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Comment by arcticbull | Hacker News Reader

Vitamin E is fat soluble, which means that you can definitely take too much (unlike C for instance, which is water soluble). It can cause headaches, nausea, blood thinning and rarely even fatal bleeding. I suspect that's a much bigger reason to be careful with the quantity of fat-soluble vitamins you take.

But also note that vitamins aren't FDA regulated, and they're a complete grab bag in terms of quality and bioavailability.

Generally unless prescribed by a doctor for a specific condition or if you know your diet is lacking in a specific vitamin (like B complex for vegans), you get more than enough from your diet. [1]

[1] https://www.health.harvard.edu/mens-health/do-multivitamins-...

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> Vitamin E is fat soluble, which means that you can definitely take too much

I think we're talking about different things here. You're talking about the risk of toxicity from taking high doses of fat-soluble vitamins. I'm talking about the risk of taking anti-inflammatory supplements / drugs generally (regardless of dose).

In general I agree with you on taking vitamins, however the reason I take a very low dose of Vit E is because I have a genetic predisposition to liver inflammation. Vit E is one of the few things which helps me reduce this inflammation which helps me mitigate against long-term damage, but reducing inflammation too much can increase risk of liver cancer, hence why I only take a low dose. This is also the reason patients with late-stage liver disease are typically not given Vit E because they're at a higher risk of developing liver cancer.

On taking Vitamins generally I think most people in the West would benefit from a high-quality low dose Vit D supplement. Something around 1,000 - 3,000 UIs daily is almost certainly safe and the majority of people would benefit. Higher doses are probably preferable in many cases, but you should be monitoring blood concentrations at that point to ensure you're not reaching toxic levels. Otherwise, yes, supplementing is silly unless you have a reason for it.

I hang out in a lot of liver health communities one of the most common reasons I find people have unexplained elevated liver enzymes is because they're taking low quality (often herbal) supplements.

What's interesting with Vitamin D supplementation is there doesn't appear to be any strong clinical evidence for its effectiveness unless you're severely deficient and on the road to rickets.

So long as your serum 25OHD concentration is >50nmol/L according to this meta analysis, there's no clear effects. [1]

> In conclusion, supplementation of vitamin D-replete individuals does not generate overall health benefits; however, correction of severe vitamin D deficiency remains essential.

Probably would be a lot better off going outside and synthesizing your own. Spending time in nature and in the sun does a lot of other useful things - for instance UV exposure induces nitric oxide synthesis too, which lowers blood pressure. [2]

[1] https://www.nature.com/articles/s41574-021-00593-z

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593895/

> there doesn't appear to be any strong clinical evidence for its effectiveness unless you're severely deficient and on the road to rickets.

> So long as your serum 25OHD concentration is >50nmol/L according to this meta analysis, there's no clear effects.

I mostly agree. Above 50nmol/L it's not so important, but most evidence would still point towards it being slightly healthier to be on the higher end of the reference range for Vit D, so therefore if you wanted to optimise your health you probably should be targeting around ~150nmol/L. We know our ancestors would have had Vit D concentrations around these levels so there's no good reason to think it would be unhealthy either.

Additionally, and what you missed here is that a lot of people in the northern hemisphere get close or fall below that 50nmol/L clinically deficient level during winter months. This is why I think in general it's probably better for people to take a low dose of Vit D than not (especially during the winter).

But to your point, if you're spending time outside and getting a bit of sun exposure every day then it's probably not needed.

> We know our ancestors would have had Vit D concentrations around these levels so there's no good reason to think it would be unhealthy either.

Yeah, I certainly don't think it's unhealthy, I just haven't seen any studies demonstrate really any effect at all over the lowest normal value. If you have some studies I'd love to see them so I can cite them in the future.

I think we're basically in agreement.

I don’t know, the advice in that link is, don’t take a multivitamin because there isn’t a lot of evidence it will do a lot of good. Instead they say you should just have a perfect diet, and to consult with a dietician if you feel you aren’t getting a perfect diet.

Seems to me that few people eat a perfect diet, and I’d be amazed if there’s evidence dieticians work better than multivitamins. People don’t eat right, not because they need education, but because unhealthy diets are tasty, cheap, convenient, etc…

And multivitamins are not all the same, they have radically different formulations, so I doubt the results of any research that didn’t specify a specific multivitamin, or break results by gender or age. (Vitamin needs/ deficiencies are often age related. Consider subsets like prenatal vitamins, vitamins for the elderly, etc…)

What about vitamin D? I've had gastric sleeve surgery a decade ago. Ever since every blood test I take usually has me deficient in that. My doctor has me on 5 to 10k, right now trying 5k. I also have gout and an abnormally high amount of kidney stones sitting in my kidney, last month I had to get a catheter and 2 trips to the ER over one lousy kidney stone.

I'm wanting to figure out the best way to regulate the things in my body with less Kidney stones, uric acid etc, and that won't upset my depression, anxiety, and ADHD.

My suspicion about vitamin D is the positive effects are minor. Short term deficiency doesn't do anything. But long term chronic deficiency negatively impacts your health. And deficiency in children is much worse than in adults[1].

I think sure take vitamin D but don't expect much.

[1] Friend that's a public health nurse says they're seeing kids with rickets and bad teeth in Marin County. Because vegetarianism, sunscreen and milk alternatives. They don't see any of that with poor kids in Oakland because they're on WIC and not getting woo woo healthcare.

> woo woo healthcare

What a time to be alive.

Another condition for supplementation is the possession of a disorder which causes malabsorption, like SIBO.

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