As incredibly resilient as Portland residents are during the rainy winter months, we still need to find ways to satisfy our craving for sunshine. Until recent studies actually explained how much our bodies need sunlight for our own natural vitamin D production—which helps regulate our mood and several aspects of our immune system—some of us regarded such cravings as purely psychological.
The summer sunshine of the Pacific Northwest is definitely worth waiting for, but in the meantime, the healthiest way to give yourself a sunshine boost is to make specific types of fish and/or vitamin D3 supplements part of your daily diet.
Vitamin D plays such a large role in your overall health because it has a combination of properties. For instance, it's an essential nutrient that's known as a vitamin, but in dietary form, it's a building block for a hormone your body needs. Vitamin D and other hormones, nutrients, and minerals work together to establish a healthy immune system and hormonal balance.
Researchers have known for years that our bodies need vitamin D to absorb and use calcium and phosphate, thereby making it absolutely vital for the good health of our bones and teeth, but relatively recent research has brought other important functions to the forefront.
For example, evidence now suggests that vitamin D plays a large role in regulating normal cell differentiation and proliferation, a key factor for cancer prevention. Vitamin D also appears to promote blood sugar regulation and sensitivity to insulin, which could potentially make a difference to people struggling to reach a healthy weight and/or control such diseases as diabetes.
Our Daily Diet Intake
Vitamin D is fat-soluble, and this makes a difference in how our bodies absorb it as a supplement. In his book, “Natural Health, Natural Medicine,” Dr. Andrew Weil, founder and program director of the Arizona Center for Integrative Medicine at the University of Arizona, recommends taking vitamin D3 after eating a large meal that includes fat to ensure full absorption. Plus, several medical experts suggest taking a calcium-magnesium supplement at the same time.
If you have digestion irregularities and/or have noticed vitamin absorption problems, consider taking vitamin D3 drops instead of pills. After eating a meal with fat, as Weil suggests, add the appropriate amount of drops to water or juice and use the liquid to take your daily calcium-magnesium supplement, too.
We recommend Carlson's vitamin D3 drops (usually labeled as “Carlson Ddrops”) because the company has a good reputation and makes its product available in different IU (International Units) amounts, including 2,000 IU per drop, which is the minimum amount many adults need during the winter months in the Pacific Northwest.
We also recommend Weil's calcium-magnesium supplements (usually labeled as “Balanced Cal-Mag” from Weil Nutritional Supplements) not only because of their superior quality but also because their calcium-magnesium combination helps ensure that your body has the most appropriate balance of these two minerals. You can buy both products at a discount from online retailers such as Amazon.com.
As many nutritionists will tell you, it's better to first seek vitamins and other nutrients from natural food sources, but in the case of vitamin D3, very few of those food sources exist.
At 1,460 IU per tablespoon, cod liver oil clearly contains the most vitamin D3; however, there also are other fatty fish sources to choose from, including wild salmon, mackerel, sardines, and herring.
You also can find vitamin D in egg yolks, albeit a smaller amount. For maximum nutritional value, we recommend buying eggs from farmers who feed their chickens a diet rich in omega 3 nutrients and raise them in a free-range and antibiotic-free environment.
Although it's true that some products—such as cereals, milk, and juice—are fortified with vitamin D, the amount of vitamin D in a typical serving often isn't enough to compensate for a deficiency because you'd need to eat or drink far too much of it to reach optimal levels. In addition, the type of vitamin D these fortified sources often use is vitamin D2, a much less effective substitute.
Vitamin D2 vs. Vitamin D3
Because vitamin D is fat-soluble, it can accumulate in the body, so that's why experts recommend getting a blood test to check your vitamin D level (such as with the 25-hydroxyvitamin D test) prior to supplementation. Doing so can help your physician determine what supplemental dosage is ideal for you. And in extreme cases of deficiency, your physician may recommend several weekly megadoses to increase your vitamin D level to the optimal range before switching to a lower maintenance dose.
Vitamin D is available in two forms: vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol). If you're taking a supplement, we strongly recommend taking vitamin D3 because vitamin D2 is a synthetic form that our bodies can only marginally absorb. Vitamin D3, on the other hand, comes from sources that produce it in a manner similar to what occurs naturally in our skin, thereby making it the option that our bodies prefer and easily absorb.
Unfortunately, when physicians prescribe vitamin D for their patients, the form that pharmacies dispense is vitamin D2. The reason for this is because when the FDA (Food and Drug Administration) originally approved vitamin D2 back in the 1920s to help people suffering from rickets disease, vitamin D2 seemed to be the best solution at the time. Since then, a mounting body of evidence clearly indicates that vitamin D3 is far superior, but the FDA still hasn't approved vitamin D3 for prescriptions.
However, vitamin D3 it is readily available over the counter as a supplement, so we recommend taking advantage of this option. Meanwhile, the Vitamin D Council and other experts in the field say they will continue to present evidence to the FDA and keep publishing studies and comparisons that prove vitamin D3 is a better choice.
For example, Lisa Houghton and Reinhold Vieth from the University of Toronto's Departments of Nutritional Sciences, Laboratory Medicine, and Pathobiology are two vitamin D experts that published “The Case Against Ergocalciferol (Vitamin D2) As A Vitamin Supplement” in The American Journal of Clinical Nutrition (October 10, 2006).
In their commentary, Houghton and Vieth state, “Here, we present the case that vitamin D2 should no longer be considered equivalent to vitamin D3 and that vitamin D2, or ergocalciferol, should not be regarded as a nutrient suitable for supplementation or fortification.”
While providing relevant background information, Houghton and Vieth state, “Although sunshine exposure and fish consumption provide vitamin D in the form of D3, a different bioactive, plant-derived form of vitamin D, named vitamin D2, was produced in the early 1920s through ultraviolet exposure of foods. This process was patented and licensed to pharmaceutical companies, which led to the development of a medicinal preparation of vitamin D2 called Viosterol.”
The studies and sources that Houghton and Vieth cite indicate that several experts questioned the assumptions agencies made about the equivalency of vitamin D2 to vitamin D3 shortly after vitamin D2 was produced. Studies as far back as 1930 showed that the activity of cod liver oil (vitamin D3) and Viosterol (vitamin D2) had different biologic values and that just one unit of cod liver oil is as effective as four units of Viosterol.
With an effectiveness ratio of four to one and a vitamin D3 source as natural as cod liver oil, it's astonishing that the FDA still hasn't approved vitamin D3 for prescriptions. Thankfully, numerous physicians and vitamin D experts have joined together to try and change such restrictions.
More Evidence From Vitamin D Experts
Dr. David Servan-Schreiber, author of “Anticancer: A New Way Of Life” states in his article “Vitamin D is Essential For the Prevention of Cancer, Heart Disease and Osteoporosis” that: “Scientific studies show that the vitamin D status (i.e., serum 25-hydroxyvitamin D level) of most individuals in North America and Europe needs to be greatly improved for substantial reduction in incidence of and mortality from cancer. In addition to cancer, epidemiological studies have shown that higher vitamin D status is also associated with lower risk of several other chronic diseases, including heart disease, stroke, osteoporosis, multiple sclerosis, and type 1 diabetes in children.”
Servan-Schreiber wrote this article with the support of 40 international scientists and physicians who, collectively, are requesting that organizations throughout the world adopt and publicize new vitamin D recommendations. And they are not alone; for years, dozens of medical experts have been claiming that the typical recommendation of 200 to 600 IU of vitamin D is too low.
In a July 2010 The Globe And Mail article titled, “Scientists Taking Vitamin D In Droves” (by Martin Mittelstaedt), Dr. Robert Heaney, professor at Creighton University Medical Center in Omaha and well-known vitamin D expert, said he personally takes 3,000 IU a day. And while attending a meeting this past year, Heaney asked nine vitamin D experts from the U.S. Centers for Disease Control how much vitamin D they take, and the amounts they reported were from 3,000 to 10,000 IU per day, with the average being 5,000 IU per day.
“I’ve talked casually with virtually everyone [in the vitamin D research community] that I am in contact with and they’re all taking vitamin D, and they’re taking it in doses greater than 1,000 [IU],” Heaney said (according to Mittelstaedt's The Globe And Mail article).
Weil also increased his recommendation—again. In a statement published on his Web site, Weil wrote, “As part of my ongoing commitment to promoting optimal health, I am making a new recommendation concerning vitamin D, raising my recommendation for vitamin D intake from 1,000 IU to 2,000 IU per day. This may sound like quite a jump, but clinical evidence has been accumulating to suggest that the higher dose is more appropriate to help maintain optimum health.”
In addition to the illnesses Servan-Schreiber mentioned, there are other diseases and symptoms currently associated with vitamin D deficiency, such as: musculoskeletal pain, osteoarthritis, muscle weakness, hypertension, depression, chronic fatigue, fibromyalgia, systemic inflammation, insulin resistance, and autoimmune conditions such as lupus and rheumatoid arthritis.
While scientific evidence indicates that these illnesses are likely associated with a vitamin D deficiency, medical experts generally agree that such diseases and symptoms are often the result of multiple factors rather than just one. Even so, evidence from several studies showed that increasing participants' vitamin D intake improved the status and severity of some of the aforementioned illnesses.
Due Diligence
Representatives from the medical community often say that medicine is not an exact science, so even though scientists are able to determine outcomes through experiments in a controlled environment, physicians don't have this luxury. Instead, physicians must make clinical decisions by using a benefit-versus-risk analysis when comparing a patient's history with current scientific knowledge.
Therefore, the more specific and factual information you can provide your doctor about your symptoms, illnesses, medications, supplements, medical history (including your family's medical history), genealogy, and work and home environments, the more accurate she can be when suggesting your next course of action.
Although more research needs to be done to determine how vitamin D deficiencies specifically affect all types of cancers and other chronic diseases, researchers strongly suggest that physicians recommend larger doses of vitamin D3 to their patients that fall into this category.
In addition, don't just get your vitamin D level tested once; test it periodically to make sure your body is properly absorbing sunlight, supplements, and other sources of vitamin D. There are some medications (including antacids) and diseases (such as Crohn's disease) that can affect the efficiency at which your body absorbs vitamin D, so if you run into problems, discuss these possibilities with your doctor.
You also might want to research the manufacturer of your vitamin D supplement to make sure the source of your problem doesn't originate there. And if you find out your supplement is actually vitamin D2 (ergocalciferol or Viosterol), switch to a vitamin D3 supplement (cholecalciferol) from a well-respected manufacturer.
One of the vitamin D misconceptions that the Vitamin D Council and others are trying to clarify is the unfounded claims regarding its toxicity. Because vitamin D is fat-soluble, some scientists and medical experts have been overly cautious in their recommendations to avoid problems that may occur when too much vitamin D accumulates in the body. Although vitamin D experts agree that there are some legitimate concerns regarding hypersensitivity issues that some people have in relation to vitamin D, most of them generally agree that any evidence indicating there is a possibility of vitamin D toxicity is either rare or doesn't exist.
Servan-Schreiber addressed the issue of toxicity in his “Vitamin D is Essential For the Prevention of Cancer, Heart Disease and Osteoporosis” article by stating, “To this day, medical textbooks mention the risk of vitamin D toxicity. Yet, the scientific literature suggests that toxicity occurs only with very large intakes of vitamin D over prolonged periods (more than 10,000 IUs daily for longer than 6 months). Except in people with disorders known as granulomatosis (such as sarcoidosis or tuberculosis), little risk (if any) is associated with vitamin D supplementation of 1000 - 2000 IU per day.”
Our Bodies Need Solar Power
Once again, research continues to prove what our bodies already know: We crave—at least in some form—what we need to survive and live a healthy life, so we all should pay attention to our internal instincts. No matter what you discover as you learn more about your body's needs, your diligence in pursuing a plan of action that is best for you, as well as any time you spend researching and implementing that plan, will ultimately pay big dividends by rewarding you with a healthier and longer life.
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