'Tis the Season For Vitamin D

Updated: Jan 8

Tis' the season my friends... TO SUPPLEMENT WITH VITAMIN D !!!

Many are truly not aware of how impactful this pre-hormone is. Yes, that's right vitamin D acts as a pre-hormone in the body that regulates cells, tissues, organs and systems! It is a key player in maintaining a healthy immune system, blood sugar metabolism, bone tissue remodeling, as well as preventing depression, age related macular degeneration, autism, and even in improving athletic performance!

“There's just clear evidence, especially in the German literature, of quicker reaction time, balance, muscle strength, endurance – all improve with vitamin D and this may explain why senior citizens on vitamin D are less likely to fall and hurt themselves” according to John Cannell, MD[1].

Considering as many as 25 million adults in the United States, the majority women, are at risk of developing osteopenia and full-blown osteoporosis, it is imperative that we include vitamin D monitoring as a general screening tool, and part of regular exams and check-ups.

To better understand how vitamin D levels are involved in maintaining bone health let’s take a closer look at the body’s mechanisms to maintain a balance of key minerals, such as calcium, phosphorous, and to a lesser extent magnesium.

A mineral stored in bone tissue but utilized in the body to maintain heart function as well as muscle contraction, regulation of brain chemistry and much more, Calcium is regulated by a checks and balance system involving the parathyroid glands and the kidneys. As blood levels of vitamin D fall, the first response is for parathyroid hormone to be released signaling the kidneys to conserve calcium, while simultaneously increasing the release of phosphate.

We see evidence of this mechanism in action on a basic blood panel when levels of alkaline phosphatase rise in response to parathyroid hormone (PTH) signaling. When a combination of normal serum calcium, but low phosphate along with high alkaline phosphatase is seen it can be a red flag that vitamin D metabolism is out of whack. Test results like this would give reason to investigate, not only a basic vitamin D level (25-OHD), but also evaluate calcitriol levels (1,25-OHD), the active form of vitamin D as well. Ideally, we want to see a 1:1 ratio between vitamin D and calcitriol. Evaluating calcitriol levels is especially needed in those with renal disease or evaluating treatment protocols relating to diminishing bone mineral density, or osteopenia.

Winter is when vitamin D levels tend to fall below optimal ranges due to the lack of sunshine in our lives and the inadequate sources in our diets.

Ashley Jordan Feirira, PhD, RDN explains, "even though some food sources do exist, the amounts of these foods or beverages that an adult would need to consume daily in order to achieve healthy vitamin D levels (> 30 ng/mL) is quite unrealistic and even comical to consider. For example, you would need to toss back 20 glasses of milk daily or 50 eggs/day to achieve 2,000 IU of vitamin D! In contrast, daily vitamin D supplementation provides an easy and economical solution to consistently achieve 2,000 IU and any other specifically targeted levels."[2] In addition to diminished dietary sources, others factors such as genetics, and inflammatory gastrointestinal disorders, such as Chron’s, or celiac disease, significantly influence absorption as well as one's ability to convert vitamin D to its active form.

Supplementing is inexpensive and can have a profound effect on the prevention of diseases across all ages and when considering prenatal nutritional needs. But how much is too much? That is where monitoring blood levels comes in. If you haven't had your vitamin D level checked now is a good time!

For about the same price (around $50) you can order the test yourself through Life Extension or for those who might be needle phobic Great Plains Laboratory has developed what's called a "blood spot test kit" that requires only a drop of blood from a finger prick. This can be ordered directly or through ReCode Nutrition. An optimal Vitamin D level is between 50 – 70 ng/ml. While your practitioner may not call your attention to vitamin D unless you fall below 30 ng/ml, directing some attention to increasing vitamin D in the diet or considering supplementation at least through the dark winter months could be beneficial. I tend to recommend supplementing vitamin D in a form similar to how it is found in food: along with the other fat-soluble vitamins (A, E, and K) and healthy fats like omega-3’s. There are two products I tend to recommend most, Vitamin D Complex by Designs for Health and ProOmega 2000-D by Nordic Naturals. For those who need added vitamin D support or do not respond to initial attempts to raise vitamin D levels, Bio-D-Mulsion Forte by Biotics Research is proving to be effective in raising vitamin D levels among those who seem to be genetically predisposed to maintaining lower levels.

You can find these and other practitioner grade supplements here.

I am particularly a huge fan of supplementing ProOmega 2000-D in teens and young adults, as more than any other age group, their risks associated with traumatic brain injury and sports related concussions, not to mention the high rate of depression are higher than others. Ensuring adequate omega-3 oils such as EPA and DHA protect the brain, should they experience traumatic head injury, and cell membranes which helps to prevent depression.

[1] Richer SP, Pizzimenti JJ. The importance of vitamin D in systemic and ocular wellness[La importancia de la Vitamina D para el bienestar sistémico y ocular]. J Optom. 2013;6(3):124–133.

[2] Ferira, A. J., Women and Vitamin D: Q and A cited from