Vitamin D Statistics: An estimated 40-75% of the world’s population is vitamin D deficient (GrassrootsHealth). Even in southern climates, 55% of African Americans and 22% of Caucasians are deficient. The reasons are many including reduced sun exposure due to indoor jobs, use of sun block, skin color, and more. Some common signs of vitamin D deficiency include stiffness, muscle cramps, bone pain, balance and gait issues (i.e. clumsiness), low back pain, poor wound healing, depression, migraines and allergies.
The Benefits of vitamin D:
Thanks to 257 epidemiological studies, 2500 laboratory studies and some significant clinical trials (1) most experts on the topic of vitamin D feel it not only helps us maintain healthy bones, but that vitamin D can significantly reduce the incidence of a wide range of cancers (breast, ovarian, colon, lymphoma, kidney, endometrial), type 1 diabetes, multiple sclerosis, psoriasis, inflammatory bowel disease, depression, high blood pressure, seasonal affective disorder and heart attacks. The following is a summary of studies which shows the striking correlations between specific vitamin D blood levels and the percentages of reduced risk of incidence of a range of common life threatening chronic diseases:
• At 95 nmol/L, all cancers
• At 125 nmol/L breast cancers by 83%
• At 130 nmol/L Type I Diabetes by 66%
• At 135 nmol/L Multiple Sclerosis by 54%
• At 85 nmol/L Heart Attacks by 30%
• At 105 nmol/L Colon Cancer by 60%
• At 75 nmol/L Incidence of falls in women by 75%
• At 110 nmol/L fractures by 50%
• At 45 nmol rickets by 99%
You will notice that blood levels around 120 nmol/L appear to be highly protective against many common cancers and other life threatening diseases. All these percentages reference a common baseline of 62 nmol/L. In my clinical experience most people’s blood levels are far below 100 nmol/L. (1)
More than a Vitamin. In reality we now know that so-called vitamin D is really a steroid hormone and that it can affect the expression of our DNA which is how it is believed to alter the risks of cancer and other diseases. For those interested in the details, vitamin D affects the transcription of a number of genes and consequently can contribute towards apoptosis (the death of a damaged cell) as well as prevent cellular proliferation (that means cell growth and division) in cells of many lineages.
Sources of Vitamin D
I’m often asked if we can get sufficient vitamin D levels from foods and the answer quite frankly no. Having said that, the best sources are shiitake mushrooms, egg yolks, cod liver oil, and wild salmon. Fortified milk is not a good source due to the use of a poorly assimilated form of vitamin D (unless you plan on drinking 100 glasses a day!). From these foods you can derive a maximum of 1,000 iu vitamin D daily. Most of our vitamin D needs are meant to be obtained from exposure to sunlight and therefore for most of us this is the only way, other than by supplementing, that we can obtain the amounts necessary to obtain blood levels up in the 100 nmol/L mark. For the most part, only outdoor workers can obtain levels up to 150-200 nmol/L by the end of the summer.
Here are some facts about sunlight:
• A UV index greater than 4 is necessary to make vitamin D
• Darker skin requires up to 7x more sunlight exposure to make the same amount as lighter skin
• If your shadow is taller than you are then you cannot make vitamin D
• You can get vitamin D from reflected light while sitting in the shade but not through a glass window (2)
What are Optimal Blood Ranges of Vitamin D?
Vitamin D deficiency is defined by serum levels below 20 nmol/L. This level is based on prevention of rickets and osteomalacia (both diseases of the bones). According to Dr. Reinhold Vieth, PhD, even at 50 mmol/L blood levels, 25% of the adult population still has osteomalacia (adult rickets). Even OHIP guidelines describe this threshold as “conservative”. (3) At a vitamin D symposium held at the University of Toronto on November 1st 2011 in Toronto, the entire panel of experts were unanimous in their opinion that these levels are too low and ignore the many epidemiological studies that suggest that higher levels can provide protection beyond simply preventing bone fractures.(4) In a time when cancer strikes one in two men and one in three women this conservative approach in my opinion is preposterous.(5)
Vitamin D Supplements
Because vitamin D is fat soluble, you can significantly increase your absorption of vitamin D if taken with a large meal that contains fat. For example, if you use olive oil in your salad or are taking fish oil supplements with your meal, this will suffice. Some vitamin D supplements are in an emulsified form which enhances their absorption and may be recommended for those with poor assimilation. I prefer vitamin D in the form of gel caps (in its own base of fat), liquids and/or sprays. Vitamin D tablets will likely be the least well absorbed, especially if taken on an empty stomach. Vitamin D can be taken daily or periodically, depending on the person and their needs. Most multivitamins do not contain enough vitamin D to meet daily requirements and/or to replenish deficiencies.
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