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Too much Vit. D as bad as too little-Danish Epidemiological study

vitamin d epidemiology

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#1 malbecman

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Posted 30 May 2012 - 06:51 PM


Note that lowest mortality was seen at 50 nMol/L



Too Much Vitamin D Can Be as Unhealthy as Too Little, Study Suggests

ScienceDaily (May 29, 2012) — Scientists know that Vitamin D deficiency is not healthy. However, new research from the University of Copenhagen now indicates that too high a level of the essential vitamin is not good either. The study is based on blood samples from 247,574 Copenhageners. The results have just been published in the reputed scientific Journal of Clinical Endocrinology and Metabolism.
Vitamin D is instrumental in helping calcium reach our bones, thus lessening the risk from falls and the risk of broken hips. Research suggests that vitamin D is also beneficial in combating cardiac disease, depression and certain types of cancers. The results from a study conducted by the Faculty of Health and Medical Sciences now support the benefits of vitamin D in terms of mortality risk. However, the research results also show higher mortality in people with too high levels of vitamin D in their bloodstream:
"We have had access to blood tests from a quarter of a million Copenhageners. We found higher mortality in people with a low level of vitamin D in their blood, but to our surprise, we also found it in people with a high level of vitamin D. We can draw a graph showing that perhaps it is harmful with too little and too much vitamin D," explains Darshana Durup, PhD student.
If the blood contains less than 10 nanomol (nmol) of vitamin per liter of serum, mortality is 2.31 times higher. However, if the blood contains more than 140 nmol of vitamin per liter of serum, mortality is higher by a factor of 1.42. Both values are compared to 50 nmol of vitamin per liter of serum, where the scientists see the lowest mortality rate.
More studies are needed
Darshana Durup emphasises that while scientists do not know the cause of the higher mortality, she believes that the new results can be used to question the wisdom of those people who claim that you can never get too much vitamin D:
"It is important to conduct further studies in order to understand the relationship. A lot of research has been conducted on the risk of vitamin D deficiency. However, there is no scientific evidence for a 'more is better' argument for vitamin D, and our study does not support the argument either. We hope that our study will inspire others to study the cause of higher mortality with a high level of vitamin D," says Darshana Durup. She adds:
"We have moved into a controversial area that stirs up strong feelings just like debates on global warming and research on nutrition. But our results are based on a quarter of a million blood tests and provide an interesting starting point for further research."
The largest study of its kind
The study is the largest of its kind -- and it was only possible to conduct it because of Denmark's civil registration system, which is unique in the Nordic countries. The 247,574 blood samples come from the Copenhagen General Practitioners Laboratory:
"Our data material covers a wide age range. The people who participated had approached their own general practitioners for a variety of reasons and had had the vitamin D level in their bloodstream measured in that context. This means that while the study can show a possible association between mortality and a high level of vitamin D, we cannot as yet explain the higher risk," explains Darshana Durup.
Therefore in future research project scientists would like to compare the results with information from disease registers such as the cancer register. Financial support is currently being sought for such projects.

#2 malbecman

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Posted 30 May 2012 - 06:55 PM

Not sure why it double posted, feel free to delete one.....

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#3 PGN

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Posted 30 May 2012 - 10:08 PM

My nutritionist recommends to achieve a level of D between 50 to 70 nmol for most people. People with a cancer history should strive for 70 to 100, no where close to the 140 in this study. He did mention something about liver buildup and toxicity if taken every day, so he said to take D3 supplements during the week 5 days on and 2 days off. If you get your vitamin D from natural sunlight, I don't think you can overdose. Your body automatically regulates it's production.

#4 gwern

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Posted 31 May 2012 - 12:29 AM

FWIW, the comments on the GRG mailing list did some informal analysis and concluded 5000 IU doses probably are not pushing you into any danger zone.

#5 niner

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Posted 31 May 2012 - 02:05 AM

If the blood contains less than 10 nanomol (nmol) of vitamin per liter of serum, mortality is 2.31 times higher. However, if the blood contains more than 140 nmol of vitamin per liter of serum, mortality is higher by a factor of 1.42. Both values are compared to 50 nmol of vitamin per liter of serum, where the scientists see the lowest mortality rate.


Around here, we most often talk about vitamin D levels (25-OH-D3) using the non-SI units, ng/ml. To convert from nmol/l (aka nM), you divide the nanomolar number by 2.5. 50nM / 2.5 = 20ng/ml. That should get people riled up...

10nM/2.5 = 4ng/ml. (deficiency)
140nM/2.5 = 56ng/ml (too much)

Sorry, but someone on the GRG got it wrong; they probably confused ng/ml for nM. 5000iu/day will put most people in the 'danger zone'. The earlier 'more D isn't always better' paper by Melamed showed a broad minimum in all cause mortality at what's frequently been quoted around here as 50ng/ml, though it's actually less. The coincidental identity of these numbers might have lead to confusion.

I reduced my D intake a while back because I didn't like the way the prostate cancer / vitamin D epidemiology was shaping up. I used to take 2000 units a day in an oil based formulation plus 667 units of dry D3 in a bone formula. I've dropped that to 2000 units three times a week, plus the same amount of the dry stuff. My last 25-oh-d3 level was in the low 40's, so I think I'll drop the oil based formulation entirely. If it wasn't for the prostate connection, I probably wouldn't do that, but I have a strong family history.

He did mention something about liver buildup and toxicity if taken every day, so he said to take D3 supplements during the week 5 days on and 2 days off.


I'm pretty sure he's wrong about that. You can take it as frequently as you like, as long as your total dose per time unit is within a safe range. Since it has such a long half life, you can take it once a week if you want. Supplemental D is best taken in the morning, as it can have chronobiological effects. (same with resveratrol)
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#6 PGN

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Posted 31 May 2012 - 03:13 AM

My nutritionist recommends to achieve a level of D between 50 to 70 nmol for most people. People with a cancer history should strive for 70 to 100, no where close to the 140 in this study. He did mention something about liver buildup and toxicity if taken every day, so he said to take D3 supplements during the week 5 days on and 2 days off. If you get your vitamin D from natural sunlight, I don't think you can overdose. Your body automatically regulates it's production.



I meant "ng/ml" not "nmol" When he told me to start adding vit D as a cancer treatment, he wanted me to take 10000 IUs a day to bring it up to 70 and then reduce it to 5000 a day and monitor every 90 days. He is a specialist in oncology, and does extensive research before recommending anything to his clients. I have been on 5000 IUs a day for awhile now, 5 days on and 2 days off. My level is about 75 and it seems to work for me. All my cancer markers and blood tests have looked good for the last 7 years.

#7 PGN

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Posted 31 May 2012 - 03:24 AM

I meant "ng/ml" not "nmol" When he told me to start adding vit D as a cancer treatment, he wanted me to take 10000 IUs a day to bring it up to 70 and then reduce it to 5000 a day and monitor every 90 days. He is a specialist in oncology, and does extensive research before recommending anything to his clients. I have been on 5000 IUs a day for awhile now, 5 days on and 2 days off. My level is about 75 and it seems to work for me. All my cancer markers and blood tests have looked good for the last 7 years.


This article with references supports my nutritionist's recommendations:

http://articles.merc...-vitamin-d.aspx

#8 SocietyOfMind

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Posted 31 May 2012 - 09:00 AM

If they didn't control for K2 and A levels, this study is a WOFTAM.

#9 nameless

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Posted 31 May 2012 - 07:49 PM

If accurate, the numbers are a lot lower than people have assumed.

Optimal amount would then be 20 ng/ml, which I expect nobody here is striving for, as it would be considered deficient. Like Niner, I seem to be constantly lowering the serum level I am going for... although don't think I'll aim for 20. 30-35 may be a better target.

@societyofmind

Possibly. Although there is no way for us to know for certain. But it would be interesting if they performed some studies measuring K2 or A intake, along with D3, and see if there are any correlations with mortality between the groups.

@PGN

Although there could possibly be valid points in a Mercola article, I wouldn't trust him in general. The majority of his articles are geared towards supplements he sells, ala LEF. He also recommends tanning beds, for instance...

Edited by nameless, 31 May 2012 - 07:49 PM.


#10 X_Danny_X

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Posted 31 May 2012 - 10:28 PM

I have been taking 10,000 IU of Vitamin D. I was planning to take them every day but I used it here and now.

Is 10,000iu of vitamin D for 5 days on and 2 days okay????

#11 nowayout

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Posted 31 May 2012 - 10:57 PM

If accurate, the numbers are a lot lower than people have assumed.

Optimal amount would then be 20 ng/ml, which I expect nobody here is striving for, ...


Well, that was basically the finding of the recent Institute of Medicine meta-analysis. I would definitely not go above 30 ng/ml, because of possible signals of increased risk of prostate and pancreatic cancer and CVD (see below). I am already at 30 ng/ml, and I take only 800 IU daily in a multi and don't get much sun.

http://www8.national...?RecordID=13050

Based on available data, almost all individuals get sufficient vitamin D when their blood levels are at or above 20 nanograms per milliliter as it is measured in America, or 50 nanomoles per liter as measured in Canada.


Upper intake levels represent the upper safe boundary and should not be misunderstood as amounts people need or should strive to consume. The upper intake levels for vitamin D are 2,500 IUs per day for children ages 1 through 3; 3,000 IUs daily for children 4 through 8 years old; and 4,000 IUs daily for all others. The upper intake levels for calcium are 2,500 milligrams per day from age 1 through 8; 3,000 milligrams daily from age 9 through 18; 2,500 milligrams daily from age 19 through 50; and 2,000 milligrams per day for all other age groups.


Quotes from the report

a pooled analysis of large cohort studies suggests an association for increased risk of pancreatic cancer with serum 25OHD levels greater than 100 nmol/L [U.S. units 40 ng/ml] that is not consistently seen in analyses of individual large cohorts.


Regarding prostate cancer, Tuohimaa et al. (2004) found a higher risk of prostate cancer for those with serum 25OHD levels above 80 nmol/L [U.S. units 32 ng/ml]. The subjects were 67 men, mostly from Norway. Although another study from Finland (Tuohimaa et al., 2004) also found an association between serum 25OHD levels and prostate cancer at levels above 80 nmol/L, a study conducted by Faupel-Badger et al. (2007) also in Finland did not find a relationship


Analysis of fully adjusted data indicated an inverse relationship between CVD mortality and baseline serum 25OHD level of 50.0 to 74.9 nmol/L. Risk began to increase at approximately 75 nmol/L [U.S. units 30 ng/ml] and then it declined after 100 nmol/L.


Edited by viveutvivas, 31 May 2012 - 11:00 PM.

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#12 nameless

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Posted 31 May 2012 - 11:25 PM

I have been taking 10,000 IU of Vitamin D. I was planning to take them every day but I used it here and now.

Is 10,000iu of vitamin D for 5 days on and 2 days okay????

Unless you currently have rickets or something, I'd say it's way too much.

I've been taking the equivalent to 2000IU daily, and my serum came back in the high 30s last time I got it tested (during winter). I'm thinking of lowering it to 1000IU daily.


10K for 5 days/week would probably put you into the 60+ range.

#13 smithx

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Posted 01 June 2012 - 12:07 AM

The relation between oral vitamin D supplementation and vitamin D25 blood levels varies fairly widely based on genetics. Some people are able to use D much more efficiently than others.

In my case, taking 2000IU per day for a year produced a blood level of only 30ng/l. In others, it might produce levels which are far too high.

The only way to know for sure is to get a blood test, find your current level, supplement for a while, get another blood test to see where you are then, and repeat, varying the dosage until you maintain your desired level for several tests.
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#14 X_Danny_X

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Posted 01 June 2012 - 01:58 AM

This is very strange, I keep hearing that you need at least 5000IU since the body uses that amount daily.

#15 niner

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Posted 01 June 2012 - 02:17 AM

This is very strange, I keep hearing that you need at least 5000IU since the body uses that amount daily.


Where are you hearing that? Different people have different needs in order to hit a given blood level, and different people will want to shoot for a different blood level depending on their risk factors, but 5000IU is a lot. Very few people will need that much, unless it's a crappy formulation with poor bioavailability.

#16 X_Danny_X

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Posted 01 June 2012 - 02:47 AM

Well what is the recommended dosage then for most folks? 1000 IU or 2000IU? doesn't the body store vitamin D?


Also for someone who works out with heavy weights, Vitamin D could be beneficial since it is a hormone/steroid.
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#17 niner

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Posted 01 June 2012 - 03:08 AM

Well what is the recommended dosage then for most folks? 1000 IU or 2000IU? doesn't the body store vitamin D?
Also for someone who works out with heavy weights, Vitamin D could be beneficial since it is a hormone/steroid.


The recommended dose is 1000IU. It isn't that kind of steroid, so there's no relevance to weight lifting.

#18 X_Danny_X

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Posted 01 June 2012 - 03:15 AM

1000IU 5 times a week, off on the weekend?

#19 nameless

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Posted 01 June 2012 - 04:59 AM

1000IU 5 times a week, off on the weekend?


As smithx mentioned, only way to know what dose to use is to get your serum level tested. It's going to vary a lot per person.

If you don' t have insurance, I believe the test is relatively inexpensive. LEF offers it too, I think. Get it tested at least once before starting D, wait several months, then retest.

If you have insurance and a willing doctor, get it tested as much as you want.

#20 X_Danny_X

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Posted 01 June 2012 - 08:54 AM

As smithx mentioned, only way to know what dose to use is to get your serum level tested. It's going to vary a lot per person.

If you don' t have insurance, I believe the test is relatively inexpensive. LEF offers it too, I think. Get it tested at least once before starting D, wait several months, then retest.

If you have insurance and a willing doctor, get it tested as much as you want.



I do have insurance and i did a vitamin d test about 1 year ago but i didnt know if the value of vitamin d that i had was okay. when i did it, my doctor took too much blood in my opinion. i felt soooooooo out of it.

i work and go to school, so i really can't afford a zombie like state at this time. i will try to do what you said, with the LEF.

#21 against_all_odds

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Posted 01 June 2012 - 02:02 PM

Well 3166IU got me to 46 ng/mL, which i thought was OK..and it was, going by what people here were doing 2 years ago.

Back then people were aiming for 50-60ng and quoting research from the vitamin d council. Speaking of which; http://blog.vitamind...ause-mortality/

It will be interesting to see where this goes.

#22 nameless

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Posted 01 June 2012 - 04:31 PM

I do have insurance and i did a vitamin d test about 1 year ago but i didnt know if the value of vitamin d that i had was okay. when i did it, my doctor took too much blood in my opinion. i felt soooooooo out of it.

i work and go to school, so i really can't afford a zombie like state at this time. i will try to do what you said, with the LEF.


It should be one vial. I expect the LEF test would take the same amount.

I don't think one little vial is going to turn you into a zombie. If your doctor takes a bucket of blood for some bizarre reason, you can alternatively just get a script from your doctor and get your blood taken at LabCorp, Quest, or whomever.

#23 arska

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Posted 01 June 2012 - 04:36 PM

It would be nice to know the result by gender as it is known that in men higher vitamin D status reflects higher testosterone levels.

#24 Kevnzworld

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Posted 04 June 2012 - 12:43 AM

I read that study earlier today on another site. Their conclusion was that the vitamin D blood level sweet spot was 50 ng. I never tested my D levels until recently. I felt I was ok because I supplement with 2500iu, plus a multi and I live in the desert. Well, when I did test it last year it came back 34 ng. I'm now at 4000iu, and I'm testing again next week
The levels that showed increased mortality in that study approached 140 ! I would suspect that anyone that maintained that level of D in their blood would develop kidney issues.
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#25 Hebbeh

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Posted 04 June 2012 - 12:53 AM

I read that study earlier today on another site. Their conclusion was that the vitamin D blood level sweet spot was 50 ng. I never tested my D levels until recently. I felt I was ok because I supplement with 2500iu, plus a multi and I live in the desert. Well, when I did test it last year it came back 34 ng. I'm now at 4000iu, and I'm testing again next week
The levels that showed increased mortality in that study approached 140 ! I would suspect that anyone that maintained that level of D in their blood would develop kidney issues.


Realize that the study values were reported in nmol not ng/ml.....big difference. 140 nmol would be 56ng/ml... see niners post #5

Edited by Hebbeh, 04 June 2012 - 12:56 AM.


#26 niner

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Posted 04 June 2012 - 01:02 AM

I read that study earlier today on another site. Their conclusion was that the vitamin D blood level sweet spot was 50 ng. I never tested my D levels until recently. I felt I was ok because I supplement with 2500iu, plus a multi and I live in the desert. Well, when I did test it last year it came back 34 ng. I'm now at 4000iu, and I'm testing again next week
The levels that showed increased mortality in that study approached 140 ! I would suspect that anyone that maintained that level of D in their blood would develop kidney issues.


Whose conclusion, the paper or the site? The paper says the sweet spot (for Danes, who might be getting their D from Cod Liver Oil that has other things in it besides D) is 20 ng/ml. I think Melamed would have it around 35ng/ml, right where you're at. The units used in the paper are nanomoles per liter, not nanograms per ml. To convert from the units in the paper to the units you're using, you need to divide by 2.5. 140nmol/liter /2.5 = 56ng/ml.

Edit: Hebbeh beat me to it...

Edited by niner, 04 June 2012 - 01:03 AM.


#27 Kevnzworld

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Posted 04 June 2012 - 03:30 AM

The vitamin D councils take on the study :
http://blog.vitamind...ortality-study/

http://blog.vitamind...ause-mortality/

I think the preponderance of research still shows that maintaining higher levels of vitamin D are associated with lower levels of disease. It is difficult to weigh all the variables and confounding factors in meta analysis studies.
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#28 Kevnzworld

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Posted 04 June 2012 - 07:26 AM

Here is a recent study published in the American Journal of Cardiology. It showed higher disease and mortality with people with less than 30 ng of D, and less in people with levels greater than 30 ng

http://extremelongev.../vitd-death.pdf

#29 stephen_b

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Posted 05 June 2012 - 08:11 PM

Mentioned in the Vitamin D council newsletter, Dr. Grant’s take on the recent mortality study.

Perhaps the most important shortcoming was that no information was obtained about health conditions at the time of enrollment or death. A possible explanation for the higher mortality rate for those with higher 25(OH)D concentrations at time of enrollment is that they had been diagnosed with osteoporosis or other conditions and were advised by their physician to take vitamin D supplements.

Since high vitamin D doses are generally unavailable over the counter in Denmark, prescriptions by physicians were very likely for those with high 25(OH)D concentrations in this study. There were 2,527 subjects with serum 25(OH)D concentrations higher than 140 nmol/l (56 ng/ml). Taking high vitamin D doses after a lifetime of low serum 25(OH)D concentrations may not correct conditions that take years to develop such as calcified arteries, cancer tumors, and osteoporosis.



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#30 GK77

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Posted 11 June 2012 - 03:39 AM

Interesting read. I personally met a researcher involved in this particular study http://www.southernc...ch/Research.htm
They shared some striking data, which I wish I could share here. I can't betray her trust, but suffice it to say, every researcher involved began taking 2500 IU D3 daily.

Intuition lends itself to the belief that too much or too little of any vitamin has potential to be harmful. I remember reading excessive folate could increase the risk of some cancers with regard to the methyl cycle, I think they were the fast growing types, like intestinal, oral, prostate etc. I'd have to look for the study.
Anyways, that's why blanket recommendations don't mean much for health (and only occasionally work) when not individualized.
Factors like current levels and co-morbid conditions are all to often overlooked.





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