ms_t, i have personal experience with problems taking d3 without getting the right balance of zinc, calcium, and magnesium. it even comes down to timing.
i thought i was going to die when my magnesium levels got driven down due to only taking magnesium with calcium and d3, never a mag supplement on its own, and not enough in my diet.
as for zinc a very standard diet can interfere with zinc absorption resulting in issues that are seen across the board in a variety of modern illnesses.
patients need to be very clear about what deficiency actually means - in many cases where deficiency is not clearly defined, you'd have to have a result outside the 'normal range'. from everything i've seen you would need to come back with either the highest or lowest value ever recorded by your lab to be flagged as deficient or toxic. however, within the normal range itself you can find extensive research showing smaller clusters associated with healthy people and sick people.
there are many nutrients of concern that i monitor for my ms. almost every result i have ever received came back inside the 'normal range'. however, they also match an 'ms patient profile' within the normal range. there is a distinctly and significantly different 'healthy control' profile, also within the normal range. neither profile is considered deficient, both are normal. that's not good enough for me, so i test and supplement to ensure a healthy blood profile, resulting from healthy dietary choices, bloodwork, and supplementation where needed.
there are well known reasons to balance d3, calcium, magnesium and zinc, based solely on the number of blended supplement products available. nonetheless, here are a couple of abstracts:
Vitamin D and calcium deficits predispose for multiple chronic diseases
There is evidence from both observational studies and clinical trials that calcium malnutrition and hypovitaminosis D are predisposing conditions for various common chronic diseases. In addition to skeletal disorders, calcium and vitamin D deficits increase the risk of ... multiple sclerosis), as well as of metabolic disorders... The aim of the present review was to provide improved understanding of the molecular and cellular processes by which deficits in calcium and vitamin D cause specific changes in cell and organ functions and thereby increase the risk for chronic diseases of different aetiology...
... attenuation of signal transduction from the ligand-activated vitamin D receptor and calcium-sensing receptor seems to be the prime mechanism by which calcium and vitamin D insufficiencies cause perturbation of cellular functions in bone, kidney, intestine, mammary and prostate glands, endocrine pancreas, vascular endothelium, and, importantly, in the immune system...
Magnesium Absorption: Mechanisms and the Influence of Vitamin D, Calcium and Phosphate1
...Pharmacological doses of vitamin D increase Mg absorption in both vitamin D-deficient and vitamin D-replete animals. A substantial amount of Mg absorption, however, occurs independent of vitamin D. In addition, vitamin D may reduce Mg retention through increases in urinary Mg excretion. Intestinal interactions between Mg and calcium or phosphate have been demonstrated in both humans and animals. The nature of these interactions cannot be readily explained by data currently available.
Vitamin D insufficiency and the blunted PTH response in established osteoporosis: the role of magnesium deficiency
Vitamin D insufficiency is common, however within individuals, not all manifest the biochemical effects of PTH excess. ... The mechanism underlying the blunted PTH response is unclear but may be related to magnesium (Mg) deficiency. ... All subjects, within the low vitamin D and low PTH group following the magnesium loading test had evidence of Mg depletion [mean(SD) retention 70.3%(12.5)] and showed an increase in calcium 0.06(0.01) mmol/l [95% CI 0.03, 0.09, p=0.007], together with a rise in PTH 13.3 ng/l (4.5) [95% CI 3.2, 23.4, p=0.016] compared to baseline. ... This study confirms that in patients with established osteoporosis, there is also a distinct group with a low vitamin D and a blunted PTH level and that Mg deficiency (as measured by the Mg loading test) is an important contributing factor.
Enhancement of vitamin D3 effect on bone metabolism in weanling rats orally administered zinc sulphate
Masayoshi Yamaguchi and Teruyuki Sakashita
Abstract. The interaction of vitamin D3 and zinc on bone metabolism was investigated in the femur of weanling rats. ... At a dose of 0.5 µg of vitamin D3 per 100 g, DNA content was at the control level. This level was increased about 2 times by simultaneous administration of zinc (1.0 mg/100 g). ... The present data suggest that the combination of vitamin D3 and zinc has a multiple effect on the stimulation of bone growth and mineralization in weanling rats, and that this effect is based on a stimulation of the DNA synthesis in bone cells.
i just posted a few studies about various nutrients in ms for mirry. you may find them interesting reading: