California no longer under lockdown - people freak out

Phoenixmgs

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Not according to her publication record, she isn't. She appears to be an expert in the cell biology of neurodegenerative diseases.
She is a expert in vitamin d.

Dr. Patrick trained as a postdoctoral fellow at Children’s Hospital Oakland Research Institute with Dr. Bruce Ames. She investigated the effects of micronutrient (vitamins and minerals) inadequacies on metabolism, inflammation, DNA damage, and aging and whether supplementation can reverse the damage. In addition, she also investigated the role of vitamin D in brain function, behavior, and other physiological functions. In February of 2014 she published a paper in FASEB on how vitamin D regulates serotonin synthesis and how this relates to autism.

It probably makes for an adequate minimum, for most people; assuming they also get out a bit in warmer months.

The simple idea of Vit D is that it have a "ready" form and a "storage" form, with interconversion between the two. The storage can do a massive heap of storing. The obvious rationale here is that because Vit D is scarce in winter, evolution has expected us to build a load up in stores during summer that will get us through winter. Most people do get by fine without supplements because they get enough sun in the warmer months, and that'll get them through winter.

The implication of deficiency is persistent low production/intake leading to low "storage" - because otherwise the stores would be converted to the ready form. In such a situation, it would probably be advisable to give a "loading dose" of very high Vit D - say, take several thousand IUs a day for a week or two, or even a massive tens of thousands one-off dose - because to take just 400IUs daily would mean a lot of it would be sequestered for storage leaving relatively little for the ready use form, so it would take weeks-months to get the blood plasma concentration up. Take a lot in one big whack, it would fill up the stores very quickly and leave plenty for the ready form.
I don't know exactly how vitamin d converts and stores and all that. I know that the vast majority of people in the UK are insufficient.

"Current recommendations for vitamin D supplementation are inadequate to address the growing epidemic of vitamin D insufficiency."


It beggars belief that you think Dr. Rhonda Patrick or the individual, anecdotal examples of Drs. Campbell and Fauci rate as more expert than bodies like the NIH, NHS, US Endocrine Society, Institute of Medicine, Mayo Clinic, Harvard University Medical School, etc. who have whole panels of experts to review the evidence base.

Obviously individual variation does factor in. Drs. Fauci and Campbell are old, age is known to be associated with impaired Vit D metabolism, so they may need more. There's also the question of whether Dr. Campbell's home test was accurate; plenty such tests are not.
Again, those bodies are basing their recommendations on bone health. We just recently started learning exactly what vitamin d even does.
 

Agema

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She is a expert in vitamin d.

Dr. Patrick trained as a postdoctoral fellow at Children’s Hospital Oakland Research Institute with Dr. Bruce Ames. She investigated the effects of micronutrient (vitamins and minerals) inadequacies on metabolism, inflammation, DNA damage, and aging and whether supplementation can reverse the damage. In addition, she also investigated the role of vitamin D in brain function, behavior, and other physiological functions. In February of 2014 she published a paper in FASEB on how vitamin D regulates serotonin synthesis and how this relates to autism.
This is what we would call "hype" or "spin". She appears to have worked on vitamin D for one postdoctoral position, from which she published the sum total of zero research (that paper in FASEB is a literature review). As far as I can see she has never secured independent funding for and run her own research project.

I don't know exactly how vitamin d converts and stores and all that. I know that the vast majority of people in the UK are insufficient.
You mean one study found ~60% of the population had plasma vit D below 50 nmol/L, the precise meaning of which is unclear, because there is no strong evidence for most of them that they would be better off if their vit D levels were higher.

Long-term, large-scale trials have been conducted with vitamin D supplementation (up to thousands of IUs daily) that failed to show a significant improvement in key indices, presumably because those who were not deficient gained insignificant benefit.

Again, those bodies are basing their recommendations on bone health. We just recently started learning exactly what vitamin d even does.
We're talking about how much vit D consumption equates to body concentrations. The evidence out there is very good that the recommendations of these agencies should ensure most people are fine; and they already recommend higher intakes for at-risk groups. If you're quoting an "expert in vitamin D" who claims that 1000IUs of vitamin D gets you 5 ng/ml plasma concentration when the actual figure in the literature is around five times higher, the real conclusion should be that they aren't anything like the expert that you think they are.

And again, there is no clear evidence vitamin D for acute respiratory infection is required at higher levels than it is for bone health. Again, here, advisory panels are perfectly capable of reviewing literature effectively and coming to reasonable conclusions. They really are better than a random cell biologist selling you hopes, dreams, and aspirational lifestyle.
 

Phoenixmgs

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This is what we would call "hype" or "spin". She appears to have worked on vitamin D for one postdoctoral position, from which she published the sum total of zero research (that paper in FASEB is a literature review). As far as I can see she has never secured independent funding for and run her own research project.
Why do you need to run a research project to be an expert on what vitamin d does? She knows her shit about vitamin d and the doctor she worked under knows his shit about vitamin d too.


You mean one study found ~60% of the population had plasma vit D below 50 nmol/L, the precise meaning of which is unclear, because there is no strong evidence for most of them that they would be better off if their vit D levels were higher.

Long-term, large-scale trials have been conducted with vitamin D supplementation (up to thousands of IUs daily) that failed to show a significant improvement in key indices, presumably because those who were not deficient gained insignificant benefit.
The page I linked to in my last post that said "Current recommendations for vitamin D supplementation are inadequate to address the growing epidemic of vitamin D insufficiency" showed that from 88-94 to 01-04 in the US that 25(OH)D levels of 30 ng/mL or more decreased from 45% to 23%. I linked that study for 2 reasons, not just the one reason. It's not just one study, vitamin d levels are rather low across the world.

You keep bringing up vitamin d recommendations and studies based on bone health. I keep telling you stop talking about bone health as vitamin d is important to other things. Can you please get off of vitamin d recommendations that are based on bone health? I've never said we need more vitamin d for bone health to prevent rickets or fractures.

The aim of your linked study was: to determine the effect of vitamin D supplementation on fractures, falls, and bone density.
 

Phoenixmgs

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We're talking about how much vit D consumption equates to body concentrations. The evidence out there is very good that the recommendations of these agencies should ensure most people are fine; and they already recommend higher intakes for at-risk groups. If you're quoting an "expert in vitamin D" who claims that 1000IUs of vitamin D gets you 5 ng/ml plasma concentration when the actual figure in the literature is around five times higher, the real conclusion should be that they aren't anything like the expert that you think they are.

And again, there is no clear evidence vitamin D for acute respiratory infection is required at higher levels than it is for bone health. Again, here, advisory panels are perfectly capable of reviewing literature effectively and coming to reasonable conclusions. They really are better than a random cell biologist selling you hopes, dreams, and aspirational lifestyle.
From the following:
Historically, 400 IU (10 ug) of vitamin D was recommended for better health because it closely approximated the amount of vitamin D in a teaspoonful of cod liver oil. However, 800 to 1,000 IU is the dose that may have a better chance of giving a patient a normal vitamin D level.

So that 400IU recommendation in the UK is just from that's how much vitamin d is in cod liver oil, which they gave to prevent rickets. That's hardly some thoroughly number crunched number based on decades of intense research.

Also, from here, 400 IUs of vitamin d isn't even good enough for bone health, let alone everything else you need it for.
Randomized trials using the currently recommended intakes of 400 IU vitamin D/d have shown no appreciable reduction in fracture risk. In contrast, trials using 700–800 IU vitamin D/d found less fracture incidence, with and without supplemental calcium.

Literally, how are you gonna say the UK recommendations are based on any kind of recent science when they say:
Each ‘1-A-Day’ vitamin D supplement contains 10 micrograms (µg) of vitamin D. This is equivalent to 400 international units (IU) of vitamin D. This is the daily amount recommended for the general population by government for general health and in particular to protect bone and muscle health.

Do not exceed the recommended dose (1 supplement per day containing 10 micrograms (µg) equivalent to 400 international units). This is a safe level of intake, designed to meet your nutritional needs. Taking more is not currently recommended.


From this study:
Supplemental intake of 400 IU vitamin D/d has only a modest effect on blood concentrations of 25(OH)D, raising them by 7–12 nmol/L, depending on the starting point. To raise 25(OH)D from 50 to 80 nmol/L requires an additional intake of ≈1700 IU vitamin D/d.

I'll use 10 nmol/L increase for simple math (and it's in the middle of the range). So 400 IUs gets you +10 nmol/L, which is 4 ng/ml. 1,000 IU would then equal 10ng/ml so hardly 5x higher. And the second part going from 50 to 80 nmol/L is 12ng/ml difference (30/2.5). So that 1,700 IUs to increase 12ng/ml so that's a 6ng/ml increase per 850 IUs of vitamin d. That again is nothing close to your statement that 1,000 UIs gives you 25 ng/ml increase (5x the number Rhonda said). And increasing your vitamin d levels is not consistent for every 500 or 1,000 IUs you take so the increase you get from supplements will always be an estimation based on multiple factors. Let me know if I fucked up the math, I don't think I did as you multiply the ng/ml by 2.5 to get nmol/L.
 

Phoenixmgs

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And that last page you linked to, I clicked on the one study that they linked to in that pdf, which was this. That meta analysis was based on prevention of ARIs and not how much/little vitamin d helps your immune system to help fight off the infections. I'm not trying to say vitamin d is gonna stop covid infections. Also that study had nothing to with say seeing what say 400 IUs does vs 1,000 or 2,000 or whatever. There's very few studies I found that are trying to determine benefits from different dosages. I'm pretty sure that meta analysis is not really capable of doing what you say it's doing because it's mainly talking about prevention vs your immune response differences based on different vitamin d levels.
 

Agema

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Why do you need to run a research project to be an expert on what vitamin d does? She knows her shit about vitamin d and the doctor she worked under knows his shit about vitamin d too.
Because in my line of work, an expert is someone with a reputation, record of excellence, publications, etc. Not someone who once attended an interview with her boss under whom she produced no published data.

You keep bringing up vitamin d recommendations and studies based on bone health. I keep telling you stop talking about bone health as vitamin d is important to other things. Can you please get off of vitamin d recommendations that are based on bone health? I've never said we need more vitamin d for bone health to prevent rickets or fractures.
For heaven's sakes, man. You say you want to talk about the immune system, and then you say we don't really know because people haven't really looked at it. So what you are arguing is that you don't know (e.g. #281 " We just recently started learning exactly what vitamin d even does.") Which is fine, but you can't go around saying 400 IUs is inadequate if you don't know, can you?

From the following:
This is, again, just an example of cherry picking your evidence and inability to recognise what you're looking at. The first is an incredibly weak source. The second is an opinion letter, not a research article.

From this study:
Supplemental intake of 400 IU vitamin D/d has only a modest effect on blood concentrations of 25(OH)D, raising them by 7–12 nmol/L, depending on the starting point. To raise 25(OH)D from 50 to 80 nmol/L requires an additional intake of ≈1700 IU vitamin D/d.
And this meta-analysis takes forty-one studies and finds an average increase of 5.3 nmol/L per 100 IUs. I think that trumps your one study quite heavily.

The other question of course is that the end result is illness and all-cause mortality. And here again, the evidence seems to be that above a certain level, the benefit approximates to nil. The Institute of Medicine suggests that it tapers off heavily around 30-40 nmol/L, being almost nothing at 50 nmol/L. They might be right, they might be wrong... but no-one has adequately demonstrated they are wrong. This also relates to the studies I pointed out from the UK government guidance previous, and which (as expected) you just skipped over like they didn't exist and I hadn't posted them, suggesting supplements were little use for most people. Because they pretty much already have as much as they need, even if for some it might be under someone's quasi-arbirtrary insufficiency threshold.

And that leads me onto...

That meta analysis was based on prevention of ARIs and not how much/little vitamin d helps your immune system to help fight off the infections.
Er, how do you argue that prevention of acute respiratory infections doesn't tell us about the immune system fighting off infections?
 

Phoenixmgs

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Because in my line of work, an expert is someone with a reputation, record of excellence, publications, etc. Not someone who once attended an interview with her boss under whom she produced no published data.
You either know your shit or you don't. You don't need publications to know your shit. My uncle knows more than the vast majority of doctors and has no degree or publications. It's not like Dr. Rhonda Patrick is someone with a Youtube channel or blog claiming she just read a bunch of shit and is an self-proclaimed expert. She's a legit doctor that studies vitamin d (and a bunch of other stuff) and studied under Dr. Bruce Ames.

For heaven's sakes, man. You say you want to talk about the immune system, and then you say we don't really know because people haven't really looked at it. So what you are arguing is that you don't know (e.g. #281 " We just recently started learning exactly what vitamin d even does.") Which is fine, but you can't go around saying 400 IUs is inadequate if you don't know, can you?

This is, again, just an example of cherry picking your evidence and inability to recognise what you're looking at. The first is an incredibly weak source. The second is an opinion letter, not a research article.
Is this one better for you? It states that Norway's vitamin d recommendation of 400 IUs is also based on cod liver oil from over 60 years ago. Again, this 400 IUs of vitamin d has hardly been researched and they've just went with it because it stops the most severe issue with vitamin d deficiency.

We really don't know vitamin d that much. You act like everything is known facts from extensive research. There's a lot we don't know, which is fine. I'm going to post an article down below on how we weren't even measuring vitamin d levels correctly (or at least consistently) until very recently.

And this meta-analysis takes forty-one studies and finds an average increase of 5.3 nmol/L per 100 IUs. I think that trumps your one study quite heavily.

The other question of course is that the end result is illness and all-cause mortality. And here again, the evidence seems to be that above a certain level, the benefit approximates to nil. The Institute of Medicine suggests that it tapers off heavily around 30-40 nmol/L, being almost nothing at 50 nmol/L. They might be right, they might be wrong... but no-one has adequately demonstrated they are wrong. This also relates to the studies I pointed out from the UK government guidance previous, and which (as expected) you just skipped over like they didn't exist and I hadn't posted them, suggesting supplements were little use for most people. Because they pretty much already have as much as they need, even if for some it might be under someone's quasi-arbirtrary insufficiency threshold.

And that leads me onto...

I had to google around to find the article because the link doesn't work, I believe this is it. The error in measuring the vitamin d concentrations mentioned in the above article are probably why that meta study has basically half the studies above the average and half below the average and only a few at the average. That whole article talks about all the vitamin d affects that aren't bone health related. And you really need to take a shit-ton of vitamin d to get those negative effects. A couple cases of hypercalcemia were from people taking nearly 1,000,000 IUs (not a typo) of vitamin d via Soladek.

I haven't purposefully skipped over anything. I may have missed something here or there but not on purpose.

Er, how do you argue that prevention of acute respiratory infections doesn't tell us about the immune system fighting off infections?
Being able to completely prevent an infection is a much taller order than helping get rid of an infection. With covid and how infections are measured, those without symptoms but test positive are an infection whereas I doubt they are counting asymptomatic flu infections as an infection in such studies. So the different terminology leads to confusion as nobody will say vitamin d (or even the vaccines) can prevent covid in the manner we determine those infections. Preventing infections tells us something but not much about the "why" and what's actually going on "behind the scenes". And Dr. Rhonda Patrick is one of those doctors that knows the "behind the scenes" stuff far more than most, she's knows a lot about all the different interactions vitamin d has within the body.
 

Agema

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My uncle knows more than the vast majority of doctors and has no degree or publications.
Yes. Your average motorcycle mechanic knows more than the vast majority of doctors too: on the subject of motorcycle maintenance, at least, and probably many other topics. The average person can also tell you about a lot of things they think they know all about irrespective of whether they really do (it's called an internet debate).

It's not like Dr. Rhonda Patrick is someone with a Youtube channel or blog claiming she just read a bunch of shit and is an self-proclaimed expert. She's a legit doctor that studies vitamin d (and a bunch of other stuff) and studied under Dr. Bruce Ames.
She might know lots of stuff. But why should we take her word for it? That's what publications, reputation, track record is about: they've left an evidence trail for scrutiny. That's the sort of reason employers ask candidates for degrees and to supply their certificate as proof, rather than just accept their assertion that they're really good. Or another way of looking at it, Judy Mikovits is a legit doctor who studied, worked under and with eminent scientists too. Is she therefore a reliable source on vaccines?

Is this one better for you? It states that Norway's vitamin d recommendation of 400 IUs is also based on cod liver oil from over 60 years ago. Again, this 400 IUs of vitamin d has hardly been researched and they've just went with it because it stops the most severe issue with vitamin d deficiency.
No, I literally could not care less about you cherry picking studies out of context.

Take that paper you cited from the worryingly named "International Journal Of Growth Factors And Stem Cells In Dentistry" (journal names like that usually raise warning flags). I normally wouldn't bother, but this journal sent my spidey-sense tingling, so I looked at it a bit harder. The journal is all of three years old, has no metrics such as impact factor. It's editorial board are mostly at low rank institutions, it has published fewer than 50 articles in its entire existence and pretty much every single one of those articles including the one you cited was written by people on its own editorial team. This also makes me have some suspicions about who is doing their peer review as well: each other. The paper you cited is very badly written generally; and it has some outrageous and flagrantly inaccurate claims that would be unlikely to pass muster at a better-run journal.

That paper is precisely the sort of thing I warn undergraduates to be careful of when I teach them literature searching: extremely low quality and credibility. And this is the eternal danger when laymen read up on science: all too commonly they lack the skills to assess the information in front of them. You've picked this up just because it says what you want it to. You do not have the skills to determine that it is junk.

Never mind that, but dismissing a meta-analysis of 41 studies through an offhand claim in a (bad) paper referring to a source that doesn't quite say what the (bad) paper claims is unscientific, to say the least.

We really don't know vitamin d that much. You act like everything is known facts from extensive research.
That's funny, because I have repeatedly said pretty much the opposite.

The point that there is more research than you are making out, and that what is there does not come close to justifying vitamin D consumption 5-10 times higher than existing government and health service guidelines as some less reliable people want to pretend.

Being able to completely prevent an infection is a much taller order than helping get rid of an infection.
Vitamin D is never going to "completely prevent" infections. The question is only how much it is going to ameliorate symptoms.
 

Phoenixmgs

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Yes. Your average motorcycle mechanic knows more than the vast majority of doctors too: on the subject of motorcycle maintenance, at least, and probably many other topics. The average person can also tell you about a lot of things they think they know all about irrespective of whether they really do (it's called an internet debate).
Yeah, my uncle can tell you off the top of his head how the body breaks down things on a molecular level. He's explained things to doctors giving lectures that they didn't know. He's done stuff his heart specialist said wasn't possible. He knows his shit and doesn't even have a degree, he just read tons of shit for his job.

She might know lots of stuff. But why should we take her word for it? That's what publications, reputation, track record is about: they've left an evidence trail for scrutiny. That's the sort of reason employers ask candidates for degrees and to supply their certificate as proof, rather than just accept their assertion that they're really good. Or another way of looking at it, Judy Mikovits is a legit doctor who studied, worked under and with eminent scientists too. Is she therefore a reliable source on vaccines?
You know you can listen to her talk and realize she knows her shit. She has all the education as well. You don't have to have the top reputation to be an expert on something. Also, Dr. Ames (who Patrick works with) is the most cited scientist in his field.
 

Phoenixmgs

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No, I literally could not care less about you cherry picking studies out of context.

Take that paper you cited from the worryingly named "International Journal Of Growth Factors And Stem Cells In Dentistry" (journal names like that usually raise warning flags). I normally wouldn't bother, but this journal sent my spidey-sense tingling, so I looked at it a bit harder. The journal is all of three years old, has no metrics such as impact factor. It's editorial board are mostly at low rank institutions, it has published fewer than 50 articles in its entire existence and pretty much every single one of those articles including the one you cited was written by people on its own editorial team. This also makes me have some suspicions about who is doing their peer review as well: each other. The paper you cited is very badly written generally; and it has some outrageous and flagrantly inaccurate claims that would be unlikely to pass muster at a better-run journal.

That paper is precisely the sort of thing I warn undergraduates to be careful of when I teach them literature searching: extremely low quality and credibility. And this is the eternal danger when laymen read up on science: all too commonly they lack the skills to assess the information in front of them. You've picked this up just because it says what you want it to. You do not have the skills to determine that it is junk.

Never mind that, but dismissing a meta-analysis of 41 studies through an offhand claim in a (bad) paper referring to a source that doesn't quite say what the (bad) paper claims is unscientific, to say the least.
Are you gonna say the 400 IU recommendation is not 50+ years old? It may not be directly connected to cod liver oil but the recommendation definitely dates back a long time.

I don't cherry pick studies at all. Please stop saying I'm cherry picking studies. You've cherry picked studies like the HCQ study that was basically like a 20 person study because of how poorly it was setup that was never going to give significant data regardless if HCQ is indeed good or indeed bad or indeed does nothing.

A study showing that 2,000 IUs a day was not enough to maintain good levels of vitamin d after achieving said levels with high dose vitamin d.

Googled this to find the following 'vitamin d dose for "30 ng/ml"' trying to find actual studies that attempted to determine how much vitamin d is needed to reach that 30 ng/ml level.

Pretty much as controlled as you can make a trial and 100% adherence as well. They were giving far more than 400 IUs a day obviously.
"Serum concentrations of 25(OH)D ≥ 30 ng/mL were only achieved in 57.1% of the subjects receiving the vitamin D, indicating that the doses may need to be increased in subsequent studies where this concentration will be targeted."


That's funny, because I have repeatedly said pretty much the opposite.

The point that there is more research than you are making out, and that what is there does not come close to justifying vitamin D consumption 5-10 times higher than existing government and health service guidelines as some less reliable people want to pretend.
The vast majority of research is on bone health with vitamin d. I'm not saying there is very little research concerning other things with vitamin d. But there's definitely not enough research done because there's not much agreement among the scientific community concerning many things with regard to vitamin d.

Vitamin D is never going to "completely prevent" infections. The question is only how much it is going to ameliorate symptoms.
That's basically what I was trying to say, which is why I said those flu studies of less people getting the flu that got vitamin d supplements isn't all too informative, it's basically a starting point to look deeper into what is actually going on.
 

Agema

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Are you gonna say the 400 IU recommendation is not 50+ years old? It may not be directly connected to cod liver oil but the recommendation definitely dates back a long time.
This is an absurd argument. The evidence base has been thoroughly reviewed with more modern studies plenty of times since then.

I don't cherry pick studies at all. Please stop saying I'm cherry picking studies.

A study showing that 2,000 IUs a day was not enough to maintain good levels of vitamin d after achieving said levels with high dose vitamin d.

Googled this to find the following 'vitamin d dose for "30 ng/ml"' trying to find actual studies that attempted to determine how much vitamin d is needed to reach that 30 ng/ml level.
You literally do cherry pick. You're doing it right there. You're ignoring huge amounts of data and just picking a few papers that suit you as if it proves the case.

Not just that, but you're moving goalposts: you first argued that sufficiency was 20 ng/ml (50 nmol/L) earlier. Now you're relying on papers using 30 ng/ml as a target - as far as I can discern simply so you can argue against 400 IUs, and still without establishing the appropriate level of clinical benefit. Of the papers you picked, the first is low quality (e.g. badly written, graphs improperly formatted), and the methodology in both undermines your argument because they lack relevance. The first takes a borderline obese cohort that don't get out in the sun and the second is looking exclusively at the elderly, both of which are already recognised as at risk groups for whom the general guidance does not apply.
 

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The error in measuring the vitamin d concentrations mentioned in the above article are probably why that meta study has basically half the studies above the average and half below the average and only a few at the average.
Uhrm, that's how averages work. That's not indicative of an error at all; that's how you calculate the mean.
 

Phoenixmgs

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This is an absurd argument. The evidence base has been thoroughly reviewed with more modern studies plenty of times since then.
The evidence hasn't been thoroughly reviewed at all. They only care about people not getting rickets with these recommendations. You think we just randomly threw a dart at the board and hit a bullseye for vitamin d recommendations 50+ years ago when we didn't even know what it did? Just maybe having enough vitamin d to prevent the worst side effects from deficiency isn't what the human body is supposed to have. Also, there's basically no evidence for doses of vitamin k either, just another dart thrown at the board for recommendations basically. There's so much that we don't know.

Today's video from Dr. Campbell: "Basically, it's saying same-old same-old. It's talking about the 400 units a day... so do peruse that with disappointment as I did." Later on in the video he talks about how he taught for 30 years that eating less fatty foods was good for cholesterol as those were the guidelines, the guidelines were wrong the whole time.

You literally do cherry pick. You're doing it right there. You're ignoring huge amounts of data and just picking a few papers that suit you as if it proves the case.

Not just that, but you're moving goalposts: you first argued that sufficiency was 20 ng/ml (50 nmol/L) earlier. Now you're relying on papers using 30 ng/ml as a target - as far as I can discern simply so you can argue against 400 IUs, and still without establishing the appropriate level of clinical benefit. Of the papers you picked, the first is low quality (e.g. badly written, graphs improperly formatted), and the methodology in both undermines your argument because they lack relevance. The first takes a borderline obese cohort that don't get out in the sun and the second is looking exclusively at the elderly, both of which are already recognised as at risk groups for whom the general guidance does not apply.
What does attaining 20 ng/ml or 30 ng/ml have to do with how much is needed to raise the levels? Based on your meta-analysis paper, 2,000 IUs a day should be plenty to keep a level of 30 ng/ml easily, but it wasn't. According to the 5 nmol/L per 100 IU study you posted and say a person's baseline level is a low 20 nmol/L, taking 2,000 IUs a day should raise it to 120 nmol/L or 48 ng/ml. And if you're already at say 30 ng/ml and you take 2,000 IUs a day, how is it going down? There isn't a current standard for what is the proper vitamin d levels and different places use different standards, I searched for one of the commonly used standards for studies. I'm not moving or changing goalposts, I'm showing how a few hundred IUs is not enough, which has been my point the whole time.

The average BMI in that study was basically the average BMI of an American who also doesn't get out in the sun, pretty damn relevant then for what the average American probably should be taking then. Older people have been hit hardest by the pandemic and the UK says 10 micrograms a day for 65 and older along with "No special recommendations for those aged 65 and above have been set; the new recommendations for the general population apply." The study shows that 10 micrograms is not nearly enough.

You have posted cherry picking bad studies. You posted an HCQ study that was basically a 20 person study yet that was good enough to prove it doesn't work even though the study showed the HCQ group did better anyway (insignificantly obviously when the count is so low). But my 8,000+ person study was worse than a 20 person study?

Uhrm, that's how averages work. That's not indicative of an error at all; that's how you calculate the mean.
When you're trying to find out how much does X raise something, having basically half the results being at the upper outlier and the other half being at the lower outlier, just maybe something isn't right? You should have a decent grouping around the average point with a few upper and lower outliers to be expect, not the other way around. Science kinda requires repeating experiments and getting the same/similar results, not getting 2 different groups of results and saying the point between them is the answer. It's kinda why psychology has a massive problem right now, they can't recreate results of their experiments. We aren't trying to find streaky baseball player's batting average here.
 

Agema

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The evidence hasn't been thoroughly reviewed at all.
Oh, but it has. Your complaint here is nothing more and nothing less than you don't like the answer they came out with, and you don't want to accept the vast weight of scientific literature they use to justify their conclusions.

You think we just randomly threw a dart at the board and hit a bullseye for vitamin d recommendations 50+ years ago when we didn't even know what it did?
I think they made an estimation with the relatively primitive tools available to them at the time, and it turns out to be a decent estimation. Much like some astronomer 2000+ years ago worked out the circumference of the world to an accuracy only ~5-20% off - depending on which source you follow for his figures - from what we measure it at now.

What does attaining 20 ng/ml or 30 ng/ml have to do with how much is needed to raise the levels?
Because you need more to raise the levels to 30ng/ml than 20ng/ml, obviously. Furthermore, that it is not a linear relationship between intake and plasma concentration; the higher the basal vit D, the more is needed to raise it a set amount.

You have posted cherry picking bad studies. You posted an HCQ study that was basically a 20 person study yet that was good enough to prove it doesn't work even though the study showed the HCQ group did better anyway (insignificantly obviously when the count is so low). But my 8,000+ person study was worse than a 20 person study?
The funny thing is, you are even cherry-picking by keeping bringing up that study to criticise me over, because it is ignoring all the other studies I have brought up or discussed across the course of the HCQ issue.

Let's remember you were citing a website with hundreds of studies that systematically misrepresented the research (where, re the above, I specifically addressed numerous papers). And even when I pointed this out to you, you have continued to make flagrantly false claims that nearly all the studies showed HCQ was beneficial.

When you're trying to find out how much does X raise something, having basically half the results being at the upper outlier and the other half being at the lower outlier, just maybe something isn't right? You should have a decent grouping around the average point with a few upper and lower outliers to be expect, not the other way around. Science kinda requires repeating experiments and getting the same/similar results, not getting 2 different groups of results and saying the point between them is the answer. It's kinda why psychology has a massive problem right now, they can't recreate results of their experiments. We aren't trying to find streaky baseball player's batting average here.
Okay, let's check those 41 studies in that meta-analysis out with a histogram of vit D rate constant (nmol / L), shall we:

0.0 - 2 : *****
2.1 - 4 : *********
4.1 - 6 : **********
6.1 - 8 : *******
8.1 - 10: *****
10+ : ***

So, exactly the sort of Gaussian distribution you think it should show. It is thus ironic for you to mention finding streaky batting runs, because that's exactly the sort of error you have made here, creating the illusion of a data pattern that doesn't exist in reality.
 

Silvanus

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When you're trying to find out how much does X raise something, having basically half the results being at the upper outlier and the other half being at the lower outlier, just maybe something isn't right? You should have a decent grouping around the average point with a few upper and lower outliers to be expect, not the other way around. Science kinda requires repeating experiments and getting the same/similar results, not getting 2 different groups of results and saying the point between them is the answer.
An average isn't an "answer". Its an average. If people are misinterpreting the average as some kind of "final answer", that's their mistake.

If you have a lot of data points significantly above the average and a lot significantly below, all that indicates is that the data has a wide distribution-- and thus that the phenomena can have very divergent effects. That happens with plenty of natural phenomena.

The takeaway from this should be that we need to plan for wide outliers, because they're relatively common.
 
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Phoenixmgs

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Oh, but it has. Your complaint here is nothing more and nothing less than you don't like the answer they came out with, and you don't want to accept the vast weight of scientific literature they use to justify their conclusions.

I think they made an estimation with the relatively primitive tools available to them at the time, and it turns out to be a decent estimation. Much like some astronomer 2000+ years ago worked out the circumference of the world to an accuracy only ~5-20% off - depending on which source you follow for his figures - from what we measure it at now.
Because they didn't come up with an answer, they are basically just like "if it's not broke (no one got rickets), don't fix it" when we have so much data on this pandemic alone to show people need more vitamin d.

Here's what the most cited scientist in the field has said about vitamin d.

Vitamin D levels are inadequate in 70% of the United States population. Almost all dark-skinned people residing in northern latitudes are particularly deficient. Vitamin D was long considered responsible only for protecting against rickets, but it has now been shown to be involved in a myriad of functions. A cholesterol derivative, 7-dehydro-cholesterol, is converted by UV light to a precursor of vitamin D steroid hormone. Then the final steroid hormone binds to a protein, the vitamin D receptor protein; the latter interacts with a 12-base regulatory sequence in vitamin D receptor-dependent genes and regulates them either in a positive or negative fashion. About 2,700 such binding sites have been found in the human genome as interacting with the vitamin D receptor protein. Extensive evidence shows that vitamin D deficiency causes—or has been associated with—a large number of diseases that affect healthy aging, such as all-cause mortality, cancer, cardiovascular disease (CVD), diabetes, brain function, and so forth. Considering this high level of deficiency and the important implications of vitamin D interactions, it is particularly important to tune up metabolism with respect to vitamin D. See SI Appendix, SI-3 Survival V/M That Are also Longevity V/M for the large literature on vitamin D clinical trials and Mendelian randomization studies.

Supplementation with vitamin D, which would prevent and relieve some of these problems, has been discouraged for two reasons: fear of toxicity (in older studies) and numerous inadequate clinical trials. Newer evidence on the effect of vitamin D on all-cause mortality supersedes these toxicity studies, concluding that there was no increased risk even when blood levels of 25(OH)D were as high as 100 ng/mL.

The use of randomized clinical trials (RCTs) for studying the effect of nutrients, as opposed to drug trials, can be subject to misinterpretation unless the level of the nutrient is measured both before supplementation starts and at its end. This precaution is necessary because many of the subjects may not be deficient in the nutrient being tested and the amount supplemented may be insufficient to raise levels adequately. The absence of such measurements can lead to erroneous negative results, as shown for various RCTs for vitamin D and as pointed out repeatedly in the nutrition literature. Many conclusions, both in medical journals and in books, that supplemental vitamins are ineffective in performing some function generally ascribed to them, should be taken skeptically if the RCT did not include measurements of the vitamin.

Thus, it is clear that vitamin D performs more than just its initially assigned function of maintaining bone health. It is important for a healthy long life, and thus it is a longevity vitamin.
Because you need more to raise the levels to 30ng/ml than 20ng/ml, obviously. Furthermore, that it is not a linear relationship between intake and plasma concentration; the higher the basal vit D, the more is needed to raise it a set amount.
I wasn't talking about raising to 30 ng/ml, I was talking about how 2,000 IUs a day doesn't even keep someone that is already at that level, at that level. And 30 ng/ml is not some super high level either.

The funny thing is, you are even cherry-picking by keeping bringing up that study to criticise me over, because it is ignoring all the other studies I have brought up or discussed across the course of the HCQ issue.

Let's remember you were citing a website with hundreds of studies that systematically misrepresented the research (where, re the above, I specifically addressed numerous papers). And even when I pointed this out to you, you have continued to make flagrantly false claims that nearly all the studies showed HCQ was beneficial.
I went over all your studies one by one right here:

And I'm the one cherry picking?

2 of your trials there are for very late-stage treatment that I was never saying HCQ will work for, we almost certainly know it doesn't and we know that's where you can get the bad cardiac side effects of the drug. Do you not recall when I said we aren't treating people for early covid and just wait until it gets bad? When is that ever a good way to treat anything? Taking something early on 1st symptoms or high risk exposure to reduce hospitalizations also reduces the strain on health care workers.

One of the other trials linked is for prophylaxis use, which I never claimed HCQ was something that will stop infections from happening. It's rather tall ask to ask any drug or treatment to STOP an infection from actually happening.

The last linked study has paragraphs of why the methods weren't the best, plus it was a study on people that were rather young and would be most likely fine if they did nothing.
 

Phoenixmgs

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Okay, let's check those 41 studies in that meta-analysis out with a histogram of vit D rate constant (nmol / L), shall we:

0.0 - 2 : *****
2.1 - 4 : *********
4.1 - 6 : **********
6.1 - 8 : *******
8.1 - 10: *****
10+ : ***

So, exactly the sort of Gaussian distribution you think it should show. It is thus ironic for you to mention finding streaky batting runs, because that's exactly the sort of error you have made here, creating the illusion of a data pattern that doesn't exist in reality.
Looking at the graph, 20 of the results I would say are outliers (basically half), which are 8 or higher or 3 and lower. You do have a whole other line of 7 results at ~7 as well, which is about 2 higher than the average (so ~40% higher, just doing basic 2/5 math, keeping it simple). Dr. Ames pointing out that vitamin RCTs are misinterpreted.

And average isn't an "answer". Its an average. If people are misinterpreting the average as some kind of "final answer", thats their mistake.

If you have a lot of data points significantly above the average and a lot significantly below, all that indicates is that the data has a wide distribution-- and thus that the phenomena can have very divergent effects. That happens with plenty of natural phenomena.

The takeaway from this should be that we need to plan for wide outliers, because they're relatively common.
Yes, that's the average. However, there shouldn't be so many outliers in determining such a thing. It's clear the studies were not all done to the same standards and processes.
 

Silvanus

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Yes, that's the average. However, there shouldn't be so many outliers in determining such a thing. It's clear the studies were not all done to the same standards and processes.
Why "shouldn't" there? Isn't it possible thats just how the data distribution falls?
 

Agema

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Looking at the graph, 20 of the results I would say are outliers (basically half), which are 8 or higher or 3 and lower. You do have a whole other line of 7 results at ~7 as well, which is about 2 higher than the average (so ~40% higher, just doing basic 2/5 math, keeping it simple). Dr. Ames pointing out that vitamin RCTs are misinterpreted.
Half the data were outliers? Do you understand what an outlier is? A fairly typical criteria for an outlier might be anything more than 2 standard deviations beyond the mean, because in science we're not allowed to take a look at the data and decide "I think I'll just ignore all the data points I feel like".

The average was 5.3. You don't even need to calculate that, the paper tells you. Never mind that the entire point of the paper is based on testing whether 2.5 or 5 is more accurate, and concluding the answer is 5.

I went over all your studies one by one right here:
If you're not competent enough to realise half the material you're citing is trash, you're not competent to usefully assess the material other people are citing either.