This post is an update to a number of past articles and blog posts, including my vitamin D recommendations and my Top 3 Dietary Supplements. And if you haven’t already seen it, please read The Cod Liver Oil Debate for the full background on this update before reading further.

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Recent research has sparked a debate over the roles of vitamin D and vitamin A in health and wellness. Various natural health proponents and organizations have jumped into the fray, offering opinion and conjecture while taking sides on the issue.

The debate stems from whether high dosages of vitamin A or D are harmful or healthy – and how much of each people should be taking.

On the “Vitamin A is bad and Vitamin D is good” side are heavy hitters like Dr. Mercola of the #1 alternative health website Mercola.com and The Vitamin D Council.

On the “Vitamin A is good and Vitamin D isn’t quite as good” side are the prestigious Weston A. Price Foundation and a number of other scientists and researchers.

RECOMMENDATIONS OF EACH SIDE

The Vitamin D Council recommendations are for a daily intake of vitamin D3 (cholecalciferol) for healthy adults of around 5000IU per day – or 1000IU per 25lbs of body weight. Additionally, they recommend a vitamin D-to-A ratio of approximately 4-5:1 with the vitamin A sourced only from plant-based beta carotene.

Based on their 4-5:1 D-to-A ratio, this would equate to roughly 1000-1250IU vitamin A per day, which they suggest you can get from diet alone (which is also less than that in many multivitamins). They note that beta carotene supplementation of around 1000-2000IU per day would probably be fine.

Having said the above, however, if you get a good deal of sun exposure on a regular basis (year round), they say you may not need to supplement with any vitamin D at all. To know if you’re deficient, their recommendations suggest getting a 25(OH)D test (also called 25-hydroxyvitamin D test).  The optimal value you’re shooting for is 50-80 ng/ml (or 125–200 nM/L), which should be maintained year round.

On the flip side, The Weston A. Price Foundation recommends less vitamin D and more vitamin A, though they recommend getting your vitamins from organic whole foods, certain all-natural brands of cod liver oil, and healthy sun exposure rather than from vitamin pill isolates. Their recommendations are for a vitamin A-to-D ratio of roughly 5-8:1, which is almost exactly the opposite of the other side’s recommendation.

This 5-8:1 ratio in favor of vitamin A equates to roughly 10,000IU per day of vitamin A and only around 1000-2000IU of vitamin D for healthy adults. They also note that when taken from a whole food supplement like the earlier-mentioned all-natural brands of cod liver oil, adults fighting off the rigors of stress or disease may safely take up to 90,000IU of vitamin A with 9000-18,000IU vitamin D for several weeks.

Finally, The Weston A. Price Foundation suggests that The Vitamin D Council is overstating the need for vitamin D. Their recommendation for a healthy vitamin D blood level is 30-50 ng/ml (or 75-125 nM/L).

 

VITAMIN K

Another fly in the ointment is the necessity of vitamin K, particularly the K1 (phylloquinone) and K2 (menaquinone) variations.  Thankfully, neither side in the debate is in disagreement about the necessity of this vitamin.

The importance of vitamin K was discovered back in the 1940’s when Dr. Weston Price found in his research that there was an as-of-then unknown “Activator X” that seemed to tie vitamins A and D together and allow them to function to their fullest extent in the body. The theory goes that this missing ingredient was vitamin K.

Today, a great deal is known about this important nutrient. Vitamin K is important for healthy bones, arteries, heart, immune system, brain function and proper blood clotting (those individuals on anticoagulants should speak with their doctor before taking vitamin K). More recently, it’s also been implicated as a potent cancer fighter.

Recommended daily intake of vitamin K (particularly K2) from the literature available ranges from 45-185mcg per day for healthy adults. Dr. Mercola recommends at least 100mcg per day (his vitamin K has a daily dosage of 150mcg). And while The Weston A. Price foundation doesn’t give specific RDAs, from the products and brands they recommend, Dr. Mercola’s recommendations fall well within their ranges.

MY RECOMMENDATIONS

Instead of rolling the dice and taking sides, I’d like to believe there’s a happy medium here. The goal, after all, is health. And we need guidelines now, not at some unknown future date when more research finally bears out the truth of the matter.

If we look at the common ground between the two approaches, we find our guidelines:

(1) Get your vitamins from whole, organic foods first, supplements second. This means eating lots of vitamin-rich foods, particularly naturally-raised (pastured), animal-sourced foods because of the fat-soluble nature of these vitamins. Get your vitamin D from sun exposure if at all possible (best times are midday when the sun is highest in the sky).

Vitamin D Rich Foods: raw dairy & butter, herring, salmon, tuna, mackerel, sardines, roe, eggs, crab, lobster, shrimp

Vitamin A Rich Foods: raw dairy & butter, liver, egg yolks, carrots, sweet potatoes, mangoes, spinach, cantaloupe, hard cheese

Vitamin K Rich Foods: raw dairy & butter, liver & organ meats, Japanese natto, egg yolks, and a wide range of green leafy vegetables (which are primarily K1)

(2) Rotate your multivitamins and other supplements every few months between a few trusted brands to vary your sources. One never knows what important cofactors could be missing from one formulation vs. another.

My recommended multivitamins/minerals*:

• Dr. Mercola’s Multivitamin Plus
• New Chapter Every Man
• New Chapter Every Man II (over 40)
• New Chapter Every Woman
• New Chapter Every Woman II (over 40)

My recommended sources of vitamin K2*:

• Dr. Mercola’s Vitamin K2
• NutriCology Full-Spectrum Vitamin K
• Jarrow Formulas MK-7

My recommended sources of vitamin D3*:

• Carlson Vitamin D3 (2000IU)

My recommended sources of healthy fish oils/EFA’s*:

• Green Pasture Blue Ice Royal Butter Oil/Fermented Cod Liver Oil Blend
• Carlson Very Finest Fish Oil
• Dr. Mercola’s Antarctic Pure Krill Oil

(3) Get a 25(OH)D test (also called 25-hydroxyvitamin D test) to find your vitamin D levels. The range between the high and the low of what both sides in the debate recommend is 30-80 ng/ml (75-200 nM/L). The midpoint between the high and the low is 55 ng/ml (138 nM/L).

Personally, my recommendation is to shoot for the midpoint and try to maintain that year round. There is, to my knowledge, no known toxicity issues with this range so long as your levels of vitamin A and K are within at least the minimal recommendations. You will also never overdose on vitamin D if you get plenty of sunlight (instead of supplementing) because your body will simply stop producing vitamin D once it’s made enough.