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Vitamin D, to supplement or not?

photo courtesy of Michele Blackwell via Unsplash

It has been well established that vitamin D is important for our immune systems, and many of you may have even heard about vitamin D in recent discussions regarding COVID19 (for an easy to read summary, check out this WebMD article; but what you may not know is how important vitamin D is for other conditions as well. 

Low vitamin D status has been implicated as a contributing factor for many chronic conditions, including autoimmune diseases (e.g. Hashimoto’s, Multiple Sclerosis), as well as cardiovascular disease, osteoporosis, and some forms of cancer.  Additionally, low vitamin D status can be a therapeutic target for mental health disorders, most notably, Major depressive disorder with seasonal fluctuations, or Seasonal Affective Disorder, as it is commonly known. We want to help you navigate your questions surround vitamin D, so here are some helpful tips: 

How do you know if you should be taking supplemental vitamin D?  

Well, the first thing you can do is contact Dr. Abigail or your PCP to do a blood test. There is also very good evidence to show that most individuals living at higher latitudes experience vitamin D deficiency, so if you have symptoms of deficiency and live in an area with less sunlight, then you may be able to do a trial of vitamin D supplementation and see how you feel. 

How much is enough?

How much is enough? Conventional, bone-centric guidelines suggest a target of 30ng/mL, however, many functional medicine and naturopathic doctors suggest a value of 50ng/mL as a good target level. 

How much is too much? 

It is pretty hard to reach the upper limits of vitamin D, which are typically listed as >100ng/mL, however, it is important to work with your healthcare team to make sure your vitamin D intake is adequate and safe.  This may involve looking at other blood parameters, such as calcium and phosphorus levels and determining the best option for you. 

I spend time in the sun, that should be enough, right? 

photo courtesy of Vitolda Klein, via Unsplash

While it is true that vitamin D can be made in the skin as a result of adequate sun exposure, those of us living at higher latitudes, will have less opportunity to be in the sun as the winter approaches, and most of us are (or should be) vigilant about our sunscreen application (take a look at some of the reasons why in our article on Sunscreens), which may block some of that sun!  Best to test where you are at with your current practices and decide if additional vitamin D is indicated.  

Can you get it from your diet? 

Well, that depends.  First of all, for the vast majority of individuals, their diet does not provide enough vitamin D on a daily basis. Additionally, some individuals are dealing with intestinal malabsorption, so dietary sources may not be efficiently assimilated. For a comprehensive overview of vitamin D and a list of dietary sources (scroll down to the bottom of the article), check out the Linus Pauling Institute Micronutrient Information Center

If I am not getting enough in my diet, what kind of supplements should I be taking? 

This can be a straightforward or complicated question, based on the individual.  Here are a few things to consider: 

  1. Dosing: some over the counter vitamin D supplements do not provide enough of the nutrient to change your blood levels, which might not impact your symptoms or disease status. 

  2. Form: vitamin D is a fat-soluble vitamin, so you will want to make sure you are taking it with food or in a liquid/gelcap form for best absorbability. Additionally, there are other vitamins/nutrients that can help with absorption, such as vitamin K. You should, however, always talk to your provider before initiating vitamin D with K, especially if you are actively taking blood thinners. 

  3. Quality: over the counter supplements can be sufficient for many things, but since vitamin D is considered a hormone, we always recommend investing in the best quality options you can afford. For a good option on a professional brand, you can go to the Freshwater Virtual Apothecary through FullScript. 

  4. Genetics: some individuals will have a more difficult time utilizing supplemental vitamin D based on his/her/their genetic profiles, particularly any abnormalities for the vitamin D receptors on the target cells.  If you have had difficulty resolving a vitamin D deficiency with supplementation, please consult Dr. Abigail to help assess whether you may have a genetic obstacle contributing to your health concerns. 

Still have questions?  Schedule a visit with Dr. Abigail online, or you can call/text 231-492-0046, to find out if vitamin D supplementation is right for you!

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