Rethinking Vitamin D
Vitamin D: The newest health darling and, true to form, the latest in the line of misinterpreted health related issues treated with overzealous hype and exposure. Although it is technically active as a secosteroid hormone, “vitamin” D is vital for optimal health. This there is no argument over. It is responsible for regulating calcium and phosphate in the blood and managing bone growth and health, and is also a key player in the immune system and neuromuscular function and inflammation. It is also believed to contribute to positive results with cancer, cardiovascular disease and some neuromuscular diseases. Moderate to high levels of vitamin D are associated with almost every positive health outcome imaginable while low levels are associated with poor health and illness virtually across the board.

Sounds like everyone should start getting their vitamin D levels up, right? What’s the easiest way since we can’t have people just running out in the sun? Supplements is what the health world has turned to. The newest cure all, vitamin D. Once again I warn, not so fast. It is likely a bit more complicated than just throwing vitamin D supplements down and kicking your heels up, living life to the fullest (sounds a little like the cholesterol issue, doesn’t it?). Supplementing with D can indeed be helpful in a number of circumstances however, blind supplementation, particularly in high doses, raises some concerns for a few reasons: source, synergy and optimal levels.

Without question, the best, most abundant and most historical source of vitamin D is the sun. Metabolized from UV-B rays by the skin from a derivative of cholesterol, the body knows just what to do with this source/form and regulates it accordingly in the body. This is the ideal source of vitamin D for humans and getting sun exposure should be the main focus of most people. For most people, a few minutes in the sun daily will give you all the D your body needs.
Available primarily in animal foods, such as seafood, meat (esp. organs) and eggs, the diet is traditionally a minor but important contributor of D. The advantage that lies here is that some of these foods contain other vitamins and minerals that act with vitamin D to enhance its effectiveness and metabolism. This synergy is key and will be covered next. Food fortified with vitamin D (such as milk and cereal) falls into the supplement category and would be considered a non ideal form of D.
Increasingly common now, particularly with the increased attention from the health and medical world, is the use of vitamin D supplements. The trick here is that there are two main forms being used, vitamin D2 and D3. Depending on the person, the need for each form varies (most people feel D3 is far superior) and we aren’t quite sure the body does well with D2 (or any concentrated form of vitamin D in general). Liquid drops are typically considered better absorbing and are likely the better option over pill form. Supplementing with D is tricky and should be done thoughtfully.

This may be the biggest issue at hand with the increasing usage of vitamin D. Without its synergistic fat soluble buddies, vitamins A and K, D can actually be problematic. All of these work together to maintain an delicate balance and adequately support one another. D supports the actions of A and vise versa and K (particularly K2) helps manage and signal subsequent actions in the body. Vitamin D does all of its magic in the optimal presence of A and K. When this balance is disrupted, such as excessive D supplementation without adequate A and K consumption, the use of D may actually be harmful. Excess D (in proportion to A and K) can cause calcification, particularly in times of calcium surplus. Think arterial plaque and kidney stones. Not good, that we can all agree on. Just as in calcium supplementation, without magnesium, D and K to balance, problems of excess calcification arise quite easily with unbalanced D supplementation.

The concept should not be shocking: intervening with concentrated and isolated nutrient supplements might not be as simple as we think. Nature has a nice balance and functions well within this framework. When we step outside this balance it is very likely that we are messing with a dynamic we can’t quite fully appreciate. So be smart about D. If you decide to supplement then be sure to search out sources of vitamin A and K. Here’s some foods rich in vitamin A and vitamin K.

Optimal Levels
The latest wrinkle in the D saga. Long story short, it’s very hard to know where the sweet spot is for each of us. After years of lower level recommendations (30-50) there has been a recent push to drive for higher levels (>60/70+). Here’s the thing: optimal levels are dependent on many, many things. The overall health status of the body can alter the optimal levels on a daily basis and couple of other important things: genetic heritage, latitude and nutrient status of other vitamins and minerals. We just covered nutrient synergy and determining optimal levels of all those is tricky. As for heritage, as a general rule, the more northern the ancestry, the lower the optimal range. As an example, lighter skin individuals might be optimal at 35-50 or lower while people with darker skin might need 50-65 or higher to be optimal. This means that our ancestors play a major role in our vitamin D situation. Additionally, the latitude at which you grew up and currently live plays a role in optimal levels. The end result is we don’t really know each of these dynamics for sure therefore we really don’t know how to predict someone’s desired vitamin D range. There’s also the time of year/season that influences optimal levels to add more intricacy to the mix.

**If you don’t know your vitamin D level, get it checked before attempting any supplementation**

Note: We still don’t know if vitamin D levels are merely a symptom of health status. Most of the research deals with associations of health and vitamin D, which means cause and effect is tough to establish. There will be much more to come on vitamin D so stay tuned.

The Bare 5 Bottom Line on Vitamin D:
1. It is a vitally important substance for optimal health.
2. Nothing in the body works in isolation. Vitamin D is no different. It needs cofactors and synergistic nutrients, such as A and K(2).
3. Sunshine is the optimal source, get your Free D whenever you can. Food is a secondary source.
4. Optimal levels are very hard to determine. Get tested if you’re curious.
5. Supplementing with D is contextual and should be thought through and done with adequate intake of A and K.

Thanks for reading, have a great week!

P.S. I use a fermented Cod Liver Oil/Butter Oil Blend to get my vitamin A and K2. You can find that at Green Pastures.

P.S.S. Here’s a few links for more info:
My post on Vitamin K2.
Articles on vitamin D and its synergy with other nutrients (Dr. Mercola and Chris Masterjohn).

P.S.S.S. A visual look at vitamin D processing…