Clearing up confusion around vitamin D: Presentations by International vitamin D researchers and experts
Not sure what to do about vitamin D for yourself or your patients? Research has highlighted the newly appreciated, vital associations between vitamin D insufficiency or deficiency and extra-skeletal diseases, such as several cancers, autoimmune diseases, metabolic disorders such as Type 2 diabetes and metabolic syndrome, hypertension, increased risk of heart failure, prenatal and neonatal complications, and acute infections. Recommended daily intakes as set by the Institute of Medicine (IOM) and the newly updated Endocrine Society guidelines are too low to adequately support the role of vitamin D for such extra-skeletal processes and disorders mentioned above, leading to increased risk of such diseases, even in healthy people.
This virtual event addressed the following key points:
- The importance of Vitamin D in health maintenance, disease prevention, and longevity, as supported by research
- The widespread insufficiency/deficiency of Vitamin D and the influential role of updated guidelines
- The safety of Vitamin D supplementation
- The potential clinical applications of high dose Vitamin D (autoimmune disease, cancer, etc.)
- The practical aspects of vitamin D’s role in health and how to apply Vitamin D research into everyday life and practice.
In Conclusion: Given its wide safety margin, effectiveness in preventing and even reversing chronic diseases, and its affordability, there is no reason not to optimize Vitamin D supplementation. The evidence is clear: higher Vitamin D levels can provide significant health benefits with minimal risk when properly monitored. Therefore, optimizing Vitamin D intake should be a cornerstone of both individual healthcare and public health strategies.
Brought to You By:
Orthomolecular Medicine News Service (OMNS), The International Society for Orthomolecular Medicine (ISOM) & GrassrootsHealth
MAIN COMPONENTS OF THIS ONGOING EVENT
Live Virtual Forum & Expert Panel, Held September 30th, 2024 (Recording Below)
This live event was held via Zoom as a high-level summary roundtable discussion.
- Goal one: to provide an interactive, public response from key vitamin D researchers and experts to the latest vitamin D guidelines update by the Endocrine Society
- Goal two: to synthesize the latest research findings on vitamin D and provide actionable takeaways for the attendees, compiled at: orthomolecular.org.
Watch the Recording
Ongoing Virtual Event
Recorded presentations and individual papers covering recent advancements and research in vitamin D will continue to be released and posted below, following the live event.
Register for Additional Updates & Ongoing Presentations Here
Ongoing Event Presentations
Dr. Sunil Wimalawansa: “Basic Concepts Important to Understanding Vitamin D” & “Vitamin D Dosing and Safety”
Dr. William Grant: “The Roles of Vitamin D in Cancer Risk Reduction and Brain Health”
Dr. Reinhold Vieth: Vitamin D “TOXICITY”
Dr. Aileen Burford-Mason: “Vitamin D: Immune System Support”
Expert Speakers and Panelists
Presentation Slides
Research Papers
- The Interdependency and Co-Regulation of the Vitamin D and Cholesterol Metabolism
Authors: Warren, T.; McAllister, R.; Morgan, A.; et al.
Abstract: This paper discusses how cholesterol and vitamin D metabolism are interrelated. It highlights the role of cholesterol as a precursor in the synthesis of vitamin D and emphasizes the regulatory feedback mechanisms involved.
Read more - Exploring the Relationship between Cholesterol Synthesis and Vitamin D: Implications and Insight
Authors: Singh, T.; Sharma, L.; Patel, P.; et al.
Abstract: This study explores the intricate relationship between cholesterol synthesis and vitamin D production, providing insights into metabolic pathways and health implications.
Read more - Vitamin K2 Puts Calcium in Bones and Removes Calcium from Arteries: A Look at the Data
Author: Passwater, R.A.
Abstract: This article examines how vitamin K2 directs calcium into bones while preventing arterial calcification, enhancing bone strength and cardiovascular health.
Read more - The Role of Vitamin K in Soft-Tissue Calcification
Authors: Theuwissen, E.; Smit, E.; Vermeer, C.
Abstract: This review highlights vitamin K’s role in preventing soft-tissue calcification and the mechanisms through which it helps maintain vascular health.
Read more - Regression of Warfarin-Induced Medial Elastocalcinosis by High Intake of Vitamin K in Rats
Authors: Schurgers, L.J.; Spronk, H.M.H.; Soute, B.A.M.; et al.
Abstract: This experimental study shows how high intake of vitamin K reverses warfarin-induced vascular calcification in rats, suggesting potential therapeutic applications.
Read more - Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health
Author: Schwalfenberg, G.K.
Abstract: This review explores the benefits of vitamins K1 and K2, emphasizing their essential roles in bone health, cardiovascular function, and overall well-being.
Read more
Questions and Answers
For questions about vitamin K, please refer to this new post here.
If my family doctor does the vitamin D blood level and it’s within the normal limits, do you still need to take more vit D continually? Thank you
A: Once you reach your desired vitamin D level, it is important to continue taking the amount of vitamin D you have been taking regularly over the last couple of months, as that is how long it takes for a blood level to fully adjust to a change in supplementation. (The time will be shorter if you started with a larger loading dose before switching to a regular maintenance dose.) In other words, keep taking what you have been taking once you get to your target level – that is what is called your “maintenance dose,” and that is what your body needs on a regular/daily basis!
The following posts contain more information on why getting vitamin D daily is important, versus taking vitamin D only once per week, month, or longer.
Do You Take Your Vitamin D Daily? Read Here
When Taking Vitamin D Can be Ineffective and Possibly Harmful Read Here
Nutrient Reference Range vs Optimal Range Read Here
Optimal Vitamin D Levels Differ for Specific Outcomes Read Here
7-dehydrocholesterol is converted into both cholesterol and vitamin D. It has been said that low cholesterol can compromise the production of Vitamin D3. What is the acceptable level of cholesterol so that our body can produce vitamin D3 through sunlight?
A: provided by Dr. Satya Nahu, MD
The relationship between cholesterol levels and vitamin D3 production is complex but important. Cholesterol is a precursor to vitamin D3 synthesis, as 7-dehydrocholesterol (a derivative of cholesterol) is converted to vitamin D3 when the skin is exposed to UVB radiation from sunlight.
There’s no universally agreed-upon “acceptable” cholesterol level specifically for optimal vitamin D3 production, as this process is influenced by various factors including overall health, skin exposure to sunlight, and individual metabolic conditions.
However, some general guidelines can be considered:
Total Cholesterol Levels: Normal total cholesterol levels are generally considered to be less than 200 mg/dL. Levels above this might be associated with higher risks of cardiovascular issues, while levels below this are often viewed as more favorable for heart health.
Optimal Range for Vitamin D Production: While specific cholesterol levels are not defined for vitamin D production, maintaining a balanced and healthy level of cholesterol is important. Very low cholesterol levels might theoretically impact the synthesis of vitamin D3, but the exact threshold where this becomes significant isn’t well-established.
Overall Health Considerations: Rather than focusing on a specific cholesterol level for vitamin D synthesis, it’s more practical to ensure that cholesterol levels are within the recommended range for overall health. The focus should be on maintaining a healthy lifestyle, including adequate sun exposure and possibly vitamin D supplementation if needed to maintain a healthy vitamin D level.
If you have concerns about cholesterol levels and vitamin D synthesis, it’s best to consult with a healthcare provider. They can provide personalized advice based on your overall health profile and any specific needs you might have.
My naturopath suggests that it might be detrimental to use synthetic Vit D supplements due to their affect on other hormones. On the market I see only synthetic Vit D and only a few forms of supplementation possible. I wonder if there were any researches on that hormone interaction and safety of Vit D in a synthetic form.
A: Regarding synthetic vitamin D – most supplemental vitamin D is actually made from lanolin, which is naturally produced from sheep wool. It is identical to the vitamin D3 that we make in our skin. Perhaps your naturopath is referring to vitamin D2? We do suggest vitamin D3 over D2 for many reasons.
Vitamin D3 is very safe and I am not aware of any research showing that supplementation has detrimental effects on other hormones. When a claim like that is made, we always ask to see the research. If your naturopath has access to the research, please send it our way.
I'm wondering why vitamin D levels are so low around the world. Is anyone talking about the geoengineering --the spraying of the skies with whatever they are spraying? Could it be that the Vitamin D producing sun rays are being partially blocked?
A: provided by Dr. William Grant, PhD
No, however, smog and cloud cover can block UVB rays. Some of the reasons for low vitamin D levels are:
1 – people being afraid of the sun due to publicity about skin cancer and, as a result, spending less time in the sun, covering up more when in the sun, and using sunscreen, including in women’s cosmetics.
2 – people spending more time working indoors rather than out.
3 – increasing rates of overweight and obesity.
My father has Vascular Dementia. Do you think vitamin D supplements would benefit him at this stage in his disease and if so in what way?
A: provided by Dr. William Grant, PhD
He probably has low vitamin D levels. Vitamin D has many health benefits, but not sure it would reduce the severity of vascular dementia once it has already been diagnosed.
Why we see breast cancer in women even though they keep their vitamin D level at optimum and mostly above 60 ng/ml? These are estrogen positive cancers that I am talking about.
A: provided by Dr. William Grant, PhD
There are many factors that increase risk of cancer including being overweight or obese, which also increases inflammation. Vitamin D has modest effects on reducing inflammation. Also, vitamin D seems to have more effects on cancer progression and metastasis and death than on cancer incidence.
Thank you for your very informative presentation today on Vitamin D with GrassrootsHealth. I'm hoping to reduce the size of the calcified or ossified body in my knee, which measures 8X10 mm. It is restricting my ROM. I cannot flex beyond about 140*. I've been taking 10,000 IU Vit D since I had melanoma in 2010. I'll get my Vit. D level re-checked, also serum Ca and free Ca. I've stopped taking Ca, which was in Stomach Comfort from Nature's Sunshine. It contained carbonic acid calcium salt (calcium carbonate) 800 mg (standardized to contain 275 mg calcium) and alginic acid. I take Nature's Sunshine Magnesium Complex 6 capsules, each contain 100 mg magnesium (magnesium citrate, 485 mg, 16%, and magnesium malate, 155 mg, 15.2% magnesium). I also take Nature's Sunshine Super Omega 3, 3 capsules 1000 mg each of anchovy, mackerel, and sardine body oil. I also take many other supplements. I eat a lot of almonds, walnuts, macadamia nuts, and pecans, and hemp and pumpkin seeds. I'm an avid cyclist, both indoors on Zwift and also outdoors on Strava, but have had to curtail some of my activities that require deeper knee bends. I would appreciate your comments and recommendations!
A: provided by Dr. Richard Cheng
The following is a starter for you (from I-OM.ai). For more Q&A, please check out: I-OM.ai. I also provided more detailed consultation, for a fee.
I’ll just add 2 points:
1. Start a low carb, low ultra-processed food, low seed oil (high omega-6 diet
2. I often use Vit K2 as high as 45 mg/day.
1. Vitamin D Levels: Ensure your vitamin D levels are within the optimal range of 40-80 ng/mL (Passwater, 2014). Regular monitoring is essential, especially since you have a history of melanoma and have been taking high doses of vitamin D.
2. Magnesium Supplementation: Continue taking magnesium supplements as they play a crucial role in bone health and can help in reducing calcification (Theuwissen et al., 2012). Your current intake of 600 mg/day from magnesium citrate and malate is appropriate.
3.Vitamin K2: Consider adding Vitamin K2 to your regimen. Vitamin K2 helps in directing calcium to the bones and away from the arteries and soft tissues, potentially reducing calcification (Schurgers et al., 2007). A dose of 100 mcg/day is recommended for each 125-250 mcg (5,000-10,000 IU) of vitamin D3 (Passwater, 2014).
4. Omega-3 Fatty Acids: Continue with your Omega-3 supplements as they have anti-inflammatory properties that can help in managing joint health (Schwalfenberg, 2017).
5. Dietary Considerations: Maintain a balanced diet rich in nuts and seeds as they provide essential fatty acids and other nutrients beneficial for joint health. However, ensure that your calcium intake from food sources is balanced and not excessive.
6. Physical Activity: Modify your cycling routine to avoid activities that require deep knee bends. Focus on low-impact exercises that do not exacerbate your condition.
7. Regular Monitoring: Get your serum calcium and free calcium levels checked regularly to ensure they are within the normal range. This will help in adjusting your supplement intake accordingly.
8. Consultation with a Specialist: Consider consulting an orthopedic specialist for a personalized treatment plan. They may recommend physical therapy or other interventions to improve your range of motion and manage the calcified body in your knee.
Conclusion:
Maintaining optimal vitamin D and magnesium levels, adding vitamin K2, continuing with omega-3 supplements, and modifying your physical activity can help manage the calcified or ossified body in your knee. Regular monitoring and consultation with a specialist are also crucial for effective management.
I know that diabetics have difficulty converting beta carotene to retinol and wonder whether they are also challenged with vitamin D conversion pathways?
A: Provided by Dr. Camillo Ricordi, MD Yes, individuals with diabetes may also face challenges with vitamin D metabolism, although the mechanisms differ from those affecting beta-carotene conversion.
Diabetes, particularly type 2 diabetes, has been associated with altered vitamin D metabolism. This may happen due to several factors:
1. Impaired kidney function: Since the kidneys convert vitamin D into its active form (calcitriol), any impairment in kidney function, which is common in diabetes, can affect this conversion process.
2. Increased inflammation: Chronic inflammation, which is often present in individuals with diabetes, can disrupt the function of enzymes involved in converting vitamin D into its active form.
3. Insulin resistance: There’s evidence that insulin resistance can influence vitamin D metabolism, as vitamin D is thought to play a role in the regulation of insulin secretion and sensitivity.
4. Low vitamin D levels: Many studies have found that people with diabetes often have low levels of circulating vitamin D, which could exacerbate issues with conversion or function.
Thus, while the specific mechanism of conversion issues is different, diabetics may indeed experience challenges with vitamin D pathways. Supplementing with active forms of vitamin D, like calcitriol, may be necessary in some cases, particularly if there’s kidney involvement. It is always advisable to consult a healthcare provider for tailored advice on supplementation.
What are the reasons you suggest Vitamin D3 over D2? A friend with Graves has been prescribed vitamin D2 by his MD. I told him D3 is better but I really don't know why.
A: Vitamin D2 (ergocalciferol) is a synthetic (non-human) product that is derived from plant precursors that is not utilized by the body as efficiently as vitamin D3, which is the form of vitamin D produced in the skin upon exposure to UVB. With a much shorter half-life, vitamin D2 remains in the blood for only a few hours. Therefore, supplementation with vitamin D3 is recommended. For more information on the different forms of vitamin D, check out this interview with Dr. Sunil Wimalawansa: https://www.grassrootshealth.net/blog/understanding-forms-vitamin-d-vitamin-d3-25ohd-125oh2d/
Would it helpful to have more of the population genetically tested for genes that have a higher risk of Vit D deficiency?
A: Since genetic testing is much more expensive and less available than vitamin D testing, it would not make sense to test the general population for genes affecting vitamin D, even for those at higher risk of deficiency. Genetic testing might come in useful for specific individuals who have a very difficult time increasing vitamin D levels with increased supplementation or who have certain genetic conditions in their family.
Is there any link between the amount of inflammation in the body and low 25OH?
A: Yes, there is a link between low vitamin D levels and higher rates of inflammation. Vitamin D is known to be associated with the risk of many inflammation-based diseases, with higher levels of vitamin D associated with lower levels of inflammatory markers and lower disease risk. It acts to suppress the production of inflammatory cytokines (such as IL-1, IL-6 and IFN which are predominant in the cytokine storm characteristic of severe COVID-19), and plays a very important role in preventing the activation of an inappropriate hyper-inflammatory immune response, therefore preventing the now infamous cytokine storm.
A meta-analysis by Jamilian et al. reviewed the research available on inflammation, mental health, and vitamin D in patients diagnosed with psychiatric disorders. The review found a significant reduction in depression, improved quality of sleep, and a significant reduction in CRP following vitamin D supplementation. Evidence-based research points to a minimum 25(OH)D level of 40 ng/ml (100 nmol/L) to fully optimize these demonstrated anti-inflammatory and immune regulating properties of vitamin D. Remember that vitamin D does not work alone – magnesium and omega-3 fatty acids are also important for keeping inflammation in check. Here is a blog about how vitamin D and omega-3s, for example, work together to regulate inflammation. https://www.grassrootshealth.net/blog/co-supplementing-vitamin-d-omega-3s-reason-take/
Since 1,25OH is usually not tested by doctors, is this a better measure? Is 25OH converted to 1,25OH when the body requires it and that means 25OH needs to be constantly “restocked”?
A: Dr. Sunil Wimalawansa discusses this topic in his presentation on Key Fundamentals of Vitamin D. Peripheral target cells for vitamin D contain both 1α-hydroxylase and 25-hydroxylase enzymes capable of converting vitamin D into 25(OH)D and then to 1,25(OH)2D to initiate a host of physiological functions. This “intracellular” generation of calcitriol in target cells like immune cells is critical for autocrine and paracrine functions of vitamin D and its DNA interactions (i.e., Genomic actions) that regulate over 1,200 essential genes. These cells access vitamin D and 25(OH)D from the bloodstream; in such instances, the converted 1,25(OH)2D is not ever released into the blood, and therefore, cannot be measured.
The measurement of calcitriol is very rarely indicated, and is used primarily to diagnose “functional disorders” of the parathyroid glands, such as hyperparathyroidism, hypoparathyroidism, and pseudohypoparathyroidism. It is also measured in hypercalcemic conditions, renal osteodystrophy, and vitamin D-resistant rickets. Calcitriol levels are useful for differential diagnosis of hypercalcemia, to exclude squamous cell carcinoma from the head and neck region, and to exclude parathyroid disease, especially when the PTH-related peptide (PTHrp) measurements are unavailable.
It is NOT a better measure of vitamin D status; serum 25(OH)D concentration is the only test a healthcare provider should request to establish the vitamin D status and correlate with diseases. The body should have a consistent supply of vitamin D3 with daily dosing preferable; this will help maintain a steady level of 25(OH)D in the blood, which is important for the autocrine and paracrine functions mentioned above.
Submit Your Questions to the Vitamin D Experts Panel
We have already received a lot of questions from our followers! Not all questions submitted could be addressed at the live forum, however, we will provide answers to all questions in some format following the event. If you have a question that you would like to have answered by one of our vitamin D experts:
Participant Stories and Testimonials
Great Symposium!
Thanks for an outstanding Zoom symposium. The speakers absolutely told it like it is. You assembled a fine cadre of dedicated and wise vitamin D experts. You created a genius vitamin D panel!
All your hard work will yield a quantum advance in acceptance of serum 25-vitamin D target of 40-60 ng/ml and ceiling of 120 ng/ml. With acceptance of a higher target range for some people, such as 70-90 ng/ml at all ages including infancy, we will start to knock down Type 1 diabetes to possibly zero to a few genetic cases per 100,000 population, tens of thousands to millions annually of cases of Type 2 diabetes worldwide, the same for multiple sclerosis, and very likely a very large segment of of Crohn’s disease and ulcerative colitis, among other mainly autoimmune disorders.
This genius panel produced a watershed symposium that will ultimately greatly benefit human health worldwide.
Bravo on this grand symposium and Bravos to all organizers and speakers!
-Cedric Garland, Dr.P.H., F.A.C.E
“Great webinar toady and thanks to all for their under-appreciated efforts.”
“I was glad to know I am not giving people bad information. I am familiar with much of what was presented. There was some important information that I did learn, and I look forward to the posting of the presentations and sharing them.”
“I attended most of the event and felt it was very informative. I was particularly interested in hearing the viewpoints of the different speakers concerning vitamin D deficiency and their collective thoughts on improving the pandemic. I congratulate you on a job well done. I look forward to learning more.”
“Congratulations on a great online forum today. The experts were amazing!”
What an informative joy to again see such great presenters globally.. I’m looking forward to future Orthomolecular Medicine events. Andrew Saul would be proud of your continued efforts. Never Give Up On Humanity
Brought to You By:
Orthomolecular Medicine News Service (OMNS), The International Society for Orthomolecular Medicine (ISOM) & GrassrootsHealth