One pharmacist who is very pro vitamin D
The following was written in Dec 2010, before he retired.
This is the start of the entire PDF which is attached at the bottom of this page
This is a set of my recommendations based on the body of evidence I have reviewed, in the form of studies, study summaries, and medical journal articles.
It is not endorsed by {my previous company} nor is it meant in any way to be contradictory to the instructions of your physician. You remain the ultimate one responsible for your health, and your physician is an important and leading part of your healthcare support team. If you see a contradiction in what is contained herein, please talk with your doctor and explore your best interests.
I recommend that anyone under the age of 45 attempt to get sun exposure of arms, legs, and trunk of body sufficient to cause the skin to begin to "pink up", but never ever so much as to cause a sunburn, on as near to a daily basis as possible. In the winter, that means that you can only do this while the sun is highest in the sky (your shadow must be shorter than you are).
During the summer months here in Texas, stay away from the heat of the day and get sun midmorning and midafternoon, for example. For a typical Caucasian teenager, 15 minutes to 1 hour of exposure will generate approximately 5,000iu of vitamin D3. For any teenager with naturally darker skin, it may take FIVE TIMES AS LONG to generate that 5,000iu. This has horrible ramifications in my mind for black women who are pregnant and deficient - question is, does this have anything to do with the statistic in the US that % of all African-american males drop out/are in & out of the legal system?
Lifeguards have been measured to make more than 20,000 iu during a day at work at the swimming pool, and there are no adverse effects because the body will only activate and use what it needs. The rest might be stored, as Vitamin D3 is a "fat-soluble" vitamin, but it is never stored when you are deficient, and estimates are that at least % of all Americans of all ages are classifiable as deficient, and it is worse as you live further north. If you are over 45, your skin has begun losing its ability to make Vitamin D3. No food has enough Vitamin D3 naturally, and the amount added to milk, for example, is of no use to anyone. After 45 or so, or if you can't get out, you must take a tablet or capsule of D3. I vastly prefer D3 (over D2) because it is the actual chemical your body makes when the sun's UV-B rays hit cholesterol in your skin. This is one reason why there are virtually no reports anywhere of D3 causing any adverse effects, even when taken in ridiculous amounts! The prescription version, called vitamin D2 (ergocalciferol), comes in 50,000iu strength only and being made by radiating mushrooms, is completely foreign to your body. Your body tries to convert ergocalciferol to cholecalciferol(vitamin D3), but is not very good at it. That is why each D2 cap has TEN times the amount of the OTC vitamin D3, and why your doctor prescribes one capsule a week, or a month, rather than every day. For most people, the body will be able to make/convert "some" D3 from the D2, but it varies wildly from person to person.
There ARE also examples in the literature of D2 causing harm when overdosed.
My first recommendation is to get tested and find out first, whether your insurance plan will cover you getting tested. If not, you need to find out up front how much your doctor/lab will charge you - mine charged $320 out of pocket. So at the same time, I also had ZRT Labs ( www.zrtlab.com ) test me, at a cost of $75. The results were within 1 or 2 points of each other, and I have since learned that ZRT is widely considered reliable and accurate for a host of lab tests, not just 25(OH)D . (That is the name of the test that must be used - there are other versions that are useless, so make sure your dr. orders this one if you are able to get insurance coverage).
After testing, you must take enough D3 to get your blood level to at least 50 ng/ml and preferably slightly higher. I consider 100 ng/ml to be the safe and prudent upper limit goal at this point, but I am open to further studies helping me choose a different level.
To my knowledge, since your body makes and controls it, Vitamin D3 5,000iu capsules do not, repeat, not, cause any adverse effects. No constipation. No diarrhea. No indigestion. No interaction with any other medication. In short, no reason to NOT take it, other than the fact that it costs around $16 per 100 count bottle (and often it is on sale as a "buy one, get a second one free"). There ARE a few rare people who are prone to hypercalcemia and have other rare diseases, and D3 is not for you unless your doctor says so.
As you will see in this set of documents, D3 not only helps insure that you can absorb calcium, but that it helps you avoid the flu, proven to improve muscular performance in people/elite athletes, helps avoid falls in the plus 50 set, has influence over at least 1000 different genes in the human genome, influences at least 20 cancers, and far more. It has been determined that every organ in your body has 3-D receptor sites that are specific for vitamin D3 (but NOT D2). It appears to me that virtually every organ relies on having vitamin D3 in order to work properly. There is a growing body of evidence that there is a link between D3 deficiency and: Nervous system deficiencies in babies, particularly autism, asthma, auto-immune diseases, multiple sclerosis, both forms of diabetes, the list goes on and on in a horrifying way. There is an irony, a sick joke, here and that is why I chose the word "horrifying'. Black/dark complexions actually block the formation of D3 as you get further from the equator. Somalian exiles in Sweden bore children in astonishing rates with "Swedish Disease", they called it that because in Somalia no children are born with autism (they invented the name). The jury is still out, but the studies are coming in fast and furious and in higher numbers than ever before. It seems every researcher is just now discovering vitamin D3 has some part in a disease they have been investigating for years.
We were promised by those in the medical profession, primarily dermatology and oncology(cancer) in the late 1980's that if we stayed out of the sun, and slathered on the newly discovered "sunblock" cream/lotion, we would be safer and healthier. This has been turned completely on its head. We are as a people, sicker and taking more and more medications than ever before. The sunblock at that time actually only blocked UV-B which is the ray wavelength necessary for your body to generate D3. So in effect, the entire population of the US was instructed to become deficient in vitamin D3 to such a level that we've seen skin cancers go UP, not go down, because apparently D3 actually helps to prevent skin cancers, along with everything else you will read about.
In the face of the evidence, I now believe that if every person over 45 was getting over 5,000iu per day, and every person under 45 was getting at least 15 minutes' decent sun/skin exposure per day, we would be far healthier than we are now. One study suggests that 300 billion could be saved per year if every person got D3 supplements for FREE, paid for by the federal government. That means to me that many families/children would have avoided austism, for example. Older people would not be osteoporotic in such high numbers, would not have died of heart attacks and strokes (at double the rate of those who had adequate vitamin D3 blood levels through supplements and good sun exposure). Women would not have 2.5 times the rate of breast cancer as those with good D3 levels, men would not have 2.2 times the level of prostate cancer. See Finland and Utah studies for these numbers.
And this is only the tip of the iceberg of diseases that have probably come to bloom because we have been taught to fear the sun - the sun that we evolved under for thousands of generations. Until this last generation, who may indeed turn out to be the first American generation ever to have a shorter life expectancy than the generation before it.
What should you do? Inform yourself, read these articles and search google for evidence for yourself. I suggest you start with "Utah" "Vitamin D" "foundation" ("insert your own disease as a search word here"), Finland, Scotland, Autism, Pregnancy, and read for yourself, decide for yourself. Consult your dr., but keep in mind that she/he may not be able to both see patients and stay current on the thousands (literally) of studies being published around the world in reputable medical journals revealing just how badly we screwed up when we "became afraid of the sun". Most were taught that the RDA of 400iu was all anyone needed, which is right for rickets but horribly wrongfully low for health. Apparently to me, keeping our children sunless in the 90's has lead to new epidemics in autism, asthma, diabetes, auto-immune diseases (where the body attacks itself), and it is worse than any crisis on wall street or in banks, to our way of life. So please read and decide for yourself whether insuring that you and yours get enough vitamin D3 (not D2) per day is worth the low, low cost compared to what the alternative might cost you or your child.
Lastly, I cannot recommend anyone take a multivitamin that contains ANY amount of vitamin A, as it has been found to be a direct antagonist of vitamin D, actually blocking it from working. Most multivitamins have absolutely NO studies showing they: reduce heart attacks/strokes/cancer/asthma/diabetes/ANYTHING, other than preventing scurvy, beri-beri, and rickets. Some even carry warning labels that they may cause osteoporosis! If you must take a multivitamin, do it once a month, not once a day. If your physician has instructed to take one daily, please follow that advice until you can talk with your dr. about "why" - and ask for studies or proof, that you will actually benefit and not be harmed by the multivitamins. I am still looking for good studies (properly run) that demonstrate that a multivitamin does any good of any kind! And remember, I do not advocate disobeying your physician but rather talking and discussing what ultimately is in your best health interests, based on science.
There are many supplements you may actually need/want, but my focus here is on D and related adjuncts which are truly basic to health. You do need to take calcium (as directed on the label), preferably those that are mixed with magnesium, manganese, and small amounts of copper and other trace elements needed. If prone to anemia as many women inherently are, some form of iron may also be necessary. If your vitamin D level is 50 or higher, you will absorb far more calcium/manganese/magnesium/iron/etc. as well as begin to store D3 properly. If you are taking a PPI that decreases stomach acid, evidence is growing that you cannot absorb calcium as well as a result, so you need even more help.
If you do start on vitamin D3 (either with or without testing before hand), keep some track of your most chronic issues that your body has symptoms of, and how they change over time as you continue taking D3. Note how often you do or do not get the flu or get sick, and compare that to before you were on D3. You just might be surprised at what is affected by a simple, cheap, safe, and readily available substance like D3 (which your body actually makes with the help of the sun). Remember, it used to be called "the sunshine vitamin" for a reason. We NEED to have sunshine in our lives, not always sitting in an office or in front of the computer/tv.
Caution: I am not saying Vitamin D3 will "do" any particular thing for any ailment you might have and you cannot expect or demand of it such behavior. I am saying that without D3 you cannot give your body its best chance for health, and the science I am seeing is continually elevating the importance of D3 in all things. Just as eating 25 different raw fruits, vegetables, and berries daily will provide fundamental nutritional building blocks, so too does D3 give you a much better chance to be healthy.
A. Ron Carmichael, R.Ph
Again, this is my personal opinion and has nothing to do with {my previous company} , who bears no responsibility for me exercising my professional judgment to educate and help my customers make the right choices towards better health.
HAPPY READING. And I will always be willing to answer any questions I can.
Update Note Feb 2013
I also recommend that the daily dosage for oral D3 be:
For pre-adolescents, 1000iu per 25 pounds,
and for over 15 or so, 5,000iu per 100 pounds, no matter what the sun exposure is for anyone living north of the Red River Texas
His website has a lot of vitamin D information http://www.vitamind.arcarmichael.com/