I am not a physician and do not counsel anyone in a manner of medical practice.  My opinions are solely mine, and nothing should be done about the information I present below without knowing what your 25(OH)D is.
In short, I present these facts and my perceptions for you to consider.  Consult the literature, especially using well-constructed studies (the NCBI site is excellent for finding studies), talk with your healthcare professionals, and decide for yourself.  This is not medical advice I present, it is information to consider.

  • Vitamin D is a steroid and a hormone - it is also known as "D3", and a more chemical-y name is "cholecalciferol"..  They did not know any better when they discovered it in the 1920s so it is called a vitamin, and we'll probably always be stuck with the wrong name.  When I mention or refer to "D" below, it's the same chemical as the Vitamin D3 you can buy over any drug store counter. 
    D2 is the prescription imitation D, which I myself would never want to take.  D3 is ALSO the same chemical your body makes when you are out in quality, raw, nekkid sunshine anytime your shadow is shorter than you are tall.

    This is for all people (Contraindications are rare, but include hypercalcemia, active sarcoidosis, active granulomatous diseases, and Williams Syndrome), especially athletes who want to not just win but also prevent the "crud-after-12-hour-flight-to-foreign-country", those with a chronic ailment or disease(DZ), and pregnant/soon-to-be-pregnant couples(not just the woman!).  Do not just read and trust - read, learn, and verify for yourself by seeking althernative sources of information, like the http://ncbi.nlm.nih.gov website, the vitamindcouncil.org website, and the grassrootshealth.net sites.  Wikipedia, for LL37, Cathelicidin, and Defensins is reasonably good, also.

  • The human body, as with virtually all other mammals, birds, reptiles, etc. has evolved to MAKE D when exposed to UV-B wavelengths of sunlight, so again by definition it is not a vitamin!  Organisms have made vitamin D from the sun for literally millions of years.
  • Vitamins are those nutrients we must have for health, but which we cannot make and must therefore EAT. We MAKE D because we must have it for health, and it's many things, but therefore NOT "really" a vitamin.
  • Evolutionary pressure in humans, as well as many other creatures, over millions of years has UNIQUELY ENABLED us to utilize D3 to:
    • Control thousands of genes in the body, which do work that is crucial for life and for health - SO FAR more than 5% of the human genome is known to be controlled by D, but the number keeps going up as science advances.
    • Separate from the one you probably already know about, D creates a separate immune system which includes making an effective antibiotic/antifungal/antiviral agent IF you have enough D - google LL37 or defensin. (you will get more than 63,000 results!)  The surface of both your lungs and your eyeballs MAKE LL37 to prevent infections. 
    • Boosts the function of the immune system you already DO know about, by increasing the production of T-cells, Interferon, and even enhancing the metabolism in white blood cells so that they are actually more able to move about faster with greater motility, engulfing foreign invaders.
    • Of course, D will improve skeletal bone strength by enabling absorption of calcium, which also is probably the fundamentally greatest virtue - your heart requires adequate calcium in order to beat, and that is the most fundamental-to-life survival need for D.
    • Deal with inflammation of any sort, including that from acute trauma like burns, bone fractures, muscle tear-down (ie,exercise), and the adverse tissue injuries caused by invading organisms and of course, sunburn!
    • Reducing the inflammation inside of the arteries and veins that ultimately lead to calcium and plaque deposits, high blood pressure, and death, caused by poor nutrition and poor exercise habits. IT DOES NOT REPLACE THE NEED TO EXERCISE AND INSURE GOOD NUTRITION! Patients with good D levels will have lower "C-RP" and Homocysteine blood levels/tests.
    • Create enzymes that are uniquely anti-oxidant as well as beng capable of mending damaged DNA helix.  There is no other agent known to be able to reattach/mend completely severed DNA strands in the human body, as D enables.
    • a protective mechanism against the DNA-damaging wavelengths of the sun (UV-A), simply by being in the sun so your body can MAKE D. ALMOST 100% of all life on earth spends its' time in the sun. Why would modern medicine refuse to acknowledge we humans need that same life-sustaining radiation?
    • A fundamental survival function is that there are systems in our body that serve to respond when we do something over and over - it must be important if we repeat it, so the body's response is to make that "something" easier or less difficult:  Running causes bones to flex, which creates an electrical signal that more calcium is needed there. If we repeat a motion, say, shooting an arrow from a bow, swinging a golf club, etc., enough times in the exact same way, what we call "muscle memory" is actually the body enhancing the brain-to-muscle-to-brain circuits.  Even the act of learning to stand as infants is an example of this response, which we are not even aware is happening.  D makes that happen!  How?
    • D fuels certain tiny hyperactive mechanisms called Oligodendrocytes, which are everywhere there are nerves. Oligos lay tendrils upon nerve cells, and monitor how busy the cell is.  A string of very busy, highly-utilized nerve cells will be enhanced by the Oligo, which literally generates a layer of special fat around the nerve cells, turning the nerve pathway's ability to convey information from a tiny path into an 8-lane superhighway for speedier transfer of greater amounts of information in both directions. 
    • We sometimes call this muscle memory, or when regarding the brain, being SMART.  This fat is called MYELIN.  Without D, Oligos cannot make myelin at anywhere near the desirable rate, and if the deficit in D goes on long enough, and there are other genetic or environmental concerns to complicate things, your Oligos may fail. . When your body begins to fail at making or maintaining myelin, we call it MS or ALS.  If MS/ALs strikes a chord of interest for you, please utilize my favorite information "Go-To" source:
      The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. . Type in your search words, such as "vitamin D MS" , then look through the PubMed and PubMed Central listings. Notice the many thousands of "hits" - more than 6,000 studies as of this writing - concerning MS and the importance of D!
    • PREGNANCY CONSIDERATIONS

    • for the pregnant woman, D is critical for the development of the fetus' immune system and all parts of the nervous system.  During the last trimester of pregnancy AS WELL AS the first few years of life, D insures the most evolutionarily advanced areas in the brain, the highest as well as the most basic, are STILL being developed, even potentiated, because the brain development does not stop upon leaving the womb.  It actually accelerates (!) because of all the new stimulii of the world!  I favor Dr. Ramachandran's TED talk on mirror neurons to help understand a little about what is going on.
    • D functions in a synergistic way with estrogen, compared to testosterone. All three of these hormones are made in the body in the same pathway, starting from cholesterol. This is why D is a steroid (sterol) as well as a hormone like the other two. 
      • The synergy between estrogen and D is very likely one reason why there are nearly FIVE times as many male infants that develop Autism as females. (males have very little estrogen compared to testosterone - both genders do have both)
      • It also plays a part in who will develop MS in life, although geographic location, inherent "D in the diet", and genetics are also sure factor.
      • The inability to generate D as efficiently "away from the equatorial regions" for dark complexions may also explain why there is a higher rate of autism among dark-skinned peoples. 
      • Religions that force women to wear sun-blocking clothes from head to toe lead to a higher rate of autism and "autism spectrum disorders"

    Studies demonstrate that the impairments caused by deficiency of D during pregnancy can be detected even 20 years later in the offspring, such as less bone density. See this study published in Pediatrics in 2015

The word, "autism", was first used in around 1943, but was not common in the medical vocabularly through the 1970s, where the average estimate was a few cases per 1000 births.  It WAS noticed far earlier and in higher frequency in countries with low "sunny day" annual counts. One wonders, though, what has changed between then and now to cause such an increase in cases of autism, and it has been documented that diagnostic ability has NOTHING to do with the increase. And why do children develop adult type diabetes, so many have death-causing allergies to foods (ie, nuts), why are so many so mildly sick so much more often (ear infections, anyone?), and as a large subset, seemingly fail to maintain the upward curve in intelligence seen in the prior decades?  Why is not perfectly clear WHAT the cause is?  Here's my suspicions regarding how we got to today, where the rate of autism is 1 in 64 births (2015) per the CDC.

  • I believe that in around 1986, a cosmetic company formed a foundation to market their new sunblocking product directly to dermatologists by persuading them that the sun was evil, because 1,500 Americans were dying from malignant skin cancers at the time.  Their logic was that the sun caused the cancer, and therefore blocking the sun would decrease cancers.  This was a FAUSTIAN bargain, a deal with the devil of horrid consequences. Ironically, those types of cancer most often develop in places "where the sun rarely/never shines". Those cancers have NOT gone down, they have sky-rocketed upwards since then, as have many other cancers!.
  • The AMA came onboard in the '80s as well, and endorsed a campaign I have called a "dermatologists' mantra", to "FEAR THE SUN", with recommendations to:
    • never go out between 10am and 4pm (thus insuring NO uv-B waves are ever available to create D)
    • always apply strong sunscreen at least 30 minutes before going out (ditto)
    • re-apply it frequently while out (ditto)
    • use waterproof versions if swimming (ditto, ditto, ditto)
    • cover-up if you can't use sunscreen. (MEGA-ditto)
  • By 1990, the "Sun is the boogie man" campaign was in full-effect.  It is appallingly obvious to this pharmacist that the most likely human to heed a doctor's advice is a pregnant woman, for she is creating another life within her and knows she wants "the best chance" for her baby.  So, mothers-to-be were the first to unknowingly, diligently, deny their fetuses the necessary D .
  • Unfortunately, autism is a horrible alteration in the normal human behavior, and it doesn't become completely obvious, doesn't reach a tipping point, probably doesn't "happen" until around 2 to 4 years of age IN MOST CHILDREN. One characteristic is that there is a clear change in behavior in a very short period of time.
  • Autism also has proven highly resistant to anything the AMA aka "modern medicine" has to offer. 
  • In 2014, the CDC reported that the rate of autistic spectrum births was 1 IN 68 births, compared to 1 in 110 births in 2006, and an estimated 1 in 150,000 back in 1990.  Clearly to me, the medical profession's persuading Americans to fear the sun has had an horrid effect on our general health and the well-being of our society. It's estimated that more than 80% of all Americans are deficient in D their entire lives.   The impact to our quality of life overall is significant, as it costs $millions more to care for each autistic child throughout their life.  Many can become self-independent, but there are far more that do not find a way to function productively.

  • I believe autism usually appears at the age of 2 to 4 years of age of the infant, right when a LOT of vaccines are needed due to maturation of the immune system building blocks coincides with development stages in the infant's brain, the higher brain functions, have been STILL TRYING TO BE IN FULL DEVELOPMENT AND GROWTH MODE since birth, LIKEWISE the development of the various elements of the immune system. The brain is being deprived of a critical enhancer hormone during this dynamic growth phase. That it happens right when the immune system begins to go into a high gear is curiously co-incidental but I do not know yet exactly how the two correlate in timing.
  • It is a well-accepted fact that breast-feeding/nursing conveys the mother's antibodies the infant needs, until its own systems have developed enough to begin to make them itself.
  • This on-going elevated rate of immune development is a well known aspect of infancy - that the baby is acquiring the ability and capability to react to environmental factors and to create antibodies at a huge rate, and is one reason why a vaccine can provide a life-long immunity to diseases that used to be the scourges of human existence.  Polio is a hugely apt example.
  • Infants are creating huge numbers of neurons and interconnections between clusters of specialized neurons in the brain constantly during the first years of life through environmental stimuli (remember Oligos' function) is also why infants learn to talk simply by hearing it, to recognize other people, to empathize (a very high-level function), as well. 
  • The fundamental difference in Einstein's brain, which was studied extensively when he died, was not realized until science finally identified the function of MYELIN, and only then could scientists realize Einstein's brain had huge amounts of myelin, far more than average, between many of the specialized nuclei in his brain responsible for higher levels of thinking.

  • UNFORTUNATELY...

  • Desperate disease states in children cause desperate searches for "why" in the minds of the parent.  It is a frantic, overpowering-logic, drive to understand.. 
  • A single dishonest physician in England fabricated a "study" of barely a dozen children, and implicated vaccinations and precisely, the mercury in those vaccines being used as preservatives, as the cause.  This was a complete lie, for which he was eventually defrocked as a doctor, the once highly respected Lancet medical journal printed a complete retraction and mea culpa, but by then the internet "had" the information as the gospel truth.
  • Manufacturers responded first with studies documenting the decades prior to the 1980s where there virtually no autistic cases despite the mercury.  This failed to calm.
  • They then removed mercury from many vaccines.  This did nothing to stem the rise in autism, and failed to calm.
  • Many parents couple the onset of the "autistic behavior" in their baby with the administration of vaccines, because of when they happen, relative to the point in brain development in the infant. 
     
  • I suspect (no proof and only by reasoning based on my limited knowledge) that it is vaguely at this time in the infant's development that:
    • vital connections are normally made and firmed up in certain areas of the brain.
    • critical parts of the immune system are coming on-line, but they are defective because of an absence in D during womb development AND during infancy after birth. Let's call them "hyper-reactive bullets".
    • The sudden presence in the blood stream of high numbers of antigens from the vaccines MAY, repeat MAY, trigger the immune system's malfunctioning elements/bullets to attack certain tissues in the brain or myelin in a way that leads to the characteristic "triad of impairments" - social & emotional interactions, imagination & flexibility of thought, and social communication and language usage. THIS IS PURE SPECULATION BASED ON WHAT I HAVE SEEN IN PATIENTS AND HOW I UNDERSTAND D TO WORK!  Regardless of the actual cause, though, there are many things I am confident of.
    • there are also other characteristic combinations such as the "triad of A" for autistics: Hyper-allergic, hyper auto-immune diseases, and hyper-asthmatic, many of these manifest in otherwise "normal" people as well, at far higher rates than prior to the late 1980's!
    • It appears to me that at a certain point in time, the chronic lack of D triggers some rogue behavior in the immune system, which in the brain then causes a seeming random change in myelinized regions, regardless of whether the parents skip vaccines or not!
    • About 10% of autistics will be credited with some "hyperdeveloped" ability, as though some paths in the brain have become MORE myelnized, more interconnected, at the same time as most connections it other critical areas associated with social behavior, emotional quotient, and empathy either lose their functions or else never develop.
    • Perhaps when some pathways are destroyed or blocked, the impulses shunt down alternate paths, and those become hyper-myelinized or otherwise optimized.
  • I continue this line of thoughts regarding D and autism with my anecdotal experiences that tend to mirror what Dr. John Cannell of the Vitamin D Council has observed in his medical practice, specializing in autistic spectrum disorder:
    • Giving autistic children high doses of vitamin D on a daily basis has a visible, detectable, verifiable positive effect in 75% of the children. He estimates around 25% will have a profoundly life-changing effect (for both the child and the family) while some 50% will demonstrate "some benefits".  And the last 25% will have no short-term, visible changes in behavior.  The earlier in life the D deficiency is corrected (over-corrected, some will maintain) then the more likely the changes can be made. 
    • PERSONAL NOTE: I have had one 22 y.o. alter his behavior in such a way that I became convinced that it is never too late, the brain is always "plastic" and able to change if you fix the deficiency. To his mother, seeing her autistic son, suddenly dressing himself and bringing himself downstairs on his own initiative, for the first time in his life, this rocked her world. At my suggestion, she had been giving him a tiny capsule of 50,000iu of D3 daily for only one month.  It is not wise to give such doses indefinitely without proper blood testing and medical monitoring. But it exemplifies that D is critically implicated in autism. 

    Is it a failure? For that last 25%, I feel that it does not mean that giving the D is not helping!  As I'll argue later, it likely does not ever harm.  It may be that the scaffolding in the brain is so damaged that it takes much longer to repair, or it may not ever repair.  But restoring a normal level of D will still provide better immune functions, stronger bones, and enable the body to function to the best of its evolutionary ability.  The evidence in cancer reduction and avoidance is also very large.

Back to "getting vitamin D"

You have to GET quality raw sunlight (anytime your shadow is shorter than you are tall, and you can actually see your shadow), over major portions of your body, in order to make the D chemical in your skin. This is when the UV-B is not filtered/blocked by the earth's atmosphere.  Clouds can block the UV-B, while allowing the DNA-damaging UV-A through to cause the burn.   To help remember which wavelength is bad, "B" is for Beneficial, while "A" to me means DNA Damage.

The AMA has completely lost their minds to think that we must ignore evolution, fear the sun and avoid exposure at all costs. We EVOLVED  in the sun!

You must get enough time in that raw sunlight for your skin-type's requirements, if you want the benefit of evolution that brought us to excellence. 

Example: Light complexion skin, high noon in the summertime, in a skimpy swim suit in Austin, Texas, it is safe to assume that person will easily generate approximately 5,000iu (125 micrograms) of D3 in only 15 minutes, and more than 20,000iu (half of a milligram, 500 micrograms) if out all day.  (Genetics play a variable in this)

MY FEARFUL EXAMPLE: I am concerned, because all things being equal, if the individual has a normal dark complexion, generating 5,000iu will take 2 or more HOURS!  So the darker your skin type naturally, the harder it is for you to make D from the sun!  The melanin is a naturally-evolved protectant from sun damage, and tends to be present more in those whose culture is close to the equator (greatest year-round sun intensity).

This is all true ONLY if no sunscreen is used, the person is not behind glass, and the location is closer to the equator than say, Oklahoma or Nebraska.  The further distant from the equator, both north and south(ie, New Zealand, Australia) the slower/harder/worse, such as far north as Minnesota. (Google "American Disease Somali" or "Swedish Disease Somali")

Your species evolved getting sunlight, raw sunlight, on a daily basis.  You evolved getting reasonable doses of around 10,000 iu of D3 daily. Only about 17% actually gets stored in fat tissue.  The raw D3 you make stays in the blood for about 24 hours and is absorbed by osmosis in the majority of tissues in the body throughout that time.  In all of these tissues and organs, raw D acts as an AUTOCRINE HORMONE, for it is activated inside the cell to perform hormonal functions.  

Fortunately, many of your organ systems have evolved to use a different version, an active metabolite, of D3 called 25(OH)D - aka 25 Hydroxy D, for which some organs actually use a mechanism which expends energy to PUMP the active D into the cell, the mitochondria, and the nucleus.  So even if there is only a little of the 25 hydroxy D, it will be sucked into the cell for beneficial actions. The use of energy to "get it" shows how important it is in the body!

Your liver metabolizes raw D3 into this 25 hydroxy D, which has a half-life that is about FIFTEEN times longer than raw D3, then releases it in to circulation.  This gives certain organs a greater guarantee of having it when it needs it. In these organs, D behaves as an ENDOCRINE HORMONE.

This summarizes the most important things which many practioners FAIL to understand:

  1. D is NOT a vitamin, as your body makes it in response to exposure to UV-B wavelength sunlight.
  2. D is somewhat fat-soluble, but only about 17%, far less than they expect
  3. Raw, unactivated D must be available all the time, not just once a week or month or 6 months. Anytime I see a study where the protocol used a massive dose once every 6 months, I know the researcher has no *clue* what they are doing, and their results will be useless for anything but mis-education and harmful headlines on the internet.
  4. A proper blood level of 25(OH)D is what mother nature gives you if you get adequate sun as your ancestors did - a level of around 50 ng/ml.  Indigenous tribes around the world who live near the equator typically test in the 45 to 60 ng/ml range, although pregnant women get higher levels. By the way: a ng/ml is one billionth of a gram per ml.   20 drops make up about 1 ml.  THAT hormone is some powerful stuff!
  5. That power is yet another indication that D is a steroid, not a vitamin.
  6. Skin cancers were promised to go down. Instead, they've multiplied many times.  D prevents cancers, but if you have no D.....
  7. "Vitamin" D3, what your body makes, is NOT the same as the D2 they like to prescribe. D2 has 80% of the affinity for the billions of receptor sites in your body as D3 does.  Your body attempts to convert D2 into D3 so it can make use of it, but only 50 to 70 percent will be converted. They like to prescribe this crappage D2 once a week, insuring that the patient will have ZERO circulating raw D3 for 3 or 4 days out of each week.
  8. They think a blood level of around 10 is "fine", and when you ask about your test, they tell you "you're fine".  You are NOT fine.  FIFTY!   50 ng/ml is "fine".  If you are an athlete or have a pathology that likewise burns up your D faster you need a higher level, such as 60 or 70 or 80 ng/ml. 
  9. A blood level is just a snap-shot in time, and cannot accurately indicate long-term how you are doing.
  10. If you lift weights or cross-train, run marathons, work manually for a living, these things all cause your muscles to be inflammed, and your body burns D to repair the inflammation.  You need MORE D. 
  11. If you want protection from the damaging effects of the sun, you need D in adequate levels.

Fortunately, D3 is available over the counter in pharmacies, in 5,000iu capsules, and is safer than water, CHEAPER than bottled water, If you have trouble remembering to take something daily, you CAN take 50,000iu of D3 once every 3 to 4 days, which actually does provide you with 50,000iu on day one, 25,000iu on day 2, 12,500 on day 3, and 6,000iu on day 4, at which point you need a new boost. I do not recommend using the 50,000iu caps unless the patient needs a higher level for documented reasons. Say, for example, RA or fibromyalgia, MS will typically need higher levels of raw D3.

DOSE?

    Contraindications to taking oral vitamin D are rare, but include hypercalcemia, active sarcoidosis, active granulomatous diseases, and Williams Syndrome.  That's it.  For the vast majority of humankind, D should be part of every day life.

    I am not a licensed physician. I am a pharmacist with decades of practice who has spent far more time investigating and evaluating vitamin D than the vast majority of health professionals.  During more than a decade of recommending D, I have never had a single instance where a patient had an adverse event, to my knowledge.  Is D Safe? - a review of 15 years' of US Poison Control phone calls related to "vitamin D". ZERO deaths during that time.  ZERO documented permanent harm!  More than 3,000 deaths from acetaminophen, and deaths from water intoxication, excessive Vitamin A (please do not take vitamin A, ever - take beta-carotene instead), and even childrens' multivitamins caused deaths.  But not a single death from D.

    I suggest 1,000iu as a single drop of Xymogen-brand liquid D for infants, daily, by placing the drop on the mother's breast just prior to nursing, or else in a bottle partially filled with just a little formula, then refilled with more formula to insure it is all "gotten". During gestation and nursing, a mother MUST get her level to 50 to 65 ng/ml and keep it there.  This may entail 10,000 to even 20,000iu D3 per day, and testing should be monthly during pregnanacy, especially for darker complexioned women and those who live "further away" from the equator.

    For children, I believe that the D they get is a factor in how tall they will eventually grow as well as how fundamentally healthy they will be throughout life., not the prime determinant like genetics are, but remember: D regulates thousands of genes.  1,000 to 2,000iu per 25 pounds of body weight seems a prudent daily, normal dose, although they should also be allowed to get a MODERATE amount of quality raw sunshine without sunscreen! Never should one be allowed to get beyond "slightly pink" and into "sunburn"! 

    For adolescents in their growth spurts, or very active physically, their needs are probably much higher. 20,000iu daily per 100 pounds, or even 25,000iu, is prudent. 

    For adults, 10,000iu to 20,000iu per 100 pounds, taken daily, is a prudent starting point.  Athletes need much more on active days - weight lifters, for example, are tearing down muscle on purpose, and planning for it to rebuild stronger.  This is inflammation.  D is for rebuilding from trauma and reducing inflammation.  I personally went from over 90 ng/ml to less than 30 ng/ml in just 5 days of intensive exercise, AND I was taking 20,000iu D3 daily and out in the July Texas sunshine from dawn to dusk. 

    It has been observed that older adults tend to have lower levels, and the medical profession assumes they are simply not able to generate as much D given the same UV-B exposure, but it may be a bias unworthy.  Perhaps they simply are less likely to be exposing their bodies to the same extent youth are.  Regardless, they need the same dosage range as adults.

    People with active pathologies, such as RA, MS, fibromyalgia, infections, cancers, etc. many need huge doses.

    ALL PEOPLE SHOULD GET A BLOOD LEVEL OF THEIR 25(OH)D established at some point where they can then determine whether they need more or less.  It varies through the seasons because of the sun intensity change as well. 

    There is no other way to know whether you are taking enough, or too much.  The best blood level test I know of is $50, from the Vitamin D Council.  I use it myself, several times a year to evaluate my own therapy. There are several other options on this link, including one for people outside the U.S.

    Warnings:  People deficient in D can be overdosing themselves on Calcium with no harm.  The calcium they are taking is literally going in one and out the other.  TUMS eaters are an excellent example - Tums is great for reducing stomach hyperacidity and heartburn, but it is made of calcium. 

    If you take too much calcium routinely, and THEN you FIX your blood level of D, you will "suddenly" start absorbing more of that calcium, and you CAN become symptomatic of hypercalcemia: muscle cramps, diarrhea, heart arrythmias, and even death.   Not from the D, but from the Calcium overdose!  Follow the RDA for your age for Calcium, and IGNORE the RDA for vitamin D which was incompetently calculated in 2010. 

    The RDA of D that YOU need, is whatever is necessary to get you and KEEP you, to around 50 ng/ml - I prefer to use the range of 45ng/ml up to 90 ng/ml, though some RA sufferers will swear they do not get relief until they are in the 120ng/ml range!

    If you are taking D, and feel that you are "getting sore joints or achey muscles" without a good cause like running a marathon, then you should definitely suspect that you are taking too much D.  Get a level.  Be certain.  If you cut your dosage in half, such symptoms will typically disappear within a few days if D is involved, with no lasting adverse effects.

    ADVERTISEMENT: Yes, I am mercenary - a pharmacist making a living, and my wife, the RN and my best friend/worst nag about my chicken fried steak & TexMex "drug" habits :D .  In addition to the D I want you to get, from anywhere reputable, I also want you to read up on this and consider taking the nutrititional essence of a serving of a salad containing THIRY fruits, vegetables, and berries, TWICE a day.  It can be done in seconds, or, you can sit down and munch your way through the same thing in about an hour of chewing.  I want everyone to take Juice Plus+.  I would very much LIKE IT, if you were to access their website through my wife's portal there, so that when you order it, she gets credit and a few bucks. It does not change your price, they just give her some money because you started with her portal AND because she serves as a distributor, an educator, and a lecturer, convincing people to be active in apprehending better health.  If you buy JP, they send it directly to you - no preservatives, never sits on a shelf in a store, AND NO ADDITIVES.  No sugar. Very little fiber, just the nutrients.  She stands ready to provide information and answer questions, and she provides health lectures throughout the southern U.S. focused on preventing disease through better nutrition.  I love the website's great attention to STUDIES DOCUMENTING WHAT HAPPENS WHEN YOU PROVIDE YOUR BODY WITH ADEQUATE/SURPLUS NUTRIENTS OVER MONTHS/YEARS:   http://ginacarmichael.juiceplus.com .   For anyone wishing to avoid that gain for Gina, just take her name out of the URL, but regardless, check it out.   Many countries' NGBs have started providing it, at no cost to the athletes, and at 2 to 3 times the daily dosage for a "normal adult", to their elite-level Olympic athletes, due to the science and the studies. It also comes as capsules, chewables, and even gummybears for kids.  They give a child JP+ for years for free each time a parent starts taking it. (In exchange for agreeing to fill out health questionnaires periodically).  I LOVE the statistics they've compiled about what happens to kids who get more vegetables, fruits, and berries!  This is an outdated graphic - it only shows 150,000 kids, while actually, there are now more than 1 million kids in 26 countries around the world enrolled in the study:

    SO. Vitamin D3 and JP+ are my two prescriptions for anyone wanting to do the best they can for their future life to be as healthy, as cancer-free, as possible.  NOT A SILVER BULLET, but the best I know how to improve my odds.

    PS - This is ENTIRELY USADA SAFE, and in fact my daughter, Lindsey Carmichael (wikipedia), and countless other Olympians around the world, take it completely without fear of WADA violations.  You can even order NSF lots, for a couple of dollars extra.   Health for a couple of dollars a day is incredible.

     

     

    ON D: If you still want more information, I get much more wordy below:

     

    PROPER BLOOD LEVELS OF D3, ACHIEVED BY ACQUIRING DAILY VITAMIN D3, IS CRITICAL FOR HUMANS AND OTHER LIVING THINGS. (ie, your house pets).

    VITAMIN D3 IS NOT A SILVER BULLET, IS NOT A GUARANTEE OF CURE, FOR ANY OF HUNDREDS OF DISEASES AND "SYNDROMES"*
    PLEASE GATHER THE INFORMATION YOU NEED TO CONCLUDE THE BEST PATH IN LIFE...

(Translate this page to your desired language)

*Syndromes are, to my pharmacy practice mindset, defined as a set of symptoms a patient has for which the doctor cannot provide a "cause", and cannot, cannot, prescribe any medication that provides a CURE. Often, prescription drugs are used to treat the symptoms of the syndrome, and *may* reduce the symptoms, the pain, the skin condition, etc., but if the patient discontinues the prescription the symptoms return. Usually, those prescribed meds come with side effects, some very serious.

This is a world-wide epidemic. Imagery published October, 2015 - an acrobat file.

 

Is there science behind my argument that vitamin D does important, critically necessary functions for health of humans? 
Why do we even call this steroidal hormone a vitamin? 

Read a summary on D's actions on your genes.

Several members of the committee which set the US Recommended Daily Allowance in 2010, at "800iu" per day, have admitted in January of 2015 that they essentially dropped a decimal point in their math:  The CONSERVATIVE RDA should actually be, according to these heavily-influenced and poorly informed professionals, 8,000iu per day.  They lack the understanding of the many roles that D has in human development in utero and in life.  They fail to acknowledge that this is a steroid (comes from cholesterol like Testosterone and Estrogen do) and is a hormone with both Endocrine AND Autocrine functions in essentially every tissue of the body.

Remember that I'm both a pharmacist as well as an elite archery coach - my initial focus on D was to provide my student athletes with an extra 1 or 2 percent more performance.  What I learned by aggressive self-education over years is how little is taught in pharmacy (and medical) school.


Just for women athletes:  You are aware, I hope, that there has been huge growth in certain injuries in women athletes, in sports like soccer. The recent publicity on "women in the military" trying to qualify as rangers is a perfect example.  Most of the women who failed the course did not "ring the bell" to quit, but instead their bodies failed them:  leg fractures and pelvic fractures led the list of causes, followed closely by tendon injuries such as tears and avulsions(where the tendon literally pops off of the bone).  These are symptoms of a lifetime of chronic vitamin D deficiency, NOT in their willingness to excel in performance.

The tendon tears that not just these women athletes, but also elite basketball, track, and even football players experience can also be due to a fairly rare side effect of taking Cipro, Levaquin, or any other flouroquinolone, combined with a chronic deficiency in vitamin D.  This class of antibiotic is used by doctors very casually and frequently, even in athletes, for soft tissue infections (lung, skin, and UTIs).  Months later, an achilles tendon ruptures during a track and field event, as a delayed side effect.   

As a coach for both beginning as well as elite archers, I am carefull to advise my athletes to keep their blood level of D ("25(OH)D" is the actual test) ABOVE 50 ng/ml, by taking oral D3 capsules AND by getting at least some reasonable skin/sun exposure during the summer months, sans sunscreen. And of course, tell your doctor you are an athlete, and wish to avoid the very slight risk pointed out in the literature as a "BLACK BOX" WARNING for the flouroquinolones.  Chances are excellent that there is a suitable, alternative, safer antibiotic if you must take one. Your need for antibiotics will drop dramatically once your D level is kept at or above the MNL of 50 ng/ml - google "cathelicidin" or LL-37, Defensins, and if you are a health professional, please utilize my favorite information "Go-To" source:
The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. . Type in your search words, such as "vitamin D" and a disease, then look through the PubMed and PubMed Central listings.

I have spoken recently with several people with MS, or else with a loved one with MS.  Here is one very good reason to consider raising the blood level of D to the 70 to 100ng/ml range.

For ALL:
My convictions regarding the hormone we incorrectly call "vitamin" D are very substantial and well substantiated.  We do not call testosterone or estrogen a vitamin, yet vitamin D is just like these two hormones, is made in the same metabolic pathway in the body, from the same base molecule(cholesterol).  It's the hormone your body makes for NERVOUS SYSTEM DEVELOPMENT IN-UTERO & in the first years of life, and for IMMUNE SYSTEM FUNCTION and INFLAMMATORY PROCESS HANDLING, throughout life. It regulates thousands of genes in your body, making it one of the most powerful medicines you SHOULD always have. It's also one of the most effective antioxidants known to man - the sole one that can actually mend both rails of the double-helix (DNA).  Problem is, you don't have enough of it.  Long-term deficiency leads to death and disease.

YOU must make D or GET D on a daily basis, if you wish to be healthy.  80% of you (Americans) DO NOT have enough D.  This means you are far more likely to get SICK, both from acute infections, as well as long-term, lifetime sentences to pain and discomfort (MS, RA, "Myalgias", automimmune diseases, and many more). D is the hormone your body makes when you are in the sun, to protect you FROM the sun, from infections, and to help you NOT die when you are injured.

I am greatly concerned that for more than 30 years, since around 1986, the medical community has created the conditions which promote severe and profound chronic "D deficiency" in the American population.  Dermatologists, in particular, have lead the "FEAR THE SUN" campaign.  This activity is insidious, it is purposefully driving a car down the freeway the wrong direction.  The most vulnerable people damaged due to this advice are pregnant women, and it is this group that is most likely to follow this malevolently negative advice.  I will explain below, but lack of adequate D during pregnancy CAUSES  a lifetime of problems, verifiable and documented well. 

This campaign started in the 1980s with the promise of decreasing skin cancer but has instead caused an epidemic of cancers, especially skin cancers, and yet they persist in their mantra, "fear the sun".  D may be the most potent anti-cancer drug in your body. (or, NOT in your body). 

THERE is "raw D3" and there is "activated D3". Your body starts by making D3 from cholesterol using the very same metabolic pathway as Testosterone and Estrogen (so it is a hormone! a steroid!).  It finishes making the raw D3 in the dermis (deeper level of your skin) when UV-B rays penetrate.  Raw D3 is also the only "over-the-counter" version of vitamin D found in pharmacies and grocery stores.

THIS raw D3 is used by the majority of cells in the body - every cell has VDRs (Vitamin D receptors), and this raw D3 is absorbed into the skin, and the enzyme 1-hydroxylase activates the D3 into 25(OH)D, which THEN regulates more than 1000 genes, perhaps as many as 2000 genes. We know this is more than 5% of the human genome! Genes driven by D produce "things" - proteins, ezymes, chemicals, many things, all necessary for major organ and system functions. 

SOME organs, such as pituitary and brain-spinal cord (neuro-endocrine, neuro-sensory, neuro-muscular, cognitive), thyroid-parathyroid, pancreas, adrenal, skin and its appendices; as well as the digestive, cardio-vascular, skeletal, renal, lymphatic, hemato-poetic, female and male reproductive systems do not primarily activate the raw D3 and seem to rely therefore on the activated form. They also do absorb SOME raw D3.  But it is clear through research they mainly need the activated form, 25(OH)D. Fortunately, the liver takes raw D3 out of the blood, activates it, and releases it back into the bloodstream so that circulating 25(OH)D is availalble for those organs. There is also evidence that many of these tissues, as well as all other tissues/organs in the body, including mitochondria in the cell nucleus, need the raw D3, and in turn activate themselves into a variety of metabolites, not just 25(OH)D3, to perform critical jobs for your body. (An "autocrine" hormone function of underestimated impact on health in addition to the better-known endocrine hormonal function!)

NOW THIS IS IMPORTANT: The raw D3 has a half-life of about 24 hours in the blood.  If you take 1000iu of D3 then 24 hours later you only have 500iu left, and the next day, 250iu! On the other hand, 25(OH)D has a half-life of around 15 days!  Medicine measures the blood levels of 25(OH)D to decide whether the blood levels are adequate. While most doctors have been stupidly taught that 10 or 20 ng/ml is "ok", it is well documented that a level of 50 ng/ml is the "mother nature" ideal level for humans that get quality raw sunlight on a daily basis.  

Beware the doctor who looks at your labs, and witholds the NUMBER, telling you instead, "your level is fine".  What is fine in her or his mind may be anything BUT fine!  Get the number.  Make sure it is over 40ng/ml!

Patients taking a statin who develop muscle pain (myalgias) are typically low in D (20 to 30 ng/ml, or worse), and in one well-designed study, 90% were able to be pain-free for two years' followup once their D level was corrected to the MNL of 50 ng/ml. 

 2015 Mar;7(3):86-93. doi: 10.4103/1947-2714.153919.  -

Statin Intolerance Because of Myalgia, Myositis, Myopathy, or Myonecrosis Can in Most Cases be Safely Resolved by Vitamin D Supplementation.

Also, be aware that you can test 25(OH)D one day and have a level of over 90 ng/ml. (Great!) Then, you go into a 5-day intensive athletic training event like cross-training, or you run a marathon or an iron-man event, or you get hit by a truck and suffer major trauma.  My own level after a 5-day event tested at below 30 ng/ml afterwards.  90 down to 30 in just 5 days.  Incidentally, I was actually taking 20,000iu each day during this period, and it still was inadequate.   This reveals how CRITICAL vitamin D3 is to muscle repair during exercise and elite athlete triaining, after a heart attack, or any great trauma! 

When an in-training athlete is chronically deprived of sunlight, and their D level is pathetically insufficient, you see it:  A basketball player running down the court plants a leg and gets a horribly distressing compound fracture from the simple impact.  Muscles tear during a dash to first base. The further into the baseball season, the longer the disabled list is and the longer it lasts, due to waning sunlight and less vitamin D.   It is a fact that elite athletes are ironically, constantly, at risk for "the crud" and worse - catching pneumonia or the flu.  Why? They are chronically taking their body's systems to the edge of exhaustion, and bringing it back.  Their nutritional needs are extremely high, but healthy eating takes lots of time, which they don't want to take away from training.  Also, of course, their D levels are deficient. Especially in those involved in indoor sports like volleyball, basketball, ice hockey, gymnastics and even worsely (not sure that is a word?) in dark-skinned athletes.  Why?(again?) - muscle training literally consumes D as it works to heal the inflammation, the purposeful damaging of the muscles, the athlete inflicts on herself. And, elite athletes get that way by using the same nerves to do the same precise motions thousands upon thousands of times. When humans use a specific "thing" liike a certain nerve pathway, or leg bones, etc. more the body has learned through evolution to reinforce those things. In nerves, an object that is called an "Oligodendrocyte" keeps tendrils on the nerves, sensing activity levels and when the nerves are used, the oligo creates a fatty layer on those nerves. This layer is caled MYELIN, and it could be called a superconductor - it turns the nerve from a little country road between the brain and the muscle into an 10-lane superhighway for faster information, communication, between the brain and the muscles.  Oligos have a higher metabolic rate than other "tools" the body makes and uses, and it relies on .....vitamin D.... to work to create myelin.  Go to the medical study wiki site and search on "vitamin D" and "MS" to see just how serious D is with regard to myelin.  MS is the loss of myelin in the brain.  Science has identified a link between chronic D deficiency and the deadly Multiple Sclerosis, and they are studying it like nothing else.

Another "Problem" with medical practice policies:

Poorly-informed doctors prescribe D2 which is available only in a 50,000iu prescription-only strength and have patients take only once a week.  Booooo! HIsssss!   IF you are taking the prescription version, vitamin D2 made from irradiated mushrooms, beware/ be aware that it has only 80% of the affinity for the VDR as our natural D3.  Your body actually attempts to convert the D2 into the more natural D3, but studies show only 50% to 70% gets converted. 

You need raw D3 every day. NOT once a week, or yet worse, a month. Some doctors will prescribe D2 for a single month, then stop, thinking they've done something good and appropriate, and it does not need to be ongoing.    A VERY well-founded and scientific argument for daily dosing of D3, as opposed to weekly or monthly dosing, is made in this paper, by Hollis and Wagner, "The Role of the Parent Compound Vitamin D with Respect to Metabolism and Function: Why Clinical Dose Intervals Can Affect Clinical Outcomes". This study took me several DAYS of study to fully grasp everything it contains.  I have fun in the strangest ways!

If you take 50,000iu vitamin D orally as a once-a-week-dose, then about three days later your body is NOT getting the raw D it needs for the rest of the week. The NET RESULT is your cells are being starved even more when the doctor prescribes D2, or has you take either D2 or D3 only once a week!

BASELINE: you need a healthy dose (minimal of 5,000iu to 20,000iu per 100 pounds' body weight) DAILY if you are generally healthy and not actively working out physically.  You need more if you are ill, have a chronic disease, are highly stressed emotionally, depressed, physically very active, and if you have a history of not getting quality sunshine year-round. And "quality" means that it is sunny enough that you can see your shadow outside, and it is shorter than you are tall. Such as between 10am and 4pm in the summer.  Atmosphere, clouds, and glass(!) all filter UV-B out of the light, allowing the more damaging UV-A rays through.  Equate the "-A" as in dnA dAmAge.  Yes. sunlight contains three "bands" or ranges of wavelengths - UV-A (higher energy), UV-B (middle range), and UV-C (low energy, almost all blocked by atmosphere).  UV-A is the nasty, free-radical creating, DNA-damaging, sun-burning wavelength.  UV-B stimulates the production of D in the dermal layer, it also can cause burn to a much lesser degree.  Your body makes D in great part to protect you from the damaging effects, the cancer-causing and aging effects of UV-A sunlight.  You have evolved to use sun to get protection from sun.  Without quality raw sunlight, you are less healthy.  You may even die, especially if you do not correct the deficiency you most likely (80+ % of all Americans are nowhere near 50 ng/ml). The fact is, D combats skin cancer as well as promoting immune function and decreasing inflammation, enhances calcium absorption and deployment throughout the body.

Caucasians in Texas in the summer can MAKE 5,000iu of raw D3 in as little as 15 minutes if they are out in the sun while wearing just a swimsuit, between 10am and 4pm. This is when the sunlight is intense enough that the UV-B component in sunlight is strong enough to make the raw D3 in the dermis. 

NOTE: Non-caucasians/darker-skin individuals may have to be exposed to that same quality sunlight for EIGHT TIMES LONGER in order to generate the same amount of raw D3.  This fact is crucial to an understanding of the ramifications of medically-induced chronic D deficiency to "the human condition". It is not uncommon in studies for pregnant african-american/dark complexioned women to test in with a level LESS THAN 10 ng/ml.  I believe this insures that the fetus will NOT be able to develop the highest neural operating system and will have a diminished potential for cognition. A study of 900+ women and their child, conducted for more than 20 years, looked at the effects of having a combination of pregnancy and a level either less than 30 or more than 30. And 30 is NOT SUFFICIENT in my opinion, but 30 is better than 10! The study's deficient level mothers delivered children who had diminished lung capacity, and reduced "neuro cognitive skills" years later, and lastly, at 20 years those grown children still had less bone density, than the "sufficient" moms. Chew on this paragraph for a minute.  Neurocognition means an ability to use the mind, essentially.  LET ME REPEAT:  For pregnant women and nursing mothers - a low level of D will, during both gestation AND during nursing, have a negative impact your child for more than 20 years. See this study published in Pediatrics in 2015.  Deficient children have impaired neurocognitive skill and diminished lung function, and at even 20 years later, have measurably less bone density. (!) And these women, in general, were NOT in the < 10ng/ml range that so many black women test in with.

Dermatologists:  Think of that.  Could your mantra, "fear the sun", have been instrumental in a cascade of horror, inequity, and 2 generations of lost potential?  I am certain that in general, pregnant black women, hugely deficient, have children that "fail to potentiate", and your mantra could perhaps be scientifically attributed to a 35-year increase in the poorer grades, dropout rate of blacks, the increase in incarceration completely out of proportion, the overwhelming unemployment levels for black men and women?  This is not "pie-in-sky" speculation.  It is a fact that the rate of autism in the black population is far higher than the caucasian. This is to me, merely a connection, a gestalt, of many solid facts of known D activities, it's horrifying to me, and I may indeed be wrong - I would be relieved if anyone could prove me wrong. If a large portion of a part of our society has been caused "failure to potentiate" mentally, intelligently, psychologically, well....isn't that significant?  And is it not the penultimate "malpractice"?

Don't believe, don't simply accept that I am completely correct in my fears.  But keep this in mind as you go through learning more about the myriad ways your body uses the D molecule.  And wonder, what if everyone had an MNL of vitamin D, around 50 ng/ml?

I recommend to every pharmacist and other health professional to read this book. I beg every dermatologist to read this, and then adopt a more common-sense approach to advising patients. Not just for the explanations for what the causative factors are for AUTISM SPECTRUM DISORDERS, but to also understand how sweeping the effects of D are throughout the body.

Autism Causes, Prevention & Treatment: Vitamin D Deficiency and the Explosive Rise of Autism Spectrum Disorder by John Cannell MD

WIBLI: "Wouldn't It Be Lovely If...."

What I would like for every physician and esp. dermatologist to advise:  Do NOT apply sunscreen before you go out. Go out and expose as much of your body as you legally can, anytime that your shadow is shorter than you are, for at least 15 minutes OR UNTIL YOU BEGIN TO TURN PINK, and then either cover up or use sunscreen.  If your location prevents you from getting that "sun with your shadow shorter than you are" due to time of year or geography, then take oral capsules of vitamin D3, a minimum of 1000iu and up to 5,000 per 25 pounds body weight, EVERY DAY. and get your 25(OH)D tested at a point that is "normal" for your lifestyle activity.  Don't test the day after a marathon, for example, or the day after you recover from an infection.  Shoot for 50 to 70 ng/ml, even up to 100 ng/ml. 

What are the dangers?  There are certain rare disease that can be a problem, and if you have one you already know about this.  The other risk is a two-step problem:  Without enough D3 you cannot absorb calcium well.  So, you can take too much calcium tablets (ie, TUMS), with no adverse effects.  The RDA for calcium for adults is 1200mg, and for growing teenagers, 1700mg, per day.  But with lousy D levels you don't absorbe calcium where.  You could be taking 3000mg (that is 3 grams) or even more without becoming dangerously hypercalcemic.  Poor dietary habits and low D lead to stomach problems so you might be more likely to eat excess Tums.  If you then CORRECT your D levels, you will suddenly start begin absorbing calcium like you were supposed to be doing all along.  Since you are still eating excess calcium, your blood levels WILL rise, and you CAN develop symptoms of hypercalcemia - muscle cramps, diarrhea/constipation, even irregular heartbeats and ultimately death is possible.  Because of the calcium, NOT the D.   

Many physicians are convinced that vitamin D, all on its' own, causes hypercalcemia and will not hesitate to use that to frighten patients away from vitamin D dosing.  This is NOT consistently verifiable in the literature, and if it was true, then during the 15-year evaluation of US Poison Control Centers' calls mentioning "vitamin D", more than 24,000 calls, would not show that there were ZERO DEATHS and ZERO INJURIES over 15 years.  More people died during this time from things like Vitamin A and water intoxication.  Acetaminophen accounted for more than 3,000 deaths all by itself. Incidentally, more than 120 calls were suicides - people who took what they thought was enough D to kill themselves, then decided they wanted to live, called in to be rescued - and yes, none of them died nor suffered injury. Guess what?  D has been shown to alter serotonin levels in the brain favorably, AWAY from depression.

 

I have an aging library of a few studies that are properly designed on a variety of diseases posted to the page at this link. I don't much bother updating it since the NCBI database is so wonderfully accessible.


If you are suffering from/interested in a particular disease state, you might find some interesitng information to download or print.

And, ALWAYS, google is your friend when trying to learn and understand more about health, provided the site is a legitimate source.  I prefer The Vitamin D Council , for one - use their search tool. . 

IT IS NOT A VITAMIN, DAMMIT!

The human body, as with most other mammals on planet earth, generates vitamin D3 continually when the skin is exposed to UV-B in sunlight.  When the sun shines, historical mankind has made D3. 

The definition: we define a “vitamin” as a nutrient critical to health, which the body cannot make on its own and thus must be taken through diet.  Ironically, since we make vitamin D, it is not truly a vitamin.

Changing the designation now, more than 90 years after it was discovered and mis-named, is not going to happen.  So vitamin D3 or D or cholecalciferol, it shall be called.
Since our lifestyle fails to get most people enough sun exposure, vitamin D must be taken as a daily oral dosage.
It is fundamentally, essentially, a part of the healthy body. There is not a cell nor a major organ, that does not require either vitamin D3 or a metabolite of it, in order to function properly.  One key regarding health is continual presence of vitamin D3.
As a pharmacist I have long been used to physicians ordering D2,(ergocalciferol) 50,000iu, once every week, much to my frustration. 

This flies in the face of logic, of the knowledge regarding how the human body acquires D3. 

IT DENIES EVOLUTION...

There is a fundamental misunderstanding physicians have that D2 is the same as the chemical (D3) the body makes; it is not.  D2 is not produced by the body in the way D3 is.  The body must struggle to convert D2 into D3, by some estimates only 50% actually makes it into the D3 form. Complicating the issue is that D3, cholecalciferol, is available over the counter, whereas D2 is by prescription only, and there is an illusion that getting insurance coverage for a bad product like D2 is better than paying less out of pocket for the more natural, more effective, identical-to-body-produced, D3. D3 has receptor sites (called VDRs) designed to perfectly fit D3's 3-dimensional form & shape. D2 is so different in shape that it has only 80% of the affinity for the VDRs. If you were taking a life-njecessary drug would you accept one that only worked 80% as good as the other?

THE FEAR THE SUN LIE: A FALSE PROMISE

With the last two generations, a sea change has occurred in a large portion of the human population’s habits.  No longer is it normal to spend time in the sun on a daily basis, for several reasons.  In the late 1980s the medical community changed their recommendations due to a concerted lobbying effort by an industry-funded "non-profit" dedicated to eliminating some 1500 deaths a year by melanoma. This was180 degrees in the opposite direction of historical medical practice, to suddenly advise people that for their health they should shun the sun at all costs.  This was in part due to lobbying by commercial interests – the invention “sunscreen” was not selling well, until the AMA (dermatologists especially!) decided publicly the sun was harmful. 
Rather than going and playing outside, many now play in front of the game console, computer, or TV.  As the level of raw sun exposure has dropped, the population’s blood level of vitamin D has dropped.  And as this chronic D deficiency has risen, many diseases once rare are now seemingly out of control.  Ironically, dermatologists will admit that skin cancers of all kinds are way, way more common than 30 years ago.  So their premise is demonstrably false, yet for the majority of these medical professionals, it is "stay the course" and continue to create fear in pregnant women to the detriment of their children's chances of a long and healthy life.

BIG PHARMA: THE NEVER-ENDING PRESCRIPTION

As a pharmacist, I stand and bear witness to this: A huge variety of medications are used to treat symptoms such as fibromyalgia, with no hope for cure, simply because the cause, the mechanism, is not understood, for either the disease or for the drug’s effects.  They are essentially a life sentence of medicating, as the drugs prescribed do not, cannot, cure.  Some/many of these disease states respond to corrective-dosing of vitamin D3 and effect a cure. The correction very likely can prevent unknowable countless diseases.  Other conditions may be fatal/irreversible, having been triggered through a combination of a chronic deficiency in D and another predisposition such as a genetic characteristic, a physical impediment, another deficiency, or perhaps a dietary oddness. 

In many cases correcting the underlying D deficiency, bringing the level of 25(OH)D by daily therapy up to 50 to 70 ng/ml, should be the first and most aggressive effort ANY physician. For the mercenary attitude, it is the most "cost effective" measure!  For the true humanitarian, it is the safest medication to attempt first.

Some symptoms are alleviated in anecdotal cases of extending blood levels to the range of 100 ng/ml, though I feel this needs to be achieved by daily dosage rather than “Stoss dosages” where megadoses (greater than 1,000,000iu!)  are employed at intervals of time. Nothing mother nature has ever done herself mimics the Stoss insult, although the body's response to a severe sunburn comes close: the elevated temperature enhances the chemical reaction creating cholecalciferol, the vasodilation of the capillary bed (the redness) enhances delivery of the D3 from the dermis into the bloodstream (liver & kidneys for activation into 25(OH)D, the pain an indication of the damage caused by the UV-A!.

Most importantly: It is critical to have a circulating, adequate level of D3 in the bloodstream continuously, as we evolved to by daily sun exposure, not just one massive dose a week.

A VIABLE ALTERNATIVE TO EVERY-DAY DOSING

A weekly bolus such as 50,000iu only secures that circulating level for 1 to 3 days. For the rest of the week the blood level is negligible, and the flow of vitamin D into the cells of the body from the blood virtually stops.

I feel a good analogy is… oxygen, which like vitamin D3, is critical for every cell's functioning – where your physician prescribing you are ok breathing only once every 60 minutes (but taking a really big breath of with only 70% of the normal amount of oxygen), instead of every few seconds, that this will have the same life-sustaining, beneficial effect. Just breath once every 60 minutes?  Give vitamin D once a week/month?  These two are equally defective in logic.

Addressing those who argue with me over the phone or even to my face at my pharmacy, that Vitamin D is a fat-soluble vitamin, I will reply that first, vitamin D is not actually a “vitamin”, as the human body can make it, defeating the accepted definition of a vitamin, and second, only ~17% of a dose of even D3 is actually sequestered in fat, so giving a weekly or every other week dosage does not result in a slow release of D back into the bloodstream as some believe.  The half-life of D3 is only about 24 hours, while the half-life of 25(OH)D and 1,25(OH)2D are much longer.

Vitamin D3 is safe enough that many adults could take a 50,000iu capsule every two to 3 days, perhaps even every 4 days, and due to the half-life of D3 (~ 24 hours),
the patient's level of D3 will always be at least what we would want each day as circulating free D3, as if the dose came from the sun.

While the 25(OH)D has become a good and relied-upon metric of D sufficiency, a study makes an excellent case for insuring that the level of cholecalciferol (aka raw D3) be continually re-enforced on a daily basis.

Humans who are “in the sun” for hours each day will develop a steady-state blood level of about 50 ng/ml of the first active metabolite of D3, 25(OH)D.  This metabolite has a much longer half-life, so it stays in the blood and available to the body for longer.  Mistakenly, it is given more respect and weight than free D3.

There is ample evidence in the study that both are of great importance.
Achieving a 25(OH)D blood level of approximately 50 ng/ml is an excellent indicator towards health, as that is what mother nature confers upon man in the sun but does not insure optimal health for those NOT in the sun.

The autocrine effects of free, continuously-circulating vitamin D3 are critical.  That D3 is either made in the skin or taken orally and then absorbed via osmosis from the bloodstream by virtually every tissue in the body including prostate, skin, intestine, brain, liver, etc., and then via cytochrome p-450 and certain, specific enzymes include hydroxylases specific for the D3, activated in the cell, to act on that cell. Each cell in the body takes in D via osmosis, and makes something critically beneficial from the D3.  D3 needs to be present all the time, not just for 20-30% of the week.

There are certain tissues, including the parathyroid, the kidneys, the mammaries, and the placenta, where in addition to the normal passive diffusion for the cholecalciferol (aka D3), a sophisticated mechanism called the megalin-cubulin system actively pumps in the 25(OH)D,  a specialized cellular transport mechanism, to the intracellular 25-hydroxyvitamin D-1-alpha-hydroxylase for metabolization. The resulting chemicals are vital for the health of the cell, and the successful potentiation of that cell’s mission in life for the host.

ONE NET EFFECT IN PREGNANCY (D HAS MANY, MANY ROLES IN PREGNANCY)

During pregnancy, the fetus receives the vitamin D in the form of those metabolites (primarily 25(OH) D) which it needs in utero for everything from successful implantation of the fertilized zygote in the womb, to potentiation of the nervous system during the last trimester. If the mother is chronically deficient in D, the fetus is also deficient, with life-long consequences in the bargain.
Upon delivery from the womb, the infant’s D dependency transitions a source of free D (via either sun exposure or mother’s milk) and begins to make the metabolites on its own. If the mother does not have an adequate level of free D3 (which the mammaries convert to 25(OH)D via the megalin-cubulin system), the process of milk letdown will have NO D in the product, and the infant will be deprived of the developmental advantages conferred by vitamin D.  Ironically, even today the standard for newborn infants with certain problems is to put them under UV-B lights so that the skin can generate vitamin D.  Before the 1980’s new mothers were routinely given a booklet at the hospital exhorting them to insure their newborn got life-giving sunshine.  But no longer, so thorough has the medical campaign against vitamin D been.

Studies are clear:nursing mothers need at least 6,000iu of D3 DAILY in addition to a sufficient steady blood level of 25(OH)D while nursing in order to provide 400 to 500 iu of D3 to the nursing infant via mom's milk each day.  There is no evidence that more D than 6,000iu has any adverse effects. Therefore, erring on the side of more is better than running the risk of deficits, as there may be some evidence that infants NEED more than 500iu per day, particularly increasing as age does, and given that physicians routinely admonish the mother to protect the child from “the dangerous sunshine”.

When might you get too much vitamin D and suffer an adverse event from that?  Certain rare metabolic disorders are a problem and you already know if you have such. If you habitually ingest a gross overdosage of daily calcium intake (The adult RDA is around 1200mg per day all sources) yet not had a problem it may be you simply aren’t absorbing enough, in which case you will likely suffer hypercalcemia once you correct an underlying D deficiency let alone take excess vitamin D, since you will begin absorbing all the calcium your body is desperate for.  In certain renal diseases, there is some logic and a little reliable information in the literature to indicate ingestion of even as much as 20,000 iu daily of D3 leads to any adverse condition.

WHY DO SO MANY DRUG STUDIES FAIL MY "SMELL" TEST?

Time and again studies have been shown where vitamin D has little or no effects, and even some where they suggest D is harmful!
These are great examples of flawed science.  Many times, they give meaningless low levels of D. Or ridiculous dosages at unrealistic intervals, like once a year.
Every study concerning the effects of vitamin D must first be evaluated regarding the protocol used.  I personally use these criteria

  1. Did it provide an appropriate dosage?  (I currently see 1,000iu/day for each 20 pounds of body weight to be a prudent starting point in the absence of a pathology)
  2. Did it document the subjects achieved a 25(OH)D of at least 40 ng/ml? (Mother Nature provides humans exposed to normal sun with a level around 50 ng/ml)
  3. Was it administered on a natural frequency?(ie, daily like sunshine happens instead of “once” or “weekly” or “worse”)
  4. Was the duration of the study long enough to effect a biological response commensurate to the disease being evaluated? (Repairing or improving the damages a chronic deficiency causes may take years rather than weeks or months)

If the study fails any of these then I conclude it fails to rise to the level of credibility needed to employ its outcome in human therapy.   
One must use the information in this article to decide whether the study is relevant.

I also recommend the non-profit website, Vitamin D Council, as a reliable and fair resource for the person wishing to find out more about the effects of vitamin D for any disease state there might be relevent studies for. I contribute $50 to $100 dollars a year to the support of this outfit.

FINALLY.  VITAMIN D3 IS NOT A SILVER BULLET.  THERE IS NO GUARANTEE IT WILL DO ANYTHING FOR ANYONE'S CONDITION, JUST AS THERE ARE VIRTUALLY NO GUARANTEES IN LIFE.  WEIGH THE EVIDENCE.

Examples of Pathetic Protocols:

A high number of studies you will find in searching online, or seeing posted in the news, are deeply flawed. The flaws invalidate the results.  Millions of dollars wasted and the highly precise, scientifically-trainined methods of thousands of persons around the world, essentially wasting their talents. 

  • Dosing: improper dosing through apparent total ignorance of the fundamental mechanics of cholecalciferol.
  • Too high of a dose but at improper time intervals: example, 1 million units once a year
  • Failure to establish the study population achieves a significant blood level of 25(OH)D: example, no levels done
  • Presumption of inadequate level as relevant: example, "we (proudly) chose 20 ng/ml (50 nMol/L) as the mark of sufficiency"
  • Proper dose at improper time intervals: example, "50,000iu given once weekly/monthly/yearly"
  • Embecile expectations: example, "800iu had no effect on osteoporosis"

Excerpts from actual studies revealing where they are totally oblivious to their own falied education/understanding:
(AND I HAVE TO ASK, "10-20 µg/d"?? ARE YOU KIDDING ME??)

QUOTES ARE INFERRED:

We recently published results of an IPD level meta-analysis showing that vitamin D in doses of 10–20 µg/d given alone were not effective in fracture prevention,

Fractures of the lower limbs occurred almost as frequently, 31/341 = 9.1%, among the vitamin D recipients as among the controls, 49/458 = 10.7%.

We recently published results of an IPD level meta-analysis showing that vitamin D in doses of 10–20 µg/d given alone were not effective in fracture prevention,
In studies with intermittent (monthly or yearly) administration of vitamin D, an equivalent daily dose was calculated.
Mean dietary calcium intake from dairy products was 868 mg/d. Mean serum 25(OH)D concentration in the third year of the study was 23 nmol/L in the placebo group and 60 nmol/L in the vitamin D group. Median follow-up was 3.5 years, and total follow-up was 8450 patient-years. During follow-up, 306 persons in the placebo group and 282 persons in the vitamin D group died (P = 0.20). Hip fractures occurred in 48 persons in the placebo group and 58 persons in the vitamin D group (P = 0.39, intention-to-treat analysis). Other peripheral fractures occurred in 74 persons in the placebo group and 77 persons in the vitamin D group (P = 0.86).


Our results do not show a decrease in the incidence of hip fractures and other peripheral fractures in Dutch elderly persons after vitamin D supplementation.
A total of 3270 mobile elderly women (mean age 84 (SD 6) years) living in 180 nursing homes were enrolled in the study. Half the women received 1-2 g calcium
daily in the form of tricalcium phosphate, together with 800 IU (20 ,ug) cholecalciferol; the other half received a double placebo. All subjects were followed
up every six months;
Annual injection of vitamin D and fractures of aged bones.
In order to investigate the effect of a supplementation of vitamin D in the prophylaxis of fractures of the bones of aged people, an annual intramuscular injection of ergocalciferol (150,000-300,000 IU) was given to two series of aged subjects: first to 199 (45 male) of 479 subjects (110 male) aged more than 85 years who were living in their own home, and second to 142 (29 male) of 320 (58 male) subjects aged 75-84 and living in a home for aged people.
Fractures of the lower limbs occurred almost as frequently, 31/341 = 9.1%, among the vitamin D recipients as among the controls, 49/458 = 10.7%.

Frankly, I view these researchers as something akin to medieval alchemists with a hint of Torquemada - injecting ergocalciferol annually to advanced-age people crosses the line of human decency.  I would expect that of Mengele.