Cautions to Synthetic Vitamin D3

#25

I had time to do a bit more research and found a few more links of interest. First this which is my favourite way of getting Codliver oil in my diet.

Next I don’t know Chris Kresser but have enormous respect for the The Weston A. Price Foundation whose president’s letter on this subject is quoted on Chris Kresser’s webpage.

As I suspected a lot of codliver oil these days is treated to take the fishiness out and synthetic vitamins added to replace the ones lost. The foundation suggests this is why codliver oil does not have the same good results at treating chest infections as it did in the 1930’s.

They recommend a brand (that I will be purchasing) and give a lot of scientific information about the importance of taking vitamin A and D together from an animal based source.

The brand they recommend is this one Extra Virgin Pure Cod Liver Fish Oil - 150ml | Rosita Real Foods – Rosita USA which looks different than the one at the end of the letter which might be a sponsor of Chris Kressers website.

The The Weston A. Price Foundation letter is here:

Weston A. Price Foundation Clarifies Recent Claims Against Cod Liver Oil

The next link is research which quite alarmingly shows that many vitamin D preparations have a lot more of the vitamin in them than stated. This leading to many serious incidence of toxicity. A couple of deaths even resulting from synthetic vitamin D that was added to commercial milk:

A review of the growing risk of vitamin D toxicity from inappropriate practice - PMC

I am not certain but would suspect that the toxicity cases attributed to fishoil in this report most likely involved fish oil that had added synthetic vitamin D.

The vitamin A and D toxicity saga is one I have been aware of and followed for many years with my father treating many of his patients successfully with Codliver Oil and grass fed butter and always wary of synthetic A and D. He was a respected Obstetrician and not a quack. My beautiful children happily took codliver oil off the spoon growing up. None of them sick for more than a day or two ever and never with chest or ear infections. All too with straight teeth and well formed bones.

Somehow I lost the plot on this in the past 10 years or so and am glad I got back on track. Make your own decisions obviously but I was glad to find the The Weston A. Price Foundation’s recommendations.

#26

Weston Price did some good work on the menaquinones. I don’t think, however, that the menaquinones had been identified as such when he used butter.

Your father may have been right to argue against synthetic manufacture some years ago. Synthetic cholecalciferol is likely to be used for most vitamin D3 supplementation and if people have taken large amount of vitamin D that is likely to be synthetic.

However, I am not aware of any current evidence that synthetic vitamin D3 is any materially different (apart from perhaps in terms of price) to vitamin D3 in Cod Liver Oil. Cod Liver Oil may include some 25 Hydroxy Vitamin D which would be good. However, that can be obtained synthetically as well and I make use of that.

There are rare examples of hypervitaminosis D. This will most likely be the synthetic D3 simply because it is cheaper and more common and to take that amount of cod liver oil would be quite difficult.

If 5ml of Cod Liver Oil is 400IU

To take 50,000 iu of Vitamin D would be over 0.6 litres of cod liver oil. I think probably drinking that would make someone queasy at least.

It would probably cost over £10.

The 3000iu capsules I buy cost £12 for a years supply. That is in total just over a million IU. Hence 50,000 iu would cost 60p (prices in GBP)

Thank you for finding a reference to the case of overfortified milk. I have read the original paper.

The dairy that overdosed people with vitamin D in the 1990s bought around 30 times as much vitamin D as they intended to and their measurement system did not work. The patients admitted from the home dairy had an average 25OHD level of 224 ng/ml (range 56-696) which is about 3 times the normal range. One 86 year old man who had hypervitaminosis D died of cardiac dysrhytmia (probably caused by the hypervitaminosis D. A 72 year old woman died because of infection because she was on immunosuppressants to treat her for hypercalcemia.

The dairy had 33,000 customers and the incidence rate of hypervitaminosis D was 5.76 cases per 10,000 people.

Milk in Massachusetts was supposed to have a maximum of 500 iu per quart which was exceeded by samples 70 to 600 times. So 35,000iu per quart to 300,000iu per quart.

Estimating therefore the dose if someone drinks half a pint of milk that would have been between about 9,000 iu to 75,000 iu. What we don’t know, of course, is what levels of vitamin D were in the milk drunk by the people who got the overdose.

I would think the dairy would have noticed the cost had they been using D3 from a natural source.

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#27

The kidney stones link with vitamin d bothered me (solitary kidney) so I did a bit of reading: from the below epidemiological study, people taking vitamin D with calcium may be at risk, particularly “in predisposed individuals”.

Go to:

In the National Health Nutrition Examination Survey (NHANES) III cross sectional study, high serum 25-hydroxyvitamin D concentrations were not associated with prevalent kidney stones (reported history or nephrolithiasis) [58]. A retrospective study performed in 169 patients with nephrolithiasis did not show a relationship between serum 25-hydroxyvitamin D level and 24-h urine calcium excretion [59].

In a prospective analysis of 193,551 participants in the Health Professionals Follow-up Study (HPFS) and Nurses’ Health Studies (NHS) I and II, performed by Ferraro et al. there was no statistically significant association between vitamin D intake and risk of stones in the HPFS and the NHS I groups but potentially a higher risk in the NHS II group (Hazard Ratio 1.18, 95% Confidence Interval 0.94, 1.48, p for trend = 0.02) [60]. Of note, the NHS II study has been performed more recently and women included in the NHS II study had a daily intake of vitamin D (mainly due to supplementation) that was much more significant than in the previous studies. It may be hypothesized that this increase in vitamin D intake may have enhanced stone risk in this specific cohort.

9. Summary

There is growing evidence that cholecalciferol administration or 25-hydroxyvitamin D serum levels, in the higher ranges, may increase urinary calcium excretion and kidney stone formation in predisposed individuals or specific groups of patients. Over the past few decades, the observation of an association between “low” levels of circulating 25-hydroxyvitamin D serum levels and a broad spectrum of diseases has been at the origin of a dramatical increase in the prescription of vitamin D. However, most of studies evaluating the effects of vitamin D administration, including studies dedicated to bone fractures, did not demonstrate a significant benefit of vitamin D [77,78,79,80].

In parallel, the risk of developing kidney stones, especially when vitamin D intakes are combined with calcium prescription, should be taken into consideration. It seems likely that some predisposed individuals, possibly prone to transforming 25-hydroxyvitamin D into calcitriol, with a reduced capacity for degrading calcitriol, or those who are more “sensitive” to vitamin D signalling, are more at risk of developing kidney stones in response to vitamin D prescription; however, the predisposing alleles have not been identified yet. The specific question regarding the Randall’s plaque should be taken into consideration. A large and possibly increasing number of stones are due to these plaques, whose formation depends on calcium phosphate supersaturation at the tip of the renal papilla. Randall’s plaques precede the development of kidney stones and are more frequently observed in children nowadays, raising concerns about a potential role of vitamin D prescribed during infancy in Randall’s plaque development, in turn leading to the formation of stones years or decades later. The identification of patients at risk of developing kidney stones in response to vitamin D prescription will be a medical challenge in the future.

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#28

I don’t think there is any doubt that a high level of vitamin D together with a high level of calcium can lead to ectopic calcification. This is not just in the kidneys.

I do weekly blood tests almost all weeks in the year so I know my 25OHD levels and they have been 400 (UK measurements) at times and recently went as high as 250 (nmol/L think 100 for USA measurements).

The 400 figure was a mistake (and arose from taking too much 25OHD), the 250 figure was perhaps a bit toppy and I have decided to aim for around 200.

I accept, however, that some peoples genes may make it better to aim for low 25OHD levels.

I did a video about Vitamin D a while ago which is here:

What I would say is that it is a really good idea to measure your levels of 25OHD in your blood every so often and be guided by that in terms of supplementation. Too high is bad. Too low is bad.

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#29

Thank you, @John_Hemming — in part because of your postings, I decided not to try higher vitamin D supplementation (which a Brazilian RCT of I think eight subjects showed 50-75% recoverage of vitiligo spots with 35,000 IU for six months. There was a German research group also using high levels of D supplementation for maybe autoimmune reversals (I can’t remember the research and I heard the PI speak in a podcast). I am likely to pull back from 5,000 IU per day to once every two days, but only after I see my Vitamin serum D levels rise above 40 (US units, so perhaps 100 in your units?). I am at 32 in January after four months of supplementation, but was never tested before this (my doctor only requested the test because I started supplementation).

I plan an extensive blood testing in the next month before creatine usage (make sure I have a cystatin baseline for kidney function) and then Rapamycin usage (vitamin D, lipids, A1c, basic metabolic, testosterone, blood cells, and thymus). Better to know before I start.

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#30

FWIW

High dose D³ discussions have been posted several times on this forum. Those posting had more details.

“The Coimbra Protocol”

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#31

Cod liver oil can be useful for vitamin D levels. If you are worried, you can always get your blood tested. If you are deficient (like me) you can add a supplement. If you are too high, you can cut back on your sources.

They key with vitamin D is to not be deficient and to not overdo it.

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#32

Thank you, @Joseph . The Coimbra 2013 vitiligo study is what I had (poorly) referenced, but I read the research paper and never saw this website you’ve linked.

Perhaps autoimmune patients suffer from low vitamin d and thus high levels are well tolerated?

Perhaps the study was only six months (but was effective in this time) and a longer-term exposure would risk kidney stones?

Perhaps the epidemiological “studies” on D correlated to kidney stone risk is incorrect?

Having read this paper a year ago, I am on the fence with this: I have vitiligo so having it reverse would be nice. And having more vitamin D should be beneficial for natural hormone/testosterone production (without TRT). But I also have only one kidney so risking kidney stones may be unwise. Like I said, I’m on the fence. Leaning toward not trying it because I was never a model anyway so a little vitiligo on my generally Lilly-white skin isn’t very noticeable.

From the website you linked:

In 2013, a study supervised by Dr, Coimbra assessed the effect of prolonged administration of high-dose vitamin D on the clinical course of vitiligo and psoriasis. In this study, nine patients with psoriasis and 16 patients with vitiligo received 35,000 IU daily for six months in association with a low-calcium diet and hydration (minimum 2.5 L daily). The clinical condition of patients significantly improved during the treatment, with no signs of toxicity observed.The results of the trial suggest that, at least for patients with autoimmune disorders like vitiligo and psoriasis, a daily dose of 35,000 IU of vitamin D is a safe and effective therapeutic approach for reducing disease activity.

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#33

Ericross2

Locate a physician in your area that is versed and uses the Coimbra Protocol.

Or follow/perform the protocol on your own.

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#34

Thank you: if I move forward I will find a local doctor to lead me through it — while I am a risk taker, high vitamin D doses for someone with one kidney while not under supervision seems rash.

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#35

:thinking:I am concerned that I don’t seem to have made the points I was trying to make clear.

As those points seem to be central to the purpose of us being here I will make one last attempt to do better :slightly_smiling_face:

  1. Taking synthetic Vitamin D was used in research a long time ago to artificially age mice.
  2. Without evidence otherwise; that the process of making synthetic vitamin D has changed since then, or that a safe dose of the synthetic vitamin has been established, we can only assume that this is nothing to worry about.
  3. As research has show that the majority of non licensed (I am not even sure what that means) synthetic Vitamin D supplements have incorrect labelling of the dosage––with many of them containing much more vitamin D than what is on the label––determining a safe dose can be even harder. Milk fortification was only a small part of this study which concluded that toxicity was a genuine issue of concern.
  4. As just about all codliver oil on the market has had its natural vitamin A and D removed and the synthetic vitamins added, it too should be considered a concern in terms of determining a safe and correct dosage.
  5. As vitamin A and D are essential for good health––a safe course should be determined that does not count on assumptions. Especially for anyone looking to reverse ageing, as a small mistake here in labelling or manufacture process could undo all of our other hard work we are doing.

My decision has been to go back to the King Oscar Codlivers (cheaper than the unprocessed codliver oil recommended by the Weston Price Foundation) and start making my own chicken liver pate again. The sunlamp also looks like a good option but is currently beyond my budget. I am also looking forward to spring.

I hope my analysis of this is clear and useful.

#36

I think you are wrong about this but without references that enable me to read any research you are citing i cannot properly respond.

Synthetic Vitamin d3 is used very widely snd there would be good current evidence of problems with it. I am not aware of any.

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#37

I think you are right to be careful about high doses. Best to know your 25ohd levels and have guidance. People with impaired kidneys can have issues with vitami d.

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#38

FWIW

A medical overview

Vitamin D - StatPearls - NCBI Bookshelf

Continuing Education Activity

Vitamin D - StatPearls - NCBI Bookshelf.

#39

I feel the research I have already posted at the link here is enough to cause concern and evidence of toxicity.

There is also the page here which I have only had time to scan which I am sure will make things clearer:

I agree that your analysis is probably correct but will be avoiding the synthetic version completely without better evidence of safety in labelling and dosage.

#40

The first paper you link to simply says it is possible to have too much Vitamin D3. As you know I produced a video in which I said this 18 months ago. There is no disagreement about this.

The second paper argues that the activities of vitamin D depend also on K2. That also I agree with.

Neither of the papers you cite and none of the current evidence you have cited substantiate the thesis that synthetic D3 is any different health wise to that in cod liver oil.

People also need to be careful as to how much Vitamin A to take as that can be an issue.

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#41

The first paper you link to simply says it is possible to have too much Vitamin D3

It didn’t simply say that it also says:

" A New Zealand study of 14 (12 unlicensed and two licensed) vitamin D3 formulations revealed that only eight were within 10% of the stated dose 24. Similarly, a US study 25 demonstrated that, of the 15 vitamin D3 preparations analysed, there was substantial variation compared with the stated dose, both in pills from the same bottle (52–136% of expected dose) and between separate preparations (9–140% of stated dose). Only one‐third of the pills analysed were within 10% of the stated dose. Of these, the licensed products revealed the greatest accuracy and least variation with the stated dose. Similarly, an Indian study revealed that, of 14 commonly used preparations, only four were found to be within the accepted 90–125% of stated dose, defined by the Indian Pharmacopeia 26. Furthermore, US studies on the fortification of foods with vitamin D have also revealed wide variations from the stated dose as nutritional products are not as well regulated as medicines."
It also says this mislabelling is causing real harm.

Neither of the papers you cite and none of the current evidence you have cited substantiate the thesis that synthetic D3 is any different health wise to that in cod liver oil.

This too is a misdirection as that was not my thesis. What I discovered from the Weston Price Foundation is that most codliver oil producers are adding synthetic vitamin D to their products and so you cannot assume the dosage problems highlighted above do not apply and that you would have to guzzle too much of it to be a problem.

The second paper also stated that a balance with vitamin A helps decrease risks of toxicity.

So irregardless of the safety of synthetic vitamin D (which is not proven by the the prevalence of it’s use) compared to the natural form it would also logically be safer to eat food that has not been fortified and provides A and D in the right balance and in levels unlikely to cause toxicity because of mislabelling. This cannot be assured with codliver oil where most brands do not state that they have been fortified even when they have.

This is why I would suggest that food sources of the two vitamins in balance would be a much safer option. Especially with people at any risk.

It is okay if you think I am wrong, but please try not to misrepresent the links I post, potentially making other members here feel they don’t need to read them. I have posted my concerns here in good faith and only want people to be aware that there are dangers.

#42

I think it is generally accepted that supplements tend to vary as to their content. Regulated medicines also vary as to their content. (less than supplements).

It is actually quite hard to find out which are the better supplements and which the worse from this perspective.

The Title of this thread is “Cautions to Synthetic Vitamin D3”. Hence I have taken that as being your thesis. However, I think we have now resolved that there is no current evidence that indicates there is any issue with Synthetic as opposed to UV generated D3.

To be honest I would expect the levels of D3 to vary in cod liver oil, but I don’t intend to spend any time researching this.

I agree that people should label cod liver oil that has been fortified. I wish labelling was more precise, but often supplement manufacturers don’t know exactly what they are selling. I have been buying some substances directly from the chemical manufacturers so I know precisely what I am getting.

I think the prevalence of use of synthetic D3 and absence of evidence of negative outcomes of use at normal levels does prove its safety, but we can agree to disagree on that.

Taking too much vitamin A can also cause problems

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#43

The quality of vitamin D as well as other supplements is a real problem indeed. I try to get third party certified ones when possible. For Vitamin D there is at least one which is NSF certified for sport here: Vitamin D-5,000 - NSF Certified for Sport

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#44

Borax put calcium back where it belongs and is very safe, look for a book called The Borax Conspiracy or Borax group on Fb