Updates on Vitamin D3

Homo sapiens evolved in Africa as a hairless ape. That creature spent LOTS of time outside, with a prodigious amount of skin exposure in a nice sunny environment. Today homo sapiens is largely an indoor mammal, and typically covers up a good deal of skin when venturing outside. Often when in a relaxed stance, say on a beach vacation, gobs of sunscreen is applied. This all adds up to much less Vitamin D synthesis happening in the skin cells. Hairless ape was designed to receive a lot of Vitamin D. The sun emits both UV-A (responsible for most melanomas) and UV-B which does not penetrate clouds or through glass and is only “full strength” at mid-day. UV-B is the ray needed to synthesize Vit D, whereas UV-A is the “tanning” frequency in tanning salons and does not stimulate much Vit D production. People who are extremely deficient in Vitamin D (less than 12 ng/mL) will respond rapidly to real sun exposure, and serum levels rise quickly. People who are marginally deficient (between 30 and 50 ng/mL) achieve optimal levels (50-80 ng/mL) more slowly. This can be taken as evidence that mankind really does needs a substantial baseline level to be fit. One exception to this rapid repletion in clinical deficient patients is in the obese. It is very difficult to get obese people “up to speed” with Vitamin D, because, as a fat-soluble vitamin, it “hides” in the fatty tissues and is not released into the circulation unless very high levels (20,000 or more IUs daily) are pushed for many months. The most elegant solution is to help the obese person lose weight — then the Vitamin D which is stored in their fat cells is liberated into the circulation as their excess fat reserves are catabolized as fuel.

Humans today are almost universally Vitamin D deficient not only because we don’t hang out naked in the tropical sun much, but also because we have not yet found a reliable way to force supplementation. Most naturally occurring sources of Vitamin D are from foods that many people don’t eat at all. For example fish livers. Or other organ meats such as beef kidneys or sheep hearts, etc. Not generally on the menu. Plus, our culture is pretty fat phobic. (That problem is getting a little better with the more appropriate switch to carb phobia… I’d much rather people focus on good fats and vegetables and forget about refined carbs in the diet.) Luckily, most doctors are now tuned into Vitamin D and checking for, and supplementing, deficiencies in their patients. Vitamin D3 (the preferred, bio-identical form) is inexpensive. Don’t be bamboozled into taking the drug form — E2, also known as ergocalciferol — which is way more expensive and doesn’t work nearly as well. Cholecalciferol, or Vitamin D3, is the form you want. A year’s supply should cost well under $50.
Probably the most important early warning that we had become woefully deficient in this broadly useful, fat-based vitamin, was an article by Reinhold Vieth (U Toronto) published 20 years ago entitled “Vitamin D Supplementation, 25-hydroyvitamin D concentrations, and safety,” (Am J Clin Nutr 1999 May;69(842-56)). This article was recently cited by John Cannell, MD, widely known as the current top Vitamin D expert (see his comprehensive website: www.VitaminDCouncil.org) as his “aha” moment for his dedication to Vitamin D research. All statements in this small article have published references that can be found on Dr. Cannell’s site.

Most of us know that Vitamin D is very important for bone density. It is equally, if not more, important than calcium. The issue of bone density will be addressed in another column. Half a century ago, scientists were under the mistaken impression that Vitamin D could be “toxic” at relatively modest doses. That’s because a fairly small dose (400 IUs) was considered effective in preventing rickets (a soft-bone Vitamin D deficiency disease) in England. Somehow, half of that infant dose was deemed an appropriate adult supplementation level as an additive, apparently supposing the rest of the D was being obtained from sunlight and organ meats (decidedly more popular on the East side of the Atlantic than in the US). There was, however, no research to back up these assumptions. Further, if the objective for Vitamin D supplementation was simply to prevent rickets, there wouldn’t be a big fuss. But Vitamin D has many more crucial roles in mammals and supplementation has become a necessity for almost everyone.

Increasing evidence, which means published research, exists for Vitamin D3 in helping slow the progress of various auto-immune diseases. The largest amount of research is in the study of Multiple Sclerosis. There is no doubt that MS incidence correlates with more northern latitudes. Relative lack of Vitamin D is likely the culprit. There is growing evidence that Lupus outcomes are improved with adequate serum Vitamin D levels.

Vitamin D has been shown to improve asthma, especially those patients who don’t do well with inhalers. Steroidal inhalers seem to help the subset of asthma patients who have evidence of allergic responses to airborne irritants in their lungs and bloodstream. This is called “reactive airway disease” or “airway eosinophilia” (referring to high number of “eosinophils,” a type of white blood cell which signals allergen exposure). If you experience wheezy breathing or shortness of breath which doesn’t respond to inhalers, make sure to check out your Vitamin D3 level with a blood test, and bring it into the 50-80 ng/mL range with supplementation. Also lung related, children with cystic fibrosis are much likely to make it into their adult years with proper Vit D repletion.

Vitamin D also improves arthritis, and nagging body aches in general. Vitamin D is a crucial supplement for fibromyalgia patients. Make sure to always take your Vit D supplement with some fat. For example, with a spoonfull of full-fat yogurt, or with a mouthful of a dish containing egg or meat or olive oil. Make sure your Vitamin D supplement is oily. Dry D doesn’t work as well.

New research proves that adequate Vit D3 levels are affiliated with lower risk for numerous cancers. In particular there is much published about this salutary effect in breast, ovary and colon cancer rates. Adequate Vitamin D levels improve the immune response in general. People with adequate serum levels are less likely to get common colds; less likely to have bleeding gums and gingivitis; less likely to get Parkinson’s disease. Other recent work has connected higher levels of Vitamin D with lower risks of high blood pressure, and other forms of heart disease.

Vitamin D improves mood. Whether there is truly a serotonin-enhancing, anti-depressive effect or whether it’s because you just feel better physically with optimal Vit D levels onboard, is not yet clear. Either way though, it’s a good deal.

Possibly the most interesting new tidbit about Vitamin D recently in the news is about telomere lengthening. Telomeres are the protective caps on the ends of chromosomes that improve the durability of these strands of genetic information as they replicate and divide again and again. Inside the nucleus of every single cell of your body (except red blood cells, which have no nuclei) lives the genetic code which runs your life. The health of your nuclei is directly related to your overall health, wellbeing and longevity. As telomeres shorten (rapidly with insults such as exposure to toxins and junk food) the chromosomes become less stable and their cells become more vulnerable to mutation. Besides good lifestyle habits (appropriate weight, drinking mainly water, eating lots of vegetables, getting enough sleep and love in your life) it turns out that Vitamin D is a major player in keeping those telomeres long and healthy.