The Institute of Medicine recommendations on vitamin D are a new low in ignorance and data suppression.

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By Marc Sorenson, EdD

The Institute of Medicine (IOM), a health arm of the National Academy of Sciences, has just released its long-awaited vitamin D supplementation recommendations. To the disappointment of the world’s leading vitamin D scientists, those recommendations make a mockery of an exhaustive body of scientific research.

The IOM suggests that 600 international units (IU) of supplemented vitamin D3 per day is ideal, and that a blood level of 20 ng/ml is sufficient for optimal human health. The IOM also suggests that supplementation with higher quantities of vitamin D could be harmful and that there are no randomized controlled trials to prove the safety or efficacy of higher levels of supplementation.

The Sunlight Institute declares that the IOM’s recommendations are ill-conceived and dangerous for the following seven reasons:

1. Extensive research indicates that if there were no other dietary source of vitamin D, 600 IU per day in adults would produce a blood level, on average, of about 6 ng/ml, a level so low that it correlates to the occurrence of the disease osteomalacia or “adult rickets.” Incredibly, in the press conference, it was stated that 600 IU would be adequate at the North and South Poles.

2. The IOM considers the 600-IU-per-day recommendation, added to dietary sources and sunlight exposure, to be sufficient for optimal health. In reality, little vitamin D is present in foods. For example, three glasses of vitamin D-fortified milk provides only 300 IU; 3.5 oz. of farmed salmon, 200 IU; a glass of fortified orange juice, 100 IU totaling a mere 1,200 IU per day including the IOM-recommended 600 IU supplement. Sunlight exposure, the most natural and productive source of vitamin D, could easily fill in the gap to a 2,000 IU level during the summer, but in the winter, north of latitude 340,(On a line from Los Angeles to Atlanta, for example) little or no vitamin D is produced. In the northern US and in Canada, “vitamin D winter” (the time during which the body cannot produce any vitamin D from the reduced amount of available sunshine) lasts for several months. Ninety-five percent of Canadians are considered (by non-IOM measures) to be D deficient in winter, and Americans in the Northern states are not much better. A 600-IU supplement plus the IOM’s recommended food sources is a recipe for a winter health disaster, which may include highly increased susceptibility to colds, influenza, cancer, heart disease MS, septicemia and numerous other maladies. It was also stated at the IOM press conference that the average American gets 200-300 IU from food.

3. Vitamin D blood level of 20 ng/ml are not really even sufficient for bone health, and that number sets research back several years. The “normal vitamin D range” printed on laboratory blood-test results prior to 2005 was from 8.9 ng/ml to 46.7 ng/ml. Based on newer research findings, that range changed after 2005, and lab test results began carrying the statement, “Recent studies consider the lower limit of 32 ng/ml to be a threshold for optimal health” with a reference to research conducted by Dr. Bruce Hollis who is widely regarded as one of the world’s top vitamin D scientists. (Hollis BW. J Nutr 2005;135:317-22) Dr. Hollis stated: “The current adult recommendations for vitamin D, 200-600 IU per day, are very inadequate when one considers that a 10-15 min whole-body exposure to peak summer sun will generate and release up to 20,000 IU vitamin D-3 into the circulation.” Hollis has also established that pregnant and lactating women need as much as 6,000 IU daily to provide for their own and their infants’ needs (Hollis, BW. J Bone Miner Res 2007;22, suppl 2:V39-44). The IOM’s low recommendations attempt to take us back to the Dark Ages of vitamin D knowledge.

4. The fact that up to 20,000 IU of vitamin D can be produced by sunlight exposure (the natural source of vitamin D) defines the IOM recommendation of 600 IU as being ludicrous. 600 IU is produced in summer sunlight in less than one minute in a light skinned individual. If God or nature created a system that produces such a vast quantity of D, there is a reason for it, and it is obvious that 5,000 IU per day is not harmful. Dr. Reinhold Vieth has presented compelling information that there is no evidence of any toxicity or adverse effects at prolonged intakes of 10,000 IU per day (Vieth, R Ann Epidemiol;2009;19:441-5).

5. The IOM also inexplicably recommended the same vitamin D intake for infants as for adults (600 IU), which to any reasonable person, is illogical.

6. The IOM used only bone health to make its recommendations, but bone health is a terrible indicator of adequate vitamin D levels because only very small quantities of vitamin D are adequate to ensure bone health. The IOM, by ignoring both observational and randomized controlled trials showing that low levels of vitamin D correlate to a multitude of health problems including cancer, heart disease, depression, influenza, Multiple Sclerosis, and autism, has done a dreadful disservice to those struggling with these and other health issues that are impacted by low vitamin D levels.

7. Ironically, the IOM consulted with several leading vitamin D researchers but then completely ignored their recommendations. This indicates a bias that may extend beyond simple ignorance and descend into the realm of concealing information.

Another of the most prolific researchers in the vitamin D field, Dr. William Grant, gave the Sunlight Institute this statement regarding his feelings about the IOM report:

“The Dietary Reference Intakes for Vitamin D and Calcium committee of the Institute of Medicine of the National Academies was essentially a tool of the agencies that funded the study, including the Food and Drug Administration and the National Institutes of Health. Federal sponsors defined the key questions, and a technical expert panel was assembled to refine the questions and establish inclusion and exclusion criteria for the studies to be reviewed. By excluding ecological studies and case-control studies in which serum 25(OH)D levels were measured at time of diagnosis, they in essence dictated the conclusion that vitamin D has no health benefits other than for healthy bones. Since 90% of our vitamin D comes from the sun, they throw out 90% of the evidence. The work of this committee contrasts with well-conducted scientific reviews such as that by the Intergovernmental Panel on Climate Change, which included over 600 scientists contributing to the report and 500 scientists as reviewers. The process was open rather than behind closed doors and resulted in a Nobel Prize for the contributors. If only health policy were treated as a science instead of a business tool.”
William B. Grant, Sunlight, Nutrition and Health Research Center (SUNARC), San Francisco

In putting forth its report, the IOM has destroyed any credibility it might have had with those who conduct the science of vitamin D. The IOM has misled the public and placed itself on a level with those who, in the past, ignorantly told us to avoid sunlight exposure at all costs. If the public follows their recommendations we will return to the Dark Ages of health awareness; the report is an absurd suppression of critically important research.

GETTING TO THE HEART OF THE MATTER: IS VITAMIN D DEFICIENCY A MAJOR PLAYER IN CARDIOVASCULAR DISEASES, DIABETES AND HIGH CHOLESTEROL?

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A most interesting piece of research on the relationship of heart disease to blood levels of vitamin D was recently published in the American Journal of Cardiology.[1] Researchers from the Intermountain Heart Collaborative (IHC) Study Group studied 41,497 subjects with at least one vitamin D measurement from 2000-2009. The prevalence of vitamin D deficiency in the subjects was 63.6%. The researchers found that during that time period, those with the lowest levels of vitamin D had highly significantly increased risk of developing diabetes, hypertension (high blood pressure), hyperlipidemia (high cholesterol and triglycerides) and peripheral vascular disease, all diseases in their own right, and all risk factors for developing heart disease. They also found that those who had none of these risk factors, but who had severe D deficiency, had an increased risk of developing diabetes, hypertension and hyperlipidemia.

Low vitamin D levels were also correlated closely to coronary artery disease, myocardial infarction (heart attack), heart failure, stroke and overall risk of death (not surprising). Of particular interest was the fact that hypertension was nearly 90% more likely in those with low vitamin D levels (less than 15 ng/ml) compared to those who had high levels (greater than 30 ng/ml). Unfortunately, the analysis did not compare those who were severely deficient with those who had "optimal levels," which I would consider to be 60 ng/ml or more. Had they done that, it is likely that the differences in disease and death rates would have been even more impressive. Other findings of this study showed that infections, kidney failure and fractures were more likely among those with the lowest levels of vitamin D.

This research is one of the best conducted and controlled that I've seen, but it is hardly the only finding that showed a dramatic increase in these diseases when comparing people with low vitamin D levels to those with higher levels. One of the most impressive compared the risk of heart attack with vitamin D levels and found those with the lowest D levels to have 2.4 times the risk of heart attack compared to those with the higher levels.[2]

As you can see, vitamin D makes a difference. if you'd rather not have a heart attack, it behooves you to optimize your vitamin D levels!

There are another dozen research papers that point out a terrific difference in heart disease rates among people with different vitamin D blood levels; however, they all come to the same conclusion. Get some sunlight and optimize your vitamin D levels!


[1] Jeffrey L. Anderson, MD, Heidi T. May, PhD, MSPH Benjamin D. Horne, PhD, MPH
Tami L. Bair, BS Nathaniel L. Hall, MD,, John F. Carlquist, PhD, Donald L. Lappé, MD, and
Joseph B. Muhlestein, MD Relation of Vitamin D Deficiency to Cardiovascular Risk Factors,
Disease Status, and Incident Events in a General Healthcare Population. Am J Cardiol 2010;106:963–968)
[2] Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-Hydroxyvitamin D and risk of myocardial infarction in men. Arch Intern Med 2008;168:1174–1180.

Are you looking for help for anemia? Vitamin D may be your answer.

Anemia is a disorder caused by a reduction of the oxygen-carrying capacity of the blood. It causes pallor, weakness, breathlessness and fatigue. It has been shown that in patients with kidney disuse, each 10 ng/mL increase in serum levels of 25 (OH) D is associated with a 29% reduced risk of anemia, whereas each increase of 10 mg/dl of c-reactive protein (CRP) were associated with dramatically increased risk.[1] There is every reason to believe that those without kidney disease would have the same benefit from higher levels of vitamin D. In my book, I discussed the profound association of higher vitamin D levels with lowered levels of CRP, an inflammatory chemical that is a strong promoter of heart disease. Vitamin D's ability to control CRP may also be the reason for the impressive, positive influence of vitamin D on anemia.

Let's get back in the sunlight (without burning, of course).

[1] Kendrick, J. et al. Report to the conference of the National Kidney Foundation, Spring Clinical Meetings. May 16, 2008

Serum vitamin D levels, heart attack and stroke: Vitamin D can save your life!

It has been some time since I posted anything about heart disease, and since I have been asked to send my agent something to present to Larry King, I thought I might as well post it as a blog, too. Suffice it to say that there is no blood test more important than vitamin D [calcidiol or 25(OH)D].

Two 2008 studies show the dramatic influence of blood vitamin D levels and the risk of heart attack. Dr. Thomas Wang and colleagues compared the risk of stroke and heart attack with serum-vitamin D levels and found a 62% increased risk in those with lowest levels compared to those with highest levels and also showed that those with low D levels and high blood pressure had double the risk.[1] Dr. Edward Giovannucci, of Harvard University, and his colleagues reported even more impressive results.[2] They found that men whose serum levels of vitamin D were less than 15 ng/ml had nearly 2.5 times the rate of heart attack as those whose levels were above 30. Their research also showed that mid-range vitamin D levels showed a mid-range risk of heart attack and stroke, meaning that vitamin D levels directly predicted the risk of heart attack at all levels. The researchers stated, “Low levels of 25(OH)D are associated with higher risk of myocardial infarction in a graded manner, even after controlling for factors known to be associated with coronary artery disease.”

Still other research showed that classic risk factors for cardiovascular disease were higher in those who ranked in the lowest quartile (fourth) of vitamin D levels compared to those whose levels were in the highest quartile.[3] Hypertension was 30% higher, diabetes 98% higher, obesity 129% higher and triglycerides 47% higher.

This idea is not really that new; it has simply been ignored. In 1990, a study in New Zealand found that those below the median level of serum vitamin D suffered 57% more heart attacks than those whose levels were above the median.[4] They also noted that the greatest number occurred in winter and spring, and that the reduced risk among those with higher levels pertained to all seasons. All of this indicates vitamin D deficiency as a major cause of heart disease. Do not ignore this information if you have a heart!


[1] Wang, T. et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117 pre-publication copy.
[2] Giovannucci, E. et al. 25-hydroxy-vitamin D and risk of myocardial infarction in men. Ann Intern Med 2008;168:1174-80.
[3] Martins, D. et al. Prevalence of cardiovascular risk factors and the serum levels of 25-Hydroxyvitamin D in the United States. Arch Intern Med 2007;167:1159-65.
[4] Scragg, R. et al. Myocardial Infarction is inversely associated with plasma 25-hydroxy vitamin D3 levels: a community-based study. Int J Epidemiol 1990;19:559-63.