The worst case scenario isn't 'healthier bones'.

It's kidney failure - https://www.cmaj.ca/content/191/14/E390

Or fatal hypercalcemia - https://link.springer.com/article/10.1007/s12098-016-2109-z

And so on.

I frankly think its irresponsible and facile for anyone to suggest there are no downsides to high doses of Vitamin D. This stuff is available OTC and a lot of folks are just gonna dose themselves ad libitum here.

I think a responsible way to look at vitamin D right now is:

- There was an association shown between low serum levels and bad COVID-19 outcomes, but low vitamin D is an indicator of frailty, so it was how much of this relation was causal.

- Now we have some early data that sure makes it look causal and it seems to be a significant effect, but it's not watertight yet.

- We know that a big fraction of us have low vitamin D levels with other health consequences from it.

- Taking a moderate dose of vitamin D now seems like a reasonable hedge: low risk of health consequences, and a decent chance of health benefits even if it doesn't protect us from the pandemic.

We get 20,000 iu of Vitamin D in like 15 to 30 minutes of sun (if you're pale skinned). Pretty sure taking 5,000 iu every day isn't going to be harmful.

Also, fun side note: Vitamin D is produced as an oil on the skin and actually seeps through your skin overtime to enter the bloodstream. So don't take a shower after getting some sun, because you could be washing off your Vitamin D.

> We get 20,000 iu of Vitamin D in like 15 to 30 minutes of sun (if you're pale skinned). Pretty sure taking 5,000 iu every day isn't going to be harmful.

You cannot overdose on vitamin D from sun exposure because the metabolic process that creates it has a concentration limit.

You CAN overdose (experience toxicity) from too much supplementation. They are not equivalent.

Some people do get toxic side effects from supplementing 5000 IUs a day, over long periods of time.

Interesting, thank you for sharing. Didn't know that. Just what Dr. Hyman recommends in his book, sounds like it's also levels that build up, and there is seasonal sun so maybe years long 5000-10000 IU supplements is overkill and why he recommends 2000 maintenance.

> We get 20,000 iu of Vitamin D in like 15 to 30 minutes of sun (if you're pale skinned). Pretty sure taking 5,000 iu every day isn't going to be harmful.

Sarcasm: Yah, getting it from sun and from a supplement are biologically identical.

You absolutely can get too much vitamin D from a few thousand IU per day for a sustained time.

Who said to give people overdoses of vitamin D?

Honestly. I’m making a simple point that giving people a free, normal dose would be beneficial to them either way. So why not.

It’s pretty hard to OD on vitamins unless you can’t read the label.

Worst case is actually vitamin d toxicity. You can take too much.

I looked into that when I was told to take 2,000 IU daily, since I had no idea what an IU of vitamin D involved. A web search said that people who were taking megadoses of vitamin D, which was mislabeled and actually 10 times stronger than what they thought they were getting, started developing problems in a month or so.

It's available right off the shelf. As long as people aren't taking an entire bottle all at once, it seems pretty safe to me. (Disclaimer: Dammit Jim, I'm a software engineer, not a doctor.)

Drinking too much water will kill you too.

The point I’m making is there is basically no drawback to giving people a normal, healthy, vitamin D supplement. Plus possible upsides.

Except the dosing in this study is a massive supra-physiological bolus that's something like 50x the daily RDV.

> Worst case scenario: We all have healthier bones.

I know people subscribing to the Vitamin D religion don't like to hear this, but this is one of those claims about Vitamin D that has been tested - and actually isn't true. https://www.medpagetoday.com/endocrinology/osteoporosis/8183...

Vitamin D pills look to be 3-5¢ per day. Hardly seems like something I’d be supportive of creating a “free” supply chain for.

The biggest issue i think it's availability. When this was hitting the new York area, vitamin d was impossible to find on the shelves. It's available now, but if we start putting out mass messaging to take vitamin d then supply will run dry again. Shady unsafe supplies will then start showing up to make a buck.

If the costs are low, then the free supply chain won’t cost much to create. If the public health savings are greater than the costs, it may be better to just mail free supplements to people than mail them postcards advising they go out and purchase them (advice most people will ignore, no matter how low the cost).

How many people will need to be paid to operate this free supply chain to provide a good that is perfectly well-supplied inexpensively privately now? How many to answer questions, field calls about missed shipments, lost pills, changes of address, etc?

The answer to every problem shouldn’t be “create a new government-funded agency to make this happen ‘for free’”. Mr Market isn’t the answer for every single thing, but sometimes it’s fine to let existing private supply chains operate. Supplying cheap dietary supplements seems to me like an area where that’s the case.

It may need to be added to SNAP/WIC; that’s a reasonable task for government to busy itself supporting this.

Why? If it’s cheap on a per-dose basis and has the potential for major social benefit (saved lives and avoided healthcare costs) that seems like exactly the sort of program that would be an efficient use of government resources. There’s a clear, measurable, and nearly immediate return on our investment.

Compare that to the cost of lockdown. To e cost of an ICU nurse. To the cost of a vaccine?

The point of making it free is so everyone will have it - not just because of the price.

Free vitamin D? Like... Sun?

During the summer months, long sun exposure should suffice, yes. But the November sun (if any) will not do much for your vitamin D status.