(Do not take 5000 mg, that's 200,000,000 IU. You'd have to chug dozens of bottles per day)
what formal education do you recommend so that I can better understand this data?
It’s clear you’ve dealt with anxiety before, but this analysis is super thorough!
And thank you for quickly fixing that mistake - that could have really harmed someone.
The author simply (and terrible mistaking) typed [mg] instead of [UI] in the first paragraph: if readed entirely, the author correct this typo in every other sentence
That is that pathway to death you are worried about?
Even taking more than a knife point renders a complete can undrinkable. Not to speak of 30 fucking grams.
I also had to immediately think of this case.
> A single, optimal sun exposure session might produce the equivalent of 10,000 to 25,000 IU from a supplement, but it will not keep increasing with more time in the sun. That's your max per session.
"In Scotland, we only get enough of the right kind of sunlight for our bodies to make vitamin D between April and September, mostly between 11am and 3pm."
https://www.nhsinform.scot/healthy-living/food-and-nutrition...
Personally I found that taking Vitamin D supplements made quite a bit of difference - and I spend a fair amount of time outside (~3 hours each day).
We have a saying here to take cod liver oil all months ending with R (in Norwegian that's September to Februar) to get both omega 3 and the vitamin D.
It also sucks a lot when it's dark before starting work, dark after leaving work, and during the day rather cold to be exposing skin to the sun.
During the spring, summer, fall months I barely need it since I'm outside so much with my dog.
In many countries it is physically impossible to get enough vitamin D from the sun, even if you go out naked.
Also did you ever notice that the cheap apartments in many places are facing north and do not have a balcony, and of course do not have a private garden? Now you are reduced to going to a park which in the "cheap" areas is also not a good spot to chill for 30 minutes.
spoken like someone who has never lived in the UK
For some people even in sunny areas, 5000 IU might be needed to get you in-range. This is highly individual.
It's much cheaper to take a few pills than it is to travel 3000km south to see the sun for 30 minutes :D
We even put Vitamin D in milk by default just so that people would get some extra.
I'm not stating the dosage is wrong. Looks like it is anyway.
Edit: for clarity I am not saying it is impossible to overdose on oral tablets, but rather that with most tablets 400 IU to 1000 IU and the safe limit so much higher than these, it seems like it would be extremely unlikely for someone to be taking 30+ tablets daily. Not impossible, but not easy either.
First: the RDA and the safety limit are not the same, and an RDA in a country being too low does not mean that the maximum safe dose is wrong.
And it certainly does not mean that there is a higher risk in under-dosing than overdosing when taking the RDA (which already includes recommendations for supplementing if you spend most of your time indoors).
I'm not a scientist, so I only know what physicians told me and what's explained in news publications or by consumer advocacy non-profits.
Here are a study (which I didn't read) and the NHS's advise on Vitamin D toxicity:
https://www.ncbi.nlm.nih.gov/books/NBK557876/
https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...
The study says:
> Most cases of vitamin D toxicity resolve without serious complications or sequelae. However, in some instances, severe hypercalcemia can lead to acute renal failure requiring hemodialysis. Cases of permanent renal damage due to vitamin D toxicity are rare.
Which sounds good, but I don't think it supports that there is no risk of oral Vitamin D overdose.
* Toxicity resulting from lack of monitoring is frequently seen in patients requiring high doses to treat ailments like osteoporosis, renal osteodystrophy, psoriasis, gastric bypass surgery, celiac, or inflammatory bowel disease.
* Patients who are on high doses of Vitamin D and taking inadvertently increased amounts of highly fortified milk are also at increased risk for vitamin D toxicity.
* According to the latest report from America's Poison Centers (APC), there were 11,718 cases of vitamin D exposure recorded in the National Poison Data System. More than half of these cases were in children younger than 5 years.
* The clinical signs and symptoms of vitamin D toxicity manifest from hypercalcemia's effects.
* Clinical management of vitamin D toxicity is mainly supportive and focuses on lowering calcium levels.
* Isotonic saline should be used to correct dehydration and increase renal calcium clearance.
A lot of those point to people drinking too much milk! (enriched milk)
* People with osteoporosis thinking "I better drink more milk for strong bones" when they are already on supplements/medicine.
* Kids drinking lots of milk and presumably not drinking any water - hence the dehydration.
PS: There are a lot of people out there that don't drink any water, and stick to juice or milk or soda, etc. They are not always fat, but that doesn't mean they don't have issues.
And my takeaway is not that everyone should be taking 10k IE, but it's a great reminder to be more consistent in taking my Vitamin capsules in winter.
I'm still standing by my point that it's "easy" to overdose on Vitamin D. Like the article already mentions, one should remember possible kidney issues and not take insane doses of it.
What the recommended daily intake should be, I don't know.
The whole reason I'm commenting on this is I used to take one of the "top" antidepressants on this list.
And I am a skeptic of antidepressants, that doesn't mean I deny all positive effects in people who are prescribed them, of course.
For what it's worth, it's also easy to overdose on Venlafaxine. It's still considered safe.
Just an example to make clear that my comment was not a critique of taking Vitamin D in general.
I don't find the article's main point surprising though. That's the reason I'm taking Vitamin D, too. Doesn't mean that it's impossible to overdose, and this point is also important, because many people still think that it would be impossible to take too much of an vitamin or mineral. Thankfully, high-dose Vitamin A / retinol supplements are not as widespread.
Seems to be a thing in conspiracy theories "they try to hide those simple tricks from you (drinking bleach, ivamectin, 100k D3, ...)
In any case, keep your blood levels in check. It's cheap and easy. There are even services you can order to have your blood sample taken at your home.
https://www.devaboone.com/post/vitamin-d-part-2-shannon-s-st...
"There are people out there doing just fine on 5000 units of Vitamin D daily. I only see the ones who develop high calcium levels. But I see enough of them to know that this is not an exceptionally rare occurrence. I have been to lectures in which physicians have claimed that Vitamin D toxicity almost never occurs. In my experience, this is false. I have seen many cases of Vitamin D toxicity in people who were taking the recommended dose from an over-the-counter bottle.
Unfortunately, none of those patients were warned about the potential for Vitamin D to cause high calcium. They all believed that they were taking a supplement to improve health and that there was very little risk. Supplements don’t require prescriptions, and most do not have the warning labels that accompany medications. For Vitamin D, a steroid hormone, that may need to change."
For D3, it is 25mcg / 1000 IU / 125%
After splitting in half it's 12.5 mcg / 500 IU / 62.5%.
I take with some fat-containing food to allow ir to absorb which is usually breakfast (yogurt, some nuts, some kind of fruit, oats), and it's a night and day difference in my mood (how easily I can control my temper if already agitated, how easily I brush off annoying stuff, takes the intensity off of my reactions and mood during conversations).
I did a blood test before starting, and if normal is between 30 - 70, I was at 10. Dr prescribed megadose of D2, followed by daily D3, but I skipped on the megadose and went straight to D3 -- makes me wonder if a megadose would build up my stores since D is fat-soluble and make it so I could miss a day and not notice.
All of the above is anecdotal from me, a self-professed cave dweller, but it's been a couple of years now, and I still notice the difference. Also, what I heard from people in Boston is that 90% of them are on a vitamin D supplement. My friend from there laughed at me when I was raving about it, saying "yeah, literally everyone here is on it".
Also, be careful taking 5000 IU/day of Vitamin D. I did this for a few months and it was enough to send my blood levels over the top of the range, even in winter.
Too much Vitamin D is not good for you. The supplement fans have gone too far in recommending too high of dosages. My doctor said she’s seeing a lot of people with excessively high Vitamin D levels now that it has become popular.
Just test your blood levels before you start and then after 3 months or so. It's quick and cheap, and the only way to know whether the dose is right.
No, that’s literally what I was doing when I reached the excessive range: 5000 IU/day in winter with an indoor job.
This commonly repeated idea that everyone is deficient and you can’t overdose on 5000 IU/day is wrong.
> Just test your blood levels before you start and then after 3 months or so. It's quick and cheap, and the only way to know whether the dose is right.
Literally what I did.
Every time I explain this online it seems like the supplement people ignore what I wrote and just parrot the same “5000 IU/day and everyone is so deficient you can’t overdose” myth.
That doesn't make it easy for most people. In my case it was barely enough to move the needle, but that's not how it will be for most people either.
> you can’t overdose on 5000 IU/day is wrong
Of course you can (though it would usually have to be really prolonged to actually cause you troubles, and even then it's mostly due to calcium rather than vit D itself). The vast majority of people won't, but you don't know whether you're in that group or not until you test yourself.
> Literally what I did.
That's good, but my post obviously used plural "you" as a general advice.
(BTW. There's no evidence of toxicity below blood level of 150 ng/ml, but there are many guidelines that consider levels way below that, such as 50 ng/ml, as "too high" already)
It's my understanding that northern Europeans evolved fair skin in order to cope with the lack of vitamin D in their diet.
i understand it as: absorbing is in the intestine, generating D happens in the skin when exposed to the sun
Edit because the comment might be to shallow for HN: I sympathize with the struggle against depression and, after first-hand experience, share the skepticism against the widespread prescription of antidepressants and the methods of evidence presented for it.
Very serious and important topic.
Regarding Vitamin D, I am also supplementing in the Winter, but I have not read the article, which says it has an estimated reading time > 10min. I use one 1000IE (0.025mg according to the package) tablet a day max.
I'll bookmark this discussion page to read TFA later maybe.
Also important to take it with Vitamin K.
Seems like it would be best to increase time spent outdoors though.
My starting levels were unknown but I assumed they were low given my usual sun exposure and some low-energy symptoms (which resolved a couple of weeks after I started taking it). I discontinued VitD then and now I only take 1000 IU/day in the winter.
> 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. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L.
> 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.
> ...
> Since 10 000 IU/d is needed to achieve 100 nmol/L [9], except for individuals with vitamin D hypersensitivity, and since there is no evidence of adverse effects associated with serum 25(OH)D levels <140 nmol/L, leaving a considerable margin of safety for efforts to raise the population-wide concentration to around 100 nmol/L, the doses we propose could be used to reach the level of 75 nmol/L or preferably 100 nmol/L.
https://hn.algolia.com/?q=vitamin+d+mistake
Vitamin D is a favorite topic around here:
IU, not mg.
K2, not K3.
Another issue is insulin syringes are labeled in "insulin units," which hapless folks reasonably assume can be abbreviated "IU."
If you are measuring out a certain number of IUs, and your calculator or formula hasn't asked you which substance you're working with, you're gonna have a bad time.
I wonder if even the simplest LLM would make this particular mistake.
EDIT: Wow, the HN-local doctors at it again. Imagine getting downvoted for sharing information from newspaper article (and honestly labeling that info as such), that probably was written by someone consulting medical professionals. But hey HN will know better!
Can you give the replyee some pointers, for example? Link to articles or studies that show a different view?
But also here is something to think about: your body will produce more D3 than that by being in the sun for just several minutes. So if you consider such a low dose of D3 an overdose then you better steer clear of the sun!
The problem with that is, that you still need to know how to interpret any results and statements within the supposedly scientific papers. If you are not a statistician, you might overlook methodology mistakes. If you are not an expert in the matter of the paper, you might not realize some side condition, that makes some statement or result of the paper irrelevant for your individual situation.
This is another superficial statement, that displays shallow-at-best understanding. Staying in the sun and producing via the skin, and intake via food are 2 separate pathways. You cannot just make wild assumptions about one of those pathways from stuff you know about the other pathway.
And actually: Yes, you shouldn't stay in the sun for too long without proper protection. Having the sun shine on your skin is not some inherently healthy thing. It too comes with acceptable dosage and overdose. Symptoms of overdose are commonly known as getting a sunburn.
See: Vitamin D and health: evolution, biologic functions, and recommended dietary intakes for vitamin D (293 citations)
> An adult in a bathing suit exposed to 1 minimal erythemal dose of ultraviolet radiation (a slight pinkness to the skin 24 h after exposure) was found to be equivalent to ingesting between 10,000 and 25,000 IU of vitamin D (Fig. 6).
Doesn't say 30 minutes, but it may be 30 minutes depending on your skin colour and the local strength of the sun.
So the paper may be well researched or whatever, but the interpretation of it is questionable.
From the abstract:
> The safe upper limit for children can easily be increased to 2,000 IU of vitamin D/day, and for adults, up to 10,000 IU of vitamin D/day has been shown to be safe. The goal of this chapter is to give a broad perspective about vitamin D and to introduce the reader to the vitamin D deficiency pandemic and its insidious consequences on health that will be reviewed in more detail in the ensuing chapters
The full article is available on researchgate[1]. Direct link to PDF [2].
[1] https://www.researchgate.net/publication/226676251_Vitamin_D...
[2] https://www.researchgate.net/profile/Michael-Holick/publicat...
EDIT: I just looked up the author, Michael F. Holick. Apparently he is one the people who identified calcitriol in 1971. I know appeal to authority doesn't prove anything, but it might be prudent to at least consider his findings.
I think the downvotes are harsh btw and in general HNers have gotten too reflexively downvoting IMHO.
Just a simple look at the side effects of high dosages:
Safety and side effects
Taken in typical doses, vitamin D is thought to be mainly safe.
But taking too much vitamin D in the form of supplements can be harmful and even deadly. Taking more than 4,000 IU a day of vitamin D might cause:
Upset stomach and vomiting.
Weight loss and not wanting to eat.
Muscle weakness.
Not being able to think clearly or quickly.
Heart rhythm issues.
Kidney stones and kidney damage.
https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-2...1) There are lots of studies that correlate Vitamin D production with sunlight exposure. For example, https://pubmed.ncbi.nlm.nih.gov/20398766/ this one lands on 1/4 of a MED = 1000 IU. Of course now we have a MED definition problem, but we're roughly talking single digit numbers for a white person in midday sun in NYC to reach 1/4 of a MED.
2) If you also supplement with Magnesium, a lot of your side effects go away. Vitamin D3 depletes Magnesium absorption.
I did have one issue related to magnesium however. If I did a very high dose of magnesium taurate and a couple of other chelated forms I would have trouble catching my breath after physical exertion similar to chronic high doses of iodine. Not the end of the world but it was unnerving.
Don't anyone else do what I do. I experiment on myself more than scientists experiment on mice minus the whole dissection bit. I am just continuing some experiments from the 1900's but as I understand it AI will be learning all of those soon. Fascinating stuff really.
> McCullough et al 2019 gave over thousands of patients 5,000 to 10,000 IU/day, for seven years, and there were zero cases of serious side effects. This is in line with Billington et al 2020, a 3-year-long double-blinded randomized controlled trial, where they found "the safety profile of vitamin D supplementation is similar for doses of 400, 4000, and 10,000 IU/day." (though "mild hypercalcemia" increased from 3% to 9%. IMHO, that's a small cost for reducing the risk of major depression & suicide.)
So why then does Mayoclinic, etc, all say 4000 IU is the limit? I think because policy is decades behind science (this happened with trans fats), and also policymakers are much more risk-averse. (this is why in California, thanks to Prop 65, up until ~2018, there used to be a warning in every coffeehouse that coffee causes cancer.)
But thanks to your comment, I will edit the intro to note what the official max safe dose is, and that more recent peer-reviewed research shows it's too low!
Regularly have my Vit D levels checked and they are always within the upper bounds of healthy reference range