Vitamin D is the cornerstone of good health, so it’s mind-boggling to me how often vitamin D levels are overlooked or given short shrift by primary-care physicians. Numerous studies have shown a link between vitamin D deficiency and devastating health problems, many of which might be avoided if we paid more attention to filling the D-gap.
If your doc gives you the brush-off when you ask him or her to measure your vitamin D level, then you need to take charge. Educate yourself, get tested, and then work with your doc to develop a plan to get your D up to an optimal level. Your continued health may depend on it!
Here's what I wish everyone knew about vitamin D to maintain healthy levels:
1. Vitamin D deficiency is a big deal.
Vitamin D is what many call the sunshine vitamin, but it’s actually a steroid with hormone-like activities that regulate the functions of over 200 genes and is essential for our growth, development, and ongoing health. A small amount of it comes from the food we eat, and some of it our bodies are able to synthesize from sunshine. But many of us are falling short, particularly those of us who spend most of our days indoors and out of the sun.
Though it might not seem like a big deal, vitamin D deficiency is considered by many experts to be an under-the-radar epidemic that’s laying the groundwork for numerous serious diseases. Because vitamin D is involved in supporting essential functions like immunity and cancer prevention, as well as neurological, cardiovascular, and bone health, it’s easy to see just how dangerous falling short can be.
2. As many as 75 percent of us could be deficient.
An estimated 1 billion people on the planet are vitamin D deficient, and many can be found right here in the northern parts of the U.S. These include:
- People with indoor lifestyles: those who spend most of their time indoors with little exposure to sunlight.
- Northern souls: those who live in the Northern Hemisphere.
- Darker-skinned people are frequently vitamin D deficient because they need more sun to get the same amount of vitamin D as fair-skinned people.
- Cover-uppers: those who keep their skin protected with clothes head-to-toe or always slather themselves in sunscreen, preventing the sunlight exposure needed for the skin to synthesize and produce vitamin D.
- Older folks have thinner skin and reduced ability to produce vitamin D, so the 50-plus set is more vulnerable to deficiency.
- Overweight/obese people and those with excess body fat.
- Gastric bypass patients and/or those with gut problems, whose guts may not be able to absorb enough vitamin D.
- Pregnant women, whose needs are greater.
3. Not feeling great? You might be deficient in vitamin D.
Vitamin D deficiency is usually one of the first things I look for in my patients who feel a bit off. While some folks may not have obvious symptoms, others may experience one or more of the following tip-offs:
- excessive sweating, despite moderate temperatures
- muscle weakness
- easily broken bones and/or symptoms of osteopenia
- chronic pain and/or aches and pains
- feeling down or blue, particularly during the winter months when days are short
True, these symptoms could be caused by a host of other health problems. But when patients complain of them, the knee-jerk reaction on the part of many doctors is simply to prescribe a heavy-duty drug regimen (often with side effects), instead of first considering vitamin D supplementation—a far simpler, healthier, cheaper, and safer therapy.
4. Get tested—and know what to look for.
You can get tested by your doctor (or order reasonably priced kits online). Remind your doc that you are looking to achieve optimal levels, not just borderline-OK ones! Most general practitioners look for an “adequate” reading of a serum 25-OH vitamin D level greater than 20 ng/ml, but I, and most of my integrative colleagues, consider this number to be on the low end. So what are the numbers to shoot for? I recommend an optimal range of 50 to 80 ng/ml.
You can use the results as a guide for you and your doc to develop a plan that’s appropriate for your situation. Another reason to work with your doc rather than monitoring levels on your own is to help guard against possible interactions with meds such as cholesterol-lowering drugs, corticosteroids, and seizure medications.
5. Take action to maintain healthy levels.
If moving closer to the equator isn’t in the cards, here’s what you can do to keep track of your vitamin D level, get it where it needs to be, and support your health no matter where you live:
- Check your level twice a year, preferably during the spring and fall.
- Expose your skin to some sun—responsibly, of course. Even 15 minutes a day at midday can help boost levels, depending on your skin tone. To help you monitor sun exposure, pick up a device, like SunFriend, or try an app to help keep on a healthy track.
- If sun exposure is not an option, make sure you supplement. There are two choices: Vitamin D3 (cholecalciferol), which is the type of vitamin D your body produces in response to sun exposure, and vitamin D2 (ergocalciferol), which is a synthetic form. Take vitamin D3 and steer clear of vitamin D2.
Take your vitamin D3 supplement (preferably combined with vitamin K2) with a meal that includes some healthy fat. This is because vitamin D is a fat-soluble vitamin, which means you need to have some fat with it for it to be absorbed. In my experience, most people need anywhere between 2,000 and 10,000 units/day, depending on their blood levels.
- Be on the lookout for symptoms of too much D3, including a metallic taste in the mouth, increased thirst, itchy skin, muscle aches and pains, frequent urination, nausea, diarrhea, and/or constipation. All of these could be signs that your D3 dose may be too high, although this is very rare.