Vitamin D3 (cholecalciferol) in a 5,000 IU table. Provides a higher dose of vitamin D for more aggressive vitamin D supplementation. Recommended for patients with low 25(OH)D blood levels who need more than a physiological dose to replete their vitamin D levels.
Humans are designed to derive vitamin D via sun exposure and not from food. Unfortunately, sunshine-derived vitamin D is limited because most individuals spend 40 or more hours per week working indoors. We have also been scared out of the sun due to fear of skin cancer and most apply sunscreen which effectively blocks the body’s ability to produce vitamin D3. Consequently the vast majority of individuals do not have normal levels of serum 25(OH) D3, which is thought to best reflect vitamin D levels. The normal range is 32-100 ng/mL, and researchers argue that 40 to 70 ng/mL is optimal1.
Vitamin D is produced in the body when sunshine strikes the skin and converts 7-dehydrocholesterol into previtamin D3, which is converted into cholecalciferol (vitamin D3). The liver converts vitamin D3 into 25(OH)D3 (calcidiol). Most cells are able to convert 25(OH)D3 into 1,25(OH)2D3 (calcitriol), which is most well-known for its modulatory influence on bone metabolism, parathyroid hormone activity, and intestinal calcium absorption. We now know that 1,25(OH)2D3 functions as a seco-steroid and influences some 1000 different genes2. Vitamin D is involved in numerous bodily functions, such as the modulation of inflammation, immune function, blood sugar regulation, and cell proliferation1,3,4.
Researchers have demonstrated that the recommended dietary intake of about 400 IU and the upper limit of 2000 IU too low1. It is thought that approximately 4000 IU of vitamin D3 represents a physiological dose and 10,000 IU is proposed as the new upper limit5. While these numbers seem high to some, it should be understood that 10,000 IU is a mere 250 microgram (mcg) or ¼ of a milligram (mg).
Our ability to absorb supplemental vitamin D3 and replenish serum 25(OH)D levels are not uniform. While varying among individuals, on average for every 1000 IU of daily supplemental vitamin D3, we can expect about a 10 ng/ml increase in serum 25(OH)D over a 3-4 month period1.
As vitamin D increases intestinal absorption of calcium, supplemental vitamin D3 is contraindicated in patients with hypercalcemia. The human body tightly regulates serum calcium levels between 8.5-10.6 mg/dL. The following conditions are associated with hypercalcemia: primary hyperparathyroidism, certain cancers, granulomatous diseases such as sarcoidosis, hyperthyroidism, and thiazide diuretics. In such patients, serum calcium and 25(OH) D3 need to be monitored on a regular basis. For those without hypercalcemic conditions, 150 ng/mL of 25(OH) D3 is often not associated with hypercalcemia, indicating that 32-100 ng/mL is a very safe range. Vitamin D toxicity is thought to occur when serum 25(OH) D3 levels reach 200 ng/mL.
Symptoms of hypercalcemia include: depression, anxiety, cognitive dysfunction, headaches, fatigue, polyuria, polydipsia, nocturia, constipation, abdominal pain, muscle weakness, musculoskeletal aches/pains, and bone fractures in the long term. Individuals with hypercalcemia will commonly indicate that sunshine tends to generate one or more of the symptoms of hypercalcemia.
For the typical Caucasian individual, it takes approximately 20 minutes of midday summertime sun exposure for the skin to begin to turn pink, which is called an erythemic dose. Approximately 10,000 IU of vitamin D3 is produced in 20 minutes for the average Caucasian individual wearing a bathing suit. Thus, individuals who enjoy sun exposure and the process of getting a suntan are not likely to be hypercalcemic.
Fair-skinned individuals who sunburn easily need to determine their tolerable level of sun exposure, and apply sunscreen thereafter. Melanin in the skin reduces vitamin D production, so darker skinned individuals such as those from the East, Africa, South America, and the Islands, require longer periods of sun exposure to attain adequate serum levels of vitamin D, and so are particularly at risk of deficiency.
In the absence of adequate sun exposure, vitamin D supplementation is considered a requirement. Everyone should have their serum 25(OH)D levels assessed as it appears to be a more important marker of human health/disease potential then serum cholesterol levels.
Most chronic conditions are thought to be associated with low serum 25(OH)D levels, including type II diabetes, heart disease, hypertension, cancer, autoimmune diseases, depression, schizophrenia, polycystic ovarian syndrome, asthma, osteoporosis, periodontal disease, macular degeneration, muscle weakness, osteoarthritis, fibromyalgia, and generalized pains in muscle, joint, and bone1,3,4.
For those without a chronic condition, it is important understand that vitamin D levels influence our daily lives in fashions that patients may not typically consider. For example, vitamin D adequacy is related to feelings of wellbeing1. Physical activity issues are related to adequate vitamin D levels including exercise performance and propensity to fall in the elderly1,6. Even resistance to upper respiratory tract infections4 and the flu2) are associated with adequate levels of vitamin D.
Suggested Usage: As a dietary supplement, take .5 - 2 tablets daily, or as directed by a physician.
KEEP OUT OF THE REACH OF CHILDREN
Recent investigations into the safety and efficacy of vitamin D3 indicate more vitamin D3 is required during the winter months and periods of cloud cover. It is advisable to raise the daily dose to 1000 IU, year round.
|(as cholecalciferol from wool oil)||5,000 IU||1250%|
*Daily Value not established
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Of the magnesium supplements tested by ConsumerLab.com, 25% failed to meet quality standards. One magnesium supplement contained only 45.4% of labeled amount, despite boasting a "GMP" (Good Manufacturing Practices) seal on its label, and another supplement provided only 28.8% of the labeled amount.
Reference: ConsumerLab.com, Magnesium Supplement Reviews and Quality Ratings, Posted 5/19/09
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ConsumerLab.com, New Product Review: Multivitamin and Multimineral Supplements, Posted 4/1/09
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Reference: June 22, 2007, FDA @ http://www.cfsan.fda.gov/~dms/dscgmps7.html