You never know when you will end up in the ICU. Your life will be clinging to remarkable technology, medical skills and wonder drugs of today’s intensive care units, but you’ll also be using your own innate defense mechanisms to cling to life.
More and more it looks as if vitamin D is the most important innate defense mechanism that humans can control. That is, your vitamin D level will either be high or low based on choices you have made. You either get UVB photons or you don’t; you either take vitamin D or you don’t. That nature leaves those choices to us, in order to make such a powerful downstream steroid hormone, is astonishing.
Drs. Arnson and Amital and colleagues of the Sheba Medical Center in Israel measured the results of the choices of 130 such patients. Even the ones that skipped the vitamin D articles in their local newspapers had made a choice. Some decided to avoid the sun or sunbeds, yet others believed their doctors when they were told, “You can get all the vitamins you need from a good diet.” Their average vitamin D level was 14 ng/ml with about 45 of the 130 critically ill patients having vitamin D levels below 10 ng/ml. The rest were not much better. Despite the small differences between the highest and lowest, the ones with the highest levels outlived the ones with low levels.
The 130 patients in the study included adults suffering the results of everything from car crashes to strokes to heart failure. The researchers measured vitamin D levels from stored blood on all patients at the beginning of their mechanical ventilation. They wanted to see if vitamin D levels had any effect on death rates, and it did. Virtually everyone died, but the ones with the highest vitamin D levels lived 24 days compared to an average of 15 days for the vitamin D deficient group.
First, as I like to say when I speak, everyone who takes vitamin D will die. It’s just a question of when. If all of a sudden, by magic, everyone in the USA had a vitamin D level of 50 ng/ml, we don’t know what people would eventually die from. It would probably be the same diseases that kill us now, only those diseases would occur later in life. Vitamin D is not a panacea; the best we can hope for is that it will let us live to our genetic potential, called squaring off the mortality curve.
How do you decide how much vitamin D to take? How do you make such an important decision for your family and yourself? How do you know? Scientists have never given 5,000 IU/day for five years to see if it is safe. True, and they will not be doing so for quite a while. The answer is firmly embedded in common sense.
Five thousand IU is about 50% of what you get when you sunbathe at noon in the summer in your bathing suit for 30 minutes. As the molecules made in the skin from the sun and the ones in vitamin D supplements are identical (cholecalciferol), it is hard to make a case that 5,000 is too much. On the other side of the argument, a typical Pascal’s Wager, is the growing scientific publications indicating not taking 5,000 IU/day is a decision you may not live to regret.