This artical very usefull and i want know about bone density and how to increase
There is a wide variety of benefits from vitamin D, and a wide variety of consequences to a deficiency. Don't only worry about bone density.
The majority of humans around the globe except for those who get outside AND live near the equator who have been tested have been found deficient in vitamin D. 1600iu of D3 is NOT a high dose. I was once quite deficient in vitamin D. I was tested back in 2007 and my levels were 12 ng/ml. The optimal range for vitamin D is around 65ng/ml-80ng/ml per the Vitamin D Council.
The elderly are usually quite deficient in vitamin D. Dr. Cannell discovered that much, much higher doses were required to overcome a vitamin D deficiency and it was better to give daily doses rather than one giant dose infrequently. And D3 is better absorbed than the rx version D2. I took 20,000iu of D3 daily for 3 months to raise my levels from 12ng/ml to 56ng/ml. I now take 5,000iu-10,000iu to maintain my levels at 75ng/ml. And all the vitamin D in the world is not going to improve bone density WITHOUT supplementing calcium, magnesium, phosphorus, trace minerals like silicon, strontium, vanadium, phosphorus, zinc, copper, and boron as well as vitamin C and K. And it is best to get these minerals in the proper form that the body and the bones can easily assimilate -- calcium hydroxyapatite, phosphorus hydroxyapatite and Magnesium Alpha-Ketoglutarate or magnesium glycinate. Taking cheap supplements with calcium carbonate and magnesium oxide are not going to be absorbed very well and consequently won't help bone density.
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There's a difference in how the body reacts to D2 (not natural) and D3 (natural) versions of vitamin D and unfortunately these studies don't always tell you which was used.
Also D alone is not sufficient, vitamin A is also necessary in the formation of new bone. So a test of D alone would tell you nothing without adequate A.
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@Mike Earussi
As is the building blocks of bone: calcium, magnesium, phosphorus, boron, silica, zinc, vitamin C, and K.
The key is sunshine. Though vitamin D supplements did not show a positive result in the mentioned research, sun exposure certainly shows positive results. A Spanish study showed that women who are sun seekers have 1/11 the risk of hip fracture as sun avoiders. Here is a list of the numerous health benefits of sun exposure:
•Seventy-five percent of melanoma occurs on areas of the body that are seldom or never exposed to sun.
•Women who sunbathe regularly have half the risk of death during a 20-year period compared to those who stay indoors.
•Multiple sclerosis (MS) is highest in areas of little sunlight, and virtually disappears in areas of year-round direct sunlight.
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•A Spanish study shows that women who seek the sun have one-eleventh the hip-fracture risk as sun avoiders.
•Men who work outdoors have half the risk of melanoma as those who work indoors.
• An Iranian study showed that Women who avoid the sun have 10-times the risk of breast cancer as those who embrace the sun.
•Sun exposure increases nitric oxide, which leads to a decrease in heart disease risk.
•Sun exposure dramatically improves mood through production of serotonin and endorphin.
•Sun exposure increases the production of BDNF, essential to nerve function.
•Sun exposure can produce as much as 20,000 IU of vitamin D in 20 minutes of full-body sun exposure.
More information and references: Sunlightinstitute.org. And, read Dr. Marc Sorenson’s new book, Embrace the Sun, available at Amazon.
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@Marc A dear friend died from metastatic melanoma at age 52. The primary source- his armpit. I was diagnosed with melanoma Stage T1A on my thigh. My dermatologist told me about 50% are caused by sun damage and 50% genetics.
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@Marc
I really love this post. Thanks a lot!
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@Marc--My uncle, a farmer who never went barefooted, had a primary melanoma on his big toe. It was never correctly diagnosed, and several years later he died of the disease. No family history either.
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My endocrinologist recommended 2000 units per day (I have hypothyroidism). I will follow his recommendation. It's not just used for bone loss.
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I was given the same recommendation for the same reason. The concern is not only due to the risk of cancer with low vitamin D levels but also significant muscle weakness that can be a result of low levels and thyroid disease. If you take multivitamins, eat a balanced diet, and exercise and lift weights daily you will see a big difference in your health, happiness, and energy levels.
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It is essential in articles like this to state the duration of follow up in the study. These people were followed for only 12 months. That's not nothing, but it may take longer than that for a sample size of just a few hundred people to show differences in an outcome like fracture events.
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Its a bit meaningless if the results weren't subdivided by genetic info. Too many people with variations in VDR status to ignore that.
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The original article repeatedly states that the participants were given vitamin D once monthly (large doses) for 12 months. It also gives blood levels: "The mean 25-hydroxyvitamin D concentration was 40.0 ± 20.1 nmol/L, which increased after 12 mo to a mean of 55.9, 64.6, or 79.0 nmol/L for participants receiving a monthly dose of 12,000, 24,000, or 48,000 IU, respectively."
As for a control group, the group receiving the lowest dose was considered the control--they were receiving the currently recommended amount of vitamin D.
I agree that 1,600 IU daily is not high--I take 6,000 IU per day in the winter. However, the group receiving the 1,600 IU dose had an average vitamin D blood level of 79, which is very good.
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@PJH
This is very useful information.
Thank you.
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@PJH Thank you for this. I wish the articles would include this type of detail.
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@PJH So if the mean is still +/- 20 after 12 months, that means that some subjects in the "mid-dose" group had serum D levels LOWER than the "low-dose" group and some subjects had serum D levels HIGHER than the "high-dose" group. Dosage is a red herring. Subjects should have been divided by serum levels.
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It seems pretty useless to me to attempt to measure Vitamin D's effect on bone loss without taking into account that there are so many other factors and other nutrients involved. Why not study its effect (alone) on heart disease, digestive problems, mental illness, or a whole host of other health issues? It makes no sense. Take it with a grain (just one!) of salt!
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The best multi-variable bone research is done by NASA. Bones are a living, adaptive protein-mineral-fat matrix that respond to load, just like muscles.
"When comparing vitamin D serum levels to the incidence of broken bones:
• Those who broke a bone were more likely to have a serum level <40 ng/ml than ≥40 ng/ml.
• Those with serum levels <20 ng/ml had 3 times the risk of breaking a bone compared to those ≥40 ng/ml.
Note:
Calcium, vitamin D, protein and magnesium are several co-factors that work together to maintain strong and healthy bones (realizing bones need 20 nutrients). When any or all nutrients are below the optimal level, bone status is impaired at the level of the lowest – the most limited nutrient. Because vitamin D deficiency is so prevalent, it is often the nutrient leading to bone status impairment. However, if one were to focus on optimizing vitamin D, without also optimizing Ca, protein, Mg, or one of the other important co-factors, no change in bone status would be observed, leading to a false conclusion that vitamin D does not affect bone status.
Because the nutrients interact in the maintenance of bone health, the effects of a single nutrient may be overlooked if intake of others is not sufficient." Grassrootshealth
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To this I would add: take vitamin K2 in the form of MK-7. To understand why, I recommend the “Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life” Why? Modern animal husbandry practices have eliminated this from our food sources. A significant benefit to using MK-7 is that calcium will be pulled from arterial deposits and moved into bones.
Amliawellness
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@C Wolf I would like to underscore your comments on low versus high serum levels of Vitamin D. If 20 of us took the same dosage every day for six months our serum levels would be scattered all over the chart. Subject do not all have the same intake of co-factors, nor do they all get the same level of sun exposure. Studies that purport to establish effect based on the number of iu's subjects took are inherently flawed. Subjects should be divided into groups based on serum levels - then you will probably find interesting differences in their results.
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The problem is one of biological plausibility. If you live at a latitude where people of your skin color traditionally live, then spending most of the daytime outside will give you calcidiol levels between 120 and 200 nmol/l via UV induced synthesis of vitamin D in the skin, corresponding to taking about 5000 IU/day of vitamin D supplements.
The question is then why animals have evolved to use such amounts of vitamin D. We know that vitamin D is converted to calcitriol, which is used for gene expression. E.g. when the body needs to absorb more calcium from the gut, calcitriol will be used to switch on a gene that codes for an enzyme that can transport calcium from th gut into the blood when calcium concentrations in the gut are too low for this to happen by itself.
But calcium metabolism is just one of a large number of processes regulated by calcitriol via gene expression. The question is why animals have evolved to let calcitriol to regulate gene expression, as this makes gene expression depend on sun exposure. This has been the case for hundreds of millions if years, suggesting that this is a deliberate outcome of evolution.
Looking out of the window now, I see a cold barren winter landscape, it's then no wonder that the optimal body configuration should be different now compared to summer now that food is scarce. But we can always eat as much as we want, so we should keep our calcidiol levels at high values using supplements.
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How was “high” Vitamin D defined? Was a dose-ranging study done to determine the optimal dose for this study? Does BMD change in 12 months? Where are the data to support the design of this study? Finally, while Vitamin D deficiency is known to cause rickets in young children, what is the basis for the assumption that Vitamin D (at any dose) might prevent/reverse osteopenia or osteoporosis?
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@Ijaz Jamall Indeed! I upped my own intake of D3 from 2000 IU once a day to twice a day following the recoomendation in Eat Rich, Live Long by Ivor Cummins and Jeffrey Gerber, MD. My take on vitamin D is that that is in the moderate dosage range, not high.
I think it’s worth remembering that many of the recommended dosages of vitamins have been and to some extent still are based on the minimum daily amount needed by an average human to prevent a particular deficiency disease, such as rickets.
It’s a good bet that there is much more to be learned about nutrition and nutritional suppplements and how they affect human well-being. In any research that is to be considered valid, thorough, correct definitions of terms and experimental parameters are required.
Who says 1600 IU of vitamin D is a high dose? Why? Compared to what? Compared to zero vitamin D, it’s as good as infinitely more, but compared to an optimal dose? Does anyone really yet know what that would be for an average human, if there is such a thing?
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Bone density is also affected by weight-bearing exercise. This synopsis of the study does not mention whether the groups were matched for exercise or not. In addition, even 1600 mg. of Vitamin D is not a very high dose, compared to what doctors often prescribe. I have a friend who takes 50,000 mg. once a week or perhaps every two weeks.
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@Barbara
50,000 iu, once weekly, for 8-12 weeks, is standard care for someone with a severe deficiency, for instance a level of 8 ng/mL. You want to be over 30. After 12 weeks, a retest is often done to make sure you've normalized. Then you step down to a smaller dose. (But keep in mind if you were deficient before, you will become deficient again if you don't mend your intake.)
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@PNK
Actually, 40 ng/ml seems to be the minimum.
"When comparing vitamin D serum levels to the incidence of broken bones:
• Those who broke a bone were more likely to have a serum level <40 ng/ml than ≥40 ng/ml.
• Those with serum levels <20 ng/ml had 3 times the risk of breaking a bone compared to those ≥40 ng/ml." Grassrootshealth
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C Wolf below is quite correct. This study is terrible and very misleading. First - the dose used in the study is no where close to being "high". I take between 5,000 IU's and 10,000 IU's every other day in winter just to keep my vitamin D level between 50 & 70 ng/ml.
But most important - is that vitamin D does not work alone. Vitamin D works in tandem with vitamin K2. It is K2 (aka MK-7 or menanquinone) through carboxylation which transports calcium absorbed with the help of vitamin D to bone. Vitamin K2 is vital for bone deposition. Most people are deficient in K2 - and that is why bone mineral density is low especially in older people. Without K2, you can take all the vitamin D you want and not make a bone density difference.
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@Michael
Look for Jarrow's Bone Up, or any other supplement with the same ingredients.
And no, I have no connection to Jarrow; it's just a good brand.
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@Michael
Yes.
If someone actually researches what is known in regard to Vitamin D they will undoubtedly come to the conclusion you have reached. I take 5000 IU vitamin D and 200mg of K2 per day. Vitamin D is very good, apparently at helping the body to resist death from cancer, which is good, (See the work from the Vitamin D Council) and very good at causing calcium retention in the body, which is really not entirely desirable, because without K2 the calcium gets into too much soft tissue. K2 is a natural product of fermenting foods, such as used long before fires were used for cooking. K2 is naturally found in many cheeses (gouda) for example, and in kimchee and sauerkraut, and fermented soybeans (natto). Other cultures use fermented fish and shrimp paste for the same kind of reason.
The problem is not with the science here, or not exactly, it is testing these various vitamins somewhat in isolation. I regard this study as somewhat towards the misleading end of the spectrum. It's worse than just useless.
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@Michael
D dose to target serum levels varies by: body size, co-factors (Magnesium, Vitamin K, Zinc, Boron, Vitamin A), lifestyle (sun exposure at solar noon by 40% skin exposed at UVB sufficient latitude & season), starting deficiency level, etc.
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This data is meaningless without comparison to blood levels of Vitamin D3.
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So 1,600 IU a day is their definition of high dose Vitamin D?
Really?
I take 50,000 IU a week.
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@Steel
Over time that dose will very likely lead to an overdose level. 50,000 IU per week is a very short-term therapeutic dose for those who are deficient.
If you've been doing that for long, better check your current level!
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@PNK
I get my levels checked yearly, and this year, even did it twice a year. Last time it was 72.
We are all different and some require such a dose for a longer period of time.
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There is not a single case of Vitamin D toxicity of anyone taking 30,000 IUs or less a day in the literature.
The body exposed to sunlight will generate as much as 20,000 IUs in one hour. How can 50,000 in one week be too much?
Lifeguards typically test out at 120 ng/ml.
The decision to set the low level of 30, was a near arbitrary decision - perhaps just enough to prevent rickets.
There are any number of methodological issues.
Given dose x, serum levels vary widely by body weight, presence of co-factors, and starting serum D levels. When Wagner, for example, ran her MUSC study data by dose, there were no results between control and treatment groups. When she ran the data by serum levels, there were very significant results in folks with over 40 ng/ml.
The next problem is that bones are a protein-mineral-fat matrix that adapts to load (just like muscles). The best measure of bone strength is bone geometry, not DEXA. Changing one variable like D while other variables are insufficient simply yields null results.
Putting it another way, would you look like Arnold if you drank his shakes but didn't exercise?
If you really want to see good bone research, look at what NASA has done. Or Lappe's D-calcium study in Navy recruits, reducing stress fractures by 20%.
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"But there was no difference between the groups in changes in bone mineral density, number of falls or number of fractures caused by osteoporosis."
Assuming the validity of these findings, this study does not at all speak to the dozens of other benefits found from supplementing Vitamin D at higher doses that the Recommended Daily Allowance (RDA).
There are hundreds of published peer-reviewed double-blind, placebo studies that show the many benefits of high levels of Vitamin D with minimal risks of receiving toxic doses.
My opinion is that we are best served receiving a healthy dose of Vitamin D from whole-body exposure to sunlight, but direct sunlight is not always plentiful, and some conditions (like Lupus) prevent people from sunbathing, so supplementation with Vitamin D3 along with regular 25-OH-Vitamin D blood tests is the next best plan.
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@John
I've never heard of any good reason to take medicine (vitamins) unless one was so deficient it was making them sick. It's true we can't make vit D from sunlight so well in winter but our body does store it for a time from summer. It's also not hard to get from dairy products and fish.
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@Ron A
There is zero UVB in winter, even if you could tolerate exposing 40% of your skin at solar noon (Holick).
Vit D half-life is a few weeks.
Actually it is difficult to get enough D from milk. 100IU D2/cup. If a 100 pound person needs 3,500IU/day (Heaney), how many cups of milk should you drink?
True, wild-caught salmon is rich in D. Affordability is the challenge.
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Cancer - especially colon, prostate and breast - is correlated with geographic location based on exposure to the sun - in other words, as you get closer to the equator, these cancer rates go down. Colds/flu shoot-up in the winter. These studies have been out there since the 70s but unless you experiment with high does, get blood levels up past 100 and have the right co-factors you are not going to be able to produce meaningful studies.
1600 IU daily of vitamin D is not a high dose. I need 7000’ish IU daily to keep my blood level in the optimal range.
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When I was trying to raise my vitamin D levels, under a doctor's supervision, I was taking at least 8,000 I.U. a day. Even at that rate, my doctor said, it would take several months to reach the target she wanted, and she was right, it took the better part of a year. (for this reason, it's actually challenging, though still possible, to overdose on vitamin D). I'm not saying that a high levels of vitamin D will prevent osteoporosis, my guess is that they won't, but how can these researchers say that taking high doses of vitamin D doesn't work, when they haven't even tried it? I can't take that study seriously.
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@Eurosceptic
True.
The very rare cases of D poisoning have involved manufacturing mistakes with doses like 1 million IU.
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How long did the trial last? Any conclusions are useless without this information. Also, without a placebo group, this cannot be a convincing piece of evidence.
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@Patricia, I skimmed the article, and couldn't find out long the patients were followed -- very odd. I did read that the first dose of vitamin D was given between November 2012 and May 2013, and that the article was accepted for publication Dec 27, 2017; accounting for time to collect the results and evaluate them and to write the paper, the trial lasted no longer than about 4 years. And why was there no control group? This study is bizarre.
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