Comment by whalesalad | Hacker News Reader

Comment by whalesalad | Hacker News Reader

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(I am not a scientist)

My interpretation is that your gut bacteria are vital for metabolizing Vitamin D and that you can take a lot of supplements but if your gut aint right it won't help.

Slightly related: I keep trying to identifty the recent report that essentially demonstrated a big calculation error in our societal wisdom regarding Vitamin D amounts - and that we need a LOT more than most people think. 2,000 - 5,000 IUD is like a fraction of it.

Edit, found it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/

    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.

and

    ....we call all responsible public health authorities to consider designating 
    as the recommended dietary allowance (i.e., the average daily level of intake 
    sufficient to meet the nutrient requirements of nearly all healthy people, 
    presuming minimal sun exposure) intake levels corresponding to those proposed 
    by the Endocrine Society Expert Committee (2011) as safe upper tolerable daily 
    intake doses for patients at risk for vitamin D deficiency (<50 nmol/L):  

    2000 IU for those <1 year of age, 
    4000 IU for those aged 1-18 years, 
    and 10 000 IU for those aged >18 years.

I wonder how these two concepts could relate. Do you need more Vit-D or do you just need a healthier environment for it to be metabolized?

I have been taking 10,000 IU every night for a week or so - going to keep cruising on it for a while to see how I feel.

Be careful. "Vitamin" D is actually a hormone that is fat-soluble which means it can build up too much in your body and cause a toxic effect and I know one person who that happened to.

The way to know you're ok at your current dosage is to take a blood test, ideally at least twice a year (summer and winter) so you can make sure you're not overdosing.

I haven't had a blood test in many years, so currently I am only on 3000 IU. It's a big difference, in one week I have 21,000 IU and you have 70,000 IU, I am only taking 30% of the dose you are.

Get a blood test!

Perhaps off-topic but my inner hacker finds it very upsetting that getting blood tests can be so cumbersome, despite being so important. Make an appointment, transit to the doctor's office, pay a bunch of money, wait for labs, wait for your doctor to explain and prescribe stuff to you. It's cumbersome enough to the point where the vast majority of humans aren't testing anywhere near the frequency they should, including myself.

I don't think running diagnostics on a human should be this hard, we run diagnostics on our apps, computers, cars more often than ourselves. I wonder if people are working on making this process a lot easier (or if it's even possible, I have zero knowledge of the space).

Quest diagnostics will let you do it yourself. I am in the process of ordering a self-serve vit-d test and metabolic panel for about $150, no doctor referral required.

(I also dislike the limitations as I feel like people are more capable of helping themselves in a lot of these situations)

It's not hard.

Google "LabCorps" near you.

You can walk in and get a basic metabolic panel in about 15 minutes, with results the next day or two, for about $50, without a doctor. I use them for frequent STI testing.

I paid $47 for this vitamin D test (via blood draw): https://www.lifeextension.com/lab-testing/itemlc081950/vitam... You get a doctor's prescription (from a Florida doctor, good for anywhere in the country) and instructions to go to your nearest Labcorp for a blood draw. So make sure you have a Labcorp near you.

Here are a few alternatives you can look into, mentioned in this discussion: https://news.ycombinator.com/item?id=15868143

[0]: https://www.privatemdlabs.com

[1]: http://www.directlabs.com/

[2]: https://www.walkinlab.com/

[3]: https://www.health-tests-direct.com/

[4]: https://www.personalabs.com/

These are definitely a step up than what I'm used to and I appreciate the effort put into the reply. I'm still naively hoping there will be a scifi-esque biometric scanner or finger-prick analyzer, as another commenter put it, some day ;)

It would be great to have very easy testing with a pin prick of blood. This dream is what kept Theranos going for so long, but hopefully that scandal does not scare off other people from trying.

Why should you even need doctor prescription for something like this? Week ago I just went to nearby lab and asked them to make a blood draw to verify my vitamin D levels and got results same day via email.

Can you tell us which lab? Did you contact them before hand?

Sorry for not being clear - I'm not in the US. I was just surprised you need a doctor prescription for something like that.

US doctors have a strong political presence through the AMA and maintain a monopoly on nearly every medical procedure, test, and many drugs. It's impossible to get anything without a doctor's prescription and it's usually impossible to get that prescription without a (paid) visit to their office.

Seriously. Gimme a finger-prick analyzer, eh?

Elizabeth Holmes founded a startup a while back to solve this problem...

It seems like it’s just tough because you generally need a fair amount of blood for each test. We could lose some of the bureaucracy but it seems hard to get away from human phlebotomists and lab techs.

well, Holmes effort was more of a con game than delivering actual solutions.

I use medichecks. I order the tests I want, a nurse comes and takes my blood at home, then a few days later I get results emailed to me and a brief rundown from a doctor that’s looked them over. If there’s any problems I can take it up with my GP, even that can be done online now.

Our most current understanding is that 7k iu is closest to optimal, and that previous recommendations were based on bad math.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/

While toxicity is a serious matter, the actual risk is generally overblown, since it requires truly heroic, sustained doses.

>The evidence is clear that vitamin D toxicity is one of the rarest medical conditions and is typically due to intentional or inadvertent intake of extremely high doses of vitamin D (usually in the range of 50,000-100,000 IU/d for months to years)

https://www.mayoclinicproceedings.org/article/S0025-6196(15)...

I'm trying to find the HN thread from a few months ago, where an HN-user's spouse (who is a physician focused on treating patients suffering Vitamin D toxicity) gave a stark warning that she has personally seen many (hundreds of) patients on ~5-10k IU/day intake hit toxicity because they did not measure their levels. Be careful! Definitely try to get a test for your levels, definitely consult a doctor if you can. If you can't, know that 5k+ can be too much for some people.

(For the record, I began taking 1-2k IU/day in March.)

Probably devaboone: https://news.ycombinator.com/threads?id=devaboone

Thanks for explaining.

This makes me wonder if there is a problem in my gut. I was on a 50k IU / week dose because of low vitamin D. It made no impact.

Being out in the sun, however, made a huge impact - so I get much more sunlight now and I'm fine. I wonder if the vitamin D issue correlates with largely indoor office work now vs farming of our ancestors and largely being outside.

I was prescribed 50,000 IU Vitamin D and told to take it once a week, and not take any other Vitamin D supplements while taking this. Everyone is different, just sharing my experience.

I would contact a doctor.

Vitamin D stores in your body can take a long time to build up, but if you store too much it can be a major problem.

You should at least consider an at home vitamin D test, I found a few online(that i didn't order in the end) that were selling for around $50.

If you're determined to do this yourself you should periodically use those tests to help keep yourself safe.

Source: I'm not a doctor.

I'm curious, do you take any form of K2 with your D3, or not? I've heard that it's beneficial as it helps prevent calcification from occurring in your veins and arteries.

> I have been taking 10,000 IU every night

It would be better to take it at lunch: from what I have read a long time ago it might affect your sleep if you take it late.

If you take 10,000IU because 8895IU is what gets 97.5% of people to 50nmol/L, you are basically assuming you need more supplement than 97.5% of people, which is highly unlikely. There are people "at risk" that have trouble metabolizing the supplement, but chances are you're not one of them.

You need to do blood tests. Don't take 10,000IU daily without consulting a doctor. The "generally considered safe" upper limit is 4000IU. You'll probably be fine with 2000IU. Too much Vitamin D can mess with your calcium and doses as low as 5000IU/daily over a few years have been reported to cause serious problems.

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