Is there an optimal daily dose of vitamin D for immune function? | Roger Seheult

Summary

This transcript discusses the relationship between vitamin D levels and health outcomes, particularly the increased risk of SARS-CoV-2 positivity when levels fall below 50 nanograms per milliliter. It highlights a meta-analysis linking vitamin D to all-cause mortality, suggesting an optimal range of 40 to 60 or 70 nanograms per milliliter. The conversation also touches on the safety of vitamin D supplementation, noting its low toxicity compared to other fat-soluble vitamins, and the nonlinear response of vitamin D levels to supplementation, where higher doses have diminishing returns.

Takeaways

• 🌞 The storage form of vitamin D, 25-hydroxyvitamin D, is crucial for health, with levels below 50 nanograms per milliliter linked to increased SARS-CoV-2 positivity rates.
• 📉 Current vitamin D level recommendations are primarily based on its role in bone metabolism, but there may be different optimal levels for immunological functions related to COVID-19.
• 🔍 A meta-analysis of studies from the 1960s to 2013 showed an association between vitamin D blood levels and all-cause mortality, with an optimal range between 40 to 60 or 70 nanograms per milliliter.
• 💊 The upper tolerable intake level for vitamin D, as set by the Institute of Medicine, is 4000 IUs per day, highlighting the importance of not exceeding this amount.
• 🚫 Vitamin D is considered the least toxic fat-soluble vitamin, with a study of 20,000 people showing minimal risk of hypercalcemia even at high supplementation levels.
• 📈 The relationship between vitamin D supplementation and blood levels is nonlinear, with the first 1000 IUs having a more significant impact on levels than higher doses.
• 🧬 The increase in vitamin D levels from supplementation diminishes as the dosage increases, suggesting a saturation point for vitamin D receptors in the body.
• 🧬 Polish scientists studied the Mayo Clinic's database and found only one case of hypercalcemia out of 20,000 people, indicating a very low risk of toxicity from vitamin D supplementation.
• 📚 A study mentioned by Dr. Patrick found no toxic effects from long-term supplementation with 10,000 IUs of vitamin D per day.
• 🌐 The transcript discusses the importance of vitamin D in both endocrinological and immunological contexts, emphasizing its multifaceted role in human health.
• 📉 The transcript suggests that maintaining adequate vitamin D levels could be beneficial for overall health and potentially for reducing the risk of severe outcomes from COVID-19.

Q & A

What is the primary form of vitamin D that is stored in the body?

The primary storage form of vitamin D is 25-hydroxyvitamin D.

What is the significance of vitamin D levels dropping below 50 nanograms per milliliter?

When vitamin D levels drop below 50 nanograms per milliliter, there is an observed increase in SARS-CoV-2 positivity rates.

How are the recommended vitamin D levels related to bone metabolism?

The recommended vitamin D levels are largely based on their endocrinological function with bone metabolism, although their exact value for immunological functioning or COVID is not yet known.

What did the associative studies involving 191,000 people suggest about vitamin D levels and SARS-CoV-2 rates?

The associative studies indicated that SARS-CoV-2 rates started to increase once vitamin D levels dropped below 50 nanograms per milliliter.

What is the 'sweet spot' for vitamin D levels in terms of all-cause mortality according to the meta-analysis?

The meta-analysis found that vitamin D levels between 40 to 60 or 70 nanograms per milliliter were associated with the lowest all-cause mortality.

What is the upper tolerable intake of vitamin D as set by the Institute of Medicine?

The upper tolerable intake of vitamin D, as set by the Institute of Medicine, is 4000 IUs (International Units) per day.

Why is vitamin D considered the least toxic fat-soluble vitamin?

Vitamin D is considered the least toxic fat-soluble vitamin because of its low toxicity profile; a study involving 20,000 people found only one case of hypercalcemia even with supplementation up to 55,000 units a day.

What was the case of hypercalcemia found in the study involving the Mayo Clinic's database?

In the study, one person out of 20,000 developed hypercalcemia with a vitamin D level in the 200-300 nanograms per milliliter range, which is considered very high.

What is the observed long-term effect of supplementing with 10,000 IUs of vitamin D daily?

Long-term supplementation with 10,000 IUs of vitamin D daily showed no toxic effects, as mentioned in a study that Dr. Patrick referred to.

How does the increase in vitamin D supplementation relate to the increase in nanograms per milliliter?

The increase in nanograms per milliliter is not linear with supplementation. The first 1000 units of supplementation increase levels by about 4.8 to 5 nanograms per milliliter, whereas at higher doses like 15,000 to 30,000 units, each additional 1000 units results in a much smaller increase.

What does the nonlinear relationship between vitamin D supplementation and serum levels suggest about the body's response?

The nonlinear relationship suggests that as supplementation increases, the body's ability to absorb additional vitamin D decreases, possibly due to receptor saturation, although this is not definitively proven.

Outlines

00:00

🧪 Vitamin D and COVID-19 Infection Rates

The paragraph discusses the correlation between 25-hydroxyvitamin D levels, the storage form of vitamin D, and the rate of SARS-CoV-2 positivity. It highlights that a drop in levels below 50 nanograms per milliliter is associated with an increased risk of COVID-19 infection. The discussion also touches on the potential need for different levels of vitamin D for immunological functions compared to its known endocrinological role in bone metabolism. A meta-analysis is mentioned, which includes studies from the 1960s to 2013, indicating that optimal all-cause mortality rates are associated with vitamin D levels between 40 to 60 or 70 nanograms per milliliter. The conversation also addresses the topic of vitamin D supplementation and its upper tolerable intake, set by the Institute of Medicine at 4000 IUs per day, and the low toxicity profile of vitamin D as a fat-soluble vitamin, with a study showing minimal cases of hypercalcemia even at high supplementation levels.

Keywords

💡25-hydroxyvitamin D

25-hydroxyvitamin D is the primary circulating form of vitamin D in the blood, which serves as a measure of the body's vitamin D storage levels. It is crucial for understanding the body's vitamin D status. In the video, the script discusses how levels below 50 nanograms per milliliter are associated with an increased SARS-CoV-2 positivity rate, highlighting its potential role in immune function against COVID-19.

💡nanograms per milliliter

This term refers to the concentration of a substance, in this case vitamin D, measured in nanograms (one billionth of a gram) per milliliter of blood. It is a unit used to quantify the levels of 25-hydroxyvitamin D in the body. The script mentions that levels below 50 nanograms per milliliter are linked to a higher positivity rate for SARS-CoV-2, emphasizing the importance of adequate vitamin D levels for health.

💡SARS-CoV-2

SARS-CoV-2 is the virus responsible for the COVID-19 disease. The script discusses the relationship between vitamin D levels and the positivity rate for this virus, suggesting a possible connection between immune function and vitamin D levels in the context of COVID-19.

💡endocrinological function

Endocrinological function pertains to the role of hormones in the body, specifically in this context, the role of vitamin D in bone metabolism and its interaction with the endocrine system. The script mentions that the established levels of vitamin D are based on its endocrine function, but its exact role in immunological functioning against COVID-19 is not yet clear.

💡meta-analysis

A meta-analysis is a statistical technique that combines the results of multiple scientific studies to identify patterns and draw conclusions. In the script, a meta-analysis is mentioned that includes studies from the 1960s to 2013, examining the association between vitamin D blood levels and all-cause mortality, indicating the broad scope of research on vitamin D's health impact.

💡all-cause mortality

All-cause mortality refers to the total number of deaths from any cause within a given population. The script cites a meta-analysis that found an association between vitamin D levels and all-cause mortality, suggesting that optimal vitamin D levels may reduce the risk of death from various causes.

💡upper tolerable intake

Upper tolerable intake is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in a population. The script mentions that the Institute of Medicine has set the upper tolerable intake for vitamin D at 4000 IUs per day, indicating the safe limit for daily supplementation.

💡fat-soluble vitamin

Fat-soluble vitamins are vitamins that dissolve in fats and oils, and are stored in the body's fatty tissues. Vitamin D is highlighted as a fat-soluble vitamin in the script, which has implications for its storage, absorption, and potential for toxicity.

💡toxicity

Toxicity refers to the degree to which a substance can cause harm. The script discusses the relative safety of vitamin D compared to other fat-soluble vitamins, citing a study that found minimal cases of hypercalcemia among 20,000 people supplementing with high doses of vitamin D.

💡hypercalcemia

Hypercalcemia is a condition characterized by abnormally high levels of calcium in the blood, which can be a symptom of vitamin D toxicity. The script mentions a case of hypercalcemia in a study involving high-dose vitamin D supplementation, illustrating the rare occurrence of vitamin D toxicity.

💡supplementation

Supplementation refers to the intake of vitamins or minerals in addition to what is consumed through diet, often in pill or liquid form. The script discusses the nonlinear relationship between vitamin D supplementation and blood levels, indicating that higher doses do not proportionally increase blood levels, which is important for understanding how to effectively supplement vitamin D.

Highlights

25-hydroxyvitamin D is the storage form of vitamin D, and levels below 50 nanograms per milliliter are associated with an increased SARS-CoV-2 positivity rate.

The optimal levels of vitamin D for bone metabolism may not be the same for its immunological function in relation to COVID-19.

Associative studies with 191,000 participants indicate a rise in SARS-CoV-2 rates when vitamin D levels fall below 50 nanograms per milliliter.

A meta-analysis of studies from the 1960s to 2013 links vitamin D blood levels between 40 to 60 or 70 nanograms per milliliter with the lowest all-cause mortality.

The upper tolerable intake of vitamin D, set by the Institute of Medicine, is 4000 IUs per day.

Vitamin D is considered the least toxic fat-soluble vitamin, with a study showing minimal toxicity even at high supplementation levels.

Only one case of hypercalcemia was found in a study of 20,000 people supplementing with vitamin D, indicating a low risk of toxicity.

Long-term supplementation with 10,000 IUs of vitamin D per day showed no toxic effects.

The relationship between vitamin D supplementation and blood levels is nonlinear, with diminishing returns as dosage increases.

The first 1000 units of vitamin D supplementation can increase blood levels by 4.8 to 5 nanograms per milliliter.

At higher supplementation levels, such as 15,000 to 30,000 IUs, the increase in blood levels per 1000 IUs of supplementation drops to about a tenth of the initial increase.

The saturation of vitamin D receptors may explain the observed nonlinearity in supplementation response.

Vitamin D supplementation and its impact on health outcomes are subjects of ongoing research, with studies suggesting potential benefits and safety.

The discussion highlights the importance of understanding the role of vitamin D in both bone health and immune function, especially in the context of COVID-19.

The transcript emphasizes the need for further research to determine optimal vitamin D levels for immune function and COVID-19 prevention.

Transcripts

so we're looking at 25-hydroxyvitamin D.

That's the storage form of vitamin D.

And what they found was as your levels started to drop below 50 nanograms

per milliliter, we started to see an increase in SARS-CoV-2 positivity rate.

And lot of these levels that we've come up with are based on

the endocrinological function of vitamin D with bone metabolism.

We don't know if that's the value that we need for

immunological functioning or COVID.

But we do have some associative studies that seem to show at least

in those studies that we talked about earlier where looked at 191,000 people

that SARS-CoV-2 rates started to go up once levels dropped below 50.

So that's an interesting number.

- [Dr.

Patrick] : meta-analysis published, I don't know the author's name,

but the studies dated back from the 1960s to the 2013.

And it was looking at all-cause mortality in association

with vitamin D blood levels.

And it was found that you know, levels, somewhere between 40 to 60, or 70, like

was the lowest all-cause mortality.

like there was this sweet spot

in terms of supplementation though, you know, the upper tolerable intake

that's been set by the Institute of Medicine has been 4000 IUs a day.

And, you know, vitamin D is a fat-soluble vitamin, what about toxicity?

[inaudible]

- [Dr.

Seheult] : Toxicity, there was a statement that I read that said

that vitamin D is probably the least toxic fat-soluble vitamin.

So there was a study where these Polish scientists looked at

the Mayo Clinic's database, and they looked at 20,000 people.

And we've talked about this in our in their video that we

recently published, one person had hypercalcemia, out of those 20,000.

And they had ranges, people supplementing anywhere from 0 to 55,000 units a day.

And really just one person.

And that person's vitamin D level, if I recall correctly,

was up in the 200, 300 range.

That's nanograms per milliliter.

And that's [inaudible]

- [Dr.

Patrick] : That's hard to do.

Wow.

- [Dr.

Seheult] : Yeah, it's massive.

- [Dr.

Patrick] : Yeah, I remember reading a study, and I'm sure you've seen this

one where there was the long-term supplementation with 10,000 IUs a day

and it was really no toxic effect.

And that was, I forgot how long term it was.

But...

- [Dr.

Seheult] : Yeah.

The other thing that I've seen is that, you know, it's

not a linear-response curve.

So as you go up in supplementation, it's not like your nanograms per

milliliter are going to go up linearly.

What we notice actually, is that the first 1000 units that you supplement

causes an increase of about 4.8 to 5 nanograms per milliliter.

Whereas, when you get up to about 15,000, 20,000, 30,000 that each additional

1000 goes up by about a 10th of that.

So it's a nonlinear relationship.

It's exponential, but the reverse of exponential.

As you go up higher and higher, the increment becomes less and less.

It's almost like you're saturating receptors, if you will, it's

probably not the case but that's what it seems to be like.

- [Dr.

Patrick]