The role of vitamin D deficiency in thyroid disorders

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  1. enliteneer’s avatar

    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!

  2. Chris Kresser’s avatar

    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.

  3. Alisa’s avatar

    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?

  4. Kim’s avatar

    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!

  5. Chris Kresser’s avatar

    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.

  6. Tyler’s avatar

    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.

  7. Chris Kresser’s avatar

    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.


  8. qualia’s avatar

    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?

  9. Kim’s avatar

    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.

  10. Tamra’s avatar

    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

  11. Chris Kresser’s avatar

    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.

  12. gigisdiamonds’s avatar

    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!

  13. Alan’s avatar


    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? 

  14. Dana’s avatar

    “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.

  15. qualia’s avatar

    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..

  16. enliteneer’s avatar

    Couple of great articles on the subject here:

    Its mentioned in several places that Vitamin A and K-2 are needed alongside Vitamin D.   Haven’t been able to find any study on this.. or the mechanism why.  Also, K2 comes in 2 forms (Mk2, MK7), but again those details seem sparce.

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