Vitamin D

Hi Everyone,

As we head into the fall season, I thought it would be a good idea to do an article about Vitamin D. Vitamin D is not just a vitamin, it is a hormone precursor. That means that ultimately it has to be converted into the hormone calcitriol to be utilized by the body. First the vitamin D that we intake has to be converted by the liver into 25(OH)D and then the kidneys and other tissues convert this into the active form 1,25(OH)2D aka calcitriol.

The “normal” range of vitamin D is fairly large, 30-100 ng/mL. However, the “optimal” or “functional” range is 50-90 ng/mL. What does this mean? Well, 80% of the population falls into the “normal” range. That is how the normal range is calculated. If you look around, my guess is that you don’t want to just be the average person walking around, you want to strive toward optimal health.

Therefore, in functional and naturopathic medicine, we tighten the normal range up and aim to fall within the “optimal” or “functional” range. This is where true health lies. So, in the case of vitamin D, you want to aim for a vitamin D level of 50-90 ng/mL. I personally aim for 65-80 ng/mL. 

Vitamin D deficiency is linked to bone diseases such as osteomalacia, osteoporosis, rickets and an increased risk for bone fractures or breaks if you were to fall. Low levels are associated with a long list of other diseases including immune system issues, pain and inflammation, rheumatoid arthritis, asthma, high blood pressure, heart disease, infertility, pregnancy complications, insulin resistance, diabetes, obesity, non-alcoholic fatty liver disease and metabolic syndromes. The list continues, low vitamin D levels are also implicated in high triglycerides, dental cavities, periodontitis, infectious diseases, cancer, brain disorders, decreased calcium absorption, reduced antioxidant capacity and a decreased detoxification ability. If the kidney or liver are not operating at full capacity, the body may have difficulty converting the vitamin D we ingest into the active form. The use of certain medications such as corticosteroids, orlistat, cholestyramine, barbiturates, and phenytoin can all lower the vitamin D levels in the body.

If you take too much of a water-soluble vitamin, the excess will be flushed out of your body in the urine. However, vitamin D is a fat soluble vitamin. That means excess vitamin D is stored in the body. The big take away is that you can absolutely take too much of this vitamin. Symptoms of taking too much vitamin D include the inability to regulate calcium, bone demineralization, pain, digestive complications, abdominal pain, vomiting, dehydration, apathy and confusion. Regularly measuring your blood levels can help you determine if you need to supplement and how much you need to supplement.

Although our bodies are able to make vitamin D, clinically I am seeing that that mechanism does not seem to be working very well for many Floridians. I treat many golfers and am continuously alarmed at how low their vitamin D levels are considering they spend 12-20 hours per week on the golf course, in full sun. I think sunscreen use is the number one culprit for this. It blocks the absorption of the sun into our skin, thereby, greatly reducing our ability to make this hormone precursor. I am of the opinion that spending about 20 minutes out in the morning sun without sunscreen can help us manufacture more vitamin D, naturally.

There are also many people coming into my office who are already supplementing with a vitamin D capsule, yet their levels continue to hover around 30 ng/mL. Either, they are taking a subpar brand or their digestion is compromised and they are not absorbing the vitamin D properly. I have had many people switch from the capsule form of vitamin D to the liquid Vitamin D3/K2 by Thorne. Every single time someone has made this switch their vitamin D blood values increase within just a few months. You can find the Thorne liquid vitamin D on Fullscript here.  I also like the liquid vitamin D3/K2 because you can easily change dosing amount without having to purchase multiple bottles. 

Since vitamin D is fat soluble, that means it is very important that you take supplemental vitamin D with food. In order to actually absorb the vitamin D you have to have the gallbladder, eject bile to help emulsify the vitamin D so it can be absorbed by the body. If you have been supplementing and your levels are not budging, make sure you are taking it with some food, particularly food that contains some fat.

There are two main forms of vitamin D that are available for supplementing if you have low blood values. Vitamin D2 is the form that is usually prescribed by your doctor if your levels are less than 30. Most of the time you pick up a tablet at the pharmacy that is a high dose of vitamin D2, usually 50,000 IU that is taken once per week. I have not seen this form give very good results. I am not a fan of taking huge doses of anything on an infrequent basis. Our bodies do not work like that. Everything must stay in balance. I like to drip things in using smaller doses more frequently throughout the day.

Vitamin D3 is more like the vitamin D that our bodies make. It appears to be more effective in raising the lab values. If you are taking higher doses of vitamin D than 2000 IU per day, then you must balance the vitamin D with vitamin K2. This is another reason I really like the Thorne liquid that I mentioned above. 

I am happy to see that many regular medical doctors are starting to request vitamin D levels on blood work. I encourage you to actually look at the number and do not just scan your lab report for a low or high indicator. If your levels are hovering around 30, I highly recommend the following protocol to get your levels up to the “optimal” range.

For one month only, make sure to write it on a calendar, take 10 drops of the liquid Thorne vitamin D3/K2 twice daily with food. During the second month, write in on a calendar, drop the dosing down to 5 drops twice daily with food. When you get to the third month you will drop down to a maintenance level of 4 drops once per day with food. At this point you would want to retest your vitamin D levels. Any time you are going to get blood work, it is a good idea to stop taking all vitamins and minerals for a week so we can see what your body is actually doing. If the retest has your levels in the optimal range, then continue the maintenance dose of 4 drops daily with food.

The important thing to know about vitamin D is to be sure you are taking it with food. Try to get out into the morning sun for 20 minutes per day so you can manufacture your own vitamin D. And finally, be sure to monitor your blood values with regular lab testing, at least annually, and aim for the “optimal” range. If you do not have a physician that will order labs for you, please reach out and I can assist you in getting that accomplished.

Finally, I want to thank all of you who reached out after last week’s article with the link to the Casey and Calley Means interview. The response from that article was phenomenal and I am so happy that you all are being your own medical advocates and educating yourself about the sad state of our current medical system. The fact you are receiving this email means you are already ahead of the masses in this arena. Have a wonderful week!

Toni Eatros, Acupuncture Physician

239-260-4566

www.AcupunctureSolutionsOnline.com