Vitamin D. It’s the cornerstone of good health, so it’s mind-boggling to me how often vitamin D levels are overlooked or given short shrift by primary-care physicians. Numerous studies have shown a link between vitamin D deficiency and devastating health problems, many of which might well be avoided if we paid more attention to filling the D-gap. If your doc gives you the brush-off when you ask him or her to measure your vitamin D level, then you need to take charge. Educate yourself, get tested (or test yourself), and then work with your doc to develop a plan to get your D up to an optimal level. Your continued health may depend on it!
1. So What’s the Big D Deal?
Vitamin D is what many call the sunshine vitamin, but it’s actually a steroid with hormone-like activities that regulate the functions of over 200 genes and is essential for our growth, development, and ongoing health. A small amount of it comes from the food we eat, and some of it our bodies are able to synthesize from sunshine—but billions of us are falling short, particularly those of us who spend most of our days indoors and out of the sun. And though it might not seem like a big deal, vitamin D deficiency is considered by many experts to be an under-the-radar epidemic that’s laying the groundwork for numerous serious diseases, including cancer. Because vitamin D is involved in supporting essential functions like immunity and cancer prevention, as well as neurological, cardiovascular, and bone health, it’s easy to see just how dangerous falling short can be!
2. Roughly 40%–75% of Us Are Vitamin D Deficient
An estimated 1 billion people on the planet are vitamin D deficient, and many can be found right here in the northern parts of the U.S. These include:
- People with indoorsy lifestyles—those who spend most of their time indoors with little exposure to sunlight.
- Northern souls—those who live in the Northern Hemisphere.
- Darker-skinned people are frequently vitamin D deficient, because they need more sun to get the same amount of vitamin D as fair-skinned people.
- Cover-uppers—those who keep skin “protected” with clothes head-to-toe, or slather themselves in sunscreen, preventing the sunlight exposure needed for the skin to synthesize and produce vitamin D.
- Older folks have thinner skin and reduced ability to produce vitamin D, so the 50+ set is more vulnerable to deficiency.
- Overweight/obese people and those with excess body fat.
- Gastric bypass patients and/or those with gut problems, whose guts may not be able to absorb enough vitamin D.
- Pregnant women, whose needs are greater.
3. Not Feeling Great? Not Enough Vitamin D Might Be The Problem
Feeling a bit off? A vitamin D deficiency may be to blame, so it’s usually one of the first things I check. While some folks may not have obvious symptoms, others may experience one or more of the following tip-offs:
- excessive sweating despite moderate temperatures
- muscle weakness
- easily broken bones and/or symptoms of osteopenia
- chronic pain and/or aches and pains
- feeling down or blue, particularly during the winter months when days are short
True, these symptoms could be caused by a host of other health problems, but when patients complain of them, the knee-jerk reaction on the part of many doctors is simply to prescribe a heavy-duty drug regimen (often with serious side effects), instead of first considering vitamin D supplementation—a far simpler, healthier, cheaper, and safer therapy.
4. Put Yourself to the Test
The Vitamin D Council, a helpful resource and advocacy group that’s dedicated to spreading awareness of vitamin D deficiency, offers a reasonably priced kit to test your levels. (It also comes in a four-pack to test the whole family.) You can use the results as a guide for you and your doc to develop a plan that’s appropriate for your situation. Another reason to work with your doc rather than monitoring levels on your own is to help guard against possible interactions with meds such as cholesterol-lowering drugs, corticosteroids, and seizure medications.
5. Know What the Results Mean
Remind your doc that you are looking to achieve optimal levels, not just borderline OK ones! Most general practitioners look for an “adequate” reading of a serum 25-OH vitamin D level greater than 20 ng/ml, but I, and most of my integrative colleagues, know this number is on the low end. So what are the numbers to shoot for? An optimal range of 50 to 80 ng/ml is where you want to be.
6. D-ficient No More: Your Simple Solution
OK, if moving closer to the equator isn’t in the cards, here’s what you can do to keep track of your vitamin D level, get it where it needs to be, and support your health no matter where you live:
- Check your level twice a year, preferably spring and fall.
- Expose your skin to the sun—responsibly, of course. Even 15 minutes a day at midday can help boost levels, depending on your skin tone. To help you monitor sun exposure, pick up a SunFriend device or try an app to help keep on a healthy track.
- If sun exposure is not an option, make sure you supplement. There are two choices: Vitamin D3 (cholecalciferol), which is the type of vitamin D your body produces in response to sun exposure, and vitamin D2 (ergocalciferol), which is a synthetic form. Take vitamin D3 and steer clear of vitamin D2.
- Take a vitamin D3 supplement (preferably combined with vitamin K2) and with a meal that includes some healthy fat. This is because vitamin D is a fat-soluble vitamin, which means you need to have some fat with it for it to be absorbed. In my experience, most people need anywhere between 2,000 and10,000 units/day, depending on their blood levels.
- Be on the lookout for symptoms like: a metallic taste in the mouth, increased thirst, itchy skin, muscle aches and pains, urinary frequency, nausea, diarrhea and/or constipation—all of which can be signs that your D3 dose may be too high, which is very rare.
For more info on vitamin D and how to get more of it with sensible sun exposure, check out this post.