Dr. Abby Kramer and Dr. Genevieve Newton take on vitamin D — arguably the most important supplement most people are still getting wrong. The episode covers the basics (D is fat-soluble, comes from food, sun, and supplements) and quickly moves into the nuances: D2 vs. D3, the superiority of D3 for raising blood levels, and the question of source — most D3 comes from lanolin (sheep's wool), while Fringe uses lichen-sourced vegan D3. K2, sourced from natto, rounds out the formula by directing calcium to bones and away from arteries.
What makes Fringe's vitamin D product distinctive is the delivery mechanism: a water-soluble powder rather than an oil-based capsule. Because vitamin D is fat-soluble, it's typically suspended in oil, but the Fringe formulation achieves roughly 2x the bioavailability of standard oil-based D3 — meaning 2,500 IU in their product functions like approximately 4,000 IU from a conventional supplement. Dr. Gen covers the deficiency statistics (94% of Americans don't meet the RDA from diet alone) and explains why the commonly recommended 600 IU daily is almost certainly insufficient for optimal health.
The target blood level conversation is practical and actionable: aim for 40–60 ng/mL, test regularly, and don't be surprised if you need 5,000 IU or more to get there. This episode gives you the science to make informed decisions about one of the most foundational supplements in a wellness routine.
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Transcript
Abby: Hello everyone, welcome back to the Fringe podcast. I'm Dr. Abby Kramer, the medical director at Fringe, and I'm here with the lovely Dr. Genevieve Newton, our scientific director, and we're here to have a conversation about vitamin D, because it is the season.
Genevieve: Yes, ma'am.
Abby: All right, so Jen, can you please tell us a bit about vitamin D? I feel like everyone has heard about it, but just so our listeners can better understand what exactly is vitamin D and what's its role in the body.
Genevieve: Yeah, because it's actually a confusing one compared to some of the other nutrients that we have to intake on a daily basis. okay, let's start at the basics. Vitamin D is what's called a micronutrient. Those are our vitamins and our minerals, meaning we need them in very small amounts, but they are essential for health and many of them, you know, are literally essential for life. So, we get into this micronutrient category of vitamins and then we also have a division between water soluble vitamins and fat soluble vitamins. So vitamin D is a fat soluble vitamin which actually means that in fact we don't necessarily need to take it in on a daily basis which we certainly do recommend that you do but your body stores fat soluble vitamins for a period of time as well. So water soluble vitamins will be excreted quickly, fat soluble vitamins will be stored. Now everyone's probably heard that vitamin D is called the sunshine vitamin and that's because unlike other nutrients, we have another non dietary source of vitamin D and in fact this other source of vitamin D is in fact the dominant really source throughout our evolutionary history. Meaning when we are exposed to the sun and it hits our skin there's this chemical pathway that takes place by which vitamin D essentially gets synthesized in the skin and it gets transported throughout the body and it can do all of these amazing things that we know. No it does. So really we can say that we have three sources of vitamin D. We've got food, we have sunshine, and then this third source is where fringe comes in and that is that we have supplements as an additional source of vitamin D. We need an additional source of vitamin D because dietary intake and distribution in food tends to be very very low. We'll talk about that probably in a little bit. Another reason why we need it is because for example you and I living in cold climates, northern latitudes, and we don't get enough exposure to sun. Even people who do live in climates where they can have sun exposure during the day, many of them are working indoors or they're wearing sunscreen, they're limiting their sun exposure. So we tend not to, on aggregate on a population level, get very much vitamin D either from our food or enough from sunshine. And so we end up needing this additional intake of vitamin D through supplements. In terms of what it does in the body,
Genevieve: So historically speaking if we were to go back into the early 1900s people really recognized the importance of vitamin D because it became very obvious that when individuals didn't have it they ended up with this skeletal deformity called rickets and so you would see these children that would grow into adults with this deformity where their legs bowed out. That was because their bones were essentially soft from a lack of dietary intake and a lack of sunshine. And so for many many years the scientific community and the medical community really focused on vitamin D as being essential for bone health, which it absolutely is. But in the meantime, we entirely missed the boat of recognizing that it was actually involved in all of these other biological processes as well. And really, I would say that at least as important as its role in bone health, and perhaps more so, is its role in regulating the immune system. So it's a primary regulator of the immune system. we look at the genes in the body that are regulated by vitamin D in some way or another, are hundreds of them. There are so many biological processes that depend on vitamin D being present in order to function properly. So we see things like and anti-inflammatory related to immune function effects. see brain cognitive effects relating to things like mood and dementia and Alzheimer's disease. We see cardiovascular effects. So you've got this whole bucket of your skeletal system, which actually ends up being not just the skeleton, the musculoskeletal system requires vitamin D, but also all of these other things as well. So it's a very important nutrient. but it's not just a nutrient. We have this other really, you know, source, reservoir of it that is coming from our sun exposure and then we've got this bucket of supplements that we really need because of our modern lifestyles. Yeah, so it's extremely, extremely important and I know Abby that you would agree with me on that and I know that you love supplementing or vitamin D is one of your favorite supplements to use in practice. So
Genevieve: Who do you recommend it takes vitamin D? Or, and who don't you recommend take vitamin D?
Abby: Yes. I mean, first, the simple answer is pretty much everyone. And I know that's like boring and sounds like too good to be true. It's kind of like the red light conversation, honestly. It's like, who couldn't benefit from red light therapy, right? However, I feel like the individuality is dependent on the person, on their lifestyle, and on their lab work. You know, if people... I recommend everyone every six to 12 months get a vitamin D test done. Because everyone is so different, their amount of sun exposure is different. Most, vast, vast, vast majority of people are deficient and at least need a maintenance dose of vitamin D to maintain healthy levels. But some people are so deficient, they really need to do a high dose for a handful of weeks. And then I like to recheck their labs, right? Because some people respond so well to supplementation. they can end up with really high levels really quickly. Some people can take months to get their levels to like a healthy, optimal level. So the short answer is everyone pretty much. I've seen a couple unicorns in 10 years that have healthy levels without supplementing, but like I could count that on one hand. The vast majority of people have kind of, from what I see, like a winter time dose and a summertime dose. They certainly might not need as much in the summer months, but I'm one of those people I need to supplement year round. I supplement more in the winter, but if I do nothing in the summer, even with being outside with my daughter and dogs and all of that, it still isn't enough for me to be kind of optimal. The only people that I pull off is if we pull out work and they're really high, which that has happened to me a few times with people, especially in winter, especially during the pandemic. a lot of people rightfully so. The data was very clear that if you have robust levels of vitamin D, you do a lot better with a COVID infection. So people were like, great, and going ham and doubling down, taking 50,000 IUs every day for a year. And their levels are too high, right? So then you can pull off, pull off for a couple months, recheck your levels, and find a good maintenance dose. But pretty much everyone needs it, honestly.
Genevieve: That really speaks to what I was saying about and it illustrates how it's something that we store in the body because it's fat soluble. So yeah, you can take breaks and there are different supplementation strategies and we can maybe talk about what we see in the clinical literature and what protocols you like to use. But I would say like the scientific literature is certainly in agreement with what you're seeing in practice. There's no doubt about that. But where things get really kind of
Genevieve: Murky is how do we define deficiency, right? Like what is the definition of deficiency? And first of all this raises confusion with respect to okay. Are we just looking and measuring deficiency with respect to how much dietary intake someone has or are we going to use those blood levels and use those as our metric of deficiency? And I think you and I would certainly agree. We want those blood levels to be the reflection
Genevieve: of what's deficient. Now, but where things get even more complicated is that even if we look at those blood levels, we don't have a uniform cutoff that is universally accepted by different medical communities and it's all over the map.
Abby: correct. Well, in the normal range is like, I mean, on standard labs is like 30 to 80, which is just such a massive range, right? So people are told, you know, they come back with levels at 31 and they're told you're perfect. You know, meanwhile, they're like depressed and have all these other problems. So it's, it's really hard to find a consensus, but like you're saying, that's also, everyone is also so different. Like for someone.
Genevieve: Right, meaning the...
Abby: They might feel great, have a healthy immune response, feel awesome, and they're like cruising at 48. And maybe that's a good level for them versus other people might like really need to bump it higher.
Genevieve: Mm-hmm. Yeah.
Genevieve: Yeah, it's definitely one of the vitamins where we have the greatest amount of inter-individual variation. But one of the things that I remember reading the statistic and being just blown away by it is is if you look at the dietary intake, so that's only vitamin D coming from food, not including coming from supplements. So you start there and you say what percentage of the population has a deficient dietary intake. Statistically speaking, it is 94 % of people over the age of one on the most recent American survey. And that's using the conventional amount of the dietary
Abby: Yeah, right. That's a low bar, too.
Genevieve: That's confusing the conventional RDA of 600. It's 600 international units a day. So at 600 international units a day, 94 % of people over the age of one don't meet that 600 level. Now, are a significant, or there is a significant percentage of the population, including children and adult males and females that do supplement, but that supplementation range is all over the map. So some are taking 200 units a day, 400 units a day 600 all the way up to you know 10,000 or even more. And then what you're seeing in practice when you get into looking at what those blood levels are then again we end up being all over the map. So if you have two people that are doing the same supplementation protocol eating the same diet their blood levels and specifically what we're talking about our blood levels of 25 hydroxy vitamin D which is that biomarker of vitamin D that we use as a lab map.
Abby: Yeah, yeah, yeah.
Genevieve: metric, they can be very different from one another. this has to do with things like how is someone metabolizing vitamin D? You have protein that transports vitamin D around the body and takes it to different places where important things happen and that's different between different individuals. So if you're somebody who is missing this vitamin D transport protein insufficiency, you're not going to have high levels no matter how much you intake. There's polymorphisms of receptors, there's differences obviously in people's
Genevieve: sun exposure, there's shocking differences related to body weight and how that affects people's vitamin D status with overweight and obesity causing a lower level overall. So those individuals can require a greater level in terms of their oral supplementation dietary intake. So the reason I think that you're so bang on with telling people this is something that you know we can come up with a strategy and I can give you a general recommendation for some
Genevieve: supplementation, but unless you test and unless we can look at that number and see how you're responding, it's going to be really, really hard to know what the optimal protocol is for you. Now, I'm curious, what sort of like clinical responses have you seen in practice using this over a decade with your patients? What do you see with respect to how people respond to supplementation?
Abby: okay, I'll go through, let's say like the top three, four things. Number one is obvious for people immune system. So those people where you hear this goes for adults and children. They get every cold that comes around. They're constantly sick. All winter long, it's like you're sick, you get a few days break, you're down with the next thing. You're around, you know, family that are sick and you just, always get everything. That's like a low immune response. You get your vitamin D levels up. People are like, this is the first winter in three years. I haven't really been sick. So that's a huge indicator even without testing. If you or your child are the people that are always saying they're sick. start taking a vitamin D supplement, get your levels checked, get it higher than like 32, you know, and just monitor that. Another huge one that isn't talked about enough is mood stabilization. So depression and anxiety. It's the sunshine vitamin, the sun makes us happier, vitamin D makes us happier. And that's a big one, especially for seasonal depression folks. We talked about this a little bit on the seasonal depression podcast with Allie, but a big one to address that people forget about a lot.
Genevieve: Yeah, absolutely. And I mean, from what I've seen, that's entirely consistent with the scientific literature. So what is pretty remarkable about vitamin D is it actually has been subject to some pretty rigorous clinical trials, some of which were massive and extremely well-funded. And it's a bit complicated to dig into.
Genevieve: Because when you do look at all of these studies, you see that, you know. They're confounded and it's difficult to compare them one to another. Certainly some of them were better conducted than others. But with respect to the clinical outcomes that we've looked at, like you mentioned the depression studies and yeah, the depression that you're seeing in practice and there are studies that absolutely support that. There was another really interesting cognition study that I saw where healthy adults that took vitamin D showed improvements in memory. from supplementation. So they weren't necessarily showing cognitive impairment, but they nonetheless showed improvements in memory. Most of the studies on vitamin D early on really, really focused on that bone mineral density outcome. if we break down the mechanism of how vitamin D affects your bones, what's going on is that it increases the absorption of calcium from the gut and then through effects that involve vitamin K, Transport that calcium to your bones and your teeth and then you get stronger bones you get stronger teeth So a lot of studies were first of all looking at okay Can we supplement with vitamin D and improve things like bone mineral density and decrease the risk of fractures and again the studies have been have been challenged by methodology issues so for example they almost never include vitamin K so most of the studies of vitamin D supplementation didn't include vitamin
Genevieve: Now they got better at making sure that they supplemented with calcium as well because if you take vitamin D and someone still has low dietary calcium well then that calcium is not gonna get like there's no calcium to absorb right so you're not gonna have bone benefits and then as you mentioned like a lot of your response depends on where a person is starting from so really when you do a study where you want to look at what the supplementation outcome is you want to know exactly what their vitamin D status is at
Genevieve: baseline and that's not always done consistent consistently in the literature either but despite these issues we still see a lot of research that shows bone benefits we see research that shows improvement in in the teeth like so for example decreased dental cavities There's some infection research that shows, as you mentioned, COVID, for example, like a reduced incidence of viral infections. Absolutely. There's also some really interesting cancer research. So cancer studies, in terms of the incidence, are hard to do, right? Because it takes a long time for cancer to manifest as an outcome. Most clinical trials don't run for 10 years. That being said, there have been some studies that have associated vitamin D or have demonstrated that supplementation can. reduce the incidence or is associated with a decreased incidence of a few different types of cancer which isn't surprising because the immune system is what manages the development of cancer and exactly exactly so if you if you look at that as an outcome it's not surprising improved biomarkers
Abby: Correct, I was gonna say it's an immune system disease.
Genevieve: like C-reactive proteins. So again, relating to the immune system and inflammation, supplementation with vitamin D has shown that. People have shown benefits in blood pressure, like reduced blood pressure. There have been some broad studies that have looked at just general mortality and have found a decrease in all-cause mortality associated with supplementation. So yeah.
Abby: That's what I wanted to, I wanted to speak to inflammation too, because, and see what you had to say about the literature, because I've seen with some patients too that were under the, let's say it's like a woman in her mid forties is like, I think I'm starting to get like arthritis in my knees. Like I'm having this weird joint pain and we get their vitamin D levels up and it goes away completely.
Genevieve: Yeah, so there's definitely, and I mean, just studies looking at C-reactive protein. It's a very simple biomarker for inflammation, has shown a reduction in clinical trials of vitamin D supplementation. Polycystic ovarian syndrome is another one that has shown benefits to supplementation. And so I know you've done a little bit looking at some of the literature on women's health and vitamin D supplementation, and it's pretty remarkable.
Abby: I mean, a lot of people refer to vitamin D as like, it almost acts more like a hormone in the body. Yep. Like it's not only a vitamin, you know?
Genevieve: Well, it is a hormone in the body. Yeah, yeah. So when it comes into the body... No, no, that's and that's why I said it's it's a confusing it's almost a misnomer to call it a vitamin because so you've got when it's when it's synthesized in the body through sun exposure that's not a vitamin at all right the vitamin part means that it's a micronutrient coming from the diet when that comes in it undergoes these hydroxylation reactions that actually make this hormone and the hormone
Genevieve: is what triggers these biological effects. So really when we get to looking at like, what is vitamin D doing in terms of its actions in the body? Well, by that point it is a hormone. And so technically that's the correct term to use once you get to that stage. But if you're looking at it from a dietary source or a supplemental source, the correct term to use would be vitamin D. And of course there are molecular differences between what those molecules look like.
Genevieve: So yeah, what do you recommend for protocols for your patients then? We've talked about differences related to what people's baseline blood levels are, but do you have like a standard protocol that you like to go to?
Abby: Um, it of course depends on the person, but I would say if I'm making generalizations on average, I'm having adults do like 5,000 IUs a day. I feel like that's a really good... therapeutic dose that will slowly for most people raise you over time, but not too aggressively. So if people, they're in a winter climate, you're indoors quite a bit, you know, you're probably low on vitamin D. That's a pretty safe dose to take. And that's kind of the equivalent of what we made our DK product at. Some people less, some people a lot more. I do pretty aggressive high dose protocols with patients that are really low, but I only do that if we see it on blood work first. And then I'll always, I'll put them on whatever protocol. Like I've put people on 20,000 I use five days a week, take a couple days off. that for a few weeks, four to six weeks, then recheck labs, then see where you're at, and then we know if we need to stay high, potentially go higher, or back off. But that's more based off of not just their number, but also their symptoms, right? I'm not afraid to go pretty high with someone if they're sick all the time, have no energy, feel terrible, and they're 18 on blood work. I'm like, I want to get you feeling better in two weeks, not two months, right? So I'm gonna be a lot more
Genevieve: Yeah, absolutely.
Abby: aggressive in that case. If someone's cruising at 32 and they're like I feel pretty good but I know that's not optimal we could do a five to ten thousand IU likely and you know have a little bit more of a gentle approach.
Genevieve: Yeah, no, that makes perfect sense and... When I kind of look at that relative to what's been done in the clinical research, it's totally consistent with what the approach that some researchers have taken where they've done this like higher bolus, 50,000 I use, 10,000 I use. I've even seen one study that was 100,000 and maybe they're doing that like once a month kind of thing. there isn't a standard protocol in research and it doesn't sound like really that there's gonna be a standard protocol.
Genevieve: clinical practice, right? Like you're going to...
Abby: No, and I think as long as you're monitoring and testing, it's fine. mean, my folks that are real low, I'm not above doing, I'll do like 50,000, I use three days a week and take the other days off. give your body a break kind of mimics more like having a day at the beach. get a ton of sun exposure. You're probably not doing that like seven days in a row. So you give your body a bit of a break works really nicely. Huge disclaimer. Do not do any of this without consulting your physician first, right? I only do this with patients I'm working with directly in practice as a patient with lab testing results and all of that. Had to throw that in there.
Genevieve: Mm-hmm. Yeah, well, yeah, no, for sure. think of I think of very, very crucial number that for for people that kind of have awareness of is what is the Synthesis which is going to happen in through the skin from the sun exposure. Like if you're out in the sun and we used a lot of this rationale when we were developing our vitamin D product and that's okay so you spend a day at the beach how much vitamin D are you going to synthesize in your skin? What's the equivalent in terms of dosing that's coming in orally? And that comes in at ballpark is around 10,000 units because when you have this exposure
Genevieve: to the skin. It's basically a chemical reaction which takes a molecule that's already present in the skin and it turns it into something else when it gets exposure to UVB rays. But for those people who have studied chemistry, you know that you're limited by the availability of how much of that chemical is there. So you're going to reach a point at which you just can't make anymore from the sun. Yeah, So we've got this like built-in kind of regulatory check mark from
Abby: It stops.
Genevieve: sun exposure that we actually don't have from dietary exposure from supplementation. Yeah, and this is this is where you know there there was there were for many years a lot of talk about excessive vitamin d exposure vitamin d toxemia and and what's going to happen from that and certainly over the last 10 years or so we've realized very very very rare even with supplementation protocols of you know 10 25 50,000
Genevieve: and done properly using monitoring under a physician supervision, you just really very, very, very rarely see side effects from vitamin D supplementation.
Abby: Yeah. Even people that they come back and their levels are crazy high, they don't feel bad. You know, it's like, OK, you've overshot. Let's back off. You know, they're not like in grave danger.
Genevieve: Yeah, oh yeah, absolutely. Yeah, yeah. No, they don't have hypercalcemia, which is like excessively high calcium in their blood, which is what was thought to be the potential harmful consequence. Just don't see that. The other number that we really zeroed in on as being kind of like our target, you'd mentioned that 5,000 units a day. There was a series of research studies that were conducted where
Genevieve: We ended up with this kind of loose consensus in the scientific, certain members of the scientific community, but in the traditional scientific community where they concluded in a publication, a scientific publication saying that they think that most people would benefit from supplementing with around 4,000 international units a day, you know, give or take a bit. and so I think, I think that that, that target makes a lot of sense given what we know about exposure to vitamin D from the sun being at around a maximum of 10,000 units per day. So that gives you room to take in some from your diet. It gives you room to make some from being outside. And it's entirely consistent with, you know, what you say you're, you're like how people are responding in. in clinical practice. it does like it definitely does make sense for people to know these things and be educated and have an awareness of what numbers are because it is pretty easy to you know, overdo it with supplementation just like it's quite easy to under do it. So, you know, especially if you're buying like a multi vitamin that has vitamin D incorporated into it. Oftentimes that will yeah, will be an inadequate inadequate value even though the number on that supplement fact
Abby: It's like never anything.
Genevieve: table tells you that it's 100 % of your daily value, for example. Like it's, it's, you know, it's right there. So yeah, we, mean, as we know, we're, always trying to educate people and get them to really understand, you know, where does this number come from? So we're talking about, obviously we've mentioned, we ended up formulating our own vitamin D supplement. Can you tell us, cause you've worked with a lot of different products in your practice over the last 10 years, some of which you liked a lot, but yet you
Genevieve: still felt pretty strongly about wanting to develop a new product and you thought there was room in the market for something that kind of came at things a little bit differently. So can you tell us about how our vitamin D supplement is unique and kind of what needs it fills?
Abby: Yes, so there's a few different reasons. I think the most glaringly obvious one is that it's water soluble. So If you guys look at the vitamin D product, you might have at home unless it's ours, which if it is, we love you for that. But they're We talked about how vitamin D is fat soluble. It's an oil-based supplement. It's usually a tincture and a dropper or in a capsule. And so You'll be able to see it's like this yellowish liquid inside. What that means when a vitamin is fat soluble is it's a lot harder for our bodies to absorb it. You lose a lot of that absorption through your natural digestive process. It's a fat, right? A lot of people know same thing applies with fish oil. People take fish oil, they get the fish burps. because you can't break it down well, right? So The same thing happens with vitamin D, which is part of the reason why people have to take crazy doses, like 20,000 IUs to get their levels up. And then so many people I see in practice over the years, know, our guts are struggling. We don't observe like our guts don't even digest things well, let alone a fat. so People are having to do higher doses than ever. And it's kind of hard on their system. And so we've made a fat soluble vitamin, a water soluble vitamin. And so what that means is you have to take around half the amount to get the same effect. Vitamin D is also kind of pesky. Like you have to take it with food. You have to take it, you know, with food, with fat, preferably a lot of people take their vitamins on an empty stomach when and they're running out the door in the morning. That's just reality. It's what it is for a lot of people or they forget. I know this after 10 years of seeing people and being like, can you please take your supplements with food? And people skip breakfast and fly on coffee and run out the door. So this solves that problem. It's tasteless.
Abby: They can put it in their beverage of choice and a little bit of water. They can mix it into food for their kids or a smoothie or even just their water and get it really easily. So the water soluble technology I feel like is the biggest differentiator. And then the other one that blew our minds that I didn't fully realize, I don't think either did you, is that most vitamin D is made and extracted from sheep's wool, which is called lanolin, which is kind gross if you think about it too much. And so we sourced our vitamin D very differently. It's a vegan source made from lichen and the vitamin K2 is also not synthetic and is made from a Japanese food called natto. So it's also vegan. So the vast majority of vitamin D products just so you guys know are not vegan, which I feel like not many people are aware of.
Genevieve: No, they're not aware of it. I remember when we were working on this formulation, we, you it really felt like we came up against a roadblock when we realized. that the source of vitamin D3 specifically because vitamin D3 I didn't talk about this but we have two forms of vitamin D in food we've got D2 and D3. D2 is found in things like mushrooms so some some plant food and then D3 is the animal source so it can be found in things like egg yolks and liver so we've got this these two forms and when you do research look
Genevieve: at how bioavailable these two different forms are, meaning when you eat it, how much of it actually gets into your body and will increase that level of 25-hydroxy vitamin D. There is a difference between D2 and D3. D2 is not useless. It's absolutely a useful molecule, but it's not as good at raising vitamin D blood levels as D3. So we wanted to make our product accessible to everybody, whether you were vegan or not.
Genevieve: but we also wanted to use vitamin D3 because that's the one that's more bioavailable. And so we found this lichen source which fits all of, ticks all the boxes that we wanted to tick. And as you said, like our... priority and value is to make things food-based as much as possible. And this is something else that people don't know about the supplement industry is almost all of your vitamins are synthetic. They're not sourced from food and they are not made in the USA either. So it's very, very difficult. They're made from the lab in China. Yeah, yeah. So certainly there are still times when
Abby: They're in a lab in China. That's the reality. Yup.
Genevieve: I find myself needing to take something and that's the only source that's available because we haven't made it yet. But you know, that's that certainly was a it was an eye-opener to me. I had no idea. It really was a it really was an eye-opener.
Abby: Yeah. It really is. It really is. Like all your B complexes, multivitamins, that's what it is. It's not real, unfortunately. And listen, not to say that stuff doesn't work, right? You can start a great quality B vitamin synthetic, you know, because you have low B12. And a few weeks later, your B12 is going to be great. So you know,
Genevieve: Yeah, yeah. No, it's not food based. It does, yeah.
Abby: better than having a deficiency, But it's really mind-opening to learn that stuff.
Genevieve: Yeah, yeah, it's kind of a good, better, best scenario where we're trying to do things in a different way. And, you know, we also, we thought a lot about dose and we went back and forth. So let's explain to people the science of this water solubility issue. And I'll talk about it in terms of numbers, because you talked about it with respect to absorption. So as Abby was saying, when you take something that's water soluble, it's able to get into the body through the intestine much
Abby: Mm-hmm. Mm-hmm.
Genevieve: more readily than if it's a fat, fats require transporters and it's just a much harder process to go through. So what this means with in terms of numbers is that if you take a supplement that has 2000 units of vitamin D and you measure the change in the 25 hydroxy vitamin D in the blood, what you see is that it's approximately comparable to that number that we saw as the target. in the scientific community of around 4,000. So it's around twice as bioavailable. And that's something that is a bit challenging for us to get across to our customers because when you look at our supplement facts, it will say that we are in one scoop, it's 2,000 international units of vitamin D. But in fact, that 2,000 international units of vitamin D is the equivalent of around 4,000 of a
Genevieve: traditional supplement that's not water soluble.
Abby: Yep. And it's 2,500.
Genevieve: Yes, it's 2,500 exactly. So we went for that number that you were seeing in clinical practice that we were talking about with that ballpark of 4,000 international units of being kind of that scientific consensus, give or take 1,000 or so. So yeah, we really thought long and hard about how much to put into this.
Abby: what dose it should be. Yeah. then, because part of the other reason is we really wanted children to be able to safely use this product and we could have children dosing that we felt good about, you know, saying, yeah, young kids can totally do a fourth of a scoop of this, no problem. And get their daily vitamin D. And then would say the other big thing is in a lot of other water soluble formulations, because obviously, It takes a bit of work to take something from being an oil to being a flavorless powder in a jar. We used like really, really clean ingredients that I've never really been able to find elsewhere in a water soluble product. So in a lot of water soluble products, you'll see maltodextrin, you'll see citric acid, you'll see the silicon dioxide, you'll see all sorts of like kind of funky stuff. And we were able to do it with chicker root inulin.
Abby: MCT oil and licorice root extract and that's it. Which is pretty amazing, yeah.
Genevieve: Yes, yeah, exactly. Yeah, it is, it is. And you talked about our vitamin, talked about our vitamin K. And I've mentioned before when you look at the studies of vitamin D supplementation and how so many of them, like literally almost none of them used vitamin K, along with it, it's wild.
Abby: Pretty wild. I mean, I guess it makes sense, but because they're trying to really just look at D, but.
Genevieve: That's the rationale, right? The rationale, but... it's almost dangerous, especially if those levels of supplementation were in the thousands because the vitamin K is needed to make sure that any increased absorption or any calcium that gets absorbed is going to end up in the bones and the teeth and not get deposited in your cardiovascular system. So it's really like if you're going to be supplementing with vitamin D, you need to add that additional vitamin K to make sure that you don't
Genevieve: up with know calcification in the vascular system like it
Abby: Yeah, now I have a question about that though, Dr. John, because I know there's not really an upper limit on vitamin K2. So what does the literature say? Like, say someone is taking 25,000 IUs a few times a week to really raise their levels would just be supplementing with like a normal daily dose of 100, 150 K2.
Abby: be enough, or would you also need a super elevated dose of vitamin K to complement?
Genevieve: Yeah, no you shouldn't because you have to think about it this way, right? What that K is for is to get the calcium to where it needs to go. If you're not taking, if you're not changing and also doing this like radically high calcium supplementation, that's not going to be an issue, right? That number is going to stay constant. So as long as you have, you know, couple hundred
Genevieve: vitamin K units, you'll be, you should be okay. Yes, yeah. So that along with food, you're gonna be.
Abby: Yeah, like ours is 130 micrograms, right? So it's like, some patients, they're doing such high dose, they might take their provider might give them like a pill that's like 50,000, right? So they could do add Rdk2, get the K2 you need, which will help that issue.
Genevieve: Yeah, yeah, and it's a very safe supplement. But certainly, it's just a cover your bases kind of thing to make sure that it's included in the supplementation. And if you are taking, I think a lot of people don't understand calcium supplementation very well.
Genevieve: And The main point about calcium supplementation is if you're going to do it, which certainly it's warranted for some people, you just need to make sure that you're never taking more than around 200 to 200 200 to 300 milligrams at a time. Because that's bolus or a bulk dose of calcium that really exceeds what your body would normally.
Genevieve: see and because calcium is so it's very biologically active and it can get deposited in the cardiovascular system. if you were wanting to supplement with higher levels, you'd want to break those supplements up into maybe two doses a day or three doses a day. And I mean, we certainly get asked sometimes by people, like, should I take calcium along with your vitamin DK? And I mean, I think it depends on the individual and that requires an analysis of what their diet is like, what their weight bearing exercise status is like. But certainly for people who don't consume any dairy products, yeah.
Abby: All I can say is I've seen so many people that are told by their primary care that their bones are terrible because so they need calcium and they're chugging these synthetic calcium pills from CVS that are literally chalk in a pill. And then they're having heart issues and their bones are still suck. they get a dexa and it's like
Genevieve: thousand milligrams a day.
Genevieve: Yeah, Usually five. Yes. Yeah.
Abby: when you get them on D&K or even a just smarter bone supplement that has a lot of minerals in it and other things that actually build their bone, their bones actually get better and start doing weight bearing exercise. So I'm like, I just, think it's hard to find someone that has a true calcium deficiency. I'm sure it's out there, but I don't think it's as common as everyone's told. Like as you age, you need a calcium supplement. And I think it's caused so many problems.
Genevieve: Well, mean, see the challenge is that there's not like there is a definition of what the dietary intake is supposed to be. But when you look across populations and different regions in the across the globe, first of all, there's a huge variability in dietary intake, but there's also variability in terms of the recommendations. So our recommendation in North America is quite high. There are recommendations that are in other parts of the world that are not nearly that high. And so
Genevieve: just don't think we have clarity about how much the body needs and it does relate to what you were talking about. Like it's this complex pathway that involves vitamin D, that involves vitamin K, that involves all of these other minerals that are needed for structural integrity of our bones. And so just taking a thousand milligrams of calcium, you know, in one sitting or you know, even two sittings, it's not an advisable supplementation strategy from a cardiovascular. Never, never.
Abby: You would never eat that in real life. And this goes back to our last podcast we did of we should also be getting calcium from our water, not just our food. And so it's just like all the minerals, all the more we read, go figure, everything works together. So whenever you're just like high dosing one mineral or one vitamin, that's probably going to come at a cost long term.
Genevieve: Yeah. Yeah. Yeah.
Genevieve: Yeah, no, I agree completely. And so I think as we've talked about today, we've really shown, I think the rationale for why we developed our product the way that we did, how it's consistent with what we've investigated in the scientific literature in terms of absorption and dosing, the clinical outcomes that people can expect, the formulation with vitamin K. Is there anything in kind of closing that you think people should understand about supplementing with vitamin DK on a daily basis or on regular basis?
Abby: I think the biggest thing is just the reality of our modern world, which this is the case with our three essentials products, is that the vast majority of people can benefit and should probably be consuming a vitamin D product. And if maybe you've been consuming a different product that's lower dose or not as high of quality to try out our product and see how you feel, know, take it every day for 30 days, get your vitamin D levels checked. Get your levels up, I think we say officially in our blog, try to aim for between 40 and 60 in that range. See how you feel with your vitamin D levels at 55 versus 30. Most people notice a massive difference, you know, before getting in the weeds and trying all these herbs and things like that to stabilize your mood. Like start with the basics, you know, in my opinion, solve like 80 % of people's problems.
Abby: Vitamin D is such like a no-brainer that impacts so much in the body.
Genevieve: Yeah, no, I agree completely that we had that conversation last time about just deal with the foundations first and make sure that you've got those bases covered. And then if you need additional supplements on top of that, that's when you can be sure that you're...
Genevieve: you're giving your body what it needs. Yeah, under those circumstances, awesome. Well, thank you for chatting with me about all of this today and hopefully soon we'll be out of winter. But as you mentioned, know, even...
Abby: Thank you. Yes.
Genevieve: I personally have a summer dose of vitamin D and a winter dose of vitamin D and I have a vacation dose of vitamin D when I go to the beach and the only way to know really what you need is to test and thankfully we have those tests available that are now easy to use which is great. All right well thanks everybody, thanks for joining us today and we'll look forward to seeing you next time.
Abby: Yep. Yes.
Abby: Yep, totally. All right, thanks Jen.
