The Institute of Medicine (IOM) dropped a bombshell recently. This organization, which the US government tasks with setting the recommended daily intakes (also called Dietary Reference Intakes, or DRIs) of various nutrients, unveiled the eagerly anticipated new guidelines for vitamin D. Given that they hadn’t been updated in 13 years—and there’s been a virtual explosion of research on the benefits of this vitamin during that time—I was looking forward, for once, to some reasonable recommendations regarding nutritional supplements.
Imagine my shock and dismay when I read the press release that began like this: “Most Americans and Canadians up to age 70 need no more than 600 international units (IUs) of vitamin D per day to maintain health, and those 71 and older may need as much as 800 IUs.” They also erroneously claimed that “…almost all individuals get sufficient vitamin D when their blood levels are at or above 20 nanograms per milliliter [ng/mL]” and set the “tolerable upper limit” at an absurdly low 4,000 IU for adults, stating that “excessive vitamin D can damage the kidneys and heart.”
A Lethal Bombshell
The fact that this fatally flawed proclamation came out a week before the 69th anniversary of the Pearl Harbor attack was not lost on me. With the institution of these bogus guidelines, the IOM launched an assault on scientific integrity that threatens the health and lives of all Americans.
I am not being melodramatic. Extensive media coverage of this dangerous advice is scaring people away from higher-dose vitamin D, just when they were finally beginning to recognize its importance in treating and preventing a wide range of diseases. I have no doubt that most doctors will fall in lockstep with these absurdly low recommendations. Regular folks will buy into it as well—if they haven’t already. A patient recently told me she and her husband stopped taking their vitamin D supplements because they heard on TV that they were harmful! As others follow suit, more and more people will suffer the consequences of suboptimal levels of vitamin D.
If you’ve cut back on vitamin D, read this article carefully. The risks of taking higher doses of this vitamin are virtually nonexistent—especially compared to the risks of not taking it.
Is Vitamin D Safe?
Let’s start with the safety concerns. In one breath the IOM caps the safe “upper intake level” at 4,000 IU per day and in the next states, “Very high levels of vitamin D (above 10,000 IUs per day) are known to cause kidney and tissue damage.” Then they admit that despite their warnings, “strong evidence about possible risks” is “limited.”
I challenge anyone to come up with even the slightest bit of solid scientific evidence demonstrating that 10,000 IU per day causes harm. Doses multiple times higher have been shown to be safe and effective, and the general scientific consensus is that toxicity is associated only with blood levels greater than 250 ng/mL.
Furthermore, the IOM’s lowball level just doesn’t make any sense. An hour of midday sun exposure at noon on a sunny day in June stimulates the production of about 10,000 IU of vitamin D. Where’s the harm in that? Does a summer day at the beach “damage the kidneys and heart”? Have you ever heard of anyone with vitamin D toxicity? Moreover, if it were potentially toxic, how could the same dose (600 IU) be appropriate for a 250-pound adult and a 25-pound child? It’s absurd! Bottom line: Vitamin D is inherently safe, even at doses much, much higher than the new DRI.
How Much Should You Take?
Another aspect of the updated guidelines I take issue with is the assertion that a blood level of 20 ng/mL or above is indicative of sufficient vitamin D status. The current standard reference range for “normal” is 30 ng/mL or higher, and the vast majority of Americans still fall short. Case in point: 87 percent of patients tested in a recent study had a vitamin D blood level less than 32 ng/mL. By sanctioning an even lower level, the IOM is giving hundreds of millions of people false assurance that their vitamin D levels are adequate.
What were these guys thinking? Dozens of leading vitamin D experts agree that even a blood level of 30 ng/mL is too low. Michael Holick, MD, PhD, who is arguably the world’s leading expert in this field, recommends 40–60 ng/mL, and the Vitamin D Council suggests 50–80 ng/mL—the average level of people who live in sunny climates and spend a lot of time outdoors. Should we advise these folks to move to the North Pole to avoid vitamin D toxicity?
In order to maintain these protective blood levels, you need to take doses much higher than 600 IU per day. I personally take 5,000 IU, which keeps my level in the middle of the optimal range—and I live in sunny California. Some people require less and others as much as 10,000 IU per day or one 50,000 IU capsule per week.
To take the guesswork out of the equation, we test our patients’ blood levels, dose accordingly (average is 2,000–5,000 IU per day), then retest in three months to make sure they’re on track.
Vitamin D Improves Health…
I’ve been extolling the benefits of supplemental vitamin D for nearly 10 years, and I make a point to keepHealth & Healing readers updated on the latest research. Last year, we discussed the links between higher blood levels of this vitamin and reduced risk of 17 different kinds of cancer. In 2009, I told you how supplementation during pregnancy and infancy dramatically lowers risk of type 1 diabetes in children, and the year before that we covered vitamin D’s role in flu prevention.
There are now more than 38,000 peer-reviewed scientific articles in the National Institutes of Health database on vitamin D. To see for yourself, Google pubmed and enter “vitamin D” in the search field. You’ll be hard pressed to find anything negative about this vitamin—and overwhelmed by the diversity of conditions for which it has been shown to be protective. Cancer. Heart disease, hypertension, heart failure, and peripheral artery disease. Metabolic syndrome and type 2 diabetes. Multiple sclerosis, rheumatoid arthritis, and other autoimmune disorders. Asthma and chronic lung disease. Depression and dementia. Autism. Falls and fractures. Flu and other infections. Even longevity!
Nutritional Medicine: An Invaluable Resource
My friend and colleague Alan Gaby, MD, has made a major contribution to human civilization. His new bookNutritional Medicine—which has 1,374 pages, weighs in at 10 pounds, and took 30 years to research and write—covers natural approaches to more than 400 different disease conditions, supported by 15,200 peer-reviewed medical journal references.
This is not a book you sit down and read cover to cover. It’s a reference book you turn to for detailed solutions for specific health problems. Suppose you have fibromyalgia. There’s a description of its underlying causes, pertinent dietary factors, and in-depth information on nine nutrients for treating it. How about congestive heart failure? In addition to diet suggestions, Dr. Gaby provides details on 19 heart-bolstering supplements.
Just imagine walking into your physician’s office to discuss natural alternatives to drugs, armed with a book that discusses thousands of studies from the conventional medical literature. I guarantee it would put an end to that common but senseless objection, “But there are no published studies on vitamins, minerals, and other supplements.”
This is the single most valuable reference book on natural remedies I’ve ever come across. At $295, it’s not inexpensive. But the information in this book will never go out of style. If a natural therapy works today, it will work exactly the same way a thousand years from now. We will add to our knowledge in the future, but we’re not going to replace it. Considering how useful Nutritional Medicine could be in helping you and your family overcome disease and achieve optimal health—now and for generations to come—it’s an investment that will pay off. To purchase your copy, visit doctorgaby.com or call (603) 225-0134.
…And Saves Money
Dr. Holick estimates that a billion people around the world have insufficient stores of vitamin D and states, “Correcting and preventing this deficiency could have an enormous impact on reducing health costs worldwide.”
An international group of renowned researchers looked at the existing scientific literature and concluded that appropriate vitamin D supplementation could reduce prevalence of hip fractures by 26 percent, cancer in postmenopausal women by 35 percent, type 1 diabetes by 78 percent, colds and flu by 90 percent, and death rates by 7 percent. They then determined the savings that would be incurred in Western Europe if everyone took enough vitamin D (approximately 2,000–3,000 IU per day) to increase their blood level from the current average level of 15–20 to 40 ng/mL. They came up with a “total reduction in economic burden of disease” of 17.7 percent, or 187 billion euros ($247 billion US) per year.
Medical writer Bill Sardi extrapolated this data and concluded that similar supplementation in this country would save us about $1,346 per person in health care expenditures each and every year. Over a decade, that would add up to more than $4.4 trillion!
Why Did the IOM Lowball Vitamin D?
Once I got over my initial shock about these new recommendations, I asked myself: How did the IOM get it so wrong? Why would anyone in their right mind think that a one-year-old baby, a pregnant woman, and an overweight 65-year-old man all require the same dose of vitamin D? How could they decrease the already ridiculously low target blood level? And why would they stir up nonexistent safety concerns?
First, the IOM focused on vitamin D’s effects on the bones. Of course it’s a factor in bone health, but vitamin D receptors are also present in the brain, blood vessels, muscles, and other organs and cells throughout the body. Their 600–800 IU dose may prevent rickets, the classic vitamin D deficiency disease, but it isn’t enough to protect against many other, far more prevalent health concerns.
Second, they didn’t even look at much of the cutting-edge research on vitamin D. If a study wasn’t a randomized, controlled trial then in the eyes of the IOM it was unworthy of consideration. Get real. These studies cost millions and millions of dollars to carry out. Who’s going to pay that kind of money to test the efficacy of an unpatented natural substance that costs pennies a day?
There’s plenty of valid research available, including hundreds of epidemiological (population-based), observational (comparing outcomes according to vitamin D levels), and small clinical studies, which forms the scientific basis for vitamin D supplementation. But the IOM ignores these studies because they don’t fit the narrow criteria used in testing drugs. It’s like ignoring Isaac Newton’s observations on gravity because he didn’t drop 10,000 apples from the tree just to be sure that some of them didn’t fall upward!
Third, the IOM is dangerously conservative—not just about vitamin D but across the board. Their suggested daily intake of vitamin C, for instance, is just 75–90 mg; I recommend a minimum of 1,000 mg. For vitamin B12, it’s 2.4 mcg; my multi contains 150 mcg. Their guideline for vitamin E is 15 IU, compared to my 300 IU or more. For all of these nutrients and many more, these paltry levels may prevent deficiency diseases, but they do not promote optimal health.
Finally, that old, inherent bias against nutritional supplements is rearing its ugly head. The IOM has close ties to the government and the disease care industry. If vitamin D were a drug, with all the sales clout of the pharmaceutical companies behind it, I guarantee it would be considered the latest and greatest thing. As a matter of fact, synthetic vitamin D analogs are currently being developed. They won’t be as effective or as safe as the real deal and they’ll cost a lot more, but they’ll fit into the model of conventional medicine.
Mark my words, these ridiculous new guidelines conjured up by the IOM will do serious harm to the American public. Now that you know the truth about vitamin D, I implore you to help me spread the word and educate others about this safe, natural vitamin.
From: Health & Healing with permission from Healthy Directions, LLC. Photocopying, reproduction, or quotation strictly prohibited without permission from the publisher. To subscribe to Health & Healing, click here.