mrandish 9 days ago

Having looked pretty deeply into Vit D studies a while back, my takeaway was (in broad strokes):

* Adding more Vit D doesn't appear to meaningfully prevent upper respiratory infections.

* However, being deficient in Vit D appears to be correlated with a meaningful number of D deficient people who do happen to get an upper respiratory infection having a more serious impact. Basically, a higher percentage of deficient people (but certainly far from all) appear to have worse symptoms for longer and have more trouble fighting the infection off. Whether that just means an extra day of feeling under the weather or that you join the very small percentage of those hospitalized for upper respiratory infection depends on the other factors you already know (age, overall health, etc) much more than on Vit D deficiency. But Vit D deficiency is very probably in the top 5 somewhere behind the two statistical Godzillas at the top, age and overall health (which are overwhelmingly correlated).

This is only worth talking about because a fairly significant number of people are Vit D deficient at least some of the time (probably more than 20% but less than half). Who and how much depends on where they live, lifestyle, age, diet, time of year and there is also a genetic propensity for deficiency that's primarily based on race.

Bottom line: If you're Vit D deficient then it may be a good idea to supplement a little Vit D which is cheap, easy and extremely low risk (Note: nothing is ever zero risk across a large enough population but supplementing a small amount of Vit D is about as safe as these things ever get). It may be especially worth considering if you're in a statistically higher risk group, location and/or season. So, if you're at elevated risk and can't be younger or healthier, at least don't be Vit D deficient too. Once you're not deficient, taking even more Vit D won't help more (and can be harmful). Mega-dosing can definitely be harmful, so please don't. Starting oral supplements once you have symptoms is also too late to matter.

In terms of confidence levels, my sense was there's pretty clearly a meaningful correlation here but causation and relative effect are fuzzy. The correlation mostly comes from looking retrospectively at the Vit D levels of those who have infections serious enough to get hospitalized. However, the Vit D correlation is far less than age or overall health (which are overwhelmingly large). The challenge is looking at it the other way, from the front end, where it gets pretty fuzzy trying to tease out high confidence causal data, narrow other factor's contributions or derive a degree of impact specific to Vit D. There are a lot of potentially confounding factors and Vit D is not usually checked in many blood work panels unless there's a reason to. Worse, long-term diary studies of diet are notoriously inexact. So much so that as an armchair amateur scientist just trying to objectively assess data, I have to attach error bars to longitudinal diary diet studies so large they usually swamp any signal. For example, the question: "Does being Vit D deficient meaningfully increase susceptibility to infection?" I don't think there's sufficiently clear data to make any judgement.

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slibhb 9 days ago

> Bottom line: If you're Vit D deficient then it may be a good idea to supplement a little Vit D which is cheap, easy and extremely low risk (Note: nothing is ever zero risk across a large enough population but supplementing a small amount of Vit D is about as safe as these things ever get).

Too much vitamin D can cause pretty serious symptoms, including neurological symptoms. This condition has been getting more common since so many people are supplementing.

kstrauser 9 days ago

Very true. That said, I've been taking 5000IU daily for the last couple years after a blood test showed my levels were a bit low. As of last week, my 25-Hydroxy D level is 76, near the middle of the 30-100 normal range.

Everyone's different: what's right for me isn't right for you. I just mean that to demonstrate that it's possible for some healthy adults to take a pretty significant amount every single day and have perfectly reasonable blood levels.

Aurornis 9 days ago

Vitamin D has a very long half-life in the body once stored. On the order of a month or two.

This leads a lot of people into slowly overdosing over several years. They start with low levels, get up to mid-range on their next blood test, and think they're on the right track. Continuing the same dose for years can easily put you over the top if you're not careful.

p0w3n3d 9 days ago

I read somewhere that additionally supplied vitamin K decreases these side effects. However I'd like to see a scientific paper instead of an article

https://www.health.com/vitamin-d-and-k-8427006

timrichard 9 days ago

> you'll just pee out the extra Vit D.

It’s fat soluble, rather than water soluble

adrian_b 9 days ago

True.

I have not checked this, but I assume that most excess vitamin D, which is stored in the liver, is excreted by the liver together with cholesterol and other cholesterol derivatives, in the biliary secretion, reaching thus the intestine, and not by the kidneys in urine.

mrandish 9 days ago

Thanks! I removed that line.

AStonesThrow 9 days ago

If we’re deficient then it may well mean that our bodies aren’t being accorded the usual natural opportunities to manufacture it!

Therefore a deficiency here is an indicator of sedentary, indoor, face-in-a-screen lifestyles that risk all sorts of poor health conditions.

The solution to D deficiency is to manufacture it by touching grass, enjoying sunlight (unprotected!!!) and exercising—not in a gym—but in that extremely large room, lit by a bright, warm lamp that’s 93 million miles away.

jerf 9 days ago

We don't need to hypothesize about our bodies not getting the natural opportunities to manufacture it. We know we don't. Plenty of people live in places where the sunlight is insufficient for significant portions of the year to generate any vitamin D. Many others live in places where they may nominally be getting enough ultraviolet to make enough vitamin D, but have too much melanin in their skin for the ultraviolet conditions where they live.

This isn't all about "oooh sooo much indoors too much screen time stop sitting so much lol lol lol". You can go outside all day in the middle of winter at the 45 degree latitude, where a lot of people live, and you will generate zero vitamin D, no matter what you do, because it isn't the visible spectrum you need. You need something that isn't in the winter sunlight at all. AIUI, it's technically not the same part of the UV spectrum that causes sun burns, but you're at least on the right track if you think of it as if you can't burn (modulo melanin), you can't generate vitamin D at all.

SoftTalker 9 days ago

Just taper into the sunlight exposure so you don't get burnt. Skin cancer is not really a price you want to pay for adequate Vitamin D levels.

AStonesThrow 9 days ago

Skin cancer is not something I anticipate, since I scrupulously avoid slathering carcinogens onto it. I protect with clothing, umbrellas, and old-fashioned hanging out in the shade [my skin tone is porcelain, minimal freckling, 100% Celtic edition]. 26 years in Phoenix metro with literally no burns and no cancer: homelessness and public transit benches notwithstanding.

niemandhier 9 days ago

To much words for truth:

More does not help by to little will harm.

I live where the sun does not shine, so I take some.