Vitamin D3

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Original article: http://defymedical.com/resources/health-articles/163-vitamin-d3


Vitamin D-3


Vitamin D is the name given to a vitally important group of micro-nutrients. When activated, vitamin D becomes a potent steroid hormone, switching our genes on or off, and instructing our cells what work to do. Vitamin D's effects are varied and profound. It is structurally similar to steroids such as testosterone, cholesterol, and cortisol (though vitamin D3 itself is a secosteroid). The term "vitamin D" refers to several different forms of this vitamin. Two forms are important in humans: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Vitamin D2 is synthesized by plants. Vitamin D3 is synthesized by humans in the skin when it is exposed to ultraviolet-B (UVB) rays from sunlight. Foods may be fortified with vitamin D2 or D3, although human’s should not rely on synthetic food fortification as a good source of Vitamin D3.
Cholecalciferol (vitamin D3) has many health benefits when levels are kept optimal and away from deficiency. This benefits include;
Anti-Inflammatory- Chronic inflammation is becoming a major focus as a cause of many disease processes such as heart disease and cancer. D-3, also called “The anti-inflammatory” hormone, has been studied as an effective treatment to reduce chronic inflammation. Vitamin D deficiency is often misdiagnosed as fibromyalgia, chronic fatigue syndrome, and others. Deficiency has also been associated with multiple sclerosis, graves disease, and age related muscle wasting. Degenerative arthritis also progresses more rapidly when there is a deficiency of Vitamin D because of its anti-inflammatory properties.
Blood Sugar Control- Deficiency of Vitamin D and D3 can inhibit the proper secretion of insulin and lead to increased insulin resistance. Studies show that supplementing with D3, especially during winter months, can help prevent and reverse Type II diabetes. The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. (Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R. Source Department of Endocrinology, University Hospital, 6 Damjan Gruev str, 1303 Sofia, Bulgaria. )
Optimal Immune Function- Vitamin D helps the immune system to fight infections. With a near-optimum blood level of vitamin D, you can expect fewer colds, 'flu, and other unwelcome opportunists (including Swineflu). Not only does Vitamin D enhance your immunity, but it inhibits the development of destructive auto-immune diseases such as diabetes, rheumatoid arthritis, lupus and multiple sclerosis.
Vitamin D is a major inhibitor of cancer, and part of this effect may be attributed to the increased vigilance of the immune system.
Blood Pressure- Optimum levels of Vitamin D3 actually tend to reduce blood pressure in hypertensive people. Supplementing with Vitamin D can help reduce the risk for hypertention.
Obesity- Deficiency of Vitamin D3 can lead to metabolic syndrome which contributes to the rapid accumulation of fat mass.

Receptor Deficiency of Vitamin D can cause:
Brain (D modulates neurotransmitters) : Depression (seasonal affective disorder)
Breast: Cancer
Skin : Psoriasis
Prostate : Cancer
Lymphocytes : Interruption in immune response
Ovaries: Cancer
Islet cells of pancreas : Diabetes
Muscle and bone : Achy and soreness, pain
Aortic endothelium : Cardiovascular disease
How supplied:

Oral capsule
Sublingual Troche
Oil Based Injectable

Pharmacy Compounded:

Vitamin D3 25,000iu Sublingual
Vitamin D3 50,000iu/ml Injectable
Vitamin D3 25,000iu-50,000iu capsule
How to Take D3:

Usually 10,000iu per day is recommended for oral use in patients who are deficient. 25,000iu-50,000iu administered orally once per week is also commonly prescribed. Here is more information regarding once per week D3 dosing: http://defymedical.com/resources/health-articles/225-vitamin-d3-a-new-way-to-take-d3-and-save-moneyThis email address is being protected from spambots. You need JavaSc
Find out if you are Vitamin D3 Deficient

You can find out if you are deficient in D3 through a simple blood test. Most lab companies offer D3 testing.
Side effects:

Can too much vitamin D be harmful? Yes, it certainly can - though anything can be toxic in excess, even water. As one of the safest substances known to man, vitamin D toxicity is very rare. In fact, people are at far greater risk of vitamin D deficiency than they are of vitamin D toxicity. ~ taken from The Vitamin D Council
What is vitamin D toxicity?
Vitamin D toxicity is a condition where blood serum concentrations of vitamin D’s storage form, 25(OH)D or calcidiol, become too high, causing adverse systemic effects.
How it happens
There is no risk of vitamin D toxicity due to sun exposure.
Because the body has a built in mechanism for preventing toxicity with vitamin D produced in the skin, there is no risk of vitamin D toxicity due to ultraviolet-B (UVB) exposure - whether from the Sun or a tanning bed.
Supplemental vitamin D bypasses this built-in protection and, if excessive amounts are consumed over a period of time, 25(OH)D blood levels can reach a point where toxicity is possible.
Toxic doses
What exactly constitutes a toxic dose of vitamin D has yet to be determined, though it is possible this amount may vary with the individual.
Published cases of toxicity, for which serum levels and dose are known, all involve intake of > or = 40000 IU (1000 mcg) per day. 1 Two different cases involved intake of over 2,000,000 IU per day - both men survived. 2 3
Serum levels: upper limit and toxicity threshold
Upper limit for a substance is the amount up to which is considered safe and without risk of adverse effects in the majority of the population.
Toxicity threshold for a substance is the amount beyond which over-saturation occurs and symptoms of toxicity manifest.
These values for 25(OH)D are as follows:
Toxicity threshold level - 200-250 ng/mL (500-750 nmol/L)
Upper limit - 100 ng/mL (250 nmol/L)
The large range between 25(OH)D’s upper limit and its threshold value implies a degree of safety at serum levels up to 100 ng/mL (250 nmol/L), since concentrations twice this amount have yet to ever be associated with toxicity. 4 In animal models, serum concentrations have reached as high as 400-700 ng/mL (1,000-1750 nmol/L) before toxic effects (severe hypercalcemia) were observed. 8 9
Symptoms: toxicity and overdose
Signs of vitamin D toxicity are high urine and blood calcium.
The first sign of vitamin D toxicity is hypercalcuria (excess calcium in the urine) followed by hypercalcemia (high blood calcium). The following symptoms may present:
nausea
vomiting
poor appetite
constipation (possibly alternating with diarrhea)
weakness
weight loss
tingling sensations in the mouth
confusion
heart rhythm abnormalities
The immediate symptoms of vitamin D overdose are:
abdominal cramps
nausea
vomiting
What to do if you think you are vitamin D toxic
Vitamin D is not toxic when used in the amounts Nature intended.
It is fairly difficult to become toxic using vitamin D3. If you think you may be toxic because you are having an adverse reaction to vitamin D but you have not been using excessive amounts like those described above, your symptoms could be due to reasons other than toxicity.
Test serum levels
First thing is to stop supplementation, then have your physician help you determine if you are toxic by testing your 25(OH)D levels. This is the same test used to determine vitamin D deficiency.
Rule out other possibilities
If results indicate levels lower than 200-250 ng/mL (500-750 nmol/L), you are most likely not toxic. In this case, the reaction you experienced may be a result of:
An underlying magnesium deficiency. This is the most common reason for symptoms brought on by using vitamin D.
Vitamin D hypersensitivity due to pre-existing high blood calcium (hypercalcemia). Often mistaken for vitamin D toxicity, hypercalcemia is a rare condition usually caused by one of the following:
primary hyperparathyroidism (most common cause)
sarcoidosis
granulomatous TB
some cancers
If toxic, reduce serum levels
If the results show a serum 25(OH)D level of 200-250 ng/mL (500-750 nmol/L) or more, you could be toxic. The following measures should be taken until vitamin D levels return to normal:
avoidance of direct sunlight exposure
avoidance of foods and supplements containing vitamin D
restriction of calcium intake
drinking 8 glasses of water daily
Once 25(OH)D levels have normalized, sunlight exposure and/or vitamin D supplementation can be resumed, taking care not to overdo it.
In most cases, vitamin D toxicity can be corrected without lasting problems, provided the body has not remained in a hypercalcemic state for too long. Hypercalcemia has the potential to cause soft tissue calcification, resulting in deposits of calcium crystals in the heart, lungs, and/or kidneys. With prolonged hypercalcemia, permanent damage is possible if calcification is severe enough.
References
Vieth, R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999 May; 69 (5): 842-56.
Koutkia, P. Chen, T. C. Holick, M. F. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med. 2001 Jul 5; 345 (1): 66-7.
Los Angeles Times Supplements guru sues over his own product. 2010/4/29;
Jones, G. Pharmacokinetics of vitamin D toxicity. Am J Clin Nutr. 2008 Aug; 88 (2): 582S-586S.
Heaney, R. P. Vitamin D: criteria for safety and efficacy. Nutr Rev. 2008 Oct; 66 (10 Suppl 2): S178-81.
Vieth, R. Vitamin D toxicity, policy, and science. J Bone Miner Res. 2007 Dec; 22 Suppl 2V64-8.
Vieth, R. Critique of the considerations for establishing the tolerable upper intake level for vitamin D: critical need for revision upwards. J Nutr. 2006 Apr; 136 (4): 1117-22.
NIH Office of Dietary Supplements Dietary Supplement Fact Sheet: Vitamin D. 2009/11/13;
Deluca, H. F. Prahl, J. M. Plum, L. A. 1,25-Dihydroxyvitamin D is not responsible for toxicity caused by vitamin D or 25-hydroxyvitamin D. Arch Biochem Biophys. 2010 Oct 18;
Baynes, John W, Dominiczak, Marek H. Medical Biochemistry 2nd edition. Elsevier Ltd 2005.
Robbins and Cotran. Pathologic Basis of Disease. Elsevier Ltd. 2005
Regalla, Sylvia MD. Dr. Jeffrey K.Harris Memorial Integrative Health Care Series. Rochester General Hospital. “Vitamin D; More than the sunshine vitamin”. October 17th,, 2009
These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
 
Defy Medical TRT clinic doctor
Thanks for the articles Nelson!

It is surprising to me that almost every patient who blood tests D3 is very deficient, or at least low-normal. Especially surprising here in FL where people tend to get more sunlight. I have also noticed that the typical dose of 5,000iu daily does not seem to increase levels sufficiently. Since its a fat soluble nutrient (or technically hormone) and can be toxic at high dosages so it is good to blood test D3 levels at least once during supplementation to make sure levels are not too high. Toxicity should not happen using the typical dosages described above.
 

Vince

Super Moderator
Effects of Vitamin D Supplementation on Insulin Sensitivity and Insulin Secretion in Subjects With Type 2 Diabetes and Vitamin D Deficiency: A Randomized Controlled Trial
http://care.diabetesjournals.org/content/early/2017/04/27/dc16-2302?platform=hootsuite
CONCLUSIONS Replenishment with a large dose of vitamin D[SUB]3[/SUB] to patients with T2D and vitamin D deficiency did not change insulin sensitivity or insulin secretion. These findings do not support such use of therapeutic vitamin D[SUB]3[/SUB] supplementation to improve glucose homeostasis in patients with T2D.
 

Will Brink

Member
10,000iu per day put me over the top of the range on the Quest 25 Hydroxy test. Might be OK to start at this dose, but it should be titrated via testing.

In people diagnosed deficient, 5k IU is a better starting dose in my experience. Only met a few that needed 10K and above to get to the mid/upper range of 25OHD, but they do exist. A discussion between Dr. Lopez and myself on various topics RE D3:

Brink Zone Radio – Vitamin D3, panaceia or scam?
 
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