>Because physical exams are performed in mobile vans in NHANES, data could not be collected in northern latitudes during the winter; instead data were collected in northern latitudes during summer and in southern latitudes in winter. To address this season-latitude aspect of the NHANES design, we stratified the sample into two seasonal subpopulations (winter/lower latitude and summer/higher latitude) before examining vitamin D status.

Yeah, I'm not surprised that the rates for vitamin D deficiency were low.

>Less than 1% of the winter/lower latitude subpopulation had vitamin D deficiency (25-OHD <17.5 nmol/L). However, the prevalence of vitamin D insufficiency in this group ranged from 1%–5% with 25-OHD <25 nmol/L /.../, even though the median latitude for this subsample (32°N) was considerably lower than the latitude at which vitamin D is not synthesized during winter months (∽42°N).

and the more northern latitude in summer:

>With the exception of elderly women, prevalence rates of vitamin D insufficiency were lower in the summer/higher latitude subpopulation (<1%–3% with 25-OHD <25 nmol/L)

Now imagine if you lived in northern Europe around the 60th parallel, where the sun doesn't get high enough in winter to produce vitamin D.

I never heard that in Germany. I only heard that if you use certain medications like cortisone that vitamin d could be problematic. Most doctors will give vitamin d supplements when prescribing cortisone, at least in Germany.

https://pubmed.ncbi.nlm.nih.gov/33549285/

Look at the molecular structure

https://en.wikipedia.org/wiki/Vitamin_D

that's a freakin' steroid with one of the bonds in the rings deleted

https://en.wikipedia.org/wiki/Secosteroid

The very premise that loading up your body with "excess" vitamins beyond what you need is already pretty fraught. Building a house without enough lumber can lead to long term deficiency - but loading up a construction site with more materials than are needed shouldn't automatically be assumed to be good.

The reality is that the modern diet has already solved so many common nutrient deficiency diseases (pellagra and goiters were a shockingly common diseases 100 years ago) that maxing out on vitamin intake has become more of something like a speculative hobby than anything else.

The strongest evidence for Vitamin D is in people who are severely deficient. Bumping up to a normal range can provide some improvements.

The health influencers started noticing that the Vitamin D studies coming out weren't matching their original hype for Vitamin D, so many pivoted to trying to make claims that most people are severely deficient and just don't know it, which provides a convenient out to dismiss the studies that didn't pre-filter for people who were severely deficient. You can find waves of people on social media repeating the idea that almost everyone is Vitamin D deficient and encouraging high dose supplementation still.

Speaking to a doctor who runs Vitamin D labs as part of her annual physical screening process, she's now actually seeing more people who have excess Vitamin D than too little Vitamin D. Upon followup she discovers that patients have listened to a podcast about Vitamin D and started taking it regularly, unaware that they're pushing their levels into the range where it can start doing more harm than good.

Vitamin D is tricky because it lasts for a very long time in the body, which means steady-state supplementation can take a very long time to stabilize. I suggest anyone supplementing for a long time get a blood test, which can be ordered without your doctor if you can't get your doctor on board.

On another topic: Fish oil has also gone through a similar cycle of being hyped up based on early results, with higher powered follow on studies showing much less interesting results.

[1] https://pubmed.ncbi.nlm.nih.gov/32918215/

[2] https://karger.com/bpu/article-abstract/41/1-3/130/328295/Su...

That trial used a dynamically-adjusted dosage of a vitamin D3 supplement, where dosing was set as to keep blood levels within a target range of 40–80 ng/mL. IMO part of the reason this trial is showing better results than the previous clinical trials of vitamin D supplementation quoted in the above article is that vitamin D has bad effects if too low and too high. Adjusting the dose dynamically to achieve an optimal range gets you the benefits without some of the negative effects.

Why not?

More importantly, I'd like to know how long it takes to write a post like this.

Everything I write, I try to research and publish in under 2 weeks.

This post looks like it grew over time. I like that quality very much.

For example, I've been supplementing with nicotinamide riboside for a few years now. I stop occasionally and when I do stiff and sore hands and knees return and I get more headaches.

I'd love to know if I'm deluding myself (placebo effect?) or there's good science that backs up my experience.

Note that adequate magnesium is critical for proper vitamin D function, but the article doesn't document it.

I think a good hypothesis for the discrepancy regarding why people with "naturally" high levels of vitamin D fare better than those who do not has to do with how vitamin D is produced naturally.

If you take the vitamin orally it might help for rickets and a few other issues but if you take it naturally via sunlight you might actually be having other benefits that aren't properly measured today.

With the current state of fear surrounding sunlight I doubt people are getting enough to see benefits and all studies use oral supplements instead of time in sunshine.

It is almost universally recognized as good to do exactly that. It's better to have one planned extra trip to return excess materials (if they can't be used on the next job) than to have multiple unplanned trips when you unexpectedly run out of this or that.

I'm not sure what the ancestral iodine source might have been. Fishing villages perhaps along the coast? Hard to say how much coast was relatively populated given challenges of shifting shorelines and archaeological efforts. You can still reproduce laden with a goiter however, and that is enough to keep chucking malnourished humans somewhere on earth.

https://en.wikipedia.org/wiki/Thiamine#Biological_functions

Vitamin D is not but rather it regulates calcium and phosphorous metabolism.

Not really. It isn't possible to be severely deficient in vitamin D without knowing it. By definition, if you are severely deficient in vitamin D, you have rickets.

So, we know the mechanism, and it's quite plausible that supplementation works.

In other words, as an skeptic, I don't think it's just an epidemiological correlation.

People who are drawing blood and trying to find some correlation between vitamin presence and health at this point are just practicing divination. The fact that it can be published in a scientific journal without any sort of RCT to back it up is palpably unscientific.

The customers of these studies are the supplement companies looking for another product to sell.