This Journal is a presentation about the use of daily vitamin D for health maintenance in our increasingly toxic global ecosystem. I hope to empower you with information about an important nutrient for daily use in your proactive disease preventive lifestyle practice.
I presented a much earlier Journal entry on vitamin D on December 17, 2010, which you can see at this link. This entry features a quality comprehensive article by Donald Miller, M.D., one of the better researchers and commentators on natural biochemical health considerations. He is a Professor of Cardiovascular Surgery at the University of Washington, and is highly respected for his work.
In brief, vitamin D is almost universally low in people who live in northern latitudes, certainly from Colorado on up north.
One of the most important things you’re missing, if you can’t get outside, is sunlight. Even if you have a sunny window in your home or office, windows absorb (and thus block) UVB rays. So, any sunlight you get through the glass won’t lead to the formation of active vitamin D. (1) Also, during the winter, chances are you would not get enough vitamin D from the sun even if you manage to get outside on a regular basis.
Above a certain latitude, the UVB rays are not strong enough to trigger vitamin D production during the winter months. For example, exposure to sunlight in Boston produced declining amounts of vitamin D after August, and none at all from November through February. (2)
Nature has designed a system in which we go into the sun, thus exposing ourselves to the sun’s UVB rays which convert cholesterol into thousands of units of cholecalciferol. The liver then converts cholecalciferol into 25(OH)D. Our organs then make the active cellular steroid hormone, 1,25-D, which helps to regulate genes in every organ of the body.
I do not routinely measure initial blood levels of vitamin D on all patients as I am finding few who are in a healthy normal range, and fewer in the optimal range of 60 to 100 ng/ml. Most patients are in the very low normal or below normal range, which is less than 30 ng/ml.
My usual approach is to estimate clients’ needs, put them on a moderate dosing of the vitamin, and then measure their blood levels after a month of dosing. If clients come to me and are already on a dosing of vitamin D, I will run an initial study to assess their level on their presenting dose of vitamin D.
As useful as measuring an initial vitamin D blood level is to determine if a client has a Vitamin D Receptor (VDR) mutation, which I find in about 50% of patients, as either a heterozygous mutation (41%) or a homozygous mutation (9%). If there is a VDR mutation, then more vitamin D will be required to flood and activate the abnormal receptor to create the beneficial effects of vitamin D. The study I recommend for assessing VDR mutations and other important mutation events is easily done through 23andMe.com.
The usual dosing I start clients with is 5000-10,000 I.U. daily. If there is a VDR mutation, then this issue is noted when considering initial and subsequent blood levels of vitamin D.
I have never heard of, or seen, a case of vitamin D toxicity. One would have to have severe liver compromise for such toxicity to be possible at these low dosing levels. The issue of vitamin D toxicity is so rare as to consider this a rather overwrought concern, especially at low dosing ranges of 5000-10,000 I.U. per day. True vitamin D toxicity can be caused by the extraordinarily large doses of vitamin D sometimes used in the medical industry of 50,000 to 100,000 IU by injection. This usually is given as vitamin D2, which is not physiologically correct.
However, if one is taking too much oral vitamin D3 for their system, this increased usage can possibly skew and diminish the absorption of the other fat soluble vitamins via the gastrointestinal tract. The other fat soluble vitamins are vitamins A, E, K1, and K2.
Also, please take notice of Chris Kresser’s informative analysis of this evolving consideration in this writing.
So, the important consideration when using higher daily doses of vitamin D, which is a fat soluble vitamin, is to be mindful of how its use may inhibit the absorption of the other fat soluble vitamins which are vitamins A, K, and E. Furthermore, if one has certain mutations which relate to these other fat soluble vitamins’ assimilation and utilization, then dosing guidelines for the 4 fat soluble vitamins must be more broadly considered.
Risk factors for vitamin D deficiency include:
- Dark skin
- Aging
- Obesity
- Pollution
- Living north of the 35th parallel
- Inflammatory bowel disease
- Sunscreen use
Vitamin D deficiency has been shown to play a role in almost every major disease, including:
- Osteoporosis and osteopenia
- 17 varieties of cancer, including breast, prostate, and colon cancer
- Heart disease
- High blood pressure
- Obesity
- Metabolic syndrome, insulin resistance, and diabetes
- Lower immune system function
- Autoimmune diseases
- Multiple sclerosis
- Rheumatoid arthritis
- Osteoarthritis
- Bursitis
- Gout
- Infertility and PMS
- Parkinson’s disease
- Migraines
- Depression
- Seasonal Affective Disorder
- Alzheimer’s disease
- Chronic fatigue syndrome
- Fibromyalgia
- Chronic pain
- Periodontal disease
- Psoriasis
The list above was modified from an excellent review of Vitamin D written by Dr. Frank Lipman, M.D., posted on The Huffington Post, October 7, 2009. Dr. Lipman’s article can be reviewed here. The article is very cogent and informative, and is supportive of Dr. Miller’s more comprehensive article, but is less biochemically and informationally dense than Miller’s article.
Vitamin D and Endocrine-Disrupting Chemicals
Endocrine-disrupting chemicals (EDCs) in our environment are xenobiotic chemicals made by human beings which are totally unnatural and injurious to human health. EDCs now number upwards of 85,000 different kinds of chemicals which were largely introduced in the ecosystem in the post WWII period. Very few of them have been studied for toxicity.
These chemicals negatively affect the activity of vitamin D. Here is a link to a writing which explains this negative effect, and describes some preventative steps you can begin to incorporate.
More on Vitamin D Receptors (VDRs)
For most of the past century it was thought that vitamin D’s primary function was to facilitate calcium absorption and help prevent osteopenia and osteoporosis. In recent decades it has been discovered that all cells in the body have Vitamin D Receptors, and that vitamin D controls and regulates nearly 300 genes.
Vitamin D affects your DNA through VDRs by binding to specific locations of the human genome. Many of the genes controlled by vitamin D are genes which regulate our immune system. Thus, vitamin D is a critical nutrient for immune system health and function.
As stated above, about 50% of people have heterozygous (41%) or homozygous (9%) mutations of their VDR genetic allele sites. Therefore this issue is very common, and it will result in a down-regulated less functional VDR. In such cases, the vitamin D dosing will need to be higher.
One’s VDR status can be checked by a variety of labs which offer this service in their genetic testing packages. As mentioned above, one such offering is from www.23andMe.com. Here one can learn about mutations one may have which control enzyme and receptor functions in the areas of detoxification, neurotransmitters, methylation, cardiovascular, digestive, endocrine, vitamin function, mineral receptors, and antioxidant functions. This study also gives information relevant to the other fat soluble vitamins.
Our primary source of vitamin D is from sunlight. Ultraviolet rays from sunlight create a chemical cascade in the skin which converts cholesterol to vitamin D. However, as mentioned above, most people do not get enough direct sunlight to produce adequate levels of vitamin D.
According to Dr. Michael Holick, another prominent vitamin D researcher, “Vitamin D is not only the most common nutritional deficiency in the world, it is also the most common medical condition, affecting over 1 billion people.”
Some Sources of Vitamin D
Vitamin D may be accrued from one’s diet from a range of healthy and common types of foods. The best food sources for vitamin D may be seen in this rather extensive listing of foods.
Most of the foods mentioned in this long list are generally good foods to consume. An exception to this statement is the consideration of tuna and mackerel which will have higher levels of organic mercury which will contribute to mercury toxicity. About 40% of people have mutation based deficiencies in a liver enzyme known as CPOX4 which involves mercury detoxification and its behavioral effects on the central nervous system.
Designs for Health has vitamin D compounded in several different forms and strengths. It is in all of their multivitamin combinations in above average dosing. For instance, their DFH Complete Multi contains 1000 I.U. per dosing of 6 capsules. This is the best routine daily multivitamin that I have found, and this level of vitamin D in a potent multivitamin is much better than the rest of the multivitamins on the market.
In addition, DFH offers the following stronger Vitamin D compounding. The first 4 capsule forms are dosing strengths per capsule:
- Vitamin D3 Pro…2000 I.U., with 1000 micrograms of vitamin K1 and 1000 mcg vitamin K2
- Vitamin D Supreme…5000 I.U., with 1000 micrograms of vitamin K1 and 1000 mcg. vitamin K2
- ADK Evail…5000 IU of vitamin D plus the other fat soluble vitamins A, E, K in balanced ratio
- D-Evail 10K… 10,000 I.U., with 1000 mcg. Vitamin K1 and K2
- Emulsi-D3, 20 oz. bottle, 1 ml. (via dropper) contains 2000 IU vitamin D, 250 mcg. vitamin K1 and 25 mcg. of vitamin K2
- Liposomal D Supreme…a liposomal delivery system. Each 0.5 mL serving (1 pump) of this citrus flavored formula provides 2500 IU of vitamin D3 and 325 mcg of vitamin K as K1 and K2.
Vitamin D and vitamin K2 work together in an important synergistic manner, and both are essential for optimal bone and arterial health as well as for maintaining the immune system in proper balance. An important Journal writing on the health benefits of vitamin K2 was presented on 2-14-15, and may be seen here. Vitamin K2 deficiency is possibly more prevalent than vitamin D deficiency.
The US government recommendations for daily vitamin D, which are established by the Food and Nutrition Board (FNB), are as follows:
- Children and adults up to age 70 – 600 IU/day
- Seniors 70 and older – 800 IU/day
The US government’s recommendations are far too low. Studies suggest that for proper functioning, a healthy human utilizes approximately 3,000 to 5,000 IU of vitamin D per day. The real need will usually be a higher dosing than this per individual lifestyle, absorption ability, and VDR genetic status.
In the clients which I dose with 5000 IU per day, the optimal blood level of Vitamin D3 of 80-100 nanograms/milliliter (ng./ml.) usually requires dosing even higher than 10,000 IU per day. Such dosing is entirely safe in anyone who does not have compromise of liver function.
Vitamin D Doses for Children:
In the absence of proper daily sun exposure, the vitamin D Council makes the following recommendations for children. Keep in mind that there are numerous variables and individual differences, so these recommendations are only estimates:
- Healthy children under the age of 1 year of age: 1,000 IU/day
- Healthy children over the age of 1 year: 1,000 IU for every 25 pounds of body weight
Dosing of Vitamin D is made very easy with the pleasant tasting Emulsi-D3 liquid dropper dispenser referenced above.
Other Important Considerations
Factors that can influence your vitamin D absorption include your magnesium and vitamin K2 intake. Magnesium is required for the conversion of vitamin D into its active form. If your magnesium level is insufficient, the vitamin D you ingest orally may simply get stored in its inactive form.
Research by GrassrootsHealth shows you need 146% more vitamin D to achieve a blood level of 40 ng/ml (100 nmol/L) if you do not take supplemental magnesium, compared to taking your vitamin D with at least 400 mg of magnesium per day.
Your best bet is to take your vitamin D with both magnesium and K2. According to GrassrootsHealth, “combined intake of both supplemental magnesium and vitamin K2 has a greater effect on vitamin D levels than either individually,” and “those taking both supplemental magnesium and vitamin K2 have a higher vitamin D level for any given vitamin D intake amount than those taking either supplemental magnesium or vitamin K2 or neither.”
Data from nearly 3,000 individuals revealed 244% more oral vitamin D was required to get 50% of the population to achieve a vitamin D level of 40 ng/ml (100 nmol/L) if they weren’t concurrently also taking magnesium and vitamin K2.
Foods with the highest magnesium levels include spinach, Swiss chard, turnip greens, beet greens, collard greens, broccoli, Brussels sprouts, kale, bok choy and romaine lettuce.
In consideration of supplemental magnesium, you may want to use magnesium threonate to provide at least some of your magnesium, as it appears to be most efficient at penetrating cell membranes, including your mitochondria and blood-brain barrier. The Designs for Health magnesium threonate supplement which I recommend is NeuroMag at a nominal dose of 3 capsules a day.
Another effective way to boost magnesium levels is to take Epsom salt (magnesium sulfate) baths, as the magnesium will effectively absorb through your skin.
The vitamin K2 which I recommend is Tri-K, at a dose of 1-2 capsules daily. For extended information and reading on vitamin K2, please refer to this website writing Vitamin K2.
Your individualized vitamin D dosage
To assess your vitamin D level, you can either use the chart below, or use GrassrootsHealth’s Vitamin D calculator. (To convert ng/mL into the European measurement (nmol/L), simply multiply the ng/mL measurement by 2.5.) To calculate how much vitamin D you may be getting from regular sun exposure in addition to your supplemental intake, use the DMinder app.
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Conclusion
Over the past 10 years the research on vitamin D has mounted into a convincing body of information to support the use of this vitamin hormone for everyone in our society. Its myriad positive health effects speak well for its broad usage in a society plagued with the very diseases it prevents.
In light of the fact that most of our population is deficient in vitamin D, we should regard vitamin D as one of the most important nutrient deficiencies present today. And, because VDR mutations are so common, vitamin D deficiency is arguably one of the most important nutrient deficiencies to correct.
Thank you for reading.
Pertinent related articles on vitamin D are listed below.
Signing off from Crestone and Beyond
Reading and References:
- Your Personal Genetic Analysis…a writing on this website about genetic testing and its utility
- Vitamin K2…a writing one this website about this important vitamin
- 14 Signs Of Vitamin D Deficiency…a 10 minute video explains
- Low vitamin D levels during pregnancy may be linked to an increased risk of ADHD
- Vitamin D for public health
- Low vitamin D levels increase risk of relapse in patients with chronic ulcerative colitis
- The vitamin D-antimicrobial peptide pathway and its role in protection against infection…this is why I tell people to take increased dosing of vitamin D before traveling on airplanes and when traveling abroad. Common sense would tell you that maintaining optimal blood levels of vitamin D will protect against infectious agents.
- Antimicrobial implications of vitamin D…another scholarly article on this subject.
- Vitamin D in Children’s Health…the opening paragraph of this article contains the important and relevant information about the importance of vitamin D in children’s health.
- Lab confirms vitamin D deficiency link to autism traits
- Why the New York Times Got It Wrong about Vitamin D…the author of this editorial about a NYT misinformation piece missed out on mentioning the crucial role of vitamin K2 and VDR receptor mutations.
- New study demonstrates vitamin D improves vascular function and decreases oxidative stress
- Shorter Days: A SAD Pattern…a very informative and helpful article about the effects of shorter days of winter on our vitamin D, serotonin, cortisol, and melatonin functions.
- Vitamin D Deficiency Increases Risk of Heart Failure
- Vitamin D & the Gut…Dr. David Perlmutter explains the importance of vitamin D and gut health and how this affects brain health.
- Fish oil and vitamin D supplementation helps improve outcomes in patients with gestational diabetes
- 50,000 Expected to Die…flu vaccinations are not the answer.
- New review investigates magnesium levels on vitamin D’s effectiveness…the important relationship of magnesium and vitamin D is presented once again in this nice summary.
- Vitamin D2 vs. D3: What’s the Difference?…vitamin D3 is the preferred form.
- New study demonstrates the effect of vitamin D on inflammation in IBD…vitamin D deficiency has been linked to many autoimmune diseases, including type 1 diabetes, systemic lupus erythematosus, and multiple sclerosis, as well as IBD, and more and more data has demonstrated that vitamin D supplementation may lengthen the remission in patients with IBD.
- Vitamin D and Colorectal Cancer Study: More Evidence it is Time to Rethink the IOM Recommendations…this article addresses the issue of the use of vitamin D in the prevention and treatment of colon and rectal cancers which is the 3rd most common form of cancer.
- Vitamin D Levels Linked to Lower Colorectal Cancer Risk…analyzing data from 17 prospective studies which included 12,800 people, researchers have rightfully concluded that higher vitamin D levels lead to lower colon and rectal cancers.
- Vitamin D vs. Flu Shots…interesting updated facts and news about vitamin D, posted here on November 8, 2018.
- New study demonstrates a relationship between low vitamin D status and menstrual disorders in women…”Vitamin D status should be assessed and supplemented accordingly to address insufficiency and for its potential effect in regulating menstrual disorders.” Posted here on 12-9-18.
- Vitamin D status and metabolism are influenced by magnesium status according to new study…according to a new randomized trial published in December, 2018, in the American Journal of Clinical Nutrition, researchers demonstrated that magnesium influences vitamin D status. Magnesium had a regulatory effect, with magnesium deficiency essentially shutting down the vitamin D synthesis and metabolism pathway.
- Vitamin D improves infertility in patients with PCOS and insulin resistance…vitamin D and inositol are discussed.
- Is Sunscreen the New Margarine?…interesting research data and perspectives here…recommended reading.
- The Top 20 Natural Remedies for Cold and Flu…this 3-7-19 article by Chris Kresser discusses the difference between cold and flu, and covers good natural remedies for both. Antibiotic resistance is included as a topic in the article. Vitamin D is an important addition to help prevent colds and flu, and will also shorten the duration and severity of the illness.
- Vitamin D and Alzheimer’s Disease: Could Deficiency Increase Your Risk?…Dr. David Perlmutter covers conclusions presented in an article reported in a 2014 edition of the journal Neurology.
- Sunshine: A Natural Mood Enhancer…a nice brief from neurologist Dr. David Perlmutter.
- New study demonstrates vitamin D and whey protein supplementation mitigate low grade chronic inflammation in patients with sarcopenia…vitamin D and whey protein improve the loss of muscle mass in aging people. Between the ages of 40 and 80 is approximately muscle loss is between 30% and 60% and is associated with disability, illness, and even death.
- New study demonstrates the effect of vitamin D supplementation on insulin sensitivity and secretion…”According to a new study published in July, 2019, researchers demonstrated that vitamin D supplementation may help slow the progression of diabetes by increasing peripheral insulin sensitivity and β-cell function in newly diagnosed diabetes patients.”
- Dr. Alex Vasquez: Vitamin D and the Human Papilloma Virus…in this video about Vitamin D and human papilloma virus, Dr. Alex Vasquez discusses HPV’s relationship to vitamin D status and response to vitamin D supplementation.
- Vitamin D and Autoimmunity…a video presentation by Dr. Alex Velasquez covering a very important nutrient link to a common set of disorders. There are now over 80 known autoimmune diseases.
- Vitamin D’s Affect on Memory, Learning, and Hippocampal Volume…”The hippocampus is the first area affected by vitamin D deficiency because it is so active. This activity makes it more susceptible to vitamin D deficiency than other areas of the brain.”
- Vitamin D for Bones: More is Not Always Better…excellent thinking here about the importance of using vitamin K2, magnesium, and adequate protein intake when supplementing with vitamin D to support bone health. This is an insightful reading. Posted on 1-26-20.
- Medicare: Saving Cents Makes No Sense…”Medicare and Medicaid cover 118 million people in the US (44 million and 74 million, respectively). This group includes the elderly and the most financially vulnerable citizens. These plans generally cover healthcare services that participating physicians consider ‘medically necessary’—that is, by conventional medical standards. To get a vitamin D test covered by Medicare or Medicaid there typically needs to be a ‘clinically documented’ underlying disease or condition which is specifically associated with vitamin D deficiency. This refusal to utilize natural medicine puts some of our most vulnerable populations at risk.”
- New study investigates the effect of high dose vitamin D on the gut microbiome…important information for consideration in regards to the many types of autoimmune disease which have arisen in the past 40 years. All autoimmune disorders begin in the gut, via a leaky gut, or a damaged gut lining. The microbiome is important in maintaining a healthy gut lining.
- Vitamin D Supplementation Lowers Blood Presssure in Children…”According to the results of a clinical trial published recently in The American Journal of Clinical Nutrition, daily supplementation of 1,000-2,000 IUs vitamin D3 for six months corrected vitamin D deficiency among obese and overweight children (ages 10 to 18 years) and significantly reduced their blood pressure, fasting blood glucose levels, and improved insulin sensitivity, compared to children who received 600 IUs per day in the study.”
- New Review Investigates Vitamin D Supplementation and Risk of Respiratory Tract Infections…posted here on 4-17-20 during the Coronavirus pandemic, we find important information on vitamin D’s action to protect the respiratory tract.
- Two Vitamin D Studies: Reducing Homocysteine & Chemotherapy Side Effects…further benefits of vitamin D are explained in this article, posted here on 7-3-20.
- New Study Investigates the Effect of High-dose Vitamin D Supplementation in Patients with Diabetic Neuropathy…posted here on 9-4-20. “This study demonstrated that high-dose vitamin D supplementation can reduce inflammation and improve microcirculation and neuropathy symptoms in patients with type 2 diabetes.”