol.

If you are supplementing with vitamin D3, the chemical you are consuming is identical to that produced in your skin under UVB irradiation. There is no evidence whatsoever that it is destroyed in or poorly absorbed by the human digestive system. If you swallow 15000 IU of vitamin D3, that is the equivalent of standing shirtless in temperate midday sun for 15 minutes, after which time you will achieve no further benefit until some time has been spent absorbing the cholecalciferol and replenishing the 7-dehydrocholesterol in your skin.

It is poorly known, that if you have to preface a statement with "it is well known", what follows is less likely to be "known" than "unattributably rumored".

how about just search hacker news? https://www.npr.org/sections/health-shots/2018/11/10/6665455...

https://www.theguardian.com/science/2018/mar/09/is-vitamin-d...

And those studies saying otherwise have been backed by a lot of questionable money: https://www.nytimes.com/2018/08/18/business/vitamin-d-michae...

Oh by the way sunscreen is terrible, it doesn't have a proven link to reducing cancer and it destroys reefs so do yourself a favor and get more sun without all the slimy goop so you can feel better AND save the planet!

Pairing K2, or consuming vegetables high in vitamin K, helps with this. Personally I both consume a supplement and use a SAD light.

I didn't have any problems getting 20k IU in the UK had to get it prescribed

taking vitamin D at such a high dose can give you health problems such as kidney stones. When I took 5000 IUs for a period of time I started getting painful kidneys just from the urinary effects.

Now I try to get my vitamin D through more normal sources by eating lots of UV-exposed mushrooms, salmon, and sardines. Plus side is these foods are all quite healthy even without the vitamin D

That is interesting. I had read that 500 was ineffective but did not know that 10000 was effective. If you've done the research what is the most reliable source you found ?

There is research implying that levels of vitamin D are only an indicator of good health, and does not cause it (i.e. correlation instead of causation): https://www.outsideonline.com/2380751/sunscreen-sun-exposure...

OP would still likely be fixing their problem though, right? That article says it is the sun exposure itself that has a positive effect, and vitamin D is the byproduct.

To be clear, that's a really useful article, just want to clarify that your intent is indeed to explain why vitamin D wouldn't work but a UVB lamp would.

Exactly.

Another possibility: higher vitamin D levels are associated with health because people who are outside more might be getting more exercise, and it's really the exercise that is doing it.

It's hard to disentangle all these things.

A related article that was on here recently-

https://www.outsideonline.com/2380751/sunscreen-sun-exposure...

Vitamin D is something we can measure and often serves as an indicator, but large scale tests have shown limited effectiveness of supplements at resolving the issues a Vitamin D deficiency causes. e.g. We increase blood Vitamin D, but there are unknown correlative mechanisms that we aren't substituting.

Good, straightforward advice from the NHS here. https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-... - just about the only vitamin that they recommend supplementing orally for the general population, at least during the winter months.

The evidence on this seems to be changing frequently, not unlike the evidence on whether taking vitamin supplements is a good idea (https://www.health.harvard.edu/staying-healthy/should-you-ge...). Generally speaking, the latest science on nutrition seems to be more subject to later revision, or even reversal, than the latest science on, say, physics or geology.

So, while we wait (perhaps decades) for nutrition to become a more reliable science, I like to consider it from an evolutionary angle. That which is very dissimilar to what my ancestors experienced, like plentiful sugar or a sedentary lifestyle, is more likely to be bad for my health.

Exposure to the sun for hours a day, including the UV part, was part of our ancestors' lifestyle from the beginnings of our species, until a few decades ago. Now it is possible that this is the exception, and we should keep ourselves shielded from UV at all times even though it was what we evolved for. But...

- we don't now much about our skin microbiome, but we know we have one and it matters, and it seems unlikely that removing all UV would not impact that - we know there's an impact on vitamin D levels, but the details of that are still unknown - we know that eczema, psoriasis, and other skin conditions have been rising in recent decades, since the "always wear sunscreen" advice became common

Now, many that's all a coincidence, and UV is bad for us, and lack of UV is good for us, regardless of the fact that it's the environment we evolved for. But I'm skeptical.

There's another important factor to consider, and that's how we expose ourselves to UV. Our ancestors used to be outside most of the day, allowing skin pigmentation to adapt to the regional and seasonal UV levels. Until agriculture came along fairly recently we also lived mostly in the shade of the forest and not in direct sunlight.

Compare that to today, where UV exposure mostly means exposing the skin to massive bursts of UV for short times, at best in an effort to build skin pigmentation that isn't sufficient. That's completely different and much more damaging, leading to the general feeling that any UV is bad.

We are also a lot cleaner. We remove dirt and dead skin, whereas our ancestors left it there and it may have acted as a protective shield from UV.

I think our ancestors lived in the full sun of the African savannah a lot more than the forest, and even in northern Europe, hunter gatherers were killing meat-on-the-hoof (mammoth, wild horse, etc.) so they were running about in the open a lot.

However, the change in exposure is surely true. I'm just not at all convinced that complete shielding from UV is a better choice than occasional UV.

Until recently, children would run around outside a lot during the summer, even in urban environments, and especially in suburban or rural ones.

Do consider that your ancestors developed in a particular latitude in a particular climate. E.g. anglo-saxons developed in northern latitudes & have pale skin. The fact that they spent many hours a day in the sun unprotected does not mean that an anglo-saxon would be advised to do the same in Phoenix.

Absolutely. I do think that the typical amount of sun which a descendant of northern Europeans, now living in Phoenix, gets is probably still not as much as their ancestors got, simply because the amount of time spent outside is so much less. But your point is well taken.

Be careful of the natural fallacy. Life expectancy was much lower a long time ago, and causes of death from poor health were not recorded very accurately.

Choosing the natural over the artificial is a reasonable default where the science is uncertain. But just remember that science has eliminated an awful lot of problems.

Also remember that natural experiences aren't always a la carte. Picking natural foods from disperate regions might be very unnatural, as is getting natural UV light after taking a shower.

Certainly, many natural things are not good. However, the idea that a complete absence of natural light (which includes UV) is good, is suspect. It reminds one of the idea, in the early 20th century, that getting rid of all bacteria was good. It turns out that there are way more kinds of bacteria than we know, and an excess of antibiotics and disinfectants is almost certainly a big part of why we have ever-escalating rates of severe allergies and auto-immune disorders.

Not that we would wish to have a complete absence of antibiotics. But, the attitude of "you have a virus, so take this antibiotic just in case there's also a bacteria", sounds a lot like "block all UV light from hitting your skin, at all times". I am skeptical.

I mostly agree. I'm just saying that you might want to stop using soap as well ;-)

Using soap has a big effect on how the UV light hits your skin, the damage it might cause, and the benefits that it might have. Of course this is all speculation on my part, but I am just warning of the idea of picking one natural thing at a time -- natural things go together.

Maybe instead of sunscreen, we should be using mudpacks. :) I think it might hurt my chances of getting employed, unless I worked only remotely. Also, my wife would have words.

However, anecdotally, the "mud beggars" at modern Renaissance Faires are said to have healthy skin. It could be a confusion of cause and effect, though.

Also, most descriptions of our ancestors show them to have been far more hairy than we are.

I think there's a business opportunity for someone to make light bulbs which emit a little UVB. Not enough to cause sunburn or raise skin cancer risk, just enough to keep our vitamin D levels up. That way you could just stick it in a light fixture and go about your normal life. Is such a light practical to build?

I try to use a tanning bed a couple times a week in winter.

is that safe?

Not at all.

Tanning beds are banned in some countries with high skin cancer rates for good reason. It is a lottery and you are accumulating risk with exposure. I strongly suspect (without any real evidence) that there are a number of beneficial health effects to moderate UV exposure that can improve quality of life for some people but the experience with fair skinned populations in high UV parts of the world has been overwhelmingly negative. The public health advice is basically written in blood on this topic and so I would view people and sites promoting alternative views with an appropriate amount of skepticism for now.

I think we need to update GTL: Golang, tan, laundry.

There are plenty of tanning (UVB) lights at all different wattages available for purchase.

I think the problem is the visible light output tends to be harsh, and the bulbs are highly inefficient, they are exensive, and they don’t last very long either.

So there would be a lot of problems to solve, not the least of which is the cultural issue you raise of scaremongering around UVB exposure in the first place.

Or just replace window glass with OP4 plastic. Not cheap.

They used to sell these (as regular-size fluorescent tubes) decades ago.

There is one FDA approved vitamin D lamp made by Sperti.com. Costs about $400, has a 5 minute timer, instructions say to use it once every other day, the UVB spectrum of the lamps is tailored to Vitamin D production. I have one, it works better than pills.

For those curious about the lamp, this is the link: https://www.sperti.com/product/sperti-vitamin-d-light-box

I agree that food doesn’t have enough vitamin D, but supplements really made the difference for me. Just get the right dosage (which is probably higher that you think).

Were you measuring in observed serum vitamin D levels, or just in subjective wellbeing? Light therapy fixes Seasonal Affective Disorder but doesn’t necessarily do so by increasing vitamin D production.

Could I ask what lamp you chose and how long you spend in front of it? I take a fairly high dose of D3 and I'd be curious to try artificial light. Thanks!

Androv 3000 uv-b lamp for vitamin d.

I never use it for more than 1 minute and I alternate between facing away and towards it. For the first month I used it every day, now more like every other day or every two days.

Tangentially related, I got an androv full-spectrum lamp several years ago for some color work. It was one of the few true "full spectrum" bulbs you can get for cheap which are decently balanced without resorting to use a combination of bulbs. And yes, we tested it with a spectrometer.

Most other full-spectrum lamps I tried at the time on amazon didn't get even close.

If you never tried, working with these lamps is weird: turning it on in the evening or night by mistake _really_ wakes you up.

So yeah, I hope Androv kept up with the quality.

Was that the desklamp? Do you happen to know a more specific model of such a lamp?

Yes, to be specific the 42W model. I did the order in 2010, to be specific, so some time has passed since I did the tests.

Maybe I should replace my daylight lamp with this, to counter the winter depression. (Norwegian).

Are these lamps safe?

A few applications à 15 min with a mercury high pressure lamp with a good reflector and you look like you went to the Caribbean for holidays. Maybe add a filter for UV-C, but there is no ionizing radiation. Just show any lamp in question to your favorite dermatologist. If he seems unhappy, you have the chosen the right lamp.

Jokes aside, skin is very photo-active and I do think lamps can help greatly against these kind deficiencies.

Most lamps emit a line spectrum though, so it is not like real sunlight. I wonder if that is the reason people going to solaria often seem to have weird skin tones. Ask a dermatologist and don't forget eye protection.

Apart from that it has the same side effects as sun exposure. Too much leads to skin aging, sunburn, cancer, etc.

Those side effects can be mitigated or at least reduced by adding extra infrared or red light. Eg sunburns are prevented or greatly reduced by treating with near infrared either before or after UV exposure.

Could you explain please how/why IR helps with sunburn? :o

There are some interesting papers turning up if you google „pubmed infrared sunburn“. One of these: https://link.springer.com/article/10.1007/BF00373376

>... now more like every other day or every two days.

Can I ask the difference? I'm assuming a typo, but haven't experienced sun shortage for at least six years, so I'm not sure on boom / bust cycle potential with these things.

I dont understand the question. The difference between using every other day or every two days?

Using every other day = use one day, then not use it the day after.

Using once every two days = use one day, then not use it the day after.

Perhaps you meant "once every three days", i.e. use it one day, then not use it for two days?

Yes I meant every three days

Do you use it only in winter, or year round?

Year round

A related anecdote:

I dabbled in light therapy and found the first lamp I tried [1] very effective. However I have also started receiving comments from my colleagues about my nice new facial tan, in the dead of winter. I freaked out because the lamp was in my field of view 30 minutes per day every day without any eye protection, and sent the lamp back to where I bought it. Subsequently I have tried three different LED-based lamps and they seem to have no effect. I have carefully measured the light output and placed myself at proper distance to get the requisite 10,000 lux in all cases. No dice.

Here's the kicker - that lamp [1] appears to be the one used in some of the light therapy research (that's why I got it). It is entirely possible that much of light-therapy research was contaminated by badly designed lamps. There is no FDA certification for any of this as far as I know.

[1] Carex Day-Light Classic Plus Bright Light Therapy Lamp. Supposedly UV-filtered.

How is a Vitamin D lamp supposed to promote the creation of Vitamin D without UV?

It only blocks most of the UV. The lamp itself is blasting a very intense amount of light, so that the circadian-sensitive mechanisms in your eyes are fooled into thinking you're outside on a bright summer day. The vitamin D is secondary to the main function of the lamp, which is to be incredibly bright in comparison to most indoor lights. The light-therapy lamp must be aimed at the eyes (even for blind people!). It just doesn't work as well if you can't see it directly. You would have to pump even more light into the room to get the same amount reflected off of other surfaces.

Also, the lamp could be putting out UVA and not much UVB, so it could tan without producing much vitamin D.

For just the vitamin D, I'd get a "5.0" UVB lamp in a bare-bulb fixture, designed and sold for indoor avian and reptile pets. Aim at arms and hands, and away from the eyes. They're about $15 per bulb, and should be replaced every 6 months, as the UVB output degrades over time. Afterward, they work perfectly fine as compact fluorescents, behind glass or under lampshades, for several more months, albeit shaped inconveniently for some fixtures.

A "10.0" bulb is for desert-species pets. The UV output is too high for the overall lamp brightness, and may damage your eyesight, as human pupils don't constrict enough. I suppose you could wear sunglasses, but that seems counterproductive to just buying a lower-UV lamp.

These "light therapy" lamps don't. They just supposedly improve mood from the exposure to bright light itself and don't claim to produce vitamin D.

LED lamps do not emit any UV unless you specifically order ones that do. Fluorescent lamps put out more UV by comparison!

Do LED lamps not produce light via blackbody radiation? If they do then they must produce at least some UV

> Do LED lamps not produce light via blackbody radiation?

I'm pretty sure the answer to that is that they do not.

No, they use electroluminescence, not incandescence.

>was a world changer within days

Question, what were your health issues and what changes did you see that quickly?

Magnesium deficiency and a general mineral imbalance that resulted in severe insomnia. I also developed a bunch of food intolerances that were getting ever worse.

I was supplementing with a lot of magnesium. Sleep returned very quickly, my need for supplementing magnesium also dropped in days.

How were you measuring magnesium need, blood tests?

After reading the "Big Vitamin D Mistake" article on HN in 2017 I also started experimenting with larger doses of Vitamin D and can attest to life-changing effects.

It has been like a permanent +5 to constitution; I am now almost through my second winter without getting sick, something inconceivable for me as a kid growing up with asthma and a whole range of puffers, and always prone to debilitating sinus infections that told hold in January and never really let up sometime around April.

That is amazing. What kind of vitamin D in at what levels did you settle on?

I initially started with 1000 IU of Vitamin D3, Costco brand, and eventually settled on 5000 as I noticed improvements in energy level as I took more.

I am at 43 latitude so I only start taking it in mid-November and start weening myself off it in late March (you never really know if/when spring will happen up here in Toronto :)

Thank you,

Couldn't it be that this depends on the person? Maybe others can use the vitamin D present in food? I.e. part of your deficit might be because your body somehow cannot process the D in food? Just guessing here..

I have no idea

Typically there isn't enough vitamin D in food to match anybody's recommended intake, unless you eat rather large amounts of seafood.

Narrowband uvb is a very effective treatment for some skin conditions. The mechanism is totally different to vitamin D and oral supplementation basically has no effect. UV exposure is a significant health risk in some parts of the world and the public information campaigns to reduce exposure seem well justified. But I wonder if there isn't a case for a narrowband uvb sunscreen that only lets those dangerous but highly effective dna mutating rays through along with some sort of cheap and reliable dosimetry.

I live in Southern California and it's common for people to have these effects when moving here from darker locales and spending time outside. My severe insomnia almost vanished after coming here.

And here I was thinking I was OK because I drink vitamin D supplemented whole milk.

> Using a vitamin d lamp however was a world changer within days

Which one do you recommend?

I mentioned the model in another reply. Androv 3000

Those concerned about low vitamin D levels can get more of the vitamin through foods.

Supplementing with D3 had very limited effect.

Non sequitur. Pills are not food.

Which lamp do you use?

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