Vitamin D: Are you getting enough?

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The sun is shining, promoting optimal health over the water.

Nature’s design is to offer us the ability to easily get enough Vitamin D.  We were born with the ability to convert sunlight to vitamin d.  Cool, huh?

The only problem is we’re deficient in sunlight.

Most of us work indoors.  And we’re taught by the “authorities” to be scared of  the sun because it's dangerous and can cause skin cancer.  It's said we must slather ourselves in sunscreen or wear protective clothing whenever we go outdoors.

We’ve created a Vitamin D deficient society by virtue of our lifestyles.

By protecting yourself from the sun, you prevent the more benign form of skin cancer, basal cell carcinoma.  You do nothing to prevent the deadly form, malignant melanoma.

And by allowing yourself to become Vitamin D deficient, you put yourself at risk for more serious forms of cancer than you prevent by avoiding sunlight.  Incidences of colon, prostate and breast cancer are significantly higher in the Vitamin D deficient person.

So what exactly is Vitamin D and what does it do?

Vitamin D is actually not actually a vitamin.  It’s a prohormone and it’s responsible for over 2000 genes in the body.  Vitamin D fat-soluble and is naturally present in very few foods.  The main naturally occurring dietary sources are cod liver oil and salmon.  The only significant plant sources of vitamin D are mushrooms, in particular shitakes.  When mushrooms are exposed to UV light, the level of vitamin D increases dramatically.

Some foods are fortified with Vitamin D, such as homogenized milk.  It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. The Vitamin D you get from sun exposure, food, and supplements is biologically inert and needs to be activated in your body.  There are two activations, called hydroxylations required to produce active Vitamin D.   The first occurs in your liver, which converts pro- vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as calcidiol. The second occurs in your kidney and forms  1,25-dihydroxyvitamin D [1,25(OH)2D], also known as calcitriol.

The main role of Vitamin D is to promote calcium absorption in your gut and to maintain the level of calcium in your blood. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Together with calcium, vitamin D can help protect you from osteoporosis.

Vitamin D has other roles in your body in controlling cell growth, neuromuscular activities, immune function, and reduction of inflammation.  There are many genes controlled by vitamin D, including those that regulate cell growth, differentiation, and death.

Common Conditions and Symptoms Associated with Vitamin D deficiency

1-      Obesity and excess weight

2-      High blood pressure

3-      Osteoporosis and osteopenia

4-      Autism

5-      Autoimmune conditions (such as Hashimotos, lupus, ankylosing spondylitis, multiple sclerosis, rheumatoid arthritis)

6-      Cancer

7-      Depression

8-      Asthma

9-      Migraines

10-  Cystic fibrosis

11-  Diabetes(both types 1 and 2)

12-  Multiple sclerosis

13-  Schizophrenia

14-  Epilepsy

15-  Osteoarthritis

16-  PCOS (polycystic ovarian syndrome)

17-  Musculoskeletal pain, including joint pain and low back pain

18-  Muscle weakness

19-  Poor balance

20-  Systemic inflammation

21-  Fibromyalgia

Tips to Improve Your Vitamin D Status

  • Get outdoors and enjoy the sunshine for at least 20 – 30 minutes a day during, preferably when the sun is highest in the sky.
  • Avoid sunscreen for a full 20 – 30 minutes.
  • Expose your arms and legs.  You need to expose 40% of your skin to make sufficient Vitamin D.
  • Be sure to avoid washing the exposed parts with soap for at least 48 hours to give your body a chance to absorb all he Vitamin D it produced as a result of the sunshine exposure.
  • Get tested for vitamin D.  The 25, hydroxyl vitamin D test is the one most commonly used.
  • Supplement with Vitamin D if you’re low.

The older you get the more unhealthy you are, the harder it is for you to make Vitamin D.  During the winter in all locations north of Atlanta, Georgia, it is virtually impossible to get enough vitamin D, even with mid day sun exposure.  If you are darkly pigmented, you’ll need more sun exposure to make sufficient Vitamin D.

Vitamin D Supplementation

If you’re unable to get your daily dose of sunshine, then take a vitamin D supplement. Vitamin D3 is best absorbed and utilized.  It’s usually from lanolin, which is from sheep.  If you prefer a vegan source, the only one I know about is Vitamin Code Raw Vitamin D3.  Vitamin D2, a less well absorbed form of vitamin D, is another vegan option.

In general, Vitamin D supplementation is much less effective than sun exposure.  It’s best to get sunlight exposure as much as possible and only use the supplements when sunlight exposure is not possible.  However, it’s best to test to determine whether you’re getting enough.  So many factors affect how well you derive Vitamin D from sunlight.  Most people just don’t get enough.  Even if you get plenty of sun exposure, it’s possible to become Vitamin D deficient.

You can overdose on Vitamin D.  That’s why I recommend a baseline test before starting supplementation.  You cannot overdose on Vitamin D via sunlight exposure, but you can with supplementation.

According to Dr. Mercola, you may need 3000 units of vitamin D per 100 lbs of body weight to correct a deficiency.  In the case of cancer or severe auto immune disease, optimal may be in the range of 5000 units per 100 lbs of body weight.  The human body, given the right conditions, can make up to up to 20,000 units in a day!

Vitamin D supplementation can be helpful for combating acute infectious disease, like the flu or a cold.  In this case, you should take 2000 units /kg per of body weight each day for 3 days.

Vitamin D has a long half life, which means that you can take it once a week rather than daily.

Vitamin D Testing

Testing for Vitamin D is very important to make sure you optimize your levels and avoid overdose.  You should test 25-Hydroxy vitamin D not the more expensive 1,25 dihydroxy vitamin d.

You can get tested by going to

Learn more about Vitamin D testing at Lab Tests Online.   This is a site where you can find information about any lab test.  It is very thorough and informative.

I have found in my practice that it's SO important to get vitamin D tested …not just once but every 3 months until your levels are in the optimal range (I target for 75 in general, but since there are so many factors involved, I tailor my recommendation to the person).

Vitamin D Levels — what’s optimal?

>100 ng/mL Excessive vitamin D
75-100  ng/mL Proposed optimal range
50-75 ng/mL Suboptimal
<50 ng/mL Deficient
<20 ng/mL Seriously deficient

For anyone with levels below 20 I generally recommend 10,000 and sometimes more for 3 months then recommend retesting.

In many cases the levels come up to the 30s by then and I recommend the same for another 3 months.  If the levels come up higher than 30's, I'd probably drop that down a bit and retest in 3 months.  If lower, I would increase the dose and monitor again soon.

The key is testing.  If someone is really low and has serious conditions, like autoimmunity, I often recommend higher doses and retesting sooner.

If you decide to skip the test and just supplement with 2000-4000 IU you run the risk of not correcting the problem.  If you supplement with 10,000 – 20,000 without testing, you run the risk of vitamin D excess.

It's important to work with a trained practitioner.  Fortunately it doesn't have to be one on one anymore.  I've pioneered training people to assess themselves with my guidance in cost-effective group programs, where you do the assessment and can ask me questions to guide you.  The program is called Assess Your Own Body Chemistry and it’s intended to teach you to read your own body’s signs, symptoms and lab tests so you can create a nutrition plan customized to your needs.

Additional reading on Vitamin D from Dr. Joe Mercola

[1] “Daily Sunlight Can Keep Cancer Away” August 7, 2008

[2] “Lack of Sunshine Causes One Million Deaths a Year” August 24, 2007

[3] Dr. Joe Mercola Comments How Much Vitamin Do You Need?

[4] Video by Dr. Joe Mercola.   1 hour video with lots of details about Vitamin D

Medical research papers on the Vitamin D cancer connection

[1]Annals of Epidemiology April 14, 2009  Dr. Cedric Garland

[2] Annals of Epidemiology July 2009, Volume 19, Issue 7, Pages 468-483

[3] Science Daily, “New Model of Cancer Development: Low Vitamin D Levels May Have Role” May 26, 2009

[4] The Journal of Steroid Biochemistry and Molecular Biology March 2007; 103(3-5):708-11

[5] American Journal of Clinical Nutrition June 2007; 85(6):1586-91.

[6] American Journal of Epidemiology October 12, 2007

Question of the day:

Have you been tested for Vitamin D yet?  If yes, what was your level?  How much are you supplementing if low?

With Love and Gratitude,

Dr. Ritamarie

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