Vitamin D Guidelines from the Endocrine Society! Sanity at LAST
Competency: Vitamin D
Reference: Endocrine Society Guidelines
At last, at last! We have guidelines that make physiological sense. Thank goodness. And the language is a masterfully written document to match with the recent timid guidelines put out the Institute of Medicine, our supposed national center for medical leadership. I was very disappointed by the IOM report last November, as they dodged their responsibility, talked only about bone health, and made it sound like their recommendations global. The Endocrine society has masterfully stated virtually the same guidelines, to be politically correct, but they put in all the necessary caveats to make sense.
For example, the Endocrine Society Guidelines (ESG) call for getting everyone to a minimum level of 30 ng. It doesn’t suggest everyone be screened, but you can’t know you are at 30 ng unless you get a test. And for those who are at risk, meaning living in a northern state, wearing clothes, working indoors, getting older, being overweight, taking a huge number of medications that suppress levels etc, may require taking 3-4 times as much. In fact, the ESG suggest that many situations also call for a loading dose to get started when you are deficient and that a good way to do that is 50,000 IU once a week for 2-3 months. And the guidelines do also give a much higher upper limit of safety, while coyly mentioning that the human body will naturally make some 20,000 IU when exposed to adequate sunshine. Instead of the IOM upper limit of 4000 IU a day, the ESC name 10,000 IU a day as a safe upper limit.. For those folks with various disease states that make for problematic D production, serial monitoring is called for. Lots of testing!
This is a masterful document of political tightrope walking, pushing the limits up to much more reasonable levels. They do recommend D administration for fall prevention but do not go to the other “non-calcemic” benefits such as cardiovascular disease prevention or cancer prevention at levels above the normal daily dose. But then they state, “The vitamin D receptor is present in most tissues and cells in the body (3, 12). 1,25(OH)2 D has a wide range of biological actions, including inhibiting cellular proliferation and inducing terminal differentiation, inhibiting angiogenesis,
stimulating insulin production, inhibiting renin production, and stimulating macrophage cathelicidin production.” Let me translate: D is really good for helping cancer (cellular proliferation inhibition), inhibiting cancer (inhibiting angiogenesis), helping diabetes (stimulating insulin production), helping high blood pressure (inhibiting rennin production), helping fight infections (cathelicidin production). So what’s left? We are all overweight, all have diabetes, hypertension, getting older, working indoors, getting the flu, having heart attacks and cancer. So, what did I miss? They even have guidelines for newborns, raising the upper limit for newborns to 2000 IU a day. Hurray, hurray, hurray!
WWW.What will work for me. I’m just tickled pink. The most emotionally charged topic I have seen in medicine for decades is finally coming out of the closet. The unbelievable resistance in the house of medicine to one of the miracles of modern medicine is finally getting clarified with official sanction. The guidelines don’t talk about autoimmune disease (that 40% of women have) and that have strong D linkages, but they finally talk real human physiology and real doses. Getting your blood level to a floor of 30 ng is lifesaving, and if you know anyone in your family that isn’t taking D, talk to them about it. It’s that urgent. It’s life saving. And now you have official guidelines. You can safely tell a new mother that her newborn should get 400 IU a day and can safely take 2000 IU a day as an upper limit. You can safely say we can all must take at least 600-800 and that 10,000 IU a day is safe. I for one take that much and my blood level is 80. I believe the science will finally indicate that 60-80 is what is the optimal human level, as that is what our bodies get to when we have abundant sunshine naturally.
Written by John Whitcomb, MD
Brookfield Longevity and Healthy Living Clinic, LLS
17585 W North Ave, Suite 160
Brookfield, WI 53045