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by arghzzz 2214 days ago
However, taking 3 vitamins is almost entirely harmless.
4 comments

Many things are almost entirely harmless, but before recommending you do them anyway, you probably want to look at whether there's any point.

Turning round in a circle three times before you leave the house is almost entirely harmless, and there's no evidence that doesn't stop you getting coronavirus...

But there is evidence of how deficiencies in these vitamins cause other problems unrelated to coronavirus. If it takes a pandemic to get people to worry about their nutrition, so be it.
> But there is evidence of how deficiencies in these vitamins cause other problems unrelated to coronavirus.

To play the devil's advocate, no, that's not true. What we have are just associations which could be spurious. It is often said the general population is deficient in this or that vitamin, but in the west at least we are no longer in danger of developing scurvy or rickets and beyond that there's actually not much evidence that vitamins improve our health.

(Note — not enough evidence means just that, and is certainly not evidence of absence)

Of course, take your vitamins, I've taken vitamin C and D long before this coronavirus and I've caught colds less frequently — but truth be told, I haven't isolated the variables, I have no idea why I felt better and it could be just coincidence.

The problem in believing diet can make a difference is that it may take resources away from investigating treatments that actually work.

In a clinical setting we are talking about high intravenous doses, which are supposedly meant to give the immune system a boost and not to fix prior deficiencies. There's not much evidence that high intravenous doses work either.

In the context of the population, keeping your distance, washing your hands, wearing masks and even if you catch the virus, minimizing the viral load you're exposed to, will probably do much more good than a healthy diet. If you do everything else, then fine, optimize your diet too, but often people get lost in minutiae, forgetting proper hygiene.

UPDATE: edited multiple times, sorry.

Actually people still suffer things like scurvy and rickets in developed countries. https://www.independent.co.uk/news/health/victorian-disease-...
Turning round in a circle three times also doesn't improve your health in general. Getting the right vitamins does improve your health.
Getting too much of many vitamins can harm your health though.
So can too much air and water and literally anything else.
Not true of B12 at least. No known upper limit as of now.
Mostly correct.

“Several studies have shown that megadoses of the vitamin can lead to outbreaks of acne and rosacea, a skin condition that causes redness and pus-filled bumps on the face. Yet, it should be noted that most of these studies focused on high-dose injections rather than oral supplements (5, 6, 7).

There is also some evidence suggesting that high doses of B12 may lead to negative health outcomes in those with diabetes or kidney disease. One study found that people with diabetic nephropathy (loss of kidney function due to diabetes) experienced a more rapid decline in kidney function when supplemented with high-dose B vitamins, including 1 mg per day of B12. What’s more, the participants receiving the high-dose B vitamins had a greater risk of heart attack, stroke and death, compared to those receiving a placebo (8).

Another study in pregnant women showed that extremely high B12 levels due to vitamin supplements increased the risk of autism spectrum disorder in their offspring (9).“

From: https://www.healthline.com/nutrition/too-much-vitamin-b12#he...

This is a question of decision-making in the face of uncertainty. We have evidence this helps. It's not conclusive evidence.

The odds of turning round in a circle three times helping are 0.000000001%. The odds of DMB helping are probably less than 50%, but more than 5% at this point. The cost is minimal.

Generally, one does an ROI calculation. To mix units and otherwise have zero rigor:

Return: P(treatment helps) * how much

Investment: P(treatment hurts) * how much + financial cost

My math on most cheap interventions, including vitamin D, are that they're obvious no-brainers, if done competently (e.g. not taking 600,000 IU per day, or sunburning oneself on a crowded beach -- dumb stuff like that always comes up in counterarguments).

Without math: There's evidence (although not proof) that they might help. They can't hurt.

I do a lot of things like that. When COVID19 first showed up, I was super-careful about contact transmission, large droplet, and aerosol, although I had no evidence which of those dominated. Were some of the things I did a waste? Indubitably. Was it a good idea to do that together? Without a doubt.

The evidence is weak, they cost money.

AFAICT Vitamin D supplementation may well be snake oil, as low vitamin D levels may be symptomatic of another condition which supplementing won't help.

I agree the evidence is weak. That's very different from no evidence (your walking in circles example).

Vitamin D pills cost $12 per bottle where I live. I would guess the economic damage from COVID19 is going conservatively going to be $10,000-$20,000 for a typical family. We can do the math.

If vitamin D has a 3% chance of reducing the economic impact by 3%, even health implications aside, we're best off with everyone taking it.

The evidence isn't strong enough to support even 50% odds of it working, but it's definitely strong enough to support greater than 3% odds.

Similar economics apply for in-hospital use, only even more so.

And yes, I'm aware of all the other correlations. Exercise, sunlight, time outdoors, wealth, and vitamin D all correlate pretty well. We need a robust set of RCTs.

Unless that average family experiences a death, how the hell is the cost going to come close to that?

Here in the UK you would expect the monetary cost to be zero. That doesn't mean you shouldn't look after your health, but seriously, wtf?

In the US, we have currently about 40+ million people unemployed, and trillion+ dollars of stimulus. That's 1 in 4 workers. Many more have pay cuts, demotions, or other economic harm. Kids are learning a lot less with school shutdowns (many are learning nothing), which has more economic impact down-the-line. R&D isn't in great shape either in many industries, cutting into the US' technological edge.

That's not to mention secondary effects, such as how that level of unemployment feeds into anxiety which inflames the current riots.

You can work the numbers however you like, but the number I gave is VERY conservative. The economic harm of COVID19 is astronomical here.

Much of that could have been mitigated with good policy, but in the US, it wasn't.

If a public health measure has even a slim chance of e.g. shortening the need for lockdowns by a few days, and costs several times more what vitamin D pills do, it's already economically worthwhile. The cost-benefit here (and in many other measures of possible benefit) is so incredibly ridiculously obvious that it's not even funny.

No, if you take the wrong 3 vitamins then your just harmed yourself by not taking the correct 3 or 2 or 5.

Nicotine patches also have been said to help.

Every study like this distracts from other studies, so it needs to be pushing towards correct.

Many are toxic (vitamin D included) in unsuitable amounts, that’s probably too strong of a statement.
The study mentions 1,000 IU D3 dosage. A quick google turns up a rough figure of 60,000 IU "daily for multiple months" can become toxic.

You're probably right, most things taken at 100x the normal dose for long period of time are toxic. (Water included)

Water is lethal at far less than 100x the normal dose. Google hyponatremia. You can die from ingesting a gallon of water in a few minutes.
The largest dosage of D3 I can find on Amazon is 5000 IU in a 240 capsule bottle. To take 60000 IU, you'd have to take a dozen capsules daily, getting a new bottle every 20 days, probably multiple times.

While possible, it does seem unlikely.

There is an interesting video about a boy who did just that, by mistaking vitamin gummies for candy:

https://www.youtube.com/watch?v=mZ6nREONy_4

I'm currently taking 60K IU D3. The dosage is 1 capsule a week, for 8 weeks, and the capsules come 4 to a pack. This is followed by a maintenance dosage of 1 60k capsule once a month.
Is this to treat a medical condition?

I'm curious why an acute high dose would be preferable over a lower dose taken daily.

No obvious medical condition, other than a vit D serum level of 15 ng/mL. Depending on who you ask, that's a deficiency. I'm personally less convinced.

It's not quite an acute high dose. The body produces the equivalent of 10,000 IU per day in high sun exposure, so 60K per week tries to achieve that level. I believe the high dosage is simply convenience. The 2K IU daily dose is pretty common as well.

Sounds like he was diagnosed with a very low level of Vitamin D and got prescribed high dosage to get up to a healthy level quickly.
There are 50000 IU capsules readily available on many stores.

Taking 100000 IU per day for months/years is not necessarily toxic, especially when reducing calcium intake.

You can bolous dose. Depending on the which country. It might be prescription only. I take 20,000 IU once a week, 1000 iu everyday. I have bought prescribed 60,000 IU in the past.
Just anecdotal observation, I have been taking 40,000 IU D3, 800mcg K2, 400mg Magnesium among other things, daily for 3+ years, no issue. I had to work my way up to that. I've been reversing calcium buildup in my vascular system to lower my CaC score. I know of many people doing the same thing, some longer than I have been. We are all doing good. I also stay well hydrated.
Sorry a bit off-topic, but what form of K2 and magnesium do you take? Can you point me to your protocol to reverse calcium buildup?
I can point you to some of the studies on calcium removal. [1] They don't create a well defined protocol, though doctors have formed their own. I take 600mcg K2 MK-7 and 200mcg of K2 MK-4. I alternate between Magnesium-lysinate-glycinate-chelate (bound to L-Lysine and L-Glycine) and Magnesium Citrate. Since I am listing papers I have to point out that I am not a doctor and this is not medical advise. This method has been working slowly for me and faster for others, likely due to epigenetic and environment factors. I take these things with fatty meals to allow D3 binding and absorption.

[1] - https://www.google.com/search?hl=en&source=hp&biw=&bih=&q=si...

Thanks so much! Really appreciate the info.
Higher ones can be found at a pharmacy
In general, yes, but not in this particular context: it is extremely common to have shortages of vitamin D, B12 and magnesium, and would take quite a bit of effort to overdose on them.

(I have already been taking all three as supplements for the last year due to other research suggesting that having a shortage of them worsens ADHD symptoms)

Yeah but come on, most everyone don't take it in unsuitable amounts just like they don't drink 6 gallons of water every day.

Taking vitamin D for the average American will surely help in keeping good immunity, bone health, etc.

D supplements as well as fish oil were thought promising until studies showed they did not really do what they were advertised to do in supplement form.

https://www.acc.org/latest-in-cardiology/clinical-trials/201...

How typical that you get downvoted when you're one of the few here to actually cite a source for your claim.

I do wonder though if this is an important caveat though:

> among healthy participants.

.. since the rest of the discussion resolves around adding supplements to fight shortages. If "healthy" implies not have said vitamin D shortage then that is still a useful study but doesn't disprove the thesis that taking supplements is probably a good idea.

Everything is toxic in unsuitable amounts, it's an empty statement that doesn't really serve any purpose and is impossible to discuss.
I took > 100,000IU for nearly 3 months (look up the Coimbra Protocol) with no ill effects. Avoid calcium like your life depends on it (even for months after stopping) and you'll likely be fine (I am not a doctor, this is not advice, just sharing my experience.)
I assume you’re saying to avoid calcium supplements, not to avoid calcium?
No avoid all calcium if you’re taking high doses of D on a daily basis.
Therapy is also deadly in too high of quantities because if you're stuck in your therapists office and can't leave then you will starve to death or die of dehydration.
B vitamins are the exception to the rule, most vitamins and minerals are toxic in high doses (like most things).
What amount of vitamin D is toxic?
Water overdoses can be serious in the worst cases, even fatal.

https://en.wikipedia.org/wiki/Hyperhidrosis

I've heard one of the only things that are safe in any amount is alcohol-free beer. Which leads to some funny images of our medical studies if that was the standard we held.
I doubt it.

Beer is mostly water and your body can literally collapse from to much of it. I made a quick search and I didn't find anything that proves what you're saying.

Yeah, it was a word-of-mouth thing which I didn't care to follow up on. Given that beer has electrolytes and too much water kills by displacing electrolytes, it does seem reasonable to expect you could drink more alcohol-free beer than water though.
While toxic amounts of basically anything are bad, introducing random facts that have no bearing on what is discussed can mislead some readers into thinking you're making a point related to the topic at hand. While it may be unintentional, this is misleading and therefore not helpful.
Look at the context. I was responding to the implication that taking 3 vitamins is categorically safe. It is not.
If your definition of "safe" is so strict that it declares that's not safe, that's fine and your decision, but it's not a definition you can live by. You're not actually holding your actions in your life to that standard, because you can't be. It's fundamentally broken to do risk analysis without considering the possible benefits as well. Otherwise you end up with the answer to literally everything being "It could be harmful", with no countervailing possibilities, and your heuristic says "no" to everything, including doing nothing. You can't live that way.
In any normal sense it is safe.
No one is suggesting an overdose though. In the amount in the study it is harmless.
The study is not suggesting the administration of toxic amounts of vitamin D