The Massive Vitamin D Blunder That Has Left Millions Deficient

March 9, 2018

Sunlight shines through trees

It is safe to say that most people within the MS community are aware of a link between vitamin D and multiple sclerosis. There is now overwhelming evidence of its role in the prevention of MS, and very convincing data for the prevention of relapses and disability progression once diagnosed.

Quite understandably, we OMSers can get a bit “blinkered” in our research and focus on the minutiae of MS alone. But it is worth broadening our horizons from time to time and stepping back to see the bigger picture. A very exciting paper from the University of Athens School of Medicine is certainly worthy of a look up from the MS microscope.

In this review the authors discovered that a simple error of calculation has led to a worldwide UNDER-supplementation of vitamin D and concerning levels of vitamin D deficiency, with potentially deadly consequences for global health.

Approximately one billion individuals worldwide, nearly 15% of the world’s population, are vitamin D deficient (fewer than 50 nmol/L) or insufficient (50-75nmol/L).

The devil is in the detail

In 2010, the Institute of Medicine, a Government Health Agency in the United States, released guidance stating that for 97.5% of the population to have sufficient vitamin D for health, their levels should be 50 nmol/L or more. They calculated that for the average adult this meant a recommended daily intake of 600IU. In the UK the NHS advises 400IU (10mcg) supplementation to those at risk of deficiency.

A further report in 2011 by the Endocrine Society advised that at least 1,500-2,000 IU/day of supplemental vitamin D might be required in adults, and at least 1,000 IU/day in children and adolescents to achieve levels of more than 75nmol/L.

But the devil, they say, is in the detail. Scientists rigorously re-analyzing the original data sets have now found that these figures just don’t add up. In fact, they proved that 8895 IU/d are needed for 97.5% of individuals to achieve values ≥50 nmol/L, and 9122 IU/day to reach 100 nmol/L.

The largest ever meta-analysis, of ALL the studies published between 1966 and 2013 on the effects of vitamin D and all-cause mortality (deaths due to any cause – including heart disease, cancer, autoimmune disease) is very clear on this. It showed that the recommended 75nmol/L level may actually be too low, and associated with higher all-cause mortality; an increased risk of death.

What is the significance of these findings?

The latest re-calculation simply destroys the previously perceived wisdom. In order to reduce your risk of death to average or below, then the level needs to be over 100 nmol/L. This means that the average adult requires approximately 10,000IU of vitamin D daily to protect them from a potentially preventable death!

The authors then make the bold step to call on “all responsible public health authorities” to set as their safe upper tolerable daily intake doses for patients at risk for vitamin D deficiency (<50 nmol/L):

  • 2000 IU <1 year of age
  • 4000 IU for those aged 1-18 years
  • 10 000 IU for those >18 years

If this were to be implemented worldwide, imagine how many cases of MS could be prevented, never mind all the heart disease, stroke, cancers and depression, to name but a few diseases!

The authors are clear that at this level there is almost zero risk of toxicity. To put this in a context outside of MS, cases of autoimmune (Type 1) diabetes have been increasing worldwide at a rate of 3% annually. Some of the theories behind this relate closely to those of MS, for example cow’s milk intake, and yes, you guessed it – vitamin D deficiency.

This paper supports Professor Jelinek’s research

In Finland, the recommendation for daily vitamin D supplementation was gradually reduced from 4000-5000 IU in 1964 to 400 IU in 1992. During the same period, cases of T1 diabetes increased by 350% in 1-4 year-olds, 100% in those aged 5-9, and by 50% in the 10-14 year-olds. Since 2006, the authorities have fortified all dietary dairy products with vitamin D (the irony of which is not lost on this audience), and cases of T1 diabetes have plateaued and now begun to decrease.

So OMSers have the right to feel just a little bit smug today, thanks to Prof. Jelinek’s pioneering research and backed up by this latest paper. People with MS following the OMS Recovery Program have of course been doing this for years! Hopefully now the wider scientific community will start to come around to our way of thinking about vitamin D and its many benefits outside of just bone health.

It may also reassure those taking these higher doses of vitamin D, if they are worried that they are in some way doing something a little risky. In fact, we are just taking what everyone else should be, and protecting ourselves not only from the effects of MS, but also many other Western diseases. Well done OMS!

Dr Jonathan White MBChB MRCOG

References:

Papadimitriou, Dimitrios T. “The Big Vitamin D Mistake.” Journal of Preventive Medicine and Public Health 50.4 (2017): 278–281. PMC. Web. 8 Mar. 2018

Jelinek G,A; Overcoming Multiple Sclerosis, the evidence based 7 step program; 2nd edition, A&U 2016; pp148-190

Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad H, Weaver CM. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011;96:1911-30.

Garland CF, Kim JJ, Mohr SB, Gorham ED, Grant WB, Giovannucci EL, et al. Meta-analysis of all-cause mortality according to serum 25-hydroxyvitamin D. Am J Public Health. 2014;104(8):e43–e50.

Vitamin D Council: Review establishes Vitamin D deficiency risk factors, prevalence and treatment for individuals worldwide 

34 thoughts on ‘The Massive Vitamin D Blunder That Has Left Millions Deficient

  1. There is no doubt in my opinion that your research is accurate but Drs all over the world are telling us we have Vitamin D defficenty. I live in Florida I get major doses of D just walking my dog or going from my home to the car, yet my Dr says my D is low. I can see where country’s with less sun may have a problem and could affect ms but if everyone keeps getting told they need more D no one is going to take this report seriously you will have a hard time convincing people I wish you luck I hope people listen

  2. Values of daily intake of vitamin D does not translate into a meaningful picture of serum koncentration of vitamin D for the individual person, only biannual blodtest does. Otherwise its just to much of a guesswork depending on sun exposure , intake of fatty fish, supplementation etc.
    Many posts on this forum confirms how people struggle to hit the right target even being religious precise about supplementation and sun exposure.
    Maybe its time to call for health authoritys to take this problem more serious an offer the public biannual testing of serum koncentrations ?

  3. Maybe it depends what form of vitamin D they are recommending. I found that certain forms of Vitamin D are much more effective in absorption. If I take Vitamin in Oil with food, my levels go up quickly at 2000 ius, and if I take a high end cod liver oil, my levels surpass the high level recommendations.

  4. A later publication on the multiple Vitamin D math mistakes
    US admits math mistake was made in 2010 in estimating Vitamin D, but will not change recommendations – Nov 2017
    URL = is.gd/VitDMM

  5. Re “It is safe to say that most people within the MS community are aware of a link between vitamin D and multiple sclerosis. There is now overwhelming evidence of its role in prevention of MS, and very convincing data for the prevention of relapses and disability progression once diagnosed”

    The first sentence in the article is correct – there IS a link between Vit D levels and MS. Unfortunately, the second sentence perpetuates the endless lack of understanding of the differences between “cause and effect” and “reverse causation”. Because OMSers can (and in fact have) become rather blinkered in their interpretations of quite a few things they also endlessly perpetuate, especially on the OMS forum pages, the idea that low Vit D contributes to getting MS and that low Vit D levels can actually CAUSE relapses in those who have RRMS. They happily tell people to take mega-doses of 100,000 IU and more of Vit D left, right, and centre, and woe betide anyone who might mention that studies have shown that bolus dosing of Vit D is really only necessary when someone is medically diagnosed as deficient, and that an increased but steady intake over time actually works better to optimise Vit D levels.

    The OMS dogma is just being repeated when it is stated above that “imagine how many cases of MS could be prevented” – yet again a statement which is not borne out at this time by any of the scientific research or evidence.

    Scientific research to date has shown links between low Vit D and MS – but it has NOT shown which comes first – i.e. does low Vit D actually contribute to getting MS, or does having MS result in low Vit D levels being found when a person is tested? There are plenty of people with perfectly adequate or even high Vit D levels who still get relapses, and the usual OMS forum responses to this are either to tell the person that they were not doing OMS 150% so it’s their fault they relapsed (victim blaming), or else to tell them to think how much worse it would have been if they were not following OMS. Neither of these can actually be proven.

    Unfortunately Prof J has started to drift away from scientific bases for some things, and I was appalled to see he had actually stated in at least one relatively recent forum post that “low Vit D will cause a relapse”. As he claims the OMS approach is based on science and research evidence, this is a bad example to be setting for OMSers, and if he believes in science then he should know better than to make such statements.

    Unfortunately, there are also some OMSers who seem to believe that if “more is good, then vast amounts of more are even better”, with some seeing Vit D levels as a competition to see who can get theirs up the highest. While Vit D needs to be consumed in really large quantities for it to be toxic, such a race is really not a good idea, and aiming to have a level of over 250nmol/L (100ngl/ml) as I have seen at least one person post in the OMS forum is just being irresponsible with your own health.

    Having said all of that, I must state that I do agree that there is a CONNECTION between MS and Vit D, but that I, like the scientists who’ve done the research, don’t actually know whether it is “cause and effect” or “reverse causation”. So, I take around 20,000 to 30,000 IU of Vit D a week, but I ensure that I take what else is also required for proper metabolisation of Vit D and reduction of the risks of hypercalcaemia which can occur with ongoing fairly high doses of Vit D – and yes, there is science to confirm this.

    Now, I shall sit back and wait to see how many OMSers jump in here protesting that they do know better than those scientists who have actually done the research, and that despite any real evidence one way or the other, they just KNOW that low Vit D was partly why they got MS and that if their levels get too low it can CAUSE them to have relapses. It never seems to occur to them that maybe a relapse was brewing away quietly without them being aware of it, and once the symptoms of a relapse become noticeable they then get their Vit D tested, and lo and behold – low Vit D. They then assume that the low Vit D caused the relapse, and the lack of scientific evidence to confirm their viewpoint is completely irrelevant.

    PS
    Why is there no link provided to the actual review article being reported on?
    Why (except for the Vit D Council webpage) are none of the cited references live links?
    Given that OMS is trying to extend its reach into the USA, why are the blood levels quoted throughout the above article given only in nmol/L and the USA measurement of ng/ml has not been included as well?

    • Many thanks for your comments, you raise some very interesting points. Any two researchers looking at the same data generally come up with different conclusions; that appears to be the case here. The OMS assessment is that the research data on the role of vitamin D in MS development and progression is compelling, as outlined on p190 of the book Overcoming Multiple Sclerosis: “The evidence for sun exposure and vitamin D supplementation is now vast and congruent, all pointing to reducing risk of getting the disease and of its activity”.

      The main point of the article was not however to simply repeat our vitamin D and MS message, but rather to lend a more holistic perspective to the vitamin D discussion, and to demonstrate that there is increasing evidence of its role in other autoimmune disease (e.g. type 1 diabetes) and of a rather significant miscalculation with regards to supplementation to achieve recommended serum levels. We have consistently argued that currently recommended dosing is inadequate, and this review bears that out.

      OMS certainly does not advocate excessive supplementation of vitamin D, and is very clear in its advice that PwMS should aim for serum levels of vitamin D of 150-225 nmol/L or 60-90 ng/ml. These levels are within the normal range, but require doses that are higher than previously recommended by many authorities.

      In making responsible recommendations for people with MS, we rely on the best evidence available. While gold-standard randomised controlled trial research in the area remains elusive, presumably due to research funding disincentives, as pointed out on p191 of the book: “The risk for PwMS, and those susceptible to MS, of waiting for more research far outweighs any perceived risks”.

      This new review article lends further evidence to the OMS position on optimal dosing and for the wide-ranging benefits of vitamin D in global health.

      Dr Jonathan White

  6. Hmm. I have MS and have been taking D3 supplements for about 10 years at increasing amounts. Just recently upped my daily dose from 4000iu to 5000iu. Then did the blood test … 205! Sorry, no baseline for comparison. So it would appear in my case that D deficiency is not my issue? Have dropped back down to 4000iu at neuros recommendation. Above said, my RRMS has been stable for a long time on a DMT and D3 regime ….

  7. I want to answer the person who asks if Vit D is part of the cause or effect of MS. I have had MS for 35 years , work full time as a Professor in a university department and was Head of the Dept, am 61 and was given a few years to live 35 years ago, by 6 top neurologists) as my attack was so bad. I booked my grave site. I have done the Swank diet since then, only much later got Copaxone (20 years) and been as religious as possible with the Swank diet, serious stress management (knowing one person’s stress is another’s challenge) then went off dairy, wheat but went back onto wheat many years ago. I added the Omega oils, and switched to oily fish. Long ago, i added Vitamin D3. To the person who asks the question: almost all the persons i knew all those years ago said i was crazy and naive. My answer , after researching as much as possible, is what is the risk/benefit ratio? The risk of very high doses of Vit D are very small, the possible benefit is medium to high. Therefore, why not take it? What real risk is there? Focus on the ratio, not endless speculation about cause or effect. That goes for diet , stress management, all of it. What do we have to lose? I wish you health and calm

  8. Vit D process and the stages and the co- minerals in the process seems to be an unspoken detail.
    In research, the process of absorbing Sunlight on the skin to being bio-available form in the bloodstream seems to often be said to not need other vits and minerals or gut health to play a part in the long process?
    This paper got me thinking about all the stages and the general health needed for the entire process, not the reductionism concept.
    From Sun to blood is a long process, it requires several organs and pathways plus the process requires health and diet factors to be considered rather than pop a pill of a precursor form of the end product, D3 is not calcitriol the active form!
    https://www.sciencedirect.com/topics/medicine-and-dentistry/mineral-absorption

  9. Almost two years ago my first vitamin D test turned out to be 8 ng / ml and for the past year I have ingested 10,000 iu daily, reaching 75 ng / ml. No relapse in my MS and no side effects. I accompany it with magnesium in tablets and two and a half liters of water.

  10. Hello everyone!

    Just wanted to post a quick comment regarding some of FB´s questions. There are actually plenty of serious studies (if you just take a little time to do some serious googling) showing the positive effect high Vit-D has on ms, for example this one from the university of cambridge:
    http://www.cam.ac.uk/research/news/vitamin-d-could-repair-nerve-damage-in-multiple-sclerosis-study-suggests

    There also have been plenty of studies showing that even very high regular dosages are safe, for example:
    https://academic.oup.com/ajcn/article/86/3/645/4649351

    It has also been proven, that Vit-D (which is falsely called Vitamin since it is actually a hormone) has immunomodulatory effects, for example:
    http://n.neurology.org/content/early/2015/12/30/WNL.0000000000002316.short?rss

    There is also lots of evidence that high doses of Vit-D can have very positive effect on ALL kinds of autoimmune deseases, for example:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897595/

    Interestingly enough, the last study was also written by Dr. Cicero Galli Coimbra, who is most known for the coimbra protocoll (please google it, if you don´t already know what it is). A pretty good vid explaining how it works:
    https://www.youtube.com/watch?time_continue=878&v=zHdS5Es94B0

    Obviously high-dosage Vit-D supplementation should not be done without supervision of a Coimbra-Protocoll doctor, as you do need to up your magnesium (very! important)-, Vit-B complex-, K2-, Zinc-, Selenium-intake and a couple other things as well (most importantly AT LEAST 2,5 lit of water / day – that is a must). The good news is that the coimbra-protocoll works incredibly well together with the OMS approach (very important: you have to avoid high calcium food intake when you do high dosage vit-d, which is not important if you only do OMS), and there are currently more and more doctors world-wide starting to offer this treatment to their patients.

    There are a couple of FB-groups where you can ask questions etc, – just google it. Also, if you have any further doubts you can always watch some of the videos the patients post on youtube – nothing more needs to be said.

    Sorry for the long post, but it bugs me to read that there are still people out there questioning the (by now) proven positive effect of high dosage Vit-D and making it sound dangerous / not effective. It is a very safe (if you have the right doctor) – and in my opinion (combined with OMS) – the perfect way to fight ms effectively and live a healthy and happy life.

    Good health/luck to you all, and thank you so much for this website.

    Cheers,
    Alex

  11. …I guess this is why when someone, including doctors, tell us “you, know, you should take x” or “research shows that x will help” we need to as patients ask: “so what is the specific dose I need to take every single day that will make a difference”…is it any wonder there is considerable scepticism about the efficacy and usefulness of vitamins and supplements within not just the medical community, but with medical practitioners/researchers because the majority of us follow the manufacturer’s label (i.e. take 1, 1000mg Vitamin D tablet daily) when in reality we need to take 10 tablets per day to be effective! So for the past 5, 10, 15 years, we have all been spending our hard earned money on taking a supplement/vitamin that has had little or no effect on our overall health and as MS is degenerative well over that 5,10, 15 years a lot of us have had a pretty crap time of it… Is it any wonder the average person is confused and upset… Let’s get this right first the time, so people don’t needlessly suffer and start to communicate “take x amount of x” …remember every this is a poison, its the dose that makes the difference….

    • Hi Bob, thanks for your comment. We try our best to work closely with doctors and other medical professionals to inform them that higher vitamin D supplementation is required in many countries around the world, especially when patients have MS. Unfortunately this is not an instantaneous fix but rather one that takes time and resources to change traditional thinking on the matter. From our extensive review of available research, we recommend 5000 – 10000 IU daily depending on location, sun exposure, season and current vitamin D levels. We are working with other MS organisations and hope that these recommendations will be included in MS treatment guidelines in the near future. Best wishes, OMS team

  12. my name Sandra. I take 400iu of vitamin d….I have had MS for over 23years. currently I am doing well…my medication is tecifidera 240mg…I have no symptoms right now…..so I am very blessed….you never know what tomorrow holds…

    • Hi Sandra, that is wonderful news! Just out of interest, do you have your vitamin D levels monitored? How did you decide upon 400 IU? Best wishes, OMS team

  13. Hi, I average between 40 000 IU and 50 000 IU of vitamin D per week for my multiple sclerosis
    What do others think of that dosage?
    Best
    David Peimer

  14. Hi, just to ask; what is the latest research in terms of how much Vitamin d 3 per week to have for our multiple sclerosis?
    I have had the condition for many years
    Thanks
    David Peimer

    • Hi David, we recommend 5000 – 10 000 IU daily depending on where you live and how much sun exposure you get. It may be worth your while to have your vitamin D levels checked to ascertain what dose would be best. Best wishes,
      Laura

  15. Hi Thanks for your inspiring comments. I have had multiple sclerosis for over 3 decades and found that taking 40 to 50 000 is vitamin D weekly helpful. What dosage do others take? Thanks. David Peimer

  16. Hi all, thanks for your inspiring comments. I have had multiple sclerosis for many years and found that Vitamin D helps. I take 40 to 50 000 iu per week. What doses do others take?
    Thanks
    David Peimer

  17. Hi again, do others take Vitamin D 3 or just Vitamin D? I have had multiple sclerosis for over 3 decades and have been taking Vitamin D 3 at those doses for many years. What about others?
    thanks
    David Peimer

  18. Hi all, do you take vitamin D 3 or Vitamin D? I have had multiple sclerosis for many years and been taking Vitamin D 3. I would be grateful to know your thoughts
    David Peimer

  19. Hi all, I do think vitamin D 3 in the dosage OMS recommends is good for my multiple sclerosis which i have had for over 3 decades. Just adding a thought
    All best to everyone
    David Peimer

  20. Hi all, what other vitamins do others take with vitamin D 3? I have had multiple sclerosis for many years and have been thinking about it combined with other vitamins
    all best to all
    David Peimer

  21. Hi, anyone any thoughts on Vitamin D 3 not just Vitamin D for our multiple sclerosis (I have had multiple sclerosis for over 3 decades)
    David Peimer

  22. Hi all, do others take other vitamins with Vitamin D or D 3 ? I have had multiple sclerosis for many years and would appreciate hearing from others as i think its time i updated
    Thanks
    David Peimer

    • Hi David, at this stage the program only recommends vitamin D3 and omega-3 supplementation. However, there is some newer evidence to suggest vitamin K2 may be beneficial too, but further research in this area is required. Also, with following a plant-based diet, some people do find that they need to take a vitamin B12 supplement too. Best wishes, OMS team

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.