Vitamin D is one of the few nutrients that has gotten its deserved attention in mainstream health media and conventional medicine. What we commonly call the “sunshine vitamin” is so crucial to your health that it’s added into foods that don’t normally contain it to prevent deficiencies, anywhere from dairy AND almond milk to breakfast cereals, margarine, and orange juice. People don’t generally get rickets anymore from D-deficiency, but it’s estimated that ¾ of American adults and adolescents aren’t getting the amount needed to support immune function, utilize calcium, or control inflammation. What are we missing?
Time in the sun and real food. That’s my answer! We should resort to those factors first, but I can use my own experience to say you may need to go beyond that to maintain optimal levels. To give some background about Vitamin D, I should first say it’s more like a hormone than a vitamin. It acts as a signaling molecule in the body and has recently been found to be involved in expression of genes that control proliferation (growth) and apoptosis (death) of cells (cancer!). Sounds pretty stellar, right?
Humans are capable of making Vitamin D organically under sun exposure. When UV rays hit your skin, cholesterol in the layers of your skin is converted to an inactive form of vitamin D, and that is then converted by the liver and the kidneys to the form the body will use. Precursors for this process exist in 2 forms: D2 and D3. The difference is quite important, as it turns out. Several studies have shown significantly higher bioactivity of the D3 molecule, cholecalciferol, which is present naturally in foods like egg yolks, fatty fish (think sardines, mackerel, herring), and cod liver oil. The counter form, D2 – also known as ergocalciferol – is less expensive and frequently added to fortified foods like orange juice and pasteurized milk. Cost favors the use of D2 since it can be synthetically made, but the body doesn’t absorb it near as well as D3. My thoughts about vitamin D requirements lie in a balance between getting as much as possible from the following, in order of importance: the sun; whole foods; and lastly, high quality D3 supplementation.
Sun-initiated production of vitamin D is the most efficient way to keep appropriate amounts present. We’ve been conditioned to be afraid of the sun, but just 5-15 minutes of exposure each day can be enough for most people, regardless of location. However, I understand the difficulty when you live in a state with 10 degree winters (holla, fellow Wisconsinites). For us folks, food is another valuable source. Although vitamin-food fortification has been attributed the savior of children from rickets (a debilitating condition of low bone density), foods blasted with synthetic D vitamins like orange juice and cereal are missing other key elements that come with the vitamin in its natural sources. Vitamins A and K2, as well as calcium, are often found in conjunction with D in whole, fatty animal products like fish, eggs, and raw milk/cheese. Vitamin D increased the absorption of calcium and A and K help keep D at regular levels. There is no single place in nature that nutrients exist alone, and for good reason. Whoever or whatever you believe created this earth and the wonderful resources it provides knew that there is a synergy necessary for us to get the most benefit from foods, and I think we should recognize the importance of consuming nutrients together.
Lastly, supplementation is a great option if you find your levels are low, regardless of other efforts. As previously mentioned, when Vitamin D comes from sources besides food or UV exposure, it can buildup and become toxic, which is why supplementation isn’t usually long-term. For this reason, it’s really important you consult openly with your provider about your bloodwork and follow-up regularly.
I noticed a couple of months ago that my hair was falling out a lot more than usual. As a twenty-something woman, I wasn’t super psyched about that, and when it continued relentlessly I decided to have some bloodwork done. The only off-kilter value was my vitamin D serum at 25ng/ml, half of my optimal goal of ~50ng/ml. I already eat plenty of quality animal products and I presume my shortcoming is at least partially a result of my northern latitude. I found a wonderful supplement through a pharmacist colleague of mine that has already begun to help my hair disaster! If you and your provider decide you should supplement, my thoughts are as follows:
- Use one in the form of D3. Many of them are, now, but D2 is still available, and the research shows you just aren’t getting as much bang for your buck with D2.
- Get a supplement in the form of an oil drop. Vitamin D is fat-soluble, meaning it can’t disperse in water. It needs to be taken in the form of fat or along with a fatty food to enable the body to absorb it into tissues. Here’s a link to the one I use which is made with MCT oil – a super readily-available type of fat called medium chain triglycerides. This makes the vitamin easy for your body to utilize quickly and efficiently.
- Continue to get your levels checked. While vitamin D levels are generally not considered dangerous, they can become toxic at high doses. This doesn’t happen with the normal levels present in food, or with the production brought about by the sun. But it can happen when supplementing. Labs are quick and most providers would be happy to order it for you, so remain proactive in the matter.
As always, be thoughtful about how you’re getting the nutrition your body needs and doing it the way Mother Nature intended, first. I recommend having an open relationship with your provider about what you want to achieve and being tested at certain intervals if you’re having trouble maintaining levels of Vitamin D. Vitamin D is crucial for mood regulation, immune function, and bone health. That’s plenty of reason to figure out if you’ve got what you need, and find what method is best for you to dose up on the “sunshine vitamin!”