Approximately 88% of the UK population has vitamin D levels below 32 ng/ml, classing them as deficient and increasing their risk of chronic illnesses; everybody - adults and children - should aim for a level of 50ng/ml which is 125 nmol/L; and experts suggest people with cancer take 125 microgram (5,000 IUs) a day to get there!
According to research (1), vitamin D regulates phosphorus and calcium absorption and so helps build strong bones, muscles and teeth. For 60 years, the medical world has known only this and so 800IUs a day or 45 minutes in the sun has been the official ‘dose’.
How naive they were?
Not even that dose is now seem as enough for bone health. In older people with the threat of osteoporosis, the total calcium daily intake is recommended by American Bone Health at 1500 mg, with vitamin D at 2000-2500 IUs.
For the past 20 years only laziness (and mischief) has prevented the importance of Vitamin D being accepted. The research was there for all to read. I wrote my first version of 'Vitamin D -are you getting enough?' in 2004. I haven't needed to alter my target levels since that day, even with more research available.
Vitamin D - essential to a healthy immune system
There is clear research that Vitamin D can correct cancer cells, restrict inflammation in the gut and prime the immune system attack.
A vitamin D receptor has been found on immune T-cells, B-cells and antigen-presenting cells. And these cells can even synthesize a metabolite from vitamin D which acts as a hormone within the immune system!
Vitamin D can activate both the Innate immune system (where pathogen-attacking T-cells have receptors) and also the Adaptive immune systems (where B-cells make antibodies using vitamin D).
Furthermore, Vitamin D deficiency is associated with greater gut problems, more autoimmune disease and greater infection (2).
It's hardly surprising then that low plasma Vitamin D levels are associated with an increased risk of cancer, cardiovascular disease, strokes, dementia, DVT, diabetes, MS, colds, flu, infection and a greater risk of death from Covid (3).
Recent research from SEA showed simply that if you developed Covid and your Vitamin D levels were below 19 ng/ml you were in trouble, but if you had levels over 29ng/ml it might cause a sniff and a cough but that was all.
Confusion 1
First, there is confusion over measurements - scientists use ng/ml, while your UK Hospital uses nmol/L which is two and a half times higher!
Hence scientists say below 20 ng/ml is dangerous; below 32 is still deficient. At your Hospital, these figures would be 50nmol/L and 75-80 nmol, respectively.
Vitamin D deficiency in the UK is defined as: 'A person having below 20 ng/ml, or 50 nmol/L' But Dr. Donald Levy, Medical Director at the Osher Clinical Center for Integrative Medicine at Brigham and Women's Hospital, and assistant clinical professor at Harvard Medical School is adamant that deficiency is below 32 ng/ml. That equates to approximately 80 nmol/L. But not being deficient, and being at a good healthy and safe level are two different things.
In the USA, the Government recommendation is that you should have plasma vitamin D levels of 40+ ng/ml to be in the healthy 'normal' zone. That means you should be above 100 nmol/L.
In 2011, following a number of good research studies, the highly respected Endocrine Society published a report stating:-
"Based on all the evidence, at a minimum, we recommend vitamin D levels of 30 ng/mL, and because of the vagaries of some of the assays, to guarantee sufficiency, we recommend between 40 and 60 ng/mL for both children and adults." Again, this would mean you should be above 100 nmol/L - and actually as high as 150 nmol/L.
Professor Michael Holick of Boston Medical School has been involved in more than 25 years of research on Vitamin D and his recent report registers similar levels for safety; above 75 nmol/L, and between 100 nmol/L and 150 m,ol/L for health.
Vitamin D - Safe, healthy levels; my view
In my opinion, and based on all these views and on the research I have read over the last 20 years, a good, safe level is 50 ng/ml or 125 nmol/L. Smack in the middle of the range recommended by the Endocrine Society.
Since nurses in UK hospitals have told my patients with 65 nmol/L plasma D levels, that this is a high level and may cause liver damage (there’s no research; it’s a complete nonsense), I would like to point out that this score of 65 is not even 30ng/ml, but 26ng/ml.
So to repeat, in my view you want to be 50ng/ml or 125 nmol/L. And starting today you need to get there as fast as possible to avoid chronic illnesses.
Confusion 2
You will read that you can derive vitamin D from a healthy diet. Be clear - there is virtually no Vitamin D in the average diet (a very little is in dairy - slightly more in Cod liver oil). If you don’t go in the sun wearing limited numbers of clothes, and at a time of day when (according to Holick) your shadow is SHORTER than you are, you must take a supplement. 5,000 IUs for people with a chronic illness, 2500 IUs for people who are ‘well’.
If you haven’t been in the sun for a while and you don’t supplement, start with 10,000 IUs for 2 months; don’t take a risk with your health!
Confusion 3
The Americans are going to scrap IUs in 2021. You will be buying vitamin D only in 'micrograms' (μg).
So, if you need to know how many micrograms you need a day, it would be 50 μg for health and osteoporosis, and ... guess what...
1-2 ---- 5 if you have a chronic illness.
And if a nurse or a doctor comes to you and says 65 is a high figure for your plasma Vitamin D - just shout very loudly ... ‘One-Two --------------- Five’.
Then you will know you are safe!