Synergy Wellness Center

Clinical Applications/Research: Vitamin D can be made in the body from sunlight, however, many shy away from the sun because of skin cancer concerns and they fail to get enough of this important nutrient. Previously known for increasing calcium absorption and helping to develop strong bones and teeth, this immensely versatile vitamin has made

headlines for its favorable effects on everything from inflammation to brain function.

Vitamin D deficiency is widespread, and in fact, it is estimated that half of all white and two thirds of all black adults have low D levels below 70 nm/L (between 90-100 nmol/L is ideal) (1). While vitamin D concentrations above 50 nmol/L are deemed technically “adequate”, “evidence suggests that a minimum of 75 nmol/L, and perhaps more than 90 nmol/L, is optimum for many health outcomes.” (2) Mean concentrations in most populations are substantially lower than this (3). “There is an epidemic of vitamin D insufficiency in the US; the public health impact of this observation could be great” (4). In the words of Dr. Michael Holick, who was instrumental in raising awareness about the importance of vitamin D supplementation, “Healthcare professionals need to be aware of the vitamin D deficiency pandemic” (5). We not only have widespread deficiency of vitamin D, but high-dose supplementation has proven to be helpful in many

situations (6). As a species, we do not get as much vitamin D as we used to get. Vitamin D is available from skin exposure to UVB radiation from sunlight (it is changed in the liver then the kidney to active vitamin D3), from diet, or from supplements. Diet is a poor source; first of all, only a few foods contain vitamin D (small amounts at that), and dietary sources provide only 40-400 IU per food serving (7 ), whereas sun exposure for 20 minutes for a light-skinned person during the summer produces at least 10,000 IU (8). Limited food sources of vitamin D3 include dark fish (such as salmon and tuna), with very small amounts in eggs and butter. Fortified foods contain vitamin D2 (the inactive form), and include milk, cereal, and some orange juice and cheeses (9). The blocks to getting enough vitamin D from the sun, however, include age, use of sunscreen, and environmental factors that reduce the strength of the rays reaching the earth (ie winter, high latitude, pollution, cloud cover, and ozone) (10). However, vitamin D supplements can deliver known, high doses of vitamin D3. “Populations living at or higher than 30 degrees latitude in either the northern or southern hemisphere, or who have a mainly indoor lifestyle, should be considered at high risk of breast, colon, ovarian, and many other types of cancer as a result of highly prevalent vitamin D deficiency” “Low vitamin D levels predict future cardiovascular events and are common in patients with type 2 diabetes” (11). A randomized, placebo-controlled trial determined that doses of 100,000 IU and 200,000 IU vitamin D lowered systolic blood pressure in patients with type 2 diabetes and baseline levels <100 nmol/L... No significant excess of adverse effects was noted” (12). The Annals of Epidemiology in July of 09, in a publication titled “Vitamin D for Cancer Prevention: Global Perspective” stated: “The upper limit [of vitamin D3] should be increased to at least 5,000 IU/d, based on expected benefits compare to anticipated minor risks” (13). A study in the June 2010 issue of the Lancet

advocates high dose supplementation with vitamin D3; they note that daily supplemental intake of 1000-4000 IU vitamin D3 would increase vitamin D levels to over 75 nmol/L in most individuals (14). Vitamin D is a very versatile nutrient. Vitamin D’s role in more diverse health-related issues has become apparent in recent years, as it relates to conditions like inflammation (suspected to be at the root of many diseases), peripheral

neuropathies, autism, heart activity, insulin resistance, polycystic ovarian syndrome (PCOS), depression, skin rejuvenation, dementia-related conditions, bone fracture repair, and many others (15),(16),(17). Additionally, a Lancet article points out that the functions of vitamin D have been extensively reviewed, and that vitamin D has important effects on brain development and function, cell proliferation, regulation of blood pressure and insulin secretion, and on the differentiation of immune cells and modulation of immune responses (18). Another article naming the many facets of this nutrient was published in Endocrinology and called “Vitamin D receptor: new assignments for an already busy receptor” (19). Don’t forget that vitamin D strengthens more than bones, too; it published “Vitamin D: the other steroid hormone for muscle function and strength” in the 2009 issue of Menopause, 16(6):1077-8, and touted some of the beneficial effects of vitamin D on the muscular system.

Vitamin D and other Specific Health concerns: Vitamin D deficiency is associated with numerous immune conditions and diseases, and vitamin D supplementation is associated with beneficial effects in a multitude of conditions, from influenza (20) to cancer/chemotherapy (21). Some of the immune conditions correlated to vitamin D intake include, but are not limited to: rheumatoid arthritis, multiple sclerosis, lupus (SLE), fibromyalgia, dermatological indications (i.e. psoriasis), diabetes type 1 and type 2, infectious disease and many others (22). Dr. Michael Holick also delves into some of the conditions vitamin D is useful for in his article published in the American Journal of Clinical Nutrition entitled “Sunlight and vitamin D for bone health and prevention of autoimmune diseases, is vital to achieve optimal

muscle performance. Dr. Michael Holick cancers, and cardiovascular

disease” (23). Vitamin D and MS: There has been substantial evidence to indicate that vitamin D is correlated to multiple sclerosis in a big way. Deficiency can be a factor for MS risk, and can also be therapeutic. The hypothesis that vitamin D deficiency is a risk factor for MS was first proposed over 30 years ago, and gained credibility after the discovery of the modulating immune effects of vitamin D (24). Vitamin D supplementation in healthy individuals has been proposed as a promising

approach for MS prevention, and disease severity has also been associated with vitamin D levels (25). Vitamin D has been known for quite some time to block the progression of MS in the animal model, and there is also limited evidence of a similar effect in humans (26).