Capitol Hill Blue Forums Science and Technology Health, Medicine & the healing Sciences Doctors fighting back against anti-vaxers online

Put it in their well!

There has been considerable Vitamin D deficiency in
whites related to the increased use of sunscreens!

I read through the PDF attached for a bit. I'm not sure "we banned a lot of people from our facebook page, and some other folks came in and said things we wish we could have, but we had to be professional" really counts as "fighting back".....

Were you trying to make a point?
What do you suggest would be an effective fight?
If you have ever had to deal with a malicious troll attack on your profession that risks the death of colleagues, you would know that such altercations can be very stressful.

I guess we could kill some of them if only we could identify them and lure them into our special medical "care", but maybe you dont understand that it might be considered unprofessional!
Maybe we should try bravely counseling them!

Only don’t counsel them about firearms!!!*

*However, I’m sure that ban does not extend to discussions about which gun will provide the correct ratio of firepower, convenience, style and cost nor to providing advice on the correct way to put a mammal out of its misery.

I live in the Pacific Northwest - we get a lot of rain. I had vitamin D prescribed by a doctor years ago. I have asked around and everybody I asked whether they took vitamin D have said they do as it was prescribed by their doctor. So, I guess, up here most of us have been told to take our vitamins. This also, incidentally, includes Hispanics and Black folks too.

Kinda gives one a warm feeling of belonging to the same group of Vitamin D users.

Unfortunately, a lot of doctors will tell their patients to take 1000 iu of Vitamin D per day, and justify that by saying the US RDA is 600 iu per day or 800 for people above 70. They learned in medical school that Vitamin D is fat soluble, so can accumulate in the body and cause calcification in the organs.

Research of the last 10 years says worries about Vitamin D overdose are vastly overstated. People have accidently been given 1000 times the RDA for months, with no ill effect. In fact, the calcification problem is caused by too much calcium in the blood!

The US RDA was set back when most people worked outside and got lots of sun. Sun exposure of half of the time that would cause sunburn gives you about 20,000 iu. That's 33 times the USRDA! The Endocrine Society says 50 ng/ml is optimal. That would require around 5000 iu per day for most people.

1000 iu/day will give you a blood level of 10, absent any summer sun exposure or oily fish consumption. That's a lethal deficiency if you catch Covid-19.

Vitamin D toxicity

Calcium metabolism is very tightly controlled by several hormonal systems responding to blood calcium levels, as to much or too little have severe effects. The active form of vitamin D is a hormone the 1 and 25 di hydroxy form D3 is formed in the kidney from VitD2. This conversion is tightly regulated by calcium levels, so that excess D2 is not converted to VitD3. This protects from excess D2 and excess calcium in the diet by not stimulating Calcium absorption from the bowel.
This protective mechanism is bypassed by taking Vit D3, which is not found in food.
So large and even massive doses of D2 are not toxic, but excess D3 can be. It is confusing, and even in this paper on VitD, it is often unclear what forms of Vit D are being discussed.

It is obviously important to know what form of VitD is in your supplements!

I don't think there is any conversion between D3 and D2. D3 comes from animal sources like oily fish, production in the skin following UVB exposure, or by supplements made from lanolin. D2 comes from plants, especially mushrooms exposed to UVB light.

Both of them are converted slowly to their 25 hydroxy form in the liver, but they remain distinct: 25 hydroxy-D3 and 25 hydroxy-D2. Those are the value measured in the blood, and can vary a lot.

The homeostatic tight regulation happens in the kidneys: The hydroxy forms are converted to 1,25 dihydroxy D3 and 1,25 dihydroxy D2. These are the active forms that bind to cellular Vitamin D receptors. D3 binds a little better, but D2 still does the job.

I have read a few papers that say some immune cells can make their own active 1,25 dihydroxy form out of the 25 hydroxy form that gets into the cell from the blood or intracellular space. That would obviously escape the tight regulation performed by the kidneys.

One reason I say there is no D2<->D3 conversion is because doctors can tell if patients with high 25 hydroxy-D are taking supplements (almost entirely D3) or being treated by a doctor with Vitamin D injections (all D2 in the US).

As for D2 being safe and D3 being dangerous, I think the original UK scare about Vitamin D toxicity was all about D2. Sunlight exposure tops out at about 70 ng/ml of D3, which does not seem to hurt anybody but people with rare Vitamin D-related diseases. Toxicity seems to start at about 150 ng/ml.

I'm sure you know a lot more about the control and role of Calcium in the body. I have not really looked at that at all.

I have read that people with kidney disease need 1,25 dihydroxy D administered very carefully so as not to screw up their Calcium levels. Just like in diabetes, built-in homeostatic regulation works a lot better than doctors trying to do the job with their clumsy over and under-dosing, that fits hospital medication schedules.

Since the kidneys actually make the 1,25 D3 from D2, when you dont have active kidney tissue, you are completely dependent on exogenous D3. To make matters even worse the typical hypocalcemia of renal failure cranks up the parathyroids to keep calcium up to normal levels, by mobilizing bone calcium and dissolving the skeleton. The resulting hyperparathyroidism raises the calcium levels and tends to deposits calcium in other organs, calcinosis. Adding D3 to this can make it worse. Its a real rock and a hard place scenario!

The kidney also make erythropoietin (EPO) needed to to generate red cells from marrow, so it also has to be provided in renal failure to treat the chronic anemia.
Its a very tricky business taking over the endocrine functions of the kidney with loss of the normal regulatory feedback mechanism.

for more details of calcium in renal failure