Vitamin D: The Truth

Have you been told you were deficient in Vitamin D?  Are you taking “prescription strength” Vitamin D and it is taking forever to get results?  Are you having side effects?  Well, believe it or not, all vitamin D is not created equal.  In fact, the RDA is nothing more than a miscalculation!  Read on for THE TRUTH!

What is Vitamin D and why is it important?

Vitamin D is an essential fat soluble vitamin that is essential for bone and immune health.  Vitamin D deficiency has been associated commonly with rickets, but recent research suggests that deficiency is prevalent in other disease states.  These include cardiovascular disease, diabetes, osteoporosis, falls among the elderly, overall mortality, cancer, multiple sclerosis, cognition, and chronic pain.  Most citizens of Westernized countries are deficient in Vitamin D, making it a pandemic!

Very little vitamin D is consumed from food sources.  In order for you to produce vitamin D, sunlight in the form of UVB rays, needs to be absorbed by the body to make vitamin D.  This can be difficult when living in Woodbury, Minnesota!  In the current market, there are two types of Vitamin D available for therapeutic use.  They are Vitamin D2 (Ergocalciferol), and Vitamin D3 (Cholecalciferol).  D2 is mostly synthetic and is added to fortified milk and in prescriptions.  D3 is commonly found in supplements.

Why should we care?

Vitamin D is involved with multiple organ systems and deficiency is very common.  The increasing numbers of deficiency are due in part to most people staying inside with little exposure to UVB rays.  So, with children staying inside most of the day and adults working under fluorescent lights, we really do not have a chance at producing enough vitamin D!  This is further compounded by sun block which repels UVB rays. Did you know that wearing SPF 8 will diminish the vitamin D production by 95%!  Once vitamin D is produced, it rapidly degenerates, as the half-life is only three weeks, hence the reason why constant replenishment is needed.

Incorrect Lab Testing

Common lab tests include testing either 1, 25 (OH)2D or 25 (OH)2D.   The former does not accurately assess the body’s serum levels of vitamin D. Very rarely is the test indicated.  25 (OH)2D will test for insufficient sunlight exposure or dietary intake.  You may have ask for this test specifically, as this may or may not be routinely performed.  An alternative method of testing is requesting a self test which can ordered via  www.vitamindcouncil.org.  To make this more difficult, some insurance companies will not pay for 25 (OH)2D test and will only pay for vitamin D testing one time per year.  If no follow up testing is performed, many patients do not even know if their treatment is effective.  Using the incorrect test will give skewed results and can mislead the treating healthcare provider.

 

Common Treatment

Common treatment is 50,000IU of vitamin D2 one weekly for four weeks.  This treatment plan is based on mostly anecdotal evidence based on flawed data.  Vitamin D2 does not convert to the active form quickly and will not adequately raise blood levels.  Vitamin D3 converts to the active form 500 times faster than D2. In addition, as soon as treatment is stopped and lifestyle remains the same, vitamin D levels will rapidly decrease.  Also, studies show that mortality rates increased for people taking D2 and decreased in patients that took D3.

What are Optimum Levels?

The Optimum level of vitamin D is not yet solidified.  Currently the recommended dietary allowance for vitamin D is 600IU/day.  The problem is that 600IU is supposed to represent 97.5%.  Recently, this figure was found to be a miscalculation and never corrected.   In addition, the RDA’s are set for a 150lb male.  This does not take in to account other health conditions, age, altitude or sun exposure.

Currently, the optimum levels of vitamin D focus on the blood level for a specific individual rather than a specific amount per day.  Most vitamin D researchers believe that a level of 20ng/ml is far too low to promote optimum health.   A level of 40mg/ml is more optimal, however, a therapeutic dose of vitamin D is between 50-70 ng/ml.  Studies show that no symptoms of toxicity were observed at levels below 200ng/ml.

Recommendations

Get outside!   Spending more time outside with the skin exposed will naturally raise levels.  For the average American, vitamin D needs to be supplemented using D3 to achieve the optimum dose measured by 25 (OH) D.   Only use SPF products when in the sun for long durations or in a geographic area that is not common for you or while on beach vacation, but not all day.   Only use vitamin D3 and monitor you levels frequently.

Sources Consulted

http://www.jabfm.org/content/22/6/698.full

https://labtestsonline.org/understanding/analytes/vitamin-d/tab/test/

https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/