Got Vitamin D? by Elizabeth Allen, ND Allen is a naturopathic practitioner located in Bismarck, North Dakota. Allen received her Doctor of Naturopathic Medicine degree from Bastyr University, Kenmore, WA, a nationally accredited naturopathic medical school. It seems nearly every month a new study is published on the health benefits of Vitamin D. Vitamin D is actually more similar to a hormone, rather than a vitamin. Vitamins are essential nutrients that cannot be made by the body. Our body can convert cholesterol into Vitamin D through sun exposure, and its chemical make up is similar to steroid hormones. Because the majority of Vitamin D comes from sun not food, people living in northern climates are often deficient in Vitamin D, especially in places with cold weather or cloudy skies. Until recently, it has been commonly thought that we receive enough Vitamin D from 15 minutes of daily sun exposure. But even in southern climates deficiency can occur due to sunscreen use. An SPF 8 sunscreen reduces Vitamin D production by 95%. In fact, the Recommended Daily Allowance (RDA) for Vitamin D is currently in the process of revision. The RDA of 400 IU was developed in 1941 based on the amount of cod liver oil necessary to cure Rickets in infants. To put the RDA in perspective, 2 hours of summer sun bathing results in 10,000 IU or more. The revised RDA is anticipated to be at least 1000 IU. Why is this important? It has long been known that certain health conditions increase the farther north one lives (e.g. multiple sclerosis). In recent years, researchers have begun looking at the link between Vitamin D and a variety of chronic and terminal health conditions. While Vitamin D deficiency is associated with immediate problems like Rickets, long term insufficiency appears to increase the risk for: Cancer, especially breast, colon and prostate Colds and flu, especially for people with respiratory conditions like asthma Depression, especially Seasonal Affective Disorder (SAD) Diabetes (I & II) Hypertension/heart attacks Lupus Multiple sclerosis Muscle pain and fatigue Osteoporosis/Osteoarthritis The greatest risk for Vitamin D deficiency occurs in: the elderly, dark pigmented skin, continual covering of exposed skin, poor fat absorption (e.g. Crohn’s Disease), kidney failure, seizure disorders and some medications (e.g. ACE inhibitors, Dilantin). Before running out and stocking up on Vitamin D, it’s best to have your blood level tested. The body has several activated forms of Vitamin D, but 25-hydroxy vitamin D (25-OH D) is the one that should be tested. An adult is considered deficient if the result is less than 25-30 ng/ml depending on the lab test. But health research seems to indicate that values up to 80 ng/ml are necessary to prevent chronic illness. Excess calcium in the blood can begin to occur at levels above 88 ng/ml. Retesting should be done 2-3 months after beginning supplements. When buying a supplement look for “cholecalciferol” or Vitamin D3 on the label. Be sure to read labels carefully since supplements and enriched foods often use Vitamin D2, ergocalciferol, which is less potent. Vitamin D3 is available in powdered, liquid and capsule form but avoid caplets and tablets since they can be hard to digest. Prescription Vitamin D3 dosed up to 50,000 IU is available. But I would recommend prescriptions only as a last resort; for example, if no change has occurred upon retesting after a daily 2000-5000 IU dose for 2 months. The toxic dose of supplemental Vitamin D varies with the form of Vitamin D. Although 2000 IU per day is considered the safe upper limit, studies have shown no side effects up to 10,000 IU. Most published toxicity reports were using at least 40,000 IU. Dizziness and heart arrhythmia are symptoms of toxicity. Cod liver oil is a good source of Vitamin D and Omega 3 essential fatty acids (EFA). The combination of EFA’s and Vitamin D is great for many of the health problems listed above. But, it should not be combined with other Vitamin A containing supplements since Cod liver oil is also rich in Vitamin A, which can be toxic in high doses. Vitamin D is naturally found in fatty fish, such as salmon and tuna. Infants and toddlers should not be given Vitamin D supplements unless prescribed by a doctor. Patients with elevated serum calcium, kidney disease or taking digoxin or verapamil should not take Vitamin D supplements unless monitored by a doctor. Accredited holistic practitioners include: acupuncturists, chiropractors, integrative medical doctors, naturopathic practitioners, osteopathic doctors.