Ivo Paunov

Vitamin D

It’s important. Once activated, vitamin D acts less like a vitamin and more like a hormone — it directly switches genes on and off. Around 3% of the human genome has binding sites for the vitamin D receptor, meaning hundreds of genes across immune, metabolic, and brain function are regulated by it (A ChIP-seq defined genome-wide map of vitamin D receptor binding).

Vitamin D is a nutrient the body needs, along with calcium, to build bones and keep them healthy. The body can absorb calcium only if it has enough vitamin D. Calcium is a major part of bones. Vitamin D also has many other uses in the body. It supports immune health and helps keep muscles and brain cells working.

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Sun exposure — how to get vitamin D without burning

Sun is the best source — a single midday session can produce 10,000–20,000 IU in skin, self-regulated (body stops at saturation).

  • UV-B (280–315 nm) required — only present when sun is high enough: shadow shorter than your height. Sunrise/sunset = zero vitamin D regardless of brightness
  • Best window: solar noon ±2 hours (roughly 10am–2pm). Need UV Index ≥3
  • More skin = more D3 — torso + back in direct sun is far more effective than face + hands
  • Stop before redness — D3 production peaks in the first 10–20 min; burning adds no more D3, only damage
  • Sunscreen blocks UV-B — apply after your vitamin D window
  • Glass blocks UV-B — sunny window = no vitamin D
  • Above ~50°N (UK, northern Europe, Canada): October–March = zero UV-B regardless of weather — supplement mandatory
UV Index Condition Exposure time (fair skin, arms+legs)
1–2 Winter / high latitude / overcast Zero — supplement instead
3–5 Spring/autumn, moderate latitude 20–40 min
6–8 Summer midday, sunny 10–20 min
9–11+ Tropical / high altitude 5–10 min

How to take supplemental vitamin D

  • Take with food containing monounsaturated fat (e.g. extra virgin olive oil) — can increase absorption up to 32% (dietary fat triggers bile release which improves D3 uptake)
  • Take earlier in the day — late-night D3 may interfere with sleep in some people
  • Do not overdose — 2000–4000 IU/day is the well-studied maintenance range for adults. Meta-analysis (PMID 36853379) shows 3200–4000 IU/day raises hypercalcemia risk slightly; do not exceed without bloodwork
  • Check blood 25(OH)D and Ca every 6–12 months to confirm you are in range and not over-supplementing. Target: 40–60 ng/mL (100–150 nmol/L)
  • Do NOT take supplemental Calcium unless a diagnosed deficiency — dietary calcium from real food is sufficient if vitamin D and K2 are adequate; excess supplemental Ca without K2 increases arterial calcification risk

Vitamin K2 (MK-7) — dose and role

MK-7 (menaquinone-7) is the long-chain form of K2 with the longest half-life (~72h vs ~1h for K1), highest tissue penetration, and highest potency for carboxylating K-dependent proteins.

Why it matters with vitamin D: Vitamin D dramatically increases intestinal calcium absorption. Without sufficient K2, that extra circulating calcium may deposit in soft tissue and arteries instead of bone — the opposite of what you want. K2 activates two key proteins:

  • Osteocalcin (bone Gla protein) — pulls calcium into bone matrix
  • Matrix Gla protein (MGP) — inhibits calcium deposits in arterial walls

Dose:

  • 90–180 mcg/day — the 3-year landmark RCT (Knapen et al., 2013, PMID 23525894) used 180 mcg/day and significantly reduced bone mineral density loss; 90 mcg is the minimum effective dose for osteocalcin carboxylation in most adults
  • Take with vitamin D and fat for co-absorption (both are fat-soluble)
  • Must be trans-MK-7 (natural, bioactive isomer) — some cheaper products contain cis-MK-7 which is largely inactive
  • ⚠️ Warfarin / anticoagulant users: K2 directly antagonizes warfarin-class drugs — do not supplement without physician supervision

Magnesium — dose and role in vitamin D activation

Magnesium is not optional when supplementing vitamin D. It is a required cofactor for both enzymatic conversion steps that make vitamin D biologically active:

  1. Liver: 25-hydroxylase (CYP2R1) converts D3 → 25(OH)D (the main circulating storage form)
  2. Kidney: 1α-hydroxylase (CYP27B1) converts 25(OH)D → 1,25(OH)2D (the active hormone)

Without adequate magnesium, both steps are impaired — you can supplement vitamin D and still not raise serum 25OHD meaningfully. The Cheung et al. 2022 RCT (PMID 35576873) confirmed this directly: the combined magnesium + vitamin D group achieved the greatest increase in serum 25OHD vs vitamin D alone. Separately, ~48% of the US population has chronically suboptimal magnesium intake (Rosanoff et al., PMID 22364157).

Dose:

  • 300–400 mg elemental magnesium/day covers vitamin D metabolism support and general physiological need
  • Best absorbed forms: bisglycinate (glycinate chelate), malate, citrate — in that order of preference
  • Avoid magnesium oxide — ~4% bioavailability, functions mainly as a laxative
  • If already using klatiLYTE: ~280mg elemental Mg per moderate-activity dose is included — likely covered
  • Split over 2 doses if >200mg per sitting to avoid GI effects

Research

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