It’s a question of hard science and hard marketing. The science of Vitamin D was truly “lost” for a long time. Vitamin D is actually a steroid hormone and as such is involved in so many critical issues of human health including: cancer, heart disease, diabetes, high blood pressure, chronic fatigue, fibromyalgia, osteoporosis, auto immune diseases like lupus, M.S., depression and thyroid illness to name a few!
The role of Vitamin D in these illnesses has become apparent as the levels of Vitamin D that seem to improve and in some cases “cure those maladies” is found to be way higher than most people currently have in their blood stream.
To many times it appears as if we are in the midst of a “Low Vitamin D” epidemic.
As far as the marketing goes, the internet rules these days and careers are made and broken on whether or not people are looking at you and Vitamin D is certainly “the hot topic”. Someone will no doubt become famous or more famous using it as a stepping stone into the public consciousness.
The reason that we are such low levels of vitamin D is a combination of medical ignorance, lifestyle and environment. The levels of Vitamin D needed to improve disease is far above the levels needed to prevent Ricketts (which is where the “normal” levels come from) so for a long time lots of doctors told lots of people they had “normal” Vitamin D levels even though they were well below the levels we now recommend to give us the best chance at health. Such teachings were not only impractical but wrong.
The amount of sunlight needed to generate enough Vitamin D to give you the kind of higher levels we are talking about these days is several hours a day and unless you belong to a nudist colony you are not getting that much from the sun. In addition that level of UV radiation poses a serious risk of skin cancer to at least some of us!
To determine you level of vitamin D, ask your doctor for “25 hydroxy Vitamin D level, that diagnoses a D deficiency in blood. If the answer comes back 1-25 level and there is no mention of the 25 level, your doctor needs to go back to the books.
The classic 1-25 hydroxy Vitamin D level that was taught in medical school for so long is a poor test because it represents a short lived type of Vitamin D and not the “total Vitamin D” in the body. Also the parathyroid gland tries to make up for low D levels by increasing the conversion of 25 to 1-25 Vitamin D, which leads to a “false normal” 1-25 level. This level is going up but the real usable source of Vitamin D in your body is dropping.
If I supplement with Vitamin D, how much should I take? That varies but most docs recommend between 2,000 and 5,000 IU on a pretty much daily basis. No matter what, you should have your 25-hydroxy Vitamin D levels checked along with your calcium if you are supplementing because Vitamin D is toxic if you get too much.
Personally, in all my years of practice, I have not seen a single case of Vitamin D toxicity even in people on big doses.
What about foods and vitamins that contain Vitamin D? Most foods have D levels in the low 100’s, even foods that are supposedly rich in D. Example: Salmon has 350 IU fortified mil 100 IU and most people need thousands of units even if they get some sun.
Are there “special risk” populations that should really have their D levels checked and monitored? As an anti-aging doc I think everyone should. But there are some medications that can lower D levels and anyone with a history of prostate, breast, or colon cancer, diabetes, heart disease or high blood pressure (to name the most common illnesses in our society) should be checked. Also since the conversion of Vitamin D goes down with age, older people need to be checked and because vitamin D comes from cholesterol, anyone who has aggressive lipid lowering therapy with a statin drug should be followed.
Finally, anyone who has had gastric bypass is at risk for low D levels.
*None of my lists are meant to be exhaustive, they are meant to show you how central to your health Vitamin D is.
That’s it for now and I hope you will help enlighten your friendly neighborhood medical professional on this topic!
About Dr. Dave’s Best
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