Rocky Mountain Family Chiropractic

Vitamin D has had a bad rap.  For a very long time, physicians have discouraged supplementation of vitamin D for anything other than bone loss related issues (osteoporosis, osteomalacia, and rickets primarily) believing that higher doses of vitamin D (25-hydroxycholecalciferol) are potentially toxic to the body.  That is true, since vitamin D is a fat-soluble vitamin it does have the potential to be toxic.  Being fat-soluble means that it doesn’t need any help getting into our cells; it just passes right through the membrane, virtually unchecked.  Non-fat-soluble vitamins have to have permission to pass through by the membrane proteins that guard the entrance into a cell.  Being fat-soluble also means that it has the potential to accumulate in the body; clogging up your liver, depositing in your arteries, and damaging your kidneys.  So do vitamin A, E, and K all of which are fat-soluble vitamins.

Could it be that we were wrong?

Perhaps not about vitamin D and the implications of being fat-soluble, but perhaps about our emphasis (or lack thereof) on vitamin D in healthcare in general.  Science has taken plenty of slaps in the face in its history.  We had proof that Pluto was a planet.  We were convinced that bloodletting relieved infections.  We’ve had countless drug recalls (most of which had proven the drug’s safety, efficacy, and quality with bulletproof double blind research trials).  But these bungles are part of the scientific process.  It is all in the name of progress.  We can’t grow if we don’t fall down a few times, right?

In spite of D’s bad reputation it has been getting a lot of press lately.  Recent research is indicating that vitamin D might have more to do for our bodies than merely Calcium absorption. In fact, laboratories are now significantly changing the reference ranges of “normal” vitamin D levels in an average adult.  Previously, those ranges were about 8-46 ng/ml.  Now, with all the evidence of vitamin D’s important role in brain health, immunity, pain levels, blood sugar, etc. those levels have been raised to: 40-100 ng/ml.  A significant change!  Recommended daily allowance (RDA) levels are at 400 I.U. of vitamin D per day.  This seems drudgingly low given the amount of research occurring.  We have to remember, however, that RDA is based on staving off blatant pathologies.  For example, the RDA for vitamin C (recently bumped up to 90 mg/day from 60 mg) was established as a baseline for people to avoid scurvy.  We now know, and it is well accepted, that significantly more (1000 – 2000 mg/day) vitamin C is needed to aid in repairing collagen, decreasing inflammation, and immune system support.  You might not have scurvy, but at 90 mg/day you will definitely not be getting these added benefits of vitamin C.  Vitamin D is the same, it seems.  Adhering to the RDA will definitely help in being free of bone density related ailments, but is there something more that D could be doing for us?  Beyond the known bone density conditions we’ve known about for years, I’ve compiled a summary of what the research is telling us below.

The Bad:

• Most Americans may have an insufficiency (levels at 5-20 ng/ml) in vitamin D.  According to a study conducted in Florida (remember that sunshine is a key element for the body to manufacture vitamin D – if someone should have enough D, it would be those in Florida) showed that men and women had vitamin D levels well below the new established reference ranges.  The sun might not be cutting it for us now days.  A secondary source of vitamin D is important for those with insufficient amounts.
• Vitamin D deficiency (levels at 0-5 ng/ml) may be linked to an increased risk of type-1 diabetes, multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosis, hypertension, cardiovascular disease, and certain cancers!
• Those with lower vitamin D status are at an increased risk of developing insulin resistance and metabolic syndrome (insulin loses its effectiveness at opening cells for glucose to flow in to).  Also, in diabetics, low D levels decrease the efficiency of beta cell function in the pancreas (cells that produce insulin).
• Some people may need to have as much as 4000 I.U. of vitamin D a day to bring their serum levels up to an acceptable level.
• A study showed that over 90% of chronic pain patients have a hypovitaminosis D.  Chronic pain patients are now being screened for their vitamin D levels at the Mayo Clinic.
• Hypovitaminosis D is associated with increased risk for hypertension.
• Hypovitaminosis D may be a factor in Congestive Heart Failure
• There is still evidence that too much vitamin D can harm the body and could contribute to: Crohn’s Disease, other autoimmune disorders, and even some other cancers.  Before you supplement, consult your physician.

The Good:

• Increased supplementation during an acute viral infection has shown a dramatic effect in getting rid of the virus, and keeping more viruses as bay.
• Chronic pain patients see significant improvement in their pain levels after vitamin D supplementation
• Vitamin D therapy reduces blood pressure.
• Vitamin D has been shown to inhibit development of autoimmune diseases including inflammatory bowel disease (IBD), rheumatoid arthritis (RA), multiple sclerosis (MS), and type-1 diabetes.
• Vitamin D may be used to combat cancers!  Cancer patients with D supplementation could have decreased angiogenesis (new blood vessels formed for the tumors), metastatic potential and tumor cell proliferation, and increased apoptosis (a kind of self destruct mechanism inside of cells).  Edward Giovannucci, D. Sc., M.D., a Harvard University Professor, said, “I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits as vitamin D…. the data are really quite remarkable.”

Vitamin D

Those interested in learning more about this vitamin can go to the following sources:

• http://www.sunarc.org
• http://www.vitamindcouncil.com
• http://www.sunlight.as.ro/sungazing/htm

Why, then are we all lacking this all-important vitamin?  Where does it come from?  Your body is designed to manufacture vitamin D, and it can do so quite effectively when it has the proper constituents and when the body is working optimally.  Here are some ways we can get this vitamin

• Diet – Most dietary D is included in fortified milks and cereals.  This is a poor source of the vitamin because it is included with refined carbohydrates, preservatives, and artificial colors/flavors.  These keep the body from working optimally, which will decrease your effectiveness in using the vitamin D.
  • Dairy
    • Cheese
    • Butter
    • Cream
    • Fortified Milk (though milk is fortified with vitamin D₂, the weaker form of vitamin D when compared to D₃)
  • Fish
  • Oysters
  • Fortified cereals (usually laden with refined carbohydrates)
  • Margarine (not a good source, and horrible for the diet anyway)
• Sun
  • UV-B rays enter the skin and help in one of the steps in the body’s vitamin D manufacturing process.
  • Research has suggested that one should start with 3-5 minutes of sun exposure, especially if you’re fair-skinned.  15 – 20 minutes of sun without sun block will generate about 10,000 I.U. with optimal conditions (mid-summer, sun at peak, maximum skin exposed).
  • Be careful if skin cancers run in your family.  Take precautions to not get burned, but remember that most sunscreens are going to block the precious UV-B rays.
• Supplementation
  • Dr. Michael F. Holick, one of the world’s foremost experts on vitamin D, of Boston University Medical Center recommends 1,000 I.U. daily for everyone through a combination of safe sun exposure and supplements.

Surely, we have underestimated the physiological importance of this vitamin.  As always, consult with your physician before beginning any supplementation program.  As we look into this deeper, there is bound to be some buzz among the medical community.  Vitamin D is emerging from an often-overlooked element to an unavoidable health and wellness powerhouse!

-William Green, D.C.

Sources:

American Journal of Clinical Nutrition 2004 May 79(5):820-5 (link)

American Journal of Clinical Nutrition. 2004 Dec;80 (6):1678S-88S

Autoimmunity Review. 2006 Feb;5(2):114-7

GUT. 2004 Aug;53(8):1129-36 (link)

European Journal of Epidemiology. 2001:17(6):567-71

Heart Fail Review. 2006 Mar;11(1):25-33

Journal of the American College of Nutrition. 2003 Apr;22(2):142-6 (link)

Journal of Rheumatology. 2005 Sep;76:11-20 (link)

Journal of Tropical Pediatrics 1994 Feb; 40(1):58

Journal of Women’s Health 2003 Feb;12(2):151-6

Mayo Clinic Proceedings. 2003 Dec; 78(12):1463-70 (link)

Minnesota Medical Association. 2003 Jan;86

Nutrition Journal. 2004 Jul 19; 3:8  (link)

Spine. 2003 Jan 15;28(2):177-9