The Optimal Dose of Vitamin D Based on Natural Levels

The Optimal Dose of Vitamin D Based on Natural Levels


“The Optimal Dose of Vitamin D
Based on Natural Levels” If everyone took 2,000 units of vitamin D
a day, it could shift the curve from average blood levels in
the mid-50’s to about a 110, which some estimate could add
years to our life expectancy. Data derived from randomized clinical
trials have convinced some influential experts, such as Harvard’s chair
of nutrition, that we should shoot for this kind of range, levels that
about 9 out of 10 people fail to reach because it may necessitate taking
between 1,800 and 4,000 units a day. The Institute of Medicine, however,
considered blood levels of 50 to be sufficient, and therefore only
recommended 600 to 800 units a day for those with little
or no sun exposure because they were only
considering bone health. But even if you just cared about
your bones and not your lifespan you’d still probably want to shoot
for the 75 threshold because there’s evidence like this
from hundreds of autopsies of people that like died in car accidents showing
osteomalacia, softening of the bones, in between 18 to 39 percent of people that
reach the Institute of Medicine target, but fail to make it to 75. There’s even been a charge that
the Institute of Medicine simply just made a mistake in their
calculations, and so using their own criteria they should be recommending
thousands of units a day as well. But the mere absence of soft bones
can hardly be considered an adequate definition either of
health or of vitamin D sufficiency. It’s like saying you only need 10 mg
of vitamin C to avoid scurvy — yeah, but we need way more
than that for optimal health. The Institute of Medicine took
the position that the burden of proof fell on anyone who claimed
benefits for intake higher than their minimal recommendations,
which is a good approach for drugs; for unnatural substances less is more
until proven otherwise. But for nutrients, shouldn’t the starting
point, at least, be the natural levels to which our bodies have become
finely tuned over millions of years? The target level of 75 only sounds high
compared to average levels today, but in modern times we
practice unnatural activities like working at a desk job, or
sometimes even wearing clothes. We evolved running around naked in
equatorial Africa getting sun all day long. If you measure vitamin D levels
in those living traditional lives in the cradle of humanity, a normal
vitamin D level would be over 100. So maybe that should be the starting
point, until proven otherwise; a concept, regrettably, many guidelines
committees seem to have ignored. Now look, the natural level isn’t
necessarily the optimal level, and maybe the body would
have thrived with less, so you still have to look at what levels
correspond to the lowest disease rates. And when you do, the highest levels do
indeed seem to correlate with less disease. You know it always struck me
when I was doing pediatrics that breastfed babies required
vitamin D drops. I mean shouldn’t human breast
milk be a perfect food? Of course for the medical profession
the solution is simple: provide the baby supplements, the drops,
but it seems like we shouldn’t have to. It should be perfect.
But, look, you measure human breast milk these days
and it has virtually no vitamin D and would cause rickets, unless the
mom had vitamin D levels up around – you guessed it – the level
natural for our species, which of course makes total sense. So it’s just like an environmental mismatch
the way we live in our modern world. It helps to think of vitamin D as what
it truly is, a hormone, not a vitamin. So if you think of it like that, then it
would be reasonable to have normal levels. We physicians try to
maintain blood pressure and all sorts of parameters
within normal limits, but why is so little attention is paid
to the status of the hormone “vitamin D”?

Comments

(79 Comments)

  • Josh B.

    My favorite YouTuber!

  • Timmy K

    First

  • Jim Wilson

    I must have missed it….HOW MUCH Vitamin D should be taken?

  • FreeD00M

    So if I want to get around 100 nmol/L how much do I have to take per day?

    Got it
    2000 IU per day.
    The ending of the video referrs to the begnning…..

  • GoustiFruit φ

    I still didn't understand if taking vit. D SUPPLEMENTS had positive effects on health, or if the positive effects were only for people having NATURALLY normal vit. D !? Dr. Pam Poppers keeps telling that vit. D is at least useless in most cases…

  • Vegetable Madness Ⓥ

    So how much would I need to sunbathe to get enough vitamin d?

  • Omar Alahmad

    Its not in the pill guys.. Maybe we get more than just vitamin D from the sun .. Who knows

  • Brad Biscamp

    Great video.

  • Steeldude

    hey michael. maybe i`m a bit slow, but i didnt quite understand how much you should take?

  • zukodude487987

    So how much D should i take again?

  • sheepnoisebah

    if 1800 gets 75 nmol/l … that means the 4000 IU range is the best one to hit the normal range of 110 nmol/l?

  • OX MONSTER

    Your over animated speaking style makes me sick. Stop this bullshit. Also there was no final recommendation; a piss poor video

  • Doug bananaboy

    Come on everyone lets eat our hormones everyday for the rest of our lives .. I don't buy it , it's not certain how much vitamin d levels we need to live long productive lives . Get and play in summer and trust your bodies ability to store the hormones it creates …my 2 bananas

  • ura soul

    the advice i repeatedly got from researchers i respect is 10000iu per day.

  • JaNein Aly

    My mom 80yrs old and does not get outside. They have her on 50,000 VitD a week. Her D levels are still at the bottom! I was just thinking that maybe she just gets that in one day and not taking daily doesn't build up her body?

  • kokoro nagomu

    if i walk from my door to my car without covering i will blister, i can't tolerate much sun exposure so i have little choice than to supplement.

  • Jacobus Baker

    Dr McDougall sais don't do it its bad for your kidneys.

  • VeganViet Ⓥ

    I'm guessing people in Eastern africa didn't take supplement and they have optimal vitamin D. Don't be scared of the sun. Looks like the benefits outweigh the risks.

  • JaxxoDam

    I like the multiple videos series! Good details

  • Michael Janavel

    😀

  • logan logan

    Hey my step mom recently got pregnant and the doctor told her that hamburger would help the baby with brain development and i was wondering if anyone could tell me why he would say this. Is it growth hormones or something in the meat? If anyone can link me a study about this it would be greatly appreciated( im trying to convince her to not eat meat, but i want the best for the baby)

  • Wesley Rodriguez

    just ordered some vitashine vegan d3 1000ui tablets ,THEY HAVE THEM IN 2000UI AS WELL AND IN THE DROPS FORM…VEGETOLOGY.COM ….PEACE

  • tim bo

    Wow, that's a lot more. Thank you for presenting!

  • Northern Vegan Momma

    I've wondered about the vit d in breastmilk ever since my son was born, thanks for the answers! 💖🌞 Can't get over that gorgeous thumbnail pic!!!

  • goldeneaglevideo

    10,000 units is what i take and have for many years and that is the dose recommended for immune system health

  • tamcon72

    Super informative; thanks for posting, Doc.

  • Corvux IX

    A lot of beating around the bush, doc

  • Plant Sugar

    Thanks this is good stuff in addition to the Vitamin D solution by Dr. Holick. 🙂

  • PoweredbyPlants

    We need more public naked days, holidays, festivals. Just for vitamin D of course 😀

  • Jollo Jakar

    Good to see "paleo" arguments enter the discussion here.

  • cosmin ckraici

    Anything on DHT natural blockers?

  • Johnny Cabral

    Dr Greger…. Just say… Hypothetically.. You got diagnosed with cancer. What would be your next move? How would you go about treatment?

  • maremacd

    Grrr. Greger enjoys being obtuse.

  • Peter

    I wonder how much better it is to get the D from sunlight rather than through pill-form.

  • WisdomTooth

    Sunlight will give you optimal levels 🙂

  • barzinio92

    Dr. McDougall says 5 minutes per day in the sun is enough for a fair-skinned person. So is he a quack? I'm really wondering about the validity of his claims now

  • Randy Wolf

    This is a video series on the site and today's video is suppose to go over whether it is preferable to get it from supplement or sun exposure, etc. this is #4 in a 6 part series i think. maybe wait until after tomorrows final post to figure out the recommendation?

  • Elliot Hulse's Breath

    I like your evolutionary approach to health and nutrition. Do we need to take vitamin D sups during summer as well?

  • R!OT EARTH

    I always wondered about the fact that we evolved without clothes, for the most part. And we currently live with clothes on while outside most of the time. I'm in Canada so in the Winter even the sun isn't powerful enough to give proper vitamin D if naked all day outside. I've been taking more vitamin D3 since this video series. I don't notice much of a difference, yet anyway. Maybe because I was never deficient.

  • Joseph1NJ

    Wait a second, this channel only has 176K subs? How can that be? I'm not vegan, not even vegetarian, and I believe the 100% free info here is close to invaluable. I gotta get on my friends and family to sub and watch.

  • Димка Невидимка

    Another Extremely well made Video! Congratulations! we like&sub:) hope you sub back:) Like # 626

  • star wars mommy

    why did the doc beat around the bushes? the usual advice I have heard is about 15-20 min. done

  • LOMBRO

    Best solution in my opinion is to take the D3 supplements and get some sun exposure in the safe hours of the day but be mindful of the sun and cover up and stay in the shade for the rest of the time.

  • Fernando Crociani

    Ottimo grazie!

  • mynameislucky

    Would have been great if this video would of given some kind of conclusion to the question stated in the title.

  • Train Everywhere

    Too much conflict of interest in those studies. Do a research for yourself and you'll find out that authors who suggest serum levels > 75 nmol/L are biased.
    Some conflicts of interest: Bio-Tech Pharmacal, Pharmavite, Novartis, Diasorin, Vitamin D Council (San Luis Obispo, CA), UV Foundation (McLean, VA), Vitamin D Society (Canada) …

    I would rather suggest reading these studies:

    2014 – What is the optimal level of vitamin D?:
    "For patients at high risk of poor bone health or colorectal cancer, accepting the potential risks of higher 25(OH)D levels may be warranted to gain the possible benefits. This is a judgement call that physicians must make in consultation with an informed patient. Apart from these high risk groups, there is no strong evidence to support health benefits of vitamin D supplementation for those with apparent mild insufficiency (40–50 nmol/L) on routine testing."
    http://www.racgp.org.au/afp/2014/march/vitamin-d/

    2014 – Observational studies vs RCTs:
    "Observational studies have identified links with several diseases, but these have either not been evaluated or not been replicated in randomised controlled trials. Randomised controlled trials for autoimmune and cancer related outcomes are clearly lacking. In addition, earlier evidence from randomised controlled trials that vitamin D supplementation (with or without calcium) increases bone mineral density and reduces the risk of fractures in older people is not seen in clinical trials that examine vitamin D only supplementation."
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972415/

    2015 – Measuring vitamin D: ''A 25-hydroxyvitamin D threshold of at least 50 nmol/L at the end of winter is a suitable treatment target.''
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654047/

    2015: Predictor of Health Outcome or Marker of Health Status?:
    "Finally, while our review focused on extraskeletal complications and discussed the related challenges, this debate might not remain limited to extraskeletal complications for long but may soon include skeletal complications. Indeed, recent evidence has suggested that vitamin D might not be as essential as previously thought for maintaining bone health and preventing falls [64–66, 124]. Vitamin D (the solar vitamin) is likely to remain a burning topic in coming years."
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436443/

    2016 – Stokes and Lammert:
    "Currently, optimal serum vitamin D concentrations are controversial, and there is a discrepancy between two key guidelines. The Institute of Medicine recommends 20 ng/ml (50 nmol/l; 1 ng/ml = 0.40 nmol/l) as adequate on the basis of bone health studies, which is in contrast to the 30 ng/ml (75 nmol/l) urged by the US Endocrine Society [My comment: conflict of interest]. To achieve levels of the latter, approximately 4,000 IU of vitamin D would be required daily. However, the safety of such a dose needs to be confirmed in further controlled trials, as, for example, a higher risk of upper respiratory tract infections has been reported with 4,000 IU of vitamin D per day in asthma patients achieving circulating 25-hydroxyvitamin D levels of more than 30 ng/ml (75 nmol/l)."
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991525/

    2016 – Global Consensus Recommendations on Prevention and Management of Nutritional Rickets (children):
    Sufficiency: >50 nmol/L
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880117/

    2016 – Vitamin D and extra-skeletal health: causality or consequence:
    "Unless more evidence of clinically meaningful effects of supplementation is available, it may be too early to recommend for or against vitamin D supplementation for maintenance of extra-skeletal health and prevention of disease, beyond the daily requirements for calcium homeostasis and skeletal benefits."
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003588/

  • Dan Haiduc

    What if the vitamin D levels should't be high, because we DO live in an unnatural state?

    What if the body expects there to be sun and other things which it does not have, if you provide it with vitamin D to signal natural sun exposure?

  • Kitty Kitty

    I take 5,000 IU daily.

  • Garlic Girl

    I think something we did over time has caused us to lose Vitamin D. Something about how we are living. My doctor said even folks who work outside for a living (her clients) have low Vitamin D levels.

  • Todd Walsh

    wuuow, did you just say evolved? . I was carefully listening to him, and he may be right about vitamin D. But if he believes we "evolved" he certainly didn't do his careful study and homework on that topic. Can't listen any further.

  • hugsru

    This is too complicated

  • Leon Schuring

    so… the higher the nmol/L of vitamin D, the better??!!

  • Robert Clayton

    The amount required to get you to this sort of level varies but is usually 5,000 to 10,000 iu.
    6,500 is needed for mothers to start providing adequate D in their milk. It's also the sort of level that whole body sun exposure can easily provide.
    It all fits together with nature but doesn't fit with the ridiculously low levels recommended by the authorities.

  • John Buckman

    To what extent dose the increases in vaccinations impact this data ? How dose the US compare to other developed countries of the world ? Are there scientific trials and data that support vaccination policy for our children?

  • Terrilee

    DO NOT INGEST HORMONES; VITAMIN D IS TRULY A HORMONE.

  • youngistan of India

    The Best Vitamin D3 Brand in Indian Market is Sunbless 60 K which is from Zydus Cadila Healthcare. This is with pre-emulsified form with Nano Technology advantage and is 4 times more effective then all other brands available in India.

  • Whole Food Plant-Based Man

    When looking at evolution, our ancestors spent the entire day outdoors under the sun hunting & gathering, and that was how their skin made D. Most hunts were unsuccessful, and they resorted to succumbing to the contents of food that were gathered, which was plant material. Meat was a very rare delicacy for early primordial humans. Honestly, in the modern age, I'm glad I take a tablet of D with my store-bought plant foods. It saves a lot of time.

  • Whole Food Plant-Based Man

    Aside from all the complexities of the D research, I continue to take a tablet of D daily because I don't get sick anymore. When I go on vacation, and I'm too lazy to take my daily D, I tend to get sick within 48 hours. My conclusion is not to stop taking D. I need to continue it no matter what.

  • Whole Food Plant-Based Man

    I will definitely start thinking of D as a hormone now. I'm going to take my daily hormone pill now.

  • Whole Food Plant-Based Man

    My brother, who is a physician, keeps saying 15 minutes in the sun per day is plenty to get adequate D hormone. He is pretty stubborn & persistent on that 15 minute number. Well, I'm glad I have Dr. Greger to settle the argument.

  • Elham M

    Hey guys, just adding my two cents here.. for those who are thinking of getting their vitamin D from spending time in the sun, please note that in order for our bodies to absorb vitamin D our skin should not be dry and void of its natural oils, which means that if we go to the beach and swim and then lay in the sun, our skin probably is not oily enough to absorb sufficient amounts of the vitamin. Even if we swim AFTER laying in the sun, the water will just wash it off…the oil should remain on the skin for a few hours, for the skin to synthesize vitamin D over time.

  • Jeremiah Alphonsus

    Yet more evolution mythology. Disappointing.

  • Bio Hacker

    eicosapentaenoic acid
    Docosahexeaonic acid
    Any 1 lolol

  • DrGerm

    When you consider the chemistry of Vitamin D; it TOTALLY is much more like a "hormone" than a vitamin, so I think you are spot on.

  • Arab Dude

    I had to endure your voice to get to the answer and in the end you didn't even answer the question! Fkn time waster

  • bennyhannasd

    Very informative and interesting. For all those confused, what I have been doing for the last 9 months that has changed my health dramatically is 16 min in a bathing suit every day around noon for sunshine (lay in a lounge chair and flip every 4 minutes). My vitamin D levels were stuck at 18 for over 5 years with progressively higher doses of D3 up to 5000 iU daily. What most doctors don't know is that for 15 min in the sun in a skimpy bathing suit your body can generate 25,000 IU of D, and this is what you need consistently if you have been deficient for a long time (which nearly all Americans are). If you live without the sun and your levels are below 30, you need to demand that your doctor educate themselves on the proper treatment of vitamin D deficiency and get on prescription dose vitamin D with regular blood monitoring until your levels get over 75. Sadly the vast majority of doctors are ignorant of the critical need of the body for Vitamin D and how to properly treat the deficiency…

  • Songo

    Should I be drinking milk fortified with vitamin D? I see lots of these at the grocery.

  • Joe Smith

    I think if the level desired for 'optimal health' can't be proven in multiple studies definitely, this whole vitamin D thing is fishy unless the blood level measures at like some super low level of 2, and again you stated no reason to test. I tested at 15 mg/nl and I bought D2 50k pills, 12 of them, 1 per week. I can still not take them. One thing is sure: I won't take vitamin D pills daily and indefinitely without consistent testing and definitive benefit. I'm quite skeptical of medical or science related to testing or treatment of vitamin D after the wide variation of the test results you showed in the graph.

    I could understand if they have proven, definitive benefits, and consistent testing, but neither? Doctors do more harm than good when they pretend they know more about this Vitamin D than they do, and most of all the supplement industry's influence in studies just makes me think no. I can stop now. Ok, I spent the money, I'll take these 12 pills but I'm not being scared into a supplement.

    My cardiovascular health is going to be phenomenal being on a plant based diet, so from a mortality perspective taking vitamin D to reduce that risk is a moot point. Can they measure soft bones? Really…if my bones start breaking a lot then I worry more. I don't trust the tests and the biased and otherwise objective but limited science behind it.

  • Johnny Boy

    Can you talk about vit D in mushrooms?

  • Quantum Chang

    Take vegan vitamin D3 derived from lichen. Pure and safe.

  • A Happy Broccoli

    We'd need a long term study in which there are several groups with no supplementation and then supplementation going up in steps of 1000 IU or so. And then see which group ends up in best health

  • Quantum Chang

    Doc, could you make a video on the optimum level of serum 25(OH)D3 for people with CKD, since their kidneys are not as efficient at converting the 25(OH)D3 to the active 1,25(OH)2D3 as that of people with full kidney functions? Should CKD people aim for a higher serum 25(OH)D3 than healthy people? What do you think? And would you include discussions on vitamin K2 in the form of MK-7 (sourced from natto beans) as a vitally important combo with vitamin D, since CKD patients tends to have higher rates of atherosclerotic formation throughout the body, especially the arteries?
    Vegan vitamin D3 are readily available now by the way for vegans needing it and very cheap, extracted from lichens.

  • TheMatron'sMilitia

    What about for a 1 year old?

  • ApoE-ε2/ε3

    You forgot to mention genetic predispositions.
    https://www.bmj.com/content/349/bmj.g6330
    https://www.snpedia.com/index.php/Rs7041

  • snarefreak4761

    What about the potential for calcification of arteries when taking supplemental Vitamin D, which could kill you? I've heard about this in a few places, but here's one.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986531/

  • VARUN.N RAO

    Is taking every day 2500IU of Vitamin D and taking 5000IU on alternative days produce same results?

  • Rena Anderson

    I’m a very faithful follower of Dr. Greger, however, we did not “evolve”!!! We were created by God!

  • HairCandy Kina

    Guidelines for balancing D with K?

  • Steve

    I take hormone D

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