50,000 IU doses of vitamin D might not be such a great idea

A commenter (Blake) on a recent post directed my attention to Dr. Stasha Gominak’s series of videos on her work treating sleep disorders with vitamin D. The videos run more than an hour, but here’s a summary of some of her points. One of her points — of course, not covered on the summary — is that those whopping 50,000 IU vitamin D pills that some doctors give to their patients to take once a week are not as effective as taking it daily in smaller amounts.

I’m not sure if she was referring to the fact that the majority of those 50,000 pills used to be in the D2 form, which is not as effective, or to a claim I’ve read elsewhere that past a certain dose, the larger the dose, the less effectively it is absorbed, so that one day of 50,000 IU actually provides less vitamin D than ten days of 5,000 IU. Of course now I can find no such citation. Aren’t I helpful?

Another reason to replete with smaller, daily doses is to lower the risk of catastrophic interactions. If you’re low in vitamin D, you’re probably low in other nutrients, and taking a whole lot of one nutrient can wipe out its cofactors, and depending on the extent of your deficiency of that cofactor, the deficiency symptoms can be pretty bad. In my case, I had unknowingly been suffering from reallllly low vitamin K levels, and the mega-whoppa-D3 dose shot it to hell. I had an asthma-like attack that was very scary. I thought about going to the ER but luckily it tapered off quickly enough and my doctor was able to get me an appointment with a pulmonary specialist within a few days.

The specialist said it was just a one-off asthma attack caused by a hitherto-unknown vitamin D allergy. I knew that vitamin D interacted with vitamin A, so I asked him if asthma was linked to vitamin A deficiency. Why I bothered, I do not know: some delusional fit of psychotic optimism hit me. He went to his computer, looked up vitamin A in the clinic’s database, which from what I could see was no better than any consumer medical database you can find online, and said that vitamin A deficiency is only a problem in orphans in India, where it causes blindness. Ah, I said. Okay then. Later I somehow stumbled onto this 1975 Japanese study and started to figure it out.

In an older person or smaller person or someone much sicker, that reaction could’ve been disastrous and even more terrifying than it was for me. By sticking with a smaller dose, my reactions would, I assume, have been smaller and hopefully more manageable.

I did appreciate Dr. Gominak’s comment that “We blame people who can’t sleep,” which I have found to be very, very true. Humans are idiots, have you noticed? I have to say, though, that I am annoyed by her claim that she is the first to recognize the link between vitamin D and sleep. Perhaps she’s just not being specific enough, or is referring only to the world of neurologists, but my osteopath mentioned it a lot earlier than 2009.

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