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Posted: Mon Dec 19, 2005 2:28 pm Post subject: Vit D
I live in London UK and finally found somewhere to buy curcumin (I'm having it sent over from the US).
Next on my list is Vitamin D, but I'm confused (not the MS). There seems to be different types and I'm not sure which is the right one. Vit D3 often is mentioned and also IU 1000???
If we are more susceptible to MS because of a lack of Vitamin D - any suggestions on what I should be taking, how many / much a day, and where I can get it from.
[I'm not after medical advice etc and promise not to sue etc]
Any advice gratefully received.
Thanks
Ian
PS I've upped my oily fish intake but assume supplements are required.
Based on the reading I did on Ashton Embry's website http://www.direct-ms.org/, I have been taking 2000 - 4000 IU Vitamin D3 (not associated with cod liver oil or vitamin A). I get mine from a local vitamin shop here in the states but it's widely avail via internet or mail order. I also have an appt. next week to check my circulating Vit D levels to make sure I'm in a safe range.
I have been taking Vit D by Source Naturels, purchased from iherb.com.
I was (and still am) confused about the D3 element but the supplement facts on the tub detail it as "Vitamin D-3 (as cholcalciferol)".
Each tab is 1,000 IU, and I take 4 each day. Without checking (Sarah will correct me if I am wrong, I hope) I think that dosage is part of the Wheldon protocol, and fits in with the dosage that Brownsfan has quoted from Direct-MS.
Joined: Jul 28, 2005 Posts: 1279 Location: Sydney, Australia
Posted: Mon Dec 19, 2005 3:55 pm Post subject: Re: Vit D
bromley wrote:
Next on my list is Vitamin D, ... There seems to be different types and I'm not sure which is the right one. Vit D3 often is mentioned and also IU 1000???
As far as I understand, the "IU" is not a type of Vitamin, but a measurement of the amount. I think it stands for "International Units" or something along those lines.
One thing to watch out for is that some Vitamin D suppliments are in the form of D2 which is a man made / synthetic; from which i have read is not absorbed or utilised as easily by the body.
I'm no expert, but I had a nutritionist recommend to me to "walk up" the vitamin D dose to the target dose over a period of several weeks. I am guessing this allows the parathyroid hormone levels to readjust to avoid a potential for hypercalcemia. There is this interplay between parathyroid hormones and vitamin D levels. I saw in the MS abstract where vitamin D caused a transient hypercalcemia in some of the subjects and they had to adjust the dose. It seems to make sense, since sunlight is the major source of Vitamin D, and if we were all still hunter-gatherers in northern latitudes, we would come out of winter and get a gradual increasing sunlight exposure over spring into summer - we wouldn't go from deep dark of winter to blazing midsummer levels of UVB radiation in less than a week. People in the tropics with year-round sun exposure and higher Vitamin D levels are already acclimated to a high D level. This is just an idea though, and I haven't found any studies on gradually increasing the dose.
If you haven't been taking vitamin D in a supplement, and if you are targeting as high as 4000 IU as a daily dose you may want to walk up the dose a few hundred IU each week to reach the target. Just an idea.
Posted: Tue Dec 20, 2005 4:31 am Post subject: Re: Vit D
Bromley wrote:
If we are more susceptible to MS because of a lack of Vitamin D - any suggestions on what I should be taking, how many / much a day, and where I can get it from.
Here's one perspective on vitamin D. The Mayo Clinic suggest that doses higher than 2000 IU/day be avoided due to toxicity problems. They also state that blood levels of 25(OH)D3 levels may be significantly elevated, although 1,25(OH)2D3 levels may be normal. Thus, hypercalcemia really needs to be addressed as well.
This paper recommends 1000 IU/day for sunlight deprived individuals.
Overall, it's kind of confusing right now since there are so many different "recommended" dosages. I tend to think that it's best to err on the side of caution when beginning a new regimen or modifying a current one. Here in the US, the RDA for vitamin D is 400 IU and many multivitamins contain this amount. Starting out with 400 IU should be safe. As Melody suggested, increasing the dosage should probably be done after a period of time to allow the body to become adjusted. However, to what level it should be increased to is likely still up for debate (I certainly don't have the answer).
Jaded wrote:
The scales are different for other vitamins by the way. Very strange, I think. Holford says IU's are an old measurement unit.
To the best of my recollection, IUs are a measure of the specific activity of the stuff that's being analyzed. Each vitamin (or enzyme or whatever) will likely have a different assay that's performed in order to determine its specific activity. When a substance is listed as x amount of IUs, then you have to know which assay was performed in order to determine the value. Sometimes, the type of assay performed is a standard to the substance being tested and the numbers should be comparable between different sources. However, having worked in a lab and having dealt with chemical supply companies, I know that there are many cases were only "units" are assigned to a substance (particularly with enzymes) and these are often not comparable as the assays differ between various suppliers. Yes, it's about this time that one becomes prone to developing headaches.
I'm no expert on this, but I have one comment. In terms of dosage, the tolerable upper intake level is 2000iu in North America and the EU (don't know about the rest of the world). That level is based on the authorities agreeing that it is safe. In the EU's study to determine that level, I think they looked at every study done on vit D consumption and found that there were a very small number of subjects in one study who experienced toxicity at 4000iu, so they made their upper level half of that, just to be safe. I think the Direct-MS folks take issue with some of the studies used to arrive at 2000iu, but I'm not educated enough to comment.
Anyway, I feel completely safe taking 2000iu myself.
I'll start with the facts - I am no expert either!
So I rely on the facts from experts. Patrick Holfold - who I respect as a nutritionist, quotes in his Bible that, as Lisa said, vitamin D is the most likely to give toxic reactions. He says it encourages calcium absorption and can lead to calcification of soft tissue. He does add that levels likely to create this are in excess of 3,000mcg, and more like 15,000mcg. He says a daily intake of should not exceed 6,600mcg for adults and 330mcg for children.
This does not compare with the 100mcg = 4000 IU I am taking!!
However, I will double check this - and probably see a nutritionist, since I am aware it may not be a simple as a book reads. The last time I was tested - about 6 months ago - my B12 and Vitamin D levels were extremely low.
Joined: Jun 18, 2004 Posts: 1472 Location: Bedfordshire UK
Posted: Tue Dec 20, 2005 5:22 pm Post subject:
Jaded, 4000iu is perfectly fine. I have been taking it daily for getting on for two and a half years now with absolutely no ill effects. Having said that, many people would say it is way too much. Not so, since if you live in Sub Saharan Africa you can easily take in 7000iu just by walking down the High Street.....Sarah _________________ An Itinerary in Light and Shadow
Completed Stratton/Wheldon antibiotic regime for aggressive secondary progressive MS in June 2007, after four years. Still slowly improving with no exacerbation since starting. EDSS was 7, now 2 or often less.
^^^^^^^^
Nutr J. 2004 Jul 19;3:8.
Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients.
Vieth R, Kimball S, Hu A, Walfish PG.
Department of Laboratory Medicine and Pathology, University of Toronto, Canada. rvieth@mtsinai.on.ca
BACKGROUND: For adults, vitamin D intake of 100 mcg (4000 IU)/day is physiologic and safe. The adequate intake (AI) for older adults is 15 mcg (600 IU)/day, but there has been no report focusing on use of this dose. METHODS: We compared effects of these doses on biochemical responses and sense of wellbeing in a blinded, randomized trial. In Study 1, 64 outpatients (recruited if summer 2001 25(OH)D <61 nmol/L) were given 15 or 100 mcg/day vitamin D in December 2001. Biochemical responses were followed at subsequent visits that were part of clinical care; 37 patients completed a wellbeing questionnaire in December 2001 and February 2002. Subjects for Study 2 were recruited if their 25(OH)D was <51 nmol/L in summer 2001. 66 outpatients were given vitamin D; 51 completed a wellbeing questionnaire in both December 2002 and February 2003. RESULTS: In Study 1, basal summer 25-hydroxyvitamin D [25(OH)D] averaged 48 +/- 9 (SD) nmol/L. Supplementation for more than 6 months produced mean 25(OH)D levels of 79 +/- 30 nmol/L for the 15 mcg/day group, and 112 +/- 41 nmol/L for the 100 mcg/day group. Both doses lowered plasma parathyroid hormone with no effect on plasma calcium. Between December and February, wellbeing score improved more for the 100-mcg/day group than for the lower-dosed group (1-tail Mann-Whitney p = 0.036). In Study 2, 25(OH)D averaged 39 +/- 9 nmol/L, and winter wellbeing scores improved with both doses of vitamin D (two-tail p < 0.001). CONCLUSION: The highest AI for vitamin D brought summertime 25(OH)D to >40 nmol/L, lowered PTH, and its use was associated with improved wellbeing. The 100 mcg/day dose produced greater responses. Since it was ethically necessary to provide a meaningful dose of vitamin D to these insufficient patients, we cannot rule out a placebo wellbeing response, particularly for those on the lower dose. This work confirms the safety and efficacy of both 15 and 100 mcg/day vitamin D3 in patients who needed additional vitamin D.
PMID: 15260882 [PubMed]
^^^^^^^^^^^
Dr. Vieth is a major researcher into Vitamin D and has published a lot on VItamin D, and has painstakingly gone back to the roots of the doses associated with toxicity and found that much of the concern about potential toxicity of vitamin D at lower doses are unfounded. It IS toxic at high doses as mentioned already by Jaded, but as can be seen in this study, 4000 IU for six months did not cause any problems in the adult subjects.
Now that it is winter, I would personally go up to 4000 IU, but not higher, and I plan on increasing gradually to let my PTH adjust down if it needs to.
I'm not an endocrine expert, but I suspect that in people whose Vitamin D levels are so low they actually have secondary hyperparathyroidism, a sudden big jolt in Vitamin D intake might cause a transient jump in plasma calcium until PTH adjusts down in response to improved Vitamin D levels. An endocrinologist would know the answer to that! If someone knows one, please ask for me!
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You could always sunbathe 
- Jelinek suggests about 15mins a day 3 times a week in UV strength 7, and supplement only when its dull or your busy.
