There is a 5000 years old epic called Ramayana which dedicates a significant part of it to a conversation between the protagonist Ram and his guru, agastya.
The summary of that entire conversation is this:
If you ever feel demotivated, defeated or dull just pray to the sun or go into the sunlight.
This message was repeated dozens of times over and over with various metaphors.
I think they were trying to hammer the point that sunlight solves a lot of issues.
I live in the tropics and there is plenty of sunshine here. So my skin doctor told me to avoid the sun at all costs, always wear suncreen and a hat, don't go out in the daytime. A few years of that and now I have a vitamin D deficiency.
Unless you're non-native and have redhead-style very white skin or some history, the doctor sounds overly cautious to paranoid.
Hundreds of millions live in such climates (including people with fairer skin) and have no problems, even though they don't do anything extreme like "avoid the sun at all costs, always wear suncreen and a hat, don't go out in the daytime".
I'm white and I lived near the tropics for a few years, big white and asian population, everybody was out in the sun all the time, hardly covered too. Skin cancer stats as good as Europe or US.
I think we’re starting to find that the “if you get sunlight you will develop skin cancer” mantra is way overblown, if not outright wrong. Being out in the sun is good for humans. In fact, we need it. But modern life largely conspires to prevent it for most of the developed world. Even when we do, we slather ourselves with sunscreen that might be doing more harm than good. Better to wear long sleeves and a hat that you can take off and at least get reflected sunlight while wearing. Oddly, it turns out that our bodies have been tuned to survive outside. Whodathunkit?
Here’s my hypothesis: it’s not total sun exposure that causes issues, it’s inconsistent sun exposure. Those of us in northern climates experience an annual cycle of very high and then nonexistent sun exposure. This causes our skin to stop producing melanin during the winter and then leaves us vulnerable to sunburn in the spring and summer. If we had year-round sun then our skin would consistently maintain melanin levels and we wouldn’t have sunburn.
I’d love to know if there are any studies trying to answer my question.
I agree. When it is sunny, I get at least 20 min of sun on my bare skin and in my eyes (not protected from UV by glasses) every other day as recommended by neuroscientist Andrew Huberman. I am however careful not to get a lot more than that at once and have high-UPF clothing, hat and sunglasses to protect myself if I ever do need to be out in the sun for an extended period. (I am of Northern European ancestry.)
Even though I believe that the vitamin D we can buy in bottles is probably just as good as the vitamin D my skin makes, I do not consider vitamin D supplementation an adequate replacement for getting UV light on my skin and in my eyes because vitamin D production is only one of the benefits of getting UV light on the skin and in the eyes. (BTW I think HN put way too much emphasis on vitamin D.)
There are UV light receptors (that use a compound called neuropsin to sense the UV light) on the skin and in the parts of the brain that receive UV light (which gets into the skull mainly through the eyes). These receptors have nothing to do with vitamin D. Getting UV light onto these receptors is a more potent trigger for the release of endorphins in the brain than exercise is.
Regular UV light exposure also increases levels of sex hormones in men and in women. In men, increasing testosterone increases optimism and motivation and drive. Again, IIUC this effect has nothing to do with vitamin D.
When people eat plants, the compounds (e.g., lutein, zeaxanthin and lycopene) that plants use to protect themselves from UV light and blue light tend to be absorbed and to end up in high concentrations in the retina. If you do what I do, namely, get UV light from the sun every other day in moderate doses, then I suggest making sure you are getting plenty of these compounds. (Alexis Cowan says that omega 3 is helpful here, too.)
Reminder that the FDA recommended daily allowance of vitamin D is 10x lower than it was supposed to be, because of a math error, and they have never corrected it.
The abstract wasn't clear to me, but looking it up FDA recommends 20mcg = 800 IU, and the paper recommends 8000 IU. It seems like others are more conservative (7000 IU).
I don't think I've ever seen the 20mcg rec, everywhere I've seen was something like 2000 (and that's what the supplements come as), but P appears correct.
What was the math error that led to this? And I'm curious now how to get 8000 IU. Just take a bunch of pills all at once in the morning?
The paper referenced Finland, which seems like a strong confirmation of safety, but the best information I could find was https://www.ruokavirasto.fi/en/foodstuffs/healthy-diet/natio... . What effective IU dose are people getting in Finland with these changes?
The 20mcg rec (the wrong rec) is quite literally on every single nutrition label in America that has Vitamin D. Maybe you haven’t noticed it. Surely you’ve seen it if you’re in the U.S.
What I don't understand is how it's possible for 90% of people to have a vitamin D deficiency, or whatever that crazy number was. Surely by that point it's just normal?
I don't know how it was approached for vitamin D, but it's all about the model they choose, which in the first instance is just something they pull out of thin air. For many water soluble vitamins and minerals the model is based on a threshold for urine excretion; up the dose until the study group is excreting as much as they take in. Until someone figures out otherwise--i.e. that it's too little, too much, or that other considerations need to be made--that's the basis for the RDA.
Between the vitamin D error (this affected US and Europe and probably more places) and the sodium/blood pressure study that was misleading if not outright false, it's amazing how a few data points can become widespread advice without much verification and follow-up.
I'm sure there's tons more cases that we don't even know about, not in the conspiracy sense, but more in the sense that there's some issues with how carefully these claims are validated before they get put out there as a rule to be followed.
Yea sun damage and cancer vs. vitamin d deficiency is a little bit of a balancing act. It also doesn't help skin color is very critical part in all of this but people view that topic as taboo to discuss. The entire reason for skin color variations is a genetic optimization for UV absorption at specific latitudes vs sunburn risks.
That and the other half of the problem is we are all sedentary as hell in all latitudes these days. Be it people hiding under AC at the tropics or hiding in heated homes in the north. We don't go outside to get enough sunlight and our fat reserves that store vitamin d don't grow large enough because we still don't go outside when the weather is tolerable.
> The entire reason for skin color variations is a genetic optimization for UV absorption at specific latitudes vs sunburn risks.
This seems obvious but was not confirmed by genetic evidence. The rate of adaptation turns out to be much higher than can be explained by skin cancer.
The real cause appears to be fertility. UV radiation breaks down folate (vitamin B9) in the bloodstream, and folate is critical for DNA synthesis and repair. Folate deficiency causes serious problems in pregnancy, neural tube defects like spina bifida, and may impair sperm production. So darker skin in high-UV equatorial regions likely evolved partly to protect reproductive capacity.
In the other direction, lower melanin production helps with vitamin D synthesis in lower sunlight environments. Vitamin D requires UV-B radiation to be synthesized in the skin, and melanin inhibits this. Vitamin D is also linked to fertility. It's involved in sex hormone production and has been associated with successful implantation and pregnancy outcomes.
If you're curious, check out Nina Jablonski and George Chaplin's work. Their hypothesis is that skin color evolution as fundamentally about reproductive fitness: dark enough to protect folate, light enough to synthesize vitamin D. Both nutrients affect fertility, fetal development, and offspring survival. They have an immediate primary impact on fertility and success, while skin cancer even in the most extreme environment/phenotype mismatch, has an onset after reproductive age.
I don't think anyone is making it taboo to say someone's melanin content affects how they absorb UV light. It's taboo when you tie it to all sorts of other things, say, how well they should do at school.
Careful with this I took vitamin d every day no problem for a year. Randomly started getting heart palpitations one week and was trying to figure out why. Got an Apple Watch to monitor for a fib. Was asking myself what changed in my life that it happened all of a sudden and realized I had started taking K2. ChatGPTs theory is that it really made the absorption of vit d effective and led to hypercalcemia.
Stopped taking vit d and k2 it resolved after a week no problems almost a year later.
You’re warning people to be cautious of taking Vitamin D… because you had problems with potassium supplements? Those are entirely different things with entirely different risk profiles.
With so much of the UK with living with unspecified malaise, some significant part of which likely contributing to their low employment participation rate, I suspect giving everyone vitamin D would be very cost effective.
English food tends to be better at home than at restaurants. Also, it tends to mostly be undefined brown lumps but it does have flavor and there are some spices. (mostly mustard)
The exception is "Chinese takeaway", which is actually as bad as the stereotype.
As a conversational point, I do recall reading an article sometime ago about people moving to the UK from sunnier places, and then suffering from Vitamin D deficiency!
I’ve wondered whether vitamin D is a real time signal within the circadian rhythm regulation system. Perhaps it is released in response to sunlight in order to let other parts of the system know it is daytime.
If it were like this, bulk dosing would be expected to be better than nothing (“maximum daytime!!!! Followed immediately by a very long slow sunset at whatever curve it is cleaned up in the body), but it would be better to dose continuously in real time at a level and body location(s) that would simulate the range of sunlight throughout the day.
Can anyone professionally familiar with the research in this area comment?
Vitamin D interacts with clock genes, which regulate the body's daily rhythms, through its ability to modulate the expression of genes like Clock, Bmal1, and Per2.
I went to the doctor about eight months ago for an unrelated ailment, but the doctor wanted to do some blood tests. Turns out I had a fairly large vitamin d deficiency.
The doctor told me just to pick up some supplements. After a couple weeks I was genuinely surprised how much better I felt. Overall less lethargic. I've been feeling over all just kind of blegh for a long time and it really seems to have helped.
My dad had suggested vitamin d and I didn't take it seriously but he was right.
I found that taking a specific brand of Vitamin D (the Genestra D-mulsion in particular) right before bed was guaranteed to give me vivid dreams. I've had half a dozen friends try it, with every single one reporting similar results.
I've heard not to take vitamin D right before bed because it will kinda keep you up. Maybe the vitamin D as a stimulant is what's gives you the extra dream awareness.
I checked the ingredients. That is because it contains glycerin. Which is a great and safe supplement to take for anyone with sleeping issues. But will cause very vivid dreams at the start. D3 will not by itself have a huge effect on dreams.
That's interesting. I know vitamin D can improve sleep quality in people who are deficient, and sleep quality helps with dream recall -- I wonder if that's the mechanism or it's something else.
A cursory search shows lots of redditors taking Vitamin D (some of them way, way too much btw) and having wild dreams too.
I take 800IU a day and haven't noticed anything on that little.
Current recommendations are 800 IU per day if you’re not significantly deficient. Always keep testing at least once a year or so. I took 5000 IU per day for a while, which ended up pushing me over 60 ng/ml. That’s considered too high a level and may have negative health effects.
Yeah, I showed a really mild deficiency in my work so they just suggested adding a low daily dose for me. I wouldn't expect to have had any side effects.
I was very deficient and they gave me 50k UI per day prescription vitamin D3 for 60 days. Sure enough I was high-normal on my next test. 800ui is likely not enough to have any effect unless you consistently take it for years.
It was for 60 days. If they continued to take this much indefinitely it would surely cause troubles, but 60 days when starting from deep deficiency is reasonable.
Supplementing any "large" amount of either Vitamin D or Bs really messes with my sleep. It makes it harder to fall asleep and I get crazy dreams (and sometimes hallucinations in bed too)
You started off writing this yourself and then "augmented" the reply of an LLM for the later part, right? Because the tone of your post changes from human to LLM as I continue reading it.
or it might be changing from anecdotal human to technical research human. Here's my question - if you had read that 5 years ago would you think it was written by a human who had done some reading on the matter, or would you think they googled it and copied some of what they found.
Obviously 5 years ago we couldn't have worried it was an LLM, but if you wouldn't have thought someone just copy pasted something without understanding it, or someone was crazy on drugs when they wrote something, then it seems somewhat unfair to give people this new accusation.
>In fairness to researchers, it can be difficult to run a randomized clinical trial for vitamin D supplements. That’s because most of us get the bulk of our vitamin D from sunlight
And how hard is it to make such controlled studies on prison populations (where both sun and food intake is also a known value)? Make it voluntary and give some incentives for those wanting to participate. Can study supplement effects for one or even five years, it's not like they're going anywhere.
That's also a question I have when I hear about diet studies. What's easier than doing such in prison populations? Make it as voluntary as it's for people outside, and there's no ethical issue. We're talking like checking the effect of this or that food or diet style, which they can let different people chose their own. They already eat what they're given anyway, that would be an improvement.
> And how hard is it to make such controlled studies on prison populations (where both sun and food intake is also a known value)?
Very hard. Not impossible, but even something as low risk as a dietary study with Vitamin D supplements would come under very heavy scrutiny and likely be rejected.
Prisoners are considered a vulnerable group with diminished autonomy so there is no such thing as “voluntary as it's for people outside“ in prison. Full stop. The Nuremberg Code, Belmont Report, and Declaration of Helsinki all explicitly spell that out.
Even ignoring the obvious “ethical issues” that have been settled since the Nazis, they’re also legally protected. See 45 CFR 46 Subpart C [1]. Even if the experiment got past the academic ERBs, the HHS ones will likely shut it down.
It’s interesting that his doctor wouldn’t prescribe a vitamin D supplement because it would supposedly be too expensive for the health care system. Fortunately, vitamin D supplements are generally inexpensive to buy. I doubt I’d ever get a prescription for one, they’d probably just tell me to pick some up at the pharmacy downstairs.
That will be why the doc tells you it's too expensive, because over the counter is cheap. It's not that they can't afford it, but in the UK there is a standard prescription price. It's under £10 per prescription for any drug that prescribed, but it's a flat fee. So if they prescribe something that costs less than the prescription charge it makes no sense for the patient.
"Putting the entire population on vitamin D supplements would be too expensive for the country’s national health service, he told me."
This seems absolutely bonkers. Vitamin D is dirt cheap, and if you can think at all beyond first-order effects, the improvement in immune health alone would likely pay for itself in terms of cost to the healthcare system.
I guess the logistics of prescribing an entire population of anything is expensive, and overkill when people can supplement it in pills or diet, or just go outside more.
"Go outside more" is absolutely a nonstarter in the places that most need this: northern latitudes in the winter.
Not only is "outside" often so cold that you need to cover enough of your skin that the sunlight would barely help, the weaker sun we get in winter just doesn't produce enough vitamin D in our bodies. That's the problem.
(Edit: "northern latitudes" can probably be replaced with "more extreme latitudes," as I believe there are some places that are far enough south that they also experience this, just at the opposite end of the year)
No one will probably believe this, but I think dust mite exposure is a major cause of vitamin D deficiency and a lot of the negative outcomes associated with low vitamin D are actually second+ order effects of dust mite exposure. Just posting in case it reaches one person out of the 100s of millions who are sick from dust mites.
citation? There's many open to believing it and the reach maybe more if there are studies that confirm causation with a high probability.
fwiw - vit-d supplementation is one of the easiest supplements available. The recommended dosage 400IU is way lower than what can actually bring your levels up. You need about 4000IU of supplementation and regular testing if you're not exposed to sunlight and/or your dairy intake is poor.
I've read hundreds of dust mite studies, and this is the conclusion I came to, but it's difficult to put in a direct single argument with a citation that most people would require to accept it. I also got dust mites entirely out of my home and my chronically low vitamin D was resolved without a change in lifestyle or supplementation.
But I'll do my best to share some of the steps toward this conclusion:
#1. There is a body of molecular research showing dust mite allergens directly damage the immune system, most importantly once you inhale their fecal pods, they cause epithelial permeability in the lungs. (this study is a good overview of several ways it directly damages the immune system, all of which are totally unrelated to type 1 hypersensitivity, btw: https://www.jacionline.org/article/S0091-6749(18)30848-0/ful...)
#2. There are challenge studies that show dust mites directly causing eczema symptoms after inhalation, which shows that dust mite allergens can act on areas other than the respiratory system, probably by entering the blood stream. Of course there are also challenge studies for asthma. (here's a paper arguing for causal role in asthma https://www.atsjournals.org/doi/full/10.1164/rccm.200811-175...)
#3. All of the major allergic diseases(asthma, eczema, rhinitis, and although it is not as well studies, I believe IBS) have epithelial damage and increased allergy as a core feature of the disease. #1 and #2 are good evidence that dust mites play a causal role in these diseases
#4. From asthma and epithelial permeability in the lungs you can get to worse outcomes from flu and covid etc, from rhinitis you can get to worse sleep and worse mental health etc and reach a large number of health outcomes.
#5. It's true that people with allergy suffer worse from all these problems, but so much damage has already been done before you even get to Type 1 hypersensitivity, but that's another story.
So basically, dust mites directly damage your immune system in the lungs, skin, nose, eyes, guts(and maybe more?), create a sustained immune response, and leads to a multitude of other bad health outcomes.
People have a mental model that vitamins are at the root level of causality, and therefore don't consider that vitamin D could also be caused by dust mite exposure.
And of course high IgE is directly caused by exposure to dust mites if you're sensitized.
I don't know the specific mechanism by which they cause low vitamin d, but two possibilities are that #1: the high and sustained immune response your body runs from constant dust mite exposure consumes vitamin D and acts like a leaky bucket. #2: dust mites somehow disrupt vitamin d production in the skin(e.g. there was one study showing https://www.jacionline.org/article/S0091-6749(13)01768-5/ful...)
Basically a two step process:
1. Keep humidity at 40% year round, using dehumidifiers. This stops their biology and makes them go dormant quickly. Their eggs and protonymphs will die out after a year or so.
2. Remove existing allergens from your home. In short: allergen covers around your bed, get rid of old fabric stuff(curtains, rugs, carpet). Launder everything you can on the highest heat possible.
Basically a two step process:
1. Keep humidity at 40% year round, using dehumidifiers. This stops their biology and makes them go dormant quickly. Their eggs and protonymphs will die out after a year or so.
2. Remove existing allergens from your home. In short: allergen covers around your bed, get rid of old fabric stuff(curtains, rugs, carpet). Launder everything you can on the highest heat possible.
>For me, that means topping up with a supplement. The UK government advises everyone in the country to take a 10-microgram vitamin D supplement over autumn and winter
My last blood test showed I was slightly deficient in vitamin D - my doctor recommended a 50 microgram (2000 IU) supplement. My next test to see how well it' working isn't for a few more months.
This article aside, there are a number of very well established benefits of vitamin D. I think “mixed evidence of small limited effect” is not a phrase that is reflective of current knowledge.
I have polymorphisms in a gene called CYP2R1 (Vitamin D 25-hydroxylase, involved in activation of vitamin D precursors). My polymorphism lead to lower levels of D3.
My doc put me on 1000mcg of D3 a day for a month after I tested low. I came back in for blood testing and my Calcium levels were extremely high (Not good!). So the doctor ordered me to stop the vitamin D to see what was going on.
As it turns out I have even more lower frequency polymophisms in a gene called CALCA (Calcitonin is a peptide hormone that causes a rapid but short-lived drop in the level of calcium and phosphate in blood by promoting the incorporation of those ions in the bones.). So basically since I do not realease a lot of Calcitonin naturally I need to get it from food.
Guess what food is extremely high in Vitamin D3[1] and Calcitonin[2]?
Salmon! I have a genetic history of people that ate a lot of salmon so this makes sense.
Genetics matter people. I will assume that most people who have irish/britsh should be getting their D3 from fatty fish since sunlight is so rare there.
Good article, but it does not cover toxicity; you can take too much vitamin D and this has very negative affects. Usually a multivitamin is enough for supplementing; taking extra is where you can run into issues; consult your Doctor.
Linking a molecule, that takes part in a complex cellular mechanism, with a general health outcome will never go well and is nonsense.
Fellow tech people forget hacking your body with innocent pills or having any meaningful effect without sacrifice. Kill your stress, maintain normal weight and have nice relations.
I do not tolerate vitamin d supplements, they make me sick. Im actually switching to eating salmon and other fish in winter + getting the sperti vitamin d lamp.
> At a checkup a few years ago, a doctor told me I was deficient in vitamin D. But he wouldn’t write me a prescription for supplements, simply because, as he put it, everyone in the UK is deficient. Putting the entire population on vitamin D supplements would be too expensive for the country’s national health service, he told me.
Ugh. It's amazing how incompetent medical systems are. I was also deficient in vitamin D and my doctor wrote a prescription. When I did the math, the cost was something like >$.10 per 1000IU. But if I bought the vitamins from a normal store, I would pay <$.01 per 1000IU. Since a person lacking sunlight only needs 1000IU, the price for giving everyone in the UK Vitamin D would be <$700k/day. And probably much less since most people won't need this high of a dose and bulk quantities would be cheaper.
For healthy people, taking extra vitamins is pointless, but giving them to people who are deficient in vitamins is one of the cheapest health interventions for the benefits.
PSA: if you're feeling off, make sure your doctor checks your various vitamin levels and see if cheap OTC vitamins help.
From a strictly biomedical point of view, mild vitamin D deficiency is trivial to correct and supplementation is indeed one of the lowest-cost interventions we have. But large health services often optimize around procurement, prescribing ceilings, and clinical workload rather than marginal benefits. In that logic, pushing people toward OTC supplements is simply cheaper to administer, even if it looks absurd from the outside.
There’s also a less-discussed layer: population screening for micronutrients tends to be episodic rather than continuous, and the thresholds for “deficiency” versus “insufficiency” have shifted over the years. Some clinicians quietly adopt a pragmatic stance - if the risk is low and the intervention is cheap, they’d rather patients self-supplement without pulling the system into it.
The general point still stands, though. If someone has persistent fatigue, mood changes, sleep disruption, or immune irregularities, checking basic micronutrient status is a reasonable first step. A small, targeted correction often produces disproportionate improvements, even if it sits outside the more glamorous parts of medicine.
Too add to this, if anyone is considering looking for otc vitamin supplementation, please check to see if the brand you're interested in has been lab tested. Heavy metals have been found in cheap stuff before in the US and the government isn't really screening for this stuff proactively.
If you consider the deficiency a national health issue, you can even subsidize a nation scale production reducing the cost even more. From a state perspective, that should be chump change considering the nation-wide effects.
There is a 5000 years old epic called Ramayana which dedicates a significant part of it to a conversation between the protagonist Ram and his guru, agastya.
The summary of that entire conversation is this:
If you ever feel demotivated, defeated or dull just pray to the sun or go into the sunlight.
This message was repeated dozens of times over and over with various metaphors.
I think they were trying to hammer the point that sunlight solves a lot of issues.
I live in the tropics and there is plenty of sunshine here. So my skin doctor told me to avoid the sun at all costs, always wear suncreen and a hat, don't go out in the daytime. A few years of that and now I have a vitamin D deficiency.
Unless you're non-native and have redhead-style very white skin or some history, the doctor sounds overly cautious to paranoid.
Hundreds of millions live in such climates (including people with fairer skin) and have no problems, even though they don't do anything extreme like "avoid the sun at all costs, always wear suncreen and a hat, don't go out in the daytime".
I'm white and I lived near the tropics for a few years, big white and asian population, everybody was out in the sun all the time, hardly covered too. Skin cancer stats as good as Europe or US.
I think we’re starting to find that the “if you get sunlight you will develop skin cancer” mantra is way overblown, if not outright wrong. Being out in the sun is good for humans. In fact, we need it. But modern life largely conspires to prevent it for most of the developed world. Even when we do, we slather ourselves with sunscreen that might be doing more harm than good. Better to wear long sleeves and a hat that you can take off and at least get reflected sunlight while wearing. Oddly, it turns out that our bodies have been tuned to survive outside. Whodathunkit?
There's a hole in the atmosphere where I live. Incidentally, one of the highest skin cancer occurrences in the world.
Calling it overblown, is... A dangerous sentiment.
We tore a hole in our atmosphere. This is not the natural way of things, no. But we do have to live with the consequences.
Here’s my hypothesis: it’s not total sun exposure that causes issues, it’s inconsistent sun exposure. Those of us in northern climates experience an annual cycle of very high and then nonexistent sun exposure. This causes our skin to stop producing melanin during the winter and then leaves us vulnerable to sunburn in the spring and summer. If we had year-round sun then our skin would consistently maintain melanin levels and we wouldn’t have sunburn.
I’d love to know if there are any studies trying to answer my question.
It’s just sunburns that cause skin cancer. It’s really that simple.
I have known quite a few people personally who have found (and removed) skin cancer.
I don't know if that means anything, it isn't n=1 sample size, it is more and my gut says it might be statistically significant.
> I think we’re starting to find that the “if you get sunlight you will develop skin cancer” mantra is way overblown, if not outright wrong.
Citation needed
I agree. When it is sunny, I get at least 20 min of sun on my bare skin and in my eyes (not protected from UV by glasses) every other day as recommended by neuroscientist Andrew Huberman. I am however careful not to get a lot more than that at once and have high-UPF clothing, hat and sunglasses to protect myself if I ever do need to be out in the sun for an extended period. (I am of Northern European ancestry.)
Even though I believe that the vitamin D we can buy in bottles is probably just as good as the vitamin D my skin makes, I do not consider vitamin D supplementation an adequate replacement for getting UV light on my skin and in my eyes because vitamin D production is only one of the benefits of getting UV light on the skin and in the eyes. (BTW I think HN put way too much emphasis on vitamin D.)
There are UV light receptors (that use a compound called neuropsin to sense the UV light) on the skin and in the parts of the brain that receive UV light (which gets into the skull mainly through the eyes). These receptors have nothing to do with vitamin D. Getting UV light onto these receptors is a more potent trigger for the release of endorphins in the brain than exercise is.
Regular UV light exposure also increases levels of sex hormones in men and in women. In men, increasing testosterone increases optimism and motivation and drive. Again, IIUC this effect has nothing to do with vitamin D.
When people eat plants, the compounds (e.g., lutein, zeaxanthin and lycopene) that plants use to protect themselves from UV light and blue light tend to be absorbed and to end up in high concentrations in the retina. If you do what I do, namely, get UV light from the sun every other day in moderate doses, then I suggest making sure you are getting plenty of these compounds. (Alexis Cowan says that omega 3 is helpful here, too.)
Wearing sunscreen might be a good idea if you are white ethnicity (that is your ancestors lived in northern Europe for thousands of years).
For others. It depends.
Native South Americans, Africans and Indians seem to get skin cancer at much lower rates.
Reminder that the FDA recommended daily allowance of vitamin D is 10x lower than it was supposed to be, because of a math error, and they have never corrected it.
https://pubmed.ncbi.nlm.nih.gov/28768407/
The abstract wasn't clear to me, but looking it up FDA recommends 20mcg = 800 IU, and the paper recommends 8000 IU. It seems like others are more conservative (7000 IU).
I don't think I've ever seen the 20mcg rec, everywhere I've seen was something like 2000 (and that's what the supplements come as), but P appears correct.
What was the math error that led to this? And I'm curious now how to get 8000 IU. Just take a bunch of pills all at once in the morning?
The paper referenced Finland, which seems like a strong confirmation of safety, but the best information I could find was https://www.ruokavirasto.fi/en/foodstuffs/healthy-diet/natio... . What effective IU dose are people getting in Finland with these changes?
> I don't think I've ever seen the 20mcg rec
The 20mcg rec (the wrong rec) is quite literally on every single nutrition label in America that has Vitamin D. Maybe you haven’t noticed it. Surely you’ve seen it if you’re in the U.S.
https://www.fda.gov/food/nutrition-facts-label/daily-value-n...
> What was the math error that led to this? And I'm curious now how to get 8000 IU. Just take a bunch of pills all at once in the morning?
Read the paper I posted. And it is easy to find 5000iu and 10000iu capsules at a drug store.
> it is easy to find 5000iu and 10000iu capsules at a drug store
Not in Canada!
What I don't understand is how it's possible for 90% of people to have a vitamin D deficiency, or whatever that crazy number was. Surely by that point it's just normal?
I don't know how it was approached for vitamin D, but it's all about the model they choose, which in the first instance is just something they pull out of thin air. For many water soluble vitamins and minerals the model is based on a threshold for urine excretion; up the dose until the study group is excreting as much as they take in. Until someone figures out otherwise--i.e. that it's too little, too much, or that other considerations need to be made--that's the basis for the RDA.
Modern life is spent indoors whereas historically during our evolution it was outdoors
Between the vitamin D error (this affected US and Europe and probably more places) and the sodium/blood pressure study that was misleading if not outright false, it's amazing how a few data points can become widespread advice without much verification and follow-up.
I'm sure there's tons more cases that we don't even know about, not in the conspiracy sense, but more in the sense that there's some issues with how carefully these claims are validated before they get put out there as a rule to be followed.
Those are two recommendations out of how many? And how many years? How many errors do police make? Actuaries? Security researchers?
One of the big issues is the momentum. Even long after these misstakes have been found doctors still give advice based on the error.
Doctors giving advice based on mistaken or otherwise bad data and outdated guidance is a pervasive problem
Let alone meddling vested interests, e.g. with RDA for sugar.
Yea sun damage and cancer vs. vitamin d deficiency is a little bit of a balancing act. It also doesn't help skin color is very critical part in all of this but people view that topic as taboo to discuss. The entire reason for skin color variations is a genetic optimization for UV absorption at specific latitudes vs sunburn risks.
That and the other half of the problem is we are all sedentary as hell in all latitudes these days. Be it people hiding under AC at the tropics or hiding in heated homes in the north. We don't go outside to get enough sunlight and our fat reserves that store vitamin d don't grow large enough because we still don't go outside when the weather is tolerable.
> The entire reason for skin color variations is a genetic optimization for UV absorption at specific latitudes vs sunburn risks.
This seems obvious but was not confirmed by genetic evidence. The rate of adaptation turns out to be much higher than can be explained by skin cancer.
The real cause appears to be fertility. UV radiation breaks down folate (vitamin B9) in the bloodstream, and folate is critical for DNA synthesis and repair. Folate deficiency causes serious problems in pregnancy, neural tube defects like spina bifida, and may impair sperm production. So darker skin in high-UV equatorial regions likely evolved partly to protect reproductive capacity.
In the other direction, lower melanin production helps with vitamin D synthesis in lower sunlight environments. Vitamin D requires UV-B radiation to be synthesized in the skin, and melanin inhibits this. Vitamin D is also linked to fertility. It's involved in sex hormone production and has been associated with successful implantation and pregnancy outcomes.
If you're curious, check out Nina Jablonski and George Chaplin's work. Their hypothesis is that skin color evolution as fundamentally about reproductive fitness: dark enough to protect folate, light enough to synthesize vitamin D. Both nutrients affect fertility, fetal development, and offspring survival. They have an immediate primary impact on fertility and success, while skin cancer even in the most extreme environment/phenotype mismatch, has an onset after reproductive age.
I don't think anyone is making it taboo to say someone's melanin content affects how they absorb UV light. It's taboo when you tie it to all sorts of other things, say, how well they should do at school.
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Can supplement D easily, together with K2.
Careful with this I took vitamin d every day no problem for a year. Randomly started getting heart palpitations one week and was trying to figure out why. Got an Apple Watch to monitor for a fib. Was asking myself what changed in my life that it happened all of a sudden and realized I had started taking K2. ChatGPTs theory is that it really made the absorption of vit d effective and led to hypercalcemia.
Stopped taking vit d and k2 it resolved after a week no problems almost a year later.
It should be the opposite, not taking K2 leads to calcification as K2 helps your body absorb calcium instead of lingering in your circulatory system.
Anyone reading any of this ignore it all and see a doctor/cardiologist/emergency if concerned.
well that would imply that these LLMs could be wrong and they should talk to a doctor instead - lunacy!
You’re warning people to be cautious of taking Vitamin D… because you had problems with potassium supplements? Those are entirely different things with entirely different risk profiles.
K2 isn't a potassium supplement
K2 is synthetic cannabinoid inspired by THC
I mean, you're not wrong, but that's not what the discussion is about.
There's Vitamin K1 and Vitamin K2. Vitamin K2 is frequently taken alongside Vitamin D.
people should actually be more careful about taking medical advice from an LLM than grabbing a vitamin D supplement.
With so much of the UK with living with unspecified malaise, some significant part of which likely contributing to their low employment participation rate, I suspect giving everyone vitamin D would be very cost effective.
Idk I think most of it comes from the food
English food tends to be better at home than at restaurants. Also, it tends to mostly be undefined brown lumps but it does have flavor and there are some spices. (mostly mustard)
The exception is "Chinese takeaway", which is actually as bad as the stereotype.
Youll struggle to get the rda from diet alone unless you eat daily fish.
https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona...
Surely they meant that the malaise comes from the British food…
As a conversational point, I do recall reading an article sometime ago about people moving to the UK from sunnier places, and then suffering from Vitamin D deficiency!
I’ve wondered whether vitamin D is a real time signal within the circadian rhythm regulation system. Perhaps it is released in response to sunlight in order to let other parts of the system know it is daytime.
If it were like this, bulk dosing would be expected to be better than nothing (“maximum daytime!!!! Followed immediately by a very long slow sunset at whatever curve it is cleaned up in the body), but it would be better to dose continuously in real time at a level and body location(s) that would simulate the range of sunlight throughout the day.
Can anyone professionally familiar with the research in this area comment?
Vitamin D interacts with clock genes, which regulate the body's daily rhythms, through its ability to modulate the expression of genes like Clock, Bmal1, and Per2.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11990303/
I apologize if this sounds stupid but has the OP ever considered moving to a country like India during december and jan, wouldn't it solve the issue?
I went to the doctor about eight months ago for an unrelated ailment, but the doctor wanted to do some blood tests. Turns out I had a fairly large vitamin d deficiency.
The doctor told me just to pick up some supplements. After a couple weeks I was genuinely surprised how much better I felt. Overall less lethargic. I've been feeling over all just kind of blegh for a long time and it really seems to have helped.
My dad had suggested vitamin d and I didn't take it seriously but he was right.
I found that taking a specific brand of Vitamin D (the Genestra D-mulsion in particular) right before bed was guaranteed to give me vivid dreams. I've had half a dozen friends try it, with every single one reporting similar results.
I've heard not to take vitamin D right before bed because it will kinda keep you up. Maybe the vitamin D as a stimulant is what's gives you the extra dream awareness.
I checked the ingredients. That is because it contains glycerin. Which is a great and safe supplement to take for anyone with sleeping issues. But will cause very vivid dreams at the start. D3 will not by itself have a huge effect on dreams.
This is such a weird fact that I googled it and sure enough it is widely noted!
my bottle of Nature Made D3 also contains glycerin
That's interesting. I know vitamin D can improve sleep quality in people who are deficient, and sleep quality helps with dream recall -- I wonder if that's the mechanism or it's something else.
A cursory search shows lots of redditors taking Vitamin D (some of them way, way too much btw) and having wild dreams too.
I take 800IU a day and haven't noticed anything on that little.
Given 10min of sunlight the body can naturally produce 15,000UI equivalent so I think gp is likely astroturfing for that brand
What is way too much? I take around 4000IU per day. Which just about brings my blood levels into the “green” area in blood testing.
Current recommendations are 800 IU per day if you’re not significantly deficient. Always keep testing at least once a year or so. I took 5000 IU per day for a while, which ended up pushing me over 60 ng/ml. That’s considered too high a level and may have negative health effects.
The reddit post was taking 50,000IU a day, which is usually the amount prescribed for someone to take once a week.
Your 4000IU isn't too much. Lots of the brands you see in stores are 5k for daily supplementation.
FWIW: my functional provider recently noted low levels in my labs and I was already taking 2K IU daily. She bumped me up to 6K UI daily.
4,000 is perfect.
That is actually a low dose.
Yeah, I showed a really mild deficiency in my work so they just suggested adding a low daily dose for me. I wouldn't expect to have had any side effects.
I was very deficient and they gave me 50k UI per day prescription vitamin D3 for 60 days. Sure enough I was high-normal on my next test. 800ui is likely not enough to have any effect unless you consistently take it for years.
That's wild. I've never heard of such a high dose being prescribed daily.
Yes, I wouldn't expect to notice anything on my dose.
It was for 60 days. If they continued to take this much indefinitely it would surely cause troubles, but 60 days when starting from deep deficiency is reasonable.
Even that sounds extreme. The "Vitamin D Hammer" for people extremely deficient is 50k IU just once, not even for a temporary period.
I was very very low, googling my level 'risk of rickets' came up!
Supplementing any "large" amount of either Vitamin D or Bs really messes with my sleep. It makes it harder to fall asleep and I get crazy dreams (and sometimes hallucinations in bed too)
Spicy food and dehydration do wonders for me!
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You started off writing this yourself and then "augmented" the reply of an LLM for the later part, right? Because the tone of your post changes from human to LLM as I continue reading it.
Yeah it’s pretty clearly a bot account, or at least someone who likes to copy paste from chatgpt to sound smart.
or it might be changing from anecdotal human to technical research human. Here's my question - if you had read that 5 years ago would you think it was written by a human who had done some reading on the matter, or would you think they googled it and copied some of what they found.
Obviously 5 years ago we couldn't have worried it was an LLM, but if you wouldn't have thought someone just copy pasted something without understanding it, or someone was crazy on drugs when they wrote something, then it seems somewhat unfair to give people this new accusation.
Had the exact same feeling. The conclusion shifts back to the human.
It contains glycerin which is 100% the cause of the vivid dreams.
>In fairness to researchers, it can be difficult to run a randomized clinical trial for vitamin D supplements. That’s because most of us get the bulk of our vitamin D from sunlight
And how hard is it to make such controlled studies on prison populations (where both sun and food intake is also a known value)? Make it voluntary and give some incentives for those wanting to participate. Can study supplement effects for one or even five years, it's not like they're going anywhere.
That's also a question I have when I hear about diet studies. What's easier than doing such in prison populations? Make it as voluntary as it's for people outside, and there's no ethical issue. We're talking like checking the effect of this or that food or diet style, which they can let different people chose their own. They already eat what they're given anyway, that would be an improvement.
> And how hard is it to make such controlled studies on prison populations (where both sun and food intake is also a known value)?
Very hard. Not impossible, but even something as low risk as a dietary study with Vitamin D supplements would come under very heavy scrutiny and likely be rejected.
Prisoners are considered a vulnerable group with diminished autonomy so there is no such thing as “voluntary as it's for people outside“ in prison. Full stop. The Nuremberg Code, Belmont Report, and Declaration of Helsinki all explicitly spell that out.
Even ignoring the obvious “ethical issues” that have been settled since the Nazis, they’re also legally protected. See 45 CFR 46 Subpart C [1]. Even if the experiment got past the academic ERBs, the HHS ones will likely shut it down.
[1] https://www.hhs.gov/ohrp/regulations-and-policy/regulations/...
It’s interesting that his doctor wouldn’t prescribe a vitamin D supplement because it would supposedly be too expensive for the health care system. Fortunately, vitamin D supplements are generally inexpensive to buy. I doubt I’d ever get a prescription for one, they’d probably just tell me to pick some up at the pharmacy downstairs.
That will be why the doc tells you it's too expensive, because over the counter is cheap. It's not that they can't afford it, but in the UK there is a standard prescription price. It's under £10 per prescription for any drug that prescribed, but it's a flat fee. So if they prescribe something that costs less than the prescription charge it makes no sense for the patient.
There's a standard perscription price in England, not the UK. in Scotland and Wales there's 0 charges to the patient
Thanks for the correction.
"Putting the entire population on vitamin D supplements would be too expensive for the country’s national health service, he told me."
This seems absolutely bonkers. Vitamin D is dirt cheap, and if you can think at all beyond first-order effects, the improvement in immune health alone would likely pay for itself in terms of cost to the healthcare system.
The amount of money lost treating sick people who now have renewed vigour to solve other problems in their life would be just too much
A year of over the counter Vitamin D is around 30 pounds. (Not including bulk discounts or administrative/distribution costs)
The population is 70 million.
So 2.1 billion pounds, about 1% of the total NHS budget.
So do Vitamin D supplements reduce healthcare costs by at least 1%
1% if the NHS budget is one thing, and 1% of healthcare costs is quite another. They are orders of magnitude different.
I guess the logistics of prescribing an entire population of anything is expensive, and overkill when people can supplement it in pills or diet, or just go outside more.
"Go outside more" is absolutely a nonstarter in the places that most need this: northern latitudes in the winter.
Not only is "outside" often so cold that you need to cover enough of your skin that the sunlight would barely help, the weaker sun we get in winter just doesn't produce enough vitamin D in our bodies. That's the problem.
(Edit: "northern latitudes" can probably be replaced with "more extreme latitudes," as I believe there are some places that are far enough south that they also experience this, just at the opposite end of the year)
Which is why the Soviet government used “ultraviolet baths” to make sure that children up North got their vitamin D.
https://www.nationalgeographic.com/photo-of-the-day/photo/ul...
I solve this with 2 150w led corn lamps in my office!
No one will probably believe this, but I think dust mite exposure is a major cause of vitamin D deficiency and a lot of the negative outcomes associated with low vitamin D are actually second+ order effects of dust mite exposure. Just posting in case it reaches one person out of the 100s of millions who are sick from dust mites.
citation? There's many open to believing it and the reach maybe more if there are studies that confirm causation with a high probability.
fwiw - vit-d supplementation is one of the easiest supplements available. The recommended dosage 400IU is way lower than what can actually bring your levels up. You need about 4000IU of supplementation and regular testing if you're not exposed to sunlight and/or your dairy intake is poor.
I've read hundreds of dust mite studies, and this is the conclusion I came to, but it's difficult to put in a direct single argument with a citation that most people would require to accept it. I also got dust mites entirely out of my home and my chronically low vitamin D was resolved without a change in lifestyle or supplementation.
But I'll do my best to share some of the steps toward this conclusion:
#1. There is a body of molecular research showing dust mite allergens directly damage the immune system, most importantly once you inhale their fecal pods, they cause epithelial permeability in the lungs. (this study is a good overview of several ways it directly damages the immune system, all of which are totally unrelated to type 1 hypersensitivity, btw: https://www.jacionline.org/article/S0091-6749(18)30848-0/ful...)
#2. There are challenge studies that show dust mites directly causing eczema symptoms after inhalation, which shows that dust mite allergens can act on areas other than the respiratory system, probably by entering the blood stream. Of course there are also challenge studies for asthma. (here's a paper arguing for causal role in asthma https://www.atsjournals.org/doi/full/10.1164/rccm.200811-175...)
#3. All of the major allergic diseases(asthma, eczema, rhinitis, and although it is not as well studies, I believe IBS) have epithelial damage and increased allergy as a core feature of the disease. #1 and #2 are good evidence that dust mites play a causal role in these diseases
#4. From asthma and epithelial permeability in the lungs you can get to worse outcomes from flu and covid etc, from rhinitis you can get to worse sleep and worse mental health etc and reach a large number of health outcomes.
#5. It's true that people with allergy suffer worse from all these problems, but so much damage has already been done before you even get to Type 1 hypersensitivity, but that's another story.
So basically, dust mites directly damage your immune system in the lungs, skin, nose, eyes, guts(and maybe more?), create a sustained immune response, and leads to a multitude of other bad health outcomes.
And since low vitamin D is associated with dust mite sensitization((https://www.worldallergyorganizationjournal.org/article/S193...) , it's also associated with all those other bad health outcomes that are actually caused by dust mites.
People have a mental model that vitamins are at the root level of causality, and therefore don't consider that vitamin D could also be caused by dust mite exposure.
IgE levels are inversely associated with vitamin D: https://www.nature.com/articles/s41598-020-77968-1
But supplementing vitamin D doesn't lower IgE: https://publications.aap.org/pediatrics/article/150/Suppleme...
And of course high IgE is directly caused by exposure to dust mites if you're sensitized.
I don't know the specific mechanism by which they cause low vitamin d, but two possibilities are that #1: the high and sustained immune response your body runs from constant dust mite exposure consumes vitamin D and acts like a leaky bucket. #2: dust mites somehow disrupt vitamin d production in the skin(e.g. there was one study showing https://www.jacionline.org/article/S0091-6749(13)01768-5/ful...)
Any pointers on how to get rid of them from your house and sleep environment to lower ige?
Basically a two step process: 1. Keep humidity at 40% year round, using dehumidifiers. This stops their biology and makes them go dormant quickly. Their eggs and protonymphs will die out after a year or so. 2. Remove existing allergens from your home. In short: allergen covers around your bed, get rid of old fabric stuff(curtains, rugs, carpet). Launder everything you can on the highest heat possible.
How did you get dust mites entirely out of your house?
Basically a two step process: 1. Keep humidity at 40% year round, using dehumidifiers. This stops their biology and makes them go dormant quickly. Their eggs and protonymphs will die out after a year or so. 2. Remove existing allergens from your home. In short: allergen covers around your bed, get rid of old fabric stuff(curtains, rugs, carpet). Launder everything you can on the highest heat possible.
Internet says to keep humidity below 50%, so a dehumidifier.
This helps. Thanks!
We need sunlight prescriptions
I know a very dark african lady that was given that by her GP, she was waring indoors a lot and in winter was not getting enough sunlight.
>For me, that means topping up with a supplement. The UK government advises everyone in the country to take a 10-microgram vitamin D supplement over autumn and winter
My last blood test showed I was slightly deficient in vitamin D - my doctor recommended a 50 microgram (2000 IU) supplement. My next test to see how well it' working isn't for a few more months.
Get a metabolic test as well to check your calcium levels since D can increase serum calcium if you have genetics like mine.
It's frequently suggested that you take vitamin K2 with vitamin D, which helps direct calcium to the bones.
Yes, Salmon is also high in K2, but for me the calcitonin was more important. My D levels and calcium levels are great now.
Isn’t vague mixed evidence of a small, limited effect pretty much what you’d find if it it did basically nothing in aggregate?
This article aside, there are a number of very well established benefits of vitamin D. I think “mixed evidence of small limited effect” is not a phrase that is reflective of current knowledge.
During the Pan I took a lot of VitD. It started giving me the feeling that my heart was beating out of my chest, so I stopped.
Vitamins A, D, E and K can be overdosed… But for vitamin D to be toxic you would have to veer quite far from the posology.
How much Vitamin D? Vitamins are good but as with many things, the poison is in the dosage. You can definitely take too much of it.
Mushrooms exposed to UV convert egosterol to vitamin D - an almost identical mechanism found in our skin
Cool fact, but so what?
So you can boost D by eating mushrooms, and keep them in sunlight if you can.
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Are you a LLM?
Life would be simpler if I was.
I have polymorphisms in a gene called CYP2R1 (Vitamin D 25-hydroxylase, involved in activation of vitamin D precursors). My polymorphism lead to lower levels of D3.
My doc put me on 1000mcg of D3 a day for a month after I tested low. I came back in for blood testing and my Calcium levels were extremely high (Not good!). So the doctor ordered me to stop the vitamin D to see what was going on.
As it turns out I have even more lower frequency polymophisms in a gene called CALCA (Calcitonin is a peptide hormone that causes a rapid but short-lived drop in the level of calcium and phosphate in blood by promoting the incorporation of those ions in the bones.). So basically since I do not realease a lot of Calcitonin naturally I need to get it from food.
Guess what food is extremely high in Vitamin D3[1] and Calcitonin[2]?
Salmon! I have a genetic history of people that ate a lot of salmon so this makes sense.
Genetics matter people. I will assume that most people who have irish/britsh should be getting their D3 from fatty fish since sunlight is so rare there.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC6566758/ [2] https://en.wikipedia.org/wiki/Salmon_calcitonin).
Good article, but it does not cover toxicity; you can take too much vitamin D and this has very negative affects. Usually a multivitamin is enough for supplementing; taking extra is where you can run into issues; consult your Doctor.
IIRC, toxicity is very rare even in very high doses (like 20 k IU a day) for weeks/ two or so months.
Evidence that multivitamin d is useful?
Linking a molecule, that takes part in a complex cellular mechanism, with a general health outcome will never go well and is nonsense.
Fellow tech people forget hacking your body with innocent pills or having any meaningful effect without sacrifice. Kill your stress, maintain normal weight and have nice relations.
I do not tolerate vitamin d supplements, they make me sick. Im actually switching to eating salmon and other fish in winter + getting the sperti vitamin d lamp.
I'm the same and I tolerate vegan D3 (from lichen). Some people are sensitive to the sheep-wool derived regular D3.
I know it’s not popular to comment about meta web annoyances, but holy shit, five popovers in a row!? One after another, like whack-a-mole?
I really want to meet the people that create these for money and ask them how much it hurt to have their ethics surgically removed.
I’ve talked to people that work at cigarette companies, online gambling, and worse. It’s always fascinating to hear their excuses.
I just used Safari's hide distracting items feature. Popovers gone.
Is it necessary to take k2 along with d3?
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> At a checkup a few years ago, a doctor told me I was deficient in vitamin D. But he wouldn’t write me a prescription for supplements, simply because, as he put it, everyone in the UK is deficient. Putting the entire population on vitamin D supplements would be too expensive for the country’s national health service, he told me.
Ugh. It's amazing how incompetent medical systems are. I was also deficient in vitamin D and my doctor wrote a prescription. When I did the math, the cost was something like >$.10 per 1000IU. But if I bought the vitamins from a normal store, I would pay <$.01 per 1000IU. Since a person lacking sunlight only needs 1000IU, the price for giving everyone in the UK Vitamin D would be <$700k/day. And probably much less since most people won't need this high of a dose and bulk quantities would be cheaper.
For healthy people, taking extra vitamins is pointless, but giving them to people who are deficient in vitamins is one of the cheapest health interventions for the benefits.
PSA: if you're feeling off, make sure your doctor checks your various vitamin levels and see if cheap OTC vitamins help.
From a strictly biomedical point of view, mild vitamin D deficiency is trivial to correct and supplementation is indeed one of the lowest-cost interventions we have. But large health services often optimize around procurement, prescribing ceilings, and clinical workload rather than marginal benefits. In that logic, pushing people toward OTC supplements is simply cheaper to administer, even if it looks absurd from the outside.
There’s also a less-discussed layer: population screening for micronutrients tends to be episodic rather than continuous, and the thresholds for “deficiency” versus “insufficiency” have shifted over the years. Some clinicians quietly adopt a pragmatic stance - if the risk is low and the intervention is cheap, they’d rather patients self-supplement without pulling the system into it.
The general point still stands, though. If someone has persistent fatigue, mood changes, sleep disruption, or immune irregularities, checking basic micronutrient status is a reasonable first step. A small, targeted correction often produces disproportionate improvements, even if it sits outside the more glamorous parts of medicine.
Too add to this, if anyone is considering looking for otc vitamin supplementation, please check to see if the brand you're interested in has been lab tested. Heavy metals have been found in cheap stuff before in the US and the government isn't really screening for this stuff proactively.
If you consider the deficiency a national health issue, you can even subsidize a nation scale production reducing the cost even more. From a state perspective, that should be chump change considering the nation-wide effects.