Nov 12 • Nutrition 101
Spotlight Nutrient: Vitamin D3
First - let’s explain the allopathic interpretation of this study (study linked below):
What the new AHA abstract ACTUALLY found
- Adults with established heart disease who had their vitamin D dosed to reach and maintain 25-OH-D between ~40–80 ng/mL had a 52% lower risk of myocardial infarction vs. a usual-care group that did not manage vitamin D levels. Primary composite outcomes (death/HF hospitalization/stroke) were not reduced. It’s a preliminary conference abstract (TARGET-D), not yet peer-reviewed.
- 52% of the treatment group needed >5,000 IU/day to hit >40 ng/mL, and dosing was titrated every 3 months with safety monitoring; doses were reduced/stopped if levels exceeded 80 ng/mL to avoid hypercalcemia.
Why “normal” lab values are often too low
- U.S. National Academies/NIH materials frame ≥20 ng/mL as “generally adequate” for bone outcomes, which is why some labs set the “normal” lower bound near 20. But that threshold was never meant to optimize non-skeletal outcomes.
- The Endocrine Society’s 2024 guideline moved away from endorsing a single universal target like 30 ng/mL for everyone, acknowledging heterogeneous needs and advising routine RDA-level supplementation only for most healthy adults <75 without indications—reserving higher targets/doses for specific populations/indications.
- Earlier (2011) guidance commonly sought ≥30 ng/mL, and many functional clinicians aim 40–60 ng/mL for broader physiology—aligning with the TARGET-D optimization approach rather than a one-size-fits-all dose. (Note: the 2011 target is now superseded, but it explains today’s differing “normals.”)
What low vitamin D implies (condensed)
- Cardiometabolic risk: Low 25-OH-D is consistently associated with higher CVD risk; however, in the general population the large VITAL RCT (2,000 IU/day) did not lower major CVD events, suggesting benefit may require targeted treatment of deficiency or higher-risk subgroups (like TARGET-D did).
- Infectious disease/COVID-19: Observational and some interventional/meta-analytic data link low D to worse outcomes and suggest benefit to supplementation—especially with multiple/adequate doses—but it’s not accurate to claim “nearly 100% of COVID deaths are due to low vitamin D.” That overstates the evidence.
- Musculoskeletal/immune: Low D compromises calcium homeostasis, bone, and immune function; very high levels can cause toxicity (hypercalcemia, renal issues, arrhythmias), which is why monitoring matters. UL for most adults is 4,000 IU/day (outside supervised care).
“Personalized doses” — how to translate this to your IDN workflow
The study’s approach mirrors what you already do: test → dose → recheck → adjust. Here’s a plug-and-play protocol you can drop into your practitioner plan:
- Baseline
- Order serum 25-OH-D, calcium; consider PTH if levels are atypical or sarcoidosis/granulomatous disease is suspected.
- Identify factors driving higher needs: obesity, darker skin, limited sun, older age, malabsorption (IBD, bariatric), meds (antiepileptics, glucocorticoids), genetic variation (CYP2R1/GC), inflammatory burden.
- Target
- For general wellness without indications: follow Endocrine Society 2024—RDA-level intake unless there’s an indication to treat/test.
- For documented insufficiency/deficiency or secondary prevention in CAD (your post-MI clients): consider a functional target of ~40–60 ng/mL, consistent with the range used in TARGET-D (40–80 ng/mL) while staying well below toxicity. Monitor calcium.
- Initial dose (examples to customize in IDN)
- 25-OH-D <20 ng/mL: 4,000–6,000 IU/day or 30,000–50,000 IU/week for 8–12 weeks, then reassess.
- 20–30 ng/mL: 2,000–4,000 IU/day.
- >30 but <40 ng/mL (CAD/immune goals): 2,000–3,000 IU/day.
- In obesity/malabsorption: consider the upper end of ranges or weight-adjusted dosing; many will need ≥5,000 IU/day short-term—mirroring TARGET-D (where ~52% needed >5,000 IU/day). Recheck in ~12 weeks.
- Titration rules
- Re-test 25-OH-D + calcium at 3 months; adjust by 1,000–2,000 IU/day increments toward target.
- If >80 ng/mL or calcium rises: pause or reduce; recheck in 4–6 weeks (this matches the study’s safety approach).
- Formulation & absorption (easy IDN wins)
- Use D3 (cholecalciferol). Pair with meals containing fat; consider magnesium sufficiency and vitamin K2 per your standard protocols (K2 especially if using higher D doses alongside calcium). (General safety/interaction notes from NIH ODS.)
- Maintenance
- Once stable in range, annual level (or seasonally for indoor workers, high latitude). For CAD clients, you can piggyback checks on lipid/inflammation panels.
NOW let’s put this in a functional frame, and create a Bedrock solution-
🌞 Vitamin D3 — Why “Normal” Isn’t Optimal
Most labs flag anything above 30 ng/mL as “normal,” but that simply prevents rickets — it doesn’t optimize immune balance, hormone health, or cardiovascular protection.
At Rooted Faith / Bedrock Nutrition, we maintain a functional target of 70–90 ng/mL year-round and adjust seasonally:
Baseline 3000 IU D3 w/ 300 mcg K2
Titrate up by 1000 IU (from 4000-10,000 daily), depending on the individual, symptomology, environment, season and more.
Functional Targets
- Ideal range: 70–90 ng/mL
- Re-test window: Every 90 days when adjusting
- Upper caution zone: >100 ng/mL or serum Ca >10.5 mg/dL → reduce/hold
❤️ Why It Matters
- Cardiovascular Health: New data show heart-attack risk may drop by more than 50 % in patients whose vitamin D is actively optimized rather than fixed at a generic dose.
- Immune & Hormone Support: Vitamin D acts more like a pro-hormone than a vitamin—governing over 1,000 genes involved in inflammation, insulin sensitivity, and hormone balance.
- Mood & Metabolism: Adequate D₃ improves serotonin signaling, thyroid conversion, and insulin regulation.
⚠️ Common Mistakes to Avoid
- Using Vitamin D₂ Instead of D₃ D₂ (ergocalciferol) is plant-derived and poorly converted to the active hormone. Studies link chronic high-dose D₂ use to increased inflammation and cancer risk, whereas D₃ (cholecalciferol) is the body’s natural form and far more bioavailable.
- Taking 50,000 IU “Once-Weekly” Doses Vitamin D is a fat-soluble hormone, not a water-soluble vitamin; the body cannot slow-release a pharmacologic megadose. A 50,000 IU spike can trigger toxic serum surges, disrupt calcium balance, and cause a downstream hormonal cascade that paradoxically worsens energy, sleep, and mood. Safe correction uses daily divided doses within physiologic limits (up to 10,000 IU/day under supervision).
- Ignoring Cofactors Without vitamin K₂ and magnesium, calcium may deposit in arteries rather than bones. Always pair D₃ with K₂ (MK-7 form) and ensure magnesium adequacy.
🧬 Personalized Nutrition, Not Guesswork
Through your Individually Designed Nutrition (IDN) program, we assess → tailor → re-assess:
- Each formula reflects genetic variants (CYP2R1, GC, VDR), absorption patterns, and lifestyle exposure.
- We use real-time lab data and your biological cues to adjust D₃ and K₂ ratios, keeping levels stable and safe all year long.
- study link: https://newsroom.heart.org/news/heart-attack-risk-halved-in-adults-with-heart-disease-taking-tailored-vitamin-d-doses?brid=UMhLMYW9DFwDYqqOZ7FU0g
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Spotlight Nutrient: Vitamin D3
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