The US recommended daily amount (RDA) of vitamin D is about 600 IUs per day. This was established in 2011, and hasn’t been updated since. The Food and Nutrition Board of the Institute of Medicine at the National Academy of Sciences sets US RDAs.
According to a 2017 paper, “The Big Vitamin D Mistake,” the right level is actually around 8,000 IUs/day, and the erroneously low level is due to a statistical mistake. I haven’t been able to find out yet whether there is any transparency about when the RDA will be reconsidered.
But 3 years is a long time to wait. Especially when vitamin D deficiency is linked to COVID mortality. And if we want to be good progressives, we can also note that vitamin D deficiency is linked to race, and may be driving the higher rates of death in black communities due to COVID.
We could call the slowness to update the RDA an example of systemic racism!
What do we do when a regulatory board isn’t doing its job? Well, we can disseminate the truth over the internet.
But then you wind up with an asymmetric information problem. Reading the health claims of many people promising “the truth,” how do you decide whom to believe?
Probably you have the most sway in tight-knit communities, such as your family, your immediate circle of friends, and online forums like this one.
What if you wanted to pressure the FNB to reconsider the RDA sooner rather than later?
Probably giving them some bad press would be one way to do it. This is a symmetric weapon, but this is a situation where we don’t actually have anybody who really thinks that incorrect vitamin D RDA levels are a good thing. Except maybe literal racists who are also extremely informed about health supplements?
In a situation where we’re not dealing with a partisan divide, but only an issue of bureaucratic inefficiency, applying pressure tactics seems like a good strategy to me.
How do you start such a pressure campaign? Probably you reach out to leaders of the black community, as well as doctors and dietary researchers, and try to get them interested in this issue. Ask them what’s being done, and see if there’s some kind of work going on behind the scenes. Are most of them aware of this issue?
Prior to that, it’s probably important to establish both your credibility and your communication skills. Bring together the studies showing that the issue is a) real and b) relevant in a format that’s polished and easy to digest.
And prior to that, you probably want to gauge the difficulty from somebody with some knowhow, and get their blessing. Blessings are important. In my case, my dad spent his career in public health, and I’m going to start there.
So, you can’t trust the government. Why do you trust that study? I talked to my MD about it, and he didn’t actually know any more than I about reasoning, but did know that there is some toxicity at higher levels, and strongly recommended I stay below 2500 IU/day. I haven’t fully followed that, as I still have a large bottle of 5000 IU pills, which I’m now taking every third day (with 2000 IUs on the intervening days).
I’m not convinced it’s JUST bureaucratic inefficiency—there may very well be difficulties in finding a balanced “one-size-fits-all” recommendation as well, and the judgement of “supplement a bit lightly is safer than over-supplementing” is well in-scope for these general guidelines.
You raise two issues here. One is about vitamin D, and the other is about trust.
Regarding vitamin D, there is an optimal dose for general population health that lies somewhere in between “toxically deficient” and “toxically high.” The range from the high hundreds to around 10,000 appears to be well within that safe zone. The open question is not whether 10,000 IUs is potentially toxic—it clearly is not—but whether, among doses in the safe range, a lower dose can be taken to achieve the same health benefits.
One thing to understand is that in the outdoor lifestyle we evolved for, we’d be getting 80% of our vitamin D from sunlight and 20% through food. In our modern indoor lifestyles, we are starving ourselves for vitamin D.
“Supplement a bit lightly is safer than over-supplementing” is only a meaningful statement if you can define the dose that constitutes “a bit lightly” and the dose that is “over-supplementing.” Beyond these points, we’d have “dangerously low” and “dangerously high” levels.
To assume that 600 IU is “a bit lightly” rather than “dangerously low” is a perfect example of begging the question.
On the issue of trust, you could just as easily say “so you don’t trust these papers, why do you trust your doctor or the government?”
The key issue at hand is that in the absence of expert consensus, non-experts have to come up with their own way of deciding who to trust.
In my opinion, there are three key reasons to prefer a study of the evidence to the RDA in this particular case:
The RDA hasn’t been revisited in almost a decade, even simply to reaffirm it. This is despite ongoing research in an important area of study that may have links to our current global pandemic. That’s strong evidence to me that the current guidance is as it is for reasons other than active engagement by policy-makers with the current state of vitamin D research.
The statistical error identified in these papers is easy for me to understand. The fact that it hasn’t received an official response, nor a peer-reviewed scientific criticism, further undermines the credibility of the current RDA.
The rationale for the need for 10,000 IU/day vitamin D supplements makes more sense to me than the rationale for being concerned about the potential toxic effects of that level of supplementation.
However, I have started an email conversation with the author of The Big Vitamin D Mistake, and have emailed the authors of the original paper identifying the statistical error it cites, to try and understand the research climate further.
I want to know why it is difficult to achieve a scientific consensus on these questions. Everybody has access to the same evidence, and reasonable people ought to be able to find a consensus view on what it means. Instead, the author of the paper described to me a polarized climate in that field. I am trying to check with other researchers he cites about whether his characterization is accurate.
An end run around slow government
The US recommended daily amount (RDA) of vitamin D is about 600 IUs per day. This was established in 2011, and hasn’t been updated since. The Food and Nutrition Board of the Institute of Medicine at the National Academy of Sciences sets US RDAs.
According to a 2017 paper, “The Big Vitamin D Mistake,” the right level is actually around 8,000 IUs/day, and the erroneously low level is due to a statistical mistake. I haven’t been able to find out yet whether there is any transparency about when the RDA will be reconsidered.
But 3 years is a long time to wait. Especially when vitamin D deficiency is linked to COVID mortality. And if we want to be good progressives, we can also note that vitamin D deficiency is linked to race, and may be driving the higher rates of death in black communities due to COVID.
We could call the slowness to update the RDA an example of systemic racism!
What do we do when a regulatory board isn’t doing its job? Well, we can disseminate the truth over the internet.
But then you wind up with an asymmetric information problem. Reading the health claims of many people promising “the truth,” how do you decide whom to believe?
Probably you have the most sway in tight-knit communities, such as your family, your immediate circle of friends, and online forums like this one.
What if you wanted to pressure the FNB to reconsider the RDA sooner rather than later?
Probably giving them some bad press would be one way to do it. This is a symmetric weapon, but this is a situation where we don’t actually have anybody who really thinks that incorrect vitamin D RDA levels are a good thing. Except maybe literal racists who are also extremely informed about health supplements?
In a situation where we’re not dealing with a partisan divide, but only an issue of bureaucratic inefficiency, applying pressure tactics seems like a good strategy to me.
How do you start such a pressure campaign? Probably you reach out to leaders of the black community, as well as doctors and dietary researchers, and try to get them interested in this issue. Ask them what’s being done, and see if there’s some kind of work going on behind the scenes. Are most of them aware of this issue?
Prior to that, it’s probably important to establish both your credibility and your communication skills. Bring together the studies showing that the issue is a) real and b) relevant in a format that’s polished and easy to digest.
And prior to that, you probably want to gauge the difficulty from somebody with some knowhow, and get their blessing. Blessings are important. In my case, my dad spent his career in public health, and I’m going to start there.
So, you can’t trust the government. Why do you trust that study? I talked to my MD about it, and he didn’t actually know any more than I about reasoning, but did know that there is some toxicity at higher levels, and strongly recommended I stay below 2500 IU/day. I haven’t fully followed that, as I still have a large bottle of 5000 IU pills, which I’m now taking every third day (with 2000 IUs on the intervening days).
EU Food Safety Administration in 2006 (2002 for vitamin D, see page 167 of https://www.efsa.europa.eu/sites/default/files/efsa_rep/blobserver_assets/ndatolerableuil.pdf. Page 180 for the recommendation) found that 50ug (2000IU) per day is the safe upper limit.
I’m not convinced it’s JUST bureaucratic inefficiency—there may very well be difficulties in finding a balanced “one-size-fits-all” recommendation as well, and the judgement of “supplement a bit lightly is safer than over-supplementing” is well in-scope for these general guidelines.
You raise two issues here. One is about vitamin D, and the other is about trust.
Regarding vitamin D, there is an optimal dose for general population health that lies somewhere in between “toxically deficient” and “toxically high.” The range from the high hundreds to around 10,000 appears to be well within that safe zone. The open question is not whether 10,000 IUs is potentially toxic—it clearly is not—but whether, among doses in the safe range, a lower dose can be taken to achieve the same health benefits.
One thing to understand is that in the outdoor lifestyle we evolved for, we’d be getting 80% of our vitamin D from sunlight and 20% through food. In our modern indoor lifestyles, we are starving ourselves for vitamin D.
“Supplement a bit lightly is safer than over-supplementing” is only a meaningful statement if you can define the dose that constitutes “a bit lightly” and the dose that is “over-supplementing.” Beyond these points, we’d have “dangerously low” and “dangerously high” levels.
To assume that 600 IU is “a bit lightly” rather than “dangerously low” is a perfect example of begging the question.
On the issue of trust, you could just as easily say “so you don’t trust these papers, why do you trust your doctor or the government?”
The key issue at hand is that in the absence of expert consensus, non-experts have to come up with their own way of deciding who to trust.
In my opinion, there are three key reasons to prefer a study of the evidence to the RDA in this particular case:
The RDA hasn’t been revisited in almost a decade, even simply to reaffirm it. This is despite ongoing research in an important area of study that may have links to our current global pandemic. That’s strong evidence to me that the current guidance is as it is for reasons other than active engagement by policy-makers with the current state of vitamin D research.
The statistical error identified in these papers is easy for me to understand. The fact that it hasn’t received an official response, nor a peer-reviewed scientific criticism, further undermines the credibility of the current RDA.
The rationale for the need for 10,000 IU/day vitamin D supplements makes more sense to me than the rationale for being concerned about the potential toxic effects of that level of supplementation.
However, I have started an email conversation with the author of The Big Vitamin D Mistake, and have emailed the authors of the original paper identifying the statistical error it cites, to try and understand the research climate further.
I want to know why it is difficult to achieve a scientific consensus on these questions. Everybody has access to the same evidence, and reasonable people ought to be able to find a consensus view on what it means. Instead, the author of the paper described to me a polarized climate in that field. I am trying to check with other researchers he cites about whether his characterization is accurate.