Reasons for low response to vitamin D

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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 after large meal - provides more gut-time for vitamin D 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
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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 C 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   Genetics    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	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
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
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Rare	Gallbladder removed 600,000/year in US	100%	Gallbladder essential to absorb vitamins dissolved in fats Consider other forms of Vitamin D: Biomulsion, water soluble Also lipase to improve fat digestion
Rare	Bariatric Surgery which bypasses the small intstine	> 200%?	Vitamin D is normally adsorbed only in the small intestine will need to get alternate source of Vitamin D
Rare	Pancreatic Insufficiency	??	Fat soluble vitamins (A, D, E, K) are not absorbed as well Note: Use water-soluble forms instead
Rare	Liver problems	50%	Use Calcidiol or Calcitriol forms of vitamin D instead
Rare	Burned skin	70%	Burn - uncertain response to supplementation
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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 145 items as of Aug 2021 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.

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See also VitaminDWiki

• Response to Vitamin D - many studies
• Dietary fat increased Vitamin D response by 32% – RCT Feb 2015
• Vitamin D Nutrigenomics - High, Medium, and Low Responders - March 2019
• On-line Vitamin D response simulation – July 2021
• 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
• All items in category Predict Vitamin D 82 items
• 24 ng lower response to Vitamin D due to obesity, low initial Vitamin D, and genetics – RCT Feb 2015
• Resveratol helps vitamin D bind to cells
• Big differences in response to same dose

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)

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Big differences in UVB responses: 20 to 36 ng after 6 weeks

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Alternate sources of vitamin D

click on chart for details

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

Vitamin D	Treats
150 ng	Multiple Sclerosis *
80 ng	Cluster Headache * Reduced office visits by 4X *
70 ng	Sleep *
60 ng	Breast Cancer death reduced 60% Preeclampsia RCT
50 ng	COVID-19 Fertility Psoriasis Infections Review Infection after surgery
40 ng	Breast Cancer 65% lower risk Depression ACL recovery Hypertension Asthma?
30 ng	Rickets

* Evolution of experiments with patients, often also need co-factors

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