It's arguably better to count how often one is buying the drops and make an estimation of dosage from that. The daily dosage doesn't matter that much, the aggregate dosage is what's going to count, and it doesn't have to be that precise.
edit: the precision comes from getting blood levels measured after supplementation.
Yes, you can track dosage that way, but squirting it into a beverage and then drinking the beverage is a good way to get off-track. What if you are in the habit of not finishing the entire beverage? Or some reaction or poor mixing occurs? It seems if the directions for a liquid medicine say to squirt it into your mouth, then you squirt it directly into your mouth.
But the trouble with supplementing Vitamin D is that you are treating a symptom. A Vitamin D deficiency usually indicates that you need to touch grass, get outdoors, do some exercise. Since the physician and clinic profit by $0 when they recommend those things, they prescribe you a pill instead. Which idea is a better solution?
Okay look, we are still talking about a symptom and not a disorder. Clearly, the subject of TFA is an aberration, being a football player, ostensibly active and exercising and being outdoors on the regular.
But most people diagnosed with deficiency are not doing any of that.
It really doesn't matter if they're making Vitamin D or whether they're being exposed to UV at all. You could be working in a post in Antarctica, and either you're at a desk job where you're sitting all day and not exercising, or you're working in a storeroom and running around outside doing highly physically demanding things and getting proper exercise. The doctor is clearly going to be concerned about the former person, but what are the indicators?
The people with low Vitamin D need to be retested and monitored during bright summer months to see if the deficiency persists. They need to be up-front about their activities and whether they're exercising properly and getting fresh air at all. The point is not the D nor the UV at all, but the D is what the physicians can detect, and the D is what they will prescribe when it goes off the rails, but what people actually, really need is not prescribable, and it doesn't profit anyone anything, and that's the crux of the problem.
Over here Vitamin D often comes in spray bottles that you're meant to just spray in your mouth. It's more convenient for me than a pill because you don't need to open a container or a glass of water, takes 5 seconds.
I thought it was common knowledge that people with darker skin living further from the Equator have a higher chance of getting vitamin D deficiency and should take supplements. Just like people with lighter skin living closer to the Equator have a higher chance of getting skin cancer and should apply additional sun protection. We have all these adaptations for a reason
Having darker skin and living in a high latitude, especially one where it's not always sunny and inviting to be outside in short sleeves/shorts can lead to this. I am outside a lot, but far enough north that soon I will not get any Vitamin D from the sun - I take a daily supplement, it's cheap insurance. Costco sells 600 for $12.50.
How is it possible that the football player mentioned in the article can suffer from a deficiency level that's severe enough to collapse?
I would expect that regularly being outside (for practice) and a normal balanced diet would be sufficient to at least get by in a country like the UK. Some depressive/lower energy symptoms during winter time, maybe, but nothing so severe as collapsing.
Shouldn't this problem show up in a much larger portion of the population? Or do very physically active individuals require more Vitamin D?
I don't know about the rest of the UK but here in Scotland the NHS recommends that pretty much everyone should think about taking a Vitamin D supplement from October to March and possibly year round for those people in risk groups:
> Shouldn't this problem show up in a much larger portion of the population?
Casual awareness of studies on this suggest that it DOES show up but the symptoms (lowered immune function, seasonal depression, bone issues) are generic and subtle enough to fly under the radar.
It is not helped that, in my experience, many US health plans do not cover the cost of vitamin D testing without a diagnosis of deficiency (which generally requires a test). While that cost is usually low it does mean that it tends not to be offered because practices tend to avoid non-covered procedures for administrative and billing reasons-- you have to actually ask your physician to do the test.
My understanding is that it is somewhat difficult to end up at serum levels of vitamin D that create actual problems, so in general my not-medical-advice suggestion would be to ask your physician about taking a supplement: they're cheap and if everyone took them it is likely population-level health would improve, and it may dramatically improve your QoL particularly in winter months.
The whole article is about the fact that, in the UK, this is an issue that isn't talked about enough. Also, the most likely reason why not all humans are dark-skinned is that it makes you much more susceptible to vitamin D deficiency outside of the topics.
23 years old. "Played football four times a week and felt fit and healthy."
Not necessarily an eating disorder, but there is high likelihood she is on some sort of diet regime. My money would be on low blood sugar lighting the fire on the vitamin D deficiency. I have seen more than a few "fit" marathon types collapse after missing/skipping a meal. They just don't have the reserves.
We tend to forget this here because the weather is mild, but we're further north than anywhere in the lower 48 US states.
It is not yet the beginning of November and sunset in London is at around 4:37pm. An hour and a quarter earlier than New York. It will be like this or darker until February.
Sun intensity by the middle of the day even on a bright day like today is not very high. For example, compared to New York, the sun intensity at noon on the clearest possible day is about half as strong. Compared to LA, getting closer to a third.
We also eat fewer carrots than we used to! And we're increasingly deficient in selenium for food globalism reasons; selenium and vitamin D are synergistic AFAIR?
A fair number of people will have been rescued from vitamin D deficiency by the incredible summer we have had, but it is absolutely a thing and we do not hear enough about it.
Because they did not, that's ridiculous. Just correlation. Their symptoms sound very similar to vasovagal syncope, which is a fairly regular occurrence in young healthy people that perhaps skip breakfast and then get their blood drawn / experience nausea / many other causes. They generally recover fine with no intervention other than some rest and getting a meal.
The article even says explicitly:
> While her symptoms are not directly linked to vitamin D deficiency
My brother after moving to NYC from LA suffered from depression during winter each year. Turns out his Vitamin D levels were also extremely low. Once he started supplementing he felt a lot better. Something to also consider and check if you yourself are affected by seasonal depression.
I live in Michigan, and I have always struggled through the winters.
I recently learned that in the winter, in the North, the angle of the sun is such that UVB rays cannot penetrate the atmosphere and your body therefore cannot produce Vitamin D. Surprisingly few people who live here are aware of this.
I take Vitamin D supplements every winter now and I think it makes a difference.
It's amazing how many different vitamins and minerals we really need to get for optimal health, compared to what we actually do get and are able to muddle along for some time with.
Vitamin D is something its easier to find and still people end up deficient and don't realize it. I think it's particularly telling how the article notes the deficiency can start in the mother and immediately be passed along to a child. How do children grow with inadequate foods? Are we collectively failing to reach our potential?
I've marvelled about this at times. This huge list of vitamins the body cannot formulate itself, but is fully designed to make good use of... but also doesn't just immediately crash and go offline if they're lacking. And how the body can hold onto these molecules/atoms for re-use over years and years.
Be careful. I was constantly reminded of this throughout "gifted" school and it caused massive burnout when I couldn't sustain that expectation anymore in my 40s.
I started taking vitamin D (D3) because one side of my family has a lot of cancer. Within a couple of days, my mood had stabilized and overall improved. Thinking about it when I noticed this, the only thing that had changed for me was taking the vitamin D.
I’ve since observed that when I run out of vitamin D or forget to take it for several days, my mood slowly declines again. Resumption of vitamin D reverses this.
I did not go into this with any knowledge of such an effect. And the vitamin D influence is stronger in this regard than what I’ve experienced from any (legal) drug. That said, it’s hardly overwhelming. Just a bit more resilience and a bit of protection from feeling overwhelmed.
I now take it in combination with K2 as I’ve heard/read K2 helps keep too much of your calcium from being mobilized by the vitamin D.
The D3 isomer is said to be significantly more bio-available than D1 and D2. And, overdosing does have significant negative consequences over time. So, do your research — and I’m not going to suggest any specific dosages.
But after largely negative experiences with what the pharmaceutical industry has to offer, D3 has been an inexpensive and valuable contribution to my well-being.
Wasn't there a study that showed up on HN that said vitamin D is insufficient and there is another component of the sun that we are missing?
Pretty sure it showed up here, but I can't remember more details about it
I thought recent research concluded that supplementation doesn’t actually work, and that vitamin D may be a read hearing and it’s actually just a byproduct of the true benefit (proper) sun exposure
Forgive me, I have no link, I feel like medical and nutrition advice changes 180 daily.
Vitamin D does about a million beneficial things. It is not just about secondary effects of sun exposure. Most D supplementation is done purely via pills and the benefits come without sunlight at all.
I think you may be referring to how D isn't a primary treatment for SAD. It certainly doesn't hurt to get more D in the winter for a lot of other reasons, but SAD is primarily treated via light boxes or anti-depressants.
That being said, vitamin D levels are slowly becoming the new "have you thought about losing some weight" in medicine. My doctor has been hyper vigilant about it, to the point where I felt borderline ashamed about it, and my issues weren't low vitamin D related at all. I felt like I wasted a lot of time and had a lot of stress trying to get my levels up. My body has trouble getting the levels up and I get fatigue from higher doses of the pills, so it was unpleasant. I'm now at the lowest end of normal, which is great, but it took almost two years to get here. It did not fix my original issue at all and I feel set me back two years trying to get my levels up.
Are you in India? I somehow doubt Indians in India are deficient. The rationale is that when you're closer to the equator, you need less sun exposure to produce the appropriate amount of Vitamin D, so people from that region have inefficient production.
It's when those people go to northern latitudes that the inefficiency starts to matter.
As a irregular Vitamin D supplementer myself I wonder if the effect is that significant for so many people anecdotically, why didn’t have have of Europeans and Russians have severe depression historically.
I did controller software for blood (plasma) analysis instruments for over a decade. Vitamin D was actually one of the harder analytes to process. Now that I'm writing this, I don't even remember what was so hard about it. I vaguely remember issues with the reagents clumping together and being harder to separate before they could be properly mixed with the sample.
Eat more mushrooms! Mushrooms contain a natural compound called ergosterol that converts into vitamin D2 when exposed to UV light (similar to our skin!) Even brief exposure to direct midday sun or UV lamps works. Mushrooms are the only non-animal dietary source capable of producing vitamin D. We collaborated on a private astronaut mission to study this in microgravity called Mission MushVroom.
Just take Vitamin D3 supplements. They are cheap like 5 cents for 1000 IU and it is highly bio-available. The supplements have been used for literally decades.
Getting it from mushrooms becomes expensive and quite a chore.
There was a nice HN discussion about an M.D.'s blog re: Vitamin D that includes some notes about toxicity. The doctor showed-up on HN and interacted in the comments, too. I found what she wrote to be valuable.
came here to say the same thing; a family member was made unwell by taking vitamin D supplements for something else minor. Nothing bad and stopped immediately.
Something interesting to me here: "Darker skin" as a standalone term implicitly means white skin is the baseline. We pretty much only see "lighter skin" or "paler skin" when it's in a comparison. We do see the absolute of "pale skin".
I tested as mildly deficient when I moved far North for a job. I'm native, so my skin color didn't help but they get a lot less sun up here. I've never been so pale in my life, lol.
I started taking a D3 and K2 supplement and a year later on my next test I tested in the normal range. Didn't notice any changes from taking the supplement, but it probably doesn't hurt to have it in my body if my body needs it.
That being said, I would test. No sense in having too much.
Being active and getting outside are associated with a multitude of health benefits and is correlated with vitamin D level. The Vitamin D Council pushes vitamin D supplementation based on this research (and funds it?) but there is minimal methodologically rigorous research showing health benefits from exogenous supplementation.
The person interviewed in the BBC article is a football player and fits the bill of 'active' and 'gets outside', none of which addressed the underlying issue.
My read on this article, which is validated by all the comments in this thread, is that it's a PSA to public health officials to have better outreach for darker skinned individuals living in the UK who seem to be getting systematically misdiagnosed because of a lack of knowledge.
> there is minimal methodologically rigorous research showing health benefits from exogenous supplementation.
In this day and age, this shouldn't be an open question tbh. There is an extensive body of research, with dozens of meta-analysis / systematic reviews aiming to settle the score on this. If you let Claude or your favorite LLM du jour loose on Pubmed I'm sure it will surface some very reliable conclusions.
> In this day and age, this shouldn't be an open question tbh.
Are you being paid by the Vitamin D council or something? I thought HN was about curious conversation.
> There is an extensive body of research, with dozens of meta-analysis / systematic reviews aiming to settle the score on this. If you let Claude or your favorite LLM du jour loose on Pubmed I'm sure it will surface some very reliable conclusions.
After I finished my degree in human nutrition, I decided to go to medical school because of the amount of free time I was spending on PubMed. I previously had high hopes for vitamin D, but I am now a skeptic specifically due to the dearth of rigorous and supportive studies on PubMed.
Do you have any favorite trials of exogenous supplementation that are in humans, large sample size, RTC with appropriate blinding, and have positive, meaningful / non-surrogate outcomes? This would seem easy to accomplish given its wide availability, low cost, and excellent safety margin.
> who seem to be getting systematically misdiagnosed because of a lack of knowledge
In contrast, vitamin D testing seems to be fairly commonplace in my practice setting, and unfortunately I see it being used as a scapegoat for dubious symptoms routinely.
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[ 0.19 ms ] story [ 103 ms ] threadIsn't that more complicated and way less precise in dosage than just taking a pill every day (or a higher dose one every week)?
edit: the precision comes from getting blood levels measured after supplementation.
But the trouble with supplementing Vitamin D is that you are treating a symptom. A Vitamin D deficiency usually indicates that you need to touch grass, get outdoors, do some exercise. Since the physician and clinic profit by $0 when they recommend those things, they prescribe you a pill instead. Which idea is a better solution?
People are usually supplementing Vitamin D during the time of the year where there's essentially zero UV light outdoors
Okay look, we are still talking about a symptom and not a disorder. Clearly, the subject of TFA is an aberration, being a football player, ostensibly active and exercising and being outdoors on the regular.
But most people diagnosed with deficiency are not doing any of that.
It really doesn't matter if they're making Vitamin D or whether they're being exposed to UV at all. You could be working in a post in Antarctica, and either you're at a desk job where you're sitting all day and not exercising, or you're working in a storeroom and running around outside doing highly physically demanding things and getting proper exercise. The doctor is clearly going to be concerned about the former person, but what are the indicators?
The people with low Vitamin D need to be retested and monitored during bright summer months to see if the deficiency persists. They need to be up-front about their activities and whether they're exercising properly and getting fresh air at all. The point is not the D nor the UV at all, but the D is what the physicians can detect, and the D is what they will prescribe when it goes off the rails, but what people actually, really need is not prescribable, and it doesn't profit anyone anything, and that's the crux of the problem.
Australia has seemingly taken the lead on advice (re vitamin d or skin cancer risks) that's based on skin color.
https://www.abc.net.au/news/2024-02-13/sun-safety-position-s...
Traditionally, health notes always just assume you're a white male.
I would expect that regularly being outside (for practice) and a normal balanced diet would be sufficient to at least get by in a country like the UK. Some depressive/lower energy symptoms during winter time, maybe, but nothing so severe as collapsing.
Shouldn't this problem show up in a much larger portion of the population? Or do very physically active individuals require more Vitamin D?
IIUC, yes they do. They don’t “spend it” as such, they require higher serum levels overall (compared to sedative individuals, all else equals).
https://www.nhsinform.scot/healthy-living/food-and-nutrition...
You ever heard of a thing called a "clickbait headline"?
Casual awareness of studies on this suggest that it DOES show up but the symptoms (lowered immune function, seasonal depression, bone issues) are generic and subtle enough to fly under the radar.
It is not helped that, in my experience, many US health plans do not cover the cost of vitamin D testing without a diagnosis of deficiency (which generally requires a test). While that cost is usually low it does mean that it tends not to be offered because practices tend to avoid non-covered procedures for administrative and billing reasons-- you have to actually ask your physician to do the test.
My understanding is that it is somewhat difficult to end up at serum levels of vitamin D that create actual problems, so in general my not-medical-advice suggestion would be to ask your physician about taking a supplement: they're cheap and if everyone took them it is likely population-level health would improve, and it may dramatically improve your QoL particularly in winter months.
Not necessarily an eating disorder, but there is high likelihood she is on some sort of diet regime. My money would be on low blood sugar lighting the fire on the vitamin D deficiency. I have seen more than a few "fit" marathon types collapse after missing/skipping a meal. They just don't have the reserves.
We tend to forget this here because the weather is mild, but we're further north than anywhere in the lower 48 US states.
It is not yet the beginning of November and sunset in London is at around 4:37pm. An hour and a quarter earlier than New York. It will be like this or darker until February.
Sun intensity by the middle of the day even on a bright day like today is not very high. For example, compared to New York, the sun intensity at noon on the clearest possible day is about half as strong. Compared to LA, getting closer to a third.
We also eat fewer carrots than we used to! And we're increasingly deficient in selenium for food globalism reasons; selenium and vitamin D are synergistic AFAIR?
A fair number of people will have been rescued from vitamin D deficiency by the incredible summer we have had, but it is absolutely a thing and we do not hear enough about it.
The article even says explicitly:
> While her symptoms are not directly linked to vitamin D deficiency
I recently learned that in the winter, in the North, the angle of the sun is such that UVB rays cannot penetrate the atmosphere and your body therefore cannot produce Vitamin D. Surprisingly few people who live here are aware of this.
I take Vitamin D supplements every winter now and I think it makes a difference.
https://pubmed.ncbi.nlm.nih.gov/2839537/
Vitamin D is something its easier to find and still people end up deficient and don't realize it. I think it's particularly telling how the article notes the deficiency can start in the mother and immediately be passed along to a child. How do children grow with inadequate foods? Are we collectively failing to reach our potential?
Be careful. I was constantly reminded of this throughout "gifted" school and it caused massive burnout when I couldn't sustain that expectation anymore in my 40s.
I’ve since observed that when I run out of vitamin D or forget to take it for several days, my mood slowly declines again. Resumption of vitamin D reverses this.
I did not go into this with any knowledge of such an effect. And the vitamin D influence is stronger in this regard than what I’ve experienced from any (legal) drug. That said, it’s hardly overwhelming. Just a bit more resilience and a bit of protection from feeling overwhelmed.
I now take it in combination with K2 as I’ve heard/read K2 helps keep too much of your calcium from being mobilized by the vitamin D.
The D3 isomer is said to be significantly more bio-available than D1 and D2. And, overdosing does have significant negative consequences over time. So, do your research — and I’m not going to suggest any specific dosages.
But after largely negative experiences with what the pharmaceutical industry has to offer, D3 has been an inexpensive and valuable contribution to my well-being.
https://pubmed.ncbi.nlm.nih.gov/35979473/
Forgive me, I have no link, I feel like medical and nutrition advice changes 180 daily.
Does this ring a bell to anyone?
I think you may be referring to how D isn't a primary treatment for SAD. It certainly doesn't hurt to get more D in the winter for a lot of other reasons, but SAD is primarily treated via light boxes or anti-depressants.
That being said, vitamin D levels are slowly becoming the new "have you thought about losing some weight" in medicine. My doctor has been hyper vigilant about it, to the point where I felt borderline ashamed about it, and my issues weren't low vitamin D related at all. I felt like I wasted a lot of time and had a lot of stress trying to get my levels up. My body has trouble getting the levels up and I get fatigue from higher doses of the pills, so it was unpleasant. I'm now at the lowest end of normal, which is great, but it took almost two years to get here. It did not fix my original issue at all and I feel set me back two years trying to get my levels up.
https://www.nejm.org/doi/full/10.1056/NEJMoa1809944 https://www.nejm.org/doi/full/10.1056/NEJMoa2202106 https://www.thelancet.com/journals/lanwed/article/PIIS2213-8... https://pubmed.ncbi.nlm.nih.gov/24445737/ https://pubmed.ncbi.nlm.nih.gov/24697969/ https://pubmed.ncbi.nlm.nih.gov/26992108/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2290997/
It’s really hard to believe that all the benefit of the sun can be achieved in a single pill.
It's when those people go to northern latitudes that the inefficiency starts to matter.
Getting it from mushrooms becomes expensive and quite a chore.
https://mitohealth.com/products/vitamin-d-25-hydroxy-calcidi...
https://news.ycombinator.com/item?id=24138590
Is there an non-lab way to know if you're vitamin D deficient?
Also old or dark skinned? Double yes.
I started taking a D3 and K2 supplement and a year later on my next test I tested in the normal range. Didn't notice any changes from taking the supplement, but it probably doesn't hurt to have it in my body if my body needs it.
That being said, I would test. No sense in having too much.
> While her symptoms are not directly linked to vitamin D deficiency
Being active and getting outside are associated with a multitude of health benefits and is correlated with vitamin D level. The Vitamin D Council pushes vitamin D supplementation based on this research (and funds it?) but there is minimal methodologically rigorous research showing health benefits from exogenous supplementation.
My read on this article, which is validated by all the comments in this thread, is that it's a PSA to public health officials to have better outreach for darker skinned individuals living in the UK who seem to be getting systematically misdiagnosed because of a lack of knowledge.
> there is minimal methodologically rigorous research showing health benefits from exogenous supplementation.
In this day and age, this shouldn't be an open question tbh. There is an extensive body of research, with dozens of meta-analysis / systematic reviews aiming to settle the score on this. If you let Claude or your favorite LLM du jour loose on Pubmed I'm sure it will surface some very reliable conclusions.
Are you being paid by the Vitamin D council or something? I thought HN was about curious conversation.
> There is an extensive body of research, with dozens of meta-analysis / systematic reviews aiming to settle the score on this. If you let Claude or your favorite LLM du jour loose on Pubmed I'm sure it will surface some very reliable conclusions.
After I finished my degree in human nutrition, I decided to go to medical school because of the amount of free time I was spending on PubMed. I previously had high hopes for vitamin D, but I am now a skeptic specifically due to the dearth of rigorous and supportive studies on PubMed.
Do you have any favorite trials of exogenous supplementation that are in humans, large sample size, RTC with appropriate blinding, and have positive, meaningful / non-surrogate outcomes? This would seem easy to accomplish given its wide availability, low cost, and excellent safety margin.
In contrast, vitamin D testing seems to be fairly commonplace in my practice setting, and unfortunately I see it being used as a scapegoat for dubious symptoms routinely.