Are You Getting Enough Vitamin D (especially in the time of COVID)
Vitamin D is having a moment, and rightfully so IMO! Even more so now that we are sitting inside all day due to the downstream effects of COVID. I honestly never gave Vitamin D much thought (my mistake!) and just associated it with those round, green pills that older people take weekly to prevent osteoporosis.
A few months ago I had my annual exam with my primary care physician. And at the end of the exam, he asked me if I had “anything else”?
Me: Well, I'm tired all the time but I'm sure that's just the life of working full-time and having three small children.
Doctor: Hmmmm…. let's run some tests. We’ll check your Vitamin D, thyroid, B vitamins, etc…
Me: Vitamin D? I live in Florida!
Doctor: You’d be surprised at how many people are low, even here since we are inside most of the day.
Two weeks later I got a call from the nurse, and you guessed it, my Vitamin D levels WERE low. I was advised to start taking a daily supplement right away.
And you know what? Within a week, I felt sooooooo much better. I am not saying it was a cure all, but that fatigue that I was not able to shake? Gone. I had more energy, more focus and my mood was better.
Vitamin D is a fat-soluble vitamin but it actually does much more than you think. D3 gets converted to the steroid hormone calcitriol in our bodies. When Vitamin D is in this active state, it has a host of functions - it has been shown to affect the expression of almost 1,000 different genes! Some of it’s contributions include muscle and bone growth, an anti inflammatory, promoter of gut health and neuromuscular health and serotonin regulation (mood, anxiety, sleep). . And because Vitamin D is also associated with serotonin regulation, we attribute it to mood, anxiety and sleep health as well.
Are you getting enough?
Actually, probably not. In the United States, approximately 70% of people have a Vitamin D level of 30ng/ml or less which is categorized as inadequate or deficient.
Since our primary source is the UVB radiation from the sun, the use of sunscreen and spending more time indoors is a huge contributor to deficiency. We also make less D3 as we age.
It is possible to get too much Vitamin D, but not common. This usually happens at doses higher than 10,000 IU. Toxic doses can result in hypercalcemia and this is usually at doses higher than 50,000 IU.
What do you do if you think you have low Vitamin D levels?
The best way to do something is get a blood level.
If a patient came up to me in the pharmacy:
I would recommend that they talk to their doctor first and get their Vitamin D levels checked
Steroids and some cholesterol lowering medications lower the absorption
I would recommend the normal OTC dose of 2000IU a day (if your doctor said to start)
I would counsel on other sources of Vitamin D such as salmon, cheese, egg yolks and fortified milk and cereal. As a whole, though, we do not get a lot from our diet.
A meta-analyses of studies done ranging from 1966-2013 have shown that people with serum levels between 40-60 ng/ml have the lowest all-cause mortality, meaning they die less of all non-accidental diseases. In my opinion, this is a good reason to look into your Vitamin D intake!