Vitamin D is a hormone-like vitamin essential for strong bones, healthy immunity and balanced mood. When you consume dietary vitamin D or produce it within your skin in response to sunlight, it needs activation by your liver to become biologically active. If you have liver disease or any kind of liver dysfunction, then you may be at risk for developing symptoms of vitamin D deficiency, even if you eat a well-balanced diet and spend some time in the sun. Your doctor can check your blood for active vitamin D metabolites and liver enzymes to determine if there is a problem.
Vitamin D Metabolism
Vitamin D actually represents a group of four related compounds, none of which are biologically active without being metabolized in your liver. After you consume food containing vitamin D or synthesize it in the epidermis of your skin, it enters your bloodstream and is transported to your liver, where it becomes hydroxylated. Hydroxylated vitamin D is also known as calcidiol, which is the main circulating form of vitamin D. Your blood serum levels of calcidiol are a useful indicator of your vitamin D nutritional status. Your kidneys, if healthy, transform calcidiol into calcitriol, which is considered the most potent form of activated vitamin D and the type that causes the most physiological effects in your body. As such, you need both a healthy liver and kidneys need to properly utilize vitamin D.
Liver Diseases
In addition to hydroxylating vitamin D, your liver is also needed to make enzymes, bile and hormones, as well as to filter your blood of toxins. Several diseases of the liver, such as hepatitis A and B, cancer and cirrhosis caused by toxins or alcoholism, negatively impact vitamin D metabolism and decrease hydroxylated vitamin D levels in your blood. Symptoms that indicate a liver problem include a tender liver with palpation, abdominal swelling and edema, as well as jaundice, which is yellowing of the skin and eyes. If you have any of these symptoms, consult with your doctor immediately, who will take a blood sample and look for reduced liver function.
Symptoms of Inadequate Vitamin D
Vitamin D deficiency is a growing concern in the United States because of lack of appropriate sun exposure, but liver disease can lead to similar symptoms even if you do seek out sunshine, according to Gordon Wardlaw, author of "Contemporary Nutrition: Functional Approach." Signs that you may be deficient in vitamin D include fatigue, depression, headaches, insomnia, weight gain and achy bone and muscle pain. With enough time, a lack of vitamin D causes osteomalacia, or soft bones, and increases the risk of osteoporosis.
Recommendations
Most people who experience vitamin D deficiency do not have a liver disease. Instead, they don't get enough sunshine and don't consume enough dietary sources. If you do have a liver disease, it is imperative that you seek treatment because a poorly functioning liver will not hydroxylate enough vitamin D regardless of how much you consume or synthesize from the sun. Consult with your doctor about the treatment options for various liver diseases.
References
- Linus Pauling Institute; Vitamin D; Jane Higdon, Ph.D.; Jan. 2008
- "Advanced Human Nutrition"; Robert Wildman and Denis Medeiros; 2000
- "Contemporary Nutrition: Functional Approach"; Gordon M. Wardlaw; 2009
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