We all know that most plants require the three basics – water, soil, and sunshine. Like the sorry little houseplant that wilts away in the windowless corner of a living room, our bodies share the same deteriorating feeling when we are subjected to vitamin D deficiency. Vitamin D research continues to unveil important information. It can be argued that vitamin D is not even a vitamin, but more of a hormone precursor. When we bask in sunshine, the biochemistry involved in this interesting vitamin, causes our bodies to bloom in many ways.
In recent years, vitamin D deficiency has increased in the general public. The deficiency is different from the epidemics of Rickets and Osteomalacia commonly seen in other areas of the world. In underdeveloped areas, there exist a deficiency in dietary calcium, phosphorous, along with vitamin D. These deficiencies can cause Rickets, which is observed in children as a softening of bones and commonly leads to fractures and deformities. Osteomalacia is the similar condition that occurs in adults, which in addition to dietary issues, the cause may also involve too much resorption of calcium from bones due to an overactive parathyroid.
Rickets and Osteomalacia are extreme versions of vitamin D deficiency. Currently in developed countries, Vitamin D deficiency most commonly surfaces as fatigue, bone and joint pain, muscle weakness and cramps, poor concentration, weight gain, hypertension, and headaches. However, symptoms can be very subtle, if recognizable at all by a patient. This deficiency has been associated in many types of cancer, heart and bone diseases, strokes, dementia, and Multiple Sclerosis.
The role of Vitamin D is still being understood. Traditionally, its biggest job has to do with the absorption of calcium. Vitamin D is made in the body when melanocytes are exposed to UV B rays from sunshine. Melanocytes release the Vitamin D precursor, which travels to the liver and then to the kidney to become activated. This active Vitamin D stimulates the gastrointestinal tract to absorb calcium from the diet. However, receptors for Vitamin D have also been found in the brain, skin, heart, prostate, testes, ovaries, and breasts. The exact chemistry of Vitamin D in these systems has not been entirely mapped out, but we know it has been observed in cell proliferation, differentiation, apoptosis, as well as neuromuscular function and moderating inflammation. It has also been observed that the immune system works much more effectively when the body has sufficient vitamin D levels, helping the body fight off illnesses, autoimmune diseases, and cancer.
So, why do we seem to be deficient? We obtain Vitamin D from our diets and from the sun. Granted since 1920, we have been fortifying dairy with Vitamin D to increase the absorption of calcium. However, natural sources include egg yolks, cheese, beef liver, and cod liver oil and fatty fish such as mackerel and tuna. Since most people do not eat a lot of these foods in their diet, other contributing factors for deficiency likely exist, which leaves the sun. The big reason why we may be deficient is that our indoor lifestyle limits our sunlight exposure. Most people just don’t go outside.
Many times a run from the car to somewhere inside is the extent of our outdoor exposure. Because windows block the UV B rays needed in the biochemistry, the sunlight must be direct on the skin in order for Vitamin D to be produced. We know that sunlight exposure has also been linked with skin cancer; therefore we are warned to cover up and wear sunscreen to be protected from the sun. Because of the vast differences in the metabolism in vitamin D across individuals, it is not well understood how much time in the sun is needed for adequate production. Other factors such as obesity, inability for the kidneys and liver to convert the vitamin D prohormone, and aging all seem to be factors.
Blood levels of vitamin D can be checked and supplementation can be prescribed based on this level. Many experts today believe the RDA for vitamin D, which is 400 IUs, is too low. If a deficiency is observed based on a patient’s bloodwork, 1,000-5,000 IUs a day can be prescribed for a period up to six months, rechecking blood levels at the end of this time. It is best to have your blood levels checked to determine the dosage best for you.
Thankfully supplementation can restore the levels of vitamin D, but getting outside may be the true issue. We often work long hours inside under florescent lights during the daytime. We may need to take a real look at how much outdoor time we get and then create habits that sustain better wellbeing. Do you need to turn off the computer, T.V. and video game and have more fun in the sun? We can check your vitamin D and see.