Vitamin D Supplementation for Optimum Health

Sunrise at Yumigahama Beach

Vitamin D deficiency is linked to osteoporosis, cardiovascular disease, cancer, autoimmune diseases (including multiple sclerosis), pain, flu, loss of cognitive function, decreased strength, and increased rate of all-cause mortality.  In addition, an increased risk for strokes, diabetes (types 1 and 2), depression, and breast and colon cancer are closely linked to low Vitamin D levels.

 An article in the Journal of Integrative Medicine1 states “Deficiency of vitamin D is now recognized as a pandemic, with more than half of the world’s population at risk.”  Approximately 50% of the healthy North American population and more than 80% of those with chronic diseases are vitamin D deficient.  80% of healthy Caucasian infants are vitamin D deficient. The rate of vitamin D deficiency tends to be greater in African-American and Hispanic children.  Those with vitamin D deficiency experience 39% higher annual healthcare costs than those with normal levels of vitamin D.

How to get the Vitamin D Your Body Needs2

The two main ways to get vitamin D are by exposing your bare skin to sunlight and by taking vitamin D3 supplements. You can’t get the right amount of vitamin D from food.  Read more on sunlight exposure below.

The good news is it is easy to have your vitamin D level checked, and vitamin D supplementation is inexpensive.

Suggested healthy blood levels of vitamin D as measured by 25(OH)D3 are:

Caucasians             125 – 175 nmol/l       =   50 – 70 mg/dl

Hispanics                 100 – 150 nmol/l       =  40 – 60 mg/dl

African-Americans      80 – 120 nmol/l      =   32- 48 mg/dl

The maximum safe levels for vitamin D in the blood is 275 nmol/l (100 mg/dl).  Sarcoidosis patients (and other granulomatous diseases) should not supplement with vitamin D because it increases granuloma production increasing the risk of hypercalcemia.  (Note: Results listed as mg/dl are the same as ng/ml.)

A loading dose of supplemental vitamin D3 of 10,000 IU/day for 3 months and maintenance dose of 5,000 IU/day “is not enough for most people in northern climes.”  Prolonged intake of 10,000 IU of supplemental vitamin D3 “is likely to pose no risk of adverse effects in almost all individuals.”  Some medical physicians prescribe doses of 50,000 IU/week for many weeks or months when a patient tests low, and vitamin D toxicity is extremely rare.

After you know your level, consider a loading dose of 10,000 IU/day for 4 months with a maintenance dose of 5,000 IU/day.  If you take this amount you must monitor your blood 25(OH)D3 level.   We can test your vitamin D3 level at the office; see below.

I have yet to see an adequate level of vitamin D in any of my patients not already taking a vitamin D supplement .  Chances are your level is low, and for some of you, dangerously low.  You vitamin D level, and potentially your health, may be improved quickly by knowing your level and taking enough vitamin D supplements.

Testing and Increasing your Vitamin D level

You can test at my office with a finger prick kit (not venipuncture).  We send the kit to ZRT Laboratory, http://www.zrtlab.com, for analysis.  You may also use the kit at home and mail it in yourself with their postage paid envelope.

A finger prick Vitamin D3 test costs $99, and results take about a week to come back from the lab.

Alternatively, you may request your medical physician to test for Vitamin D3 level during your next blood test.  However, you should test your vitamin D3 level every 4 months if you plan to increase your vitamin D3 supplementation.

My Personal Experience with Vitamin D

In September of 2012 I tested my vitamin D level with a kit.  Results showed 32 ng/ml which is too low (even after adequate sunshine exposure over the summer).  Over the next 4 months I supplemented with 10,000 IU per day, 5,000 in the AM and PM.

In January of 2013 I retested and my level increased to 65 ng/ml.

Good test numbers are important, but did I notice any changes in my health?  Yes.  Each winter for many years I could count on a terrible sore throat for about a week, sometimes twice.  Over the winter of 2011-12 I had three.  Since increasing my vitamin D in the fall of 2012 I did not have a sore throat for the entire 2012-13 winter.  My immune system was very solid, even being exposed to multiple sick children and adults daily in my chiropractic office.

I stayed on 10,000 IU per day for four more months and retested in May of 2013; my level remained steady at 64 ng/ml.  With adequate sun exposure for the next 4 months, I will take 5,000 IU (recommended maintenance dose) and retest in September.

Sun Exposure and Vitamin D3

The most natural way to get vitamin D is by exposing your bare skin to sunlight (ultraviolet B rays). This can happen quickly; you don’t need to tan or burn. You only need to expose your skin for around half the time it takes for your skin to turn pink and begin to burn.  There are a number of factors that affect how much vitamin D your body produces.  These include the time of year and time of day, where you live in the world, the type of skin you have, and how much of your skin is exposed to the sun.  For more information on your sun exposure needs, use the VitaminDCouncil.org charts.

For example, in Boston, we only have about 4 months a year of adequate sunlight: Mid-April to Mid-August.  With skin type III, the charts state I’d need an hour of midday sun to make 1000 IU of D.  Who has time for that?  And, some of you are sun-sensitive and have been told to avoid all sun.  You can understand why most of us are deficient, and supplementation may be the only way to have adequate vitamin D levels for optimum health.

Make sure you are supplementing with vitamin D if you are breast-feeding.

Dr. Scott Fuller, DC, CCST

1. Integrative Medicine  Vol. 9, No. 1, Feb/Mar 2010  Joseph Pizzorno, ND, Editor in Chief

2. VitaminDCouncil.org

Thanks to Dan Murphy, DC for providing Vitamin D research.

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