Ask the Doctor – Vitamin D and MSZoltan P. Rona, MD, MSc July 1, 2009
Dear Dr. Rona:
“Oh God, no” was the response when a young friend of mine told a doctor at Toronto St. Michael’s Hospital MS clinic that she was taking 14,000 iu of vitamin D a day. “There is no long-term evidence that it does not cause harm to the immune system…we don’t know what blood level has to do with toxicity.” She was further told to follow the Canada Food Guide and ‘eat whatever you want’ when she asked about food allergies and allergy tests. (Her GP considers allergy tests unnecessary!)
She was diagnosed with MS when she was 16, changed her diet and dropped gluten and dairy and citrus — a lot of healing after that — even an optic nerve lesion disappeared. Normal and very active life until her late 20s when she fell off a bike. Knee surgery was delayed and she developed a chronic pain syndrome. She is 33 now and still in pain and on morphine. Vitamin D level was 37 when first checked approximately three years ago, and she has gradually been increasing her vitamin D intake. It is now just over 100. One pain specialist would like to se it closer to 200. I told her to re-read Harold Foster’s book on MS.
She is now afraid to take the 14,000 — her mother was a pharmacist and seems to agree.
This MS clinic is apparently one of the largest in the world and according to their web page it’s the largest clinical trial and research centre in the world. I happened upon a fundraising function for the clinic and did not pick up the promotional literature because of a prominent pharmaceutical company logo.
So there – we all now understand that vitamin D is more dangerous than pharmaceuticals in the treatment of MS. This is very strange indeed, or is it?
Idiots!! Staying out in the sun every day for two hours makes close to 20,000 IU of vitamin D. Where are all the dead bodies from that? If those hysterical idiots had bothered to read the literature, especially anything written by Dr. Vieth at U of T, they would talk differently. The pharmacist and the doctors there are just plain hysterical idiots. I’m sure your research will find numerous research articles, which basically say the same thing. Below is an article I recently wrote on this subject. Pass it on to your friend. The whole concept of vitamin D toxicity is a myth.
Research indicates that to get 4000 IU of vitamin D daily if you totally avoid the sun, you must drink 40 glasses of milk a day or take 10 typical multivitamin pills daily. As mentioned earlier, a more optimal daily dose of vitamin D is 10,000 IU daily. At that dose, I have never seen anyone run into side effects or toxicity symptoms in over 30 years.
“Fear of vitamin D toxicity is unwarranted, and such unwarranted fear, bordering on hysteria, is rampant in the medical profession. If there is published evidence of toxicity in adults from an intake of 250 ug (10,000 IU) per day, and that is verified by the 25(OH)D concentration, I have yet to find it.”
1999, Reinhold Vieth PhD
Department of Laboratory Medicine and Pathobiology
University of Toronto
Some very good news has come out of research on the connection between Multiple Sclerosis (MS) and environmental factors such as vitamin D deficiency. It seems that vitamin D adequacy may be necessary to prevent the expression of a gene that is thought to code for MS. According to study leader, Dr Sreeram Ramagopalan:
“Our study implies that taking vitamin D supplements during pregnancy and the early years may reduce the risk of a child developing MS in later life.”
The February 2009 study was published in the PLoS (Public Library of Science) Genetics journal reports. See https://www.plos.org/ No doubt, these findings are a source of anxiety for most mainstream doctors as well as organizations that act as support groups for various diseases such as MS, cancer, autoimmune diseases of all kinds, chronic fatigue syndrome, fibromyalgia and numerous other chronic diseases that respond well to vitamin D supplementation.
For more information on the thirty or more ailments that are helped by vitamin D, see
One of the universal truths (or myths) we were all taught in medical school thirty or more years ago was that fat-soluble vitamins like vitamin D were toxic at certain levels. It was said that daily doses of over 2000 IU would elevate blood levels of calcium, damage the kidneys irreversibly and lead to generalized atherosclerosis (hardening of the arteries).
To this day, I still hear conventional medical doctors regurgitating these same fears to their patients. The Canadian government’s Health Protection Branch (HPB) has eagerly agreed, prohibiting the sales of supplement capsules greater than 1000 IU and preventing the fortification of other than dairy products with the nutrient. Just a few months ago, AOR (Advanced Orthomolecular Research) was forced to stop selling their 5000 IU per capsule vitamin D supplement.
Biotics Research used to have a 2000 IU per drop supplement, which has similarly been terminated in 2008 by the HPB. Doesn’t it always seem odd to you that whenever research indicates a benefit from a certain food supplement, then that same food supplement suddenly experiences a great deal of opposition from the drug czars? Millions of people in this country and in most of North America are vitamin D deficient. Restricting access to supplemental vitamin D is clearly a big mistake. Are any of you sharp-minded lawyers listening?
According to the world research authorities on vitamin D, the Vitamin D Council, fears of high dose vitamin D are irrational. To quote the Vitamin D Council from their web site:
“The single most important fact anyone needs to know about vitamin D is how much nature supplies if we behave naturally, e.g., go into the sun. Humans make at least 10,000 units of vitamin D within 30 minutes of full body exposure to the sun, what is called a minimal erythemal dose. Vitamin D production in the skin occurs within minutes and is already maximized before your skin turns pink.”
Does vitamin D supplementation cause liver toxicity? Does it cause fatty liver? After all, fish and many other animals store vitamin D in the liver. The truth is that vitamin D deficiency can lead to liver failure and that supplementation of vitamin D to normal levels reverses liver disease. In people with non-alcoholic fatty liver disease (NAFLD), a growing problem in North America thought to be caused by insulin resistance, the levels of vitamin D are usually quite low and the liver dysfunction can be brought back to normal with adequate vitamin D supplementation. A 2007 study concludes that vitamin D3 may play a role in both the development and progression of NAFLD.
What if you take drugs that affect the liver like the statins that are used for lowering cholesterol? Statins like Lipitor, Pravachol, Mevacor, Zocor and Crestor all can potentially cause liver toxicity. Statins also deplete conzyme Q10 levels. These all work by inhibiting enzymes (HMG CoEnzyme A reductase) in the liver that manufactures cholesterol. This class of drugs gradually reduces Coenzyme Q10 by at least 40% over a period of a year creating such unwanted symptoms such as fatigue, weak and tired muscles, lethargy and a general sense of low energy. A deficiency of Coenzyme Q10 can result in high blood pressure. Thus, statins can theoretically increase your risk of having a heart attack or stroke.
Coenzyme Q10 is the most important nutrient for ideal heart function. It is used by the energy producing cell organelles known as the mitochondria and is vitally important for a normal cardiac output. Studies indicate that supplementing with Coenzyme Q10 improves every measurement of cardiac function. Three months of Coenzyme Q10 supplementation can lower blood pressure in at least half the people who take it who have elevated blood pressure. It has also been shown to be important in cancer treatment, especially in breast cancer, Parkinson’s disease and periodontal disease.
Interestingly enough, one study done in 2009 indicates that 92% of people who developed muscle damage from statins (myositis-myalgia) were able to reverse this side effect with vitamin D supplementation. In other words, taking a supplement of vitamin D may help correct liver damage caused by statins. Perhaps other drug side effects can be helped by vitamin D but that remains to be seen. The take away message here is that, if you are on a statin, take a Coenzyme Q10 supplement but also get your vitamin D blood levels checked.
Vitamin D deficiency leads to as much as a 60% increase in cancer rates. Oncologists in Toronto, however, have been telling all my cancer patients that they should take no supplemental vitamins when receiving radiation or chemotherapy. The reasons for this are just as nebulous, having no basis in scientific fact.
In June, 2007, in a flurry of generosity, even the highly conservative Canadian Cancer Society recommended that we all supplement with 1000 IU daily of vitamin D. Unfortunately, a daily dose of 1000 IU will do nothing to correct a deficiency. According to Dr. Reinhold Vieth PhD, researcher at the University of Toronto, blood levels don’t even measurably rise until 4000 IU (100 micrograms) is consumed. Real toxicity (hypercalcemia and rampant atherosclerosis) begins at 40,000 IU (1000 micrograms or 1 milligram) only after many weeks of use. For more on this issue, see
My advice, and it’s quite a conservative one, is for all Canadians (and Americans living in northern latitudes) to supplement with a bare minimum of 4000 IU of vitamin D3 daily during the winter months. This is especially true for pregnant women who have a family history of MS or cancer, just to name a couple of diseases that can be prevented by vitamin D supplements.
Most individuals will some benefit with vitamin D supplements within 3 or 4 months but, since there is a great genetic variation in terms of vitamin D metabolism from individual to individual, the changes may be evident either earlier or much later. The best way to monitor the safety and effectiveness of supplements as well as how much you may need at any given time is with periodic blood tests.
In the summer, provided you get adequate sunshine (at least half an hour a day), you may not need supplements and no monitoring is really necessary because the body monitors and adjust blood levels of vitamin D automatically. For example, if you are out in the sun for over 5 hours, you could theoretically be making 100,000 units of vitamin D under your exposed skin. Despite this, the blood levels will be adjusted such that the vitamin D levels remain stable. If you then stay out of the sun for many days, the skin reserves of vitamin D will slowly be moved into your bloodstream to normalize levels there. This sort of thing will not happen with oral supplements and, if you happen to supplement at doses much higher than 4000 IU daily, the potential for toxicity is there. So, as a general rule, if you supplement at very high doses for any length of time, get regular blood testing for 25-hydroxy-vitamin D done at least every 3 months.
Zoltan P. Rona, MD, MSc, offers consultations on nutrition and natural remedies in Thornhill. He has recently retired from medical practice as a Complementary and Alternative medical practitioner and now strictly offers nutritional consultations. He is the medical editor of The Encyclopedia of Natural Healing and has also published several Canadian bestselling books, including Vitamin D, The Sunshine Vitamin. To see more of Dr. Rona’s articles, visit: www.highlevelwellness.ca and for appointments, please call (905) 764-8700; office located at: 390 Steeles Ave. W., Unit 19, Thornhill, Ontario