Vitamins
Evidence: strong_human
Vitamin D3 (cholecalciferol) is hydroxylated in the liver to 25(OH)D (calcidiol), then in the kidneys to 1,25(OH)2D (calcitriol), the active hormone. Calcitriol binds the nuclear vitamin D receptor (VDR), forming a heterodimer with RXR that regulates >1000 genes. Key actions: upregulation of intestinal calcium/phosphorus absorption (TRPV6, calbindin), modulation of innate immunity (cathelicidin LL-37 antimicrobial peptide production), suppression of adaptive immune overactivation (Th1/Th17 to Treg shift), regulation of PTH and osteocalcin for bone mineralization, and modulation of insulin secretion from beta cells.
Standard: 5000 IU daily (125 mcg)
Loading: 10,000 IU/day for 8-12 weeks to correct deficiency (<30 ng/mL), or 50,000 IU weekly under supervision
Maintenance: 2000-5000 IU/day (dose to maintain 25(OH)D at 50-80 ng/mL)
Administration: oralsublingual
Timing: With largest fat-containing meal of the day (fat-soluble). Morning preferred.
Duration: ongoing (lifelong for most people in northern latitudes)
ALWAYS co-supplement with Vitamin K2 (MK-7) to direct calcium to bones/teeth rather than soft tissues/arteries. Magnesium is required for D3 metabolism (4 of 8 enzymatic steps require Mg). Optimal blood level: 50-80 ng/mL (not just >30). Obese individuals require 2-3x higher doses due to sequestration in adipose tissue. Sun exposure produces D3 with a natural feedback mechanism that prevents toxicity — supplementation does not have this safeguard. Testing is mandatory before high-dose supplementation.
D3 (cholecalciferol) is superior to D2 (ergocalciferol) for raising and maintaining blood levels. Lanolin-derived is standard; lichen-derived available for vegans. Oil-based softgels preferred over tablets. Brands: Thorne D-5000, NatureWise, Bio-Tech Pharmacal (high-dose Rx). Test 25(OH)D blood levels quarterly until stable.
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