Why Some People Are Always Vitamin D Deficient The ABCs of Vitamin D


Kanika was taking good dose of elemental calcium (important for bone health). Her diet was nutritious. She was active and looked strong. Still her sacrum (part of the vertebral column) got fractured without any prior warning while descending stairs. Her bones went hollow and she was not even aware.

If your body looks fine on the outside, it doesn’t necessarily mean that you are okay on the inside too. You can see the wounds/inflammations/abnormalities on your skin (and take care of it right away). But you cannot look into the mirror and tell what organ/system inside the body is under attack, behaving abnormal and needs immediate care.

That is why healthy looking people are taken by surprise when unexpected fractures, heart attack, strokes, cancers and other life threatening diseases/disorders come knocking and take a major chunk of a joyful life away. Ignorance is not a bliss. Life does not forgive an uncaring attitude towards health and nutrition.

I write this post to draw your attention to a very serious pandemicVitamin D deficiencythat has created grave concern because of the devastating capacity it carries. A staggering 85% population is Vitamin D deficient/insufficient.

There are 13 vitamins [A, B1, B2, B3, B5, B6, B7, B9, B12, C, D, E & K] that human body needs to function effectively and stay disease free. All these vitamins are obtained from food; however, there is one vitamin that is so vital to us that nature designed a way to synthesize this vitamin inside the human body when no food is available.

Nature chose energy of the sun to make this vitamin. Energy of sun comes to us in form of packets called ‘Photons’. Photons get generated due to nuclear fusion in core of the sun and take up to 170,000 years to come to the surface of sun, and then only 8.3 minutes to reach earth. When photons (in UVB spectrum of sunlight) hit human skin, in the epidermis (top layer of skin), it converts 7-dehydrocholesterol into Vitamin D.

This Vitamin D is inactive and its activation happens in two phases at two different places:

  1. It is taken via blood to Liver (where it is converted to Calcidiol) and then to Kidney (where it is converted to activated form of Vitamin D, called Calcitriol).
  2. Then, blood takes this activated form to whole body to be used for innumerable important functions. Though majority of Vitamin D is activated by kidney, there are 10 different organs that produce it and use it locally (because it is important to the health and function of those organs).

Kanika’s bones became porus that led to its breaking despite taking calcium. This is because her body was Vitamin D deficient where the deficiency stayed undetected/untreated.

SO WHAT ARE THE BENEFITS OF VITAMIN D?

  1. Vitamin D enhances intestinal absorption of magnesium, phosphate, zinc and iron.
  2. It maintains calcium homeostasis in bones, kidneys and parathyroid gland.
  3. It initiates physiological response in 36 different organs of body (of 78 total organs in human body).
  4. It is also known to fight and keep away fatal infections/cancers.

WHAT HAPPENS WHEN VITAMIN D IS DEFICIENT?

  1. Reduced Level of Vitamin D in body reduces the calcium absorption from intestines to only 10-15% of its consumption.
  2. Its deficiency during pregnancy leads to gestational diabetes, preclampsia, high BP, less immunity and small infants.
  3. There is 30-50% increased risk of developing and dying of colorectal, prostate, breast, ovarian, pancreatic and esophageal cancer.
  4. Its deficiency also causes fatigue, widespread musculoskeletal pains, depression, osteoporosis, osteoarthritis, osteomalacia, rickets (soft bones and bow legs in children), deformed spine, psoriasis, diabetes and autoimmune diseases.

These reinstates how vitamin D is very important for our body and concrete steps must be taken to ensure that we don’t get vitamin D deficient.

HOW TO KNOW IF YOU ARE VITAMIN D DEFICIENT?

Take ’25 Hydroxy Vitamin D’ test at a lab. This is a simple blood test that measures level of Calcidiol (25 Hydroxy vitamin D) running in blood.

PRE-TEST:

  • You must not expose yourself for prolonged time to direct sunlight for 6 weeks before taking this test.
  • Stop taking any Vitamin D supplement 3 days prior to the test.
  • A 4 hours fasting before test is required.

POST-TEST: When you get your report, see where your vitamin D stands:

  • Less than 20 ng/ml – Deficient
  • Between 20-30 ng/ml – Insufficient
  • Between 30-100 ng/ml – Adequate
  • Between 100-150 ng/ml – Not a risk but could lead to irregular heartbeat
  • Higher than 150 ng/ml – Toxicity leading to hypercalcemia

If your reports have reading in nmol/L then divide the reading by 2.5 to arrive at ng/ml value. (Check this tool  for conversions.)

I have never come across even a single case of Vitamin D toxicity. All I see is highly deficient reports. A healthy number to aim at for a well functioning body is 40 – 70 ng/ml.

IF WE GET VITAMIN D FROM the SUNLIGHT (AS WELL AS from the FOOD), WHY ARE WE SO DEFICIENT IN IT?

Vitamin D from the SunIt’s not the whole spectra of sun rays but the shorter wavelength, high energy UVB rays that produce Vitamin D when they fall upon the skin. To receive these rays, a person has to expose large area of skin to the bright sunlight in time period of 11AM-2PM.

Who does that? In blazing summers, that’s impractical. Inwinters, we don’t receive bright sunlight regularly, also we are completely wrapped up in winter clothes and skin is not exposed to sunlight.

Fair skin people need 20 minutes a day in sun and dark skin needs 60 minutes (the melanin in dark skin acts like natural sunscreen and blocks most UVB rays). Clouds reduce UVB rays by 50%, Pollution reduces it by 60% and if you are behind a glass (car/bus window or glass office building or glass windows at home) the UVB rays are reduced to almost zero.

Dermatologists advise protecting your skin from UVB rays. These high energy rays cause sun burn, solar retinopathy, skin cancer, faster skin aging, cataracts, macular degeneration, etc. That is why creams have SPF (Sun Protection Factor) and eye glass manufacturers make glasses that protect eyes from UV radiation. Anything above SPF of 8, reduces UVB penetration by 95-98%.

Unprotected skin exposure to sunlight causes skin to get wrinkled and loose (due to destruction of elastic tissue), sallowness (yellow discoloration), discolored patches, dilation of blood vessels under skin, etc. Most prevalent form of cancer is skin cancer.

The number of new skin cancer cases that are diagnosed in US in a year are greater than breast, prostate, lung and colon cancers all combined. For same reason, Institute of Medicine does not recommend sun exposure for Vitamin D generation. I agree. One, because it is dangerous and two, because sunlight is not always available.  And if it is, exposing major portion of skin to it in 11AM-2PM window is highly impractical.

BUT WHY CAN’T FOOD PROVIDE REQUIRED VITAMIN D?

Vitamin D in FoodVitamin D is stable up to 200°C. We cook our foods at a much higher temperature and for long time, which makes sure that not just the vitamin D but most other vitamins in food get destroyed. What is to consume is calories without much nutrition.

Most foods are extremely low in Vitamin D. The quantity of Vitamin D in milk, egg yolks (considered good sources of vit D) is also so less that we need to drink 40 litres milk or eat 50 egg yolks a day to meet 2,000 iu minimum healthy daily requirement for an adult individual.

Oily fishes and portabella mushroom have good amount (450-750iu per 100g). Then again, large population is not eating fish everyday and most of us eat only white mushroom, which has miniscule 7 iu per 100 gram.

The developed countries in world are putting additional vitamin D into the milk and cereals (fortification) to bring up vitamin D levels in public, but without much success. This needs to be tested and treated at an individual level. This leaves us to only one option:

VITAMIN D SUPPLEMENTATION

A person who is not Vitamin D deficient must take the following recommended value:

  • 18+ years: 2,000 iu/day
  • 1-18 years: 600-1,000 iu/day
  • 0-1 years: 400-1,000 iu/day

BEST TIME: The best time to take Vitamin D is early part of day with the heaviest meal. Since the Vitamin D supplement suppresses sleep hormone: Melatonin, it should be avoided in evening or else it will disturb the sleep. As the fat soluble vitamin is best absorbed with meals, it makes sense to have it with breakfast or lunch.

IMPORTANT: people who are obese need 3 times the recommended value. As Vitamin D is fat soluble, excess fat in an obese person takes up most Vitamin D from blood and stores it. To maintain the required concentration of Vitamin D in blood, obese person needs higher supplementation. An adult obese person needs 6,000 iu/day.

CAUTION: Do not buy plant based D2 (ergocalciferol) supplement (derived from UV irradiation of ergosterols from yeast). Many studies point that they are not very effective in increasing Vitamin D levels in body.

WHAT VITAMIN D SUPPLEMENT TO BUY?

It’s better to buy D3 (cholecalciferol) supplement derived from UV irradiation of 7-dehydrocholesterol from Lanolin (a yellow waxy substance created by sebaceous glands of wool bearing animals like sheep). These days, plant based D3 is also produced by some companies through UV irradiation of Lichens and this tends to be little expensive compared to D3 derived from Lanolin.

Cod Liver oil (oil extracted from liver of fish called cod) is also good source of Vitamin D. 1 tablespoon delivers 1,400 iu Vitamin D; however, it’s very difficult to drink due to its taste. Also, it has high Vitamin A, deficiency of it seldom occurs and if taken in excess, it harms the liver. This is why it is not recommended.

However, do not worry about the toxicity of Vitamin D with the mentioned dosage as toxicity happens only when people take 50,000 iu/day for a very long period of time (months).

POINTERS FOR VITAMIN D SUPPLEMENT DOSAGE

  1. One must go for Vitamin D test every 6 months to see if he is in healthy range of 40-70 ng/ml.
  2. In case the person is deficient,largedosageis required to bring up the Vitamin D levels in body.
    • A dose of 10,000 iu/day or 60,000 iu/week of D3 needs to be taken for 8 weeks
    • Then 5,000 iu/day or 60,000 iu every fortnight for additional 8 weeks.
  3. Post this, Vitamin D test should be done again and if levels are normal, person needs to be on Vitamin D3 recommended daily dose for life.

The above dosage is what most doctors/orthopedics suggest; however, there are many things to be considered while treating a deficiency or consuming Vitamin D supplements.

What to consider while on Vitamin D Supplements:

  1. Meet a good doctor to decide the course you need to follow.
  2. The supplementation needs to be controlled/stopped in case of certain conditions/disorders/medications: pregnancy, hyper-parathyroidism, lymphoma, sarcoidosis, kidney disease, etc.

Most of my clients who complained of widespread body aches, joint pains, fatigue and depression in spite of being put on scientific diet and exercise, were found to be vitamin D deficient. Once their Vitamin D level came to optimum level through correct supplementation, they found renewed energy and stamina in them.

I am sure it did not just impact their energy and feelings. The right amount of Vitamin D in their system was giving them strong bones, fighting cancer causing agents and deadly infections, regulating heart function, blood pressure, insulin secretion by pancreatic beta cells (and lot many things as scientists try to unravel the mysteries about how body uses this most important vitamin).

Please make sure you are not deficient in it. Deficiencies create Defeat in life and sufficiency creates Success. May God grant you abundant success in all areas of life.

This has been an exceptionally long post. I thank you for reading it. May you gain from this read.

Health, strength and shape to you. Amen!

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