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Comment by PragmaticPulp | Hacker News Reader

The title doesn’t match the abstract. This isn’t a study of the tolerable upper limit of Vitamin D intake. It’s a case report of a single individual who was taking astronomical doses of Vitamin D with disastrous consequences.

It’s certainly possible to take too much vitamin D without coming anywhere near the silly doses this person was consuming.

Anyone taking aggressive vitamin D doses should invest in a vitamin D test after 6-12 months. If you find your serum results approaching the upper end of the reference range, reduce intake slightly. There are no known benefits to excessive vitamin D serum levels, but there are documented health downsides.

If you find yourself reading pop-science articles with unbridled enthusiasm for megadosing vitamins, you’re probably not reading scientifically accurate health advice. Supplementing with moderate doses is fine, but megadosing anything is almost always flimsy pseudoscience.

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Everything you say is subjective (at best) or tautological (at worst) until you put a number to what you are calling a "megadose" or "excessive." "Megadose" is relative and needs to be couched with the emerging (not really, it's a decade old at least I believe) that the current official RDA of vit D is about 4-5x TOO LOW and was based on bad data (or a misinterpretation of the data).

Whether or not that's true, the article isn't talking about 4-5x the RDA.

It's talking about massive doses beyond even the most aggressive supplementation, much less a normal days intake.

According to the paper she was indeed taking 325 times the recommended daily dose of Vitamin D for 20 months.

The paper is indeed pretty silly. "How much is too much? Somewhere between 1x and 325x RDA apparently."

Thank you for posting the actual number instead of just saying "excessive" or "megadose".

(It's true, I didn't read the article.)

Fortunately, there is a link at the top of the page, which leads to the very article that OP is talking about.

...the current official RDA of vit D is about 4-5x TOO LOW...

The person in the study was taking 162.5x the largest recommended daily allowance.

> Everything you say is subjective (at best) or tautological (at worst) until you put a number to what you are calling a "megadose" or "excessive."

The Vitamin D blood level range is clearly indicated on the blood test results. That’s why I suggested that people get the blood test.

Blood test shows too little Vitamin D? Supplement more. Blood test shows you’re approaching or exceeding the upper limit? Supplement less.

There’s nothing subjective about it.

> the current official RDA of vit D is about 4-5x TOO LOW and was based on bad data (or a misinterpretation of the data).

This claim, however, is unbounded. We can’t just go around telling people “more is better” and that the official recommendations are vaguely “too low” and expect people to just guess at the real range.

> This claim, however, is unbounded. We can’t just go around telling people “more is better” and that the official recommendations are vaguely “too low” and expect people to just guess at the real range.

I don't understand this sentence at all. 4-5x is an extremely specific amount, with no guessing.

Megadosing B12 (if your diet isn't already sufficient in it, which is common amongst certain vegan diets) is still a good idea, no? I recognize this might be the only exception.

I don't see any evidence that it's a bad idea, but from poking around I get the feeling that there is still a lot about it that we don't know.

For instance, it may be monkeying around with blood flow to the kidneys somehow.

"Among patients with diabetic nephropathy, high doses of B vitamins compared with placebo resulted in a greater decrease in GFR and an increase in vascular events."

https://jamanetwork.com/journals/jama/fullarticle/185758

House AA, Eliasziw M, Cattran DC, et al. Effect of B-Vitamin Therapy on Progression of Diabetic Nephropathy: A Randomized Controlled Trial. JAMA. 2010;303(16):1603–1609. doi:10.1001/jama.2010.490

So, it's probably fine, but honestly nobody really knows.

I mean yeah if you're doing heroic doses of something that you pee out, then your kidneys will be stressed out

... if you're doing heroic doses of something you can't pee out then it's a bit worse

"megadosing" doesn't sound like its required for any reason unless you're malnourished, in which case your doctor would tell you how much to take. Adjusting your diet to not require "megadosing" due to malnourishment sounds like a better plan for long term health.

In addition, studies suggest that high levels of B6 and B12 in the blood are correlated with higher risk of certain cancers, such as prostate and lung cancer. In my opinion, having mild nutrient deficiency is not cause for alarm if you're a fully grown adult, and in fact, studies suggest that malnutrition might confer a longer lifespan.

I do not think those are good suggestions for the average person. I've read meta analyses about low caloric intake but not about malnutrition, which in general is a bad idea.

That being said most people who aren't severely restricting the types of food they eat, and eating healthy food, are unlikely to have significant malnutrition.

The lung cancer thing I remember was specifically smokers, so its not straightforward.

>studies suggest that malnutrition might confer a longer lifespan.

There are some data suggesting that inadequate supply of this or that nutrient reduces certain aging mechanisms and leads to longer lifespans in a laboratory setting. However, outside of a laboratory setting these nutrient deficiencies can affect the body's ability to fight infections and heal injuries, which on average cancels out any benefits.

More generally, trying to increase lifespan by adjusting the diet seems to me like trying to fix a car by playing with the buttons and knobs on the dashboard. You might obtain a small improvement, but you're not really going to get anywhere unless you open the hood.

Are those malnutrition studies about nutrient deficiency or caloric deficiency?

The trouble with Vitamin D is afaik, as with some other vitamins, that it is fat-soluble rather than water-soluble. So the excess of the Vitamin won't be flushed out through the urine - but rather accumulates in the fat. At some point this accumulation may lead to toxicity ("Hypervitaminosis D" [1]).

Personally, I dose 4000-5000 IU D3+K2 in the darker seasons and that has been working well for me.

Vitamin B12 is water-soluble and therefore should not cause accumulation in healthy people.

[1] https://en.m.wikipedia.org/wiki/Vitamin_D_toxicity

Do you dose the D3/K2 combo on a daily basis? I've got https://amzn.com/B075R56QCQ which i do ~3 times a week.

I did that every day and started to have muscle pains and weakness after a while. After doing some research and experimentations, turns out you also need to take magnesium if that happens.

Every day year-round or just in winter at high latitudes?

That sounds like too much, which can cause calcium deposition in soft tissues. I'm 250 lbs / 113 kg and only take 125 μg (mcg) of D3 and 100 of K2 MK-7 once every other day (qod) because of D status for COVID prophylaxis and chronic premature distal osteoarthritis.

Calcium, magnesium, sodium, and potassium in balanced amounts along with K and D maximize bone health. Alkali metals supplementation alone is rarely a good idea because of the often common transports and osmotic competitions.

In general, a multivitamin, b complex, and omega 3 in the form of canned fresh sardines or anchovies (fish oil capsules are typically low in actual 3 and high in 6) is probably enough for most people.

5-10 mg/day of extra zinc during the annual cold season is fine too.

Don't supplement with E without a specific medical need.

I can say, as an anecdote of one, that I have been taking 5000 IU of D3 along with K2 and Magnesium every day (almost) for about 3-4 years, with no ill effects and what I believe to be a positive effect, in that I have not been ill at all during that time. Cold, flu, anything.

My beginning D3 levels were 39 ng/ml, so just under the ideal range of 40-60, and not really deficient. I have not tested recently, though I believe my numbers would be higher now. I also try to get at least 30 minutes of sun exposure over most of my body 3-4 times per week. Fortunately I live where I can get good sun exposure year-round. Point is, test your serum D3 level and do whatever you need to get into the desired range, and don't take more than that level of supplementation. I do believe that sun exposure is a better choice than supplements, if practicable.

It's my understanding that oral availability is lower than IM, and that people who are deficient get 70,000 IU injections.

I'm entirely untrained, but my amateur evaluation of the situation leads me to take 50,000 IU orally once each week or two. I imagine that twice that amount would be fine, too.

> I imagine...

That's not really science.

Given it's your body, the most valuable thing you have, perhaps a more fact-based approach is warranted?

I was pretty deficient (14 ng/ML) and I was prescribed 50k/week orally.

You are spot on: https://en.wikipedia.org/wiki/Hypervitaminosis

I sure hope so because I've been taking half a serving of these little suckers for a while now: https://amzn.com/B001LXRWWE

Here's a breakdown of the DV for some of the vitamins for a full serving:

B1 = 33x (yes, 3333%)

B2 = 30x

B6 = 40x

B12= 83x

Why would you need so much?

Supplement Marketing

If you do strenuous workouts frequently then this helps you recover faster and workout longer. If you are just couch potato then it’s actually detrimental and you can develop all sorts of problems including peripheral neuropathy.

Is there reason to believe that 10x vitamin B is insufficient to recover from a workout?

Strenuous workouts don't cause chronic deficiency and don't eliminate chronic overdosing.

I used to run ultra marathons, when you push your body to the limit like this, you do run into limits and deficiencies, not chronically but during hours of running and this extra overdosing does help the body function better

Ultra-marathons aren't "strenuous exercise" by any reasonable definition, they're much more extreme. For most people "strenuous" involves high heart rates for a half hour or so.

>If you do strenuous workouts frequently then this helps you recover faster and workout longer.

Is that (and the amounts mentioned) based on science, or just what some gymnast dude said?

>just what some gymnast dude said

The technical term is broscience

I have recently been using the Whole Earth and Sea Bone Structure multivitamin partly because it has much more reasonable doses of almost everything (except B12 for some reason):

https://www.vitacost.com/natural-factors-whole-earth-sea-bon...

They liquify plants and then ferment them in some proprietary process that they don't go into detail about (I wouldn't be surprised if they use some GMO bacteria that goes against the non-GMO advertising, since many commercial vitamins are produced by GMO bacteria). I just use two pills a day (what the chart shows data for, most vitamins from 1/3 to 2/3 of recommended daily amount). Eating a healthy diet, there should be no need for 100% or more of nutrients in a supplement, but it is frustratingly difficult to find reasonably dosed multivitamins.

I do that. I drink at least one 5-hour energy drink per day. I feel less depressed when I do that, but don’t try this at home without consulting doctor. I experiment with myself a lot and know my limits.

B3 overdose is dangerous if you have susceptibility to gout.

This happened to me after I inadvertently megadosed by consuming a knock-off Berocca drink containing something like 10x RDI.

That was over 10 years ago. I have not had a gout attack since.

Edited: Risk is actually for Vit B3 (Niacin). The drink I had contained massive amounts of B12, B3 and others.

https://www.mayoclinic.org/drugs-supplements-niacin/art-2036...

Megadosing B12 gave me dizziness and trouble sleeping (I had hypervitaminosis)

No, megadosing B12 isn’t a universally great idea.

For example, elevated B12 levels are associated with increased lung cancer risk in a dose-response fashion: https://pubmed.ncbi.nlm.nih.gov/30499135/

The only time megadosing B12 is a good idea is if you have confirmed low levels via a blood test and need to quickly raise your levels to the normal range.

Don’t assume you can guess your B12 status by reading random articles on the Internet. Low B12 has become a favorite hypothesis among the alternate medicine crowd, so online information about B12 supplementation has become corrupted with pseudoscience.

I’ll admit that I fell for the idea that B12 deficiency was rampant due to modern diets. Then I got a blood test and discovered that my B12 levels were toward the upper end of the reference range already.

On the bright side, B12 absorption is very nonlinear. A megadose might only cause slightly more absorption than what you find in a regular multivitamin. Most of the megadose is simply not absorbed.

And to be very honest, whenever I read articles about the dangers of excess Vitamin D seems I'm reading an article on the dangers of malnourishment. In a country of obese people.

Yes, don't mega dose but you have to go out of the way and ignore all warnings and be reckless. It's the equivalent of "hey, how much aspirin should I take?" And just take a random amount

I do take it, but I know how much of the RDA that corresponds to

> pop-science articles with unbridled enthusiasm for megadosing vitamins

That's an instant red flag for bullshit.

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