Wednesday, March 23, 2011

Is Vitamin D Safe? Still Depends on Vitamins A and K!

From Posted on December 16, 2010 by Christopher Masterjohn 

In the last several weeks, two momentous occasions have occurred in the world of vitamin D.
First, the Institute of Medicine (IOM) released its new report.  It tripled the recommended intakes, doubled the upper limit, and commissioned researchers to go forth and test the effects of intakes higher than the upper limit, as this would be safe under proper supervision and provide valuable information.
This sucker is 999 pages long.  When I finish reading it, you can look forward to one heck of a blog post on the matter.  Stay tuned, folks.
The second momentous occasion occurred two days ago (Tuesday, December 14, 2010) when bestselling business author and tango champion Tim Ferriss released The 4-Hour Body.  Tim’s last book, The 4-Hour Workweek, was number one on the New York Times,Business Week, and Wall Street Journal bestseller lists and has been translated thus far into 35 languages.
In his new book, he discusses my research on the interactions between vitamins A, D, and K, and gives the following warning:

Supplemental vitamin D increases your need for vitamin A, so don’t forget the aforementioned cod liver, which includes both.
Hooray!  It’s wonderful to see someone with this type of reach get this information out there.
I first raised the issue of vitamin A-and-D interactions in the spring of 2006 in my article on vitamin A and osteoporosis.  I developed these thoughts further and introduced their interactions with vitamin K in the fall of 2006 in my article, From Seafood to Sunshine: A New Understanding of Vitamin D Safety, and in the spring of 2007 in my article, On the Trail of the Elusive X Factor: A 62-Year Mystery Finally Solved, Vitamin K2 Revealed.
I formally published my hypothesis that vitamin D toxicity results not so much from hypercalcemia but moreso from causing the excessive production of vitamin K-dependent proteins, leading to defective forms of these proteins in the absence of adequate vitamin K, in my December, 2007 Medical Hypotheses paper, Vitamin D Toxicity Redefined: Vitamin K and the Molecular Mechanism.  Tufts University researchers confirmed the first prediction of this hypothesis the following year, showing that when vitamin A protects against vitamin D toxicity, it curbs the excessive production of vitamin K-dependent proteins.
When I wrote these articles, all the most compelling research I had was from animal studies.  I wish that when I wrote them I had known that proof of principle for vitamin A-and-D interactions had already been experimentally demonstrated in humans.  This revelation, however, had to wait for my 2009 Wise Traditions lecture, Cod Liver Oil: Our Number One Superfood.  (You can get the DVDhere).
In 1941, Irwin G. Spiesman published a human trial in the Archives of Otolaryngology, a journal published by the American Medical Association, Massive Doses of Vitamins A and D in the Prevention of the Common Cold.
Spiesman treated 54 individuals who suffered from frequent colds (five to seven colds per winter) with massive doses of either vitamin A alone, vitamin D alone, or vitamins A and D together.  He treated them during the winter, for as many as three years, with a dosing schedule reaching a maximum of 40,000 IU for vitamin A and 300,000 IU for vitamin D.
Spiesman found that vitamins A and D only reduced colds when fed together:

[Click on the title of this post to go to read the rest of this article.]
[Here are some comments found in the article:]

Several commenters on this blog and on my Facebook Fan Page have provided testimonials about their negative experiences with vitamin D supplementation that support the protective effects of vitamins A and K:
Cynthia Frederick, March 2010 I, and many others I’ve met on forums, have adverse reactions to Vit D3, even the lower amounts of 2,000 IU/day and even though we were tested and were deficient. And we do not have the conditions that would make Vit D contraindicated. . . . I’m waiting for the long-term effects to take place in people taking these higher amounts who are not simultaneously increasing their Vit A and K levels. In 10 years I wager we will be hearing about the negative effects that the higher doses of this ‘miracle nutrient’ have had on those taking it. . . [in a later comment] As I mentioned before, there seems to be a subset of us for whom even low doses (1,000 IU/day) of Vit D cause kidney stones, chest pain, fatigue, and aches and pains, even though our 25 OH D levels were ‘low’ (23). We get these symptoms as soon as a week after using the D. . . . I saved myself a trip to the ER with the above symptoms by remembering previous articles of yours about balancing the fat-soluble vitamins, and took about 100,000 IU of Vit A from fish oil and 5 mg of K2. Within 1/2 hour ALL the symptoms disappeared. This happened more than once so I know it is not coincidence. You are definitely on to something here.
Lynn Razaitis, June 2010 I certainly know what happens when you get these ratios off. I naively had a vitamin D shot of 200,000 units after a serious viral infection that used up my vit A. I wrecked my kidneys, thyroid and who knows what else. It took 6 months and Chris’s articles to figure out what the heck was going on with me. Within weeks of getting my vit A up with cod liver oil and a ton of liver (and I was thyroid blood testing monthly so I had test results to compare) my thyroid hormones all normalized. It was fairly stunning.
Andrea Schüler, June 2010 I stopped taking D3 because I developed tendonitis, bursitis, tendon calcification and aches and pains. I brought my level from 20 to 50 in the 25 OH test but maybe the 2000 – 4000 IU daily was not good for me or I have not enough A and K. I will test again to see where my levels are after several months without D3 pills. Maybe I should check Vit. A and K levels too.

I read with MUCH interest your blog post on the need for Vitamin A and K, and especially that you are having success with eliminating many of the side effects of vitamin d that I too have found to be present in a certain percentage of people.
I’ve been studying Vitamin D intensively for approximately 3 years, use it in clinical practice with real people on a daily basis and have answered well over a 1000 questions from people about their vitamin d experiences on my website.
Interestingly, I’ve been able to prevent and/or reverse the exact same symptoms that you are finding by always dosing with magnesium at the same time as giving the vitamin d.
If someone has these reactions, I’ll have them stop the vitamin d and do an intensive magnesium replenishment program for about a week before they start taking it again and, voila, no more issues with chest pain, anxiety, insomnia, jitteryness, kidney stones, etc.
I have found that these symptoms are rampant in the general population and are symptoms of magnesium deficiency in and of themselves. There is also quite a bit of evidence that Vitamin D depletes magnesium, and so I find these symptoms are an ‘induced’ magnesium deficiency in those who are already ‘borderline’ magnesium deficient.
When queried after the fact, I find that almost all of these people with these severe reactions had many of the symptoms of magnesium deficiency before they began taking vitamin d, but that these symptoms went unrecognized and undiagnosed- in part because magnesium blood testing is worthless.
I’d be interested in finding out about the relationship between Vitamin A, K and magnesium. I always try to tell people that vitamins are not drugs and don’t work alone in a vacuum. They work together as cofactors in relationships that science may not understand yet. This seems like a perfect example of those relationships.
Kerri Knox, RN
I have always taken magnesium daily for many years, mag glycinate specifically. 200-400mg/day. And I know others who have problems with Vit D take it regularly also. All I know is the symptoms always resolve after taking good doses of A, E, and K.
I take 3000IU/day of D3. The other week I ate chicken liver every day for lunch and felt great, lots of sleep and energy. It made me think of this:
My numbers:
22 ng/ml after extended daily consumption of recommended daily dose of green pastures fermented CLO
46 ng/ml after adding 5000 IU D3 to the CLO listed above
38 ng/ml after dropping the 5000 IU D3 during the summer but continuing the CLO
Rob, accutane induces vitamin A deficiency. See the DVD of my 2008 Wise Traditions lecture, “The Fat-Soluble Vitamins and Mental Health” ( or my article version of that lecture, “The Pursuit of Happiness.”
Mike, 30 mg/day beta-carotene supplements were shown to kill people in huge randomized controlled trials and the trials were therefore terminated early. Many people say this is because it was isolated beta-carotene or because the population was exposed to smoke or asbestos, but Wang’s group at Tufts showed, using a ferret model, which is very similar to humans with respect to responses to beta-carotene and cigarette smoke, that 30 mg/d beta-carotene alone is more harmful than 1 pack/d cigarette smoke. However, 6 mg beta-carotene seemed helpful, and it’s possible that coadministration of vitamins C and E would have made the 30 mg/d safe. Some of the toxicity in the Spiesman paper above was actually due to beta-carotene. In any case, you cannot get 30 mg/d from food, so I would not worry about consuming beta-carotene from food.
The Primalist, I don’t know the answer and I think there are many unresolved questions about the vitamin D’s in marine oils. Obviously it’s false that D2 comes from plants and D3 from animals, as fish are animals (though this may be accumulated from plankton or other non-animal sources). I think it’s important to realize that we don’t know the biochemistry as much as the hysteria-driven vitamin D movement maintains that we do, and therefore we should look at clinical effects of foods, and not try to extrapolate from specific chemical forms in foods or rely too heavily on 25(OH)D levels in and of themselves.

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