Megadosing Vitamin D: Part 1

Megadosing Vitamin D

The question of how much vitamin D we need to supplement with is a subject that is both contentious and highly debated. And even more controversy arises when discussing using high doses of vitamin D as a medicine, rather than lower doses for simple maintenance purposes. In this newsletter we will look at some good science on megadosing with vitamin D, but first let’s have a quick look at what a maintenance dose should look like.

The U.S. National Institute of Health suggests a daily intake of 600 IU to reach a serum level of 20 ng/ml vitamin D in the blood (considered to be a sufficient amount), and it sets an upper limit of 4,000 IU per day. Thus, anything above that is considered to be a high dose by medical professionals. However, that did not stop some conventional medical professionals from seriously testing out the upper limits of vitamin D dosing.

But, before we get to that, let’s touch upon the idea that even the upper limit of 4,000 IU of vitamin D daily is insufficient for maintaining general well being.

Is 4,000 IU Daily Enough?

In The Journal of Steroid Biochemistry and Molecular Biology (October 2017), authors Patrick McCullough and Jeffrey Amend released their study questioning the definition of what was an acceptable “high” dose of vitamin D.

In this combination of data analysis along with a small actual study using high dose vitamin D treatment, the authors conclude that our daily requirement will not be met by 4,000 IU daily. McCullough elsewhere suggests that this current medical recommendation is below the requirements of the body, and that we should be taking closer to 10,000 IU daily, just for general health.

In their conclusion, the authors include this comment: “It appears from our data, and the studies that we have reviewed, that long-term supplementation with oral doses of vitamin D in the range of 10,000 to 25,000 IU a day is safe for people to take.”

Those who follow my work, or who have consulted with me, know that my general recommendation is 25,000 IU of vitamin D per week (however you want to divide that up: 5,000 IU, five days a week or 25,000 IU once a week). Not long ago, I wrote about a COVID study in which the scientists concluded that one should ingest about 35,000 IU of vitamin D weekly, just for basic immune support.  (Source)  However, it seems like I might be erring too far on the side of caution.

This move towards upping the recommended daily intake of vitamin D is gradually increasing among serious scientists and medical researchers.

Further Support for Higher Levels

For example, experts from the Council for Responsible Nutrition (in 2013) suggested increasing the maximum daily limit to 10,000 IU daily, based on their analysis of clinical studies showing no toxicity in persons given 10,000 IU daily for long periods of time.

The amount of daily vitamin D ingestion needed to produce adverse effects varies widely. In most adults, daily intake in excess of 50,000 IU (1.25 mg) is needed to produce toxicity (Miller and Hayes 1982). Clinical trials in the last decade or so have found no hypercalcemia in subjects taking 10,000 IU (250 µg) in long-term clinical trials.”   (Source)

The lower recommended dose from the NIH (4,000 IU) was based on early research which mostly only looked at the value of vitamin D for promoting bone health, by way of enhancing calcium absorption. However, we now know that vitamin D plays a host of roles in other organs and systems of the body. In fact, according to the NIH website,  “vitamin D has direct effects on the epigenome and the expression of more than 1000 genes in most human tissues and cell types”.   (Source)

One health professional often interviewed for articles on vitamin D, integrative physician Dr. Ana Mihalcea, believes that most of her patients require 10,000 IU daily, to attain optimal cognition and energy levels.

Dr. Mihalcea maintains that, while most of her patients have “adequate” levels of vitamin D from a conventional perspective (i.e. 20 ng/ml as recommended by the NIH), nonetheless many of these patients were still showing symptoms of fatigue, muscle weakness and poor cognition, all of which are known symptoms of vitamin D deficiency. In such patients, she increased their blood levels to 70 ng/ml, or more, using supplements, in many cases resolving those symptoms.   (Source)

Meanwhile, the Vitamin D Council for over a decade now has recommended the average person maintain a blood level of 50 ng/ml. (For more on vitamin D testing and how to compare different readings, especially the difference between U.S. and Canadian measurements, see this newsletter).

Physician and surgeon Dr. Joseph Bosiljevac, has discovered that there is a great deal of variability in what constitutes an optimal serum level of vitamin D among his different patients. He maintains that some of his patients see great benefits at 60 ng/ml, while others require 120 ng/ml, or even more, to attain the same level of benefit. And, while some studies have shown vitamin D toxicity to occur when serum levels are above 150 ng/ml, McCullough has patients who are fine at levels above 200 ng/ml.

Which is all a little confusing. So let’s dig deeper.

High-Dose Vitamin D Therapy

Essentially, what a lot of these unorthodox medical people are saying is that some people, especially those with certain diseases, may need much more vitamin D than healthy people do. And, in many cases, people with “incurable” diseases have had recovery after being prescribed high doses of vitamin D.

As Dr. Mihalcea has said, vitamin D can be used “as a medicine, not just a preventative vitamin”.

Let’s now look at some examples of where vitamin D is being used as a medicine.

Autoimmune Disease

Autoimmune diseases occur when the body’s immune system starts attacking healthy tissues, and since vitamin D regulates immune cells, including those which counteract the autoimmune response, this is a disease where using high levels of vitamin D makes perfect sense.

It was discovered that after suffering with an autoimmune disease for long periods of time, the patient becomes “vitamin D resistant”, being less responsive to vitamin D supplements, and even to making D from sun exposure.

One autoimmune specialist, Dr. Cicero Coimbra, author of the Coimbra Protocol, found that many of his patients with multiple sclerosis (MS) went into remission after taking massive doses of vitamin D (along with some other supplements).

Dr. Coimbra’s clinic has treated over 15,000 patients who have autoimmune disorders and, at least with MS patients, he claims about 85% go into remission. He has also had significant improvement in patients with Crohn’s disease, IBD, lupus, rheumatoid arthritis, and psoriasis, who follow his protocol.

One interesting observation Dr. Coimbra made was that many of his patients who did not respond to vitamin D treatment were under high levels of stress. He found that these people needed to reduce their stress levels and how they responded to stress, for the vitamin D protocol to be effective. One reason for this may be due to stress depleting copious amounts of magnesium from the body, and vitamin D requiring magnesium for proper absorption and utilization. (Source)

The Coimbra protocol ranges from prescribing 150 IU of vitamin D per kilogram of body weight, up to doses as high as 1,000 IU per kilogram of body weight daily. (e.g. 120 lbs equals 54 kg which would mean taking 54,000 IU of vitamin D daily.) Such an approach, he believes, also requires that patients are “routinely tested to ensure their parathyroid hormones, calcium, and other micronutrient levels are in balance”.

In Part Two, the final part in this series, I will look at a few other areas where megadosing vitamin D has been proven to be safe and effective, and examine the history of this therapeutic approach.

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