Vitamin D: What You Need to Know

In an article recently published by The New York Times, widespread vitamin D testing and supplementation were derided as an unnecessary, non-evidence based, potentially dangerous trend.   Geo Espinosa, ND,  wrote an excellent response explaining the errors of the article and a detailed explanation of current research and best practices in functional medicine.  I highly recommend reading Dr. Espinosa's response for a detailed rebuttal of the NY Times article.

Is there such thing as too much vitamin D? Should you be taking vitamin D? What about testing? Here's what you need to know:

Above all, both patients and practitioners should exercise caution taking health advice from the media. Their primary goal of the media to get more people to read their stuff, not provide the best health advice to the public. It is our job to evaluate clinical studies and apply the best knowledge to individual patients.
— Geo Espinosa, ND

Regarding Trends in Health and Wellness:

Vitamin D is not immune to the inevitabilities of any hot ticket health item of the day: people can, and often will, go overboard. Many people assume that if vitamin D is good, then a lot of vitamin D is even better.  Sometimes too much of a good thing is indeed too much.

How Much is Too Much?

This depends on your individual needs. Larger doses of 5000 to 10000 IU are well tolerated in people with deficiencies.  The amount of Vitamin D needed varies and depends largely on weight, height, skin tone, and lifestyle. Often people need less vitamin D supplementation in the summer if spending time outdoors.

Excessive vitamin D supplementation (greater than 5000 IU daily if not deficient) can result in nausea, vomiting, anorexia, fatigue, cardiac arrhythmias, and other symptoms. Chronic over-supplementation can lead to calcification of soft tissues resulting in life-threatening conditions like renal failure and atherosclerosis. This is why working with a trusted practitioner to determine the amount of vitamin D you need is important.

What I Look For in Lab Work:

Serum 25 (OH) D Testing: gives 3-week snapshot
Deficiency: < 50 ng/ml
Optimal: 50-70 ng/ml
Excess: >100 ng/m

Spectracell Micronutrient Testing, which I offer, gives us a longer-term picture of vitamin D levels in your white blood cells (4-6 month snapshot of 35 vitamins, minerals, and antioxidants). This is a fantastic option for determining deficiency and supplement need.

Why Are We Seeing Higher Rates of Vitamin D Deficiency?

  • Low gastric acid - gastric acid is required to breakdown fats and absorb vitamin D. With the increasing use of PPIs (proton pump inhibitors), antacids and general GI dysfuntion, fewer of us are absorbing vitamin D found in foods. 
  • Sunscreen use - Sunscreen blocks the absorption of vitamin D through the skin. Heavy sunscreen use has contributed to higher incidence of vitamin D deficiency.
  • Indoor lifestyle - Culturally, we spend many more hours indoors and out of the sun than previous generations.  Less time in the sun = fewer chances to absorb vitamin D.

What We Know About the Role of Vitamin D:

Vitamin D is a prohormone and contributes to many important processes in our bodies. A few of the many important roles of vitamin D are:

  • Regulates calcium utilization
  • Contributes to antioxidant function
  • Anti-cancer activity
  • Immune modulating
  • Anti-inflammatory
  • Enhances insulin secretion
  • Hormone regulation
  • Gene regulation
  • Cholesterol metabolism

Vitamin D Deficiency is Associated With:

  • Osteoporosis
  • Adrenal fatigue
  • Cancer
  • Diabetes
  • Dementia
  • High cholesterol
  • Hypertension
  • Hormonal imbalance
  • Pain in muscle and bone
  • Weight gain

Where Can You Get Vitamin D Without Taking Supplements?

10-15 minutes of sun exposure on your upper body (arms, face, shoulders and neck) without sunscreen provides about 10,000 I.U. of Vitamin D daily!

Fatty cold water fish (like wild-caught salmon), dairy products, egg yolks and mushrooms are all great food sources of vitamin D.

Bottom Line:

Individual attention and moderation are key! Talk to a trusted healthcare practitioner regarding your vitamin D levels, testing and supplementation. Adequate vitamin D levels are an important part of your overall health and can have a profound and noticeable effect on your wellness. So, don't listen to the naysayers AND make sure to talk to your practitioner about how much vitamin D is right for you!