The Hidden Epidemic Low Vitamin D
Mention vitamin D and most people think “sure, we need it
for strong bones.” But did you know we
need it for prevention of heart disease, cancer, diabetes, and more? How about for a healthy immune system? And would you have guessed that about 50% of
us are deficient in this vitamin powerhouse!
Vitamin D is actually a pro-hormone that is made in our skin
upon exposure to sunlight. The sun’s
ultra-violet B (UVB) rays convert cholesterol into vitamin D3 (cholecalciferol). Diet provides a small amount of vitamin D2
(ergocalciferol) found in fish, egg, fish liver oils and mushrooms. It seems nature did not intend for us to get
vitamin D from food, rather we are designed to make vitamin D from the sun.
To be fully functional vitamin D must first be transformed
by the liver into calcidiol which is the main storage form. From there, it moves down one of two
pathways. In the first pathway, through
the kidney, calcidiol is turned into calcitriol, which works to regulate calcium
levels in the body and is essential for life and for strong bones. Vitamin D receptor (VDR) activation in the
intestine, bone, kidney, and parathyroid gland leads to the maintenance of calcium
and phosphorus levels in the blood and to the maintenance of bone content. A lack of vitamin D leads to soft bones or
“rickets” and this is the primary reason we now have vitamin D fortified foods,
notably milk and orange juice.
It is the second pathway that is generating so much
excitement in the medical world. This
pathway for calcitriol production is in the various tissues of the body where
it acts locally, either inside or around the cells. It activates the VDRs that are found in most organs,
including the brain, heart, skin, gonads, prostate, and breast. VDRs are also found in the white blood cells
of the immune system.
Calcitriol is the most potent steroid hormone in the body,
and that means it is very effective in turning genes on or off. Some of these genes control proteins that
fight cancer. Some of the genes affected
by vitamin D are very ,close to other genes that relate to every disease known
to man and we are learning that the human genome has over 2,000 binding sites
for calcitriol!
For many years low levels of vitamin D have been known to be
associated with higher rates of cancer, especially prostate, breast and
colon. It is believed that the local
production of calcitriol may be responsible for the anticancer benefit of
vitamin D, by acting to regulate cell growth and decrease the risk of the cells
becoming malignant. It is estimated that
there is a 30 to 50% reduction in risk for developing colorectal, breast, and
prostate cancer either by increasing vitamin D intake to least 1000 IU/day or
getting enough sunlight to raise blood levels of vitamin D into a normal range.
Vitamin D deficiency is now thought to play a role in the pathology
of at least a dozen varieties of cancer as well as high blood pressure, heart
disease, stroke, autoimmune diseases, diabetes, depression, chronic pain,
osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects,
periodontal disease, and more.
What is the optimal amount of vitamin D for the body? It is estimated that the body will naturally
produce about 20,000 IU of vitamin D with just 20 minutes of full body sunlight
exposure. This is full intensity
sunlight, say between 10am and 3pm, only from spring to fall, and is called the
erythema dose as it is just barely enough to turn Caucasian skin to pink. We have a control mechanism to limit further
production as the skin begins to darken and further UVB light starts to degrade
vitamin D. Darker skin requires as much
as 6 times the exposure to make the same amount of Vitamin D, which limits
natural production but also means darker skinned people need even more sun.
It is virtually impossible to get enough vitamin D from our
diet. Our distant ancestors spent their
entire lives in the sun, and over time we’ve migrated to latitudes so far north
or south of the equator that the UVB rays get filtered out, especially in the
winter months. Furthermore, we now cover
with clothing, live and work indoor, drive instead of walk, and have gone
overboard with sunscreen and sun avoidance.
It is no surprise we are deficient in our most potent steroid hormone
and anti-cancer wonder!
You can test for vitamin D deficiency with a simple blood
test for 25-hydroxyvitamin D (calcidiol).
Normal levels are 30-100 ng/ml, with 70-100 ng/ml being optimal, and at least
50 ng/ml as the minimum to insure benefit.
People at high risk for vitamin D deficiency include the
elderly (who don’t make as much in the skin), people that are overweight, and
people that spend all their time indoors.
Consider patients that are seriously ill or hospitalized – they are usually
indoors constantly and missing out on one of nature’s most potent hormones –
while they need it most!
Increase your vitamin D levels naturally by getting 20 minutes
of full sun exposure daily to as much of the skin as possible. DON’T burn!
In the winter, periodic tanning bed exposure is ok. Again, DON’T burn.
Taking a vitamin D supplement is the most practical and easy
way to increase vitamin D levels. I
recommend a D3 supplement of at least 2,000 IU/day for children and
adults. The half-life of vitamin D is so
long, that one can take weekly or even monthly doses to average out at a good
daily dose. Most doctors will prescribe
a 50,000 IU capsule of D2, once every few weeks or monthly. I prefer the natural D3 form given
daily. Doctors still panic with concern
of vitamin D toxicity, but the fact is that doses of up to 5,000 IU/day are
shown to be very safe. But, simply take
what you need to get your blood level right, and recheck blood levels every 3-6
months until you get it right!
For further reading I recommend “The Vitamin D Solution”
written by one of the world’s experts on vitamin D, Professor Michael Holick of
Boston University School of Medicine.
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Bio
Scott Rollins, MD, is Board Certified with the American
Board of Family Practice and the American Board of Anti-Aging and Regenerative
Medicine. He specializes in Bioidentical Hormone Replacement, thyroid and
adrenal disorders, fibromyalgia, weight loss and other complex medical
conditions. He is founder and medical
director of the Integrative Medicine Center of Western Colorado and Integrative
Weight Solutions. Call 245-6911 for an
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