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November 30, 2010

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Paul D.

History is on the side of the skeptics here. Vitamin hype has almost always turned out to be bogus. Dr. John Ioannidis's comment in The Atlantic (http://tinyurl.com/32tcd59) is relevant: "How should we choose among these dueling, high-profile nutritional findings? Ioannidis suggests a simple approach: ignore them all." (and the articles goes on to explain why you should do that.)

AllenS

I just had some blood work done by the VA. It showed that I have a vitamin D deficiency. I was told to start taking Cholecalciferol. I'm 64 years old and of dark complexion. I spent a lot of time outside. I'm not lacking in sunshine. Using the Googles, both my age and complexion are factors that may have something to do with the deficiency. I started to take the vitamins.

Jay

nonsense!
Tthe experts say a blood level of 20ng/mL is adequate because that is the bare minimum to prevent rickets. That does not mean levels higher than 20 are unhealthy and dangerous. IN fact, they could be beneficial, but there is not a lot of objective research in this area.
This same pattern occurred with iodine, where the government recommended just enough iodine to prevent goiter, and everyone assumed more is unhealthy.

Thomas Collins

I remember a ditty my late great father used to sing. The words to the ditty are:

The black strap molasses and the wheat germ bread,

Make you live so long,

You wish you were dead.

I think my father's ditty achieved a higher level of scientific rigor than all these dueling studies from the folks with all the funny letters such as P and h and D after their names have achieved.

hit and run

"Have you ever noticed, by the way, when you go forward what do you do? You take Vitamin 'D'. When you want to go backwards, you, well, hell there's not even such a thing as Vitamin 'R',right? Vitamin 'R'. Sounds like a dirty movie. Anyway. So while we're taking our supplements and exercising and doing all the right things, the Republicans are just sitting up there sipping on a Slurpee. There's no vitamin 'D' in Slurpees. And do you think Republicans are getting any vitamin 'D' from an appropriate amount of exposure to sunshine? Do you? Well, have you seen how white Republicans are? I mean, how much sun can they be getting if they're that white."

Kevin B

I was diagnosed as hypothyroid at the beginning of 2010. My Doctor started me on low doses of thyroxine and gradually upped the dose, testing my TSH levels regularly and trying to get me balanced. I went from 25 to 50 to 100mcg and was still showing as heavily hypothyroid.

I'd got up to 200mcg and then my test showed I was well over the correct range. I gradually reduced again to 125mcg whereupon the test showed me as being well under again.

Looking back, (and after googling vitamin D and hypothyroid), it seems clear that during the summer months, when I was getting plenty of sunshine, I needed less thyroxine than during the winter months.

I've started taking cod-liver oil tablets so we'll see where that takes me, but if that doesn't work, I'll see if I can scrape up the resources to move south for the winter.

jimmyk

Interesting to compare the WSJ headline with the NYT's:

Panel: Triple That Vitamin D

The Institute of Medicine has tripled the recommended amount of vitamin D most Americans should take every day to 600 international units from 200 IUs set in 1997.

Guess it's a glass half-empty vs. half-full thing.

boris

Slurpees fortified with Resveratrol !!!

Thomas Collins

Well, what do you know. My father's ditty has made YouTube. See LUN. There's also a reference to yogurt in the ditty and for what all I know other foods (I didn't listen to it all).

Melinda Romanoff

uh-oh, Memeorandum link.

Old Lurker

Do limes have Vit D?

Thomas Collins

I drive a gear shift, H&R, so there is no vitamin D. Just vitamins 1-5 and R.

Melinda Romanoff

OL-

No, that's the gin.

jimmyk

Vitamin hype has almost always turned out to be bogus.

That "almost" has some pretty important exceptions (C for scurvy, D for rickets, etc.) The issue with D is that doctors have been telling people for the last 30 years to slather themselves with sunscreen, in addition to having lots of darker-complexioned people living in northern places where half the year they don't get sun. So there's reason to believe there could be an issue, at least for some people.

Threadkiller

Maybe they could adjust the airport backscatter x-ray, add some ultraviolet, and offer it as a health aid. People that want to avoid the evil doctors, that would amputate your skin, can get healthy while they get searched.

Mike

Scary (il)logic: it hasn't been disproved, therefore go with the hype. I'd much rather "let's see what actual science proves about Vitamin D", which is the point when we know which way is safe and beneficial... and whether taking more of it is actually harmful. Acting prior to having proof is dangerous -- that's why it's called "hype". My folks always said: "it's going in your mouth, make sure you know what it is". Right now, the actual science on Vitamin D appears contradictory, with actual specialists (like the osteoporosis one in the article, whose life-long work in the field is simply shrugged off as "unconvincing" by the article-writer who, I guess, is more qualified than this specialist, since the writer feels so smart as to be able to dismiss an atual specialist with such flippant disregard?) coming out on both sides. The pattern should be familiar: we've seen this exact pattern in the various health crazes/fads over the past few decades, where hype exceeds fact, people swallow the hype, and then we find out the hype was all wrong later on. Act according to proof -- not in the absence of it.

Maureen

There's no evidence that Vitamin D has any harmful effects, unless you're practically swallowing a bottleful every day for a month. There's plenty of evidence that people in modern society tend to be a quart low on Vitamin D, and that they have trouble absorbing enough from food or sun. There's also plenty of evidence that D helps common health problems of modern society. So taking more Vitamin D would seem to be a no-brainer, especially since it's not very pricey.

Richard

Congrats to "hit and run" for applying the most convoluted, nonsensical, logic I've ever heard to a topic not even remotely related to his jibberish.

On the other hand,in regard to the topic of the post - being an immunopharmacologist that just happens to have MS and therefore has actually studied the subject - I can aptly note that studies have already demonstrated that D3 is safe - in even very high doses. In one study in which patients took from 28,000 to 280,000 IU/wk (), patients' serum 25(OH)D concentrations reached twice the top of the physiologic range without eliciting hypercalcemia or hypercalciuria. The data supports the feasibility of pharmacologic doses of vitamin D3 for clinical research, and they provide objective evidence that vitamin D intake beyond the current upper limit is safe by a large margin

Readers should take the time to watch the must-watch video: Entertaining Expert Lecture on Vitamin D ... in which the latest research is discussed, and that 1,25-dihyroxy Vitamin D3 deficiency is linked to a surprising number of health conditions such as depression, back pain, cancer, both insulin resistance and pre-eclampsia during pregnancy, impaired immunity, macular degeneration, and neuromuscular diseases such as multilple sclerosis (up to 40,000 IU per day over a 12 month period). In the video, Michael Holick, MD, one of the major vitamin D experts ... discusses vitamin D relating to bone and muscle health and the prevention of autoimmune and chronic diseases, and answers the question, "Can vitamin D help prevent certain cancers and other diseases such as type 1 diabetes, cardiovascular disease, and certain autoimmune and chronic diseases like rheumatoid arthritis and osteoporosis, and even the flu?"

And by the way, I've been taking 15,000 I.U of D3 for over a year - and have had only 1 MS relapse during this time (when previously had up to 5)... no longer require my blood pressure medication, have experienced a decrease in my fasting glucose levels, and am almost afraid to say it for fear of sounding like a loon - but have not even gotten the flu when it ran rampant in my household.

And another by the way ... be sure to take the effective human form, vitamin D3 or cholecalciferol, not the prescription form - ergocalciferol, or vitamin D2. Prescription doesn't necessarily mean superior. In fact, the prescription form may be significantly inferior, as with vitamin D2.

Harry

"Do limes have Vit D?"

I don't know, Old Lurker. If only we had some way of looking up such things! Like, say, a global information network with millions of pages on every subject imaginable. With special software applications -- we could call them "search engines" -- to sort through it all and find the data we want in a fraction of a second.

Wouldn't that be great?

Melinda Romanoff

Richard-

Congrats on the MS control, but you seem to be new around here, otherwise "hit and run" would make perfect sense.

Ed Maisch

Completely non objective comment. I have been having problems with my skin. I noticed it was worse in the summer and less so in winter, but not much I tried really helped. I happened upon some cod liver oil on a close out shelf, bought it and started taking one a day, simply to see what it might do. I was not thinking it would help anything specific just remembered my parents saying that their mothers cure for what "ailed you" was cod liver oil. I started last summer. I noticed my skin seemed to be less problematical. Soon the problem was all but gone. About that time I also noticed I had the smell of cod liver oil in my urine. Out of an abundance of caution I backed off. Within 3 days the skin problem was coming back.
Guess all I can say is "It works for me." If anyone cares, I am a white guy in upstate NY.

hit and run

Richard:
Congrats to "hit and run"...

Thank you. Sometimes I feel like my contributions go uncongratulated.

...for applying the most convoluted, nonsensical, logic I've ever heard to a topic not even remotely related to his jibberish.

Even better: you get me.

Clarice

I take Vitamin D supplements but then in winter I spend little time outside and blood tests showed I was low on it. I doubt it will harm me even if it proves less efficacious than some think.

Jane (sit on the couch or save your country)

Clarice, I've continued to taunt you for days over at You Too altho I will admit, the best is yet to come. But please, do not miss it.

Herbum, Verbum, et Mineralis.

Vitamins A,D,E, and K are fat soluble and can overwhelm the ability of the body to excrete them in overdose, thus poisoning the user. If the public is stampeded into believing that they are Vit. D deficient, there will be inevitable horror stories of overdose. That's why the caution about safety.

There are no poisons, only poisonous doses.
===============================

RichatUF

No, that's the gin.

The cornerstone of any nurtitious diet.

AllenS

Herbum,

With all due respects, I'm not being stampeded into believing that I'm vitamin D deficient. I am vitamin D deficient. My blood test says so. That's why, at 64 years old, on a doctors recommendation, that I'm taking the vitamin. Take what was recommended, and if you do, there's no reason why a person should overdose.

Verbum works best.

No problemo, AllenS. You are monitoring your levels and following professional advice. But Vit D is available OTC, and my statements above stand about horror stories.
================================

Paracelsus turns in his grave.

Oh, heck; it's 'Herbis, Verbis, et Mineralis.
===============================

CG

I have noticed that scientific studies that "disprove" the health benefits of Vit. D tend to rely on doses that are minimal: 400 IU.

That will prevent rickets, but not colds or cancer.

jimmyk

Act according to proof -- not in the absence of it.

Mike makes the common mistake of giving "doing nothing" a privileged position. This is what delays potentially valuable drugs for years even after they have been deemed safe. "Not taking Vitamin D" is a just as much a decision as "taking Vitamin D." One has to balance the risks and benefits and decide which way to go.

There's also the issue of overreliance on so-called experts. Let's remember all these experts who told us to substitute carbs for fat in our diet, and in the process likely contributed to millions of people getting diabetes and other obesity-related problems. Then twenty years later it's "Oops, never mind." Or the experts who have deemed the science of global warming "settled." Unfortunately science has fads and isn't always objective.

sbw

Interesting, Richard. I'm shuttling to and from a wonderful teaching hospital, taking care of someone with Transverse Myelitis -- auto-immune inflammation of segments of the spine. We know too little.

peter

and pellagra. Let's not forget pellagra.

cathyf

Kevin, I have Hashimoto's, and my endocrinologist was almost more concerned about getting my vitamin D levels up than my thyroid levels. I take 7,800 IU per day and it's finally up where it should be. Of course I'm also a a computer programmer who currently works in a basement office and arrives and leaves work in the dark...

(Another) Barbara

Then twenty years later it's "Oops, never mind."

If only. Except for Gary Taubes and a few others, the government and their allies in the press are still pushing carbs on us (followed by statins and insulin, natch) and supplying dire warnings about fats. (Yes, I mean you too, Michelle!)

I'm about as worried about Vit D toxicity as I am about snake bites and errant lightning bolts. Read about it in the literature. Vitamin D toxicity is rare, rare, rare and nearly always caused by massive doses over long periods of time. If concerned though, you can have the amounts in your blood tested periodically in your neighborhood lab relatively cheaply. It's the amount in your blood that counts, not how much you swallow in supplements.

Neo

EVERYBODY KNOWS that embryonic stem cell are going to cure every mality known to man. Why bother ?

Bruce

I'll put this study in with the advice they gave about switching from butter to hydrogenated margarine.

Bill

"I am applying a bit of common sense here"

No, you're really not. You are applying "well this makes sense to me" as an overlay for random other, unexplained phenomena (nonspecific medical problems for a demographic group). It's not common sense. It's about as likely to be accurate as reading tea leaves.

You make a quasi-caveat: "often risky when science is involved," but then obliterate it "but away we go." You could just as easily say "There's no reason to believe this, but I do, and I suggest you may want to as well."

It's irresponsible. You dismiss "two bone guys" as unconvincing. Um, the two bone guys (to say nothing of either their credibility or that of the entity publishing the report) did something called scientific inquiry. I personally find "a random blog guy" less convincing than "two bone guys," but that's the beauty of science. You don't have to rely on credentials: you can look at how they arrived at their conclusions. Oh wait, you can't, because you published this before seeing the report. Wow. Regardless of what they did, it seems more reliable than applying the "what seems to make sense to me" test, along with having read various things and applying the same test to them.

You cite two sources (one of which is another random blog guy, which relies on the second source). The second source Scientific American, (though it has "Scientific" in the name) is not a scientific publication. It is part of the lay press, which reports on stuff--including reporting on stuff that appears in scientific publications (in this case, in an article that's 2 years old--rebutting new research with lay reporting on old research...not too convincing).

Like many articles in the lay press, it skimps on details and plays up "potential" benefits. In short, you can "not buy it" if you want to, but you're not qualilfied to have an opinion. You don't cite any reasonable arguments, and you don't quote anybody positing any reasonable arguments. Further, you're arguing against something you haven't read. Geez.

Bill

"I am applying a bit of common sense here"

No, you're really not. You are applying "well this makes sense to me" as an overlay for random other, unexplained phenomena (nonspecific medical problems for a demographic group). It's not common sense. It's about as likely to be accurate as reading tea leaves.

You make a quasi-caveat: "often risky when science is involved," but then obliterate it "but away we go." You could just as easily say "There's no reason to believe this, but I do, and I suggest you may want to as well."

It's irresponsible. You dismiss "two bone guys" as unconvincing. Um, the two bone guys (to say nothing of either their credibility or that of the entity publishing the report) did something called scientific inquiry. I personally find "a random blog guy" less convincing than "two bone guys," but that's the beauty of science. You don't have to rely on credentials: you can look at how they arrived at their conclusions. Oh wait, you can't, because you published this before seeing the report. Wow. Regardless of what they did, it seems more reliable than applying the "what seems to make sense to me" test, along with having read various things and applying the same test to them.

You cite two sources (one of which is another random blog guy, which relies on the second source). The second source Scientific American, (though it has "Scientific" in the name) is not a scientific publication. It is part of the lay press, which reports on stuff--including reporting on stuff that appears in scientific publications (in this case, in an article that's 2 years old--rebutting new research with lay reporting on old research...not too convincing).

Like many articles in the lay press, it skimps on details and plays up "potential" benefits. In short, you can "not buy it" if you want to, but you're not qualilfied to have an opinion. You don't cite any reasonable arguments, and you don't quote anybody positing any reasonable arguments. Further, you're arguing against something you haven't read. Geez.

Porchlight

By GINA KOLATA

I bet she really hates this song.

Clarice

Rats, Jane!!

Charlie Martin

Of course I'm also a a computer programmer who currently works in a basement office and arrives and leaves work in the dark...

... wearing a "Keep out of direct sunlight" tee shirt.

NH Dad

Richard is correct. I'm a healthy person in my early 40's, 175 lb, 6'1" in height. I lap swim 8 miles per week for exercise/training. I've also had psoriasis in small, un-noticable areas since I was 19...nothing major and nothing a cortizone shot every 6-12 months wouldn't control. 12 months ago I came down with psoriatic arthritis in my fingers and feet. At the same time I started to get heavy spots of psoriasis on my knees...bigger spots then I've ever had. I freaked. Through research and on the advice of a ADHD Doc I started mega doses of D-3 (5,000 i.u.'s) Within a week all psoriasis on my skin was 80 % healed. ALL SIGNS OF PSORIASIS ON MY SKIN HAVE CLEARDED UP TO THE SAME POINT THEY WOULD HAVE FROM A CORTIZONE SHOT. My fingers and feet pain also improved although not as dramatically as the skin. I've been on D-3 now for 45 days and feel great. I have my yearly physical next week and had the blood test this AM...I'm curious what the Dr will say.

Brenda

Level was 18 now 49 and feel a helluva lot better than I did. Watch this....http://www.youtube.com/watch?v=Cq1t9WqOD-0

Logan

Dr. J. J. Cannell has done a lot of work summarizing pro-hormone (not really a vitamin) D research at his website, www.vitamindcouncil.org
He includes links to a long list of Medline abstracts, and his archive of newsletters has many provocative comments on the evidence and his interpretations.
The available information is not yet complete in the prospective sense, but it is extensive. Anyone who takes the time to read up on this topic will be impressed.

Dale

CG said: "I have noticed that scientific studies that "disprove" the health benefits of Vit. D tend to rely on doses that are minimal: 400 IU.

That will prevent rickets, but not colds or cancer."


It's kind of like giving a dehydrated patient a tablespoon of water a day and then claiming water doesn't prevent dehydration.

caro

Did anyone point out that our Hit and Run's brilliance was again quoted on the Campaign Spot yesterday?

Ignatz

--Congrats to "hit and run" for applying the most convoluted, nonsensical, logic I've ever heard to a topic not even remotely related to his jibberish.--

Does MS attack the funny bone?

daddy

I was right Hit,

Bad Hair Day indeed. It's like Sunday morning infomercial Talk Radio.

Where's Saint John's Wart? How 'bout aromatherapy? Omega 3 or 4 or 5? How 'bout some ground up rhinoceros horn and bear gall bladder for sexual potency? What's next, Castor Oil? Chicken Soup? Crimony.

CayyyyyyyyyyyyyyyyRooooooooooooo Corn Syrupppppppppppp!

Bill

"It's kind of like giving a dehydrated patient a tablespoon of water a day and then claiming water doesn't prevent dehydration."

No, it's like giving a dehydrated person a tablespoon of a mystery substance a day. Your analogy suggests that vitamin D is a direct cure for cancer in much the same way that water is a direct cure for dehydration. Even if vitamin D is the key to curing cancer, it's certainly not that direct of a cause/effect link. This statement assumes efficacy and blames inadequate use.

Incidentally, scientific study doesn't "disprove" anything (impossible to prove a negative). The studies being mentioned simply don't show evidence for effectiveness of vitamin D as a cure-all.

A number of commenters offered examples. (I had this bad-health situation, I'm taking vitamin D, and now I'm much better.) I'm overjoyed for you. People feeling better is a very good thing.

But anecdotal evidence is not scientific evidence. It's possible studies aren't finding evidence of vitamin D evidence because they aren't looking for the right thing (or in the right population, or in the right way, etc., etc.).

Advocating large doses an innocuous treatment because it seems like it might be helpful is not terribly good medicine, but hey--it's harmless, right? Advocating large doses of fat-soluble vitamins can be dangerous, for reasons already discussed.

T. Brady

Bad hair? Don't tell Gisele!

jimmyk

Advocating large doses of fat-soluble vitamins can be dangerous, for reasons already discussed.

Not taking them also has risks, especially given that, as has been pointed out, levels can be monitored. While you are correct that anecdotes are not science, "science" can take a long time to come to definitive conclusions, and in the meantime one has to make decisions.

Moreover, science has proclaimed lots of things later proven wrong (or at least having strong doubts cast on them), like the carbs for fat message of the food pyramid that I mentioned above. So I think all your scoffing about TM's post is a little overblown.

Depends on how crazy it gets.  That's why the cautions.

I think Bill and I are both concerned about public perceptions. I can certainly imagine a scenario in which the public starts taking Vit D recklessly and there are poisonous doses.

What I don't know is precisely the level of Vit. D deficiency in the population. I suspect there are far fewer people actually deficient in Vit. D than the number of people who will take more than they should, if this becomes a popular craze.
=================================

BobDenver

Mality. I like it.

Nate Whilk

jimmyk wrote, Mike makes the common mistake of giving "doing nothing" a privileged position. This is what delays potentially valuable drugs for years even after they have been deemed safe.

It's not a mistake. It also keeps the far more numerous ineffective or dangerous drugs that you NEVER hear about from harming people or wasting their money. One we DID hear about was thalidomide.

It's absolutely true that experts sometimes make mistakes. That's why it's news. And we like to hear those stories because it reassures our own egos.

One has to balance the risks and benefits and decide which way to go.

I agree. Just make sure you're as fully informed as possible.

Jeff

gee ...

it appears that the commentors worried about a vitamin D stampede are commenting on the wrong article ...

the 2 bone guys are claiming that Americans are not vitamin D deficient ... if anything they are telling everyone not to worry about their D levels ... of course they are looking at vitamin D from a bone perspective ... great ... doesn't mean they have a clue about any other benefits of D ... in fact I'd be willing to bet they don't have a clue one way or another ...


jimmyk

It also keeps the far more numerous ineffective or dangerous drugs that you NEVER hear about from harming people or wasting their money.

Um, I said "after they've been deemed safe." I don't have a quarrel with the safety requirements. It's the efficacy requirements that add years to the process. So thalidomide is a straw man.

Sara (Pal2Pal)

I was kind of shocked when I had my first blood work done in over 5 years to learn that my Vit. D and cholesterol levels were critically low. I don't absorb fat too well. But on the D, I knew it was because my back pain had kept me pretty much a prisoner upstairs for months and for probably the first time in my life, I hadn't spent the Summer baking in the sun. The doctor put me on a prescription level D supplement for 15 days. At the same time, I made a special effort to get outside every day. When I was retested, my levels were at the high end of the normal range. Two months later, with no more high dose supplements, just me getting out in the sun each day, and my levels were well within normal range. We've scared people so much about the harmful effects of the sun, then slathered on the sun screen, it is no wonder so many have low D levels and then are overdosing on supplemental D. And being a fat soluable vitamin, like A, one can overdose. You can buy A in a water soluable form, D just takes a half hour of direct sunlight on the skin, but it can set up up a calcium deficiency if you have too much D and not enough calcium or vice versa, D and calcium work together in the body. Like the B vitamins, taking too much of one can set up a deficiency in the others.

Terry Gain

I don't believe anything I read in the New York Times. Even the stuff I know to be true.

Boatbuilder

I'm with you, Terry. Even "and" and "the."

Carol Herman

My internist had such bad knee pain, he couldn't even exit his car, without being handicapped by the pain. He was going to head into knee replacement surgery, when it was suggested to him to "just try 25,000 units of D, a week. BINGO. Success! No need for the knee replacement therapy.

How do I know? I was at my regular visit, and complained about back pain. Nothing so dreadful that I couldn't rise out of the chair. But it was "there." Constantly. So, he told me about the success he's been having with "D" ...

The pharmacy is downstairs, in his medical office building. I asked him for a prescription. (He actually takes twice the dose.) (And, yes, my blood test showed I was deficient in D. But I'm only allowed one capsule a week. WOW! Did it work wonders!

He also told me that I should go to a physical therapist. HA! Don't need to! I've erased my back pain. And, he also shifted me from ACTONEL, to PROLIA. Which is injected twise a year.

Nobody lives forever! And, some things don't work for other people, that I find work gangbusters for me. Soon I turn 71. Old bones really do creak.

Buford Gooch

Errata: I do not think that word means what you think it means.

weight lifting benches

Wow! You've got huge comments. That's it! It didn't cross my mind that too much vitamin D can be harmful too. I only believe that vitamins have no side effects, except for vitamin A. Well, that's it. Aside from maintaining a healthy diet and taking your vitamins daily, everyone should observe proper and daily exercise as well. There are lots of exercise that requires less of your time. All you need to do is surf the net.

jorod

Are they talking about Vitamin D or Global Warming?

Paul D.

Folks here should remember the hype about antioxidants. Well, they did a study to see if vitamins C and E help against lung cancer, and they found megadoses of these actually made the cancer worse. It seems white blood cells generate reactive chemicals to kill things, and high levels of antioxidants can interfere with that.

Paula R. Robinson, M.D.

New poster. I'm a family physician in a small town, but have done duty (recently) as a hospitalist in a large city. At both locations I have tested for Vitamin D deficiency, found large numbers of sufferers, and treated with Vitamin D3 fairly aggressively when warranted (having found over-the-counter Vitamin D3 to offer benefits not seen with prescription Vitamin D2). The following is anecdotal. In persons with a deficiency, Vitamin D3 intake appeared to help (not necessarily cure): intractable infection, congestive heart failure, intractable skin ulcers, neuropathy, confusion (in patients with dementia), and inflammatory bowel disease. Patients on Vitamin D often showed a lower requirement for thyroid replacement and improved glucose tolerance. Again anecdotally, improved energy and mood were seen in bed-bound patients with over-the-counter Vitamin D, but not with ergocalciferol (prescription Vitamin D).

tea anyone

Paula R.
In what quantity should over the counter vitamin D be taken?

The comments to this entry are closed.

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