Vitamin D Supplementation Improves Cognitive Function: 12-month RCT | Hacker News Reader

Vitamin D Supplementation Improves Cognitive Function: 12-month RCT

pubmed.ncbi.nlm.nih.gov

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Interestingly, Oxidative stress is considered to the main cause of COVID-19 infection severity, according to Dr. Roger Seheult in his bio-chemistry analysis of SARS-CoV-2 in human body. He also explained why Vitamin D could help reduce the mortality of COVID-19 due to Vitamin's ability to slow down oxidative stress.[2]

Dr. Seheult is the main lecturer of his popular YouTube channel MedCram[3] and is a board certified physician in Internal Medicine, Pulmonary Diseases, Critical Care Medicine and Sleep Medicine.

[1]: https://youtu.be/gzx8LH4Fjic?t=28

[2]: https://www.youtube.com/watch?v=Mdc7T2UTHBI

[3]: https://www.youtube.com/channel/UCG-iSMVtWbbwDDXgXXypARQ

My sister got leukemia while part way through her doctorate. After it went into remission, she was unable to recall new information long enough to read papers and had to put her studies on hold. Eventually a doctor did a blood test that included vitamin d levels, and she was in the single digits (don't remember units but it was supposed to be at least 20). She started supplementing and graduated this spring. Just one data point, but it was pretty clear that remedying a deficiency made a marked improvement in her case.

The interesting analogy Ross Tucker (https://sportsscientists.com/who-are-we/) uses is adding vitamins and mineral is like adding a wheel to a car. If you onyl have 3, then adding the 4th is really going to make a massive difference. If you already have enough however, it's like adding a 5th wheel, which will essentially do nothing, and could be harmful.

It works well as an explanation, as people do seem to try and reduce complex functions to simple rules, and extrapolate from specific populatiosn to create general rules (not helped by studies that are minimally generalisable)

Also look at Liebig's barrel (https://en.wikipedia.org/wiki/Liebig%27s_law_of_the_minimum#.... It was originally applied to plant growth, but it is a helpful metaphor for vitamin substitution.

Similar story. My mind was in fragments from diseases. Vit D in low teens. Started high level vit D at start of Covid Brain function is approaching my old levels. Now I take a lot of supplements, so it’s always tricky to pin it down. But so far so goods.

Vitamin D is vital for adaptive immune system function too!

When a T-cell encounters a foreign pathogen, it extends a vitamin D receptor. A signaling device allowing it to bind to the active form of vitamin D. Only after this can T-cells perform their intended function. [1]

Which is likely why healthy levels > 40 ng/mL significantly reduce COVID mortality, there's been > 2 dozen obersvational studies and at least one randomized controlled one. [2]

1. von Essen MR, Kongsbak M, Schjerling P, Olgaard K, Odum N, Geisler C (April 2010). "Vitamin D controls T cell antigen receptor signaling and activation of human T cells". Nature Immunology. 11 (4): 344–49. https://doi.org/10.1038/ni.1851

2. Entrenas Castillo, M., Entrenas Costa, L. M., Vaquero Barrios, J. M., Alcalá Díaz, J. F., López Miranda, J., Bouillon, R., & Quesada Gomez, J. M. (2020). "Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study". The Journal of steroid biochemistry and molecular biology, 203, 105751. https://doi.org/10.1016/j.jsbmb.2020.105751

Funny -- I was just digesting a competing study released recently[0] which showed little-to-no benefit from vitamin D, Omega 3 fatty acids, and exercise (either alone or in combinations). That study used 5X the daily vitamin D as this one. So I guess the jury's still out and I may choose to continue to err on the side of supplementing vitamin D.

[0] https://www.upi.com/Health_News/2020/11/10/Study-Little-bene...

Or just get some sunshine! It's likely there are other benefits, besides just the vitamin D.

Oddly the study didn't seem to state (from the abstract anyway) if the participants were deficient in vitamin D to start with or not.

Sure, but the winter climates in many geographical regions don’t provide adequate sunlight during winter.

I was pretty amazed to Discover that Spirit Airlines is doing round trip flights for $75 to Orlando from my local airport. If you’re in the Midwest in a midsized city that’s cold and dreary in winter there’s a good chance you can find a similar deal.

A lot of this interest in vitamin D is motivated by the desire to not die from getting infected with sars-cov-2. Or not dying in general. Travel like that is counter-productive currently.

I know different people have different risk tolerances, but there’s no way I would get on a plane during a pandemic if I don’t have to.

An airplane is probably a safer place to be than your local grocery store right now.

Unless airplanes are alternatives to grocery stores, even if that comparison was accurate it would be meaningless.

Am I the only one who finds it laughable to consider trusting the word of companies the likes of Delta, Southwest, and US Air? They seem fundamentally incompetent in pretty much every other aspect of anything that doesn't involve literally keeping the plane from crashing. Why would I believe the air filtration systems are even going to be operational, say nothing about effective when they are?

Pressurized airliners have about 15 air changes per hour or 3-4x what’s typical in an office building. This is air exchanges with the outside, not filtration cycles which are in addition. Even if the filters were entirely INOP, I suspect you’re no worse off than sitting in an office building.

Now, I’m not doing that right now, but there’s little reason to think major US carriers aren’t doing what they say they’re doing and if the air change mechanism wasn’t working, you’d see oxygen masks deploying as that’s the mechanism by which the aircraft remains pressurized.

Sitting in an office building is one of the worst places you can be for avoiding getting sick.

Kids kind of makes it all pointless. They catch everything and bring it home.

It was nice not being sick for so many months.

2 weeks after they went back. Bam, everyone sick.

And that’s with intense mask rules and distancing

You're not wrong, but that doesn't mean that we can't take other measures to get back below R=1. The primary one I can think of is for governments of the world to give long term contracts to N95 mask makers so they can fully spin up their factories. It's been 9 months for $diety's sake.

Non-fit homemade and non-rated masks help prevent others from getting sick. But if everyone had access to cheap N95 that actually prevented them from getting sick we'd be a lot better off. The kids would still be getting it and getting everyone sick at home/school because they wouldn't wear them consistently right, but people without kids at home wouldn't be getting sick at nearly the rate. Every bit counts.

Maybe the masks and distancing don't actually work?

At the grocery store I can bolt at a moment’s notice if I see anything sketchy happening. No can do on an airplane. There could be a guy sitting next to me and coughing all over me for hours.

I don't know if this is mind blowing or not because people don't seem to use it but...

If you live in a suburb or further out, basically every major grocery chain does pickup orders.

I order online, drive to the store, and an employee puts the groceries in my trunk. I never go inside.

It's also... free. So anyone with a car(most of us in the USA/CA) can do it.

Congratulations, you have proposed the least ecologically sustainable vitamin boost I've ever heard. Every day brings new surprises.

Well I mean, in Australia, that leads to skin cancer, so I'll just take some tablets thanks!

We're starting to get into some pretty controversial territory here, but I think you're probably better off still getting at least SOME sunshine.

It's speculative, but I believe the skin cancer risk can be dramatically reduced by making sure you're not getting too much linoleic acid in your diet (note: you really have to try at this, tho -- almost every1 is!).

Here's a study in mice:

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1751-1097....

Of course, that's not humans, but I think the fundamental mechanisms at play should be the same.

More broadly, this article is interesting, and makes the case for more sun exposure:

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

Interesting. Other information [0] suggest that I should consume more lineolic acids compared to other fats to help my risk of Heart Disease that runs in the family. Not looking good for me hey!

[0] https://www.hsph.harvard.edu/nutritionsource/2014/11/05/diet...

Doctors in Australia recommend approximately 15 mins of sunshine a day in Australia.

This is pretty easy to achieve, even in winter, for us... and is unlikely to "lead to skin cancer"

Vitamin D taken via pill is not the same an that manufactured by sunlight. The pill form has side effects like causing too much absorption of calcium in the intestines, which leads to other problems. This is something that doesn't happen from sunlight.

Correct. Perhaps even more important than vitamin D is nitric oxide. The summarised advice is to avoid the sun when it is high in the sky (noon-ish), get some sun in the mornings/evenings, and supplement vitamin D. This ensures good levels of vitamin D and nitric oxide while reducing skin cancer risk.

Details here: https://youtu.be/Kvh4D_osFXs

> Or just get some sunshine!

Where I live I haven't been able to get sun actually on my skin for the last three weeks.

I saw sunshine through the window one day last week while in a meeting, but it was gone an hour later. According to my weather app the next break in cloud is more than a week from now.

Even when there is sunshine in the winter, it's often too cold to expose more than a tiny amount of skin anyway. Please don't assume we all live in California.

>Please don't assume we all live in California.

Same here, although at least there's sun on weekends for me (if it isn't cloudy). Looking out the window, and being outside on the weekend with a winter hat and long sleeves is probably not allowing a lot of vitamin D.

I'm wondering if there's something like a good lamp that gives UV light without being too strong.

UV bath in Russia.

https://www.nationalgeographic.com/photography/photo-of-the-...

That doesn't work at the latitudes some of us live at.

https://new-wayland.com/blog/onward-to-100-nmol/

No. I'm a computer scientist and work at the computer. In my free time i play at the computer. I don't like to walk around for kilometers in my free time.

Just because some people want to do it / can do it, it is not the same for everyone.

I’m allergic to the sun. Autoimmune. A day in full sun will mean months of agony.

There's a big difference between the amount you need to not get rickets (around 100 IU) and the amounts that seem to move the needle on other outcomes (2000 IU or more). The study used 800 IU which to me, isn't great.

One important factor in vitamin studies is the prevalence of vitamin deficiency in a particular population. E.g. vitamin D in the US might not be as effective because it is already added into many food products, e.g. milk, which is not the case for other countries.

Even within a population, vitamin D deficiency will vary by lifestyle, skin tone, and climate. All three of which vary a lot in the US.

My understanding is that even the definition of what constitutes deficient isn't settled due to how it's measured. For example, many African Americans show deficient even though it's believed they aren't.

In Germany (probably in most european countries) it's not allowed to add vitamin D to food. So it's really important to know about it.

Still, almost no one knows about it...

Vitamin D is added to milk and butter in Sweden, even obligatory for some kinds! But that's because of our sad lack of sunshine for many months on end of course, so I expect the other nordic countries does something similar.

> 40.7% of participants had 25(OH)D levels of less than 20 ng/mL at baseline, and according to current guidelines, all were allowed to take 800 IU/d of supplemental vitamin D outside the study medication.

So, even the controls were given D3 supplements if they were deficient. That kind of throws the whole study into question.

It might also be worth mentioning that measuring 25-hydroxy is also an approximation at best. That still has to be converted to 1,25-dihydroxyvitamin by the kidneys. People with high insulin resistance (diabetics, pre-diabetics) or kidney damage tend to have problems converting 25-hydroxy. Measuring 25-hydroxy is primarily used for toxicity and even that has variables that are difficult to measure, so a statistical baseline is applied.

I'm not so sure it does, as something like 800 IU of Vitamin D is the daily minimum.

> That kind of throws the whole study into question.

Well, that turns it into a study that checks if extra vitamin will have an effect, even when there is no deficiency. It doesn't throw the study into question, but it may not apply to what the people on this thread are talking about (what's never clear).

I have not looked at the underlying study, but that article definitely does a terrible job of being clear on the caveats of the study. E.g. this nugget was left for the last paragraph of the article:

"Our exercise intervention was a simple home strength exercise program, which likely was not challenging enough in our unexpectedly active study population, where over 80% already engaged moderate to high intensity exercise," she said.

I would take anything from this study with a pinch of salt. I doubt if it was a well controlled study.

It's worth noting that vitamin D has a lot of high-confidence but low-effect results going for it, including a lot of strong meta-analysis over many health outcomes. What I mean by this is that it usually seems to conclusively either do something beneficial, but minor, almost nothing in the case of many studies, and in the case of some others, something very beneficial (as we've seen a few of in relation to covid recently).

Although Vitamin D isn't a particularly exciting supplement most of the time, that isn't enough of a reason for us to ignore it, as the proper way to make the decision of taking it or not would be to perform a cost/benefit analysis (as we should with any other supplements, lifestyle changes, etc).

The costs of vitamin D are just about as low as any supplement gets, and can be between $0.01 and $0.05 per day. The non-financial costs such as side effects or potential adverse effects are practically non-existent as well. So I do think that even those that have a healthy bit of skepticism over some results should still consider supplementation - there are a lot of potential benefits even if some are minor, and almost no risks or real costs. The optimal way to supplement is to get a blood test before+after starting supplementation in order to be confident you're taking the correct amount, but this isn't required of course. But I think the cost/benefit analysis is clearly in favor, so I didn't hesitate to add Vitamin D to my list of supplements that I take daily (https://nearcyan.com/supplements/ if curious), along with many others at this point.

almost no risks or real costs

I worry a little about risk compensation, or whatever the equivalent is for diet. That is to say, if I feel like I'm all set on vitamins & minerals via pills, maybe I don't need to try so hard to eat my fruits & vegetables anymore...

Worth noting that the above mostly talks above Vitamin D specifically, not multivitamins. D is the only one you do not naturally get from food (ignoring fortified food), and it also as mentioned above one of the cheaper ones. Multivitamins are far more expensive in general.

Mushrooms? Salmon? Liver? Eggs? All of these have vit D without being fortified (mushrooms being a bit debatable as to if its fortified)

And its a little misleading not to talk about sunlight - technically that's not a food, but you were kind of implying you couldn't get it from the natural environment.

Vitamin D2 + D3 per 100g portion of mushrooms, according to this website from the USDA Agricultural Research Service (https://fdc.nal.usda.gov/)

- Mushrooms, raw: 0.2 µg (7 IU)

- Mushrooms, Chanterelle, raw: 5.3 µg (212 IU)

- Mushrooms, enoki, raw: 0.7 µg (29 IU)

- Mushrooms, maitake, raw: 28.1 µg (1123 IU)

- Mushrooms, morel, raw: 5.1 µg (206 IU)

- Mushrooms, oyster, raw: 0.7 µg (5 IU)

- Mushrooms, portabella, raw: 0.3 µg (10 IU)

- Mushrooms, shiitake, raw: 0.4 µg (18 IU)

- Mushrooms, white, raw: 0.2 µg (7 IU)

As you can see, there are many types of mushrooms and most of them do not have much vitamin D. Some do, but unless you are a mushroom nerd you are getting the wrong kind.

Young adult daily recommended dose = 1000 IU

Just came across this fascinating review:

https://fungi.com/blogs/articles/place-mushrooms-in-sunlight...

267,000 IU after exposing mushrooms to 14 hours of UVB?

Holy cow.

So, much like humans, mushrooms produce vitamin D from sunlight?

How much vitamin D is in a mushroom is going to depend more on how they are grown and stored then on the particular species afaik (in particular how much uv radiation it is exposed to).

I believe also that there will be more vitamin D in mushrooms that are irradiated to give them a longer shelf life. I don't think usa is a country where that practise is common, but i believe it is common in some other countries.

using a multivitamin daily is considered 'expensive' ?

Trying for a rough estimate of the yearly cost of taking a multivitamin daily, I get about $10 USD a year. For the 15% of the global population that live on less than $2 a day, that's around a week's wages. For the 56% that live on $2 - $10 a day, it's slightly more affordable, but still a significant cost.

Now, that's a cheap multivitamin, so it's got about 300IU of vitamin D, which is a pretty small dose. At a guess it's probably cheaping out on some of the other ingredients as well. On the other hand, ingredients bought in bulk and distributed through outlets in the developing world with very low overhead might be more affordable.

EDIT: the numbers for global poverty are probably out of date, but you get the point

10-20$ a year, compared to just D which comes down closer to 2-3$ a year. And again considering the other vitamins are much easier to come by. D is usually the ones that's more commonly lacking, especially in northern places.

We could fortify beer and Coca Cola with it. While it’ll be on the label, I bet 9/10 people can’t rhyme off what is fortified.

(Around here, it’s salt, milk, flour and cereals that get fortified).

Dunno where fluoride fits, but that too.

You belong to an interesting language isolate with whoever wrote this article:

SUNNY VALLI CRAG

http://3.251.20.7/log-details/?log_id=490&y=2009

I was puzzled by your phrase "can't rhyme off". Google returns very few instances that are not related to spontaneous spoken word poetry (which is likely an example of convergent evolution). After poking around a bit, it seemed as though I had heard a similar phrase before "try (to|and) rhyme off" in which 'rhyme' is synonymous with 'to list' as well

Best wishes for yourself, your friends and your family during these uncertain times!

what a fun phrase. wiktionary says canada: https://en.wiktionary.org/wiki/rhyme_off

That reminds me of a fun Canadian song that got passed around in the early Kazaa days (I had thought it was a Corky and the Juice Pigs song, but it is hard to attribute based on Google):

T'was the Scots that built this Country

https://www.youtube.com/watch?v=QakAwOhBkbA

I'll add that even many non-dairy milks are fortified with Vitamin D - check the label.

The way I understand it is that drinks fortified with Vit D are nearly always fortified with D2, whereas the consensus seems to be that D3 is the way to go. Not sure whether that's because D3 is less stable in drinks, or maybe there's another reason to prefer D2 there?

According to this article D3 is never vegan: https://www.healthline.com/nutrition/vitamin-d2-vs-d3#TOC_TI...

I believe “being vegan” is the point of most milk substitutes.

Fair point, but D3 can also be derived from lichen, which is vegan.

https://www.vegansociety.com/resources/nutrition-and-health/...

Cow's milk is also commonly fortified with D2. I'm guessing the vegan argument likely isn't the only reason.

"Risk compensation", to use your term, is a perfectly rational way to deal with these issues!

> and almost no risks

This isn't true--especially for Vitamin D. We have several doctors at this point who deal with cases where too much Vitamin D causes Calcium uptake issues and affects cognition and heart function.

Vitamin D is NOT something like Vitamin C. Your body easily dumps excessive Vitamin C so you can take fairly massive doses with no real ill effects.

Your body has a much tougher time excreting Vitamin D--so large doses of Vitamin D can cause issues and accumulate.

Yes, this is true and worth mentioning in some cases, as some commenters have noted. Although as far as my knowledge goes, almost all cases of issues are where the patient is taking either an absurd amount (>10x what they should be), or has some other very unusual/absurd health issue. We can only provide disclaimers for so much, but for the sake of completeness, this is worth mentioning and indeed correct.

Too much Vitamin D without sufficient Vitamin K can lead to high levels of serum calcium that are not absorbed into the bones. One function of Vitamin K is to shuttle calcium into the bones. You can often purchase combined Vitamin D and Vitamin K supplements to avoid those issues.

It’s not vitamin D that needs to be excreting but calcium. That’s why some supplements include vitamin K2, allegedly to absorb calcium into bones.

It is fat soluble. You can develop toxicity, and the effects are not trivial: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...

It seems based on casual reading of research that more people are deficient than not and dosing to toxic levels is unlikely. But it's not a bad idea to do this under the care of a doctor.

For reference: The level of toxicity listed in your link is 60,000IU per day. Fauci said he takes 10,000IU per day. The bottle I purchased recommends 2,000IU per day.

Get your blood work done people.

There's an expert that specializes in vitamin D toxicity cases and regularly posts here. She sees cases at less than the 10000IU daily dose Fauci takes.

I would be hesitant to go above 4000IU daily without monitoring blood levels every six months or so.

Its winter here in Canada, I'm taking 3000IU per day. I drop that to 1000IU in the summer. I'm not a doctor, not recommending you do the same. Just sharing.

Obvious warning but there's a lot of name dropping and I'm not sure what leads people to think Fauci 1) takes 10kUI or 6kUI per day 2) that it's the right dose for them 3) that they can make conclusions on what to do with their health based on a forum.

Get your blood checked, get recommendation from a doctor... before supercharging your blood with calcium & other fun stuff...

The 10,000 number is hearsay I overheard as a family member listened to this english nurse who professed to taking 5,000 himself. - https://youtube.com/user/Campbellteaching

I imagine someone reading this may not have healthcare coverage, but bloodwork can be cheap! Save up! Please be cautious

> I would be hesitant to go above 4000IU daily without monitoring blood levels every six months or so.

I did that for a little while (though the nurse practitioner at my work clinic wasn't too keen on signing off on non-medically indicated blood tests). IIRC, I was supplementing at 5000IU a day and after a few months wound up with a higher blood level than I was comfortable with, based on the ranges that came with the tests. After that, I reduced down to 2000IU a day or less.

I've been much less into supplements in general, but I only take 2000IU irregularly now.

Just sharing too: I was taking 3000IU per day like you and noticed really positive changes to my mood and general wellness by increasing to 9k (my pills are 3k each).

But since seeing the alarming articles on HN I reduced a bit, and I'm thinking of getting my blood tested.

Her post about someone with serious health problems with over-dosing vit d (in this case, just 5,000 UI):

https://www.devaboone.com/post/vitamin-d-part-2-shannon-s-st...

Her post about vit d in general:

https://www.devaboone.com/post/vitamin-d-part-1-back-to-basi...

> 5000 international units (IUs) daily. Five years later

Five years. Of 5000 IUs per day

Five years. Of more than 10x the EU RDA (and maybe 5x more than the US RDA, still)

But please tell me again how easy it is to overdose

I admit I didn't make that clear, the point was 5k UI is not healthy to take long term. But you build a supplement regime around it, and then just keep taking it for years. That's how easy it is.

And in another thread a guy was saying his daily D3 was 20,000 IU a day as if it was perfectly normal.

I was found to be extremely deficient in a blood test and personally been prescribed 10k UI, or maybe even 50k I can't remember, but it was a weekly tablet for only 6 weeks.

Yes I read that report and was not convinced. One anecdote. Not in a peer reviewed journal etc.

If you do take Vitamin D, variant D3 is by far best, and it may be wise to take vitamin K2 as well to avoid calcium metabolism issues (calcification).

The problem is TIME. Taking 10,000 IU for a medium amount of time will very very likely be fine.

But due to fat solubility and therefore slow build up in the body, you are increasingly growing towards toxic levels over a long time.

The body can only regulate vitamin D before synthesis, after sunlight exposure. But if you take already-synthesized vitamin D, that regulation won't kick in and you're free to get hypervitaminosis.

Time in combination with individual biology are what brings issues here. Get blood work done (it cost me 30€ in Germany but was combined with 2 other tests).

On the one hand yes you could take it for a short time, but on the other why take excessive doses at all and risk falling into a bad habit? When there are lower doses that are both effective and safe?

From "The Big Vitamin D Mistake" by Dimitrios T. Papadimitriou (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/)

> This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency.

Then, a person that consumed from 8000 IU to 12000 IU per day and had kidney damage due to high calcium levels in his blood.

https://www.webmd.com/vitamins-and-supplements/news/20190408...

What about D3K2 supplementation (adding in K2 supplementation) to counter these high levels of calcium?

I always see Americans (apologies for making assumptions if you're not) throw around blood testing like it's something trivial and casually done. Here in the Netherlands, it takes a real medical indication and some pushing of a doctor to get any testing done. Alternatively, you use a private testing company that costs 200 to 400 euros for a comprehensive screening. Question to the public in various countries - how easy is it to get preventative tests done where you live, and what does it cost?

"A real medical indication." This is anecdotal, but I just told my doctor (GP) my symptoms, that I am vegan and hence don't eat milk products. I was also on quitting smoking. Got a reference for blood test and smoking cessation (Zyban). I don't remember if smoking cessation was insured, but the rest all was. Going to your GP is free (via mandatory insurance) in The Netherlands. I got my vitamin D and B12 checked among other things.

If you are taking vitamin D supplementation, your physician will surely prescribe you periodic testing, at the very least if you ask for it. But since I have a private testing point just beside my office, I go there without doctor prescription; last time it cost me 17€ to get my vitamin D checked. This is in Italy.

In Germany you have to pay (35-40 EUR) for your blood test to check for deficiency even if you were previously found deficient and must re-check after supplementing. My doctor also doesn't give a fuck and never asked me to re-test.

I understand why this is the way it is (cost-savings), but this needs to change. It has been shown that preventative screening can be very cost effective as opposed to reactive treatment.

The Dutch health care system is allergic to preventative care. It's stunningly hard to try and just get routine things checker/done. As an Australian, having lived in four different countries, I'd say the Dutch system is the odd one out here.

More preventive care -- specifically screenings -- isn't always better. Humans are piles of goo, each person is different and totally normal, healthy baseline values are frequently quite different for different people. There is no such thing as a "normal" person.

The negative effects of false positives can easily outweigh the benefits of early screenings. For example, an NHS study shows that PSA antigen testing for prostate cancer is actually net harmful. [1]

Of course this isn't a blanket statement against testing in general, I'm just cautioning you against pre-judging the Dutch system as somehow less effective on the basis of "lack of preventive care" in general based on your personal experiences. It could well be that the other systems you participated in were less effective but attempting to placate anxious humans wanting to feel like they're 'doing something.'

[1] https://www.telegraph.co.uk/news/2020/01/17/prostate-cancer-...

UK system is the same.

Amazing when something goes awry, not great at preventing the thing going awry though they have made some good improvements recently (starting with their website debunking bullshit claims and headlines in the press).

In Hungary you can get it done anytime for like 10 euros.

More complex screenings can cost between 30-100 euros.

Or get it all for free if your doctor prescribes it. It is quite easy, you just have to be a bit lucky to have a doctor who actually want to go trough the investigation about your health issues.

In Spain you go to your healthcare doctor and ask, and they will usually grant you the blood test, but it depends on them. I never had any issues though.

Yep, expect for this weird COVID-19 year, were it's advised to no overload the health system, usually you would only need to see your GP and tell him/her "it's been a while since last check up" or "I'm feeling weird/tired/not sleeping well" and usually they would begin by a basic blood test.

I think 200-400 euros once per year (hell it doesn't even need to be that often if you're young) should be acceptable on NL standard of living, here in Croatia if you get a private life insurance plan (around the same amount/year) they include some yearly tests + general checkup and cover up to 200 EUR tests in partner clinics.

Same in Germany. Even when paying privately (despite being in the common healthcare), I've had problems getting an appointment.

It's sad, because a full blood profile (including hormones) has such huge cost to benefit ratio in avoiding completely unnecessary speculative wild goose chases.

In India, Its pretty easy to get various preventative tests done. As for as prices, its cheap enough for engineers but non-trivial sums for a majority of the population.

As an example here's a list of all the tests, prices that a diagnostic center chain in South India provides https://appointments.aarthiscan.com/#/city/Bangalore/select-... https://aarthiscan.com/test-package/preventive-health-checku...

The test for Vitamin D is about 16EUR and comprehensive blood screening starts at 18EUR

You can get an extensive screening for around 120 here in Amsterdam. Probably more expensive if I go through official doctor and have to pay it with eigen risico (first few 100 euros of healthcare you pay yourself).

Where is that? I only looked online, I haven't found anything online that cheap that includes vitamin/mineral levels + hormones.

Did it at https://www.yourlabs.nl/, current price is 189. But you are right, hormones is a seperate test

Can you share the location please? Very interested

Did it at https://www.yourlabs.nl/, current price is 189. But you are right, hormones is a seperate test

Italy here: just went to my doctor and said "hey, i should get a blood test since I haven't had one in a couple years"...my doctor said "yes, please do" -> got a prescription and went to the hospital. I think I paid something like 20 euros to do it at a private hospital that is affiliated with the state health program, after I added urine testing and a couple of additional tests to the bloodwork.

This is not accurate : although I will not deny Dutch doctors are weary of preventive testing, it depends on your doctor.

My current doctor agrees to get my blood tested quite easily ( I don't have very serious issues ). It is not expensive either. When symptoms improved, we agreed let's test again, see where we are.

My previous doctor however, was very adverse. I left him because of this.

In India, I can get almost any blood test with no requirement to get a prescription. The phlebotomist will even come home to collect the blood sample. The prices are fairly reasonable and most tests will be under $20.

Where I live, you can get just about any blood test you want or heard of done at a days notice (excepting clinically conditional time rubrics for the sake of test accuracy, ie: waiting a couple weeks+ after possible HIV exposure to get an HIV test, that kind of thing) at any one of dozens of private laboratories for extremely reasonable costs. Complete blood profiles go for a little over the equivalent of 25 dollars US and most typical tests are not far below or just above that figure. Exotic tests can get more expensive but rarely exceed a price equivalent to 200 dollars for truly unusual things like specialized checking for exotic tropical diseases.

Socialized health is also available here but with the usual pushing and prodding necessary for anything outside the most basic, routine preventative tests, and slow at that. Advanced countries with socialized healthcare offer wonderful advantages for medical catastrophes and sufferers of chronic illnesses that would be hard to privately insure against, but when it comes to preventative discretionary healthcare, my impression is that they can be awfully bureaucratic (I used to live in Canada).

Roughly the same in the UK, at least in my experience.

In Romania, getting blood work is very common, even for trivial things. A few years back it was also very cheap, about 20-30 euros for the basics.

To be fair, that's not cheap for Romania. Most people can afford it, yes, but that doesn't mean it's cheap.

Agreed, it's not very cheap for Romania, but the ratio between salaries and blood test prices is better than in other Western countries, assuming prices have not changed significantly in the past few years.

I don't know if the ratio is better. In Spain wages are way higher and blood tests are free. And after reading some comments here it doesn't look that expensive in other countries compared to their median wages.

I know Romania pretty well and I'd say they have Romanian wages and European prices on almost everything.

I have free health care through my university here in Finland and my doctor writes me any test I can back up sufficiently. If I want to go the private route, a basic blood panel with minerals and vitamins is somewhere around 100 euros. Not cheap but definitely doable.

A few tips from living in the Netherlands

1. Find a different huisarts, one that specializes in expats. Check on google maps reviews. I found a great one that will give me referrals whenever I ask. 2. Go to that doctor and tell them you've been tired and want to check nutrition levels.

We found a local huisarts that does walk-ins in the mornings which makes it much easier.

My partner went and said he was having stomach pains and that we recently went vegan, that was enough to get a referral for a blood test.

If your car breaks you would spend 400 eur in an instant without even thinking. If you feel something is off or to do this comprehensive biochemical tests every 3 or 5 years is not that expensive.

When I was in the US they did a full test on me as a matter of routine. Here in Sweden they stare at me like I'm crazy when I ask if I could maybe get something tested.

Source for the Fauci claim? I've seen a claim of 6000 (not sourced properly), the RDA is 600, I couldn't find even a dubious source for 10000 and all decent sources didn't give a dose at all.

Given that 10000 is considered more than the maximum safe amount by many health authorities, I doubt Fauci would say he's taking that much even if he did.

The Big Vitamin D Mistake: https://pubmed.ncbi.nlm.nih.gov/28768407/

> A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L.

What is IU compared to micrograms? (Is it international units? My girlfriend mentioned this measure to me this morning when I gave her a vitamin tabled measured in micrograms, I don't know much about it).

It depends on the vitamin. 1 microgram of vitamin D is 40 IU.

> Fauci said he takes 10,000IU per day.

Source please?

I find Fauci said 6,000IU

https://vitamindwiki.com/Dr.+Fauci+takes+6%2C000+IU+of+Vitam...

> Taking 60,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity. This level is many times higher than the U.S. Recommended Dietary Allowance (RDA) for most adults of 600 IU of vitamin D a day.

Well of course, drinking 100x times the recommended amount of water would be even worse.

A 50,000 IU pill is smaller than a pinto bean. I'm not saying to not take vitamin D, but it can be overdosed with serious negative side effects and the best way to not do that is to consult your physician.

Where did you find 50k pills? I'd like to get some...

Most I find anywhere are 5k, and I'm the only one I know that buys them. In a supremajority of cases 50k daily would mean... let's see... about 10 fistfulls of pills. It takes dedication to swallow that much every day.

50k is a one time thing, you shouldn't take this everyday! Read other comments there are articles about the toxicity of 60k per day leading to kidney failures.

I would never take more than 10k daily, and even that might be too much. I really need to have my blood tested.

Here in France when doctors prescribe vitamin D it's a one time thing, say for 3 months. It's in liquid form and comes in a small glass tube.

It's either 50 or 100k.

Here's a picture : https://journaldunenaturopathe.files.wordpress.com/2015/02/i...

I was mostly joking. I rarely take as much - only when I have a bad flu or the beginning of one. And it's included in the yearly checkup: I'm either deficient or, since I started supplementing seriously, normal.

In the US, I was prescribed weekly 50kIU pills. They were the same size as my current 2k doses.

I think it looked something like this [0]. Curiously it was much cheaper than my supplements after insurance and was like $0 or $5.

[0] https://images.app.goo.gl/gVh2XUrbSihcg2HN6

taking normal reccommended doses, even getting your levels to average from low takes forever.

The fear of Vit D overdose is funny if it wasn't tragic and possibly a factor in Covid mortality

- In Winter (especially USA/Canada/Europe) most people are deficient. Even more so the older and less active you are

- Read the labels and do basic math. A lethal dose of common OTC medicine is not that hard to obtain as well, are you going to ask a doctor how many Tylenols to take or are you going to read the label?

- Sure, if you're insecure go to the doctor and get it checked. But don't be surprised if consultations and lab exams are backed up at the moment.

- Vit D is fat soluble. Yeah you don't need to keep cranking high doses every day, the buffer lasts long. In fact for some people 10kIU should be good for a week. Review your dose, test your levels if you're taking a high dose for a long time.

In all those "Vit D overdose" stories there's someone doing something blatantly stupid for a long time OR (for the benefit of the doubt) they might have some other unknown problem or contributing factor.

I've looked up your list and remembered great movie Vitamania. Most striking part was that to people living in space, no suplements are provided except vitamin D. Every other is gained from various food they eat. And the supplement industry is barely regulated and HUUUGE in US.

"The non-financial costs such as side effects or potential adverse effects are practically non-existent as well."

This not accurate. I remember that there was an article on the front page of Hacker News an article that explain that Vitamin D is actually a hormone and telling the story of woman that had been prescribed high level of supplementation that could not talk anymore. It had something to do with her calcium intake regulated by that hormone. Luckily she was so distressed she stopped taking the supplementation but still it took her six months to get back to to talking normally and a normal hormone concentration level.

EDIT : I found the article : https://news.ycombinator.com/item?id=24261948

I assume they were talking about supplementation at normal supplementation levels, not 10x - 100x that.

As someone pointed out below, if you drink 10x-100x the recommended amount of water, you're likely to have adverse effects (almost certainly including death at 100x) too.

This case, I think: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313753/

It looks like she was getting 600,000 IU injections every week for three months. That's 85,714 IU per day. The NHS recommends maintenance does of 400 IU per day, others recommend up to 2000 IU.

As with this study the dose used is often quite low, driven by paranoia about overdoses. Other studies have been very short term, had small numbers of subjects and thus would only find very large effects, or used large irregular "bolus" doses which are very bad and no longer used.

I went through one meta-analysis and found only 3 of about 35 studies that were actually useful. So take a close look at the methods section of the paper. You don't just read the abstract, do you? Do you?

Why 600 IU / day is not enough:

1. Meta-analysis that concluded this was faulty due to back statistical analysis and understated need by a large factor Nutrients 2014, 6, 4472-4475; doi:10.3390/nu6104472 "A Statistical Error in the Estimation of the Recommended Dietary Allowance for Vitamin D" by Paul J. Veugelers and John Paul Ekwaru

2. Lactating women who get only the RDA have vitamin D deficient milk. This makes no sense if the RDA is valid

3. When people go out in the sun their bodies produce up to 10,000 IU per day but not more. Why produce all that Vit D if it is not useful?

Sorry I am away from my paper trove so I do not have the cites for 2 and 3.

This sounds like an important study, but unfortunately it is effectively unpublished; neither Google Scholar nor Sci-Hub is able to find the full text. I'm not willing to trust it without reading the methodology section, and I'm not willing to pay $32 to read it.

If any of the study authors happen to read this: pay close attention to how you publish, the journals will destroy all the value of your study in exchange for a few bucks, if you let them.

>2020 Nov 4. doi: 10.3233/JAD-200926. Online ahead of print.

Give it time.

Anyone have experience using any nootropics or something else that helped with cognitive function? Some friends I know have tried adderall during school and I was curious your experience with any of these.

Effect size... around 5% improvement in the FSIQ score. Not very big.

Although the dose of 800 IU/day was small.

Thanks for the summary! On the other hand, I'd take a 5% bump basically for free.

5% is a Cohen's d* of 0.3 — a small-to-moderate effect by itself, but surprisingly large for a mere vitamin/hormone rather than a targeted drug.

* https://en.wikipedia.org/wiki/Effect_size#Cohen's_d

That's interesting, but they claim the effect was "substantial" and it was statistically significant, but they do not provide the magnitude of the difference. They do not provide the experimental group's baseline metric for cognitive function and the increase.

It also doesn't mention anything about how it controlled for patients' initial levels of vitamin D, or what those levels were. There could be a threshold effect, for example, where raising levels to X produce the result observed, or a linear relationship between D levels & cognitive function...

Certainly the full extent of things like this would require additional research, but the basics would be known just from the data collection on the patients and their results.

I'm not saying I doubt the research: I know vitamin D has some interesting and diverse impacts on the body, so this result would not surprise me if it's true. But the abstract was lacking in important details. (And unfortunately the university library to which I have access does not have this journal in its databases)

You know I use a vitamin d supplement because I'm not a big outdoors guy and I livein the northern USA and I was deficient at my last annual inspection. That said why does HN seem to have a vitamin D story everyday? It's not a magic pill. If you have deficient levels you should do something about it, but it's not a cure all.

Lately it does effectively sounds like a magic pill.

HN seem to love three health subjects:

1 - Vitamin D

2 - Fasting

3 - Did I mention fasting?

This is specifically for older adults, not a general result.

Still seems promising, though.

Moreover:

> Participants were all native Chinese speakers aged 65 years and older with Mild Cognitive Impairment

So - these people were re-acquiring previous cognitive function, not improving their lifetime baseline intelligence.

Quite surprised based on my primitive biology that in a 12 month trial they could observe differences in telomere length. That seems a remarkable outcome and if true would suggest prolonged benefits.

Not only that, older adults with mild cognitive impairment. The headline and the paper are quite different.

This study was done in China. It is important to know the locals behaviour with regards to natural Vitamin D source (the Sun). Locals do not like to have "too dark skin" and as such are using sun screen with factor 50 and try avoid sunshine altogether.

This study might have different results in other parts of the world.

Why does it have to be supplementation?

Nutrition science is mostly unreliable because it is difficult to study, is very limited and progress is slow. The supplementation industry capitalizes on this ill-reported junk science.

For many years, vitamin D2 was sold as supplementation. Now it is well-known that D2 is not bioavailable to humans. Similarly, it is well-known now that even D3 is mostly useless without K2. Now, some D3 supplements come with K2. Who knows what we'll find in the future?

Even more ridiculous is iron. The iron in spinach is basically rust. It is not bioavailable to humans. Not only that, it induces oxidative stress in humans. Ever heard you need anti-oxidants? You do, if you've been eating spinach or cereal fortified with rust or supplements with such iron. Our body needs a specific organic compound of iron: heme. You can't just swallow a nail and get iron from it.

Vitamin A, D, E, K are all available in animal fat, in exactly the forms we can readily absorb. Animal fat has been a crucial part of diet for every human culture forever. There has never been a single exception... until recently when junk science and industry PR started selling seed oil as a "healthy" replacement. As a result, a large portion of population is deficient in these vital nutrients.

Seed oil is highly problematic because... it's seed. Not only does it have no nutrients, plants don't want you to eat their seed. That is the one thing plants don't want you to eat, more than anything else. That is why they pack it with the most dangerous toxins they can come up with.

Nutrition science is hard but nutrition is easy. Just eat what humans have been eating for thousands of years.

I read that there is 15 UI of vitamin D in a steak. You need 25 or 100 times that per day. It’s more likely that humans evolved to get their vitamin D from sunlight (although we also know that introduces cancer risk) than eating a whole cow every day. It seems like you’re trying to make the facts fit your preferred narrative re. meat consumption.

>I read that there is 15 UI of vitamin D in a steak. You need 25 or 100 times that per day.

And how do you that for a fact? It's nutrition science. It's not reliable. These numbers of how much we need has been changing for as long as I can remember.

>It seems much more likely that humans evolved to get their vitamin D from sunlight

Humans have lived in Northen Europe for at least 10,000 years. They didn't take any supplements and there no evidence that shows any vitamin D deficiency in those populations.

Humans in Northern Europe have adapted to those conditions with very light skin that maximizes sunlight exposure.

> And how do you that for a fact? It's nutrition science. It's not reliable. These numbers of how much we need has been changing for as long as I can remember.

The changing numbers are why I gave such a wide range. Regardless of who you believe, it’s completely impractical to get the vitamin D you need from meat. It’s not even in the right order of magnitude. What is your proposed required daily value of vitamin D? If you’re going to go around claiming it’s possible to get your needed vitamin D from foods, you ought to have done some math to back up this claim.

The only relevant math I need is that humans have done fine with animal fats for thousands of years. The value I need is what I can get naturally.

And BTW, I have dark skin, I live in one of the Northest parts of the world humans live, haven't taken vitamin D supplements in years and my vitamin D levels have been great (upper middle of whatever acceptable range they use) when I got tested several times over the past years. I don't even care anymore. I will continue to eat what humans are supposed to eat and I'll be fine.

Even if your numbers are not good, you should not be eating these chemicals in isolation. We don't need nutrients, we need food.

Nutrient-nutrient interaction is very difficult to study, but it has been found to be crucial every time they've managed to do it.

Perhaps you’re eating some food that has been supplemented with vitamin D. For example, one cup of milk fortified with vitamin D might have 100 UI (as much as six steaks).

I don't drink milk, lactose intolerant.

> The only relevant math I need is that humans have done fine with animal fats for thousands of years.

That's true, however, humans have been spending days mostly inside, both living and working, for much, much less time than that, which dramatically affects how much natural D they are getting from the sun.

I'd love to see some research on the overall exposure to sunlight, on average, a person has received over the last century. My guess is that in very recent decades, especially the last couple, as working remotely and not needing to leave the house even to commute, sunlight exposure has plummeted.

Also, the risks of sun exposure have been widely reported over recent decades and advances in powerful sunblock have made even those who do spend time outdoors less likely to absorb the sun's rays.

So to place it in the context of how humans have lived for thousands of years ignores the realities of modern times.

Again, nutrition science is very misleading.

Sunlight doesn't have vitamins. What supposedly happens is that when you get exposed to sunlight, some of the cholesterol in your blood gets converted to Vitamin D. What part of sunlight, you might wonder. Is it the visible spectrum? No, it's infrared, you know the thing that you get from your radiator.

So, two factors determine how much vitamin D you're going to get:

- cholesterol levels in your blood

- how much heat you're exposed to (i.e. how warm your room is)

I'm sure we need sunlight for other things... like our sleep cycles or whatever... but we definitely don't need it for vitamin D.

No, it's ultraviolet. The opposite side.

Another commenter pointed out the factual error about vitamin D coming from IR vs. UV, but there’s another misconception in this post.

The amount of IR you get exposed to is not the same thing as how warm your room is. If you touch a hot pan, or get hot because you’re hanging out where the air temperature is high, that heat isn’t being transferred to you by IR. It’s being transferred by thermal conduction: https://en.m.wikipedia.org/wiki/Thermal_conduction

So even if vitamin D was created by IR, you wouldn’t get any from sitting in a hot room.

And even in Northern Europe, people were outside all the time. Nowadays we sit in the dark offices in the artificial lighting.

My wife has noticed that her severe COVID patients all have vitamin-D levels in the single digits. YMMV.

There was a thread on here the other month about a chronically ill person who was accidentally overdosing on Vitamin D. I believe the conclusion of the piece was don't take copious amounts of Vitamin D and assume no side effects.

Check the amounts. ISTR the person that you mentioned was taking a substantially higher dosage than was tried in this study.

what is the deal with hn and vitamin d

It's hacking the body!

At least the Soylent thing more or less died off. In a way it's comforting to know that the übermenschen on HN are as fad-prone as anyone.

It died off because it's more commonplace now. Lots of people are taking meal replacements.

Biohacking!

As a group of people who spend large amounts of time infront of a computer and not outdoors we're all particularly vulnerable to deficits in vitamin D.

FWIW It seems to published in a journal with a company that also publishes studies showing how music can help Alzheimer's etc. Not a particularly reputable source.

Is music helping Alzheimer's patients considered implausible?

Yeah. Naively i would be more surprised if it didn't (why wouldn't stimulating the brain help with a degenerative brain disease?)

Well it depends on how you define "help". Dementia or Alzheimers is a neural disease that seems correlated with brain plaque - the underlying issue of plaque/neural self cleaning mechanism failures wouldn't be countered even if it makes them feel better and possibly slightly improve function it is still a downward slope of progressive brain damage.

I had been taking D for almost a year every day. (4000 dose) and wasn't feeling well at all. Once I stopped D and take it occassionaly I feel much better.

Did you take a soft-gel or hard tablet?

Soft-gel

With Vitamin K? otherwise it's useless I've heard.

I forgot, yes I took it together with K2 before sleep.

I find the soft gel ones don't do me any good. I do better with the hard pill type and even better with topical cream. I think it's something to do with the cheap vegetable oil they are packed in.

...in Older Adults with Mild Cognitive Impairment

Milk and sunshine probably cheaper

Vit. D supplementation is dirt cheap. Like $15 for a years worth. That’s a lot cheaper than milk.

Milk contains 100 IU vitamin D per cup in the US. A typical supplement dose is 2000 IU.

You're not walking around naked like our ancestors? Do you use sunscreen in the summer? Work indoors?

We're shielded from most of our potential Vitamin-D intake.

Can mods ban submissions about vitamin D please? This forum has turned into infowars...

Do you find it helpful in life to operate with more, or less information?

With medical information on the internet, it’s a quality over quantity situation

More, as long as the new information will lead people to agree with my pseudointellectual position.

Imagine if they let older people get more sunshine in nursing homes they would have better health outcomes. Instead they locked them up even more during the pandemic.

Study posted on here earlier showed link between low vitamin D and covid death. Like 60% of people that died from Covid had vitamin D deficiency.

Locking up old people in cramped nursing homes, spreads communicable disease, causes mental health decline, and is just terrible for their well being and shortens their life.

Thats why we need an army of robot nurses in the future, that will treat these people in their homes.

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