Vitamin D in the summer

[Shashi]

Now that it's warmed up outside, I'm spending more time outdoors, usually anywhere from 15 to 30 minute per day, unless I'm swimming, in which case it'll be a couple of hours in the sun.

I'm currently taking, on the advice of my doctor, 10,000 IU of Vitamin D3 every night. Would I still need to take this much Vit. D if I'm spending time outside? (I need to schedule an appointment to get my Vit. D rechecked, along with my cholesterol.)

[Sequoia]

Whether or not you would need to reduce the dose on the D3 would depend on the blood test results.

[struck-a-nerve]

Good question!

I just found out today my D3 is 15!! Holy cow. Waiting for my PCP to call and tell me how much to take. I will ask her about the sun as well and let you know what she says

[JerryD]

Just for kicks... what is the worry about vitamin D ? Let's go over some simple stats. When your PCP sees that your vitamin D is under 20, he will probably give you a shot with about 20,000 up to 50,000 iu's. In one shot !!
If you take 5000 to 10,000 iu's per day, it will probably take a while to reach a median range.
And remember that people with MS probably don't have the metabolisms of those people who are 'healthy'. Vitamin D is a hormone. How is your body doing with producing the other hormones that 'normally' would be automatically produced by your system.
I guess, other than a contra-indication with other meds one would take, I have to think if it occurs naturally in food or from sunlight or if the body produces it, automatically, it is probably needed by your body to exist.
Asking a regular MD about vitamins or nutrition is almost a joke. Unless you find one that is involved with 'integrative' medicine. Good luck in your quest.

[struck-a-nerve]

Asking a regular MD about vitamins or nutrition is almost a joke. Unless you find one that is involved with 'integrative' medicine. Good luck in your quest.

FYI....my MS neruo ran the tests, who is excellent and believes in keeping the PCP in the loop on all things regarding my health and allows them to work with me on all possible items they can. This is a referral back to my PCP from my neuro. I feel like I am in excellent hands.

....

[Ted Hutchinson]

If you go to the GRASSROOTSHEALTH website you will find a graph of different daily intakes and the measured 25(OH)D range that produced in different people.
For each different daily intake the different responses are around 100ng/ml or 250nmol/l.
So with that amount of variation no one can predict how your body will respond.
We can only suggest that 1000iu daily for each 25lbs you weigh is a good starting point and retesting using the postal 25(OH)D blood spot tests (about £25 in UK NHS CityLabs £30 international) after 3~6 months will show you if that is sufficient.
Remember MS is an inflammatory condition and Vitamin D is most effective as an anti inflammatory agent around 50ng/ml or 125nmol/l so keeping your vit d above that level will reduce the progression and minimize disabling consequences.

I can't post links as I'm new here but if you search for
"Vitamin D Levels Correspond to Disability in MS"
You should find an article by Dr. Ellen Mowry explaining her research showing higher vitamin D less disability. She's done other work with MRI scans showing more vit d fewer new lesions so there should be no delay in getting your 25(OH)D up into the 50~60ng/ml zone.

I'm not convinced that swimming/sunbathing does much to raise Vit d levels. The vit d is made very near the surface of the skin and while you may get some absorption while you are in the sun the swimming/towelling dry/showering may remove some of the newly made d3.

How much you make also depends on age and cholesterol level, many people are cholesterol reducing and 7 dehydrocholesterol the molecule that converted to Cholecalciferol (vitamin D3) by UVB is in the cholesterol family. You can't reduce the amount of cholesterol your body makes without also prematurely ageing your ability to create vitamin D3. Another factor is BMI. The more overweight you are the lower your vitamin d in plasma as it tends the bulk of your body is diluting the action/effect of vit d. (hence the importance of adjust intake to your weight)

[Sequoia]

Hi Ted,

Any member can post links here, providing the links are to reputable sources.

Only links posted by Moderators will be live links. The rest can be cut-and-pasted into your browser.

[JerryD]

Ted,
Very well stated .
I just looked at an article on Web MD about vitamin D levels. Really the best thing to do is get lab tested and supplement as needed. I am at around 55 ng/ml and my doctor said to try to get it closer to 70 but I am at a safe level now. For those who are smart enough to check their levels, it turns out there may be a connection to heart disease and some other life threatening maladies. So, even though I am not a doctor, I think everyone should get it tested.
Vitamin D is synthesized by the skin in conjunction with the liver ( utilizing cholesterol ) through sunlight absorption . Using sunblock, wearing sunglasses and covering ones body with clothing would hamper vitamin D production. And there may be a genetic connection to the inability to produce the correct amounts desired, as well.
So get it tested, and fix it soon. Good luck

[JerryD]

I just read this on the NIH site. The range that is best for vitamin D in the blood is between 30 ng/mL to 50 ng/mL. If you are tested and the number isn't at least 30, you are considered insufficient. That is like being malnourished.
I am at around 45 ng/mL and my doctor says to continue to take 5000 iu's daily. He would like me to achieve a level of 70 ng/mL.
The site says that MD's could prescribe as mmuch as 50,000 iu's per week for people that are extremely deficient.
So I think it is relatively clear that we all should know our levels and get them checked regularly.

[struck-a-nerve]

Jerry you levels are great! How long have you been on D? And do you know your baseline? I am so curious to follow the process of getting my levels up.

[Kimmy92279]

I just read this on the NIH site. The range that is best for vitamin D in the blood is between 30 ng/mL to 50 ng/mL. If you are tested and the number isn't at least 30, you are considered insufficient. That is like being malnourished.

I remember when I was first diagnosed in January I had my Vit D and B12 levels checked at the time. Technically I was borderline around 30 for Vit D. My nurse practitioner mentioned though that with all the new research coming out about Vit D and it's importance there's been talk of upping that good range to be between 50-70. I just rechecked after taking 4000 a day for the last few months and I'm finally up in the 50's thankfully.

[Ted Hutchinson]

I just read this on the NIH site. The range that is best for vitamin D in the blood is between 30 ng/mL to 50 ng/mL. If you are tested and the number isn't at least 30, you are considered insufficient. That is like being malnourished.

But as we also know that naturally people living outdoor near naked lives in sunny places tend to reach vitamin D equilibrium at 50ng/ml the top end of the range seems more sensible.

Who thinks human milk should be a complete vitamin d replete food for human babies?
That won't happen unless the mother has a 25(OH)D around 60ng/ml

Having a paler skin and nearly hairless body enables higher vitamin D3 production and living away from the equator those people with palest skin were able to make and STORE more vitamin D. The half life of plasma vit d is about 3 weeks and the Vitamin D unavailable winter above latitude 50N lasts from the end of September through to the end of Feb, so you can work out how many half lives that is.

Imagine your life savings being halved every 3 weeks and you can see you have to have a lot of vitamin d capital stored in TISSUE as well as plasma to survive that Vit d winter. We only have significant amounts of vitamin D stored in tissue around 60ng/ml.

[Twenty Miles]

My blood tests always show low D. I take 20,000 iu per day. I've debated with sun exposure if I should reduce the dose. My sun exposure is infrequent so, if anything I might reduce 1 or 2 doses by 5,000 units. I can say this that I feel remarkably better at a higher dose.

[Ted Hutchinson]

My blood tests always show low D. I take 20,000 iu per day.

Are you sure you are taking vitamin D3 and vitamin D2. The form created in the human body is Vitamin D3 Cholecalciferol, the plant form Vitamin D2 Ergocalciferol tends to speed up the rate at which Vitamin D is used up. I've heard of one woman using 150,000iu Vitamin D2 daily (prescribed by her doctor) in an effort to raise 25(OH)D. Vitamin D3 doesn't need converting so you are able to use it quicker easier and without any loss so it's much more effective.

I've debated with sun exposure if I should reduce the dose. My sun exposure is infrequent so, if anything I might reduce 1 or 2 doses by 5,000 units. I can say this that I feel remarkably better at a higher dose.

Personally I'd only suggest people reduced vitamin d3 intake AFTER they have had a 25(OH)D showing a level significantly above 70ng/ml

It may also be that you are short of vitamin D cofactors such as MAGNESIUM
The vitamin D Council explains the role of magnesium and vitamin D metabolism at the VITAMIN D COUNCIL DOT ORG about-vitamin-d/vitamin-d-cofactors/magnesium/

Particularly when taking higher amounts of vitamin D3 it's a good idea to check magnesium intake. There are online calculators that will help you work out how much you are getting from food. But most people will benefit from an extra 500mg/daily from supplements. 100mg with each meal and 100mg before bed. There are various ways of supplementing with magnesium unfortunately only 4% of the magnesium in MAGNESIUM OXIDE is absorbed so it's a pity that mg oxide is the most common form in supplements.

The other vitamin D cofactors are listed at the vitamindcouncil vitamin-d-cofactors website.
and again it's worth checking that you have adequate sources of all of these if you want the vitamin D you are taking to be used effectively and safely.

PS it's still telling me I can't post url's

[Twenty Miles]

Hello,
Yes I do take D3 etc.

Also I take Magnesium at two different times of the day per Tara's instructions.

My last blood test was in July, with taking 5,000 iu my Vit D 25 on my blood test came in at 26.1.

Thanks for the information.