Vitamin D: The Sunshine of Your Life?

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Reader’s Summary:

  1. Are dermatologists right about the sun being bad for us all the time?
  2. Why is sunlight so vilified by some physicians?
  3. What does Vitamin D really do for us and our immunity?
  4. What diseases does it play a major role in humans? What help does it give?
  5. What other conditions might optimizing your vitamin D levels help?

I was in a lounge watching the news last week and overheard a group of dermatologists talking about the new FDA rules for sunblocks that will go into effect in January  2012. There was unanimous agreement among them all that sunlight was the source of everything that was bad in their world. One of the doctors said to another, “No human should be out in the sun; they should just take vitamin D3 from the drugstore instead of getting it from the sun.” It was at that point I knew this was going to make a blog post about this.  Apparently, we’ve forgotten that photosynthesis supports most of the food chain on this planet.  And we are the mammal with an energy hog in our heads that needs energy.  Since our skin is derived from neuro-ectoderm and we, too, use photosynthesis to make Vitamin D for our protection from poor electron dense foods in summer.  Maybe we should re-think our position on Vitamin D?

The next time a dermatologist tells you the sun is bad for you should tell them about this study:  The further you are away from the equator, where the sun is strongest, skin cancer rates are HIGHER.  Hyperlink to study.

It is beyond me why the sun is so vilified. We could not have evolved past single cells organisms without it. We all learned that simple fact in school. But now with our advanced degrees and plaques on our wall, are we going to blame all skin diseases all on the sun? I decided to add pieces to the immunity levee in the QUILT because of this conversation. And before we start, let me be clear: In my opinion, it is better to get Vitamin D3 from natural sources before a supplement, but there is a catch to this pearl of wisdom.  First, review this link on natural Vitamin D production.

If your O6/O3 ratio is suboptimal, your epidermis is more at risk for cancers caused by UV light, so using sunblock and supplemental Vitamin D3 makes some sense in this case. The problem I have encountered is few people know what their true O6/O3 ratio is! In the dermatology literature, recent studies point out that melanoma is now more common in people who use sunscreens! I think this is likely true, but not because the sun is so bad; I think it has more to do with not getting enough sun because we wear clothes today, and we eat the wrong foods at the wrong time of the year.  Our modern lifestyle dehydrates us chronically,  and causes us to lose both Vitamin D and magnesium. This is our greatest risk factor for skin cancer in my opinion. Australia is the classic example of this risk factor today.  Anyone who is struggling to get their Vitamin D levels higher likely has a co-morbid magnesium deficiency due to a lack of water from poor mitochondrial function.  People forget that one of the main by products of mitochondrial production is water.


They also may have an environment loaded with non native EMF and blue light.  Magnesium is hydrophilic and without water, we lose Magnesium (Mg). There are 3 metabolic transactions from Cholesterol (Cholecalciferol) that occur under the skins surface where our “storage version” of Vitamin D (Calcidiol) is made and gets transformed in our kidneys and liver to the “active version” of Vitamin D (Calcitriol) in the liver. All 3 reactions require Mg as a cofactor. Mg however need the mitochondria to make cell water int he cell to work properly.  If the mitochondria do not make water, taking a Mg supplement is a waste of time and resources. It is physiologically impossible to have a 25(OH) blood test (“Storage-D”) to be less than 35 ng/dl and a Magnesium RBC level to be above 6.5mg/dL because of the negative feedback tied to calcium levels. This is why Magnesium and Vitamin D deficits walk together, and why they are associated with cancers. Magnesium is also a co factor for telomerase that controls our telomere lengths. I also think it is because the humans who get this melanoma and use sunscreens are high risk because of their underlying and undiagnosed poor O6/O3 ratio and a large side of carbohydrates that cause dehydration initially.

Vitamin D: The Immunity  Steroid

In medical school, I learned that Vitamin D was a hormone that was important in bone metabolism and that is where it really ended until I began to read about Vitamin D3 five years ago in all that research that has uncovered it does for our cells. The major effect is that it modulates the immune system as its receptor is found on T helper cells (regulator cells), the same cells that the HIV infection wipes out in AIDS victims. So if your Vitamin D levels are low, they turn off the epigenetic switches on genes that turns on the immune system protector cells and keeps us free of diseases from viruses, bacteria and fungal infections. In fact, since I got my level checked 5 years ago, I have not been seriously ill.

DISEASES ASSOCIATED WITH LOW VITAMIN D LEVELS: (below 30 ng/ml on a Vitamin D 25 (OH) test

  • Rickets and osteomalacia and psoriasis
  • Hypocalcemia
  • Seizures, muscle tetanus and heart failure in the newly born
  • Osteoporosis and Osteopenia
  • Cancer of all types
  • Heart disease (the number killer of men and women)
  • High blood pressure development
  • Obesity from all causes
  • Osteo and Rheumatoid Arthritis
  • Mental illness of all types
  • Chronic pain centrally or peripherally mediated
  • Muscular weakness
  • Radiation poisoning
  • Diabetes…..especially metabolic syndrome and T2D development
  • Multiple sclerosis and most autoimmune diseases

Take a look at this PDF on Vitamin D to see just how off the current IOM recommendations are in medicine.  It is eye opening to say the least.

What does Vitamin D do–and what should you know about Vitamin D?

  1. Facilitates increased intestinal absorption of phosphorus and calcium as well as suppression of parathyroid hormone secretion to increase our plasma calcium concentrations. It, however, does not dictate or direct where this calcium will be deposited in our bodies.  There is also not a strong negative feedback control loop within the gut for Vitamin D.
  2. Levels above 50 ng/ml are associated with increased adiponectin levels and low leptin levels. High adiponectin and low leptin levels means you are less likely to be obese. So higher vitamin D levels can help us trim our fat stores and offset the effect of seasonal carbohydrates in causing weight gain. By decreasing fat levels, we can avoid the initial steps that lead to insulin resistance and eventually develop Type 2 Diabetes.
  3. It’s a natural antibiotic that assists WBCs in clearing infections. It does this by stimulating immune cells to make a protein called cathelicidin in our skin.  This does not happen well in our gut, but works like a charm in our skin with UV and IR exposure. This protein is found on T cells within our skin, macrophages, neutrophils, and on our epithelial cells in our guts and respiratory system. It actually helps defend us from viruses and bacteria all the time when its optimized. In our gut linings, it also activates the T regulator cells to protect the intestinal lining and the GALT that lies right behind the brush border. The light required for this activation may come from the prokaryotes in our gut microbiome who naturally release large amounts of light.  Our enterocytes have to contain DHA in their cell membranes to decipher the signal properly.  It now appears that low vitamin D status in the gut maybe a huge risk factor for the development of HIV general infection. Another major immune affect of Vitamin D is that is has the ability to block intracellular signals of NF Kappa beta and of TNF alpha. Both of these chemicals are part of the machinery that causes upregulation of the stressful cellular response mechanisms in many pathologic diseases like cancer, autoimmunity and in obesity.
  4. It’s a direct inhibitor of the hormone renin in our kidneys and helps protect us from developing systemic systolic blood pressure elevation. It also protects the kidney directly from high levels of uric acid production that come from end stage fructose metabolism.
  5. A single nucleotide polymorphism (SNP) has been linked to the development of early heart disease. This SNP is on the C allele of SNP # rs4646536 and is being studied in the NIH VITAL trial currently ongoing. This is a second mechanism to prevent heart disease but a more common one will be discussed below.
  6. When the skin makes Vitamin D3 naturally, usually 10-20,000 IU are made locally in the skin. The excess Vitamin D3 is then broken down to its degradation products, which have been shown to inhibit the development of psoriasis in studies. These degradation products prevent the proliferation of the lower levels of the skin from reproducing at a faster rate than normal. This is the pathology found in psoriasis. The lower epidermis is known to grow 25-40 times faster and the skin gets a large red plaque on its surface as a result. This is why light therapy is so effective in treating psoriasis. It’s kind of ironic that dermatologists don’t look at the pathological causes of this disease. Here, sunlight is curative because it stimulates Vitamin D3 production to make excess Vitamin D3 to make degradation products. Anyone with psoriasis should have their Vitamin D levels checked and optimized before they do anything else. Most have extremely low levels and they tend to be obese and have higher cancer rates across the board.
  7. In autoimmune diseases, we need to advocate for much higher levels of Vitamin D from sunshine. Why? In order for circulating vitamin D to perform its functions, it must first activate the vitamin D receptor (VDR). The gut is broken down in those with AI’s due to an altered microbiome.  They also tend to be DHA depleted.  The problem is that many people with autoimmune disease have a genetic polymorphism that affects the expression and activation of the VDR and thus, reduces the biologic activity of vitamin D within the skin and gut.   Studies have shown that a significant number of patients with autoimmune diseases have several VDR polymorphisms. There are over 25 variants of VDR polymorphisms now known and the list grows monthly. If you have a VDR problem, you require much higher circulating levels of Vitamin D from sunlight to bind to these defective receptors. As we have mentioned in multiple previous blogs, a leaky gut predisposes to the development of autoimmunity. Fundamentally the leaky gut maybe due to a lack of bacteria leaking UV and IR light to our enterocytes to activate the innate immune system and the VDR.  Moreover, optimal Vitamin D levels are also linked to “tighter junctions” between the enterocytes of our intestinal lining making our guts “less leaky.” If the gut is less leaky, our immune system is stronger because it does not have to be activated constantly to protect the rest of the body.  We have also seen above that vitamin D levels play a huge role in our immune surveillance in our GI tracts. It appears to be critical to push your levels to much higher plasma levels in these cases. I strongly recommend talking this over with your doctor. The fears of Vitamin toxicity from sunlight are very overblown in my estimation and the risk of too low a level for disease propagation is far too common and risky for your health. There is a concern about oral vitamin D supplementation in case where non native EMF predominates.  There is now very recent evidence out from Dr. Hector DeLuca about MS and autoimmune encephalitis. Dr. DeLuca believes that the degradation products of vitamin D3 and/or some byproducts of solar radiation confer health to us in some fashion. He says vitamin D3 degradation and sunlight is somehow active against a range of autoimmune illnesses. In his latest work, that “something” he is studying is active against an experimental model of multiple sclerosis. I have always felt that MS, ALS and Guillian Barre are tied in some fashion to vitamin D metabolism and a loss of light. It appears Dr. DeLuca believes this as well.
  8. Vitamin D is a fat soluble molecule. It means you should take it with fat for absorption. But it also means that some people will not absorb it well at all. Who? Those with a leaky gut, who have people with IBD, Crohn’s, Ulcerative colitis, liver disease, those without a gallbladder, and those on a low fat diet that 99% of nutritionists and dietitians recommend. If your are a reader of this blog, you know I don’t advocate that stance at all.Who else has to worry? Those who are on NSAIDs, steroids longer than a two weeks, those on blood thinners or anticoagulants, those on reflux medicines and antacids, and synthetic hormones like birth control pills. Are you starting to understand now why we have an epidemic of hypo vitaminosis of vitamin D?
  9. Can you have a normal plasma D level and still have low vitamin D activity? Yes you can, and it is probably the biggest silent epidemic out there today. I most commonly see this in obese folks with hypothyroidism. 90% of the cases of hypothyroidism in the USA are cause by Hashimoto’s disease. This disease is an autoimmune disease and these patients universally have defective VDR receptors. That means they need very high levels of blood Vitamin D levels from sunlight and optimization of their thyroid function to get results. Often, many obese people get stuck not losing weight because their doctors are fooled into thinking their thyroid and Vitamin D levels are fine. Most of the time, the levels are sub therapeutic and patients find amazing results when their plasma levels are pushed a bit by the clinician. The problem is most MD’s are afraid to advocate for the sun’s light.  This is an area where you need to speak to your doctor. I often see this in post op cancer patients, too, under extreme stress. Patients with high cortisol levels suffer the same fate.
  10. Age will decrease your skin’s ability to make vitamin D3 from sunlight and cholesterol. As we go from age 20 to 60, we lose that ability by a four-fold magnitude. The darker our skin, the worse the conversion. So as we age, we need more sun or supplementation, not less of either. This is why so many older people see a higher incidence of neolithic diseases as well.
  11. Humans have a Vitamin D savings bank in our body. It is supported by a good protein diet and a leads to a better Vitamin D level. An Epi-paleo diet is an optimal choice for this bank account. It works by making a protein called Vitamin D binding protein (DBP). It acts like albumin does in the blood. The vitamin D-binding protein (DBP) is a highly specific carrier for vitamin D and all of its metabolites found in the plasma. This allows us to store vast amounts of Vitamin D. Why do we need that from an evolutionary standpoint?  Vitamin D synthesis from cholesterol by the sunlight is thus maintained within physiological limits estimated to be 0.01 to 2.5 mg of cholecalciferol per day. 2.5 mg per day translates to 100,000 IU per day! If we are protein deficient, we do not have this ability and our stores are low in low light levels. It not only protects our Vitamin D stores, but it also prevents the toxic effects of a high vitamin D level in the blood. Humans start to store Vitamin D3 when Vitamin 25(OH)D level is above 40 ng/ml.The interesting finding is that it is only around a level of 60 ng/ml that the stores are sufficient to see us through a winter with a resultant optimal D level. This is why dietary composition is critical for immunity the further one gets from the equator.  Seafood is on of the few foods high in Vitamin D levels.  At the equator there are no foods with Vitamin D because the tropical sun provides all we need. This information also shows why flu season peaks in winter months in epidemiological studies. It also helps explain why those who are chronically ill or have serious diseases like cancer have very weakened immune systems. This is why cancer patients have higher risks for developing multiple neolithic diseases as they age. Peripheral neuropathy and pain is one such example. Those with low HDL levels or frank liver disease tend to make the lowest amounts of DBP. The liver is our organ that really is a solar organ that mimics photosynthesis.  Liver disease or low HDL states are seen in hepatitis cases and in patients with metabolic syndrome as well. It also explains why other neolithic diseases afflict those people and why they all seemingly have low vitamin D levels, too. This is why we see an epidemic in the USA today. Before, we never looked for it, but now we are beginning to understand just how vital Vitamin D is for immunity and health.
  12. In 2007, Richards found that higher vitamin D levels are also associated with longer telomere lengths. This means that optimal vitamin D levels reduce our cellular aging risk, reduce utilization of our stem cells, and decrease the leakiness of our mitochondria which drive the action of the telomerase enzyme that dictates telomere length. So it makes sense if your D level is low, your telomeres will be shortened and this, too, will put you at heightened risk for neolithic disease. All cellular systems seem to point to disease and increased aging with lower vitamin D levels. Aging is also associated with calcium efflux in mitochondria.  This is among one of the most congruent findings I have seen in biology since I began to review the biochemistry and literature in this area.
  13. When you optimize your vitamin D3 with sunlight, you will notice your HDL will rise 10-30% in the first year.  I look at low HDL as a cause of low redox and poor solar exposure.  This signifies that the liver is doing a better job of “skimming” the portal circulation for endotoxins. This is the major mechanism that Vitamin D protects the heart, in my view. We all hear from doctors that a high HDL protects the heart. This is how: It makes the liver a master of defense for the nervous system. It also protects the brain from endotoxin assault form the gut, it reduces all causes of mental illness and it is a main defense in the brain gut axis.  Read my VAP blog here to freshen up on this physiology.  Higher levels of VDR activation means less hypoxia in the brain and better mitochondrial density and function in the brain and heart.  This increases the magnetic sense within mitochondria by increasing electron tunneling on the inner mitochondrial membrane.
  14. Regarding cancer and Vitamin D3:   The gene that codes for  E-cadherin can be epigenetically silenced via promoter hypermethylation.  This explains why Vitamin D3 cannot “prevent”  or “cure” all cancers, since the E-caherin gene is under the direct regulation of Vitamin D3.  Many people do not understand this on off switch with regards to cancer.  



So, I think I have just skimmed the surface here why Vitamin D does a ton more than I learned in medical school 20 years ago. I keep reading about it because we are finding out new things it does daily in organs like the brain and nerves. Consider this: the ApoE4 allele is the allele that conferred the ability of humans to leave Africa and evolve and live in lower levels of solar radiation, yet still capture enough Vitamin D to survive. This allele is associated with other diseases these days, but it was ideally matched for humans who needed to migrate north and south from the equator for many reasons.

It is also vitally important to our immunity and defense. New studies in 2009 showed that that Vitamin D also decreases the risk of breast cancer in women when their levels were over 50 ng/ml. I have a sense this increase must come from sunlight and not a supplement.  This has huge implications for all women and all oncologists in my view.

Here is another interesting finding on vitamin D in 2008: it also improves athletic performance. You don’t believe it? Consider this: The 2010, Chicago Blackhawks became the first team to have their Vitamin D levels maintained all season long via diet and supplementation–and they won the Stanley Cup. You might be inclined to say they had the best team and maybe that is why the won. But a closer look at the data showed something more interesting: they had the fewest injuries and games missed due to illness in the entire league–by a large margin. They changed their protocol because one of their player’s wives saw a physician by chance who knew about this finding and shared it with the team trainer and they implemented it. That news spread to many other major professional franchises and several implemented changes to their off-season regimens. Two of those teams were the NFL’s Green Bay Packers and the Pittsburg Steelers. By the way, both of them played in the Super bowl the same year (Feb 2011), and they both optimized their Vitamin D levels. Coincidence? Maybe it is. But I will let you decide how to use this information best.

I hope you discuss this information with your doctor and decide on a new healthy course. Your health depends upon it.


1) Wu S, Liao AP, Xia Y, Li YC, Li JD, Sartor RB, Sun J: Vitamin D Receptor Negatively Regulates Bacterial-Stimulated NF-{kappa}B Activity in Intestine. Am J Pathol. 2010 Jun 21
10) Fiber depletes Vitamin D levels.


  1. Right on. I wonder how long it will be until professional sports nutrition becomes a big deal and is based upon the science. I want to see dunks from the 3-point line and few injuries. Actually Steve Nash sees a naturopath and gets vitamin injections and look at how good he is at his age, with an injury and everything. He else figured out he was intolerant to gluten.

    You could expect people made out of paper to be pretty down on the wind. And people eating an industrial diet without enough nutrients are going to hate on sunlight for burning them and making them look old. But it's critical, and for reasons that have nothing to do with vitamin d so the advice to just supplement is misguided. Vitamin d sups are great but they don't replace the sun by a long-shot.

    • Trust me its already a huge big deal. Many teams are lining up docs who have the latest research on it. Most players agents have them on it now and getting optimized.

  2. That's why my Psoriasis cleared up when I was tanning…. hmmmm

  3. Thanks. you had posted this on my PH advanced D question.

    "I think you either have a problem with your Vitamin D binding protein or you have a SNP issue with your VDR."

    What are the names of these tests that I should order and discuss with the doctor?

    • They are genetic tests for the allele I mentioned so you would need to see a special doc. I think a PCP or a nephrologist can check your Vitamin D binding protein reactivity.

  4. since I went paleo I no longer sunburn…

  5. nice post doc. i have been getting an increasing number of solar keratosiseses (keratoses?). they seem to get worse in the winter (i live in the south of new zealand – we have a massive ozone hole over us all year round). i have wondered if the sun is really the cause of this. they seem to be better in the summer. could it be that actinic keratosis has more to do with vitD. your thoughts?

    btw, this is the first year (since going paleo) that i have not been affected by what i consider SAD.

    • @ Tim If youre getting those kind of changes it tells me something is a miss. It maybe the shear amount of sun due to the ozone hole you mentioned or it could be your O6/O3 ratio. You should discuss this with your doc.

  6. Adriana G says:

    Dr. K, am I correct in understanding that Vitamin K2 is essential in conjunction with vitamin D3 for us to get the maximum benefit?

    • Vitamin D3 basically allows us to absorb Calcium better but Vitamin K2 tells that calcium what tissue to go to.

  7. I heard lately that just popping some vit D isn't enough. That vitamins A,D and K work together and that they need to be within certain ratios of each other for them to work properly. Any input on this ratio Dr K? Also, should all three be taken together or it ok as long as you get them all daily?

    Love the site – keep up the good work!

    • @ RJ. this is true……we need a balance of all these vitamins co factors to get it all working. Vitamin A is a co factor in the conversion of cholesterol to the steroid precursors, Vitamin K is needed for directing Calcium to the correct tissues and in making several clotting factors and D is needed for Ca/P control and down regulation of PTH. All play a role. Vitamin A is also altered in circadian mismatched so high choleseterol and a trashed hormone panel are always a sign of a light problem. The light problem is usually too little sun and too much chronic blue light exposure. Fixing one is not going to correct the entire issue because all of them are biomolecules tied to light frequencies. Every molecule in biology has its own specific absorption and emission spectra. We need to focus on that and not the supplement and reverse our issues with these endogenous vitamins. Vit D and Se play huge roles in immunity too. Mg/Ca/P all play major roles in bone metabolism but we used to believe Mg and Ca were coupled for this but we know they are not any longer and their are separate hormonal controls for each ion.

      I recall a theory about how high Vitamin D levels could cause a problem by depleting Vitamin K. I also believe that Chris Masterjohn brought this particular paper to my attention on his blog or FB wall. This mechanism could cause higher rates of atherosclerosis or heart disease or central neurologic decline. So balance is critical to the biochemistry. Consider this….. vitamin D increases the expression of proteins whose activation depends on vitamin K-mediated carboxylation of some proteins. With increasing levels of Vitamin D, the demand for carboxylation increases as Calcium increases, this decreases the pool of vitamin K in the body as well. Since vitamin K is essential to the central nervous system and plays important roles in protecting against osteoporosis and calcification of the peripheral soft tissues like the arteries. Vitamin K deficiency results in the symptoms associated with hyper-vitaminosis D. This is supported by the observation that animals deficient in vitamin K or vitamin K-dependent proteins exhibit some similarities to lab animals fed toxic doses of vitamin D3. Support also comes from the observation that vitamin D and the vitamin K-inhibitor Warfarin have similar toxicity profiles and exert toxicity synergistically when combined. The hypothesis further proposes that vitamin A protects against the toxicity of vitamin D by decreasing the expression of vitamin K-dependent proteins and thereby exerting a vitamin K-sparing effect. We also know that Vitamin A is a co factor in Vitamin D synthesis from cholesterol. This occurs at the conversion of cholesterol to pregnenolone. Pregnenolone eventually can become vitamin D with cellular biochemistry alterations.

  8. the last blood work i had determined i was VitD deficient so was instructed to begin suppliments and "we'll see how you are doing next year". if my results are no better, what should be my course of action? are there specific follow up tests that could shed more light on the source of the deficiency?

  9. Doc, after going paleo and getting my vit d up to a measured 58, I have developed problems with calcium that I never had before. I have reason to suspect high urinary calcium and bone loss. I just don't seem as big frame wise and have dropped a great deal of weight (I'm lean with no extra body fat). Cutting salt intake helped with the calcium secretion.

  10. Adriana G says:

    Have you seen this thread on Mark’s Daily Apple on keratosis?
    People are reporting good results with cod liver oil.

  11. @sage…..that is not good advice in my view. You need to be optimal especially heading into winter. You need to optimize yourself if your doc wont. You can do it by adjusting your Vitamin D3 dose, adding Mg and Vitamin K2 and retesting your levels in 2 months…..then readjusting. You can go to to order the blood test without the doctor.

  12. @Perry if your D is that high and your calcium is still low… definitely need to see an endocrinologist or nephrologist who understands Vitamin D metabolism. I bet you have a SNP or VDR issue. You may wind up at a geneticists office some day.

  13. Cameron House says:

    Hey Doc,

    Sorry that this question is a little off topic but I don't know where to really ask it. I remember reading somewhere, I think in the MDA thread that, that you said gynecomastia was the result of a skewed omega 3/6 ratio aromatizing? testosterone and turning it into estrogen. So will optimizing 3/6 ratio cure it? Is there anything else you would resomend to deal with it.


    • @ Cameron……lots of causes of gynecomastia. Lack of AM sunlight ruins the LH surge and lowers your testosterone and raises E2. They need to be worked up. Most common reason for man boobs is aromatization of testosterone to E2 (estradiol) This can be blocked by drugs or by lots of green tea. The other way to do it is use DHT cream directly on the chest wall because there are a ton of DHT receptors on the male chest. One problem though. YOu cant source DHT cream in the states. You have to buy it in Europe of Mexico and quality varies. If you want to read more about its use go to a transgender site women to men…….this is where you will see many women shrink their boobs with DHT to avoid surgery.

  14. thank you Dr K, i am a canadian, so as i understand it, i cannot have a medical test of any kind done without my doctor's referral.

  15. Great post, Doc! But what are those of us to do who have no gall bladder? Just take higher doses? I just went to a progressive endocrinologist with my daughter in law today (Love this guy-he uses bioidentical!) and he told her to take vitamin D at night which was the first I'd heard that. My leaky gut is much better but not much I can do to get back my gall bladder. 🙁

  16. "This is why light therapy is still so effective in treating psoriasis today."

    I'm curious if regular sun exposure is enough to qualify for light therapy or does this light need to be targeted at the site of the psoriasis?

    Also, is their any research that links sun exposure (Vit D) to help treat other skin ailments such as acne or warts? I understand you are talking about different animals entirely, but it makes me wonder about the sun's reparative abilities to damaged skin cells.

  17. @Todd……I think the sun has a clear role in psoriasis. And the fact that tons of derm literature links psoriasis to cancer can not be understated. I think this points to an altered skin biochemistry because of its substrate parts. In my view the consistuents that make up the skins tissue is vital to the development of the disease and I think the sun affects this tremendously. I think derms need to look at the tissue content of omega sixes in skin and not the plasma to see if that is not the key event in setting the stage for oncogenesis. It should be an easy study to do because the skin is easily biopsied and we have 300 million americans who eat a SAD. In fact just go into a Taco Bell and ask for volunteers to have their skin examined. College students would trade skin for beer money pretty quick. I know I would have in college. I sold blood and other body fluids back then!

  18. I have SAD, so I sit outside in the sun literally every day. I live in a hot climate. I just had my D levels measured for the first time and it's 19!

    Since I don't seem to be able to synthesize D from the sun, will I have a problem upping my levels with a supplement too?

    Does low D cause SAD?

  19. Thanks for the informative post.

    I always hear a lot about correlations between low D levels and various health problems. Is there solid evident that the low D causes or is part of the cause of these diseases, and not that the diseases lower the D levels?

    Also, is there solid research showing that increasing D levels affected prognosis?

    What about obesity? Have people had an easier time losing weight after correcting bad D levels?

    Thanks 🙂

  20. Thanks for the informative post.

    I hear all the time about a correlation between low D and various diseases. Are there solid studies that show that low D causes (is a factor in causing) the diseases and not the other way around?

    Does correcting D levels have a positive affect on prognosis?

    What about obesity? Have any studies shown that obese people were able to lose weight easier after correcting D levels?


    • @ Ruth. Great questions. Vitamin D not only decrease risk but it should be part of a treatment plan for these diseases in my view. I also advocate a much higher D level for my patients. The only cases where I am careful is those on coumadin for the reasons already given. And truthfully I try to get them off coumadin so I can optimize their vitamin D levels. Many Vascular surgeons are surprised to hear that coumadin causes arterial calcification. Once they do they generally move to other anticoagulants.

  21. Dr. Kruse, do you have any insight into possible connections between dysgraphia and ADHD?

  22. Thanks for the info Doc!

  23. Adriana G says:

    Doc, the last couple of posts you've touched on nutrient deficiencies in the western diet – omega 3, magnesium, vitamin d3, vitamin K2… Could you dedicate a post to the top 5 (or more) supplements that you think should be included in all paleo diet followers? And maybe some guidelines on dosages and good sources? (assume leptin, metabolism, cortisol and hormones are in check)

    • @Adrianna There are no top 5 supplements for everyone without knowing what their labs look like and how their diet is constructed.

  24. Doc, would you consider a post about the gallbladder and how that factors into all this? I so wish I'd found my naturopath before I had mine out. 🙁 There are MANY of us in the same boat though. Especially women. Fat, fair and forty. LOL well, I'm not fair. Not fat anymore either. But well over forty now. 🙂

  25. Pat Summit, coach of the Lady Vols basketball team just revealed she is in the early stages of dementia..perhaps Alz Disease.

    Does low Vit D3 have anything to do with the current explosion of AD? I did not see any mention of D3 in your AD posting.

    And if you were her physician, would you feed her brain lots of coconut oil and high doses of Vit D3 to stop the progression?

    • Vitamin DR in the brain appear to be playing a role and if I was in Summit's shoes Id swim in coconut oil, eat it and make sure my D was optimal. Since I am an LSU fan I wont be emailing her……..but someone might share my blog link?

  26. Is it possible that low Vit D levels (below 10) for a number of years could cause elevated platlette counts?

    • @ Tim yes it is. A low D like that tells you something is radically wrong biologically and inflammation is up somewhere using all the D up

  27. Thanks, Doc, I'll be watching for that blog post!

  28. In response the radiation questions I have gotten by email here goes. As a spine surgeon I use Xray daily in the OR. We also have badges that track our radiation exposure. I keep mine in my pocket at waist level because this is where I get the most exposure. Since I have optimized my vitamin D level my radiation levels have dropped by 120% over the last 5 yrs. For completeness sake I also take some supllemental Iodine twice a week and that will help too. The point being that an optimal vitamin D level will protect your from Xrays and from UV radiation. And I am very fair skinned and freckled and have always burned easy. I still burn here and there but I have not used sunscreen at all in 5 yrs and I am constantly sun exposed now. I used to worry about the sun a lot. I don't fret over it any longer. I would if I ate bread wheat and a SAD however.

  29. Right. By SAD I meant seasonal affective disorder. I feel bad with no sun, so I make a point to get some sun every day. And yet, my D is 19.

    So, to repeat my questions:

    Since I don't seem to be able to synthesize D from the sun, will I have a problem upping my levels with a supplement too?

    Does low D cause SAD?

  30. Dr. Davis from the Heart Scan Blog talks a lot about the side effect having overcome SAD with supplemental D3. He recommends getting 25(OH)D up to about 60-80 ng/dl for heart disease.

    • I agree with Dr. Davis about Vitamin D being protective for heart disease but the only risk one needs to be cognizant of with supplementing D is if you are on coumadin. Then Vitamin D can accelerate your heart disease unless you get off coumadin and change to another agent that does not deplete vitamin K. That is a critical point. Vitamin K2 is very heart protective as well because it removes calcium from coronary artery intimal layers and will reduce your calcium plaque scores.

  31. Jack said:" And I am very fair skinned and freckled and have always burned easy. I still burn here and there but I have not used sunscreen at all in 5 yrs and I am constantly sun exposed now. I used to worry about the sun a lot. I don't fret over it any longer."

    I am also rather fair skinned, but not as much as you.

    Is it ok to use (Melanotan II)in situation like yours?

    This summer I used, 2 injections per week, each 0.5mg, total of 10mg. Have not used any oils or creams.

    Have best tan in my life (I am 71yo), newer burned.

    MSH-Melanocyte-stimulating hormone)

    Melanotan II is a synthetic derivative of MSH


    • I have no experience with this at all. I will find out more about it and report back. Does this require a Rx or is it OTC?

  32.… this is a pretty great list.

  33. Hi Dr K, you gave me some advice via twitter re my husband who has a high urinary calcium (calcium high 12.9mmol/L) to creatinine (0.7mole ratio). (you said to dose up with mg and K2)

    Prior to June he was taking vit D3 5k per day. Started getting tired, constipated, headaches, and had a small kidney stone. He immediately stopped vit D, I sent him for blood test – he only tested 125nmol/L (50ng/l). Started mag citrate 400mg and K2 MQ7 45mcg day.

    Feeling better, constipation gone, headaches gone. Eats paleo. Otherwise normal blood tests, urine oxalate normal.

    Just had a re check of urine – still high calcium 12.5.

    I've ordered a higher dose K2 for him (LEF) and mag malate instead of citrate.

    Any suggestions?

    BTW – We saw kidney specialist (who said it was vit D related) and kidney dietician – who recommended a grain based diet (phytates to absorb calcium! – no he isn't going to do that), cut all vit C supps, cut salt, drink lots. I asked her about K2 protection of soft tissues, drew a blank there. (oh my!)

    • @Julianne. I completely disagree with your husbands doc. Several large population studies in both men and women have shown that, within reasonable limits, patients with the highest dietary calcium levels also had the lowest rates of new calcium stone formation. Apparently, dietary calcium acts as a scavenger in the digestive tract and prevents absorption of intestinal oxalate. Any modest increase in risk of stone formation from additional calcium absorption is more than compensated for by the reduction in oxaluria. With his modest D level and his urinary excretion rate the dietary intake had nothing to do with this.
      Excessive animal protein (>1.7 g/kg of body weight) increases the body's acid load. This additional acid load is buffered or neutralized in part by the bony skeleton, which then releases calcium into the general circulation. This extra serum calcium is eventually excreted by the kidneys into the urine, exacerbating any hypercalciuria. Acid loading also directly inhibits renal calcium reabsorption, resulting in an increase in urinary calcium excretion. Animal protein also contributes a large purine load. Purines are the precursors of uric acid, which can form uric acid stones, lower the urinary pH, increase the overall acid load, and generally increase urinary calcium excretion and stone formation.

      Excessive carbohydrate consumption also increases intestinal calcium absorption and renal excretion. Excessive caffeine and alcohol use can do the same. Excessive urinary phosphate excretion is also a cause and can be seen with high carbonated beverage intake or high phosphate levels in urine. Also hyperparathyroidism can cause this too.

      If the doc really believed his D level was a problem they could test their hypothesis by giving him 100 mgs of hydrocortisone for Three days and this would dramatically impact his urinary excretion. I bet if they do this they will find it's clearly not his D level

    • And upping his K2 is a great move……..tell me more about his paleo diet

  34. Re diet:

    prior to the small kidney stone in June – he was fairly low carb (after reading Taubes, and wanted to lose about 4 kg) and yes he would have been having 1.7 g per kg protein per day, maybe more. After that, I suggested he increase carbs. He did – to about 100 grams day, still similar protein and daily alcohol about 300mls wine or 800mls lite beer day. caffeine 4 -5 cups tea and 2 coffee per day.

    Now, last 3 weeks – similar protein approx 1.7 g per kg, about 80 – 100 g carbs day, more than half of that as fresh fruit. Last 3 weeks no alcohol, strict paleo except milk in tea and coffee. He drinks quite a lot of sparkling mineral water, 2 litres day.

    His serum calcium is normal. Uric acid normal. Urinary citrate – good level.

    Tested for hyperparathyroidism – negative

    Has polydypsia – has always had this – drinks and pees 4 litres day. Tested for diabetes insipidus – negative.

    Less protein? 1 g per kg per day? More carbs – as root veggies / greens, less fruit? Cut the sparkling water / less caffeine?

    BTW – his father had both gout and kidney stones.

    (The dietician said he should keep having calcium – suggested dairy products, but also grains for phytates (strange to me) – and less protein.)

    Hope this helps – thanks for your reply.

    • Julianne I think his diet is likely a bigger player. Moderate the protein, up the carbs, stop the alcohol and coffee and fizzy water and then see how it goes.

  35. Dr. K, what is your opinion on the tanning beds? There are so many pros and cons. Seems to me that if you do the tanning beds for reasonable amounts of time and don't burn you can get your good D that way but I've had a basal cell carcinoma already and don't want another one.

  36. @Pam. Not sure I can advocate them. Id rather people get real sun when it's Available and when it's not I would supplement with D3, K2, vitamin A instead of the tanning booth. And if you use a tanning booth I would strongly suggest you know what your O6/3 ratio is first. it seems to me very few people do this. Too bad.

    Here is another viewpoint.

  37. Thanks so much, Dr. K. I'm a big believer in Vit D now. Since I started supplementing, I've not had a sunburn and have only had 1 cold sore on my lip (used to have to slather sunblock on my lips…not sure why it popped up, but I think it may be stress related. Dang deadlines!)

    At any rate, I'm wondering if you have any advice regarding kids. I have girls, 8 and 10. They spend a lot of time out doors (we homeschool) but I'm wondering about supplementing their Vit D. What are your thoughts? (I've considered the drops that my husband and I use or Cod Liver Oil). Thanks!

    • @julie. I supplement my kids with vitamin D and they all eat paleo with leptin rx guidelines. We also use coconutoil and olive oil as topical lotions and it seems to work well. The one time i did not do this was right before the AHS when i spent a day at the beach and got a tad bit pink……

  38. Thanks, Dr. K!

  39. Christine says:

    Hi Dr. K, I noticed on the paleo hacks site a /NYC for your location. Do you have an office in NYC and if so are you seeing new people? My mom is there often visiting her new grandson and I would love her to have an appointment with you. No doc she has seen so far gets it. She lives in FL, I am in MN.

    • @Christine I am from NYC and have the ability to do some optimization work there for private patients. Normally they are from my internal networks. I would suggest however you look into another NYC Dr. who is excellent. Dr. Eric Braverman.

  40. Christine says:

    I live in MN, and winter is upon us…. my condo has a tanning bed…. should I use it?

    • @Christine……I can answer this if you tell me what your O6/3 ratio is now and what your current Vitamin D level is now.

  41. Is there a good like minded physician you might recommend in the Austin /San Antonio area?

  42. Christine says:

    thanks Dr. K. I really need to get those panels done! I will look up Dr. Braverman, appreciate the referral. i am following you on the HCG forum as well. Thanks so much for all your input.

  43. In April of this year my labs for D3 were 17. In October they were 85.

    What I did to correct that was MASSIVE doses of D3. I took 2,500,000 iu in the first week. for the next three weeks I took 100,000 iu daily. I am now on 50,000 iu daily.

    It is critical to remember that while you are not optimal your body is stealing the D3 for other things that it would not normally use it for. Additionally we store 2 million or so IU for emergencies. I suspect I ran out decades ago.

    Also remember that if your reserves are gone you CANNOT make D3 from sunlight, that pathway is the first to go.

    If you look at the effects of too much versus too little you find that too much is a far better state of heath than too little.

  44. @jonathon. Give them context of your situation. What you posted here most wont believe but obviously i do. We need to educate people and doctors.

  45. Some medicines interact with vitamin D.

    The following medications may increase the need for vitamin D.


    Bile Acid Sequestrants










    Mineral Oil


    Oral Corticosteroids



    Sodium Fluoride

    Valporic Acid

  46. Sodium fluoride should open some eyes…..

  47. Joe Brancaleone says:

    Any thoughts on good D level for an infant? We've been supping our 9 month old with Carlson 400IU drops daily, and she gets some adequate sun exposure here in southern Cali, but I'm suspecting I should bump it more than the suggested dosage. To how much I'm not sure. Baby is basically paleo eating + breastfed. Also mom is only about ~80% paleo and also probably low D level, does this factor in for baby?

    • @Joe I approach this one differently. Never ask the pediatrician first. Get Mom tested and see where she is at. If she is low the baby is real low and then the baby needs to be tested. Most pediatricians these days don't test D and they should in my view like they do for B12 and folate levels. After six months of breast milk, an infant needs vitamins A and D, according to the textbook "Pediatrics and Child Health" I think if you have this talk with the pediatrician after you know what Momma's levels are you will make better headway.

  48. @Jack "Sodium fluoride should open some eyes….."

    Can you expand on this subject please ? Also, you mention that you drink lots of green tea and its seems that green tea is notoriously high in fluoride. Do you pay attention to fluoride content in green tea ? Do you filter out fluroide from your drinking water ?

    Is there a brand that is not fluroide rich, if so which one ?

  49. Dr. Jack,

    I take a Multi-Vitamin each morning that supplies 100% of my daily needs for Vitamin K (80mcg). Ditto Vitamin A (5,000 IU)

    My question: What is wrong with this? Is K2 the same as K? Or do I need to take K2 in addition to my multi-vitamin?

    I can't find the answer to this with Google Searches.

    PS) For Canadians, you can get your Vitamin D3 tested at home and mail it in. Only $US65 here: Only 2 blood drops required.

    Many thanks,


  50. @Julie Give this quote to your dermatologist when she tells you that again.

    Quote Dr. Edward Giovannucci, a Harvard University professor of medicine and nutrition who laid out his case in a keynote lecture at a recent American Association for Cancer Research meeting in Anaheim, Calif.

    His research suggests that vitamin D might help prevent 30 deaths for each one caused by skin cancer.

    "I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits as vitamin D," Giovannucci told the cancer scientists. "The data are really quite remarkable."


    Good thread with awesome contributions by grace. Pay attn to her responses in the thread

  52. MastadonBob says:

    I'm a bit confused by bullet point 8 above, Dr. K. You state that certain types of folks have problems absorbing Vitamin D.

    I don't have a gallbladder and I've taken one Bayer 325mg aspirin tablet as a blood thinner every day for years.

    Does this mean it's not advisable for me to supplement vitamin D-3 or should I take more?

  53. @Mastadon Bob It means you may not absorb it as well and may need to consider either changing the dose or how you take it or adding some of the cofactors required for absorption in the gut. Remember we are designed to make it in our skin. Co factors are magnesium, zinc, vitamin K2, boron, and vitamin A. We only need tiny amounts of these nutrients for good vitamin D absorption. You also should take it with fat. If you still have trouble you may have a rancid D source. This happens a lot with Cod Liver oils. Check your D level biannually!

  54. Dr Kruse,

    I found that tomato paste offered some protection against the sun(lycopene?), but you advise against nightshades. Should I skip the tomato paste?

    • @Andre As a male if your HDL is below 70 I would avoid all night shades. As a women if you are sub 60 you get the same advice. Once you are north of them I think you can add them back

  55. @Alexandra regarding your question about high blood pressure and Vit D3. Vitamin D directly effects the renin angiotensin aldosterone system. Many clinical studies have long suggested an association of inadequate sunlight exposure or low serum 1,25-dihydroxyvitamin D3 levels with high blood pressure and/or high plasma renin activity. D3 functions as a potent negative endocrine regulator of the renin gene expression. This down regualtion provides some insights into the mechanism and is why I recommend a minimum level of 60 ng plasma level by Sept 15th in the Northern hemisphere in my blog on Vitamin D.

    The concept of vitamin D regulation of blood pressure through the Renin Angiotensin Aldosterone system should open a new ideas to clinicians/researchers in trying to explain the physiological functions of the vitamin D3 in the endocrine system. For nephrologists it provides a basis for exploring the potential use of vitamin D3 in prevention of hypertension.

    The low light conditions also do some amazing things to the thyroid pineal axis to modulate this axis and further cause massive changes in the brain orbitofrontal axis too to affect behavior (docile, depression) and lower metabolism while the blood pressure caves.

    Vitamin D binding proteins become the bank account to prevent most of these side effects if that system is working well. In most it is not.

  56. FYI: In number 11, the peripheral neuropathy link is broken.

  57. Dr. kruse,

    My husband has psoriasis that has become worse after our HCG round. He has lost 40 pounds, from 205 to 165. I have read about toxins being stored in fat and possibly losing this fat has released an onslaught of toxins that is effecting his skin. Also possibly his liver is or has been taxed. Should we consider detoxifying his liver. And if so, what do you recommend? His Vit D is at 50, and he has been taking 10,000 units of D daily. TIA

    • @Fara this is a controversial area. Personally I do believe that the last 30 lbs of fat is loaded with a lot of toxins. So using NAC, sillymarin, Alpha lipoic acid all make sense. A vitamin D of 50 is too low in my opinion but as you raise it you need to be mindful that he will need Vitamin A and and vitamin K2 as well to balance the Vitamin D supplement.

  58. @ Pat In a study of 78 women between the ages of 48 and 64, it was found that higher levels of vitamin D were associated with larger HDL particles. The researchers concluded that vitamin D may protect against cardiovascular risk by promoting large HDL particles, which are healthier than smaller HDL particles, and assisting in the transport of cholesterol from tissues back to the liver. (Journal of Clinical Lipidology, April 2010)

    Another reason I advocate a higher Vitamin D level than people like Chris Masterjohn. Its good to be safe but if you have lower HDL and a bad HDL size it makes more sense to do something than nothing in my view. Discuss this with you doc on you next lipid draw. This group of labs you sent me over the email would concern me to talk to a lipid specialist.

  59. Dr. Kruse,

    What is your ideal Vitamin D3 Vitamin 25(OH)D level for a blood test. I recall reading someplace that you recommended 80 to 100 ng/ml but now I just can't find it anywhere. Is this target level correct?

    Many thanks,


    • @Grizz I like the level between 70-100 but I want my own patients at 60 by Sept 15 in the northern hemisphere. There is a reason for this that will be the focus on a chapter in my book where I did a risky N-1 experiment on myself to prove the point.

  60. If I were to try getting more vitamin D through the sun, how much daily exposure should I aim for? Your website is so informative, thank you for putting so much work into it!

    • @Jenny Exposure to sunlight for extended periods of time does not normally cause vitamin D toxicity normally by sun exposure itself. Within about 20 minutes of ultraviolet exposure in light-skinned individuals (3-6 times longer for pigmented skin), the concentrations of vitamin D precursors produced in the skin reach an equilibrium. This means that and any further vitamin D that is produced by sunlight is degraded by the Vitamin D bonding proteins in the skin. It appears this is how psoriasis treatment works from sunlight. SO the short answer to your question is it depends upon where you live and your skin color. For most people on this earth the answer is 20-30 minutes you make about 10,000IU from the sun to help your immune system function. According to some sources, endogenous production with full body exposure to sunlight is approximately 250µg (10,000 IU) per day. According to Dr. Michael Holick, "the skin has a large capacity to produce cholecalciferol" his experiments indicate: "Whole-body exposure to one minimal erythemal dose [a dose that would just begin to produce sunburn in a given individual] of simulated solar ultraviolet radiation is comparable with taking an oral dose of between 250 and 625 micrograms (10,000 and 25,000 IU) vitamin D3 orally.

  61. jack, in your reply to Grizz on the question of you recommended levels "between 70-100 but I want my own patients at 60 by Sept 15 in the northern hemisphere" Im confused, isn't 60 quite a bit lower than what you recommend? Im am trying to make a recommendation to my mother in law who cancer treatments for a rare sarcoma in her leg in 2009. She had the lump in her leg removed and radiation. She is clear of the cancer. She was recently tested for 25(oh)d and was on the "low side of normal" I have asked her to tell me the value. I had her get Carlsons Liquid Vit d3 4000IU and suggested she take 2 drops or 80000. She is taking fermented cod liver oil and high vitamin butter oil but not other meds or supplements. She is in good health at 70. Your comments and guidance are appreaciated! Thanks!

  62. Hi Dr. Jack,

    what is your opinion of Astaxanthin as an anti inflammatory and overall supplement?

  63. alex gatsis says:

    The following recommendation is from Chris Kresser's blog. I believe this comes from Chris Masterjohn's research. I was wondering what your thought are on this?

    Thanks so so much!

    Contrary to what some researchers and doctors have recommended, there's no evidence that raising blood levels of 25D above 50 ng/mL is beneficial, and there's some evidence that it may cause harm. Studies show that bone mineral density peaks at 45 ng/mL and then falls again as 25D levels rise above 45. Other studies have shown that the risk of kidney stones and CVD increase with high 25D levels, due to elevated serum calcium levels that accompany excess vitamin D.

    However, we also know that vitamin A and vitamin K2 protect against vitamin D toxicity, and vice versa. As I explained in the vitamin A section, fat soluble vitamins exist in a synergistic relationship. It's possible that the people in the studies above that experienced problems with excess 25D levels were deficient in vitamin A or K2, or both. This is why it's so important to supplement with all of the fat-soluble vitamins together.

    • @Alex if someone is deficient in their diet taking too much D3 can be a problem. The problem with CK and CM theory is that there is not a lot of documented cases to support their claims. Considering how woeful the SAD is in A D K and E if they were correct we should be seeing record reports in the literature currently. But the only records I see are from the amount of cases of low D cases from the Vitamin D council. I happen to have a lot of clinical experience with the fat soluble vitamins since I treat osteoporosis daily. I have written a 4 part osteoporosis series that include how I handle this disease with the osteoporosis Rx.

  64. @Jackie Wu This study should wake up every physician and patient who reads it…….Natural UVB protects from cancers…….looks like conventional dermotolgy needs a new mantra.

    Anticancer Res. 2012 Jan;32(1):223-36.

    Ecological studies of the UVB-vitamin D-cancer hypothesis.

    Grant WB.


    Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA.



    This paper reviews ecological studies of the ultraviolet-B (UVB)-vitamin D-cancer hypothesis based on geographical variation of cancer incidence and/or mortality rates.


    The review is based largely on three ecological studies of cancer rates from the United States; one each from Australia, China, France, Japan, and Spain; and eight multicountry, multifactorial studies of cancer incidence rates from more than 100 countries.


    This review consistently found strong inverse correlations with solar UVB for 15 types of cancer: bladder, breast, cervical, colon, endometrial, esophageal, gastric, lung, ovarian, pancreatic, rectal, renal, and vulvar cancer; and Hodgkin's and non-Hodgkin's lymphoma. Weaker evidence exists for nine other types of cancer: brain, gallbladder, laryngeal, oral/pharyngeal, prostate, and thyroid cancer; leukemia; melanoma; and multiple myeloma.


    The evidence for the UVB-vitamin D-cancer hypothesis is very strong in general and for many types of cancer in particular.

  65. Fiber screws Vitamin D………more conventional advice with holes…….

  66. I need to know how the hell it is that a neurosurgeon knows the risks of Vit D & Coumadin (Warfarin), but not a single one of my "specialized" docs has ever mentioned it to me. I've been on Coumadin since 2003 and have been told it is entirely safe to be on for the rest of my life. I had no idea that there is a risk with Vit D.

    I have been battling metabolic syndrome since 2010 when I was found to be Vit D deficient. I supplemented, got my levels up and then stopped supplementing. I now just go out in the sun for 15-30 minutes a few times a week. Just tested my levels and I am at 79 nmol/L. At the same time, I take 12.5 mg of Coumadin daily because I have Antiphospholipid Syndrome.

    Question: Am I at significant risk here for arterial calcification now that my Vit D is good?

    And in comment #37 you said of your patients that you "try to get them off Coumadin" so that you can normalized their Vit D. How exactly do you get them off Coumadin? Is that possible for someone like me with Antiphospholipid Syndrome? Or am I just screwed?

    Also, you said that when vascular surgeons realize the problem, they switch to other anticoagulants. Which ones?

    Thanks for all you do. You are changing lives and, I hope, changing the way medicine is practiced in the future.

    • @TheKid I will answer why my eyes were opened to this new reality in the next blog post. I promise you as much as it will open your eyes to many amazing things we are capable of it will allow you to peer into how my mind works to to realize these things too. I have been practicing a different brand of medicine now for 5 years that made these insights easy. If you read my blog on vitamin K2 it may enlighten you further. it is in my 4 part osteoporosis series.

  67. Hi Dr. Jack,

    Recently, I began taking a daily vitamin D supplement that contains 5,000IU (Vitamin D3 GOLD). A few days after I began taking the supplement, these constant migraine-like headaches began! I finally put two and two together and stopped taking it immediately (yesterday) and today my headache is nearly almost gone. I was pretty disappointed that there could be such a strong correlation between the vitamin D and my headaches because I really wanted to start taking it after all the perceived benefits that I've read about. So after doing some research on the internet I have not yet come up with a solid answer as to why this occurs. Here were my beginning theories..

    1. Overdosing on Vitamin D (many sites varied on the amount of what not to exceed, but the lowest I saw was 10,000 IU and seeing as how it's still far too cold to be outside for extended periods of time I kind of ruled this one out)

    2. Perhaps some people are just more internally sensitive to Vitamin D

    3. Could it be the supplement itself? (after researching the supplement and looking up all it's reviews I thought for sure I had found a winner)

    Those were just the ones that came to me at first, but now I am just completely lost on it.

    • @ Kayla a headache with D3 means it is probably in an omega six oil. Check that. If not it could be a an additive.
      Toxic levels of D are hard to get. In humans you'd have to go voer 225-250 ng/ml which I have never seen. 10,000 a day is a standard dose in my practice. I always recommend vitamin K2 with it and a paleo diet to give the E and A in food form……..I doubt you are sensitive to vitamin D because its a required human vitamin. My bet is you got a bad batch.

  68. Thank you for the great post on the various roles of Vit D. I'm only at 60 and have leaky gut & AI issues. I think I'll work getting my levels up a bit more. It sure seems to take quite a bit of supplementation to raise blood levels.

    Also – since going paleo I find a rarely get sunburned. Prior to paleo I could burn in 10 minutes or less. I am vary fair skinned – my husband is fond of telling me that my people came from the forest. Fortunately for me my skin has never allowed me to wear sunscreen. It breaks out into an insanely itchy rash that lasts for days – so I have learned to pay attention to how much sun I am getting and use shade (nature's natural sunscreen) as required.

  69. Hi Dr. Kruse.

    Any concern about the INCREASED risk of cancer some studies have found about pancreatic and prostate cancer with Vitamin D?

  70. tamarie says:

    This is interesting but confusing. I live with crohns and gerd and now a neurogenic bladder that no doctor knows how I got. All they want to do is drug me up but I refuse. I am on no drugs but am suffering. Have been told by friends and by a natural path doctor to take a ton of vitamins and supplements and have but I am no better. Are there any tests I should get to find out what kind of diet I should be on or supplements I should take? Also when trying to find the reason for the neurogenic bladder I went to a neurologist to rule out MS and had a MRI done which was negative but found a pituitary tumor which I had remove in 2010 but still no answers or help for my other health problems. Any advice?

    • @Tmrie Read my Leptin Rx blog an my CT protocol of 2/11/2012 That is where you should start. then come to my forum and ask questions…….you need a keto version of the diet with CT to repair nerves. When my next two blog get released you maybe very interested in seeing how the Theory of CT meets modern human cases.

  71. tamarie says:

    Do you practice Darwinian/Evolutionary Medicine?

  72. Hi Dr. Kruse! Thank you so much for all your informative posts–I feel so empowered to be able to have information on how to take care of my own health better! With regards to #8 that you have posted that those with Crohn’s will have trouble absorbing vitamin D, will supplements be adequate to bring those levels up, or is there something else that IBD patients can be doing to help absorb it better? I’ve also been enjoying the sun in addition to supplementation (as I was tested to be deficient earlier this year).

    • @Yvonne best way is to use fat when you take the D3, K2, together. They are both fat soluble. the other issue is after you take them you need to assess your levels after two months to check the level to adjust up or down the dose depending upon your gut absorption.


  74. Lauren Porter says:

    Dr K, I am re-reading blogs and just getting to this one. What do you think of TS Wiley’s theory that Vitamin D deficiency is most likely linked to insufficient darkness, not insufficient sunlight? (She says that because it’s a hormone, it has receptors that work in cycles like all hormones and that with sufficient darkness – nighttime, winter, etc – the receptors will work properly and a person will have sufficient levels of Vitamin D.) Thanks, as always.

    • @Lauren I think it is entirely possible but I dont buy it because of when we know Vitamin D became a biology staple. Vitamin D also has the bonding protein system which is designed for use in winter……if she was right it should be used for summer but we know it does not work that way. It activates 3% of the human genome too. Molecular biology ties vitamin D back 600 million years for use in all life forms on this planet. At that time frame we had stable day night times on the planet. If the Vitamin D receptor went back to 3.8 billion years I may buy it, but I dont.

  75. Monte Diaz says:

    If someone does not absorb vitamin d well due to leaky gut what are our options for supplementation? I’m thinking of using the liquid form of D3 and just holding it in the mouth till it absorbs. 5000 IUs is just 5 tiny drops so it shouldn’t be hard. Is this a good way to go? How about topical?

    • @Monte Diaz I have never faced this issue clinically so I cant say. There is some sublingual absorption and I think there is an IM injection used as well.

  76. Dr Jack, what is your opinion about latitude and UVB? If i live in higher latitude ( N 55 ) should i get sun at peak of the noon, because even in the summer the sun often does not get 50 altitude degree, so is this a problem or i am more cynic about that? Thanks.

  77. Great Article.

    It would be nice to read about why Lupus patients need high amounts of Vit D. or why they can’t synthesize it. Or Hold it or use it/

    Thank you

  78. This is the first place I’ve see say Vitamin D levels are stored for the winter. Makes sense.

    My question: I live in Costa Rica so get plenty of sun (although I have one VDR polymorphism by 25 Hydroxy levels were 73ng/ml last test). I’m in NYC for a week in the winter and supplementing with D3. Do I need to supplement? Will I feel the difference?

    Most people think of supplementing as “I had my D today so I feel good”. Not- “I got a lot of sun last week, I feel good. ”


    • “my” not “by”. Sorry!

    • If you are designed to make something endogenously in the human body it is not wise to take it exogenously in a pill without understanding your specific context. I do not know your context so I cannot comment on it. This is why we have a journal section on the forum on my website.

  79. Thank you Dr Kruse, You state in your book that it took you 3 years to correct your O6/O3 ratio, but do I understand from this blog Vit D should correct sooner, and HDL should rise within one year conditional on a epi paleo approach?

    What about years of sunscreen use – do Vitamin D levels start to increase on cessation of use?

  80. Crystal says:

    Hi Jack, thanks for the info. I’ve read varying information on best time to take Vit D-what do you recommend? Thanks in advance.

    • Crystal I normally am not a fan of Vitamin D3 pills. Here is why:

      • Hi Jack.
        My D25-25.2 LOW, D1.25-90.7 HIGH. VDR Taq +/+ (plus 6 more mutations). What do I do? I live in Florida. Have myriad of unexplained health issues and on disability now at the age of 50 (Female).

        • I do this quite a lot at my site for my members. It might be wise for you to consider that.

          • Hi Jack. I have found some information related to my question on the web by googling your name plus the issue I am facing. Thank you for this indirect help.
            I have also listened 2 of your podcasts and I am hooked now.
            What you might find interesting is that in the former Soviet Union light, electric, magnetic, sound and water therapies were mainstream therapies used in every inpatient and outpatient clinics since early 1900s may be even before that. It is called physiotherapy, (not to be confuses with physical therapy). Pretty much every health malady was first treated with the power of nature- from receding gums, UTI or cervical dysplasia, to aches, pains and inflammations in any part of a body. Pharmaceuticals were never the first line of treatment, physiotherapy was.
            What else is interesting, after I had listened to your podcasts, that I am the only one in my family, living in America having so many weird health issues, from dysautonomia (POTS) to neurological symptoms. My mother who is 80 and sister who is older have NO health issues whatsoever. I could not understand why. Now I think I understand- there is no TOTAL internet, cellphones, ipads etc. addiction in Russia. May be in big cities, but certainly not everywhere. Before I got sick, I was working 12-14 hours/day in front of computer, even though I lived in Paradise (the Cayman Islands) I was focused on food to maintain heath, not light or water.
            I am not sure how I ended up on your site searching for the answer to my question, but I am glad I found you. I have tried everything there is to try to fix my health issues with ZERO rezults.
            There is way too much information on your site to digest, but, I will start with what I can- CT, blue light,DHA and water. May be my 7 MTHFR mutations incl. VDR TAq and abnormal vit. D test . results don’t matter so much after all.
            By the way, CT therapy is traditionally used in Russia, pretty much everyone knows about it. This video will entertain you, even little kids do cold water dipping
            Thank you for everything that you do!

          • Nat, thanks. You might like this one:


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