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Why should we supplement with Vitamin D?

Originally known for its crucial role in maintaining calcium levels for bone health; it is rapidly becoming apparent that we have vastly underestimated Vitamin D’s significant importance for our overall health and wellbeing. In short, it’s looking very much like we’re facing an epidemic of Vitamin D deficiency, with potentially grave consequences.

What diseases are associated with Vitamin D deficiency?

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)
• 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 is vitamin D?

Although it’s called a vitamin, vitamin D is really a hormone not a vitamin. Vitamins cannot be produced by your body; we get them from dietary sources, whereas hormones like vitamin D are made in your body.
What does vitamin D do?

Like all steroid hormones, vitamin D is involved in making hundreds of enzymes and proteins, which are crucial for preserving health and preventing disease. It has the ability to interact with and affect more than 2,000 genes in the body. It enhances muscle strength and builds bone. It has anti-inflammatory effects and bolsters the immune system. It also helps the action of insulin and has anti-cancer activity. This is why vitamin D deficiency has been linked with so many of the diseases of modern society. Due to its vast array of benefits, maintaining optimal levels of vitamin D is essential for your health.

Where do I get vitamin D from?

The only 2 reliable sources of vitamin D are the sun and supplements. Sunlight exposure is the only reliable way for your body to generate vitamin D. Vitamin D is produced by your skin in response to exposure to ultraviolet radiation from the sun. In fact, this is such an efficient system that most of us make approx. 20,000 units of vitamin D after only 20 minutes of summer sun without suntan lotion (or clothes!) That’s 100 times more than the government recommends per day! There must be a good reason why we make so much in so little time.

You do not generate vitamin D when sitting behind a glass window, whether in your car or at home because these UV rays cannot penetrate glass to generate vitamin D in your skin. Also sunscreens, even weak ones, almost completely block your body’s ability to generate vitamin D.

The other reliable source is vitamin D3 supplements (not vitamin D2)
Only about 10% of your vitamin D comes from diet, so it is nearly impossible to get adequate amounts of vitamin D from your food.

What are the food sources of vitamin D?

1. Fish liver oils, such as cod liver oil (although this should be avoided due to heavy metal exposure). Fatty wild fish like mackerel, salmon, halibut, tuna, sardines and herring
2. Fortified milk, orange juice and cereal (artificial source)
3. Dried Shitake mushrooms
4. Egg yolks

However to get adequate amounts of vitamin D from food, you would have to eat at least 5 servings of salmon a day or drink 20 cups of fortified milk.

Does the sun not pose a health risk?

It is true that the sun has the potential to do harm. The key is in the dose. In the last few years, numerous studies have shown that modest exposure to sunlight may actually be good for you, helping the body produce the vitamin D it needs to keep bones healthy and protect against cancer, including skin cancer.

Repeated sunburns—particularly in children and very fair-skinned people–have been linked to melanoma, there is however no credible scientific evidence that moderate sun exposure causes it. Since it’s almost impossible to get adequate amounts of vitamin D from food alone (including fortified milk and fatty wild fish), the sun and supplementation are your best sources. I’m not suggesting you bake in the sun with suntan oil or go to tanning salons. It is important to remember that after you have received enough sun to top up your vitamin D, you must either apply a natural sun lotion or cover up using clothing or a hat.

How much sunshine do I need?

All living things need sun, the key is balance. Too much sun exposure can cause melanoma and skin aging, while too little creates an inadequate production of vitamin D. The amount needed depends on the season, time of day, where you live, skin pigmentation and other factors. As a general rule, if you are not vitamin D deficient, about 20-30 minutes a day between April and September with at least 40% of your body uncovered and without sunscreen is adequate. It doesn’t matter which part of the body you expose to the sun and it is advisable to alternate body parts to avoid overexposing one area of skin. Many people want to protect their face, so just don’t put sunscreen on the other exposed parts for those 20 minutes. Remember to cover up after this time frame.

The further north or south you live from the equator the less Vitamin D the sunlight creates in your skin in the winter months. Even if you are sitting in the sun in a bathing suit on a warm January day the sun is not strong enough to create vitamin D (at this latitude). In the summer months, most of us are stuck indoors and don’t get outside. As a general rule, if your shadow is taller than you are, the sun is not strong enough to produce vitamin D. So remember if the sun is not strong enough, you are covered up or indoors, it is important to supplement to maintain healthy levels of vitamin D.

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.

This is why it is important to test the levels of vitamin D in the blood. Current recommendations vary depending on the source but according to the most recent studies, the Mayo Clinic and the NHS laboratory that we use, 50nmol/l is adequate. Some studies do however suggest levels of 75nmol/l are more effective.

How much vitamin D should I supplement with?

Most important is that you take vitamin D3, (cholecalciferol) the active form of vitamin D. Do not take vitamin D2 as it is not as biologically active or as effective, as vitamin D3. Also taking the right amount is crucial.

If you are deficient in Vitamin D or have low bone density 5000 IU is recommended. If you are not deficient then 2000 IU is recommended. Only supplement when you are not getting the sun exposure required to produce the vitamin (20-30 minutes with at least 40% of clothing removed). These dosages are only a rough guideline based on current recommendations. After blood spot testing the dosage should be varied for the individual to achieve the optimal level.

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 some of 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 diarrhoea

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. It is possible to overdose 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. It is also important to mention at this point, that although children can benefit from vitamin D supplementation at lower doses. All supplements and medication should be kept out of the reach of children.

It is a good idea to monitor the levels of vitamin D in your blood a couple of times per year to ensure they are at the correct levels. This can be done with a simple test similar to a diabetic person testing blood sugar. Please ask for further details on how this is carried out.

Can I take cod liver oil to get my vitamin D?

Although Cod liver oil contains a fair amount of vitamin D, it also contains high amounts of vitamin A. Vitamin A at these levels antagonizes the action of vitamin D and can be toxic at high levels. Cod liver oil also contains mercury and other heavy metals which are detrimental to health.

What about the use of tanning beds to get my vitamin D?

Dr Graeme does not recommend tanning beds because we don’t really know if they are safe. The light sources vary with different tanning beds. This makes them unpredictable; some artificial UV lights emit very powerful radiation and are therefore unsafe. In addition, most commercial tanning beds emit an unknown amount of EMF (electromotive force) and because one is so close to the actual bed, it may be an unnecessary high dose. As discussed above there are better sources of vitamin D with fewer risks.

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