Vitamin D- New Research

Vitamin D, I know you have heard of it. The chances are good that your doctor has tested you for it. About 10 years ago when I started testing for it I was shocked to see so many of my patients coming up deficient. At that time, I was practicing in Orange County California. How could the majority of my patients be deficient? Wasn’t this the sunshine state? Then about five years ago I expanded my practice to Phoenix and low and behold the same phenomenon was happening in the desert.

It got me and a lot of other physicians asking the same questions about Vitamin D. I practice in the southwestern hemisphere of the united states. Sun exposure is a lot higher here than in the northeastern united states where some folks see gray skies more than 300 days per year. Gross deficiency can be a real problem in those places. If someone is grossly deficient then fracture rates and damage to joints can skyrocket.

In the last 10 years quite a few books have been published on vitamin D. Some proclaim it to be the cure for a wide variety of conditions and diseases. They lead you to believe that all you need is more Vitamin D and suddenly your health will turn around. I certainly wish that was the case. Adequate Vitamin D is required for good health however I don’t see the reversal of the deficiency to be a magic bullet for most people. Health happens as a whole with all the parts working together in concert. Generally, a complete holistic approach works better to enhance health than anything else.

Theories behind Vitamin D Deficiency:

• Sunscreen use – Vitamin D requires UVB light for conversion in the skin. I will have a blog coming out shortly on sunscreen. We are entering the longer days of summer and this is the time to talk about it.
• Fluorescent Lighting – exposure to fake light instead of natural light.
• Decreased consumption of milk and dairy products. Not all alternative milk products are fortified with calcium and Vitamin D. You must read the labels carefully.
• Regular use of acid blocking medications. These block calcium absorption in the digestive tract which affects Vitamin D status.
• Increased body mass index increases the amount of Vitamin D required by the system. Vitamin D is fat soluble so the more body fat that is present the more the vitamin becomes diluted.

 Individuals Most at Risk for Vitamin D deficiency:

• Dark skinned individuals
• Menopausal women
• Veiled women
• Seniors and nursing home inhabitants
• Multiple fractures
• Pregnant and Lactating women
• Breastfed Newborns
• Malabsorption Digestive conditions such as IBS, Crohn’s Disease, Ulcerative colitis, Celiac disease, and infections conditions.

Testing for Vitamin D

The correct test is the 25, Hydroxy (OH) vitamin D level – blood test

Within Normal range is 30-100 ng/ml

Deficiency is <30 ng/ml

Optimal range is 50-70 ng/ml

Dosing:

There are a range of ways that doctors can prescribe Vitamin D3 to increase the level. Here is an example of aconservative dosing:

Appropriate Dosing if someone is within normal range – 2,000iu vitamin D3/day

Appropriate Dosing if someone is deficient – 10,000iu Vitamin D3/day for 2 months and then reduce to maintenance dose of 2,000iu/day.

Breastfed babies – 400iu/day

Children – 600iu/day

**Note Vitamin D3 comes from sheep’s wool or fish. That is where most of the supplements are derived from. If you are vegetarian the only source is Vitamin D2 from mushrooms or another plant based source. Vitamin D2 is not as effective and may not be converted to the active form of Vitamin D3.

Regular testing is recommended. Every 6 or 12 months. This is to ensure that the level has optimized.

Calcium and Vitamin D3

New information has come out on calcium. It is not the bone builder that we once thought it was. In fact, new studies are suggesting that calcium alone does not decrease osteoporotic fractures. The new research is showing that Vitamin D is more important than calcium in reducing fracture rates. It is better to consume calcium rich foods than it is to supplement with calcium.

Calcium rich foods include green leafy vegetables, salmon and sardines with bones, nuts, and beans.

Optimizing Vitamin D will help the following conditions:

• Osteoporosis and decrease fall risk
• Lower the risk of some cancers
• Help reduce pregnancy complications
• Reduce coronary heart disease and blood pressure
• Reduce dementia and Alzheimer’s risk
• Reduce body mass index and depression

Osteoporosis is a clear example of a condition showing increased benefit when Vitamin D3 is optimized. However, is it more effective to combine it with a good bone building program. One that focuses on a mineral rich diet, weight bearing exercise, hormone balancing, and specific supplementation.

We do not exist in a vacuum. Everything we do affects the whole system. It is important to remember this when it comes to health. What you do every day matters more than what you do once in a while. So go out for a walk, enjoy the sunshine and smell the flowers in the air. Life is good.

-In Service

Dr. Purcell