The Role of Vitamin D Deficiency in Thyroid Disorders | Chris Kresser

The Role of Vitamin D Deficiency in Thyroid Disorders

by Chris Kresser

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This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.

Note: This will be my last post until the end of August. My wife and I are going up to the Sierras to hike and soak in the hot springs for a few days before the big acupuncture licensing exam next Tuesday. The day after that we head to southern Mexico to surf and relax on the beach for a couple of weeks.

I won’t have time to respond to comments while I’m away, but please do leave them and I’ll answer when I come back. I’ve got a few more articles in the thyroid series, and next up after that will be type 2 diabetes & metabolic syndrome. Have a great August!

Vitamin D is all the rage. It seems like every day another article is published in medical journals or the mainstream press about the dangers of vitamin D deficiency, and the benefits of supplementation. In this article we’re going to discuss the impacts of vitamin D on thyroid physiology and wade into the increasingly murky topic of vitamin D supplementation – specifically as it relates to thyroid disorders.

Vitamin D deficiency has been associated with numerous autoimmune diseases in the scientific literature. Vitamin D plays an important role in balancing the Th1 (cell-mediated) and Th2 (humoral) arms of the immune system. It does this by influencing T-regulatory (Th3) cells, which govern the expression and differentiation of Th1 and Th2 cells.

Vitamin D deficiency is also specifically associated with autoimmune thyroid disease (AITD), and has been shown to benefit autoimmune-mediated thyroid dysfunction.

Vitamin D has another little-known role. It regulates insulin secretion and sensitivity and balances blood sugar. This recent paper showed that vitamin D deficiency is associated with insulin resistance. And as we saw in a previous article, insulin resistance and dysglyemcia adversely affect thyroid physiology in several ways.

“Okay, big deal,” you say. “I’ll just take vitamin D supplements or get more sun.”

Not so fast. Research over the past two decades has identified a variety of mechanisms that reduce the absorption, production and biologic activity of vitamin D in the body.

  • Since vitamin D is absorbed in the small intestine, a leaky and inflamed GI tract – which is extremely common in people with low thyroid function – reduces the absorption of vitamin D.
  • High cortisol levels (caused by stress or medications like steroids) are associated with lower vitamin D levels. They synthesis of active vitamin D from sunlight depends on cholesterol. Stress hormones are also made from cholesterol. When the body is in an active stress response, most of the cholesterol is used to make cortisol and not enough is left over for vitamin D production.
  • Obesity reduces the biologic activity of vitamin D. Obese people have lower serum levels of vitamin D because it gets taken up by fat cells.
  • Not eating enough fat or not digesting fat properly reduces absorption of vitamin D. Vitamin D is a fat-soluble vitamin, which means it requires fat to be absorbed. People on low-fat diets, and people with conditions that impair fat absorption (like IBS, IBD, gall bladder or liver disease) are more likely to have low levels of vitamin D.
  • A variety of drugs reduce absorption or biologic activity of vitamin D. Unfortunately, these include drugs that are among the most popular and frequently prescribed – including antacids, replacement hormones, corticosteroids, anticoagulants and blood thinners.
  • Aging reduces the conversion of sunlight to vitamin D becomes.
  • Inflammation of any type reduces the utilization of vitamin D.

“Okay, fine,” you say. “I’ll just get my vitamin D measured, and if it’s low, I’ll take supplements.”

If only it were that simple. We now know that certain people with normal serum levels of vitamin D still suffer from deficiency symptoms. How is this possible?

In order for circulating vitamin D to perform its functions, it must first activate the vitamin D receptor (VDR). The problem is that many people with autoimmune disease have a genetic polymorphism that affects the expression and activation of the VDR and thus reduces the biologic activity of vitamin D. Studies have shown that a significant number of patients with autoimmune Hashimoto’s disease have VDR polymorphisms.

In plain English, here’s what this means: if you have low thyroid function, you might be experiencing vitamin D deficiency even if your blood levels of vitamin D are normal. It also means that, if you have a VDR polymorphism, it’s likely you’ll need to have higher than normal blood levels of vitamin D to avoid the effects of vitamin D deficiency.

“Okay, I get it,” you say. “I may need higher vitamin D levels than the average person if I have one of those genetic defects. So tell me what my levels should be!”

Well, this is where we venture into murky territory. The question of how high vitamin D levels should be is very difficult to answer in the case of someone with autoimmune thyroid disease. Studies suggest the optimal 25(OH)D level is 35 ng/mL for the average person. Some researchers (notably Dr. John Cannell and colleagues at the Vitamin D Council) have suggested that 50 ng/mL should be the minimum level.

The bulk of the evidence, however, doesn’t support that claim. For starters, the other authors of the study Dr. Cannell used as the basis for his 50 ng/mL recommendation came to a very different conclusion from the same data. In the paper they published in the American Journal of Clinical Nutrition, they wrote that their data confirmed the previously acknowledged optimal level of 35 ng/mL – not the 50 ng/mL suggested by Dr. Cannell.

What’s more, some recent studies have shown that higher isn’t better when it comes to vitamin D. A study in the American Journal of Medicine found that, in most people, maximum bone density occurs at 25(OH)D levels between 32-40 ng/mL. When levels are pushed above 45 ng/mL, as recommended by Dr. Cannell, bone density starts to decrease. Another study published in the European Journal of Epidemiology found that South Indians 25(OH)D levels above 89 ng/mL were three times more likely to have suffered from heart disease than those with lower levels.

If you’ve been following this blog for a while, you know that we don’t put too much faith in epidemiological studies. They don’t prove causation. They only show a relationship between two variables. But the relationship of vitamin D to calcium levels also provides a plausible mechanism by which high 25(OH)D levels could increase the risk of heart disease.

Complicating the matter further, recent work by researcher Chris Masterjohn suggests that the harmful effects of vitamin D toxicity are at least in part caused by a corresponding deficiency in vitamins A & K2. The fat-soluble vitamins A, D & K2 work synergistically, as Masterjohn has described in his Cod Liver Oil Debate article and a recently published scientific paper.

Masterjohn’s hypothesis, which has been confirmed by others, raises the possibility that the higher levels of 25(OH)D that were linked with lower bone density and heart disease may be safe if vitamin A & K2 levels are sufficient. Unfortunately, there is no clinical evidence (that I’m aware of) that helps us to answer this question.

“Okay, okay,” you say. “Just tell me how much to take already!”

I wish it were easier to answer this question. Really, I do. I think about it a lot for my own patients.

The research is clear that 35 ng/mL is the minimum level for optimum function for healthy people. But people with autoimmune thyroid conditions aren’t healthy.

They often have GI disorders, inflammation, stress, excess weight, VDR polymorphisms and other factors that impair their production, absorption and utilization of vitamin D. This suggests that the minimum 25(OH)D level for those with AITD may be significantly higher than for healthy people.

My current approach with these patients is to do a cautious trial of raising their serum levels to a range of 60-70 ng/mL. If their symptoms improve at this level, I will then switch them to a maintenance dose while watching for clinical signs of vitamin D toxicity. These include kidney stones (also a sign of vitamin K2 deficiency), low appetite, nausea, vomiting, thirst, excessive urination, weakness and nervousness. I will also monitor serum calcium levels, because elevated calcium in the blood is a sign of vitamin D toxicity and a significant risk factor for cardiovascular disease (especially in the presence of vitamin K2 deficiency). Calcium levels above 11-12 mg/dL (or 2.8-3 mmol/L) are indicative of vitamin D toxicity.

I will also make sure these patients are getting adequate amounts of vitamin K2 and vitamin A in their diets. Sources of vitamin A include organ meats, cod liver oil and full-fat milk and cream from grass-fed cows. Sources of vitamin K2 include fermented foods like natto, hard cheeses and kefir as well as egg yolks and butter from grass-fed cows. I may also use a vitamin K2 supplement (MK-4/MK-7 combo) if patients can’t tolerate fermented foods.

Finally, if you’re interested in finding out if you have a VDR polymorphism that could be affecting your metabolism of vitamin D, Genova Diagnostics has an Osteogenomics panel that tests for them. I’m not sure how much value this test has clinically, however, since it doesn’t provide any information about how the VDR polymorphism affects vitamin D metabolism in each specific case. That’s still something that would have to be figured out using the “trial and error” process I described above.

In time we can hope that the explosion of research being conducted on vitamin D will lead to more clarity on the question of appropriate serum 25(OH)D levels for people with autoimmune diseases. For now, we have to make our best guess based on clinical results and anecdotal reports.


Join the conversation

  1. Ever since I had a thyroidectomy (Full due to cancer), I have had issues with low Vitamin D. Is it related?

    My tests have hovered between 20 – 30 and according to Kaiser the recommended is 30 – 100 which seem like a huge range. I have read to shoot for the 80 range. Even while taking 50,000 D2 every week, I can’t increase my D levels.

    Any ideas?
    Symptoms: Teeth become very sensitive that it hurts to brush my teeth, fatigue easily.

    • I live in CA where we have plenty of sun but I do wear sunblock and usually try to stay covered up. I have read Food and sun aren’t ever enough to increase your D. Maybe I need to increase my 50,000 a week dosage? I’m curious what is causing this. Is it because they removed my thyroid? My Endo says no its not related.

  2. very interesting read !
    im 25 and have suffered from thyroid symptoms for many many years its only the past year the doctors have decided to do something, i dont have my levels to hand but im currently on 100mcg of levothyroxine and have been for the past 5 months nearly (i did 4 months on 50mcg before hand) iv never seen an endo and after 9months they have only just gave me a leaflet explaining things …. didnt really tell me much like but iv also been on vit d for 11 months now (they have just upped my dosage amount im on my 4th course of 3 month treatment (got 1 1/2 months left) when i questioned it they said oo everyone gets low over the winter and when i said iv been on it for over 9 months i got no response ….. do you have any idea as to why after so long my level still isnt okay ?

    • Hello fellow thyroid sufferers,
      My experience with thyroid has been i have no thyroid gland for nearly 30 years. ( Partial thyroidectomy then auto immune destroyed remainder ) My experience with endocrinologists has been dreadful, waste of time.
      I have suffered chronic fatigue for nearly 30 years, but at long long last, i have remedied it. Firstly vit d3, more by accident.
      We in the UK measure nm/ml, as apposed to your ng/ml. Simple, multiply ng by 2.5 and you get nm. So one of your reports, Chris C, reports 109 ng, that is 272 nm/ml. Maybe causing excess calcium in blood. I run at about 200 nm/ml. I’ve read that 300nm/ml is beginning of toxic.
      Yes, that’s high, whether that’s toxic or not, but yes high. I’ve seen reports that lifeguards run at 250nm/ml, so maybe not. It does appear that exposure to UVA, which does not make vit d, ( UVB does ) this eliminates excess D, but i’ve also seen that excess D via supplements does not normalise so easy in UVA. One aspect of vit d supplements, we should take vit K2, to prevent excess calcium going into blood, not good, you want it in your bones. The chronic fatigue, and i suspect balance of hormones, unbalanced i suspect when thyroid excess or deficiency, i take DHEA, Swanson Ultra, 100mgs x 10 daily. Yes a high dose, but it works, also increases metabolism and lost about 20 pounds. I also add Swanson Ultra Pregnenolone, 50mgs x2, all 1st thing in morning, ( good to balance ant excess eostogen, good for men and women i believe,brilliant, i now play football and no longer have massive fatigue. Lots pro and against such a regime, i also cured, yes cured Colitis of 6 years standing, by adding L Tryptophan powder. Yes i take a lot of supplements, but i now have quality in my life, i’m 67 years old, feel 50.
      When the so called medical experts screw up like this, i took the responsibility for myself, and it works, all natural, no drugs, it may be a gamble, but so is very poor health, which i no longer have. I call it, suck it ans see!
      Good luck

    • They say Green is life. I have tested that theory. I was diagnos with graves disease, in other words thyroid disease, at age 23. I am now 28 and i’ve been off meds for 2 yrs now. I smoke Marijuana 1 or 2 times a MONTH. This has helped me for the past 2 1/2 yrs. GREEN = LIFE

  3. I have been taking levothyroxine ever since i was 22 and I am 34 now. Just recently I have found out from blood test that I have Vitamin B12 and Vitamin D3 deficiency. When I took My vitamin b supplement, vitamin d and levothroxine together, I had bad constipation and headache. So I called up my pharmacist and she told me never to take any medicine together especially when you have any kind of complication. I also googled and found out this site that talks about it, So guyz, Listen and feel your body, Don’t just blindly follow everyone. Now Today I feel much better.

  4. I had a tsh and vit d drawn my tsh was .391 and my vitamin d was 11.1 we waited 6 weeks and redrew it and my tsh is now normal at 1.18 and my vit d is now 9.8. we initially thought that my vit d was lower due to night shift, but now I’m on night shift. Im just wondering what is going on with my body. I’m extremely tired a lot and I’ve gained a massive amount of weight in the last year…

    • Candace, if you ever find out please let me know. I am tired constantly and my general practitioner just says lose weight, lose weight……I would exercise and did exercise just too tired to move now.

      • Something to think about-if you are constantly drop dead tired, you might have a CMV virus like I did which acts like mono. Check your iodine levels and supplement if low. Also, I took lysine, 500 mg twice a day for the viral issue.

    • Just curious if you have had your other thyroid levels checked? T3s and T4s?
      If I had a Th of over 1.0–I would be symptomatic with hypothyroid. Please make sure your endo is performing all thyroid panels/ antibodies and not just TSH.

      • Yes, he does. This is first time this Endo has ordered a Vit D level. I have had a parathyroidectomy (one gland) back in 2011 and around 2012 is since I have had this extreme tiredness and fatigue. In March my calcium level was slightly elevated but was back to normal thus last visit in July. He’s done TSH, t3 t4 and it’s an Endo I see but it’s an office of endocrinologist and thyroid center, just recently added the thyroid center to the name.
        I feel as if I am viewed as lazy due to my obesity and that is so not the case.

        • Hi Elaine.
          I know the feeling. I had the same thing!! It is awful when they blame your weight. I had a baby and had gained 60 pounds. Little did I know my thyroid had completely crashed! I could not lose the weight for anything and was absolutely exhausted ie could barely drag myself up the stairs. Awful I thought I was dying.
          Do not let them tell you it’s YOU being fat and lazy. You know when something is wrong with your body! I was still incredibly symptomatic (depression, hair loss, plantar fasciitis, joint pain, hip pain, brain fog, weight gain all with a “normal” level of thyroid hormones. But had extremely low ( but in range) t4 and t3. I take 5 grains of armour a day now and Vitamin d in winter. I try to eat a lot of iron
          I beg you and Candace to find an endo/ naturopathic that will treat your symptoms and not just your tests…. We are being kept sick by unknowledgable doctors ( including endocrinologists) that think we are lazy…I have now lost 40 pounds since taking armour. I hope you can begin to feel better.

          • Hi I’m researching endocrinologist/naturopath gp’s for an under active thryroid but struggling to find one; do you know of any? I did have a referral to an NHS endocrinologist but he has refused to see mr unless I take levothyroxine first. I want to know if there’s another more natural route? Look forward to hearing from you.

            • Hi Jeanette
              Thyroid UK can provide you with a list. I haven’t yet been down that road, although I do have that list. I think it is good you are exploring that route first. Best wishes, Clare

          • I’ve had chronic fatigue, massive daunting chronic fatigue for nearly 30 years, since thyroid opp.
            I now and haven’t had a thyroid gland for most of this time.
            I’ve helped it some by using adrenal supplements 3-4 times a day. Last 18 months, no adrenals just DHEA, brilliant, Swanson DHEA Ultra 100mgs, 8, yes 8 a day, first thing in morning only, plus 150mgs Pregnenolone. Lost weight, no more fatigue, i play walking football, got my life back. Delroy Colbert is on You Tube on DHEA, basically saying can’t hurt you, i am taking 8 times recommended dose, very cheap , very effective.
            Reduces cholesterol, tones muscles, it’s made of Yam, non patent able by pharmaceutical companies. So invariable put down, but brilliant.
            if i reduce, less energy, so i stay on 800mg.
            I do use ERFA thyroid, used to use Armour, got fed up with inconsistent supply.Pharmaceuticals trying to block supply again.
            Wicked world we live in, trying to stop people getting well, for profit. Hell will be standing room only! I’m known as a grumpy old git, is it a wonder.

    • In reading a lot of the situations I too are tired, no energy fatigued, and agreed with the doctors to chemically remove my hyper thryoid was probably the best thing to do, now I totally disagree, I believe the medical field of physians have this mentality that totally removing the thryoid is the thing to do, mine was not cancerous, just plan old overactive, I believe that keeping what you have and regulating it is a whole lot better, so far I have been able to keep my job with GODS grace and a good understanding from where I work, This was something I felt I needed to mention and hope this will help someone else, so I feel that if someone is about to have their thryoid removed and don’t need to think and be the last resort before doing this Thanks

  5. I have Hashinoto,s Thyroididis diagnosed in 20o4 .I have been on 25 micrograms of Levothyroxine since. i was also taking Crestor Statins. A few years later blood tests before a hip replacement revealed Vit D deficiency and osteopenia in my lower spine. I took high dose vit d and levels went up. A year later they had dropped again. i blamed the statins and stopped taking them. Took high dose Vit D over 3 month period, levels up. A year later deficient again. I have heard that the drug company warn of bone loss with long term use of Levothyroxin. Is it interfering with the absorption or production of Vit D from food and sunlight? I am awaiting a bone density scan. PS I lived in the south of France for some of these years and have a very good diet.

  6. I have Hashinoto,s Thyroididis diagnosed in 20o4 .I have been on 25 micrograms of Levothyroxine since. i was also taking Crestor Statins. A few years later blood tests before a hip replacement revealed Vit D deficiency and osteopenia in my lower spine. I took high dose vit d and levels went up. A year later they had dropped again. i blamed the statins and stopped taking them. Took high dose Vit D over 3 month period, levels up. A year later deficient again. The drug company warn of bone loss with long term use of Levothyroxin. Is it interfering with the absorption or production of Vit D from food and sunlight? I am awaiting a bone density scan. PS I lived in the south of France for some of these years and have a very good diet.

  7. My daughter is 11 and her ferritin Level is 4
    Her haemoglobin was 9.1 now back up to 11
    But after doing more bloods they have told me her thyroid is 15.7 her b12 is 134 and her vitamin d is 24
    What does this all mean
    She hasn’t been to school for nearly 6 months she sleeps all the time has massive mood swings and fatigue
    Lost loads and loads of weight and she was like a bean pole anyway
    Waiting on a paediatrician at the moment

    • Was the thyroid hormone that was tested TSH? If so, 15.7 could indicate hypothyroidism. Many people feel that TSH isn’t a very good indicator of thyroid health and recommend testing T3 and T4 levels. You will have to specifically ask for these tests but it sounds like it would be a good idea in your situation.

      She sounds like she has hypothyroidism, which many doctors do not thoroughly screen for in teenagers. I became hypothyroid in my teens and it wasn’t diagnosed until many years later. That is not the optimal way to go, so you may need to find another doctor for your daughter.

      Good luck!

    • Interested in your comment about your daughter. What do you mean her thyroid is 15.7? Is that TSH? That is a very high number. TSH should not be used to diagnosis but anything over 3.0 ( and by most educated endos 2.0) is suggestive of hypothyroidism. Before I was diagnosed hypo mine was 5.5 and I could barely function- I thought I was dying. Seriously.
      Your daughters fatigue and very low vitamin d should be investigated these are both indicative of thyroid disease/ dysfunction. Under 30 is deficient. You should ask your pediatrician to test her for the following : free T3, free T4, reverse t3, t3 uptake, thyroid antibodies( test for hashis). For most people with hypo to feel good -their free T3 is in the upper levels of the ” normal range”.
      Please do not take no for an answer. Find someone that will do these tests and understand t3 and t4. If levels are in low normal range and she is symptomatic she is hypo. Find a doc that prescribes natural desicated thyroid for replacement therapy. Do not accept t4 only synthetics ( synthroid) . Been there done that. Believe me. She will get better. Best of luck. It must be really hard. There are many great resources out there for thyroid issues, most docs are not educated, including endos. You can order your own tests, too.

    • have her B12 checked that was what was wrong with my 13 year old daughter, she wanted to sleep all the time had heart racing and would pass out , they wanted to put her on heart meds and one Doctor said have the heart Doc checked her vit B 12 levels i said I do not think so, so he checked her’s and it was so low and she also had eye vision lose also. So please check out B12 there is so many things it can do to our bodys when we are low in it . She has to have a shot .

  8. I would like to add that I spend many hours outside during the spring/summer/fall season. This vitamin D issue is also confusing to me.

  9. Hi,
    I have been on levothyroxine since 1992 for hashimotos/hypothyroid. As of about 5 years ago, my thyroid blood work started coming back that I was taking too much, then they would lower the dose over a 9 month period, which was not fun. Then, 6 months later, too low, so they raised it back up, then too high, etc. , etc. eventually leading to a vitamin D test, which came back that I was deficient and I was put on 50,000 units once a week for a month, then a few weeks later the test came back fine. I had been concerned already that there was no explanation for the thyroid hormone test results all over the place so I went to an endocrinologist. He ran tests, said my vitamin D level was 35, but he wanted it higher and wanted me to take his special vitamins at $30/month and take Lipo lyte injections (which are for weight loss – I am 5’3″. 122lbs). I quit going to him. I recently had both the thyroid and vitamin D tests and again, they lowered the thyroid hormone dose, and I’m back on 50,000 units of vitamin D, but this time it’s vitamin D2 not D3. I’m concerned that someone needs to find the cause for the out of control thyroid hormone after almost 20 years of the acceptable results on the same dose. Is it all about age?

    • I am a Naturopath Dr. I believe that thyroid is all about having a clean gallbladder. When fats and protein can not be digested via the gallbladder then the Vit D numbers go down. One can begin cleaning the gallbladder by eating organic apples, apple sauce and introducing almond butter as the main protein to eat.
      A great way to clean the gallbladder, which is a porous bow tie shaped gland that is housing the parathyroids (Vit D,) is to look up oil pulling and clean the thyroid by swishing the oil, never swallowing it. I believe in flushing the gallbladder with old fashioned cleanses. These cleanses have been around for a long while. A working gallbladder with clear and clean bile ducts, (the vitamin Choline helps clean bile ducts.) equals a sharp receptive thyroid. I should know. I became a doctor to have a baby because my thyroid was flat not producing TSH. My baby is 21 years old and my one fourth of a thyroid and one parathyroid is working perfectly without medicine.

      • Hello. What if you don’t have a gallbladder? Is it the same protocol? What would you recommend? Thank you.

      • Sherry, the thyroid doesn’t make TSH, TSH is what regulates the (healthy) thyroid and is produced by the pituitary.

      • The gallbladder does not contain the parathyroids … they are inside of the thyroid, which is in fact bowtie or butterfly-shaped (the gall bladder is not). And TSH is a pituitary hormone that signals the thyroid to produce t4.

      • The gallbladder is a porous bow tie shaped gland that houses the parathyroid? I hope this was a mistake because if not you are a scary Doctor. The gallbladder is no where near the parathyroid glands.

        • I couldn’t believe I was reading that! Whomever monitors this site needs to delete that crazy answer. No way she is a legit naturopath Dr.! And you’re right, if she IS, then that is scary and I fear for any patients she may acquire!

  10. Im happy i found this article!
    I have hypothyroidism for 23 years & struggle with Low Vitamin D the past year. My Dr wants me to take 50,000 iu
    of compounded Vitamin D 1x a week for 12 weeks. I’m starting to rethink this after reading that vitamin K2 can help absorb it.
    I’ve been taking 5,000 iu daily with no vitamin K2 & wondering if I should start there. My D total was 32.8

  11. First of all, this is an excellent article.

    I have the same problem as reported in the article. My vitamin D levels drop very rapidly as soon as stop the intake of medicine, possibly due to hypothyroidism. The question is should I be taking Vitamin D medicines all my life or is there another way out?

    • In order to keep Vitamin D levels up you either need to get sunlight exposure or take Vit D3 or maybe both. After a person gets to optimal D3 levels some folks opt to get plenty of sunlight in summer and then take a supplement in winter depending of course on the climate where you live. Also research the role of cholesterol in the conversion of Vit D.

    • True but u must understand that due to low vitamin D u have thyoride …just focus ur vitamin D …I am sure u don’t take need medicine of thyoride ..its my personal experience…..

  12. I`ve been recently diagnosed with Iron deficiency and vitD deficiency and I`m on heavy monthly periods of 5 days per month, which I think makes my deficiency even worse. Thanx for your article and comments.

    • Iron anemia will prevent you from converting T4 into T3. Few hypothyroid people or their doctors know this. Both conditions have similar symptoms such as hair loss and fatigue so many times people blame their thyroid when what they need is to increase iron intake and not increase their thyroid meds.

    • Hi Mimi,

      Try taking a sublingual B12 METHYLcobalamin supplement of 5000 micrograms. I take Natural Factors that I buy on Chris also has a page on B12 deficiency that you should look at.

      • AnnF
        Be careful with the B12. I found out I’m D deficient & when I did, I found out that my B12 was extremely high from taking to much supplements. I was taking them thinking that I was in need of B12 because I was so tired. Instead, after seeing a doctor to get blood work because I was still so exhausted, I found out my vitamin D levels are extremely low & my B12 was extremely high. I still need to go back to get my thyroid checked. Supplements are not always the answer. It’s just best to get some blood drawn & find out for sure what the real issues are. God luck.

        • Hi, what form of b12 do you take? If it is cyanocobalamin ( in most supplements) some people cant covert this and it builds up in blood. Try taking a methlcobalamin, or a b complex with methyl- b vitamins.

  13. A nutritionist just told me the other day that high vitamin D levels negatively effect thyroid function in people who are hypothyroid. Do you have any idea where this idea is coming from? are there any situations where this might be true?
    I’m one of those with a fairly high vitamin D need due to poor immune function, chronic infections and inflammation, high cortisol, poor absorption and dysbiosis. I also take Cod liver oil and she said I should take fish oil instead. If I took fish oil, I probably would run into trouble with the 5,000 IU I take daily. I maintain my levels between 80-90 ng/ml. My serum calcium is within optimal levels.

    • Hi Rosanna,
      Ugh! Don’t take fish oil! There are a lot of problems with it. Stay with good old Cod Liver Oil. Just about everyone in the world takes Cod Liver Oil. I have been taking Carlson that I buy from It is not in capsule form, but you know, it really isn’t bad, and doesn’t repeat on me. (BTW, I don’t work for, I just buy a lot of stuff from there. A LOT of stuff.). If your levels are too high, ditch the D3 supplement. I think that your absorption rate is actually pretty high, but your cells might not actually be able to use it.

      I think maybe you should have some genetic testing done to see if there is something wrong there. I have been having increasing problems over the years, and now I have hyperthyroidism. I am definitly going to heve genetic testing done…just as soon as I find out where, how, and which.

  14. Hi am 32yrs old i did write on here before as got a underactive thyroid then got diagonized with vitamin b12 defincency and vitamin d and had ask if my thyroid had caused theses now they think i might have also autoamine hepertits i dont know really how much more i can take i seem to be getting more and more defincency dont know what to do ? Do you think my thyroid caused all this or my body just nature falling apart thanks

    • Hi Lisa,

      How much Vtamin B12 are you taking? A lot can happen to B12 in your body beforeyou can use it. I think you should switch doctors. Autoimmune hepatitis? Give me a break. Get a genetic test done and see what’s what. I mean, there could be something wrong with your liver, but if there is, it is more than likely a genetic malfunction. One vitamin deficiency, especially B12, can cause others. It can also cause ALL kinds of problems, some of which never really go away.

      On Chris’ B12 page, I wrote a list of supplements I have been taking, and except for my apparent recent hypothyroidism — I just was told today — I have been feeling pretty good. I also added B2 recently.

  15. I have had hypothyroidism for 32 years. Even with the synthroid I have not had any increase in energy and my weight has gone up even though I am as physically active as I can be. Three years ago I was put on B12 injections weekly and continued that until a couple months ago when it finally showed up normal so I am now trying once a week. Also when the b12 came back good my vitamin D was very deficient (9). I have been taking very high doses of Vitamin D weekly for over a month and I am still very very tired, sleepless, my skin is horribly dry, my depression is back full force and I also have anxiety and sometimes panic attacks. I am at my wits end. Oh yeah, and last fall I found out my thyroid is completely covered in nodules. No surgery is recommended at this point but it may be in the future. HELP!! I need some energy. I work 5-6 days a week for the USPS so I need some stamina!

    • I was on synthroid, eltroxin, levothyroxine for 30 years, no change in horrible fatigue and itchy skin, always zonked out. I switched to dessicated thyroid almost a year ago with amazing difference after about 2 months and a few dose increases. Get off synthetic thyroid replacement which your cells do not properly know how to absorb (thus the reason you never feel better) and use dessicated. I wish people/doctors would talk more about dessicated but it’s cheap and can’t be patented so pharmaceuticals never mention it anymore. 🙂 hope that helps

    • Dear Wanda,

      Be careful supplementing with Vitamin d3 and having thyroid.
      After supplementing with Vitamin d3 i crashed and felt better and recovered after i stopped supplementing.Sunlight gave me no problems.

      • I work 6 days a week and getting out into the sunlight is a big problem. I do try to get out on Sundays but it doesn’t seem to be enough. I am now on natural thyroid (switched 2 weeks ago). I am hoping and praying this will help me with my issues. I am at my wits end with all of this. I just want to feel like doing something. My husbie and I enjoy dancing and with the tiredness and pain associated with all my issues I just don’t feel like dancing more than one or two dances a night. I just don’t enjoy much of anything anymore. I do my best to smile and go on but it is getting very hard. I was diagnosed with hypothyroidism at the age of 14 and it has been an ongoing problem. I am now 46. I just want to enjoy life.

        • You might need to prioritize. All you really need is 20 minutes of sunlight to generate the vitamin D your body needs for the day and you can get that even if you work. Walk for lunch. There is some evidence to suggest that sitting in artificial/work light all day further depletes the body of vitamin D so if that is true, sunlight is needed even more.

          • Well, not so much artificial light as fluorescent light. Unfurtunately, Congress is trying to phase out incandescent bulbs, which really don’t cause problems. Thanks, Congress.

          • Individuals with dark skin need more time in the sun at least 30 minutes or more. I have recently read that placing mushrooms in the sun increases the Vit D that is absorbed when you eat them.

        • I need advise. I have always been healthy. I am not a large person. When I went for routine blood tests a yr ago,my vitimam d level was 15 calicum normal.dr put me on 50000 units of d for 3 months. Then 2000 units. It did not take to it al very wel,butI did it as told. When I went back to see this dr I asked him if I needed it checked again answer no. He said I am sure your levels are fine now. That was a yr ago. This past May I went to a new dr hedid routine blood tests. My calicum levels were vey high vitiamin d also more follow up same bloodwork following month. Calicum high, d high. Again rechec followig month cal cium higher vitiman d low. This dr did a pth and it was very high. I have been diagonsed with primary hyperparathyroidism. My question could all that vitiman d that I took have caused this? Thanks

    • Wanda – I’ve been hypo for 15 years and here’s some things we’ve figured out that helped me feel better (both of my parents are hypo). If you have some control over your schedule, get up at the same time* every morning and take your medication, natural or not, with one full glass of water, and then GO BACK TO BED FOR AN HOUR. If you have a lot of time allowed in your morning, eat breakfast after that hour and then sleep for one more hour. (I cannot always do this but it helps a lot on vacation.) That hour of sleep after the medication will not feel very heavy; if you can manage the hour after breakfast, it may feel like the best sleep you’ve ever had.
      *This may mean you get up at 5 a.m. to take a pill. It’s fine.

      Then get up, do your stuff, and at least 3 to 4 hours later, eat lunch and take all your vitamins or supplements; I’m on 1 little tab of D3 at 2000 IU (but I’m lab-tested deficient, don’t overdo this), 600 mg of Calcium that also has another 400 IU of D3 (you may need more or less Calcium than I do; I’m 35), and a super B complex plus C that helps with the depressed feelings (I’m not clinically depressed but you do feel sad about having low energy, right?). Take those with food and get some sun for 10 or 15 minutes at the same time.

      Enjoy the rest of your day doing whatever you want, then go to sleep at the same time every night.

      I hope this helps!

    • Hi Wanda,

      The thyroid specialist should really have a look at you. Meanwhile, coconut oil, ginger, raw garlic, turmeric, pumpkins, brazilian nuts, plenty of fish (fish with limited exposure to toxins ie mercure), blackcurrent juice should provide some reliefs for a hypothyroid. Google the food you want to eat to check its effect on the thyroid, some foods decreasing the thyroid activity.

    • Please read the book, Jennifer’s Way. I just finished it, and found that there is a connection between low functioning thyroid, Vitamin D, and other issues based on silent celiac disease (where you have neurological symptoms or none at all). Your intestines are damaged and you can’t absorb nutrients like vitamins, etc. The damage from gluten is not a fad, it is a serious issue.

  16. I appreciate the article. I was concerned by your statement about epidemiological studies and lack of ability to assess causality. There are a myriad of different types of epidemiological studies. Studies on prevalence and correlation where the risk factors and outcomes are assessed simultaneously can only identify correlations and do not elucidate causality. However prospective studies where the risk factors are assessed at baseline and patients are followed to track a specific outcome can in fact shed light on causality. Any study that evaluates the impact of an exposure on a subsequent outcome has the potential to quantify causality. Of course you always have an issue of whether all co founders have been captured but this is a separate issue to address. Epidemiological studies can assess causality.

  17. I am a 28 year old woman with 2 kids.. The problem I have is a fast heart rate, excessive sweating, no appetite, weight loss, and a couple other problems… I had my thyroid checked and results came back multi nodular goiter .. So my levels were checked but they are normal.. What is wrong with me.. Oh yea I have no sex drive or pleasure when I have sex it’s like no feeling.. Please help.. I’ve told all of this to my doctor but they said I’m normal..

    • Have you had your adrenals or estrogen levels checked? I assume not by reading your post. These 2 things can cause excessive sweating with higher heart rate along with other symptoms.. Seeing that you also have orgasm issues I would see a ob/gyn get your hormones checked. I am thinking definitely a estrogen problem. If your dr won’t listen to you find another who will.

      • Excessive sweating can be from progesterone being too low. It can also be from having a hypoglycemic episode or from not consuming enough electrolytes.

    • Hey! I have hypothyroidism, and I’m having some of the same issues you are. Get a copy of your results, and go see a specialists. The specialist I was seeing, said someone around the age of 25 should have TSH levels around 1.25 not 3. 3 is normal range for those that are older.

    • get rechecked. sometimes the levels are not accurate. do it a few times within several months. you can be hypothyroid and not have the levels show up. also iodine deficiency might be part of it.

    • you should go and see a holistic dr. There are so many test that need to be done to diterman thyroid function and if your dr isn’t doing all of them then you’ll never know if your thyroid is functioning normally or not.
      It sound to me like you have hyperthyroid.
      Go see an other dr. And just remember your body knows how to make a human ( your baby’s) it will know how to heal it self too…
      You just need to find out what you need to change in yor diet or add on supliments
      God be with you! Xx

    • Please see an endocrinologist AGAIN! I went 5 years with tests reading normal until I visited the 3rd endocrinologist and he recognized I had all the symptoms, but my results were reading within range. They were on the higher range. I finally had radiation therapy and I’m doing fine after determining the right dosage of levothroxine. Please don’t stop until you are diagnosed.

    • What you have described is explained by Dr. Brownstein, MD in his book titled, Iodine – Why You Need it and Can’t Live Without it. I recommend you become educated about the need for the correct type of iodine. Do not settled for a skin test. A urine test is necessary to get accurate results. Go to Amazon for the book or just google Dr. Brownstein to learn detailed information.
      Medical doctors are taught that iodine is harmful to the thyroid, but Dr. B explains the need for it very clearly and has hundreds of patients who are living proof that it dramatically improves health and can reverse or greatly lessen thyroid issues.

    • You have a goiter, but your levels are normal? I never heard of such a thing! Go see another doctor.

      A lot depends on your ancestry and your sex, so what is normal for one person may not be right for another. Also, make sure you get enough iodine.

      • I also should have said that I have all those things, and was just diagnosed with slight Hyperthyroidism. Don’t look to Chris’ ebook, he starts with one “title” about hyperthyroidism, then spends the whole book talking about hypo. Unfortunately, I also Googled Hyper, and even though sentences looked right, when I clicked, all the info was for hypo. I don’t mind the weight loss so much, but the shaking (made worse by asthma medicine) and rapid heartbeat, I could do without.

  18. hi chris

    i,am 32 years old i had graves disease 11 years ago they tryed to treat me with carbinzole sorry spelling might be wrong? but i was allergic so they gave me radio iodine treatment and it killed my thyroid and made me underactive .
    i have just been diagnosis with b12 deficiency and vitamin d deficiency. i have had my loading dose of injections of b12 now i just have them every 3 months and i have loading does of vitamin d which are 25,000 iu oral solution once a week for 9 weeks while still taking vitamin d tablets daily ? do you like this vitamin is to high as i was reading your article made me a little worried ? my doctor hasnt really explained if it was the thyroid or not? do you think the thyroid has cause theses deficiency ? also will the thyroid keep giving me more issues like this? be good to actually have some feedback thank lisa

  19. My 17 yr daughter I found out has high calcium levels, low vitamin D. Recently she fell and hit her head, they were saying she has concussion symptoms. However I don’t know how much I agree. This past year going form A-B average to C and D. Trouble concentrating, dizzy/light headed all the time and common stomach aches in the morning. Her pediatrician said she just does not eat well and needs to drink more water. We have been battling her high cholesterol for years, and the just keep telling her to diet and exercise. I had another doctor test her and found that she also has low T3 levels, and after over a year on 10,000 Vit D a day she has gone from 28 to 40. I really hope this new doctor will give us some new answers. She had been battling weight and numerous issues for years.

    • Hello! Before I was diagnosed with hypothyroidism, I had very bad headaches, body aches, stomach aches, etc. It got so bad, I thought I had the flu for a month. It was all caused from the high TSH levels. Since then, they have evened them out. Def get all the bloodwork done!

    • Hi Rita,

      It could be a lot of things. Has your daughter had any xray, MRI, etc. done of her head? It could be a tumor.

      If her cholesterol is high, it could be a clogged artery or vein. I wouldn’t worry too much about cholesterol normally. Studies are finding out more and more that some people are just naturally high, and that their bodies are o.k. with it. However, if she has been on a very low fat diet for most of her life, that could be trouble. Fats are very important for keeping everything running in the body. Make sure she eats plenty of oilve oil. She could also take it in a shot every day. Since she would be taking it for health reasons, buy the imported from Italy kind. She should also take Cod Liver Oil evey day. She should also eat oatmeal in cold weather and oat products like cookies and Cheerios in warm weather. Make sure she doesn’t get overheated.

      It could be allergies. Have her take Zyrtec or some other allergy medicine. I took a homeopathic one by bioAllers this year. I liked the first box, but not the second. See if taking sudafed — the store brand, 30 mg, kind — helps, it could be her sinuses.

      She may need glasses. Have her try 1x readers. I have 20/20 vision, but still need the readers.

      As I said for others, look at my list of vitamins on Chris’ B12 page. Make sure she takes 5000 mcg of sublingual methyl (not cyano) cobalamin, which is B12, B2, magnesium, C, and the D (in your daughter’s case, I wouldn’t worry about it), Iron, and zinc. She should eat foods that are high in iodine.

      You did not specify which kind of stomach ache your daughter had. Is she nauseous, or in pain? I would get terrible pain in my stomach in the morinings as soon as I would drink water, but that stopped when I started taking Magnesium. My son used to throw up mucous every morning until he started taking Zyrtec year-round. Both he and I have serious mucous problems. I get very nauseous from it, and drink Unfiltered Apple Cider Vinegar mixed in water with honey, but after a month or two, I just can’t stand the vinegar anymore.

      Maybe your daughter should cut back on the water and drink a glass of Gatorade a day. I drink quite a bit, and have thought it might be a problem. It is hard to quit, though, I suffer from dry mouth. While I am thinking about it, avoid artificial sweeteners like the plague! They are in just about everything these days, so read labels.

      Well, there are a few suggestions, but I really think it it probably a vitamin deficiency. You should have her genetically tested to see if there is any possible reason why she may not be able to process vitamins.

      Good Luck.

  20. I had postpartum thyroiditis after my first child that resolved. I did not get it again with my second child. Now 2.5 yrs later I have been feeling way off. I feel hyperthyroid symptoms but had my levels checked and the doc said they were normal. I just got the results and it shows my TSH at .6. My T4 at 1.2. Even though this is within range could I still be hyperthyroid?

    • Yes you can still be hypothyroid. Same thing happened to me and it went undiagnosed for over ten years because I didn’t go to a good endocrinologist. I ended up w hashimotos and hypoparathyroidism. You need a good endocrinologist to check for thyroid peri oxidase antibodies, calcium, vitamin d and who will treat symptoms not blood test results.

    • at a the of 6 I feel horrible, sounds like you have an issue, some ranges are different at 4 I was out of the range of normal in some countries, 6 is not normal….

    • I am not sure how they arrive at these numbers, but for vitamin levels, they take a sample of people” take the average, and that is the “normal” number. Whether or not those people were high or low, nobody knows. Very scientific. I have a felling they do pretty much the same thing with most levels.
      If you know what it felt like to be hyperthyroid, then I am sure you are again. Think to yourself if anything about you or your life changed recently. Giving birth for the first time was pretty obvious. If something did change, try to change it back. You might want to see your gynecologist and explain your feelings to him. There might be something wrong or just off.

      Take your vitamins, and eat foods rich in iodine.

  21. What about magneisum?
    I managed to take vitamin D after being 11 ng/ml and B12 deficient, only if I took extra magnesium.
    With high dose of D, I got issues I related to PTH and calcium. When I had taken enough (like 800 mg) before starting D it was better.

  22. Im really nervous… I have been feeling really out of it. I am 31 and was diagnosed with Hashimotos last year while pregnant. I have goiter but tsh level is 3.2. Bloodwork just in and vitamin d is 11 and b12 is 307. I am as lso experiencing a host of GI issues. Could something else be going on? CBC normal…

    • Hi Asley,

      B12 deficiency is tricky. You can have all the tests come back normal, and still not have your cells be able to use it. Take sublinguals. I had a host of problems with my GI tract, well, dairhea, until I started taking B12. Then I was constipated all the time until I took Magnesium. Look at my list on Chris’s B12 page. Also add Folic acid, C, and B2 to the list.

      As I wrote to someone before, there is no way that your thyroid is functioning properly if you have goiter. Go to another doctor, and supplement with iodine (don’t go overboard on the iodine, though).

      BTW, from what I have read, it is not clear if Hashimotos is caused by B12 deficiency, or vise versa, but I always see the two linked.

      • Sorry, I hit Comment before I corrected Asley to Ashley, and before I wrote, “Don’t worry, it’ll all work out. Vitamins and minerals aren’t like big pharma medicines. You can just keep adding one at a time without worrying about taking too many together (doses should be watched,of course). Medicines, that is when you worry about one being added on to another. It takes the body time to heal itself once it has the right tools, so just eat right, excercise, sleep right, take your supplements, and wait.”

  23. Hi. I just happened on your site. I recently had my Vit D level tested and find it to be at 45 and I take a D3 supplement and a K2 supplement. In June 2012 my level was at 70 with the same supplements. Since that time I had a whipple procedure (December 2013) and I suspect this is the reason my levels are lower while taking the same supplements. I do have to take digestive enzymes, Creon, since the surgery and I understand that my problem absorbing fats naturally could be my problem. So, how do I increase my number? Being a cancer patient I know it’s important to get my level higher, like 70+, but how do I do that under my particular circumstances?

    Thanks in advance for your direction.

    • Hi Bonnie,

      Your body will tell you which fats you can and can’t process, so experiment with a little at a time. Try Cod Liver Oil, grapeseed oil, and pork fat — lard is probably best. Even water soluble vitamins need fat, as you probably know. Can you get a vitamin patch to wear, or shots? Look for problems with and alternatives for your digestive enzime. I have heard you have to watch those, even the papya one.

      Bragg’s Unfiltered Apple Cider Vinegar is good for just about everyone. So is honey, look for an internet newsletter called, “Bee Pollen Buzz” for info.

      Best of Luck.

  24. Hi. I am a 45 yo female who has been feeling just plain “cruddy” for about 3 years or so now. I had a complete hysterectomy 12 years ago. I have felt fatigue, hair loss, weight gain, and real problems sleeping. Been trying to convince my doctor for years that something is wrong. My vitamin d level a year ago was 13, now it is 11. She just put me on 50,000 unit per week for 12 weeks again. My mom had an inactive thyroid. My thyroid levels continue to be between 2.5 and 3, which is in the range, so they won’t do anything about it…but, as a nurse, and as the daughter of someone who had a thyroid problem, I know there is something wrong. I feel it…I know it. My estrogen level was also very low, raised some a couple months ago when they increased my medication dosage, but now since July it has gone down again by 30. I started to see a GYN because of an onset of bacterial vaginosis, which doesn’t seem to go away either. I am a home health nurse, and one of my patients is a diabetic, so I also test my blood daily with her…usually around 11:00 AM or so, before eating lunch. My levels usually run between 67 and 78. I am sick and tired of being sick and tired. Is it time for me to see an endocrinologist?

    • Has anyone ever taken a look at your transferrin saturation? For me, taking a specific iron supplement worked. (apparently the free soluble iron level was okay, but the transferrin saturation was not high enough).

      • I think I have the same problem, Judy. My dr. just tested my iron level and transferrin saturation. My iron was 77, TIBC was 408, but iron saturation was only 17%. I wonder if this warrants supplementation as well??

    • Hi Missy,

      Start taking B12, and all the vitamins I have listed on Chris’s B12 website, plus B2, Folic Acid, Vitamin C, and eat iodine rich foods. Get your testosterone tested. Women need testosterone as much as estrogen, and estrogen supplements can almost wipe it out. Have yourself genetically tested for anything that might interfere with vitamin and mineral use — I know the MTHRFR gene is important with B12 deficiency.

      Last but not least, get another doctor.

    • Missy your should be between .5 and 1.5 . My dr hemmed and hawed over a level of 5 for months just kept testing but no Rx and i ended up in the ER blown up huge with fluid, chest pain, trouble breathing. Untreated hypothyroidism can result in myxedema. It can crush your brain or your heart. See an endocrinologist please.

  25. I was diagnosed with hypothyroidism 13 years ago when I was 14 years old. My TSH was within normal limits for years up until about 5 years ago. I got pregnant last October and my tsh was 169, my obgyn said she has never seen a tsh that high. My levothyroxine was increased from 200mcg to 225mcg. My tsh stayed within normal limts for months and two months after my son was born it was 0.9 the best it has been in years, the decreased my levothyroxine to 200mcg I just had it rechecked a few days ago and its 6.3 so they increased it to 225mcg again they also check my vit d and it is 21. She prescribed me a once weekly dose of vit d and I am to have it rechecked in two months. My question is, is it normal for tsh to be all over the place? Should I try to look into why it cant stay within normal limits very long? I am also a nurse so I know to take it 1-2 hours before you and and take it the same time everyday which is what I do. I am so exhausted all the time. I am worried something more serious is going on. Any help is appreciated!

  26. Hello, I stumbled across your article while trying to unravel the mystery of a prescription made out to me without explanation by my doctor who is particularly uncommunicative. Thank you for this article and the cmments it all makes sense to me now.

    I am 29, lived all my life in the tropics and then moved to germany last year and developed Hashimoto’s the same year. (i know as i was regularly checking for the last few years). Now I went for a checkup and they tested my FT4 and TSH (only) and she gave me a prescription for a higher dosage of euthyrox (75mg/day) and a vitamin D capsule.

    I am concerned as she prescribed a 20,000 IU softgel tablet (main ingredient- cholecalciferol solutions oily -20 mg ) to be eaten once a week for 50 weeks, without testing the vitamin D levels in my blood or even scheduling further monitoring in the coming few months. Is that alarmingly high? It it going to be harmful in the long run?

    Thank you again for this article.

    • If she won’t communicate with you, get another doctor. You wouldn’t let a plumber just start working on your pipes without telling you what was wrong, would you? Why let a doctor do as she pleases with YOUR body?

      • Sorry Nisha, I hit Comment again instead of return.

        Second, She had to have taken your blood for your other levels, so she probably did other routine tests, including Vitamin D, as well. Having said that, the amount of vitamin D she prescribed for that long of a time does seem excessive, especially since she is not monitering your levels, and once they are high enough, you can start overdosing on it….go to another doctor.

  27. … forgot to mention that in the last year I also became Gluten Intolerant but since I refuse to go to a GI for this I do not have an official Celiac diagnoses, another in the autoimmune family. Compared to what I went through 6 years ago, teaching myself the gluten free diet and following it has been easy.

  28. My health decline was eventually nailed to be caused by a severe (4) and long-term (2+ decades) D deficiency which began with crippling, Level 10 shin bone pain nothing could touch, then I became diabetic, was diagnosed with Graves disease and Graves eye disease, goiter but no one could explain the shin pain at that time. One of my 7 specialists noted the extremely low D off on of my labs and offhandedly added the supplement to my growing bottle lineup. About 8 weeks later I noted a slight lessening of the pain level and less frequency of acute attacks. Meantime I’d run out all of my s/t term disability and elected to take a very early retirement I was fortunate enough to qualify for so I could give my fight for my health 100% of my attention. Alkaline Phosphatase was the key … home in a wheelchair 24/7 you have nothing better to do but Internet research and teach yourself to read your own labs – my level was 411, normal is about 50-150. Among the things it could indicate was ‘high level of bone turnover’ – my body had been so depleted of D it was literally cannibalizing my bone marrow! Osteoporosis as well as Osteomalacia had already set it. I was 50 years old.

  29. I take D3 every day and my levels are good however, I ran out of capsules about 7 days ago and haven’t been able to purchase any for the moment.

    How long does it take for the D3 levels to go down in the body?

  30. Lots of the supplement companies have been taken over by big pharma. ‘Seven Seas’ cod liver oil manufacturers for instance and many more. For this reason I will not seperate the pushing of some supplements and drugs, it is all profit.
    I wonder whether the renaming of vitamin D to its true ‘type’ a hormone would make people any more cautious with supplementing it?
    I mean our body makes so many hormones but if you say you are supplementing them people go all cautious on you then 😀
    I am really happy for those of you who have been relieved of illnesses by it. I really wish it would do this for me, I was so disappointed.

    • Big Pharma, or no, you gotta do somthin’! I am cautious about what I take, but supplements like Cod Liver Oil are better than other processed D. The alternative is a not too pleasant life and early death.

      I was going downhill fast and could hardly walk before I started taking B12. Big Pharma? Yes. Life Saving? YES!

  31. Hi I’m hypothyroid for last 15 years since I was little I have had syptoms leading up to hypothyroidism .jst before I got pregnant with my oldest child doctor did tests but she gave me results same day I told her I was pregnant and she said it low but pregnancy does strange things to results so she wasn’t worried . Anyway bad pregnancy with preeclampsia followed . I wasn’t recovering from delivery and six months later I was diagnosed as hypo thyroid . Anyway I was slowly buit up too 100 mg dose which worked a chArm . Until this last year maybe more . I feel all the same symptons stuff body aches pains hair loss no plucking if eyebrows for ages and also they are receding . Psoriasis, puffed out tired etc moon face . Bad pmt anxiety depression . Had bloods done everything fine even though I’ve been on same does ten years plus I even had preeclampsia again despite normal pregnancy In between . Vitamin d was low it was. 18 . Could it be that us making me unwell this much ?? Or something can be going on with thyroid despite bloods being fine ? Desperate fir answers . I’ve insisted on seeing a specialist

    • I am sick of the orthodox Medical Doctors be it M.D’s or D.O’s
      who give all the so call great Pharmaceuticals to patients like
      myself with no regards of the awful tailspin they put you in
      and then just keep adding more because of the nutritional deficincies they cause . Then the patient dies of some
      unknown reason and the Pharmaceutical Industry goes on
      untouched . No body know or seems to care as long as this
      Industry continues to propel the economy.

    • Hi Sarah,

      Preeclampsia is high blood pressure. Nobody knows why it happens. One of the problems with HBP, though, is that most doctors buy into the “white coat” theory and dismiss HBP as nerves. I have heard this story over and over, and though they tell the doctor they are not nervous, the doctor dismisses the readings just the same.

      Look at Chris’s B12 page. Look for my vitamin list, and start taking them. Also take B2, C, Folic acid, and a supplement of or foods rich in Iodine.

  32. Hi had thyroid removed due to cancer and gave subsequently had 2 sessions of radio iodine treatment, the last one in Feb 2013. Not really sure if should be taking vitamin d. Asked my consultant and he said not required, but levels not been tested. A collegue of mine thinks that pharmacist of mine thinks i should be taking it and quite a high dose. Really not to sure.

    • Hi T,

      Find out exactly what your levels are, and then procede. There is a lot of wiggle room with most Vitamins, even A, which certainly has to be watched.

      To me, Chris doesn’t really do a good job here of telling us what we should do about vitamin D, “You could do this, but not so fast. You could do that, but not so fast.” Give me a break.

      You are safe at 3000 to 4000 units a day if you are deficient. If you are only comfortable with 3000, then take that. It is better than nothing. Take it with regular fat milk.

  33. Sadly the FDA has been in bed with the pharmaceutical industry for a very long time. They (FDA) allow us to be poisoned slowly through our food and water supplies, then through pharmacology, offer their remedies usually in the form of nsaids, ssri’s, warfaren, blood thinners etc and so on..
    Most males above 19 are severely deficient on testosterone.. You see, the thing is they know what they are doing to us and its affecting everyone different because none of us are of the same chemical make-up. Low T due to low vit D. Use liquid vit D under your tongue.. Straight into the blood stream.

    Everything from a.d.d, to Parkinson’s disease to fibromyalgia is all caused by the poisoning of our food and water.

    Doctors are nothing more than glorified pill peddlers.. They are kept just dumb enough to never figure it out and still sound smart enough to push the drugs

    Unless you live near the equator, everyone should be supplementing vitamin D and heavily up to 10k IU a day.
    The next thing you all need to do is drink distilled water and stop eating processed foods. Its even getting bad with all this GMO garbage infiltrating our fresh veggies they are pushing on us that is stripped of any beneficial nutrients we need which is why our bodies are so out of whack these days.

    What really bothers me is they know all this.. They don’t care, its a trillion a year industry for pharmaceuticals..

    Educate yourself.. Discernment is key even when reading a blog like this..

    I can testify that vitamin D cured my bi-polar disorder, my depressions, my social anxiety, my energy levels etc etc.. Its all connected.

    Dopamine deficiency is another huge problem…

    Alkalize your bodies… Think of your body as a very complex salt water refinery.. Disease will run rampant in an acidic pool… but alkalize it… And yup, you guessed it.. You will cure yourself of just about everything even cancer..

        • Hi Riley. There are a number of websites you can go to that will provide you with lists of foods that are more alkaline vs those that are more acidic. You can also put a pinch of baking soda in a bottled water, cap it, shake it and drink it. This may help some, but the key is to consume a more alkaline diet. Generally animal protein is a no-no and fresh vegetables are good. Good luck.

        • It sounds weird, but Apple Cider Vinegar turns alkalai in your system. Drink a teaspoon of Bragg’s Unfiltered Apple Cider Vinegar in warmish water with a little unpasteurized honey twice a day. Also, eat more sauerkraut.

    • Hi Travis,

      Low testosterone can also be caused by too much estrogen. Why consume estrogen raising foods every day, and it’s getting worse. More and more, our food supply is becoming tainted. We don’t get the same nutrients we get out of it we once did. I do believe supplements are the way to go and they should be started before problems arise.

      I don’t believe that doctors are necessarily bought out by big pharma, but I do believe they like to see instant results, even more than their patients do, and to that end they kind of turn a blind eye to side effects, nor do they report them as they should.

      The tainting of the FDA began with the Reagan administration (sorry to bring politics into it, but that’s when it happened) and their push for NutraSweet. After that, they really didn’t seem to care.

  34. Thank you so much for this information! My 8 year old daughter has had gut problems, chronic constipation, for a long time. At around 6, she was diagnosed with encopresis. Other doctors have just treated the constipation. Luckily, the encopresis has resolved. Of course, she still suffers from constipation so prunes have become a regular in her diet. Her new doctor told me that her constipation could be related to her thyroid. He was right on. She also has horrible cramps behind her knees, which was the reason for our latest visit. Her vitamin D level was tested at only 18!

    I have suspected that the 2 were related. I’m an RN so I naturally look for the connection in blood tests. Your blog confirms my suspicion. Now, the search in how to help her. I will definitely tell her pediatrician of this information when she has her levels redrawn. He has not yet decided to treat her hypothyroid. He tells me we should retest it when we recheck her Vitamin D level. I am assuming this is due to her age.

    Do you have any advice for me? Is there anything else I should ask when I take her back for her next labs?

    Thanks in advance.

    • To Kathy, I would recommend your daughter take magnesium right before bed to combat constipation. Most people are low on magnesium because the soil is depleted and very little is in our food these days. You might have to look into a liquid magnesium supplement such as Calm which is a powder you can make into hot drink because most other magnesium supplements are such large horse pills I’m not sure a child could get one down. There are also transdermal magnesium creams that are just recently available, but I don’t know how much actually will get absorbed through the skin. Saw some of the cream on Amazon. So you might want to research magnesium as means to alleviate her problems. It will relieve muscle cramps too if that is what is causing behind the knee pain.

    • You need to see if your child is sensitive to milk or gluten. My son had constipation, night terrors and poor self control. Then we tested him and he has casein sensitivity to dairy. Once we stopped all dairy for a few weeks all problems went away. Good luck.

  35. Hi,
    can anyone tell me why there are people with hashimoto’s – like me – who can’t tolerate
    Vitamin D?

    I tried different brands, took it with vitamin K2 and magnesium. PTH and calcium levels are

    • I cannot say why but it seems it gives me rotten effects. A few people on the net seem to be mentioning this now. For a while in the past I thought I was odd as everyone else seemed to be saying how fine and dandy they all were doing on supplements.
      At least when we post that we cannot take it for side effects, someone somewhere might come up with an answer. I have Hashis too.

    • Markus,

      I had the same problem. I now take the VitaFusion gummy D3, and all is fine. Sometimes, it is the capsule or fillers they use that upsets my stomach, but until I started taking Vitafusion. I also take a liquid pour out a spoonful Cod Liver Oil, and I tolerate that very well too.

  36. I am a regular user of sunbeds and also regularly testing my vitamin D levels (which are normally in the 50-70 ng/ml range).
    Now, my question is if there is a direct relationship between a high vitamin D level and the TSH level?
    I am 61 years old and have never had a TSH test until recently when it turned out to be quite high (17.13 with the norm being between 0.35 – 4.94). My Free T4 was fine, just in the middle of the norm).
    Could it be so that, since most people have low or even very low vitamin D and the norm for TSH therefore most likely is created from people with low vitamin D, the norm is wrong?
    If there is a direct relationship between vitamin D level and TSH level, maybe it is natural that the TSH goes up when vitamin D is high?

    • Hi there,
      I don’t think so. In my case, the exact opposite is the case. My TSH is completely out of whack, but has been high like yours, 11, 20, now it was 59 or >150 the past year.. and my Vit D level was 17. I’m a 30 year old female. My vit D is always low, granted I don’t drink a lot of milk or spend too much time in the sun (gotta love Irish skin). They may be related, but each is separate.

  37. Hi Group!
    I am 30 years old. In 2005, I was diagnosed with Hashimoto’s Thyroiditis. Since that time, my thyroid condition has deteriorated and my dosage for Levoxyl steadily increased from 25 mcg to now 125 mcg. In 2011, doctors felt nodules on my thyroid and after having a bunch of ultrasounds and biopsies performed, I was diagnosed with papillary thyroid cancer. That October, I had my thyroid removed and surprisingly, I dropped 80 lbs over 6 months. I know I’m stupid, but at that point, I figured my life was great and I stopped taking my medication. I was not having the symptoms of weight gain and depression as I had experienced in the past.
    Lately though, my life has taken a turn for the worse. In the past month, I have been in 2 car accidents, because I have fallen asleep at the wheel. The last accident totaled my car. Luckily they were both single vehicle accidents and I didn’t hurt myself or anyone else… just be beloved car. My doctor has told me not to drive, and I am hoping to schedule a sleep study to check for narcolepsy (but insurance company is saying I don’t qualify for a hospital test and want me to do it with a home kit). My TSH is >150 and so my endocrinologist has increased my dosage from 100 mcg to 125 mcg. He has also instructed me to take double the dose for a week and then repeat lab work.
    I am wondering a couple things:
    1) Are the symptoms of severe fatigue and falling asleep while driving due completely to the TSH levels or does anyone know of a correlation between hypothyroidism and narcolepsy. Articles I’ve read seem to say they are both autoimmune conditions, but I’m not sure if the hypothyroidism could be responsible on its own. I had a sleep study done in 2010 and it came back negative, so I highly doubt that I have sleep apnea, and then after that, they want to do a MSLT for narcolepsy, but I don’t know if I’ll get approval from the insurance company.
    2) Does anyone else just feel like a victim – having to take medication for the rest of your life. I am dealing with the depression separately, but its a vicious cycle. I am depressed, so I don’t want to take my medication which makes me more depressed. I don’t have a suicide plan, but I wouldn’t mind if I were dead. Does this make me suicidal? I know there’s something wrong with me, but I don’t know how to put together all the symptoms to get a diagnosis. I don’t want to be put on a stimulant (due to a history of drug abuse), so I’m praying the synthroid/levoxyl makes me able to drive / work again.
    3) I also have low vitamin D. I think my level is in the – teens .. like 15 or 17. I think taking 10,000 IU weekly is stupid and I should just take 500 IU or whatever the OTC amount is. I’m sure I’m really screwing up my cardiovascular system and possibly my musculoskeletal system but truly, I don’t want to lose more weight and I just don’t really care about much of anything (again, the depression talking). Ugh, anyone have any words of wisdom/hope? I’d be greatly appreciative to hear about it.
    Thanks for reading 🙂 Good luck to everyone out there!

    • I can’t type much but yes no thyroid and no meds is going to do this and more. You have to be on meds. Check this website for tons of great info. She had thyroid cancer also and saved her own life with the help of a great doctor. You need proper testing and proper meds.

      Good luck

    • amanda, the autoimmune symptoms are related. they are all gut issues. seek out a nutritionist that can help you get your health back. i understand about feeling a victim. i too have struggles with many health issues and feel the system has failed us. So little emphasis is put on nutrition and yet it is the foundation of what feeds us. The best analogy i have thought of is that it would be like not putting the right type of fuel in your car (so leaded or diesal in an unleaded car) and then expecting it to run properly! as for the depression, which i know first hand (myself and my son both have it) how hard it can be, needs to be addressed first to be able to focus on your other needs. Vitamin B has worked wonders for my son and as well for a friend of mine’s son. There is hope.

    • I have been on 50,000 IUD a week now for over 2 months. The depression and fatigue have subsided. I have no ill side effects, except for constipation. If you do your research, you’ll find that it really takes extremely high doses to be toxic and your doctor can monitor this.Constipation is a small price to pay not to be so depressed and fatigued.Also my joint pains and back pains are gone too.

  38. I have low vitiamin D I was told to take more vit. D by one endocrinologist . But that contradicted another test that I am allergic to the vitamin. I have Lyme disease. I probably have a pituatury/adrenal thyroid problem. I am allergic to many food stuffs. Vit d is not manufactured by sun light. It may well suppress the immune system. Many Lyme suffers get put in hospital with psychotic medication which makes the immune system even worse. They could of given us proper treatment with neutrients and proper care for 3 months. But you get sectioned. If you say you have Lyme. Even a positive blood test does not help. 3 positive tests they still can’t quite believe it. Lyme changes liver function tests and inflammatory cells so they appear normal.
    On this basis they will not give you intravenous antibiotics. Because you don’t have the right markers. If they are given antibiotics at the right level then the blood markers will then show up.
    They then say people are over diagnosed.

  39. I have just found out my vitamin d is low but was told to eat food with more calcuim but i constantly get kidney stones caused by calcium what can i do id rather have a baby then a stone any advice thanks

  40. What about hyperparathyroidism… I understand your body may lower d as protection from high calcium? So confusing 🙂

  41. I have hypothyroidism and have the usual symptoms of estrogen dominance many women in perimenopause have which includes having hard time losing fat in hips and thighs. I discovered somethings that will get the fat off and also make you less moody. First is progesterone cream because most woman over 35 are low in progesterone and way too high in estrogen. Then you can also take Calcium D-Glucurate and DIM (Diindolylmethane) both of which are made from certain vegetables and they help both men and woman who are estrogen dominant to loose fat around lower body and in men will lose the manboobs. It helps by lowering estrogen levels and also helping the liver to process out excess hormones floating around in the body. It takes 2 months of taking both daily before the process starts to kick in but it really does work! I have been working out 2 hours a day every day nearly for over 4 years and nothing was making the butt, hip, thigh fat budge untill this. It’s finally starting to go away. I keep measurements of each part in order to gauge it’s effectiveness. Research these supplements for yourself. Hope that helps others.

  42. I have Hypothyroidism going on 19 years now and was just diagnosed 2 years ago with Hoshimotos. They tested my Vitamin D levels and found that I was low and told me to start taking 2000 IU’s a day, I did that for a year and when I retested I was still too low. I was told to start taking 5000 IU’s a day and retested 90 days later and I am still too low now they want me to start taking 10,000 IU’s a day. The PA that has me taking the supplements didn’t say to retest after a certain amount of time, do you think it would be a good idea to recheck levels again soon? Also after being on 50mcg of Levothyroxine for 18 years last February my TSH levels were extremly high and was put on 100mcg and then retested 30 days later and levels were still too high and then was put on 150mcg of Levothyroxine. I was retested 90 days later after being on the 150mcg my levels were way to low, now I’m on 125mcg and levels are fine. What do you think could make my levels go so crazy after being on the same dose for so many years?

    • Yes, you should retest while on 10,000 a day. You shouldn’t stay on that long term unless you need to. This happened to me too, not getting my D levels up even with 10,000. The thing that finally made it go up was adding K2 to the mix. That finally after probably two years of trying made my levels rise. D shouldn’t really be supplemented without the K2.

      Good luck.

      • Thanks MPW for the information! I think I’m going to go back and see and Edocrinologist and have them help me out with this. I’m not confident that my PA is real familiar with the Vitamin D problems of a person that has Hoshimotos. I not only have Hoshimotos but I also am over weight and am almost 50 years old, I have alot of things going against me right now.

    • I was diagnosed with Hashimoto’s 9 years ago and I can definitely relate to your post. My thyroid bounces around from high to low at an alarmingly fast rate. One endocrinologist has suggested even taking my thyroid out to keep my levels from dramatically changing all the time. The longest I have ever gone with “almost normal” numbers was 6 months and even then I was slightly low. It seems like when my Synthroid gets increased due to being hypo, my body overreacts and then I get majorly hyper. I have had many cardiac issues due to the constant ups and downs. I have been told that eventually the Hashimoto’s will kill my thyroid and I will just stay low, but mine continues to bounce around even though my thyroid antibodies are some of the highest they have ever seen . I have gone from very low to dangerously high in a matter of 2 weeks. I have learned that flip flopping thyroid numbers is just a part of this crazy disease. That being said, I was also recently diagnosed with very low Vit D. My level was somewhere between 8 and 9. I have been feeling the worst I have ever felt. The fatigue and muscle/bone aches sometimes keep me in bed for days. I have just started supplementation and desperately hoping it will help. I was told that auto-immune diseases can interfere with absorption of many things. I also tend to be low on ferritin, B12, and potassium as well. I hope your thyroid calms down. I did have to switch from levothyroxine to synthroid because my body didn’t seem to respond to levothyroxine. Synthroid seems to work better. I have heard this from many thyroid sufferers as well. It might be something to think about. Best wishes to you. I know how hard it can be to deal with a crazy thyroid.

  43. I have hypothyroidism (5years). I have been taking Levothyroxine my dose has been at 112mg for about a year now. In October I started getting stiffness in the hands and feet while asleep but as soon as I wake up its gone. I recently tested positive for thyroid antibodies doctor said they are supposed to be under 10 but mine were 3,016. Now I’m starting to freak out. Does anyone have any recommendations or advise?

    • My antibodies were >1000 and my endo said they would probally stay that way till my body killed off my thyroid. 🙁 I don’t like this Hashis thing.

  44. Hi,

    I am wondering if this thread is still active- but the original post by Dr. Kresser seems to be making a balanced scientific argument. I am 35 yo, 5ft 9′, 150lbs +/-5lbs (over the past 10 yrs) and a non-vegetarian.

    here is a step by step of what has happened:

    About 10 yrs ago- I first started noticing stomach issues- malabsorption- / steatorrhea ( no IBS diagnosis) – no treatment.
    2. then came low B12- concurrent with that- was numbness/tingling in hands and legs– treatment: B12 shots 1g/ every month then tapered off- some OTC supplements..and then over the years- blood levels have always been hovering around the ‘acceptable range’
    3. then came fatigue- loss of focus, tiredness in the legs, malaise- foggy brain..5 yrs ago
    a sleep study 3yrs ago revealed sleep disorder and restless legs..
    a neuro analysis indicated weirdly enough moderate to severe ADHD-
    4. a concurrent blood test for the first time (maybe checked for the first time) high LDL – no issues with thyroid.
    5. present: high LDL (4.6mmol/l), low Vitamin D (59nmol/l)..and all the GI symptoms continue-

    So- should I take Vitamin D supplements? or should I try and figure out whats wrong with my GI absorption- i.e. this is what has been wrong for the longest time..

    would really appreciate any input..

    thank you!

  45. Hi, I just wanted to let everyone know about this website
    Ordered my own vitamin D test for $60 and had results in 2 days.. My question is this, I have all of these symptoms of vitamin D deficiency, but my level showed up at 35. That is with taking 2500 Iu a day. I was really hoping that was going to be my answer, is it possible for me to have symptoms with that level? Symptoms are muscle pain, trigger points, back pain, hip and buttock pain, no memory, joint pain, tired, foggy brain, sleep issues, I cannot exercise. I am pretty tired of feeling this way, it has been about 5 years Now and would love to figure it out . Thank-you

    • Hi, I have autoimmune Hashi and low platelets. After years of dealing with brain fog I descovered it was from allergies. I started taking a claritin or zyrtec everyday and I have been free from the brain fog. It is wonderful !

    • I started feeling bad about 9 months ago. Tingling in my feet, hands, fatigue, weakness, muscless in my legs and arms aching, my heart fluttering, shakiness. Awful. I finally had blood tests that showed my D level to be 25. I have been taking different amounts of D3 for two months now. I’m a little better but not much. It’s awful stuff and sometimes my muscles ache so bad I can’t stand it. I need to be tested soon but I just lost my job so maybe I will order a do it yourself test. I have been surfing the web and so many people who have low D levels feel SO bad and it seems to take a long time to raise the levels. Trying to figure it out. The amount of D people are taking is all over the board so I’m trying to figure it out. I take minimum 5000 mg every day and sometimes I take 50,000. This is frustrating and hope that it’s over soon. What a nightmare.

  46. Hello everyone.

    Can someone point me to testing for the VDR Polymorphism? The test that Chris recommends from Genova Diagnostics (Osteogenomics panel), is pretty involved. Isn’t it possible to just test for the VDR polymorphism? I have Hashi’s and am not tolerating Vit D supplementation at all. I’ve been taking it for a long time and only just now figured out some of my symptoms are Vit D supplementation. Not sure what I’m going to do about keeping Vit D levels up.


    • Hi Rubi,

      If you take the doctor subscribed D3 for a short while, like a few weeks, it is fine. However, once you reach a certain point, and continue taking high doses, you run the risk of poisoning yourself. When you make D from the sun, your body knows when to stop.

      Make sure your doctore checks it while you are on the prescription after about two weeks.

  47. Hi There:
    I’ve been diagnosed with Hashimoto’s recently and my thyroid levels aren’t too far off of being “normal”. I’ve had increase in weight and have battled depression and fatigue, fog brain, for years. I take levothyroxine and take 10k iu of Vit d3/day. My question is, some of my symptoms have gotten better, but I would like to see continued relief. (weight loss and depression relief) What kind of Dr do I see to help me? I’ve just seen an endocrinologist. He’s increased my levoxy dosage and didn’t mention anything about supplementation. Should I see a holistic Dr in combination? I take a new blood test in 6 weeks.

    • Hi Melanie,

      10,000 units of D3 a day is A LOT. I would cut it back to 4000 at the most. Drink milk with it.
      You could see a holistic doctor, but Most people go to hematologists.
      Definitely take 5000mcg sublingual methylcobalamin (B12) each day, B2, Folic Acid, C, and Magnesium.

  48. Hi Chris,

    I’m glad to find some articles like this, discussing the Vit. D/autoimmune connection, and the cautions required. I have had psoriasis since I was very young, and now exploring whether I have hypothyroidism as well. Are you familiar with the Marshall Protocol? It is a protocol that treats autoimmune diseases, based on the premise that (in very laments terms) VDR’s can be blocked by specific mutating bacteria. If you’re familiar with it, I’m curious what your thoughts are on the Marshall Protocol for treating autoimmune diseases.

  49. Hey Chris. I appreciate your cautious approach to Vitamin D deficiency and it’s related issues… I’ve been seeking information on Vitamin D deficiency and possible related conditions since December. I live in Guadalajara, Mexico and have found that there is absolutely no understanding, concern or solutions for vitamin D deficiency here. For this reason, I find myself researching on the internet and awaiting a shipment of Vitamin D3 from the U.S.

    My issue is a bit more complex than the possible modern 20th-21st century “American” lifestyle caused vitamin D deficiency. I’m a 43-year-old male carrier of Familial Anenamatous Poliposis/Gardners Syndrome. I had my colon removed in 1983 and my rectum removed and reconstructed with my Ileum as a J-Pouch. 7 years ago I was diagnosed with hypertension, gastritis, duodenitis, inflamed gallbladder due to many gall stones, ulcers in the entrance of my stomach (possibly caused by H. Pilori), and hiatal hernia. I elected against removal of my gallbladder (due to economic limitations) and stopped seeing the internist and other doctors and stopped taking medications after being given an impossible diet that excludes almost all foods with the exception of Salmon… I researched the internet for alternative diets and it seems that I lowered my bloodpressure and my cholesterol levels and removed the inflamation of my gallbladder.

    With all of my diet changes (not lowfat, but much more vitamin/mineral–fruit/vegetable conscientious) and periods of exercise, I found that my weight didn’t decrease and my energy levels didn’t increase… Fine. For years I dreamed of having the flexibility for being able to exercise regularly and for living in a city with ready access to descent parks for running and hiking. 1.5 years ago we located permanently to Guadalajara and found ourselves (my wife and I) with great parks for both heavy-duty hiking and for running. From March through July we were ravine hiking (1000 xs better than a Step machine) for two hours 5 days per week. If you want to feel your heart popping out of your chest… I lost weight. Possibly 10 pounds during that period. I believe I gained a ton of leg, gluteal, stomach and back muscle from the ravine climbing making it incredibly easy to change to running 40 minutes 4 xs per week in August. I’ve run on and off over the past 20 years and this time around (much more enthusiastic and probably much more responsible/conscientious) I noticed something very discouraging… From September until late November, I noticed that my body had decreasing energy for the runs, decreasing to between 28 and 33 minutes 4-5 days per week… 4 kms (2.6 miles). This would be fine for me if the situation didn’t continue evolving negatively. Late in November I began experience muscle pain (lactic acid burning) in my right calf at the halfway point… And then I began experiencing the burning in my thigh. And then pain in my left knee… all the time the burning beginning increasingly earlier in the run, until I couldn’t make it past 8 minutes…

    Just before experiencing the burning, I had been experiencing what I thought was recurrence of the inflamed gallbladder on the right side of my gallbladder just below my right rib cage and a pain behind my left back ribs where I imagine is my left kidney or my stomach… I figured that the pain was from the ulcers and we made an appointment with a GI.

    During the interview/exam with the GI who supposedly is amongst the elite of Mexico (was the director of the Mexican GastroEnterological Association) and supposedly met my J-Pouch surgeon during a conference in Chicago. He asked me if my surgeon was Dr. Gorstein when I said that my surgeon supposedly was #1 in his field in the world…

    The GI here in Guadalajara didn’t want to do an Upper Endoscopy since he said it was enough that I had one 7 years ago… not even to check the ulcers or my duodenum… He didn’t believe I had problems with my gallbladder and that the pains weren’t caused by the ulcers or possible kidney problems… Nor did he ask for a sonogram… However, he said that I had hypertension he believed could cause kidney disease he called hypertension of the kidney (although that doesn’t exist)… and he recommended a visit with a cardiologist… The GI mentioned that the J-Pouch is constructed with the Ileum guarranteeing vitamin B-12 deficiency and other malabsorption problems. Instead of requesting blood tests, he suggested I inject B-12… He also prescribed an anti-cramping medication for the large intestine.

    The B-12 injection coincides with the extreme muscle fatigue. But doesn’t make sense. The following day I began with the more extreme running problems and also met with the Cardiologist who said that I must take blood pressure medication for the rest of my life. He also prescribed pain relievers for what I am certain isn’t back muscle pain. I purchased the medication. However, I didn’t use it due to it’s ban in the U.S. by the FDA due to risk of causing heart attacks… Yes, you read correctly; the cardiologist prescribed a medication banned in the U.S. due risk of causing heart attacks. The BP medication he prescribed is also a diaretic… I imagine I don’t need a diaretic due to not having a large intestine nor a rectum, mainting me constantly on the edge of dehydration. The BP medication also creates a risk of causing liver and kidney problems. However, he didn’t ask for liver or kidney tests before prescribing the BP medication; he prescribed those tests for day 28 of taking the BP meds.

    Since the GI mentioned J-Pouches and malabsorption problems, I decided to research deficiency problems connected with muscle cramping or muscle burning and stumbled upon Potassium, Vitamin B-5 (if I am correct) and Vitamin K (if I am correct). I read that B-12 injections can cause potassium deficiencies, possibly leading to muscle pain. I also read that potassium deficiencies can lead to hypertension and heart attacks. So, I ordered blood tests for all vitamin Bs, Potassium, Iron (since I was almost low in Iron when diagnosed with duodenitis 7 years ago) and an Ultrasound… For some reason they threw in a Vitamin D test also…

    The ultrasound revealed that most of my gallstones had disappeared (3 small ones remain) and that my gallbladder wasn’t enflamed. The ultrasound revealed that my pancreas, kindneys and spleen were normal…

    The blood tests revealed my B-12 levels over the roof (although I didn’t have high energy levels). It also revealed normal iron and Potassium levels. The laboratory/clinic didn’t understand testing for Vitamin Bs that weren’t B-12… Go figure! My vitamin D came back low 18.5 (here considered almost normal, although must of the modern literature states that 18.5 really is lower than just an insufficiency)… A few weeks later I took the blood and urine tests prescribed by the Cardiologist, revealing that my Cholesterol, Glucose and sodium levels were towards the low range of normal… However, my triglicerides were at the low range of high… The cardiologist mentioned that the triglicerides were probably raised by the diaretic aspect of the medications, prescribing the same medication but without the diuretic part… I haven’t filled that prescription, opting for walking in shorts without a shirt for 40 minutes every other day and waiting the vitamin D3 10,000iu shipment from the U.S.

    The cardiologist didn’t want to talk about the possible connection between Vitamin D and high blood pressure… It’s not from low potassium levels. Nor is it due to high cholesterol levels or high sodium levels… Seems obvious. However, here in Mexico, you can’t readily find Vitamin D3 suppliments above 400UIs and it costs 1600% more than in the U.S. However, for some reason or another he suggested that I have my thyroids tested later on… (The GI checked my thyroids and said they were small). Aside from not losing much weight through regular exercise, the only possible symptom of hypothyroidism I notice is that over the past 5 years or so, the outer half of my eyebrows have all but disappeared…

    I hope you have the time for reading this and responding…


    • Ross, Did you ever resolve your issues with the burning of your muscles? And your disappearing eyebrows?! I know that when my eyebrows have disappeared (twice) it’s been due to my off-kilter TSH levels. My thyroid was removed some yrs back due to nodules that kept filling up with fluid. I finally asked that it be removed and on biopsy it was found to have pre-cancerous cells. Since then, recently, I have been found to have low lvls of Vit D (24ng/dl) so I’ve been put on 50kIU/wk for 90 days along w/ my usual supplement of D3 w/ my calcilum carbonate 2x/day pills I take as part of my regimen. I have Lupus, you see, and have had it for over 27 yrs now. It’s been treated and am now in “remission” but I have fibromyalgia so the pain and stiffness of my joints is pretty bad. If not the fire, then it’s the pan for me.

      I’m hoping you’re still in Guadalajara and able to enjoy it’s ravines! I was on a road trip on a motorcycle through there in 2002 and had it not been otherwise, I’d’ve loved to have settled there. Still would if I had my druthers.

      Please post an update if you can, to my e-mail if you can’t. I’m REALLY interested in the outcome of your case!!!

  50. Hi how low is to low, My test show level was at 16, started researching about it, all the symptoms they say I have also have had thyroid issues one side was removed and there was a small amount of cancer, still have 1/2 thyroid and they don’t know if that side has cancer, kidney issues have had sugar issues for years, skin problems I could go on so I look at all lab work I have and see as far as I can tell have been low for at least 8yrs, But none of my Dr ‘s seem to concerned, so I wasn’t but now don’t 16 just a little low…

  51. Something I recently discovered is if you take Vitamin A supplements it can interfere with your Vitamin D3 absorption. So take them different times of day so there is no interference. I think this is the reason my blood test barely had me in normal range despite many hours of sunlight per week during warm weather plus also taking 10,000 IU of Vit D3 per day. Taking Vit A in evening and going to retest in a few months and see if my level changes.

    • Hey Angela, I don’t believe supplimentation would interfer with production of Vitamin D in the skin… However, the research claims that if you are sufficiently overweight to classify as obese, the vitamin D produced in your skin will be trapped in your fat cells… That said, you may be a skinny Minnie… and this wouldn’t mean diddly 🙂 I’m interested in knowing if you levels increased ingesting the 10,000 IU per day and how long were you taking it. And did your doctors or the instructions on the bottle suggest you take the suppliments during or right after eating some form of fat (could be avocado, yogurt, olive oil; doesn’t have to be unhealthy)? … because… if Vitamin will not be absorbed without some form of fat attachment. Vitamin C and the Vitamin Bs are water soluble. Vitamins A, D, E, and K are fat solable. The fat soluble vitamins stay in the body longer. The water soluble vitamins leave your body in the urine. So, if you have diarhea… or you dring a lot of coffee or black tea… or if you are taking a diuretic for high blood pressure or for inflammation… or bloating… you would have to up your intake of the water soluble vitamins. But, if you are on an anti-fat diet, you are probably slowly killing yourself 🙂 Chris isn’t following these conversations…

      • Hi Ross, At my recent doctor visit he would not retest my Vit D. Apparently my insurance doesn’t allow frequent testing. Will try again in a few months. I’ve been taking 10,000 IU of Vit D for over 2 years. Prior to that I was on 2,000 & 4,000 IU. All totaled this is about 4 years straight I have been on Vit D and have not gotten any colds or sinus infections, my health has improved dramatically despite having an autoimmune illness called CREST. This winter I decided to start indoor tanning and am curious again whether my D levels would get too high. But considering I was spending hours outdoors last summer while taking 10,000 IU and barely just testing into low-mid of the normal range on D I am still probably not overdosing. I don’t have symptoms of too high D. I also take E & K and switched from A to Beta Carotine.

        I am concerned now over the recent comments concerning B12 injections as my doctor prescribed biweekly and now weekly home injections of Vit B12. He said it would help with my weight loss plus also chronic fatigue and he figured would help as I was treated for Lyme disease a few years ago by another doctor when I lived elsewhere. From what I have read Lyme spirochetes devour B12 stores as an energy source leaving the person chronically low. As far as B12 helping weight loss I personally didn’t believe my doctor. But after I have an injection I lose 2 lbs over a matter of a couple days hence he changed me from biweekly to weekly doses. I am concerned over the B12 and potassium comment, but do not understand what the mechanism is that would cause injected B12 to lower potassium. I already have low potassium, explained by one former doctor being related to being a salt loser because of an adrenal condition. It seems to be something runs in family as my grandmother has had low potassium problems throughout her life too. I take 600 mg potassium pills per day in order to avoid severe leg cramps and muscle spasms. Otherwise I wake up in excruciating pain from morning leg cramps and in summer when I am so active sweating like a horse I have to be extremely careful. I also take magnesium glyconate before bed. I have the muscle cramp problem for years now and have only started B12 just recently so it isn’t the cause of the problem, but at same time don’t want to make it worse if indeed injectible B12 is bad. I did not find the sublingual B12 to work at all.

  52. Thank you for this article! It’s the first time I’ve come across a connection between Vitamin D and blood sugar issues. I’ve been feeling terrible (vertigo, hypoglycemia- after eating, exhaustion, flushing, freezing, foggy, eczema) and was recently diagnosed with a multinodular goiter on my thyroid but my tests came out great – except for lower than normal Vitamin D despite supplementing with 1000 iu. My doctor is baffled so I’m trying to piece things together. Now, I’ll look deeper into this connection between Vitamin D malabsorption and insulin. Any further guidance or literature recommendations would be greatly appreciated.
    Thank you!

    • Hi Eva,

      Your doctor is baffled probably because he doesn’t realize that 1000iu per day is insufficient to increase one’s levels. There’s a study on PubMed that showed that HEALTHY men needed 3,000-5,000 ius a day just to maintain their levels. You could be malabsorbing it, but it could also be that you’re not taking nearly enough in the first place.


  53. I see a pattern of foods that have vit D also contain iodine. I further see a pattern of obesity and thyroid issues (and multiple cancers) up ticking when the baking industry switched from using iodine in baked goods and introduced bromines, a known goiteroid and carcinogen; and ‘anti-iodine’. I strongly suspect that iodine needs to be added to the D balancing equation, and that foods containing bromine, and soy be completely avoided.

  54. Chris,
    Eureka! I found you! Diagnosed with Hashimoto’s and severe Vitamin D deficiency in June: TSH 18, TPOAb >6500, Vitamin D level was too low to detect.
    Have been taking Synthroid and 50,000IU D4 1x/wk but still struggling to get well after 5 mos of ttmnt. TSH levels bouncing around; Vit D has only climbed to 15 (dose doubled to 50,000 IU 2x/wk), cholesterol going up not down! (Dr. gave me until Feb to lower it – high 200s w Triglycerides above 190 – then statins) Ugh. Very motivated to get well!
    I’m not taking anything other than Synthroid, prescription Vit D and started 200mg Selenium this week. I purchased your High Cholesterol Action Plan. I know I’m FUBAR. Any other recommendations? I am extremely interested in a consult.

    • Suz,

      Have you considered magnesium deficiency? You should research it in regards to converting to active form of D and cholesterol levels.

  55. Hi Lisa,

    I know this is a lot easier said than done, but try to be as patient as possible — I think once you get your vitamin D levels up, and also your b12, that a lot of those other tests and/or diagnoses won’t be necessary. All of your problems MAY be due to your incredibly low “D” levels. (Because they’re so low, you may need more calcium, magnesium, K2 and boron too, but Chris would know more about that.)

    People with multiple sclerosis have completely healed after restoring their vitamin d (and sometimes b12) levels, so there is hope.

  56. I have been feeling bad for years. I would constantly say to family “my hormones are messed up”. I could feel it. Weight gain started, recurrent kidney stones resulting in multiple lithotripsy procedures. Then irregular periods, mood swings, etc…. they would check thyroid…levels were always normal. I also habe had IBS for some time. Ended up with gall stones and removal of gallbladder. Ended up with hysterectomy. Was seeing GYN for years with all my symptoms…I could tell he was frustrated with me. He just wanted to give me hormones and anti depressants. I refused antidepressants assuring him I was NOT depressed….something was wrong. I decided to go to an endocrinologist after years with GYN. On first exam she tells me my thyroid is enlarged. Again..labs reveal normal thyroid levels except she ran an extra test I never had done before…anti TPO. It was elevated…. sonogram of thyroid revealed multiple nodules and chronic thyroid disease. I have been on thyroid hormones now over a year. Lab levels always normal but I continue to feel worse and worse. Finally, they order vitamin D. My level was 8.5. She said she had never seen one that low before. B12 is also low. Now they are running a pituitary panel…im waiting on results. I went in to early menopause prior to hashimoto diagnosis. I continue with IBS….and they are saying I may need growth hormone. I will soon have a Stim. Test. I feel hopeless…I just want to feel better.

  57. Yes, they compete to some degree but that doesn’t mean they cancel each other out. A & D appear together in fish and organ meats which have been highly prized foods in traditional hunter-gatherer peoples for millennia. When there’s any apparent conflict in the scientific data, I always look to anthropological evidence and the natural composition of foods to resolve it.

  58. The nd/ml measurements are the desired blood levels.  IU measurements refer to supplementation.  The reason I haven’t given a specific recommendation is that the amount you supplement with depends on your current levels.  It doesn’t make any sense to recommend that “everyone” take 10,000 IU.  Vitamin D can be toxic when blood levels rise above 85 – 100 ng/ml, especially in the presence of K2 and A deficiency.  I suggest people maintain levels of approx. 40-60 ng/ml.  If you’re low, you can use 6-10,000 IU to bring your levels up, but you have to test to confirm and to make sure you don’t go to high.  After that, generally 2,000 IU is good for maintenance.

    • Great article, Chris. Okay, so here is my question (and feel free to email me if you can, so I get your reply). I had, at age 24 a bunch of autoimmune thyroid stuff and had my thyroid removed. I am now in my mid thirties and have been on thyroid replacement since, without incident. I’d say, “feeling great”, except I do have other weird symptoms, though they kind of existed pre-thyroid.

      For instance, I’ve been gluten free since I was 24, but still struggle with candida (only as a white tongue) when having more sugar. I have chronic digestive issues. My endoscopy was perfect, so I suspect I have gastroparesis. I only realized this after suffering for a while, especially the last few years. I have all the symptoms of gastroparesis but just don’t want to have that icky radioactive test. Still, the slow digestion affects what I can eat (greatly, I’m not good with most of the foods I ate before- and healthy stuff… like brussels sprouts don’t digest… so my try at veganism utterly failed).

      Currently, I’ve had off and on muscle twitches (but they seem related to digestive trouble) for several years. Sometimes they are gone for months and months, other times happen a lot. It seems to be, as I said, in sync with my tummy not digesting. I have times when I fall asleep and feel my dreams begin too quickly, before I’m fully asleep (hypnagogic speech- began when I was anemic eight months ago, while trying to be vegan). I also have times when my food doesn’t digest (or maybe when I have too many carbs/ sugars, though my blood sugar test -not the glucose, the other one- shows I’m okay). When my food doesn’t digest I get other neuro symptoms too- numb chin, until the acid subsides, etc. Occasionally I get small, sporadic hives from eating foods- but all IgE tests show normal.

      The freakiest thing is that since my digestion got bad I can feel my brain get cluttered at certain points, which is new. Kind of like it’s not fully awake, mainly when I’m tired or hungry but it’s freaky. It feels most like intrusive thought OCD, but comes and goes only when the food I eat doesn’t digest. For instance, if my food comes up (as it often does with gastroparesis, in the evening) then I don’t seem to have that brain stuff happen. When my food stays down but doesn’t digest, I get the cluttered brain and ocd sensation. It typically goes away with rest or when my food comes up.

      How does this relate? I suspect I’m deficient in vitamins, but modern medicine (Western variety) doesn’t oft check on such stuff or look into levels per person (what we might need opposed to the norm). Is 1000 mg of Vit D. good? Should I have more? Also, someone told me that people who have had autoimmune issues shouldn’t take Vitamin D… that it only helps BEFORE they have autoimmune issues.

      Anyway, I’m in California. Any suggestions you have on Vitamin D or anything would be great. Thanks.

  59. I’m really confused on how much Vitamin D supplement to take. Your article uses a ng/ml unit of measure but every Vit D supplement I’ve seen is listed in IU measurements. I have been taking 2,000 IU’s a day but recently heard a news report that 10,000 is now being recommended. This time of year adequate sunlight is not available here as we sometimes have weeks with nothing but cloud cover and fresh fish is not readily available. So Vit D softgels are what I rely on. How much should one be taking?

  60. Chris-
    I just subscribed, thanks to this article. I don’t know if I am technically hypothyroid, but none of my medical tests are extreme enough to indicate anything. I am desperate, so I figured the more information the better…so thanks. I have low Vitamin D, high LDL, slightly high cortisol, bottom of ‘normal’ T3, T4, but relatively ‘normal’ TSH. They had me on Vit D supplementation, but my levels went up really, really slowly (though they are now at 25). I now take 2000-4000IU a day to keep them there. I do take ‘Rainbow Light Women’s One’ which has A and K supplementation as well.

    I’ve essentially felt like hell ever since my daughter was born 5 years ago, but particularly bad the last 5 months (low energy, weakness, joint pain, numbness, whole hand and foot pain, etc). I feel like I am 90, despite being an athlete, non-smoker, non-drinker, vegetable lover my whole life. It’s just so confusing and severe that I can’t believe that they can’t figure it out. I hope to piece it together with the assistance of some of your excellent research/analysis.
    thanks again.

    • Ur info u posted bout health issiues ur having..blew my mind…I could have written it..really sorry ur having these problems hate to admit that glad I’m not alone..wish the best for u…thank u

  61. Re vitamin D levels obtained through sunlight – this review shows that levels reached in a variety of studies – farmers, surfers 105 – 163nmol/L
    Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety
    Also uptake appears to be related to genetic differences.
    Common genetic determinants of vitamin D insufficiency: a genome-wide association study
    By the way – I’m really enjoying your series on Hashimotos – I was diagnosed last year when I had a general check-up. Slightly high TSH, follow up anti-body test showed they were very high.

    • Interesting enough ~ 165nmol/L (66ng/mL) is the middle of the normal range, at least, in the US. When I had Vitamin D toxicity issues last year I noticed my Vitamin D level approached that level and seemed to level out after stopping intake for several months.

      I wouldn’t be surprised if ~ 165nmol/L is optimal, assuming optimal intakes of Vitamin A and K2 as well.

  62. @chris
    you say “Their levels don’t rise above 80 ng/mL.”
    well, 80ng x 2.5 = 200nmol. i was stating 120-50nmol is usual in “sunny” people acording to several studies. so where’s the problem?
    fyi: the unit ng/L is pretty much meaningless outside the US, as it actually doesn’t make much sense to measure the concentration of molecules in a fluid as its mass. that’s about the same as asking for 350g of eggs in the supermarket. of course, as usual, the US thinks holding on to ridiculously outdated and illogical units is somehow cool..

  63. “Complicating the matter further, recent work by researcher Chris Masterjohn suggests that the harmful effects of vitamin D toxicity are at least in part caused by a corresponding deficiency in vitamins A & K2.”
    I’ve been saying for some time that vitamin A should become the next vitamin superstar.  I believe I experienced subclinical vitamin A deficiency and that it affected my reproductive health and also the fetal development of my daughter.  She was born with vesicourinary reflux bilaterally (in plain English, her urine sometimes ran up into her kidneys on both sides) which was diagnosed at age four months.  They tried telling me it was genetic.  I believed it for a while.  Then I ran across a WAPF paper stating that vitamin A is necessary in fetal kidney development.
    And then I found these.
    Sorry about the bizarre font size changes, your comment software apparently uses rich text instead of plain.
    But yes.  This is serious.  There are people walking around with blood pressure and kidney problems.  There are women struggling with bad menstrual symptoms and infertility.  And it might all have been preventable.

  64. Chris,

    Great article.  I have greatly benefited frm taking Vitamin D supplements . I was beginning to think that more is better as long as you keep your level below 100ng/mL. I have pushed my level to approx 90mg/mL and am concerned. I have reduced my dosage of Vit D3 to bring my level down. Probably what has happened is I reduced grain comsumption greatly and no wheat consumption at all and this has caused my increased levels.  Basically I don’t need as much! Fortunately I don’t supplement large doses of Calcium, about 300mg a day.
    Is the half life of supplemented Vit D3 about 3 to 4 weeks? 
    Is the half life of Vit D3 produced from UVB rays about 6 to 8 weeks? 

  65. I have been trying to unravel all the things that have been going on in my body for about 11yrs now. And you have hit the nail on the head with all the problems I have had.
    The doctors tell me you have this wrong and that, but never have they tried to teach me how to deal with it or to put it all together. Thank you so much for taking the time and effort to
    put this out there so I can see how it all lines up!

    Now I will print this and take it and a few other pages you have here and give them to my new doctor. Who at least seems to want to help me!

  66. Chris, I hope you and your wife enjoy your vacation. I just came back from a week at the beach. Hopefully, my D came up from the 42 last month. I suppose the question when sunning is – where do we draw the line between risking sun cancer and maintaining D levels? I unintentionally burned a few times on my trip. Hopefully, the D was worth it. I will say that I had lots more energy last week. I, personally, always feel better after getting out in the sun. I have been detoxifying my gut and I’ve remained GF for the past six months. Hopefully, that will help with D absorption. My real problem now is not Hashimoto’s, as the antibody attacks have all stopped, but my adrenals are still in poor shape. My doc is treating the adrenals with natural supplements, so it takes longer than the HC route.
    Thanks again for a great article and for drawing the connection between adrenals and vitamin D as well. This article is definitely a keeper.
    🙂 Tamra

    • Hi everyone,

      As Kim said, and as the article outlined, sunlight is sufficient for healthy people under 40, but may not be for those over 40 with inflammation and other conditions.

      Qualia, I’m not sure where you got those numbers. Here’s a figure from a study looking at young healthy people in Hawaii with more than 15 hours a week of sun exposure. Their levels don’t rise above 80 ng/mL. In that same study (the one Kim is referring to), some of those people who spent that long in the sun were vitamin D deficient.

    • Tamra, you mentioned, you detoxify your gut; how do you do it? I’m gaining wisdom from this blog since I began researching the web for gluten influences on thyroid. I stopped eating wheat, felt better for a while, but every time I eat something, I feel slightly to very tired or sleepy (I usually do not overeat) and it makes me think it is my weak gut. Any thoughts on how to strengthen it? Also, can swollen feet and face be a sign of vit D overdose/sensitivity/intolerance? I stopped taking D, and swelling/water retention is gone. thanks for your input

      • Oh my
        I had to cut off all my rings a couple of months ago. I had been taking vit d and K2 daily for 5 months. I have had problems with it before at 4000 iu a day. So, I was only taking 1000 so it was gradual and I didn’t realise the swollen fingers and feet were that. I also was having bad anxiety and very sore red gritty dry eyes. These things have gone since I had to stop supplementing nearly 3 weeks ago for tests which got held up. I tested extremely low in D last year so I was hoping the lower dose wouldn’t effect me badly. I am at a loss what to do to get up my levels. I breathe better when I am on D but cannot tolerate the other effects.

  67. You can’t depend on the sun to get optimal Vit. D levels since the majority of those suffering from thyroid conditions do NOT convert UV light efficiently into Vit. D. I recall a study done in Hawaii of people who spent at least 11 hours per week in the sun with no sunscreen. Of those tested, over half were still Vit. D deficient.  However, I think the jury is still out on the best way to supplement this w/o causing toxicity. There’s a lot of conflicting views.

  68. why try to find and define “a new” optimal D level in complicated ways when we just can measure the levels of healthy, young individuals around the globe that get plenty of sun each day (“beach guard” or farmer example)?
    just look what they have and aim for a similar level. and afaik that’s around 120-150nmol? what’s wrong with that?

  69. Thanks, Tyler.  I am concerned about the increasingly common recommendations being made to take up to 10,000 IU (or more) of vitamin D without any consideration of A & K2 status. The unintentional effect of this could be an increase in heart disease due to hypercalcemia.

    I’m especially concerned about that because many people who are supplementing with vitamin D are also taking calcium supplements.  That combination could be very dangerous.

    Jenny Ruhl, author of Diabetes Update, wrote a good article on this recently.  She started having issues when she boosted her 25D level from 39 to the upper 50s.  She did some research and found out that calcium levels in the normal upper range have been associated with increased risk of heart disease.


    • You say that higher D levels are associated with more cardiovascular disease — perhaps this is not because high D causes CVD — but rather most people with high D levels are consuming foods that are naturally high in Vitamin D — like organ meats and fortified Dairy products — and diets high in animal foods have been shown to increase the risk for CVD…perhaps that explains the association?

    • I am taking at about 10,000 units of D3 every day. I take 1200MG of calcium, 100MCG of K2 for every 1000 units D3 and around 800 -1200MG magnesium and a table spoon of cod liver oil. My D was test at the end of last Sept at 25ng/ml. I have not been tested since but wil be soon. Some of the muscle ache and weakness is gone and I had been taking adrenal supplements which helped. I ran out of the adrenal supplements and felt so much better I did not buy more. Within one week my muscles started aching again in my legs, my heart feels like it’s pounding, anxiety, feeling of shortness of breath. I started taking the adrena supps again two days ago. I can eat like crazy and not gain any weight. When I first started feeling bad I had been a little overweight and then the weight just rolled off. Does my supplement combination sound correct to you as far as the amount of each one to each other? I tried to find how much to take of all together and found different answers. I also read that adrenal exhaustion is frequent with low D. What do you think and thanks for the help. Judy

  70. This is a great article. I like how you don’t follow suit of most others and just recommend high undefined levels of D without covering the roles of other factors and co-factors. Just the other day Dr Davis covered a post on a patient with D deficiency and getting their levels to 60/70 ng/ml on 10,000 IU a day without explaining any co-factor roles of K2 and A. I possibly see some issues of everyone jumping on the D bandwagon regardless of healthy diet practices or analyzing their situation and need in depth.

  71. Alisa: for healthy people under the age of 40, sunlight and fatty fish are best.  For people over 40 and/or those with autoimmune disorders, inflammation, obesity and gut problems, a combination of sunlight, fatty fish and supplementation is probably best.

  72. Good article, Chris. I just got Dr. Kharzzian’s book on thyroid disorders and he goes into a lot of detail about this and all the other issues that cause/effect thyroid, etc. It’s actually pretty complicated but he is right in assesing thyroid problems as auto-immune in nature. The problem for most people is that they’re not getting the correct blood tests to determine what’s wrong.

    I always look forward to your writings and hope you have a great vacation!

  73. Oh wow, this (as usual) is a much more complicated medical issue than we like to hope for.

    I haven’t seen any studies pertaining to this, and am curious on your opinion. Do you think naturally obtaining Vit D via the sun is optimal, or do you think supplements are just as good? I have always thought the natural process of obtaining vits and minerals is best (via food, sun, etc.) just from a logical standpoint, but does it really matter?

    • I live in the desert and also have hypothyroidism. I had a vitamin d3 level of 16, which constitutes a severe deficiency. As I said I live in the desert, I do not normally wear sunscreen and I was tested at the height of summer. It is therefore reasonable to assume that sun exposure is not enough for e, and I have been told by my endo to take 5000IU’s every day, I have yet to be tested again. My mom has has hashimoto’s, and she indicated that in the past that her vitamin d levels have also been low. I can only assume there is a direct connection between thyroid disorders and vitamin d that can not be corrected by sunlight. I was told that my body it not converting it to it’s useable form. I think that intestinal issues relating to vitamin d3 absorption may be associated with the difficulty some thyroid patients experience with gluten. Therefore, perhaps correcting intestinal issues coupled with adequate sunlight may reduce the need for supplementation of vitamin d. But that is just a theory.

      • New research has shown that direct sunlight is the best source but the vitamin D is produced on the skin. Your body needs 48 hours to fully absorb that vitamin D on the surface of your skin. So if you shower after sun exposure, you effectively wipe away the vitamin d on your skin. Also, if you get sun filtered through a window, most windows block UVB rays, which is the rays that produce vitamin D and let in UVA rays only. Because of our man made life style we have to compensate for so many factors that normally wouldn’t have to worry about in a natural life style closer to nature….making life more and more complicated.

        • Khalil,

          So if Vitamin D takes 48 hours to be absorbed, and presumably everyone should get a daily dose of sun for Vitamin D production, then when are we supposed to shower? I am NOT going on Naked and Afraid just to try out a more natural lifestyle.

  74. I’m aware of Holick’s opinion.  Unfortunately, there are studies that demonstrate decreasing bone density as levels increase above 45 ng/mL.  I do suspect that this is probably more a problem with K2 & A deficiency than it is too much D, but the point is that this is controversial stuff.  I personally wouldn’t be comfortable recommending levels above 80-90 ng/mL for any significant length of time.

  75. According to Michael Holick

    Vitamin D intoxication doesn’t happen until around 300 ng/ml, and that even at 10,000 IU a day, this will not cause vitamin d intoxication.  The kidney’s apparently do a good job at regulating *activated* vitamin d 1,25(OH)2 in the blood.
    Personally, I’ve been doing 4000 IU a day, every day for a year.  When I tested a year ago  (Canary Club)  I was at 19ng/ml.. I’ll be testing later this month to see the results!

    • Everyone is different and in my case Vitamin D ‘intoxication’ happens at much lower levels.

      I got the symptoms of Vitamin D toxicity at only 109ng. Somewhat later I found out I had a very low blood manganese level, which appears to be exacerbated by Vitamin D. At 10,000 IU/day, even 50mg manganese a day is not sufficient to normalize my blood manganese level. I’ve since dropped back to 5,000 IU/day to see if that helps improve the situation.

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