Dr. Cindy's Basic Guide to Vitamin D

One of the hottest topics in health care today revolves around the powerful benefits of vitamin D. It seems as though the health benefits of vitamin D have leapt from relative obscurity to the top of the list of useful self-care in health-care-related strategies. Well known for its role in the prevention of childhood rickets and the intestinal absorption of dietary calcium, vitamin D has now been found to be important in protecting the body from a wide array of diseases. From mood disorders, mental clarity, autism and birth defects to autoimmune dysfunction, heart disease, obesity and cancer, vitamin D appears to play a vital role in them all. Indeed, according to the Vitamin D Council, vitamin D's influence on key biological functions mandates that it no longer be ignored by health-care professionals or anyone striving to achieve or maintain a state of optimal health and overall well-being.

What Exactly Is Vitamin D?
Commonly referred to as the "sunshine vitamin," vitamin D is not really a "vitamin" after all. It's actually a potent hormone called cholecalciferol that was misclassified as a vitamin. Its metabolic product, calcitriol, is a secosteroid hormone that directly impacts the expression of over 2,000 genes in the human body. There are two major forms: (1) vitamin D2 or ergocalciferol--the plant form; and (2) vitamin D3 or cholecalciferol--the human form.

Why is Vitamin D So Important to My Health?
Achieving and maintaining optimal vitamin D levels in your body many prevent and/or even reverse the progression of certain conditions, including cardiovascular disease; 17 different types of cancer, including colon, breast and prostate cancer; autoimmune diseases like multiple sclerosis and rheumatoid arthritis; type I and type 2 diabetes; and osteoporosis or osteopenia. Optimal levels of vitamin D have been shown to increase HDL cholesterol, reduce triglycerides, reduce small LDL cholesterol, normalize blood sugar, enhance insulin responses, reduce inflammation, normalize blood pressure, enhance immunity and prevent bone fractures. It can also increase physical energy, increase mental clarity and significantly improve a variety of mental health-related conditions, from seasonal affective disorder to pervasive developmental disorders, mood disorders and even psychotic disorders like schizophrenia. Some now even believe that vitamin D deficiency is often misdiagnosed as fibromyalgia.

What Causes Vitamin D Deficiency?
The major culprit in vitamin D deficiency is inadequate sun exposure. There are also a number of health-related problems that can affect the absorption of vitamin D from dietary sources. Vitamin D is fat-soluble. This means that, in order for it to be absorbed by the intestinal tract, fat must be present. People who have health-related problems that prevent their bodies from absorbing fat from dietary sources may also become deficient in vitamin D. Examples of some of these problems include: cystic fibrosis, Crohn's Disease, inflammatory bowel disease and a variety of autoimmune dysfunction. Similarly, because it is fat soluble, vitamin D can also get locked up in the fat stores of obese individuals and therefore not be absorbed.

What Is the Prevalence of Vitamin D Deficiency?
Vitamin D deficiency is currently being referred to as a pandemic, with up to 85 percent of the world's population affected. For those living in the northern hemisphere, where there is less sun exposure, the prevalence is probably closer to 100 percent.

Who Is at Risk for Vitamin D Deficiency?
Those at highest risk for vitamin D deficiency are individuals of all ages who have little to no sun exposure, the elderly and overweight, and darker-skinned individuals. By age 40, your ability to convert vitamin D from the sun diminishes to about half that of younger people. By age 70, most people have lost around 70 percent of their vitamin D sun-conversion capacity. As mentioned earlier, heavier people are less likely to convert vitamin D, because it gets "locked-up" in their fat stores. The melanin pigment in darker-skinned individuals acts as a natural sunscreen, blocking the absorption of vitamin D from the sun. As such, dark-skinned individuals require five times more sun exposure to get the same amount of vitamin D as fair-skinned individuals. Typical levels of vitamin D without supplementation are <20 ng/ml in winter and 20 to 30 ng/ml in summer, all of which represent deficient levels.

How Do I Know if I Am Vitamin D Deficient?
The only way to confidently know your vitamin D status is to have a blood test. ,The correct test for a vitamin D level is called 25-hydroxyvitamin D or 25(OH)D. Vitamin D screening should be preferred as a routine part of your overall health-care plan. Your primary care physician can run this test for you. It is also possible for you to obtain a self-test kit through ZRT Laboratory (http://www.zrtlab.com/Page.aspx?hid=1821). Remember, deficiency may be present even when there are no symptoms.

What Is an Optimal Level of Vitamin D for Me?
The minimum level of 25-hydroxyvitamin D remains controversial. Most experts have argued in the past that a rock-bottom minimum is 25 to 30 ng/ml. Many now agree that a level of 50 to 70 ng/ml is necessary to slow or eliminate all phenomena associated with deficiency. Please note the difference between "normal" and "optimal." You don't want to be just above the cutoff for deficiency; you want to be optimally healthy.

How Do I Increase my Vitamin D Level?
There are three ways to ensure an adequate level of vitamin D:

1. Sunlight is your ideal source. The skin produces approximately 20,000 IU of vitamin D in response to 20 to 30 minutes of summer sun exposure.

2. If regular exposure to sunlight is not an option for you, recent research indicates healthy children under age two should take at least 1,000 IU per day. Children ages two and up should take 2,000 IU per day. Healthy adolescents and adults between 80 and 130 lbs. should take at least 3,000 IU per day, while those over 130 lbs. but less than 170 lbs. should take 4,000 IU per day. Those over 170 lbs. should receive at least 5,000 IU per day. Of course, amounts will vary depending on individual differences and adequacy of vitamin D levels and dosing. Much higher dosages may be necessary for some individuals to achieve and maintain optimal vitamin D levels.

Ideally, you should assess your vitamin D level before beginning supplementation, followed by another level two to three months later to assess the adequacy of your dose. Also, blood levels should not be checked sooner than eight weeks after a dose change, so the full effect is allowed to develop.

There is simply no other way to gauge the adequacy of vitamin D dosing.

3. Regularly use a tanning bed and increase your exposure to full-spectrum lights.

How Can I Maximize the Benefits of Vitamin D Supplementation?
Too often, the smallest mistakes impair your efforts to correct vitamin D deficiency. To ensure the maximum benefits:

1. Take gelcaps. The oil "vehicle" of gelcaps ensures absorption, while the white powder tablets are inconsistently absorbed--and sometimes not absorbed at all.

2. Take only vitamin D3, or cholecalciferaol, the human form. I advise avoiding vitamin D2, or ergocalciferol, the plant form, altogether. While D2 may work for some people, it fails to work for most. Ironically, D2 is found in the prescription form of vitamin D (usually dispensed as a 50,000-unit tablet).

3. Take your dose during the daytime. When they take it during the evening or at bedtime, some people find that vitamin D can disrupt sleep.

For more information go to http://www.vitamindcouncil.org/ or http://www.grassrootshealth.net/.

CAUTION: Please enlist the support of a physician for assessing and optimizing your level of vitamin D, especially if you have a history of high calcium levels, parathyroid issues, sarcoidosis, kidney disease or cancer; vitamin D must be precisely managed in these conditions, because of its effect on calcium metabolism.