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The best way to supplement with vitamin D
Vitamin D……….. is the flavour of the month.
It has always been important, but in COVID times, it has taken on a new level of significance. People who run in to trouble with COVID, frequently have low levels.
A few studies have suggested boosting levels improves outcomes.
A few……….as the research trickles in, the results are not always what’s expected. Sometimes it helps, sometimes it doesn’t.
Jeckell & Hyde
This phenomenon of SOMETIMES, doesn’t only apply to COVID, it applies to pretty much everything, vitamin D is thrown at.
And it is thrown at a lot of things……….
Vitamin D in perspective
Vitamin D is a very important contributor to our health, it regulates the expression of more than 200 genes.
Being vitamin D insufficient is extremely COMMON.
The reason, the ultimate source of vitamin D is SUN EXPOSURE and being exposed to the sun, is not as common, as it used to be.
Plus, low levels of vitamin D, go hand in hand with metabolic imbalances. Click here to learn more.
And being insulin resistant is frighteningly common.
So where does that leave you ?
Addressing vitamin D shortages
As card carrying member of modern society, with a verified vitamin D deficiency. The short answer….
You probably need to supplement with vitamin D.
NOTE : This will only have benefit, if you are genuinely deficient and you need to keep tabs on your vitamin D levels.
The long answer….you need to create the kind of lifestyle, that fixes the bad body chemistry, behind your insufficiency….
i.e. GET SOME SUN and LOSE SOME WEIGHT.
NOTE : If you need a little help with the weight loss component, download The Willpower Report, it’s free, for suggestions on where to start. Here is the link.
Yes but, I am deficient now…..I can’t wait ! So we’re back to supplementing…
Ways to supplement with vitamin D
On the supplementing front……………. you have options. You can swallow a little every day, as a pill or get a mega-dose, in a jab from your health care provider, every now and again.
Many people opt for option number 2….
Hell, it’s SO MUCH EASIER !
Granted it’s not pain less, but it’s a case of set it and forget it.
It’s how we do things
Of course, even for the uninitiated, at first glance, it’s very UN-NATURAL. But it is not, unprecedented. Loading up on vitamins is a strategy…..
It’s done for vitamin B12 and iron.
In fact, in both these cases, it’s often seen as superior, because, both these nutrients have absorption issues. The reason it works, is the body stores these vitamins………so the mega dose, allows the stores to be quickly repleted. Once the store is topped up, the body can then dive into these abundant stores, to meet it’s need.
It’s assumed that vitamin D works the same way….
The vitamin D cupboard
The storage cupboard for vitamin D is traditionally seen as fat cells, but, there is a growing body of evidence that suggests, this is not the REAL storage cupboard.
The real storage cupboard is muscle.
NOTE : This does have some interesting implications, which I talked about it, here.
But at the end of the day, details, shmeetails…………. IT’S STORED ! So, loading up the stores, is THE SOLUTION !
Not so fast………..
A deep dive into the vitamin D literature
This is what a group of British researchers concluded, when they did a deep dive, into the vitamin D literature – which is in and of itself, is a BIG UNDERTAKING ! I said, vitamin D is a HOT TOPIC, I wasn’t joking.
Our team, focused on problems, that have ALWAYS been associated with vitamin D deficiency.
Rickets and TB.
Vitamin D historically
In the case of rickets, the vitamin D connection was noted in the 1920s and a daily dose of cod liver oil, was prescribed. It worked like a charm. But it tasted AWFUL.
So, there have been trials to switch out the oil and replace it with shots.
They found a couple of trials, all using slightly different regimens, below are the results of a well conducted study in 3046 children, using shots of 100 000 IU every 3 months for 18 months.
You can see – it didn’t work.
Next, they scanned the TB literature, to find, a similar story. It works when given in low doses on a regular basis, but the benefit, is lost, when high doses are given, intermittently.
Vitamin D in acute respiratory infections
The phenomenon showed up, when vitamin D was used to prevent acute respiratory tract infections, low dose daily maintenance supplementation is effective, but intermittent high-dose bolus, is NOT.
If it walks like a duck and talks like a duck
IT IS A DUCK.
Or should I say DUD. Injecting mega doses of vitamin D into someone, every so often, does not DO THE TRICK ! In fact, as our team, unpacked the data further, they actually found data to suggest, the practice, could be COUNTER PRODUCTIVE i.e. harmful.
Blame it on BIOLOGY……..
The vitamin D triad
We talk about vitamin D, as if it is one single chemical – it’s NOT.
There is the vitamin D we make (calciferol), the vitamin D that circulates (calcidiol) and the vitamin D that does the magic (calcitriol). The vitamin D that really matters, is the last guy. To DO THE MAGIC, he must enter cells and hook up, with the vitamin D receptor.
HE MUST GET INSIDE THE CELL.
What makes this situation, even more tricky, is vitamin D does not swim about, in the blood – he usually rides, in his custom made chariot, the vitamin D binding protein. Unless, something happens to his wheels. To enter the cell, vitamin D MUST BE WHEEL LESS.
Eish ! It’s complicated….
Getting it straight
- We make vitamin D / calciferol from cholesterol.
- We store 25(OH)D / calcidiol.
- We usually supplement with 25(OH)D. Although sometimes is use vitamin D2 (ergocalcidiol), not vitamin D3 (cholicalcidiol).
- We measure our vitamin D levels, by testing for 25(OH)D / calcidiol in the circulation
- We use 1,25 (OH)2D / calcitriol. But, to work it must be INSIDE cells, because the receptor for vitamin D, is located INSIDE the nucleus
And to round things out, we make and “throw away”, other metabolites such as 24,25 (OH)2D and 1,24,25 (OH)3D.
With so many moving parts……….
The work horses in this process are enzymes, who are tasked with adding hydroxyl groups.
- The first hydroxyl, is added in position 25, it takes vitamin D, from a provitamin (calciferol), to the real deal (calcidiol).
- The second hydroxyl, is added at position 1, by an enzyme known as CYP27B1 – makes the vitamin D useful (calcitriol).
- The third hydroxyl, is added at position 24, by an enzyme known as CYP24A – this takes the vitamin D, out of commission.
Vitamin D levels are tightly regulated
The last two enzymes, which effectively control vitamin D levels, by activating / inactivating the stores, take their cue, from a bone hormone, known as FGF23 (fibroblast growth factor). FGF23’s job, is to control phosphorus levels.
This guy is not the BIG BOSS, but he is THEIR BOSS !
His expectation, is that the extreme bump in vitamin D levels, is going to cause potentially catastrophically high phosphate levels, because vitamin D facilitates, intestinal phosphorus absorption. To avoid compromising bone health – he orders the two cytochromes, to take care of the vitamin D problem.
The activating enzyme stands down and the deactivating enzyme, gets busy.
The end result………….
The levels of active vitamin D, deep inside the cells, plummets.
i.e. vitamin D STOPS working.
Genes are not turned on, benefits don’t accrue.
Flying under the radar
When you supplement with a vitamin D, in a way that give you a little, every day……..which is a far more “natural” scenario, FGF23, doesn’t react.
When you give a mega dose.
HE PANICS !
The trouble is, this response is not FLEETING, his panic attack, lasts for several weeks. Below is the data from a study, in 45 people, who were given a single injection of 300 000 IU ergocalciferol into their muscle.
At the three month mark, FGF23 was still “ordering”, vitamin D levels down.
Vitamin D everywhere, but not a drop to drink !
The current explanation for the failure of vitamin D, to show benefit in clinical trials, is it only helps people who are REALLY deficient, but it also might be creating a pseudo vitamin D deficiency. Eish ! Biology is complicated…..
The point is, if you’re supplementing, supplement in a way, that mimics, nature.
Take your vitamin D as a “vitamin”, not as a drug !
Vitamin D for growth and rickets in stunted children: A randomized trial. Pediatrics (2021)147:e20200815. Crowe FL, Mughal MZ, Maroof Z et al.
Effect of a 300 000-IU loading dose of ergocalciferol (Vitamin D2) on circulating 1,25(OH)2-vitamin D and fibroblast growth factor-23 (FGF-23) in vitamin D insufficiency. J Clin Endocrinol Metab (2013) 98:550–6. Turner C, Dalton N, Inaoui R et al.
Effect of monthly high-dose vitamin D supplementation on acute respiratory infections in older adults: A randomized controlled trial. Clin Infect Dis (2020) 71: 311-7. Carlos A Camargo, John Sluyter, Alistair W Stewart, Kay-Tee Khaw, Carlene M M Lawes, Les Toop, Debbie Waayer, Robert Scragg.
The lungs are equipped to handle potential intruders, the fumigation process depends on getting enough of the sunshine vitamin….
Apes, monkeys and humans all use a vitamin D bug spray to keep their airways free of germs so don’t monkey around load up with vitamin D to beat colds and flu
You’ve got a built in vitamin D conservation plan, that keeps your vitamin D status, SUFFICIENT – even in the middle of a freezing cold winter, in the Northern latitudes. .