![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 112. Go back in thread:
Posted by JLx on November 2, 2004, at 12:07:55
In reply to Vitamin D and depression, posted by JLx on November 1, 2004, at 17:27:18
Hi Larry,
From the "Supplements for brain fog" board,
>I'll just make a summary statement here, but the 4000 IU recommendation is based on solid research, and it's quite a new finding. It takes a while for the facts to filter through into what we know.
Yes, and often alternative med is on the cutting edge. I remember well how many years earlier I was reading about free radicals and antioxidants there before it hit the mainstream. And look at the medical establishment's refusal to pay attention to the guys who made the ulcers/H. pylori connection. My impression is that this might be one of those things, and if so, it could take years before we all "know different" and meantime we're setting our health back that much more too.
> I think the oral toxicity of vitamin D is related to the bolus effect. What that is is the huge serum concentration spike that comes from uptake across the gut wall. Vitamin D synthesized in skin trickles out into the blood, via diffusion. The total amount made from acute sun exposure is not just suddenly dumped into the blood. It's the essence of a timed-release vitamin D repository.Ok, I'm not understanding this I don't think. I read that it only takes 15-30 minutes of sunlight to get 20,000 IU of Vit D (if Caucasian). You're saying that amount is in the skin and then trickles out slowly into the blood? Then once it's in the blood, the excess accumulates in the fatty tissue. When needed and not being supplied through the skin or diet, the body then draws it out of the fat. I still don't see the difference between the Vit D that's stored in the fat that originally derived from the sun or that which originates in the diet per food or supplement. What if you were in the habit, as some people surely are or were historically, of eating a lot of salmon daily while also getting a lot of sun? No danger, surely! So, is there some difference simply in the supplemental form and what it does and how it's utilized later? That seems to me to be the crux of the problem and I haven't read anything to suggest that taking cholecalciferol is somehow different in the body other than as you say, a short spike as it's dumped rather precipitiously into the blood stream. But again, surely that is not so different than eating that salmon while basking in the sun.
And once it's in the fat, and NOT needed/drawn by the body as it must be for those who get a lot of sun day after day, then what?
This is interesting about obesity and Vit. D:
http://www.cholecalciferol-council.com/obesity.htm
"10. Obese subjects obtain lower 25(OH)D levels when exposed to ultraviolet light or when they take supplemental vitamin D.
A. True.
B. False.True. Obese subjects appear to deposit some their vitamin D in their excessive fatty tissue, thus impairing their ability to raise their 25(OH)D levels."
So the more fat you have, the more of the Vit D that you do get, is deposited in the fat. I would think all that fat stored Vit D would be a kind of insurance against becoming deficient. But it sounds like it's the opposite from that and the other correlations he notes.
That compounds my confusion about this storage business and how it becomes toxic. A saturation point is reached? So then too much is in the blood all the time?
And perhaps this is the stupidest of questions, but what happens to the Vit D stored in fat when a person loses weight? Is it broken down instead of released when the fat stores themselves are used for energy?
It sounds as if small doses of Vit D throughout the day would be the answer to the bolus problem. When physicians do supplement to bring up Vit D levels, they do so in pretty large doses of 10,000 IU. What do you think of that sublingual emulsified version? An advantage or problem in bypassing the stomach?
> Did you catch note of the positive effects arising from a single oral dose of 100,000 IU? I recall seeing that last night, as I was skimming. It gives one pause, with respect to oral toxicity.
>
> LarYes, I notice also that the massive by-accident doses, sometimes huge and over a fairly long period of time, were apparently not irreversible.
It's all very confusing. It sounds as if we've been scared a lot and thoroughly for no good reason.
JL
Posted by Larry Hoover on November 2, 2004, at 12:08:39
In reply to Re: Vitamin D, and safety » tealady, posted by JLx on November 2, 2004, at 11:20:57
Posted by JLx on November 2, 2004, at 12:20:55
In reply to Re: Vitamin D and depression » karaS, posted by raybakes on November 2, 2004, at 2:26:07
> > I'm definitely going to raise my intake of vitamin D - not sure by how much though. 4,000 IU or even 2,000 IU sounds a little scary to me. I'll probably end up building up to that though.
>
>
> I've been taking vitamin D3 from biotics for about the last three weeks - I did get a splitting headache with even the smallest amount, suggesting that my calcium balance was disrupted. I'd heard that parathyroid is raised in vitamin D deficiency, causing excess calcium to be broken down from the bone - I'd also heard that vitamin A reduces the action of parathyroid hormone.
When I tried vitamin A 4000 IUs at a time, it took me 12-16,000 IUs before I could take 400-800 IUs of vitamin D without getting a headache - over 800 IUs and the headache would last all day!I don't understand why the headache. Vit D is low, parathyroid is then high to release calcium from bone, and Vit A inhibits the calcium release...so taking Vit D decreases parathyroid thus decreasing calcium AND taking A ALSO inhibits the parathyroid as well so less calcium is released? Your headache is from less calcium? Could this be alleviated then by taking calcium with the Vit D?
It was Larry's comment to me that Vit D might help my calcium-sensitivity problem that started me researching this so I'd like to try to understand the connection.
> What I have noticed in the three weeks is that a bone injury I've had after a bump in June, has healed and is no longer painful. I would like to take more vitamin D but I suspect I might be breaking down too much bone still
But wouldn't the Vit D prevent the bone breakdown as there would be no need for the parathyroid doing its calcium-from-bone thing?
>- just found one of the reasons perhaps....i've been working hard to reduce my homocysteine levels, and it seems excess homocysteine can lead to bone loss - so maybe if I reduce my homocysteine more, I'll be able to tolerate higher doses of vitamin D?
> Homocysteine as a predictive factor for hip fracture in older persons.
> "These findings suggest that the homocysteine concentration, which is easily modifiable by means of dietary intervention, is an important risk factor for hip fracture in older persons"
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15141042
>
> RayIs that homocysteine -- apart from Vit D insufficiency, or perhaps the Vit D is more of the "first cause"? Iow, how do they know in the study that it's the homocysteine in isolation that is the connection.
In that reading I did about Vit D yesterday, the impression I got, that sounded exciting, is that the researchers are wondering if Vit D is the underlying problem that ties such things as depression, heart disease, osteoporosis, diabetes, etc. together.
JL
Posted by JLx on November 2, 2004, at 12:27:48
In reply to Re: You get an A+ on your paper. Congrats. (nm) » JLx, posted by Larry Hoover on November 2, 2004, at 12:08:39
Posted by karaS on November 2, 2004, at 21:40:49
In reply to Re: Vitamin D and depression » karaS, posted by raybakes on November 2, 2004, at 2:26:07
> > I'm definitely going to raise my intake of vitamin D - not sure by how much though. 4,000 IU or even 2,000 IU sounds a little scary to me. I'll probably end up building up to that though.
>
>
> I've been taking vitamin D3 from biotics for about the last three weeks - I did get a splitting headache with even the smallest amount, suggesting that my calcium balance was disrupted. I'd heard that parathyroid is raised in vitamin D deficiency, causing excess calcium to be broken down from the bone - I'd also heard that vitamin A reduces the action of parathyroid hormone. When I tried vitamin A 4000 IUs at a time, it took me 12-16,000 IUs before I could take 400-800 IUs of vitamin D without getting a headache - over 800 IUs and the headache would last all day!
>
> What I have noticed in the three weeks is that a bone injury I've had after a bump in June, has healed and is no longer painful. I would like to take more vitamin D but I suspect I might be breaking down too much bone still - just found one of the reasons perhaps....i've been working hard to reduce my homocysteine levels, and it seems excess homocysteine can lead to bone loss - so maybe if I reduce my homocysteine more, I'll be able to tolerate higher doses of vitamin D?
>
> Homocysteine as a predictive factor for hip fracture in older persons.
>
> "These findings suggest that the homocysteine concentration, which is easily modifiable by means of dietary intervention, is an important risk factor for hip fracture in older persons"
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15141042
>
> Ray
>
>Ray,
Are you trying to imply that I'm old???? Just kidding. That's good to know if I am not able to tolerate a higher dosage of vitamin D. Hopefully I'm taking enough extra B vitamins (and A in my multi) so that I won't have any problems going up to 800. 4,000 IU may not be so easy... let us know how you manage with this in the future.Kara
Posted by raybakes on November 3, 2004, at 13:53:41
In reply to Re: Vitamin D and depression » raybakes, posted by JLx on November 2, 2004, at 12:20:55
> I don't understand why the headache. Vit D is low, parathyroid is then high to release calcium from bone, and Vit A inhibits the calcium release...so taking Vit D decreases parathyroid thus decreasing calcium AND taking A ALSO inhibits the parathyroid as well so less calcium is released? Your headache is from less calcium? Could this be alleviated then by taking calcium with the Vit D?
Hi JL, I think my problem is immune related - parathyroid hormone appears to trigger the production of the immune messenger 'interleukin 6' that initiates the breakdown of calcium from bone...and so does homocysteine..
'Interleukin-6 production by human saphenous vein endothelial cells was significantly stimulated following a 24-h treatment with homocysteine'
I have genetic predisposition to manufacture excess proinflammatory interleukins (cytokines), so even if I normalize parathyroid hormone, I think my chronic inflammation might still initiate the release of calcium from bone.
some interesting abstracts..
I think the vitamin D is working really well for me, but I've just got to be very careful not to take to much for my own unique immune imbalances.Ray
Posted by raybakes on November 4, 2004, at 4:03:01
In reply to Re: Vitamin D and depression » raybakes, posted by karaS on November 2, 2004, at 21:40:49
>
> Ray,
> Are you trying to imply that I'm old????No, but I bet my Zimmer fame is faster than yours!!
Posted by Larry Hoover on November 4, 2004, at 12:18:00
In reply to Re: Vitamin D and depression - Larry Hoover » JLx, posted by JLx on November 2, 2004, at 12:07:55
> Hi Larry,
>
> From the "Supplements for brain fog" board,
>
> >I'll just make a summary statement here, but the 4000 IU recommendation is based on solid research, and it's quite a new finding. It takes a while for the facts to filter through into what we know.
>
> Yes, and often alternative med is on the cutting edge. I remember well how many years earlier I was reading about free radicals and antioxidants there before it hit the mainstream. And look at the medical establishment's refusal to pay attention to the guys who made the ulcers/H. pylori connection. My impression is that this might be one of those things, and if so, it could take years before we all "know different" and meantime we're setting our health back that much more too.I couldn't agree more. Linus Pauling, a two-time Nobel laureate, was vilified in some of the most unscientific and political acts I've ever seen in the scientific arena.
Here's a lovely essay on the subject.
http://www.internetwks.com/pauling/hoffer.html> > I think the oral toxicity of vitamin D is related to the bolus effect. What that is is the huge serum concentration spike that comes from uptake across the gut wall. Vitamin D synthesized in skin trickles out into the blood, via diffusion. The total amount made from acute sun exposure is not just suddenly dumped into the blood. It's the essence of a timed-release vitamin D repository.
>
> Ok, I'm not understanding this I don't think. I read that it only takes 15-30 minutes of sunlight to get 20,000 IU of Vit D (if Caucasian). You're saying that amount is in the skin and then trickles out slowly into the blood?Yes. Just as you'd get if you someone got vitamin D from a transdermal patch.
> Then once it's in the blood, the excess accumulates in the fatty tissue. When needed and not being supplied through the skin or diet, the body then draws it out of the fat.
There may not be any excess to store. It's hard to say, as there is a constant give-and-take between tissues and blood. It's called a complex equilibrium. There's a bidirectional transfer going on all the time.
> I still don't see the difference between the Vit D that's stored in the fat that originally derived from the sun or that which originates in the diet per food or supplement. What if you were in the habit, as some people surely are or were historically, of eating a lot of salmon daily while also getting a lot of sun? No danger, surely!
One of the differences might be free vitamin D versus bound vitamin D. Vit D is fat soluble, so it surely attaches to circulating lipoproteins, e.g. HDL and LDL. I'm suggesting that a high oral dose might produce an overload of free vitamin D, whereas vitamin D from dietary intake or from skin production might circulate only in the bound form.
> So, is there some difference simply in the supplemental form and what it does and how it's utilized later? That seems to me to be the crux of the problem and I haven't read anything to suggest that taking cholecalciferol is somehow different in the body other than as you say, a short spike as it's dumped rather precipitiously into the blood stream.
The toxic effects, if there are any, might be solely from the spike itself. That is my hypothesis.
> But again, surely that is not so different than eating that salmon while basking in the sun.
Maybe it is, as neither might produce surges in free vitamin D.
> And once it's in the fat, and NOT needed/drawn by the body as it must be for those who get a lot of sun day after day, then what?
Given that people in the sun do not get vitamin D overdoses, it is possible that production is down-regulated at some threshold concentration. Or, the body might be able to store much more of it than was previously realized. I lean towards the first explanation.
> This is interesting about obesity and Vit. D:
>
> http://www.cholecalciferol-council.com/obesity.htm
>
> "10. Obese subjects obtain lower 25(OH)D levels when exposed to ultraviolet light or when they take supplemental vitamin D.
>
> A. True.
> B. False.
>
> True. Obese subjects appear to deposit some their vitamin D in their excessive fatty tissue, thus impairing their ability to raise their 25(OH)D levels."
>
> So the more fat you have, the more of the Vit D that you do get, is deposited in the fat. I would think all that fat stored Vit D would be a kind of insurance against becoming deficient. But it sounds like it's the opposite from that and the other correlations he notes.It's more of a dilution effect. A non-obese subject might have ten pounds of adipose tissue. An obese subject might have 150 lbs. The net effect is to draw vitamin D out of the blood, as entropy demands that concentrations equalize across all possible boundaries.
> That compounds my confusion about this storage business and how it becomes toxic. A saturation point is reached? So then too much is in the blood all the time?Too much free vitamin D, is my concern.
> And perhaps this is the stupidest of questions, but what happens to the Vit D stored in fat when a person loses weight? Is it broken down instead of released when the fat stores themselves are used for energy?It redistributes among the remaining tissues. The process is slow, and is probably regulated so that free vitamin D levels do not surge.
> It sounds as if small doses of Vit D throughout the day would be the answer to the bolus problem. When physicians do supplement to bring up Vit D levels, they do so in pretty large doses of 10,000 IU. What do you think of that sublingual emulsified version? An advantage or problem in bypassing the stomach?Sublingual emulsified....hmmm. Emulsified in what, in particular?
Frankly, the best source would be e.g. fish liver oils, as the vitamin D would surely be associated with the appropriate carrier fats.
> > Did you catch note of the positive effects arising from a single oral dose of 100,000 IU? I recall seeing that last night, as I was skimming. It gives one pause, with respect to oral toxicity.
> >
> > Lar
>
> Yes, I notice also that the massive by-accident doses, sometimes huge and over a fairly long period of time, were apparently not irreversible.It just takes the body a little while to redistribute the vitamin properly. Water-solubles redistribute quickly. Fat-solubles take a long time.
> It's all very confusing. It sounds as if we've been scared a lot and thoroughly for no good reason.
>
> JLI agree with that conclusion, 100%. I don't know what to make of the deception, but it is intentional.
Lar
Posted by KaraS on November 4, 2004, at 14:10:53
In reply to Re: Vitamin D and depression, posted by raybakes on November 4, 2004, at 4:03:01
How does using a sun lamp inpact the amount of Vitamin D one should take, or doesn't it?
Posted by Larry Hoover on November 4, 2004, at 14:38:05
In reply to Re: Vitamin D and depression - question, posted by KaraS on November 4, 2004, at 14:10:53
> How does using a sun lamp inpact the amount of Vitamin D one should take, or doesn't it?
If the sun lamp is the sort that can cause a sunburn, it has the wavelengths of light required to make vitamin D. UV-A is the tanning range of wavelengths. UV-B is the burning range of wavelenghths, but also the one that creates vitamin D. The distinction between UV-A and UV-B is arbitrary, but that's the rough picture.
£@®
Posted by tealady on November 4, 2004, at 21:00:32
In reply to Re: Vitamin D, and safety » tealady, posted by JLx on November 2, 2004, at 11:20:57
> > haven't read your posts but my view differs from Lar..
>
> Well, I hope you get a chance to read the links I posted as well as the links on those links, when your exams are over.I promise :)
>
> In this one, subjects were given either 1000 or 4000 IU for 2-5 months and as a result the "serum calcium and urinary calcium excretion did not change significantly at either dosage during the study."
>
> Of the 4000 IU dose, they said,
>>
> "Because all available evidence indicates that a long-term vitamin D consumption of 1000 µg/d is needed to cause hypercalcemia, there is a large margin of safety with 100 µg/d. [I welcome any discussion of evidence implicating harm with vitamin D3 (not D2) in adults at doses <1000 µg/d. There is simply nothing published about this, except in infants.]" http://www.ajcn.org/cgi/content/full/74/6/863
>
> So, he's saying that it takes 40,000 IU of long term consumption of Vit D to cause hypercalcemia.
>
> Here's his discussion of "no observed adverse effect level" and the upper limit established by the Food and Nutrition Board. He makes the point, if I'm reading this correctly, of the same thing I wondered about re children versus adults: FNB).http://www.ajcn.org/cgi/content/full/74/6/866
>
> "Unlike the ULs for most other nutrients, the UL for vitamin D is not internally consistent across age groups. According to the model for deriving ULs, adjustments rely on body weight ratios (4). On the basis of what is probably a more rigorously established UL for vitamin D for infants and assuming a body weight ratio of 10, the infant data imply that the adult UL should be 250 µg/d; this value is within the adult physiologic production rate for vitamin D (5)."
>
> That's 10,000 IU.maybe due to needing to grow infants and kids need more anyway? they have to form a lot of new bone completely from scratch ?
>
> The later he says,
>
> "The FNB has not made it clear to health professionals that the LOAEL (not the UL) should be used as the numerator in calculations of the therapeutic index for nutrients. As a result, pharmacists almost always warn patients against taking the highest dose of vitamin D available over the counter (25 µg/pill, 1000 IU). They are warning patients against taking the very dose that adults need to ensure that 25-hydroxyvitamin D concentrations exceed the decision point for vitamin D insufficiency (11). To see first-hand the real-life effect of the current UL for the public, I suggest that readers pose a naive question to their local pharmacist about the risk of taking the 1000-IU vitamin D pills."
>>
> > Personally if I was you I wouldn't go overboard on VitD(considering your calcium stone history)..and yes, it is probably possibly to overdose from sunlight but most peope tend to burn and move out of the sun after a while<g>
>
> Actually, from what I read, the skin system of Vit D intake automatically only allows so much through, and that is the time it takes for a Caucasian to read 1/4 of the way to a sunburn.over here thats maybe a 3 minutes?sometimes..less for babies. Had a kid that would blister in less very quickly..maybe a couple of minutes?...just white skin, nothing wrong.
What strength sun are they measuring?>So, there is no way in effect to overdose no matter how long in the sun.
I know someone who suspects he may have when in Arabia..thinks he went manic from the overdose of sun possibly.
> But what's really interesting is that there doesn't seem either to be any toxicity from the buildup over time, which we're told is the big concern with Vit D supplementation. Which makes sense. As numerous people are now pointing out, our ancestors spent plenty of time in the sun, and yet here we are.
I agree most of us need more time in the sun.
The really poor folk are the women in those muslim countries who are required to cover up fully..they apparently suffer from VitD deficiency..hardly surprising.Most folk who get sunburn don't go and repeat the experience every day:) Actually one likes to stay right out of the sun the next few days...so its inbuilt for sure!..any tiny amount of sunlight stings!
But it IS lovely to sunbake..especially in early spring(or last Month of winter really)..so that tells me that I benefitted from that dose of sun.
If I lived in a cold climate, like say the UK or Canada or parts of the US, I definitely would take some halibut liver oil or cod liver oil daily from November to March say.
Over here its good in winter too, but not in Qld(subtropics and tropics).>
> I think it was on the Mercola site where he makes the point that anybody who lives in a latitude above 30 is at risk for overall Vit D deficiency, simply because we're just not that close to the sun even during our summer months. I checked and see I live at 43.well I agree for the winter months anyway.
>
> From your article:
>
> >Even in long-term vitamin D deficiency, the plasma calcium level can be maintained by PTH-- at the expense of the bones, which are tapped as a calcium reservoir and gradually are depleted of their mineral content. PTH also reduces the level of circulating phosphate by inhibiting renal phosphate reabsorption. More than 99% of our calcium and phosphate is in the extra-cellular matrix of bone, and the depletion of total body stores of calcium and phosphate in vitamin D deficiency leads to soft, poorly mineralized bones that bend rather than break under stress.
>
> That's what I'm worried about. My mother, who is 79, now has osteoporosis. And she had a better head start in terms of diet habits than I have. My 6-year-older sister broke her foot recently by just turning her foot off her shoe. A couple studies that talk about Vit D and parathyroid status: http://www.ajcn.org/cgi/content/full/74/2/206
> http://jcem.endojournals.org/cgi/content/full/86/3/1212
>
> >In the absence of sunlight, a daily intake of 5 to 10 microgram (200 to 400 IU) of cholecalciferol is considered adequate.
>
> That is the point of contention with the current research, which I am finding compelling and convincing.
>
> > Hypervitaminosis D, caused by the overuse of vitamin D supplements, leads to rampant hypercalcemia, hypercalciuria, and metastatic calcification. The toxic state persists for a few months after discontinuation of the offending agent if the overuse of cholecalciferol is the cause, but it lasts for only a week or so if toxicity is caused by calcitriol. Chronic hypercalcemia can result in irreversible cardiovascular and renal damage.
>
> This has been the conventional wisdom, but where's the proof?I'm not sure JL of the proof, but I thought maybe this was based on something.
I've heard that taking large doses of both VitD and calcium supps could cause kidney stones..which I thought you had had..so the warning was more to do with that than VitD toxicity in itself. I don't know what level would be needed though.
Maybe you should just get your calcium from diet only if you are going to take large doses of VitD? just in case? Larrian (the urologist whose done kidney ops etc) reckons its dangerous for most women to take calcium supps, and they should try to get the calcium via diet. I only take it as I already had osteopenia and was already on a high calcium diet. I probably should check out all my PTH pathway levels as my phosphate levels are high.I guess one's phosphate level as well as PTH would play a part in the overall picture..not to mention the immune system<g>
>
> > my thoughts added
> > and colchicine is in gingko ..so gingko and lithium may tend balance out each other to an extent in their effect on the parathyroids.
>
> Not sure why you're telling me this. I don't take lithium, or gingko either at the moment.Oh, I was just trying to do a quick post that I assumed would be maybe read by others as well :) ]
Came across that info when I was looking at the effects of supps to answer a post for TJ I think, but I saw later he isn't on them any more. However many here are so I thought I'd add it anyway, just in case anyone wanted to know.>
> We all know that the medical establishment is notoriously short-sighted and prone to scare tactics concerning nutritional supplements, yet don't think twice about prescribing drugs long term, even for children, that have been tested on limited adult populations for a short time. I'm not much of a conspiracy theorist, but it's a fact that a lot of prevention of disease will put them out of business! ;)LOL..yes I agree
>
> JL
Posted by KaraS on November 4, 2004, at 22:58:50
In reply to Re: Vitamin D and depression - question » KaraS, posted by Larry Hoover on November 4, 2004, at 14:38:05
Posted by Larry Hoover on November 6, 2004, at 18:45:13
In reply to Re: Vitamin D and depression - Larry Hoover » JLx, posted by JLx on November 2, 2004, at 12:07:55
On reading this chapter on calcium, it looks like oral vitamin D toxicity begins in the liver, although serious effects take considerable time to develop.
http://books.nap.edu/books/0309063507/html/250.html#pagetop
There's a table that shows that someone was taking 300,000 IU for six years!
http://books.nap.edu/books/0309063507/html/279.html#pagetop
Even this ultraconservative assessment of vitamin D requirements (AI estimate at 200 IU for adults) does not show toxic effects at 20,000 IU. The determination of vitamin D need is solely on the basis of not having rickets.
Lar
Posted by jrbecker on November 14, 2004, at 13:49:29
In reply to Re: Vitamin D and depression - Larry Hoover » JLx, posted by Larry Hoover on November 6, 2004, at 18:45:13
i've actually tried a supplementation of vit. D myself last winter and actually found it to be modestly helpful. i thought i'd post some more links on the subject...
WebMD report
Vitamin D May Ease Depression
Low Blood Levels of Vitamin D May Be Linked to Cause of Depressionhttp://my.webmd.com/content/Article/91/101374.htm?pagenumber=2
Nutr J. 2004 Jul 19;3(1):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 - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9539254
Psychopharmacology (Berl). 1998 Feb;135(4):319-23.
Vitamin D3 enhances mood in healthy subjects during winter.Lansdowne AT, Provost SC.
Department of Psychology, The University of Newcastle, Callaghan NSW, Australia.
Mood changes synchronised to the seasons exist on a continuum between individuals, with anxiety and depression increasing during the winter months. An extreme form of seasonality is manifested as the clinical syndrome of seasonal affective disorder (SAD) with carbohydrate craving, hypersomnia, lethargy, and changes in circadian rhythms also evident. It has been suggested that seasonality and the symptoms of SAD may be due to changing levels of vitamin D3, the hormone of sunlight, leading to changes in brain serotonin. Forty-four healthy subjects were given 400 IU, 800 IU, or no vitamin D3 for 5 days during late winter in a random double-blind study. Results on a self-report measure showed that vitamin D3 significantly enhanced positive affect and there was some evidence of a reduction in negative affect. Results are discussed in terms of their implications for seasonality, SAD, serotonin, food preference, sleep, and circadian rhythms.
Publication Types:
Clinical Trial
Randomized Controlled TrialPMID: 9539254 [PubMed - indexed for MEDLINE]
Posted by KaraS on November 14, 2004, at 17:12:20
In reply to Re: Vitamin D and depression, posted by jrbecker on November 14, 2004, at 13:49:29
> i've actually tried a supplementation of vit. D myself last winter and actually found it to be modestly helpful. i thought i'd post some more links on the subject...
How much did you take in your trial?
Posted by jrbecker on November 15, 2004, at 12:39:36
In reply to Re: Vitamin D and depression » jrbecker, posted by KaraS on November 14, 2004, at 17:12:20
> > i've actually tried a supplementation of vit. D myself last winter and actually found it to be modestly helpful. i thought i'd post some more links on the subject...
>
>
> How much did you take in your trial?2,800 - 4,200 IU
Posted by jrbecker on November 15, 2004, at 13:08:38
In reply to Re: Vitamin D and depression » KaraS, posted by jrbecker on November 15, 2004, at 12:39:36
this was just one study, and albeit a small one, however, the finding was still interesting in that it showed that a very high dose of vit D was superior to light therapy. Unfortunately, I couldn't locate the fulltext of the study to investigate its methodology, nonetheless, it highlights further evidence for the usefulness of vitamin D in SAD.
J Nutr Health Aging. 1999;3(1):5-7.
Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder.Gloth FM 3rd, Alam W, Hollis B.
The Department of Medicine, The Union Memorial Hospital, Baltimore, Maryland 21218-2895, USA.
Seasonal Affective Disorder (SAD) is prevalent when vitamin D stores are typically low. Broad-spectrum light therapy includes wavelengths between 280-320 nm which allow the skin to produce vitamin D. This study was designed to test the hypothesis that vitamin D deficiency might play a role in SAD. A prospective, randomized controlled trial was conducted in a group of 15 subjects with SAD. Eight subjects received 100,000 I.U. of vitamin D and seven subjects received phototherapy. At the onset of treatment and after 1 month of therapy subjects were administered the Hamilton Depression scale, the SIGH-SAD, and the SAD-8 depression scale. All subjects also had serum levels of 25-hydroxyvitamin D (25-OH D) measured before and 1 week after intervention therapy. All subjects receiving vitamin D improved in all outcome measures. The phototherapy group showed no significant change in depression scale measures. Vitamin D status improved in both groups (74% vitamin D group, p < 0.005 and 36% phototherapy group, p < 0.01). Improvement in 25-OH D was significantly associated with improvement in depression scale scores (r2=0.26; p=0.05). Vitamin D may be an important treatment for SAD. Further studies will be necessary to confirm these findings.
Publication Types:
Clinical Trial
Randomized Controlled Trial
Posted by KaraS on November 18, 2004, at 1:47:04
In reply to Re: Vitamin D vs light therapy for SAD, posted by jrbecker on November 15, 2004, at 13:08:38
> this was just one study, and albeit a small one, however, the finding was still interesting in that it showed that a very high dose of vit D was superior to light therapy. Unfortunately, I couldn't locate the fulltext of the study to investigate its methodology, nonetheless, it highlights further evidence for the usefulness of vitamin D in SAD.
>
>
> J Nutr Health Aging. 1999;3(1):5-7.
>
> Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder.
>
> Gloth FM 3rd, Alam W, Hollis B.
>
> The Department of Medicine, The Union Memorial Hospital, Baltimore, Maryland 21218-2895, USA.
>
> Seasonal Affective Disorder (SAD) is prevalent when vitamin D stores are typically low. Broad-spectrum light therapy includes wavelengths between 280-320 nm which allow the skin to produce vitamin D. This study was designed to test the hypothesis that vitamin D deficiency might play a role in SAD. A prospective, randomized controlled trial was conducted in a group of 15 subjects with SAD. Eight subjects received 100,000 I.U. of vitamin D and seven subjects received phototherapy. At the onset of treatment and after 1 month of therapy subjects were administered the Hamilton Depression scale, the SIGH-SAD, and the SAD-8 depression scale. All subjects also had serum levels of 25-hydroxyvitamin D (25-OH D) measured before and 1 week after intervention therapy. All subjects receiving vitamin D improved in all outcome measures. The phototherapy group showed no significant change in depression scale measures. Vitamin D status improved in both groups (74% vitamin D group, p < 0.005 and 36% phototherapy group, p < 0.01). Improvement in 25-OH D was significantly associated with improvement in depression scale scores (r2=0.26; p=0.05). Vitamin D may be an important treatment for SAD. Further studies will be necessary to confirm these findings.
>
> Publication Types:
> Clinical Trial
> Randomized Controlled Trial
>
Thanks. I have been using my lightbox again so I'm not sure how much I should increase my vitamin D intake. Even if the D is more effective for SAD, the lightbox also helps me keep my sleep-wake cycle regulated.
Posted by jrbecker on November 18, 2004, at 14:01:57
In reply to Re: Vitamin D vs light therapy for SAD » jrbecker, posted by KaraS on November 18, 2004, at 1:47:04
have you been cognizant of any benefits from the Vitamin D supplemenation?
Posted by KaraS on November 18, 2004, at 20:52:04
In reply to Re: Vitamin D vs light therapy for SAD » KaraS, posted by jrbecker on November 18, 2004, at 14:01:57
> have you been cognizant of any benefits from the Vitamin D supplemenation?
>I haven't started it yet. I'm trying to figure out how much I should take given that I am already using the lightbox.
Posted by Elainep on March 8, 2005, at 13:44:13
In reply to Re: Vitamin D and depression, posted by jrbecker on November 14, 2004, at 13:49:29
Thanks for the confirmed information on 4000iu a day being a safe dose, jrbecker, although these results indicate that 4000iu a day raises your level over time, so I'd still recommend that people get their blood levels tested before they start taking such a dose, and then tested regularly so they know what it's actually doing, rather than running blind. I must say I'm glad that Vit D is obviously being discussed so seriously and at length on this post. I personally think it must be a really common contributor to depression and mood swings, and everyone on this list would be well advised to get a blood test done. I can't repeat often enough how it's changed the life of my daughter. She's completely back to normal now, I KNOW she'll be fine from here on in because several days after her megadose even the colour in her face changed. She suddenly looked healthy again. You could just tell by looking at her that her body was working properly again. And as Barbara and I have been discussing, even if your depression is worse in summer it may still be Vit D. Don't be fooled into looking for SAD symptoms by season, or by depression only, as my daughter's depression had rapid cycle highs and lows: it looked like cyclothymia.
Enough ranting. Thanks again for the further info jrbecker.
Elainep
Posted by mystery road on March 10, 2005, at 8:07:09
In reply to Re: Vitamin D and depression, posted by Elainep on March 8, 2005, at 13:44:13
> Thanks for the confirmed information on 4000iu a day being a safe dose, jrbecker, although these results indicate that 4000iu a day raises your level over time, so I'd still recommend that people get their blood levels tested before they start taking such a dose, and then tested regularly so they know what it's actually doing, rather than running blind. I must say I'm glad that Vit D is obviously being discussed so seriously and at length on this post. I personally think it must be a really common contributor to depression and mood swings, and everyone on this list would be well advised to get a blood test done. I can't repeat often enough how it's changed the life of my daughter. She's completely back to normal now, I KNOW she'll be fine from here on in because several days after her megadose even the colour in her face changed. She suddenly looked healthy again. You could just tell by looking at her that her body was working properly again. And as Barbara and I have been discussing, even if your depression is worse in summer it may still be Vit D. Don't be fooled into looking for SAD symptoms by season, or by depression only, as my daughter's depression had rapid cycle highs and lows: it looked like cyclothymia.
>
> Enough ranting. Thanks again for the further info jrbecker.
>
> ElainepCould you please elaborate on your daughters protocol?..Especially her "mega-dose" and her daily vit D intake..What form? etc..
Thanks..
MR
Posted by TamaraJ on March 10, 2005, at 13:03:45
In reply to Re: Vitamin D and depression, posted by mystery road on March 10, 2005, at 8:07:09
I, too, am interested in the protocol, and what is a safe amount to take on a daily basis.
Thanks.
Tamara
Posted by Elainep on March 10, 2005, at 15:07:58
In reply to Re: Vitamin D and depression, posted by TamaraJ on March 10, 2005, at 13:03:45
To Tamara and MR
Here are the links I suggest you read (at the bottom of this post).
I've included (the last link) a messageboard of people who self-supplement with vit D.
My advice is to get your blood tested. It's an easy test, well known as it's done frequently for the elderly.
My problem with self dosing is, although I don't think you need to worry short term about the effects, if you do something like take 4000iu/day for 5 years you might end up with a problem, if it continually increases your blood level over time. Vit d is an important thing to have daily in your body and the only way to tell how you're doing is to get tested. So I would really encourage you to get tested: it's not an expensive or difficult test, just may require some pushing on your part on your doctor (who may be resistant through ignorance).
A megadose is the only way to get immediate results and you need a doctor's prescription for that, unless you want to down bottles of pills at once. Plus you need to check out your calcium and phosphorus levels. I know it would be easier to 'fix' yourself, but by taking a supplement yourself you know nothing about where you're starting from, how long before your levels are normal, and it may get mixed up among everything else you're doing as to whether it has an effect or not.
What level is safe? There is so much argument/discussion about that. Maybe it depends on your body size/metabolism rate. That looks to be the case in my family. I don't like flying blind when there's no need to. I suspect my daughters and I may end up on an amount greater than 1000iu a day, but I'm looking for a maintenance dose and that's different to upping your levels in the first place. (Actually I'd like my levels to go up: if they don't go up on 1000iu I'll be asking my doctor for a megadose myself of some form after six months trial.)
Okay, enough of that. You're all adults out there and need to make up your own minds, but just let me say that this is KNOWN Western medicine, not some kind of pseudoscience, but the problem is western medicine only looks for it in the cases of the elderly and maybe those with unipolar depression some time in the winter (obvious SAD cases). Widen the breadth of the SAD definition and get yourself tested. It's easy and well worth it.
Elaine
http://www.cholecalciferol-council.com/major_depression.htm
http://www.holistic.com/holistic/learning.nsf/0/c9ef2bd696792d7087256e2b00706973?OpenDocument
http://www.washingtonpost.com/wp-dyn/articles/A43711-2004May20.html
http://www.nichd.nih.gov/prip/
http://www.superbherbs.com/advitamins.html
http://www.detnews.com/2003/health/0309/03/health-258921.htm
http://www.direct-ms.org/vitamind.html
http://www.vitaminlife.com/product-exec/product_id/11802
http://www.mercola.com/2003/jun/18/vitamin_d_cancer.htm
http://my.webmd.com/content/Article/91/101374.htm?pagenumber=1
http://sunlightandvitamind.com/
http://www.mercola.com/2002/feb/23/vitamin_d_deficiency.htm
http://www.immunesupport.com/library/showarticle.cfm/ID/5324/e/1/T/CFIDS_FM/
http://forum.lowcarber.org/archive/index.php/t-215413.html
Posted by mystery road on March 10, 2005, at 19:59:06
In reply to Re: Vitamin D and depression, posted by Elainep on March 10, 2005, at 15:07:58
Elaine..
Thanks for your help..You seem so adamant about getting tested first but frankly I'm gonna try the vit D therapy no matter what..My depressive symptoms are so bad I'm willing to forgo the test just to see if there's any relief from the therapy by titrating upwards to 4000iu over a month..If I find some relief, I'll get tested..if not, I'll either change the protocol or quit the therapy..I've tried EVERYTHING over the past 10 yrs with no consistent results..This is the next missing step..I'll post my results..
MR
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