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by stevenkovar 3021 days ago
I would recommend reading this article about the connection between vitamins D, A, and K, and how they inter-play with one another: https://www.precisionnutrition.com/stop-vitamin-d

It was pretty eye-opening (and alarming) when I read it.

In short: While Vitamin D is great for everyone, your body will begin lacking in vitamins A and K because of the effects of D (too much of a good thing, essentially). It's all about finding the right balance for yourself.

Snippet from the closing:

1. Get enough vitamin D… but not too much. Doses of around 1,000 IUs per day — even as high as 2,000 IUs a day in the winter months when you’re not exposed to much sunlight — are likely safe. Especially when other key nutrients are included, such as vitamin K, vitamin A, and magnesium. You can ensure you are getting enough of these by taking a quality multi-vitamin.

2. Support vitamin D’s work Remember that other nutrients act together with vitamin D. Consume a wide variety of minimally processed foods to help get vitamin D’s nutritional colleagues such as magnesium, vitamin A, and vitamin K.

Eat your greens and fermented foods. Dark leafy greens — such as kale, spinach, or Swiss chard — are good sources of vitamin K1. They’re also high in dietary magnesium. Fermented veggies such as sauerkraut along with eggs, meats (especially organ meats such as liver) and fermented/aged cheeses are good sources of vitamin K2.

Eat the rainbow. The carotenoid form of vitamin A is found in colorful fruits and veggies. Eggs, butter, full-fat dairy (such as cheese) and organ meats are also great sources of the active retinol form of vitamin A.

Keep your intestinal flora happy and healthy. Vitamin K conversion happens in the GI tract. So eat plenty of fermented foods and prebiotic fiber, consider a probiotic supplement, and avoid antibiotics unless absolutely necessary (research has found that broad-spectrum antibiotics can reduce K production by up to 75%).

Review all medications and supplements with your doctor and/or pharmacist. Many medications, such as corticosteroids like Prednisone, weight loss drugs like Orlistat, cholesterol-blocking drugs like statins, and/or high blood pressure drugs like thiazide diuretics can disrupt the delicate balance of vitamin and mineral regulation in the body. Make sure you know all the side effects and interactions of any medications (or “healthy” supplements) you are taking.

4 comments

> taking a quality multi-vitamin

I try to be cautious with vitamins. It appears that taking them in pill form might not be safe. I switched to a high-nutrient diet that focuses on getting nutrients from food wherever possible.

Some examples of cases where vitamins that are beneficial in food form might be dangerous in extracted form:

Vitamin E and the Risk of Prostate Cancer: https://jamanetwork.com/journals/jama/fullarticle/1104493

Dietary Supplements and Mortality Rate in Older Women: https://jamanetwork.com/journals/jamainternalmedicine/fullar...

Death Stalks Smokers in Beta-Carotene Study: https://www.webmd.com/smoking-cessation/news/20041130/death-...

I haven't checked the others, but in the first one they seem to have given people 400 IU Vitamin E, which is equivalent to 180mg synthetic Vitamin E or 12x the RDA for Vitamin E. And they did that for 7-12 years straight. Also, the increase in cancer risk doesn't seem that significant if I'm reading the results right.

I'm not a fan of multivitamins that go crazy over the RDA unless I know the RDA number is way too low to begin with (like in Vitamin D's case). It's also an especially bad idea to go crazy over RDA with fat-soluble vitamins, because those are the ones that are stored in your body for longer periods of time. At least the water-soluble ones come out when you pee, but I think there's some new evidence that even some of those is stored or at least it may not be a good idea to "mega-dose" on them.

Some vitamin E supplements have 1000 IUs. See my other comment in this thread.
I recall Rhonda Patrick explaining on a podcast that they used an extremely high amount of vitamin E, all in the form of alpha-tocopherol which leads to depletion of gamma-tocopherol.

But I agree about trying to get your vitamins from your diet in general.

I wouldn't call the dose extremely high. Some over the counter supplement pills have 1000 IUs and it looks like the study was done with only 400 IUs. (It's over the current recommended daily intake though.)

Here is some more reading:

* Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements http://annals.org/aim/fullarticle/1789253/enough-enough-stop...

* Vitamin B.S. https://www.theatlantic.com/health/archive/2015/02/vitamin-b...

* Experts: Don't Waste Your Money on Multivitamins https://www.webmd.com/vitamins-and-supplements/news/20131216...

* The Case Against Multivitamins Grows Stronger https://www.npr.org/sections/health-shots/2013/12/17/2519558...

* A Scientist Debunks The 'Magic' Of Vitamins And Supplements https://www.npr.org/sections/health-shots/2013/07/23/2045251...

> Get enough vitamin D… but not too much. ... even as high as 2,000 IUs a day

2,000 IU is not a high level of Vitamin D. That's a medium-to-low level of Vitamin D. 20,000 IU is high.

Most people can very safely take 5,000 IU and won't come even remotely close to seeing negative health consequences. Quite the opposite, studies have suggested you may need that level of VitD intake just to get up to a healthy blood reading, especially if you have low sunlight exposure.

The old RDA guidelines have increasingly been shown to be a scientific embarrassment over the last 20 years.

Correct me if I'm wrong, but don't the vast majority of cases of hypercalcaemia caused by excessive D consumption involve daily doses of 40-50,000 IU? I'm sure I've read this before. If 20,000 IU is high, 50,000 IU must be enormous, so I too would very much doubt 2,000 is 'high'.
For reference, i was on a 50k IU dose of D3 last year for schools of months. It's considered therapeutic for diagnosed and lab-confirmed deficiency.

Since then I've periodically stayed on s 10k IU supplement three times a week. That's just over the counter.

Do you take vit K and magnesium to compensate possible side effects?
I take a daily multivitamin that supplements those.
did a doctor prescribe the 10ks? that seems high compared to what I was suggested for a lab confirmed deficiency. Someone I know with a severe deficiency was prescribed very high levels only for a month or so.
10k IU is available OTC, so its not a prescription, but I do take it on my doctor's recommendation. I don't get a lot of sun, especially in the winter, and I've had chronic deficiency of D3, so I supplement at higher levels than what I'd get in your average multivitamin. 50k IU is what I was prescribed for two months to get me above the minimum recommended blood levels, and it barely did that.

I do also get my D3 levels checked annually as well, as should anyone with a diagnosed deficiency.

I've had doctors prescribe 10k IU vitamin D. Mine was really low and i have auto-immune thyroiditis. Vitamin D works really well for auto-immune disease for me. It has gone.
It very much depends. There are genes having a strong influence on vitamin D metabolism, and there are people for whom 5k I.U. are too much. (Essentially, they are metabolizing D3 into calcitriol and the other form I keep forgetting too fast)
50,000 IU is typically taken on a 1-4 week interval. Being in renal failure, I myself take it once a month and increase to twice per month in the winter.
My doc had me on 25,000 IU once a week for a few months to get me through a sluggish period where I felt low T even though I was excercising. It’s funny how people claim certain doses are low or high. This is probably based upon what their doctor told them to take or what they heard from someone just as uninformed as themselves. Surely there’s a body mass chart for dosing that would clear this up for everyone?
Did your doc give you vitamin K as well, and did they check your calcium level?
Yes. She gave me K. I don’t recall if the blood test showed calcium.
Did the treatment seem to work? Did your T-levels rebound?
Oh yes. It was paired with other treatments too though so I can’t be sure of causality.

I was getting acupuncture, began excercising more, eating more veggies, and dealt with the factors that were bringing about my depression.

> So eat plenty of fermented foods and prebiotic fiber, consider a probiotic supplement

There is very little conclusive evidence that suggests probiotics are actually useful. In the EU and USA companies are not able to claim health benefits from them legally.

Some good studies cited on the Wikipedia article: https://en.wikipedia.org/wiki/Probiotic#Scientific_reviews_a...

Yeah, many diseases are related to the microbiome (although there is the question of where does the cause/effect arrow point?), but current probiotics are for the most part not sticking around in the gut. The usual suspects just have an indirect effect on the bacteria you already have, and get excreted within days/weeks. Spore forming bacteria survive longer, but might become a problem of their own if overpopulated. Also.. if your goal is a more diverse microbiome, then supplementing the most abundant L-bacillus strains might not be a particularly effective option?

And the microbiome is so vast that it’s hard to influence on the long term. With a very strong probiotic you get 5 * 10^10 bacteria (of which most die in the stomach and small intestine), but at the same time you have 3.8 * 10^13 native bacteria settled and accustomed to your body, feeding on the sugar you have just eaten. You need a lot of those tablets to have a meaningful impact.

Just like a great body, a great microbiome gets made in the kitchen. AFAIK dietary changes work way faster than popping probiotics. With the exception that you are missing certain strains (eliminated by antibiotics?), which should be replaced.

They may be useful in some situations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424311/

I was prescribed some a year or so ago when I was on some heavy antibiotics. Reading that article still makes it look like efficacy is pretty minor. Since it doesn’t really hurt to take it why not?

Every time I've had to take antibiotics here (which admittedly has only been a couple of times) the doctor made sure to tell me to take probiotics as well until the course of antibiotics was over.
If you are deficient then the amount you take is dependent on how your levels change given a trial amount. No one is the same here.

Testing is really the only way to know how much you should be taking