Top 5 signs you
may have a vitamin D deficiency that you will notice as an individual
include onoing musculoskeletal pain, frequent or intense colds and flus,
neurological symptoms such as depression, impaired cognition and
headaches, unrelenting fatigue and head sweating
As a society,
three key things that indicate a vitamin D deficiency are increasing or
stable rates of the incidence of breast cancer, the increase in the
number of pre-term births and, now, an increase in the incidence of type
1 diabetes
An estimated 40
percent of Americans are profoundly vitamin D deficient, defined as
having a serum level below 20 ng/mL (50 nmol/L); 75 percent of American
adults and teens are deficient when a sufficiency level of 30 ng/mL is
used. If the sufficiency cutoff is moved to a healthy 40 to 60 ng/mL
(100 to 150 nmol/L), as recommended by the GrassrootsHealth panel of 48
vitamin D researchers, deficiency rates in the U.S. would likely be in
the high 90 percent bracket
20 ng/mL is
grossly insufficient for good health and disease prevention. According
to the most recent research, a vitamin D level between 60 and 80 ng/mL
(150 to 200 nmol/L) appears to offer the greatest protection against
cancer and other chronic diseases
Pregnant women
need a minimum vitamin D level of 40 ng/mL (100 nmol/L) to help prevent
premature birth and other pregnancy complications
Optimizing your
vitamin D levels may help you prevent cancer, heart disease, autoimmune
diseases, infections, neurodegenerative diseases and much more.
Optimizing it is extremely simple and can be measured for success using
an in-home test and some form of intake
Last year’s 30-day new year’s resolution
guide was a big hit. This year, for the month of January, we will
revisit this tip-a-day format by looking back at 30 of the most-read
Mercola.com articles of all time, reviewing the topics readers have
found most valuable over the years.
First on the list, and the topic of this article, is vitamin D
deficiency. What are the risks? How can you determine if you’re
deficient? And what are the benefits of raising your vitamin D level? Vitamin D deficiency
is incredibly common around the world, but many mistakenly believe they
aren't at risk because they consume vitamin D-fortified foods, such as
milk. Few foods have therapeutic levels of vitamin D naturally, and even
fortified foods do not contain enough vitamin D to support your health
needs.
Despite its name, vitamin D is actually a steroid hormone that you
obtain primarily through sun exposure, not via your diet. Since most
dermatologists and other doctors recommend avoiding the sun and using
sunscreen before venturing outdoors, vitamin D deficiency has reached
truly epidemic proportions around the world.
Unfortunately, while the justification for sun avoidance is that it may reduce your risk of skin cancer,
by avoiding sun exposure you risk vitamin D deficiency, which in turn
raises your risk for many cancers — not only internal ones but also skin
cancer, as well as a whole host of chronic diseases.
Considering the importance of vitamin D for disease prevention,
strict sun avoidance is likely doing far more harm than good. The major
problem with sun exposure is burning, not overall exposure. And, the
easily treatable forms of skin cancer — squamous and basal cell
carcinomas — are the ones most likely to form.
Definition of Vitamin D Deficiency
According to research1
published in June, 2018, an estimated 40 percent of Americans are
profoundly vitamin D deficient, defined as having a serum (blood) level
of vitamin D below 20 ng/mL (50 nmol/L). Sufficiency is defined as
having a level of 20 ng/mL or higher.
Calling someone with a vitamin D level of less than 20 ng/ml vitamin D
deficient is like calling someone over 400 pounds simply overweight; in
both cases a grossly serious understatement.
Seventy-five percent of American adults and teens are deficient in vitamin D when a sufficiency level of 30 ng/mL is used.2
If the sufficiency cutoff were to be moved to 40 to 60 ng/mL,
sufficiency rates in the U.S. would likely be in the high 90 percent
bracket.
It’s important to realize that 20 ng/mL has repeatedly been shown to
be grossly insufficient for good health and disease prevention and,
really, anything below 40 ng/mL (100 nmol/L) should be suspect. For
example, research has shown that once you reach a minimum serum vitamin D
level of 40 ng/mL, your risk for cancer diminishes by 67 percent,
compared to having a level of 20 ng/mL or less.3
Most cancers occur in people with a vitamin D blood level between 10
and 40 ng/mL (25 to 100 nmol/L), and the optimal level for cancer
protection now appears to be between 60 and 80 ng/mL (150 to 200
nmol/L).
Several studies also show that these higher vitamin D levels are protective against breast cancer specifically. Importantly, a 2005 study4
showed women with vitamin D levels above 60 ng/mL have an 83 percent
lower risk of breast cancer than those below 20 ng/mL! I cannot think of
any other strategy that can offer that kind of risk reduction.
More recently, a pooled analysis5
published in June 2018 of two randomized trials and a prospective
cohort study came to a near-identical conclusion. The objective was to
assess whether there are any benefits to having a vitamin D level above
40 ng/mL, as most studies do not venture into these higher levels.
Indeed, mirroring the 2005 findings, women with vitamin D levels at
or above 60 ng/mL had an 82 percent lower incidence rate of breast
cancer than those with levels of 20 ng/mL or less. Published research by
GrassrootsHealth reveal as much as 80 percent of all breast cancer
incidence could be prevented simply by optimizing vitamin D and nothing
else.
Top 5 Signs of Vitamin D Deficiency
The only way to definitively identify vitamin D deficiency is via
blood testing. However, there are some general signs and symptoms to be
aware of as well. If any of the following apply to you, you should get
your vitamin D levels tested sooner rather than later, and take
proactive steps to boost your level into the 60 to 80 ng/mL range:
1. Ongoing musculoskeletal pain and achy bones
— According to vitamin D researcher Dr. Michael Holick, many who see
their doctor for aches and pains, especially in combination with
fatigue, end up being misdiagnosed as having fibromyalgia or chronic fatigue syndrome.
"Many of these symptoms are classic signs of vitamin D deficiency osteomalacia,6 which is different from the vitamin D deficiency that causes osteoporosis in adults," Holick says.
"What's happening is that the vitamin D deficiency causes a defect in
putting calcium into the collagen matrix into your skeleton. As a
result, you have throbbing, aching bone pain."7
2. Frequent illness/infections
— Vitamin D regulates the expression of genes that influence your
immune system to attack and destroy bacteria and viruses, so frequent
illness and infections of all kinds, including colds and flu, is a
tipoff that your immune function is subpar, which likely means you’re
low on vitamin D. 3. Neurological symptoms
— This includes depression, “feeling blue, cognitive impairment,
headaches and migraines. In 2006, scientists evaluated the effects of
vitamin D on the mental health of 80 elderly patients and found those
with the lowest levels of vitamin D were 11 times more prone to be
depressed than those who received healthy doses.8
The same study also found low vitamin D was linked to poor cognitive performance. Several other studies9
have also linked vitamin D deficiency with poor mental function,
confusion, forgetfulness and difficulty concentrating. Headaches and
migraines are also associated with low vitamin D.10,11 4. Fatigue and daytime sleepiness — Studies have linked low vitamin D to persistent fatigue.12,13 In one case, a woman struggling with chronic fatigue, daytime sleepiness (hypersomnia), low back pain and daily headaches was found to have a vitamin D level below 6 ng/mL.
Her symptoms resolved once she raised it to 39 ng/mL.14 Another study15 found women with vitamin D levels below 29 ng/mL were more likely to complain of fatigue than those with levels above 30 ng/mL. 5. Head sweating —
According to Holick, a classic sign of vitamin D deficiency is a sweaty
head. In fact, physicians used to ask new mothers about head sweating in
their newborns for this very reason. Excessive sweating in newborns due
to neuromuscular irritability is still described as a common, early
symptom of vitamin D deficiency.16
Top 5 Risk Factors for Vitamin D Deficiency
Several factors will influence your risk for vitamin D deficiency, including the following:
Rarely spending time outdoors and/or always wearing sunscreen
— Researchers have noted that vitamin D deficiency is prevalent in
adults of all ages who always wear sun protection (which blocks vitamin D
production) or limit their outdoor activities.17 The ideal time for sun exposure is between 10 a.m. and 2 p.m., when the UVB rays are present.
Darker skin — Your skin pigment acts as a natural
sunscreen, so the more pigment you have, the more time you'll need to
spend in the sun to make adequate amounts of vitamin D. If you have dark
skin, you may need as much as 10 times more sun exposure to produce the
same amount of vitamin D as a person with pale skin.
Being 50 or older — As you get older, your skin
doesn't make as much vitamin D in response to sun exposure. At the same
time, your kidneys become less efficient at converting vitamin D into
its active form. Older adults also tend to spend more time indoors (i.e.
getting even less sun exposure and therefore vitamin D).
Obesity
— Because vitamin D is fat-soluble, body fat acts as a "sink" by
collecting it. If you're overweight or obese, you're therefore likely
going to need more vitamin D than a slimmer person. In one recent study,18 vitamin D deficiency was three times more prevalent in obese individuals.
Gastrointestinal problems — Vitamin D is
fat-soluble, which means if you have a gastrointestinal condition that
affects your ability to absorb fat, you may have lower absorption of
fat-soluble vitamins like vitamin D as well. This includes gut
conditions like Crohn's, celiac and nonceliac gluten sensitivity and
inflammatory bowel disease.
Health Benefits of Vitamin D Optimization
Optimizing your vitamin D levels has been shown to have a powerful
effect on health, helping protect against a wide variety of diseases.
Among them:
Dry eye syndromes.19,20
Macular degeneration,21,22 which is the No. 1 cause of blindness in the elderly.
Autoimmune diseases — Vitamin D is a
potent immune modulator, making it very important for the prevention of
autoimmune diseases such as multiple sclerosis, inflammatory bowel
disease and psoriasis, just to name a few.
Gastrointestinal diseases.23
Infectious diseases, including influenza and HIV.24,25
Cardiovascular disease — Vitamin D
is very important for reducing hypertension, atherosclerotic heart
disease, heart attack and stroke, as it plays a vital role in protecting
and repairing damage to your endothelium.27
It also helps trigger production of nitric oxide — which improves
blood flow and prevents blood clot formation — and significantly reduces
oxidative stress in your vascular system, all of which are important to
help prevent the development and/or progression of cardiovascular
disease.
According to Holick,28
vitamin D deficiency increases your risk of heart attack by 50 percent,
and if you have a heart attack and you're vitamin D deficient, your
risk of dying from that heart attack is virtually guaranteed.
Indeed, a Norwegian study29
published in The Journal of Clinical Endocrinology and Metabolism found
“a normal intake of vitamin D” significantly reduces your risk of death
if you have cardiovascular disease.30
Neurological diseases such as Alzheimer’s disease31,32 and epilepsy — In one study,33
epileptics given a one-time megadose of vitamin D3, ranging from 40,000
IUs all the way up to 200,000 IUs, followed by a daily dose of 2,000 to
2,600 IUs a day for three months to bring each individual’s vitamin D
status to at least 30 ng/mL, resulted in significant improvements.
Ten out of 13 had a decrease in the number of seizures, five of which
experienced more than a 50 percent reduction. Overall, the group had a
40 percent reduction in the number of seizures.
Lupus — According to researchers in Cairo,34
most patients with systemic lupus erythematosus have some level of
vitamin D deficiency, defined as a level of 10 ng/mL or less, or
insufficiency, a level between 10 and 30 ng/mL.
Obstructive sleep apnea — In one
study, 98 percent of patients with sleep apnea had vitamin D deficiency,
and the more severe the sleep apnea, the more severe the deficiency.35
Bone health, falls and fractures — A 2006 review36
looking at vitamin D intakes and health outcomes such as bone mineral
density, dental health, risk of falls, fractures and colorectal cancer,
found “the most advantageous serum concentrations of 25(OH)D begin at 30
ng/mL, and the best are between 36 to 40 ng/mL.”
Obesity and diabetes — Research37
has shown vitamin D supplementation (4,000 IUs/day) combined with
resistance training helps decrease your waist-to-hip ratio, a
measurement that is far better at determining your risk for Type 2
diabetes and heart disease than body mass index.
Type 1 diabetes — Data from GrassrootsHealth’s D*Action project to prevent Type 1 diabetes38
suggests maintaining a vitamin D level between 40 and 60 ng/mL (100 to
150 nmol/L) may prevent Type 1 diabetes, and stop the progression of the
disease, which is a growing problem.
Neurodegenerative diseases, including Alzheimer’s, Parkinson’s and multiple sclerosis (MS)39,40,41 — Research shows MS patients with higher levels of vitamin D tend to experience less disabling symptoms.42 Vitamin D deficiency is also common among patients with Parkinson’s43 and seniors with severe vitamin D deficiency may raise their risk for dementia by 125 percent.44
DNA repair and metabolic processes — One of Holick's studies45
showed healthy volunteers taking 2,000 IUs of vitamin D per day for a
few months up-regulated 291 different genes that control up to 80
different metabolic processes, including DNA repair and autoxidation
(oxidation that occurs in the presence of oxygen and/or UV radiation,
which has implications for aging and cancer).
Preterm birth — A level of 40 ng/mL has also been shown to offer powerful protection against preterm birth if you’re pregnant.46
Women with a vitamin D level of at least 40 ng/mL may lower their risk
of preterm birth by as much as 62 percent, compared to having a level of
just 20 ng/mL. Women with a history of preterm birth gain even greater
protection — an 80 percent reduction — when raising their vitamin D
level above 40 ng/mL.
Pregnancy complications — Having a
vitamin D level above 40 ng/mL also protects the mother by reducing her
risk of preeclampsia, gestational diabetes and prenatal infections by
approximately 50 percent.47
All-cause mortality — Studies have also linked higher vitamin D levels with lowered mortality from all causes.48,49,50
Check Your Vitamin D Level Twice a Year
Regular, sensible sun exposure is the best way to optimize your
vitamin D status, but many will need to take an oral vitamin D3
supplement, especially during winter months.
The only way to gauge whether you might need to supplement, and how
much, is to get your level tested, ideally twice a year, in the early
spring, after the winter, and early fall when you level is at its peak
and low point. This is particularly important if you’re pregnant or
planning a pregnancy, or if you have cancer.
Again, the level you’re aiming for is between 60 and 80 ng/mL, with
40 ng/mL being the low cutoff point for sufficiency to prevent a wide
range of diseases, including cancer.
GrassrootsHealth makes testing easy by offering an inexpensive vitamin D testing kit
as part of its consumer-sponsored research. By signing up, you are
helping further vital health research that can help millions in coming
years. (All revenues from these kits go directly to GrassrootsHealth. I
make no profit from these kits and only provide them as a service of
convenience to my readers.)
All women are also encouraged to enroll in the Breast Cancer Prevention project,51
to track your vitamin D level and help prevent an initial cancer
occurrence, or, if you’ve already had it, to help prevent a recurrence.
In addition, anyone affected by Type 1 Diabetes is invited to enroll in the Type 1 Diabetes Prevention Project.
Required Dosage Is Highly Individual
Research52
suggests it would require 9,600 IUs of vitamin D per day to get 97
percent of the population to reach 40 ng/mL, but individual requirements
can vary widely, and you need to take whatever dosage required to get
you into the optimal range.
As noted by Carole Baggerly, director and founder of GrassrootsHealth,
a nonprofit public health research organization dedicated to moving
public health messages regarding vitamin D from research into practice:53
“Our first paper, published in 2011, showed the dose response
relationship. You can easily see that two people taking the same dose
(e.g., 4,000 IU/day) could have very different results. That’s why
testing … is so important.”
If you’ve been taking a certain amount of vitamin D3 for a number of
months and retesting reveals you’re still not within the recommended
range, then you know you need to increase your dosage.
Over time, with continued testing, you’ll find your individual sweet
spot and have a good idea of how much you need to take to maintain an
ideal level year-round. GrassrootsHealth also has an online vitamin D calculator you can use to estimate your vitamin D3 dosage once you know your current serum level.
Additional Guidelines When Using Oral Vitamin D3
Aside from determining your ideal dose of vitamin D3, you also need
to make sure you’re getting enough vitamin K2 (to avoid complications
associated with excessive calcification in your arteries), calcium and magnesium.
Research54,55
has shown that if you’re taking high doses of vitamin D while having an
insufficient magnesium level, your body cannot properly utilize the
vitamin D you’re taking. The reason for this is because magnesium is
required for the actual activation of vitamin D. If your magnesium level is too low, the vitamin D may simply get stored in its inactive form.
This may actually help explain why many need rather high doses of
vitamin D to optimize their levels. According to this scientific review,
as many as 50 percent of Americans taking vitamin D supplements may not
get significant benefit due to insufficient magnesium levels.
On the other hand, when you have an optimal magnesium level, your
vitamin D level will rise even if you’re taking a much lower dose.56 In fact, previous research57 has indicated that higher magnesium intake helps reduce your risk of vitamin D deficiency — likely by activating more of it.
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