#009 Rhonda Answers the Most Popular Questions About Vitamin D
Dr. Rhonda Patrick addresses popular vitamin D questions, including optimal supplementation, potential toxicity, differences between sun-made and supplemental D, and the most bioavailable forms. She discusses factors affecting D levels and the importance of testing.
Deep Dive Analysis
10 Topic Outline
Introduction to Vitamin D Supplementation Questions
Factors Regulating Vitamin D Levels and Synthesis
Defining Adequate and Optimal Vitamin D Blood Levels
Calculating Vitamin D3 Supplementation Dosage
Individual Variability in Vitamin D Needs and Measurement Importance
Risks of Excessive Vitamin D and Toxicity (Hypercalcemia)
Role of Calcium and Vitamin K in Vitamin D Metabolism
Differences Between Sun-Made and Supplemental Vitamin D
Bioavailability of Vitamin D Forms (D2 vs D3)
Factors Affecting Vitamin D Absorption from Supplements
6 Key Concepts
25-hydroxyvitamin D
This is the major circulating form of vitamin D that is measured in blood to indicate a person's vitamin D levels. It is a precursor to the active vitamin D hormone, formed after vitamin D3 is transported to the liver.
Vitamin D Sweet Spot
This refers to blood levels of 25-hydroxyvitamin D between 40 to 60 nanograms per milliliter. Research indicates this range is associated with the lowest all-cause mortality and the longest telomeres, suggesting optimal health outcomes.
Gene Polymorphisms (Vitamin D)
These are variations in the DNA sequence of genes that alter the function of enzymes involved in converting vitamin D3 into its more bioactive forms. Such polymorphisms can make individuals less efficient at processing vitamin D, requiring higher supplementation.
Hypercalcemia
This condition is characterized by high levels of calcium in the blood, which can be an acute consequence of excessive vitamin D intake. High blood calcium can lead to the formation of calcium phosphate crystals in blood vessels, contributing to atherosclerotic plaque formation.
Telomere Length
Telomere length serves as a biological marker for aging; longer telomeres are indicative of a younger biological age and less accumulated cellular damage. Damage, including DNA damage from UVB, accelerates telomere shortening.
Mycele
In the intestine, vitamin D associates with these spherical lipid particles. Myceles, containing vitamin D, are then absorbed by gut cells (enterocytes), a process that is stimulated by the presence of fat and bile acids.
7 Questions Answered
There's no simple answer due to many regulating factors like sun exposure, age, body fat, and genetics. It's recommended to get your vitamin D blood levels measured to determine the appropriate dosage, aiming for the 'sweet spot' of 40-60 nanograms per milliliter.
Blood levels of 25-hydroxyvitamin D between 30 to 80 nanograms per milliliter are generally considered adequate by the Endocrine Society, but studies suggest optimal health benefits are seen in the 'sweet spot' of 40-60 nanograms per milliliter.
Yes, excessive vitamin D can lead to toxicity, primarily through hypercalcemia (high blood calcium), and studies show a U-shaped curve where both very low and very high vitamin D levels are associated with higher all-cause mortality.
Yes, 100% of vitamin D3 produced in the skin from sun exposure is available to the bloodstream, whereas only about 60% of orally supplemented vitamin D3 is available. However, sun exposure comes with the trade-off of causing DNA damage.
Vitamin D3 is more effective at raising serum 25-hydroxyvitamin D levels than vitamin D2. Absorption of supplemental vitamin D is also slightly increased when taken with fat or in a carrier oil like olive oil.
Vitamin K (K1 and K2) is crucial for activating proteins like osteocalcin and matrix gla protein, which ensure that absorbed calcium is directed to bones and other tissues, preventing its accumulation and precipitation in blood vessels.
Age significantly impairs the skin's ability to produce vitamin D; a 70-year-old produces only about 25% of the vitamin D from the same amount of sun exposure compared to a 20-year-old.
18 Actionable Insights
1. Measure Vitamin D Levels
Get your vitamin D levels measured, ideally before and after you begin supplementing, or at the very least a month or two after you’ve started, to ensure efficacy and personalized dosing.
2. Target Optimal Vitamin D
Aim for vitamin D blood levels between 40 to 60 nanograms per milliliter, as studies show this range is associated with the lowest all-cause mortality and longest telomeres.
3. Adjust D3 Supplementation
If deficient (e.g., 20 ng/mL), supplement with 2,000 IUs of vitamin D3 daily to reach 30 ng/mL, or 4,000 IUs daily to reach 40 ng/mL, adjusting based on measured levels.
4. Maintain D Sweet Spot
Strive to maintain vitamin D blood levels between 40 to 60 nanograms per milliliter, as both too low and too high levels are associated with higher all-cause mortality.
5. Ensure Adequate Vitamin K
Ensure you have enough vitamin K1 and K2 to help direct absorbed calcium to bones and other tissues, preventing its accumulation in blood vessels, especially with adequate vitamin D levels.
6. Prioritize Vitamin D3
Choose vitamin D3 supplements over vitamin D2, as D3 has been shown to be more effective at raising serum levels of 25-hydroxyvitamin D.
7. Enhance D Absorption
Take vitamin D supplements with or immediately after a meal containing some fat, or choose supplements where vitamin D is in a carrier oil (like olive oil), to slightly increase absorption and bioavailability.
8. Choose Stable Carrier Oil
Select vitamin D3 supplements that use a stable carrier oil like olive oil, avoiding oils prone to oxidation such as soybean oil.
9. Consider 4,000 IUs D3
Consider taking 4,000 IUs of vitamin D3 per day, especially if you do not get much sun, wear sunscreen, and do not have gene polymorphisms affecting vitamin D conversion.
10. Adjust D3 by Lifestyle
Consider 4,000 IUs of D3 daily if not obese and getting little sun; consider 2,000 IUs daily if not obese and getting a lot of sun (e.g., in Southern California).
11. Increase D3 for Polymorphisms
If you have gene polymorphisms that make your body less efficient at converting D3, you may need to significantly increase your daily dose (e.g., up to 10,000 IUs) to reach adequate levels.
12. Reduce D3 if Levels High
If your vitamin D levels are too high (e.g., 90 ng/mL), reduce your daily supplementation (e.g., from 5,000 IUs to 2,000 IUs) to bring them into the optimal range.
13. Supplement D Over Sun
Consider supplementing with vitamin D rather than relying solely on sun exposure for production, as UVB radiation causes DNA damage which contributes to aging.
14. Understand D3 Dosage Effect
Know that approximately 1,000 IUs of vitamin D3 per day can raise blood levels of vitamin D by five nanograms per milliliter.
15. Supplement with K2
Consider supplementing with around 50 micrograms of vitamin K2 per day, preferably from a natural natto source, as an insurance to ensure calcium goes to the right places.
16. Consult Your Physician
Always run the information by your physician if applicable, as the podcast content is for informational purposes only and not intended as medical advice.
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4 Key Quotes
Just because something's good, something's good for you doesn't mean you want to take excessive amounts of it.
Dr. Rhonda Patrick
The accumulation of DNA damage is one of the major cellular mechanisms of aging, of the aging process.
Dr. Rhonda Patrick
Vitamin D3 made from the sun is more bioavailable than vitamin D3 taken from a supplement. And that's it. That's the only difference.
Dr. Rhonda Patrick
I think it's very important to have enough vitamin K1. And I also like having vitamin K2 in the body to make sure that all the dietary calcium that is absorbed, particularly if you're absorbing 40% of your dietary calcium, if you have adequate vitamin D levels, making sure that the calcium is going to the right place and doesn't form these calcium phosphate crystals in the blood vessels.
Dr. Rhonda Patrick
1 Protocols
General Vitamin D Supplementation Guideline
Dr. Rhonda Patrick- If you are not obese, don't get a lot of sun, and are inside a lot, consider starting with 4,000 IUs of vitamin D3 per day.
- If you are not obese but get a lot of sun (e.g., live in Southern California or Arizona), consider starting with 2,000 IUs of vitamin D3 per day.
- Get your vitamin D levels measured, ideally before and after you begin supplementing, or at least a month or two after you've been supplementing, especially if you suspect gene polymorphisms.
- Adjust your vitamin D dosage based on your blood test results to aim for the 'sweet spot' of 40-60 nanograms per milliliter.
- Consider supplementing with around 50 micrograms of vitamin K2 per day (preferably from a natural natto source) as insurance to ensure absorbed calcium goes to the right places.
- Take vitamin D supplements that are in a carrier oil (like olive oil, avoiding soybean oil) or consume them with a meal that contains some fat to slightly increase absorption.