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Comment by throwaway5752 | Hacker News Reader

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.

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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...

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.

> 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.

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