The Death of a Parent Affects Even Grown Children Psychologically and Physically

Grief is both real and measurable. Scientists now know that losing a parent changes us forever.

The death of a parent is one of the most emotional and universal human experiences. If a person doesn’t know what it’s like to deal with the loss of a father or mother, they most likely will one day. But just because the passing of a parent happens to almost everyone doesn’t make it any easier. The death of a parent is not just traumatic, it informs and changes their children biologically and psychologically. It can even make them sick.

“In the best-case scenario, the death of a parent is anticipated and there’s time for families to prepare, say their goodbyes, and surround themselves with support,” psychiatrist Dr. Nikole Benders-Hadi says. “In cases where a death is unexpected, such as with an acute illness or traumatic accident, adult children may remain in the denial and anger phases of the loss for extended periods of time…[leading to] diagnosis of Major Depressive Disorder or even PTSD, if trauma is involved.”

There’s no amount of data that can capture how distinctly painful and powerful this grief is. That said, there are a number of psychological and brain-imaging studies that demonstrate the magnitude of this loss. The posterior cingulate cortex, frontal cortex, and cerebellum are all brain regions mobilized during grief processing, research shows. These regions are involved in storing memories and dwelling on the past, but they’re also involved in regulating sleep and appetite.

In the short term, neurology assures us that loss will trigger physical distress. In the long-term, grief puts the entire body at risk. A handful of studies have found links between unresolved grief and hypertension, cardiac events, immune disorders, and even cancer. It is unclear why grief would trigger such dire physical conditions, but one theory is that a perpetually activated sympathetic nervous system (fight or flight response) can cause long-term genetic changes. These changes — less pre-programmed cell death, dampened immune responses — may be ideal when a bear is chasing you through the forest and you need all the healthy cells you can get. But this sort of cellular dysregulation is also how cancerous cells metastasize, unchecked. 

While the physical symptoms are relatively consistent, the psychological impacts are all but unpredictable. In the twelve months following the loss of a parent, the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders considers it healthy for adults who have lost their parents to experience a range of contradictory emotions, including sadness, anger, rage, anxiety, numbness, emptiness, guilt, remorse, and regret. It is normal to withdraw from friends and activities; it is normal to throw oneself into work.

As ever, context matters. Sudden, violent death puts survivors at higher risk of developing a grief disorder, and when an adult child has a fractured relationship with a parent, the death can be doubly painful — even if the bereaved shuts down and pretends not to feel the loss. “Coping is less stressful when adult children have time to anticipate parental death,” Omojola says. “Not being able to say goodbye contributes to feeling depressed and angry.” This may explain why studies have shown that young adults are more affected by parental loss than middle-aged adults. Presumably, their parents died unexpectedly, or at least earlier than average.

Gender, of both the parent and child, can especially influence the contours of the grief response.

Studies suggest that daughters have more intense grief responses than sons, but men who lose their parents may be slower to move on. “Males tend to show emotions less and compartmentalize more,” Carla Marie Manly, a clinical psychologist and author, told Fatherly. 

“These factors do affect the ability to accept and process grief.” Studies have also shownthat loss of a father is more associated with the loss of personal mastery — purpose, vision, belief, commitment, and knowing oneself. Losing a mother, on the other hand, elicits a more raw response. “Many people report feeling a greater sense of loss when a mother dies,” Manly says. “This can be attributed to the often close, nurturing nature of the mother-child relationship.”

At the same time, the differences between losing a father and a mother represent relatively weak trends. “Complicated bereavement can exist no matter which parent is lost,” Benders-Hadi says. “More often, it is dependent on the relationship and bond that existed with the parent.”

Grief becomes pathological, according to the DSM, when the bereaved are so overcome that they are unable to carry on with their lives.Preliminary studies suggest this occurs in about 1 percent of the healthy population, and about 10 percent of the population that had previously been diagnosed with a stress disorder. “A diagnosis of Adjustment Disorder is made within three months of the death if there is a ‘persistence of grief reactions’ exceeding what’s normal for the culture and the religion,” Omojola says. “In this situation, the grieving adult has severe challenges meeting social, occupational, and other expected, important life functions.” Even adults who are able to go to work and put on a brave face may be suffering a clinical condition if they remain preoccupied with the death, deny that their parent has died, or actively avoid reminders of their parents, indefinitely. This condition, known as Persistent Complex Bereavement Disorder, is a trickier diagnosis to pin down (the DSM labeled it a “condition for further study”).

Elisabeth Goldberg works with grieving adults as a relationship therapist in New York City, and she has seen the toll that long-term grieving can take on a marriage. Specifically, Goldberg suggests a (somewhat Freudian) link between losing a parent and cheating on a spouse. “I see many affairs as manifestations of unresolved grief about losing a parent,” Goldberg says. “The adult child stays in a state of disbelief, and rejects reality in many ways in order to feed the delusion that the parent is still alive. The grieving child needs a new attachment figure, that’s the psyche trying to reconcile the denial and grief. So rather than say, ‘My mother died,’ the grieving child can say, ‘While Mommy’s away, I will play with someone other than my spouse.’”

In more concrete — and dire — terms, unresolved grief can spiral into anxiety and depression. This is especially true when the parent dies by suicide, according to Lyn Morris, a licensed therapist and VP at Didi Hirsch Mental Health Services. “Adults who lose a parent to suicide often struggle with complex emotions such as guilt, anger, and feelings of abandonment and vulnerability,” she told Fatherly. Indeed a 2010 study out of Johns Hopkins University confirmed that losing a parent to suicide makes children more likely to die by suicide themselves.

How to cope in a healthy way remains an active area of scientific inquiry. Ross Grossman, a licensed therapist who specializes in adult grief, has identified several “main distorted thoughts” that infect our minds when we face adversity. Two of the most prominent are “I should be perfect” and “they should have treated me better” — and they tug in opposite directions. “These distorted thoughts can easily arise in the wake of a loved one’s death,” Grossman says.

When a son or daughter reflects on how he or she should have treated a deceased parent, “I should be perfect” thoughts tend to rise to the surface. Grossman’s patients often feel that they should have done more and, “because they didn’t do any or all of these things, they are low-down, dirty, awful, terrible human beings,” he says. “These kinds of thoughts, if left undisputed, usually result in a feeling of low self-worth, low self-esteem, shame, self-judgment, self-condemnation.”

On the opposite extreme, patients sometimes blame their deceased parents for not treating them properly, and never making amends. This is similarly unhealthy. “The usual result of this is deep resentment, anger, rage,” Grossman says. “They may have genuine, legitimate reasons to feel mistreated or abused. In these situations, it’s not always the death of the parent but the death of the possibility of reconciliation, of rapprochement and apology from the offending parent.”

“The possibility has died along with the person.”

In extreme cases, therapy may be the only way to get a grieving son or daughter back on his or her feet. But time, and an understanding spouse, can go a long way toward helping adults get through this unpleasant, yet ubiquitous, chapter in their lives. “Husbands can best support their wives by listening,” Manly says. “Men often feel helpless in the face of their wives’ emotions, and they want to fix the situation. A husband can do far more good by sitting with his wife, listening to her, holding her hand, taking her for walks, and — if she desires — visiting the burial site.” Via Fatherly (Health & Science / Psycology) by Joshua A. Krisch.



Stress Management Techniques

Pregnancy can be a blissful time rich with new experiences, sensations, and emotions that enrich your life in a plethora of exciting ways. And yet, it can also be filled with the not-so-pleasant stuff like morning sickness, fatigue, and mood swings.

During this turbulent time, countless books, and “parenting experts” tout the importance of reducing stress levels, but there seem to be far fewer discussions about what we can actually do to accomplish this. In today’s post, I hope to bring you some of my favourite tips and tricks to help you feel more grounded and at peace throughout your pregnancy.

First Thing’s First, What Kinds of Stress Are There?

Typically, there are three different types of stress that people experience:

1. Time-related stress: stress related to feelings that there just aren’t enough hours in a day.

2. Anticipatory stress: stress due to imagining what might go wrong in the future.

3. People stress: when you feel stressed around certain people.

What Coping Mechanisms Are Useful for Each Category of Stress?

1. Time-related stress:

• The best way to cope with this is to improve your time management skills. Making a to-do list and writing it down is essential in my opinion. This is vital if you are experiencing ‘Pregnancy Brain’! From there, I like to go one step further and divide your tasks into the following categories: Urgent, Important, Delegate, or Forget It. This tells you what needs to be done immediately, what needs to be done eventually but isn’t pressing, what can be passed on to someone else, and what might not even actually need to be done any more.

• Figure out when you’re most productive and do the most important tasks during that time frame. Deciphering what environment is most conducive to you being productive is also helpful; if you need quiet time, see if you can go into work an hour early or stay an hour later when there are less people in the office.

2. Anticipatory stress:

• It’s easy to think of all the things that could go wrong during pregnancy or as a parent in general, but worrying won’t change the outcome. What are the smallest things you can do in the now to make yourself feel more in control of the situation you’re fantasizing about? Is the future picture you’re painting realistic or are you exaggerating things in your mind? And if you’re fearing something about the future, ask yourself what would be your “upper limit” in that situation that would cause you to change your actions. For example, if you’re worried about pain management during labour, what will be the signs that will help you decide if you will or will not have an epidural? Defining your threshold and sharing it with your partner can be helpful.

3. People stress:

• Everyone has an opinion when it comes to parenting, which can become exhausting. Know when you need to cut yourself off from other people—or at least limit your time with them. From there, develop strategies to decrease the amount of time you’re near them. It can be as simple as sitting on the opposite side of the table if you’re at dinner or putting on headphones at work.

• Know when you need down time to recuperate and be able to say “no” when that mood strikes.

• Try to develop empathy for the other person. Your mother may want to be involved in the pregnancy because hers wasn’t… knowing this can help you separate your emotions from her behaviour.

Overall Methods to Decrease Stress

1. Progressive muscle relaxation*:

This technique involves tensing and releasing different muscle groups so you know how it feels to have fully relaxed muscles. First, you squeeze the muscles as hard as you can for about five seconds. Really focus on what it feels like to have tense muscles. When those five seconds are up, quickly release the tension and exhale. Pay attention to the difference between super tense and super relaxed muscles. Here’s the series of clenching/relaxing that I would follow (TIP: put on some relaxing music in the background as you do this!)

• Forehead: raise eyebrows as high as you can

• Eyes: clench eyelids tightly

• Mouth: open your mouth as wide as you can so your jaw feels stretched

• Neck and shoulders: raise your shoulders so they get as close to your ears as possible

• Chest: take a deep breath and hold so your chest feels tight

• Stomach: suck it in as much as you can

• Butt: squeeze your butt cheeks together

• Right arm: clench your fist and extend your arm as hard as you can

• Left arm: see above

• Upper leg: extend your leg as hard as you can and focus on how tight your quadriceps and hamstrings feel

• Lower leg: put your ball of the foot on the floor and tighten your calf muscle

• Foot: curl your toes downward

2. Go out in nature and unplug.

• There’s something about being fully immersed in nature, whether that’s through taking in a sunset or sunrise when it’s quiet outside, feeling grass on bare feet, or basking in some hot rays of sunshine. Being immersed in nature not only promotes peacefulness, but your body also reaps the physical benefits of doing so such as absorbing some much-needed vitamin D or inhaling some fresh oxygen.

3. #BoringSelfCare

• This has become a new trend in the social media world that involves doing extremely mundane tasks as a form of helping yourself feeling better. It might be as simple as making your bed, doing the dishes, or packing your lunch for the next day. The best thing about #BoringSelfCare is that it can make you feel slightly more in control when things seem all over the place.

4. Do a totally brainless activity.

• Yes, I watch The Bachelorette. I’m not proud of it, but after a long day of exerting mental and emotional energy, this show allows me to shut my brain off. I get the same sensation when I read a really stupid trashy magazine that consists of fictional stories about celebrities. Find something—anything—that let’s you go practically brain dead.

5. Learn to say no and set boundaries for yourself.

• It’s easy to feel like you need to say “yes” to everything due to social pressures or to avoid hurting people’s feelings. But if you continually put yourself second (or third or fourth) on the priority list, you’re just going to get burnt out. Once the baby comes, this will become even more important – be good to yourself. Remember the advice you get on airplanes: You have to put your own oxygen mask on first before helping someone else.

6. Engage in a hobby that makes you feel good about yourself—or pushes yourself outside of your comfort zone.

• Try something totally new that pushes you out of your comfort zone. Seeing your ability to learn and adapt to new situations and environments reminds us that we’re resilient and hobbies also give us time away from our stressors. I actually just started taking a pottery class for the first time, and it’s been amazing to realize that I’m capable of learning something totally new. Plus, those Wednesday night classes give your partner and baby a chance to bond with each other… every Wednesday night! For more on how to build your resilience, check out this other blog post of mine.

7. Eat well and exercise.

• If you’re downing six Red Bulls a day, eating drive-thru food every five days a week, and sitting on your butt 24/7, your body is going to be in such a poor state that handling stress will just throw it over the edge. Cue getting sick, feeling like garbage, and having to possibly miss work (which, of course, only adds more stress). Do yourself a favour and eat as clean as you can during more overwhelming periods. It’s also important to find a form of exercise that connects to you. Many experts highlight the benefits of yoga and meditation—which are certainly helpful and can be done at home even after baby arrives! —but if you feel less stressed after punching a boxing bag for 30 minutes, do that!

The Bottom Line

Identifying the type of stress you experience most often, knowing how to identify stressors, and finding helpful solutions on how to deal with these stressors are the keys to feeling more grounded. And never forget: you’re more capable, resilient, and powerful than you know! Written by Kristina Virro, BA, MA (Journalism), RHN, MSc (Psychotherapy – current) from anxiety



The Nuances of Vitamin D—and How to Get Enough of It.


We’ve been interested in the role vitamin D plays in our overall health for a while—particularly as it emerges that so many of us are quite deficient, particularly in the age of sitting inside all day and sunscreen. “Vitamin D” is sort of a misnomer because it doesn’t really behave like a vitamin; rather it functions more like a hormone. The form you typically consume (in food or supplements, or indirectly via the sun) is vitamin D3, but your body converts this into a steroid hormone, called calcitriol. Once vitamin D is turned into this active form, it travels throughout the body and plays a part in a number of diverse (and vital) functions: It builds bones and muscles; it also has anti-inflammatory effects, and helps to make enzymes and proteins that prevent diseases; it affects aging. High levels of vitamin D have been linked to stronger immune systems, while low levels are associated with cardiovascular disease, diabetes, and cancer. The full extent of vitamin’s D impact has yet to be fully understood—nearly every cell and tissue in our body has vitamin D receptors (proteins that bind to vitamin D); and in its active form, vitamin D can interact with the vast majority of the body’s cells. Below, vitamin D expert, Rhonda Patrick, Ph.D., shares the latest research on vitamin D (including some of her own)—which touches on aging, mood, autoimmunity, and autism (to name a few)—and spells out how to be sure you’re getting enough.

A Q&A with Rhonda Patrick, Ph.D

How many people globally are thought to be vitamin D deficient, and how does that compare to the U.S.?


First, we need to define “vitamin D deficiency.” The U.S. Endocrine Society, which uses a medical model that considers the broader set of vitamin D3 functions instead of just those related to bone, recommends that serum vitamin D levels above 30 ng/ml are adequate, levels between 29 ng/ml and 20 ng/ml are inadequate, and below 20 ng/ml are deficient. If we are to use this definition of adequate, much of the world falls in the category of either inadequate or deficient. According to meta-analyses of several studies that have assessed serum vitamin D3 levels worldwide, the global average vitamin D3 level is actually 20 ng/ml, which is pretty close to full-on deficient…and that’s the average. In the United States, approximately 70% of the population has vitamin D levels below 30 ng/ml.


Is our modern lifestyle (more time at the computer, less outside) and increased sunscreen use the major cause of this widespread deficiency, or do other factors play into the epidemic?


Yes, it is generally thought that the main reasons why vitamin D3 levels have decreased over the last few decades is due to more sunscreen use and spending more time indoors on computers. Since UVB radiation from sunlight is required to produce vitamin D in the skin, anything that blocks UVB rays such as sunscreen will also prevent your skin from making vitamin D3.

Another possible contributing factor to low vitamin D3 is the increased obesity epidemic. Vitamin D3 is a fat-soluble vitamin, which means it is stored in our fat. A higher body fat percentage can decrease the bioavailability of vitamin D3 by as much as 50% by soaking up the vitamin D and preventing it from making its way to our other tissues. This means that overweight and obese individuals may have less vitamin D that is available to be used by the body.

Other factors that regulate the ability of the skin to make vitamin D3 include age (a seventy-year-old makes about four times less vitamin D3 from the sun than a twenty-year old); melanin, which acts as a natural sunscreen; and latitude, which dictates whether UVB rays can reach the atmosphere.


Beyond skin coloration and latitude, what else determines how much vitamin D a particular individual needs? Are there genetic differences?


Genetics also play an important role when it comes to vitamin D. Gene polymorphisms, normal variations in the sequence of DNA of a gene that can alter its function, exist in several different genes involved in the vitamin D pathway. One gene that is subject to these sort of variations that can either affect how good we are at converting the precursors of what we normally call “vitamin D,” 25-hydroxyvitamin D, is known as CYP2R1. If we have a polymorphism that makes this gene less efficient at doing its’ job, then we’ll see less 25-hydroxyvitamin D being converted in the kidneys, and this will show up on the blood test we can get at our doctor’s office. In the future, we may see this giving us valuable insights since it may mean that certain individuals would have to take more vitamin D in order to achieve “sufficiency.”


What role does vitamin D play in aging?


Vitamin D3 is actually much more than a vitamin; it gets converted into a steroid hormone that has been shown to affect the activity (expression) of almost 1,000 different genes in the body, which is about 4.6% of the human protein-encoding genome! Let that sink in for a moment. I wouldn’t want 5% of the parts in my car engine to be working inappropriately if I wanted the car to have longevity!

But…returning to your question: Vitamin D does seem to affect the way we age. Mice that have been genetically engineered to not be able to respond to vitamin D (a vitamin D receptor “knockout”) manifest dramatic signs of aging in all the organs on a cellular level. You do not want to be these mice. There are multiple mechanisms by which vitamin D regulates the aging process, including telomeres. Every cell in your body contains DNA, which is present in your chromosomes, and the integrity of your DNA is crucial for your cells to function properly. Telomeres, which are caps at the end of chromosomes, help maintain that integrity. They protect our DNA from damage and deterioration. The length of our telomeres has been shown to correlate pretty well with our biological age. In this capacity, they serve as a marker for aging. If you have short telomeres, you’re biologically old. If you have long telomeres, you’re biologically younger. As in all things, there’s more nuance to it than that, but for our purposes, it’s useful to realize that we can be chronologically older, but have a biological age that is in line with those younger than us.

A couple of studies have shown that vitamin D can slow this telomere shortening that naturally happens with age. In one study involving 2,100 female twins, those with the lowest vitamin D levels had shorter telomeres that corresponded to five years of aging. Women that had serum levels between 40-60 ng/ml also had the longest telomeres compared to age-matched controls with lower vitamin D levels. Telomere shortening is accelerated by inflammation and DNA damage, as well as cell division. Every time a cell divides to give rise to daughter cells, the telomeres get shorter. We know that vitamin D activates DNA repair genes and anti-inflammatory genes to reduce damage at the telomere. This is a good thing for a whole host of reasons, but in the context of telomeres, it means extending their shelf life just a bit longer. Once the telomere runs out, the cells either die…or worse, they stick around in a “senescent” state, failing to do their normal function and instead becoming a source of damage to nearby cells by causing inflammation.


How can vitamin D intake affect our behavior and mood? What are other effects, physical and mental, of low levels of vitamin D?


This question touches on my own research that I did during my postdoctoral training. Among the 1,000 genes that vitamin D controls is a gene in the brain called tryptophan hydroxylase 2 (TPH2), which encodes for the rate-limiting enzyme that converts tryptophan into serotonin in the brain. It was my work that identified that this gene, TPH2, has a sequence that indicates that it is activated by vitamin D, suggesting that vitamin D may be important to producing serotonin in the brain from tryptophan. That’s pretty important! Serotonin regulates a broad range of cognitive functions and behaviors. It regulates social behavior, impulse control, decision making, anxiety, memory, impulse aggression, so-called “sensory gating,” and more.

We know that serotonin does these things because dozens of studies have teased out what serotonin does by depleting normal people of their serotonin temporarily. The way this is done is actually pretty clever and a little more harmless than it sounds: Tryptophan, the amino acid serotonin is made from, has to be actively transported into the brain. Another group of amino acids, however, will be transported preferentially before tryptophan if there’s enough of it sitting around. So that means you can actually give people a shake of branched-chain amino acids, a common component of bodybuilding supplements, and, in about 7 hours, around 90% of the serotonin in the brain is depleted. What happens then? People become impulsive, their long-term thinking shuts down, they become irritable, anxious, depressed, and their sensory gating, the ability to block out extraneous stimuli in the environment, becomes impaired. Aside from mood, serotonin is also important for many other things. We’ll get back to that in a second, however.


Can you explain how vitamin D is linked to our gut, inflammation, and autoimmunity?


This may surprise some people, but gut inflammation is also linked to serotonin: Not the serotonin in the brain, rather serotonin that is produced in the gut. Around 90% of the serotonin in the body is actually produced in the gut by a separate tryptophan hydroxylase gene called TPH1. This gene has a very important distinction from TPH2, the brain variety. Instead of being activated by vitamin D, TPH1 appears to have a sequence that is associated with repression. In other words, when vitamin D is around, it probably stops the conversion of tryptophan (in the dietary protein we eat) into serotonin in the gut. Don’t get too alarmed by that, however, serotonin made in the gut doesn’t have a lot to do with the amount of serotonin in the brain, since all of the serotonin in the brain is actually made in the brain by TPH2. In other words, serotonin does not cross the “blood-brain barrier.” We need just the right amount of serotonin in the gut because too much causes gut inflammation where serotonin serves to actually activate immune cells in the gut. In fact, it’s been shown that getting rid of serotonin in the gut in several different animal models of colitis and irritable bowl syndrome ameliorates the inflammatory symptoms associated with these inflammatory gut diseases. Since we now know that TPH1 is most likely repressed by vitamin D, this suggests that vitamin D deficiency may lead to excessive immune cell activation in the gut and, thus, inflammation.

My work also identified that vitamin D may be regulating autoimmunity through this same gut-serotonin pathway. Tryptophan, in addition to being converted into serotonin in the gut, can also be metabolized by another enzyme to generate a compound called kynurenine, which is essential for the production of regulatory T cells. Regulatory T cells are essential for telling the immune system, “Hey, this is my cell, it is not a foreign invader, do not attack this cell.” They play a very important role in dampening the immune response and preventing autoimmunity. Because tryptophan can be used in the pathway to make serotonin, through tryptophan hydroxylase 1 (TPH1), if that gene is hyperactive because there is low vitamin D, it may be sucking all the tryptophan into that pathway and producing a lot of serotonin in the gut, which then means less tryptophan is available to this other pathway that is essential to making regulatory T cells that keep autoimmunity at bay.


Can you talk a bit about the potential link between low levels of vitamin D and autism?


Low levels of vitamin D had been linked to autism and low levels of serotonin in the brain had also been linked to autism, however, until my work linking vitamin D more directly to serotonin, nobody had put the two together. Serotonin is so much more than a neurotransmitter. During early brain development serotonin actually acts as a brain morphogen because it shapes the structure and wiring of the brain. Serotonin tells neurons where they should go and what type of specific neurons they should become. It is literally acting as a growth factor in that sense during early brain development. Several studies have shown in mice that inhibiting the production of serotonin in early brain development causes functional and structural abnormalities in the brain, some of which manifest later in behavior that is said to resemble some autistic-like behaviors, insofar as mice can mirror the complexity of human behavior. Since vitamin D is required to activate this gene that produces serotonin, and the developing fetus depends on the mother’s vitamin D levels, if the mother is low in vitamin D then there may not be enough for the developing brain to produce serotonin. This could lead to abnormal brain development and autism, particularly in combination with other gene polymorphisms that already increase autism risk.

The other way in which the vitamin D-serotonin pathway may influence autism is by keeping the autoimmune response during pregnancy at bay. What is interesting is that mothers with autistic children are three times more likely to have high levels of antibodies against fetal brain protein in their blood cells. Said another way, they are three times more likely to show signs that their immune system was actively engaged against the developing fetal brain. There is really no good explanation as to why, but it suggests that the developing fetus may be recognized as “foreign” in these women. This may cause the immune cells to actually make antibodies that attack proteins in the developing brain, which could alter the way the brain develops. In fact, this has been shown in pregnant monkeys.


Is it possible to have too much vitamin D?


Yes, it is possible but not common. Data compiled from several different vitamin D supplementation studies reveal that vitamin D toxicity is obtained at doses higher than 10,000 IU. Toxic doses of vitamin D can result in exceedingly high serum levels of calcium, known as hypercalcemia and have been reported at doses higher than 50,000 IU.


How can we be sure we’re getting enough vitamin D? What are the best sources?


The best way to know if you are getting enough vitamin D is to get a blood test that measures your vitamin D levels. Meta-analyses of studies done ranging from 1966-2013 have shown that people with serum levels between 40-60 ng/ml have the lowest all-cause mortality, meaning they die less of all non-accidental diseases.

Supplementation with vitamin D3 is a good way to ensure you get adequate vitamin D. 1,000 IU of vitamin D per day, in most people, will raise serum levels by about 5 ng/ml. A good vegetarian source of vitamin D3 is lichen. Some foods have been fortified with vitamin D, including milk (100 IU per 8 ounces) and orange juice (100 IU per 8 ounces), but if we’re trying to fix inadequacy, these numbers are really a drop in the bucket. They’re not very much at all. Furthermore, dairy products are a sub-optimal choice for fortification for the approximately 50 million Americans who are lactose intolerant. If, like me, you are someone who decides to supplement, the upper tolerable intake level set by the Institute of Medicine is 4,000 IU. One study showed that people that were considered to be vitamin D deficient were able to raise their serum levels to sufficient levels after supplementing with 4,000 IU of vitamin D3 per day. Via Goop.