Reasons for low response to vitamin D
Overview of Poor Response
~ 50% of all people have a low response to vitamin D3
~ 10% of all people have a ZERO response to a LOW dose
There are 40+ reasons for poor blood response
Here are some of the common reasons
| Obese Elderly Poor gut | 2X more needed or gut-friendly |
| Health problem reduces levels examples Autism,Anemia, Diabetes Some Cancers |
2X more needed |
| Fail to take with the largest meal | 1.3X more needed |
| Low Magnesium, smoking | 1.3X more needed |
Detailed Reasons for poor response
| Occurrence | Reason for low response | Typical % extra D needed |
Comments |
| Common | Excess BMI/weight | 150% | Obese need 2X to 3X more |
| Common | Vitamin D was not taken with/after large meal |
40% | Take during/after largest meal - perhaps largest = most likely to contain fat evening meal or largest meal Note: avoid late in the evening |
| Common | Magnesium - low (Gut needs Mg to absorb Vit. D) |
30% | Many reasons - which include low stomach acid and antacids |
| Common | Smoking | 30% | Smoking reduces vitamin D - many studies -9 ng reduction |
| Common | mono-unsat fat ratio -low | 20% | Need higher ratio of mono to poly fat ratio |
| Common | Cola - soft drinks | 20% | Cola removes Calcium, Vit D consumed in restoring Calcium |
| Common | Boron - | 15-39% | Boron increases vitamin D in the blood claims 6 mg ==> 24% -Boron is also known to build bone - perhaps by increasing vitamin D |
| Common | Oil-based Vitamin D | 20% | Oil-based Vitamin D helped the least Some olive oils decrease absorption by 25 % Bio-Tech uses a water-soluble form of Vitamin D |
| Common | Vitamin K2 -low | 10% | Overview Vitamin K and Vitamin D perhaps 100 microgram/ 1000 IU of vitamin D |
| Common | Cholesterol - reduced in diet | N.A. | Cholesterol is needed to make Vitamin D from the sun Low Cholesterol DOES NOT appear to affect vitamin D supplementation |
| - - - - - | |||
| Sometimes | Extremely Vit D deficient | 200% | Low dose can result in ZERO increase if very deficient When body is very deficient all vit. D is immediately consumed Note: sometimes extreme deficiency is due to genes. |
| Sometimes | Health - low | 200% | Unhealthy body consumes a lot of vitamin D - see extremely deficient (Examples: MS, HIV, some cancers, Diabetes, Depression. . |
| Sometimes | Anemia | 40% | Liver is needed to process vitamin D Sometimes need to add Iron as well as vitamin D |
| Sometimes | Fatty Liver | 40% | Half of seniors have fatty liver, vitamin D reduces inflammation, Calcidiol or Calcitriol might be taken instead of Vitamin |
| Sometimes | Drugs which consume or block Vit D |
50% | Taking drugs such as Statins, Antiseizure, Prednisone, AIDS drugs, Orlistat, Questran, Dilantin, Phenobarbital, Rifampin, Methamphetamine.. |
| Sometimes | Genes | 50% | Genes need to be functioning properly to process vitamin D Twin studies VDBP CYP2R1 also kidney Note: sometimes cells do not get Vitamin D even though tests are OK see below on this page |
| Sometimes | Taking D2 vs D3 | 30% | Sometimes D2 will actually DECREASE the level of D3 Note: D2 has a short half-life and should be taken daily |
| Sometimes | Too much UVA vs UVB | 20% | UVA appears to actually DECREASE vitamin D levels Avoid getting a lot of sun thru windows or very early/late in the day |
| Sometimes | Winter birth | 11% | Winter birth, 11 % more likely to be vitamin D deficient as an adult |
| Sometimes | Oral contraceptives INCREASE response |
-20% | Oral Contraceptives INCREASES vitamin D levels Perhaps due to less blood loss/anemia |
| Sometimes | Test results inaccurate | * 20% -20% | Overview Graph of tests from 1000 labs Vitamin D differences of 5 ng are meaningless - Aug 2015 |
| Sometimes | Gut - poor | 100% | Bio-Mulsion form of vitamin D was designed for poor guts Topical Vitamin D bypasses the gut |
| Sometimes | Probiotic + - | * 20% -30% | 1/3: 30% increased D bioavailability; 1/3: 20% decreases |
| Sometimes | DDT, pesticides | 20% | Pesticides - 2016 |
| Sometimes | Plastics, sewage based fertilizer | 10% | BPA PFAS PCB |
| Sometimes | Vitamin A - excessive | 30% | Attenuates responses for > 10,000 IU vit D: from cod liver oil or [Accutane |
| Many children in developing countries get excess Vit A doses every 6 months](/pages/acne-accutane-vitamin-a-vitamin-d-and-suicide/) | |||
| Sometimes | Roundup/glyphosate | ? % | Gut bacteria and liver |
| Sometimes | Stress | ? % | Cortisol consumes Cholesterol needed to make Vitamin D |
| Sometimes | Autism | 100% | Autistics have half of the response to Vitamin D – RCT Oct 2018 |
| - - - - - | |||
| Rare | Gallbladder removed 600,000/year in US |
??% | Gallbladder essential to absorb vitamins dissolved in fats Consider other forms of Vitamin D: Biomulsion, water dispersible Also lipase to improve fat digestion |
| Rare | Bariatric Surgery which bypasses the small intestine |
> 200%? | alternate source of Vitamin D |
| Rare | Pancreatic Insufficiency | 10-20% of population |
Fat soluble vitamins (A, D, E, K) are not absorbed as well Note: Use water-dispersible forms instead |
| Rare | Liver problems | 50% | Use other forms of vitamin D instead |
| Rare | Burned skin | 70% | Burn - uncertain response to supplementation |
| - - - - - | |||
| Sun/UV | Skin - Dark | 250% | vitamin D produced varies with darkness of skin: White = 0%, Black = 250% |
| Sun/UV | Skin - Elderly | 100% | varies with age: teenager = 0%, 60 years = 100% this due to thin skin or low cholesterol in skin |
| Sun/UV | Skin - Sunburned | 30% | varies with % of skin which is burned Burns and bone loss 75% less |
| - - - - - | Reduction in Vitamin D actually getting to cells - downstream from Vitamin D Testing | ||
| Test invisible | Genes | Genes, problems which often run in families Vitamin D Receptor 499 items as of Jan 2024 Vitamin D Binding Protein 178 items as of Nov 2024 CYP27B1 174 items as of Jan 2024 |
|
| Test invisible | Cells | Low Magnesium | |
| Test invisible | Cells | Low Omega-3 | |
| Test invisible | Kidney | Poor Kidney |
Note:
Any study will rarely consider even 4 of the above factors
Factors are sometimes additive: example, 50% + 50% = 100% = 2X as much Vitamin D is needed
Reasons for not getting benefits - even if blood tests are OK

click on image for details See also Kidney Low Magnesium, Low Omega, Vitamin D Receptor Vitamin D Binding Protein.
See also VitaminDWiki
Dietary fat increased Vitamin D response by 32% – RCT Feb 2015
Vitamin D Nutrigenomics - High, Medium, and Low Responders - March 2019
10 reasons for poor response to Vitamin D (race, binding protein, etc.) – Nov 2017
Vitamin D injection helped migrants a bit, but some had poor or even negative responses – Dec 2017
Many reasons why vitamin D deficiency has become epidemic in past 30-40 years
13 reasons why many seniors need more vitamin D (both dose and level) - July 2023
Some people need more vitamin D to get the same response – perhaps due to genes – Nov 2014
24 ng lower response to Vitamin D due to obesity, low initial Vitamin D, and genetics – RCT Feb 2015

Wide range in the responses after 1 year (black dots)
Example: 2400 IU dose: 75-140 nmol response (30-56 ng)
Example: 400 IU dose: 50-110 nmol response (20-44 ng)
Big differences in UVB responses: 20 to 36 ng after 6 weeks

Alternate sources of vitamin D
click on chart for details

40-150 ng of Vitamin D needed to treat health problems
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