It’s Summer – Should You Worry About Vitamin D?

A little bit of sun can do a whole lot of good. When the warm rays hit your bare skin, your body begins to produce vitamin D, or the “sunshine vitamin,” in response. This essential nutrient helps keep our bones strong and our heart healthy.

But as more and more Americans shun the sun for shady beach umbrellas, super-SPF sunscreen, and air-conditioned offices, so do have the rates of Vitamin D deficiency climbed. It’s estimated that almost three-quarters of pregnant women in America are vitamin D-deficient, predisposing their unborn children to all sorts of problems; furthermore, more than half of American children today are lacking in Vitamin D. Worldwide, the deficiency affects one billion people. In my practice, 80 percent of patients with Vitamin D blood tests are revealed to be deficient.

It’s clear we have a major epidemic on our hands. Symptoms of vitamin D deficiency may not be obvious, and it’s easy to assume you’re getting enough – but you may be assuming incorrectly.

How much vitamin D do I need?

How much vitamin D you need varies with age, body weight, percent of body fat, latitude, skin coloration, season of the year, use of sun block, individual variation in sun exposure, and – probably – how ill you are.

As a general rule, old people need more than young people, big people need more that little people, fat people need more than skinny people, northern people need more than southern people, dark-skinned people need more than fair skinned people, winter people need more than summer people, sun block lovers need more than sun block haters, sun-phobes need more than sun worshipers, and ill people may need more than well people.

What I, along with many of my colleagues around the country, are finding is that even in populations spending what we thought was adequate amount of time in the sun, there are low blood vitamin D levels. I am not sure why at this stage, but there is an easy and affordable solution: vitamin D supplementation.

Here are some guidelines:

Vitamin D3 - 2000 IUIf your blood level is above 45ng/ml and for maintenance, I recommend 2,000-4,000 IU daily depending on age, weight, season, how much time is spent outdoors, where one lives, skin color and obviously blood levels. In other words if you are older, larger, living in the northern latitudes during the winter, are not getting sun and have dark skin, I recommend the higher maintenance dose.
Vitamin D3 5000 IUIf your blood level is 30-45 ng/ml, I recommend you correct it with 5,000 of vitamin D3 a day for 3 months under a doctor’s supervision and then recheck your blood levels.
Vitamin D3 10000 IUIf your blood level is less than 30 ng/ml, I recommend you correct it with 10,000 of vitamin D3 a day under a doctor’s supervision and then recheck your blood levels after 3 months. It takes a good 6 months usually to optimize your vitamin D levels if you’re deficient. Once this occurs, you can lower the dose to the maintenance dose of 2,000 – 4,000 IU a day.

What are the symptoms of vitamin D deficiency?

There is no clear pattern of symptoms. In fact many people remain asymptomatic despite low levels. But here are the more common symptoms

  • Fatigue
  • General muscle pain and weakness
  • Muscle cramps
  • Joint pain
  • Chronic pain
  • Weight gain
  • High blood pressure
  • Restless sleep
  • Poor concentration
  • Headaches
  • Bladder problems
  • Constipation or diarrhea

What diseases are associated with Vitamin D deficiency?

Vitamin D deficiency has been shown to play a role in almost every major disease. This includes:

  • Osteoporosis and Osteopenia
  • 17 varieties of Cancer (including breast, prostate and colon)
  • Heart disease
  • High blood pressure
  • Obesity
  • Metabolic Syndrome and Diabetes
  • Autoimmune diseases
  • Multiple sclerosis
  • Rheumatoid arthritis
  • Osteoarthritis
  • Bursitis
  • Gout
  • Infertility and PMS
  • Parkinson’s Disease
  • Depression and Seasonal Affective Disorder
  • Alzheimer’s Disease
  • Chronic fatigue syndrome
  • Fibromyalgia
  • Chronic Pain
  • Periodontal disease
  • Psoriasis

What about vitamin D toxicity?

It is impossible to generate too much vitamin D in your body from sunlight exposure: your body will self-regulate and only generate what it needs. Although very rare, it is possible to overdose and become toxic with supplementation as vitamin D is a fat soluble vitamin and therefore stored in the body for longer periods of time. Therefore if you are taking 5,000 IU or more daily, you should have your blood levels monitored approximately every 3 months.

What blood test should I have to check my vitamin D levels?

The only blood test that can diagnose vitamin D deficiency is a 25-hydroxy-vitamin D (25 OH vitamin D). Unfortunately, some doctors are still ordering the wrong test, 1,25-dihydroxy-vitamin D. In fact a common cause of high 1,25-dihydroxy-vitamin D is a low 25(OH)D or vitamin D deficiency. So when doctors see the 1,25-dihydroxy-vitamin D is normal or high and tell their patients that they are OK, they are often vitamin D deficient.
Your doctor can and should do this test for you. If you don’t want to go through your doctor, the ZRT lab does a blood spot test that you can order without going through a doctor.

What is the ideal blood level of 25 hydroxy vitamin D?

The current ranges for “normal” are 20 to 55 ng/ml. These are much too low! They may be fine if you want to prevent rickets or osteomalacia, but not for optimal health. The ideal range for optimal health is 50-80 ng/ml.

How often should I have a 25 hydroxy vitamin D blood test?

At least once a year especially at the beginning of winter. If you are supplementing, I suggest you monitor your vitamin D levels approximately every 3 months until you are in the optimal range. If you are taking high doses (10,000 IU a day) your doctor must also check your calcium, phosphorous, and parathyroid hormone levels every 3 months.

A few tips on supplementation.

Always take your Vit D supplement with some fat, as it is a fat soluble vitamin. If you take it on an empty stomach or without any fat, it won’t be absorbed, so you are basically wasting your time (and money). When taking 5,000 IU a day or more, look for formulas that include Vit K, as the benefits of vitamin D are enhanced when combined with vitamin K, especially when it comes to heart health and bone strength.

PIONEER IN FUNCTIONAL AND INTEGRATIVE MEDICINEFor Dr. Frank Lipman, health is more than just the absence of disease: it is a total state of physical, mental, emotional, spiritual and social wellbeing. Dr. Lipman is a widely recognized trailblazer and leader in functional and integrative medicine, and he is a New York Times best-selling author of five books, How To Be Well, The New Health Rules, 10 Reasons You Feel Old and Get Fat, Revive and Total Renewal.After his initial medical training in his native South Africa, Dr. Lipman spent 18 months working at clinics in the bush. He became familiar with the local traditional healers, called sangomas, which kindled his interest in non-Western healing modalities.In 1984, Dr. Lipman immigrated to the United States, where he became the chief medical resident at Lincoln Hospital in Bronx, NY. While there, he became fascinated by the hospital’s addiction clinic, which used acupuncture and Chinese medicine to treat people suffering from heroin and crack addiction. Seeing the way these patients responded so positively to acupuncture made him even more aware of the potential of implementing non- Western medicine to promote holistic wellbeing. As a medical student, he was taught to focus on the disease rather than the patient, and now as a doctor he found himself treating symptoms rather than the root causes of illness. Frustrated by the constraints of his training, and the limitations in helping his patients regain true health, he began a journey of discovery to search for the path to meaningful long-term health and wellness.He began studying nutrition, acupuncture, Chinese medicine, herbal medicine, functional medicine, biofeedback, meditation, and yoga. Dr. Lipman founded the Eleven Eleven Wellness Center in 1992, where he combines the best of Western medicine and cutting edge nutritional science with age-old healing techniques from the East. As his patient chef Seamus Mullen told The New York Times, "If antibiotics are right, he'll try it. If it's an anti-inflammatory diet, he’ll do that. He’s looking at the body as a system rather than looking at isolated things."In addition to his practice, Dr. Lipman is the creator of Be Well, an expanding lifestyle wellness brand he founded in 2010 to help people create, sustain and lead healthier lives.