Dosage For Vitamin D, K2, and Calcium

all this is dr mubeen sayeth from doctorbean.com welcome to one more show and today we are going to talk about something that i have been getting a lot of comments about and that is the dose for vitamin d and what should be the accompanying dose for vitamin k or and or calcium so that is the discussion that we are going to do today so welcome to the show let's start our discussion so here i have a few links and a few tabs open here these tabs are present the the links are present in the description as well welcome everyone so this is uh from harvard and what i wanted to take from here was to put this this is for vitamin d to put this into perspective four ounces of cooked salmon contains approximately 600 international unit of vitamin d so we're going to talk about how much vitamin d is necessary but i i thought this was an interesting thing that how much salmon contains how much vitamin d then here we're going to talk about this as well coimbra protocol protocol so coimbra protocol he is a doctor cicero quimbra he is a neurologist so james kelly who is a good friend from canada he had sent this over to me to look into and he he has helped today with the with the discussion so um and hello everyone hello margaret hello michael uh so i wanted to make sure that we look at the coimbra protocol as well which is a high vitamin d dose administration for some serious diseases like parkinsonism and multiple sclerosis and so on then there are some links over here that are about what is called holy calciferol and i have done the discussions about vitamin d many many times today i'm not going to go into the functions of vitamin d instead today i'm going to talk about the dosage dosage variations that various people have tried and the accompanying dosage for vitamin k2 and the calcium so today's all about dosage and the disclaimer this is not a prescription for any of us this is just an educational material for to assess and explore what various doctors have been prescribing to their patients so this is about ergo calciferol that is the vitamin d present in the plant so called vitamin d2 this is something that is really important i have this link in the description so please make sure that you look at this one this is also sent by by james kelly and here the basic gist of this all is that instead of 600 to 800 international units of vitamin d every day it seems like 8 800 international units per day is the right number so that is a discussion here and the reason for why they think that is the way this is another link which is really really important in this link what they have discussed is what is the comparative dosage of vitamin d for example algocalciferol or coal calciferol or vitamin d3 and d2 that we find in either in our skin or from food versus calcified diol which is the second stage of the vitamin d and in our body and i'm going to discuss that in detail and they've compared them so we're going to talk about this as well this is really an important article here this is one more and that is the this is the importance of body weight so i wanted to make sure that we can look at the vitamin d dose with the body weight so various body weights or bmi levels may need varying levels of vitamin d so we'll talk about that as well then there is this vitamin k2 or the the vitamin k's flavor that needs to be accompanied with the vitamin d so we'll talk about this one and its dosage here is again the dose recommendation i have a amazon's you know supplement bottle here as well just to show then over here this is about the reference intake for vitamin a vitamin k arsenic and others so we'll talk about that too and finally for calcium what are various dosages and stuff so this is the basic links that are present and let us start now our discussion so look we'll start from vitamin d the takeaway for today is the following one we should become clear that what is the vitamin d level that we can take daily number one number two what form of vitamin d is important for us to take is it choli calciferol or the normal supplement which is called vitamin d3 or is it the calcified diol which is the second stage of vitamin or it is calcitriol so that is the second part third part is we have to see that which body weight will require how much vitamin d then the fourth takeaway is with the vitamin d how much k2 should be taken and how much calcium should be taken so that that is a discussion so it's all about dosage so look at this vitamin d the very first stage that we can eat from in food for example salmon or the vitamin d that is formed in our skin by the uvb light and i have discussed that in the past or the vitamin d that is in vegetable for example mushrooms or the vitamin d that is in the fortified foods all of those vitamin d's that we can take from outside vitamin d3 or d2 are the primary intake source or production source in the skin from there we also know that that vitamin that we eat will then go to from a git it will go to our liver and liver from dit or from skin it goes to liver liver hydroxylizes it or changes it and it becomes calci diol or calcified diol so this is what i call the second stage of vitamin d metabolism it is still not the active stage then the kidney or some other cells as well can then take up this calcified diol or the second stage of vitamin d and then convert that to kelsey triol or the third and final stage of vitamin d which is the active form so the takeaway today is going to be how much to take this one or are there people amongst us who need to take the second stage instead of the first one or are there people who need the third stage as well so that is a discussion so let's start here what we are talking about is this is the vitamin d3 and d2 the first stage they recommended daily allowance so today what i'm going to do is i'm going to show you the dose that is recommended and then i'm going to show you the dosage that various doctors have used in higher doses of vitamin d and what kind of safety margins they've seen and what what kind of therapeutic outcomes have seen so the regular normal dose or daily allowance recommended allowance from in the u.s 600 international units per day for vitamin d3 in europe 800 international units per day in france 1 000 international units per day so that is the recommended daily allowance this paper that i showed you here this paper claims that the calculation of the rda is incorrect and the correct daily intake should be 8800 international units so i have put that over here as well that the corrected rda by those authors is 8 800 international units per day now question is should we take this form of vitamins or should we take calcified io so it's a very simple thing look the first form of vitamin or inactive vitamin has to go to liver by getting absorbed from our our git or coming from the skin and then become converted to the second stage so if there is a problem with the skin conversion what does that mean maybe we are tan in our color maybe we use a lot of sunscreen maybe we do not have enough sun so whatever is the reason if our skin or maybe it is winter a cold time and we are wrapped up and bundled up in clothes all the time so whatever is the reason if our skin doesn't have a chance to make lots of vitamin d then we need to figure out an active form or we need to take the supplements so if we take supplements then the second issue that we have to figure out is that is our intestine gastrointestinal system is a git correctly absorbing the vitamin d or not so those folks who have in an issue with the skin making vitamin d or have a git issue that they have a mal absorption problem with the git or whose liver isn't working correctly in all these cases the second form of vitamin d or the calcified diol is given because the first form cannot get converted to second form because either the first form is not made or if it is eaten it is not absorbed or if it is absorbed and goes to liver then the liver is not metabolizing it or converting it correctly because liver has a problem so in that case the second phase second stage and that is by excuse me by prescription now if we have let's say kidney issues let's say we have a chronic kidney disease which causes the kidney not to function correctly and convert the second form to the third form not correctly then the third form will have to be given so i hope this becomes clear that who is a candidate for the supplements most or all of the healthy individuals will be candidate for supplements those individual excuse me those individuals with the skin issues or with the sunlight issues with their daily lifestyle or with git issues or with liver issues they may need to go to calcify diode and it is by prescription only at least in the us if individuals have kid knee issues then they'll have to go to once again prescription with kelsey trial now going back to the dosage 600 and 800 and 1000 corrected according to some authors is eighty eight hundred then let's look at the high dose there are doctors who have been giving five thousand international units per day or ten thousand international units per day and i'll show you doctors who are giving 100 000 to 300 000 international units per day so high dose is very common as well in my own practice i use for covert 19 time nowadays i use 5000 international units per day on a regular basis the toxicity has been observed to be at 50 000 or more international units per day if vitamin d is taken for more than two months now so this is the second level so this was rda here is a little higher dose this is my recommendation then uh even higher dose so for that the coimbra protocol that i showed here dr coimbra he is here so they have been using vitamin d from 10 000 international unit to up to 300 000 international units per day so that is a lot of uh vitamin d so i see a question here laurette dillon says oops is this is the active form iv for d3 so uh the active form of vitamin d can be oral or injectable but vitamin d3 or d2 is usually oral and that is the supplements that we usually get okay so back here so even up to 300 000 international units per day and he is a neurologist so he has been treating multiple sclerosis parkinsonism and other diseases with high dose of vitamin d so it would be interesting if you can look into that protocol as well i tried to read it but that was all in spanish so i could not then bmi based dose adjustment so let's say that if your bmi if you have some extra weight then how much vitamin d should you take so normal bmi which is usually between 18.5 to lesser than 25 these numbers that i showed above are for the normal bmi so that is again 600 800 1000. or let's say 5000 nowadays for a few months per day international units if the bmi is overweight bmi that is the range is 25 to lesser than 30 then the recommended change in vitamin d levels or intake is 1.5 times that of regular so if if a person in normal bmi range is going to take let's say 5000 international units then a person who is overweight will have to take 5000 multiplied by 1.5 that is 7500 international units per day then if somebody is obese then they may need to have two to three times the vitamin d so for that means that let's say 5000 is international units is regular for one day then three ten thousand to fifteen thousand international units per day for somebody who is obese and what is the reason for that there is uh an important thing to notice and that is so i'm gonna draw it here as the vitamin d appears in our body from various sources that may be the skin that may be plants or fish etc so food or skin so as the vitamin d enters our body it will go through our fat cells so fat cells will act like a container or a depot to store this vitamin d that just arrived so let's say this vitamin d is going to be stored in the fats then what happens is that our liver on a daily basis is going to pull the required what for required amount of vitamin d convert that to calcified diol or kelsey diol and then give it to the body so vitamin d will be stored in the fats so if somebody has a lots of fat cells then they would store more vitamin d in them so their general requirement increases so back here then for obese folks two to three times the normal rda for overweight 1.5 times the normal rda then there is another link that was sent today by james kelly once again and that was about the vitamin d hammer so vitamin d hammer here so this is a so this is what is their vitamin d hammer and what they do in that is for their patients they either give 50 000 international units that so one time fifty thousand international units then regular rda or they give ten thousand international units thrice daily so that mean means thirty thousand international units in a day and then for two to three days and then regular [Music] i know that one of my family members they were having age 60 62 they had lots of muscle pains and and fatigue and could not walk because of the pains in feet and etc so the doctor who saw her he gave her 200 000 international units at one time and then he put them on a weekly i believe hundred thousand international units so it seems high but she has been since very very fine she doesn't have those complaints anymore so high levels of vitamin d have been used and so this is the another example of using high levels of vitamin d now some quick math so before i go to math that is more discussion more detailed discussion of vitamin d dosage i'm gonna go to the accompanying vitamin k2 and vitamin and calcium so let's look at it so when we are taking vitamin d it is important to take vitamin k with that too and especially k2 the reason for that is that when vitamin d is taken vitamin d's function is to mobilize calcium and mostly it would deposit that in the bone however it's going to look at phosphate and calcium levels in the blood and if for some reason it doesn't have the right calcium it's going to increase that calcium in the blood by increasing the absorption and by increasing the reabsorption from the kidney and by mobilizing it from or depositing it into the bone so there is a complex mechanism i've discussed it before end result is there is calcium in the blood now if that calcium is not appropriately routed to bones then that calcium is going to start getting stored in soft tissue for example blood vessels and kidney in the kidney it can cause kidney disease it can cause stones and eventually kidney failure in the blood vessels when it would be deposited there it would cause atherosclerosis and eventually hypertension and heart failure and these are just a couple of things that extra calcium can do there can be other issues as well so what we do is we need vitamin k2 k2's function is to actually activate those proteins that would help remove calcium from the soft tissue and help them be deposited in the bones so it is necessary that when we are taking vitamin d especially if in the higher doses and for a prolonged period of time we have to take vitamin k2 so that our kidney and our blood vessels are not unnecessarily calcified or developed stones in them so for that the vitamin k2 1000 international unit of vitamin a and d should accompany it so 1000 iu of vitamin a and vitamin d should accompany so there are two types of vitamin k2's one is called mk7 and that is a long chain vitamin k2 and the other one is called mk4 that is a short chain vitamin k2 mk7 is more potent so 100 microgram of vitamin k2 mk7 form every day or if it is going to be mk4 form then 1000 microgram every day so if you see here i have a this if you look at this one this is most active form of vitamin k2 mk 7 again i have nothing to do with this brand i just opened up amazon and search for vitamin k2 so nothing i do not even know who they are but if you look at their if you look at their daily allowance if you see here they are saying vitamin k2 mk7 form or menokinone 7 90 microgram 80 of daily recommended value so in the u.s since 2020 is beginning we have been using the uh the abbreviation or the metric daily value instead of rda or elemental so what it is saying is that the daily value 80 of the daily value is present in one serving size and maybe one serving here is one soft gel so if you see here it says serving size one soft gel serving per container so total sixty gels in there and one soft gel has eighty percent of the daily value present in it so that is how we would look at the vitamin k2 so vitamin k2 i would not increase the vitamin k2 with vitamin d for example if we are taking 5000 international units i would not recommend that we go and take 500 microgram of vitamin k2 i would stop it at white at 100 microgram now please remember that vitamin k is in three forms vitamin k1 k2 and k3 k1 is much more active for coagulation and clotting k2 is much more active with the calcium type metabolism but it is also important for clotting or used in there k1 can be converted to k2 as well so those people who are using vitamin k based anticoagulants they should not take extra vitamin k without asking their doctors so patients on vitamin k antagonist for anticoagulation should not take vitamin k so please be careful if you are taking blood thinners talk with your doctor first and that means if you're not going to start vitamin k2 then also don't start high dose of vitamin d without talking with your doctor correct so so there is a comment here by mary remember that vitamin k clot so works against comedian or warfarin so that is exactly what i'm talking about i didn't want to name the drugs itself but if you are taking any uh k antagonist then please don't take more k because you're already taking drugs that are blocking the vitamin k taking more k would actually cause coagulation which can then cause the problems for example strokes or heart attacks and so on and finally calcium so calcium's recommended daily allowance is one thousand to two thousand milligram and i'll show you a table here and i have this link in the description as well so here you can see table 19 to 15 years 1 000 milligram daily upper limit is 2500 and so on so you have this table over here now the important thing to keep in mind is that calcium it can also become dangerous especially calcium extra calcium present can cause kidney disease or aggravate the kidney disease extra calcium can cause if it is too much extra then it can cause constipation fatigue lethargy nausea vomiting extra calcium can cause cardiac arrhythmias as well so if you are a heart patient and you're taking drugs for heart maybe you're even taking calcium channel blockers in that case taking calcium can become really really bad so make sure that you do not take calcium without talking with your doctor now if you're not going to take calcium that means you're not going to take vitamin k2 extra that means you're not going to take vitamin d extra so if there is any such reason for example kidney disease or cardiac issues or other hyperparathyroidism so if there is a condition like that then all of these supplements will have to be first discussed with your doctors and then taken right so calcium rdas are those now one more thing for the calcium rda is there is a couple of things here recommended daily allowance elemental calcium and then daily value they're all kind of different things in the us now from 2020 we have started talking about daily value so if you see here this is a calcium 500 milligram and if you see here how it says on its label amount per serving percent daily value so vitamin d so it is d and calcium together 400 excuse me 400 international units or 100 which i i doubt that that is really the daily value but anyways that's the the thinking about calcium 500 milligram or 50 of the daily value and so they are assuming that daily value is 1000 milligram and that can change based on the person's need and age and their their height and their body weight and their kidney status and their hypertension status and cardiac tissue status and so on but this is what they have so please realize that daily value is just a percentage number of the recommended dose so i hope that that is clear so here if you wanted to just know the doses you can stop here so 5000 international units of vitamin d then with that 100 microgram of let's say vitamin k2 mk7 form and then with that about 1 000 milligrams of calcium with this now i'm going to go into a little bit more depth so whoever wants to stay around please do and that is some math with calcium oh sorry vitamin d so 40 international units of coli calciferol that is the vitamin d coming from the vitamin d3 coming from the fish or from our skin is one microgram of holy calciferol so one microgram is called 40 international units 4 000 international units per day for three months when given usually create the plasma level of 40 nanogram per milliliter of kelsey diol so remember this please that when we administer vitamin d when we administer this d the measurement is done on this stage so we do not measure this in the blood instead once it has become converted into the second stage it is the second stage that is measured so back here four thousand international units when given for about three months they bring the plasma levels to 40 nanogram per mil per milliliter and normally from 30 to 50 nanogram per milliliter it's supposed to be normal but if you would see for example coimbra protocol they can go up to higher numbers two or three hundred nanogram per milliliter as well 100 000 international units given stat that means given once can produce so please realize this is very important within seven days so liver can take up to seven days to metabolize the the vitamin d that we have taken that vitamin d actually goes into the fat storage then liver keeps pulling it out of there and keeps metabolizing we're activating it to the second form so if we give hundred thousand international units that that means if i get 100 000 today now within seven days or after seven days i will develop 42 nanogram per lit milliliter of the kelsey diol levels and onwards so that means if i am not sure that what is my level at this time but i want to make sure that winter is coming i want to i want to be healthier and i haven't gotten my test done then possibly 50 000 to 100 000 one time would give me at least a chance to come into the normal range then after seven days liver is still going to continue to pull more vitamin d this hundred thousand has gone and stored in the what in the fats then it would continue to pull more vitamin d from there and continue to metabolize and provide from anywhere from 42 nanogram per milliliter to up to on the lower side 39 nanogram per milliliter on daily basis for 70 days so 100 000 units given now can help a person stay in the normal range for up to 70 days again this means that the person has a correct absorbing git the person has a correct liver is not obese is not overweight so all those parameters have to be taken into account but this is for a healthy individual then and my own anecdote over here the patient that i had checked who had cancer as a co-morbidity and was deteriorating very fast with cover 19 i had given him 200 000 international units stacked and then i maintained them further so a hundred thousand international units here half life so this is also a very important point here half life means the amount of time in which the the the plasma levels of some drug drop to half cholecalciferol that means from outside when we give vitamin or from skin when that is given the half life is up to two months and the reason once again is the same the vitamin would go get stored in the in the fatty tissue from there liver would continue to pull it out and metabolize and make it available for the body so up to two months it would be stored and used so that is it would become half every two months calcified diol that is the second stage of the vitamin d which is after the hydroxylation that happens in the liver this has two weeks half-life so if you're giving calcify diol because a person has git issues or they have liver issues or they have skin for example tan or they're living in a place where there is less sun etc then you're if you're giving them scales if you diol then it would stay consistent or half life is two weeks the reason for that is cholecalciferol is much more lipophilic it likes the fats and attaches to them much better than calcified ion some more information here so there are some uh metrics you would see nanogram per milliliter versus nanomole per liter so when you see nanogram per milliliter so here is the conversion if you multiply nano nanogram per milliliter with 2.5 that would give you nanomole per liter so for example 50 nanogram per milliliter is 125 nanomole per liter then there is a article here which is i think is very important for dosage and that is i believe this is the one uh this is the one so here what they have discussed it if you see here on average serum levels this part is what i'm going to discuss now what this say is if somebody is getting up to 1 000 international units of vitamin d every day so that means 400 or 600 or 800 or up to 1000 then their plasma calcium level increases by 4.8 nanogram per milliliter per day so or as long as you're taking it and then there is an upper range after that it would stop becoming higher it would just then start persisting so 12 nanomole per liter or 4.8 nanogram per milliliter can be the increment per 1000 units given daily if on the other hand a person is given 15 000 to 20 000 units daily then their plasma levels will increase by 1.1 nano mole per liter per thousand units so for example if you are giving them 15 000 international units then they would increase by 6.6 nanogram per milliliter or 16.5 nanomole per liter so that is a bit of the discussion with the dosage i hope that that helps this was a very common question that i had been receiving that what should be the dose of vitamin d and what should be the dose accompanying with vitamin d for vitamin k2 and the calcium so i hope that that makes sense i hope you're all fine tomorrow is my off i'll see you on monday and once again thank you to everyone who has been donating and supporting this work please like subscribe and share and i'll see you on monday the good news on monday we'll have dr harara with us who is making the rapid test kit for covet 19 which does not need machines and that can be used in a point of care or at home so we're going to ask him how is that going and secondly on tuesday we'll have dr paul marek with us of math plus protocol once more with us and we are going to discuss some more things so i had a long discussion with him today we talked about what are the things that he is seeing that doctors are not aware of and he would like to discuss those for example the phases of the of the disease and what phase should be managed in what way and then secondly the mask etc so we'll have him with us on tuesday i'm super excited about it so thank you very much see you next week bye

Channel: Drbeen Medical Lectures

Views: 378,077

Keywords: drbeen, medicine, nursing, med school, microbiology, sars-cov-2, covid-19, coronavirus, usmle, mbbs, nclex, cytokines, Health (Industry), Medicine (Field of Study), Pathology (Medical Specialty), what is, nursing (field of study), Nursing school (organization), vitamin d, vitamin k2, calcium, cholecalciferol, mk-7, menaquinone, coimbra protocol, supplements

Id: mg2eBhGB3T8

Length: 36min 45sec (2205 seconds)

Published: Sat Sep 12 2020

Reddit Comments

[u/Smith5002x]

Anyone watch this? Can you please give a summary of the dosage he recommends.