This is an excellent article that I came across in the quarterly journal “Wise Traditions” published by the Weston A. Price Foundation at http://www.WestonAPrice.org , which was written by Krispin Sullivan, CN.
For the nutritionists and those interested in their dietary habits, it’s a real eye-opener. Vitamin D is one of those vitamins that tend to be overlooked in our diet as we have the mistaken belief that the sun takes care of all our vitamin D needs. This is not the case, as you will see from the article.
With the fad in low-fat dieting, it is estimated that more than 50% of Americans are deficient in vitamin D (a fat-soluble vitamin found in fish, lard and butter) which can cause anything from several autoimmune diseases including multiple sclerosis, Sjogren’s Syndrome, rheumatoid arthritis, thyroiditis and Crohn’s disease, to osteoporosis, fibromyalgia, chronic fatigue, peripheral neuropathy, infertility, breast, prostate and skin cancer.
Dr. Prabhala’s research sparked my interest and led to a search for current information on vitamin D how it works, how much we really need and how we get it. The following is a small part of the important information that I found.
Any discussion of vitamin D must begin with the discoveries of the Canadian-born dentist Weston A. Price. In his masterpiece Nutrition and Physical Degeneration, Dr. Price noted that the diet of isolated, so-called “primitive” peoples contained “at least ten times” the amount of fat-soluble vitamins” as the standard American diet of his day. Dr. Price determined that it was the presence of plentiful amounts of fat-soluble vitamins A and D in the diet, along with calcium, phosphorus and other minerals, that conferred such high immunity to tooth decay and resistance to disease in non-industrialized population groups.
Today another Canadian researcher, Dr. Reinhold Vieth, argues convincingly that current vitamin D recommendations are woefully inadequate. The recommended dose of 200-400 international units (IU) will prevent rickets in children but does not come close to the optimum amount necessary for vibrant health.’ According to Dr. Vieth, the minimal daily requirement of vitamin D should be in the range of 4,000 IU from all sources, rather than the 200-400 currently suggested, or ten times the Recommended Daily Allowance (RDA). Dr. Vieth’s research perfectly matches Dr. Price’s observations of sixty years ago!
VITAMIN D FROM SUNLIGHT
Pick up any popular book on vitamins and you will read that ten minutes of daily exposure of the arms and legs to sunlight will supply us with all the vitamin D that we need. Humans do indeed manufacture vitamin D from cholesterol by the action of sunlight on the skin. But it is actually very difficult to obtain even a minimal amount of vitamin D with a brief foray into the sunlight.
Ultraviolet (UV) light is divided into 3 bands or wavelength ranges, which are referred to as UV-C, UV-B and UVA. UV-C is the most energetic and shortest of the UV bands. It will burn human skin rapidly in extremely small doses. Fortunately, it is completely absorbed by the ozone layer. However, UV-C is present in some lights. For this reason, fluorescent and halogen and other specialty lights may contribute to skin cancer.
UV A, known as the “tanning ray,” is primarily responsible for darkening the pigment in our skin. Most tanning bulbs have a high UV-A output, with a small percentage of UV-B. UV-A is less energetic than UV-B, so exposure to UVA will not result in a burn, unless the skin is photosensitive or excessive doses are used. UVA penetrates more deeply into the skin than UVB, due to its longer wavelength. Until recently, UV-A was not blocked by sunscreens. It is now considered to be a major contributor to the high incidence of non-melanoma skin cancers.’ Seventy-eight percent of UV-A penetrates glass so windows do not offer protection.
The ultraviolet wavelength that stimulates our bodies to produce vitamin D is UV-B. It is sometimes called the “burning ray” because it is the primary cause of sunburn (erythema). However, UV -B initiates beneficial responses, stimulating the production of vitamin D that the body uses in many important processes. Although UV-B causes sunburn, it also causes special skin cells called melanocytes to produce melanin, which is protective. UV-B also stimulates the production of Melanocyte Stimulating Hormone (MSH), an important hormone in weight loss and energy production.’
The reason it is difficult to get adequate vitamin D from sunlight is that while UV-A is present throughout the day, the amount of UV-B present has to do with the angle of the sun’s rays. Thus, UV-B is present only during midday hours at higher latitudes, and only with significant intensity in temperate or tropical latitudes. Only 5 per cent of the UV-B light range goes through glass and it does not penetrate clouds, smog or fog.
Sun exposure at higher latitudes before 10 am or after 2 pm will cause burning from UV-A before it will supply adequate vitamin D from UV-B. This finding may surprise you, as it did the researchers. It means that sunning must occur between the hours we have been told to avoid. Only sunning between 10 am and 2 pm during summer months (or winter months in southern latitudes) for 20-120 minutes, depending on skin type and color, will form adequate vitamin D before burning occurs.’
It takes about 24 hours for UV-B-stimulated vitamin D to show up as maximum levels of vitamin D in the blood. Cholesterol-containing body oils are critical to this absorption process. Because the body needs 30-60 minutes to absorb these vitamin-D-containing oils, it is best to delay showering or bathing for one hour after exposure. The skin oils in which vitamin D is produced can also be removed by chlorine in swimming pools.
The current suggested exposure of hands, face and arms for 10-20 minutes, three times a week, provides only 200-400 IU of vitamin D each time or about 100-200 IU per day during the summer months. In order to achieve optimal levels of vitamin D, 85 percent of body surface needs exposure to prime midday sun. (About 100-200 IU of vitamin D is produced for each 5 percent of body surface exposed.) Light skinned people need 10-20 minutes of exposure while dark skinned people need 90-120 minutes.
Latitude and altitude determine the intensity of UV light. UV-B is stronger at higher altitudes. Latitudes higher than 30° (both north and south) have insufficient UV-B sunlight two to six months of the year, even at midday.” Latitudes higher than 40° have insufficient sunlight to achieve optimum levels of D during six to eight months of the year. In much of the US, which is between 30° and 45° latitude, six months or more during each year have insufficient UV-B sunlight to produce optimal D levels. In far northern or southern locations, latitudes 45° and higher, even summer sun is too weak to provide optimum levels of vitamin D. A simple meter is available to determine UV-B levels where you live.
VITAMIN D FROM FOOD
What the research on vitamin D tells us is that unless you are a farmer, lifeguard or a regular sunbather, you are highly unlikely to obtain adequate amounts of vitamin D from the sun. The balance must be obtained from food. So-called primitive peoples instinctively chose vitamin-D-rich foods including the intestines, organ meats, skin and fat from certain land animals, as well as shellfish, oily fish and insects. Many of these foods are unacceptable to the modern palate.
Fish make vitamin D from the precursor of vitamin D found in algae. In the higher mammals, vitamin D is made from precursors in lichen and green grass. Reindeer fat, for example, is a good source of vitamin D because reindeer feed on lichen. Vitamin D will be found in the butterfat of ruminant animals that feed on green grass, and in pigs that spend time in the sunlight. (Pigs resemble humans in that they convert sunlight to vitamin D.) Eggs will contain vitamin D if the chickens have obtained it from insects or fishmeal. Salmon must feed on algae in order to store vitamin D in their fat. Thus, modern farm-raised salmon are poor sources of this essential nutrient.
Modern diets usually do not provide adequate amounts of vitamin D because of the trend to low-fat foods since we no longer eat vitamin-D-rich foods like kippers, tripe, chitterlings and lard. Deficiencies are therefore pervasive and widespread.
VITAMIN D MIRACLES
Sunlight and vitamin D are critical to all life forms. Standard textbooks state that the principal function of vitamin D is to promote calcium absorption in the gut and calcium transfer across cell membranes, thus contributing to strong bones and a calm, contented nervous system. It is also well recognized that vitamin D aids in the absorption of magnesium, iron and zinc, as well as calcium.
Actually, vitamin D does not in itself promote healthy bone. Vitamin D controls the levels of calcium in the blood. If there is not enough calcium in the diet, then it will be drawn from the bone. High levels of vitamin D (from the diet or from sunlight) will actually demineralize bone if sufficient calcium is not present.
Vitamin D will also enhance the uptake of toxic metals like lead, cadmium, aluminum and strontium if calcium, magnesium and phosphorus are not present in adequate amounts. Vitamin D supplementation should never be suggested without calcium and magnesium supplementation at the same time.
Receptors for vitamin D are found in most of the cells in the body and during the 1980s there was considerable speculation that vitamin D contributed to a healthy immune system, promoted muscle strength, regulated the maturation process and contributed to hormone production.
During the last ten years, researchers have made a number of exciting discoveries about vitamin D. They have ascertained, for example, that vitamin D is an antioxidant that is a more effective antioxidant than vitamin E in reducing lipid peroxidation and increasing enzymes that protect against oxidation.
Vitamin D deficiency decreases biosynthesis and release of insulin. Glucose intolerance has been inversely associated with the concentration of vitamin D in the blood. Thus, vitamin D may protect against both Type I and Type II diabetes.
The risk of senile cataract is reduced in persons with optimal levels of D and carotenoids.
PCOS (Polycystic Ovarian Syndrome) has been corrected by supplementation of D and calcium.
Vitamin D plays a role in regulation of both the “infectious” immune system and the “inflammatory” immune system.
Low vitamin D is associated with several autoimmune diseases including multiple sclerosis, Sjogren’s Syndrome, rheumatoid arthritis, thyroiditis and Crohn’s disease.
Osteoporosis is strongly associated with low vitamin D. Postmenopausal women with osteoporosis respond favorably (and rapidly) to higher levels of D plus calcium and magnesium.
D deficiency has been mistaken for fibromyalgia, chronic fatigue or peripheral neuropathy.
Infertility is associated with low vitamin D. Vitamin D supports production of estrogen in men and women. PMS has been completely reversed by addition of calcium, magnesium and vitamin D. Menstrual migraine is associated with low levels of vitamin D and calcium.
Breast, prostate, skin and colon cancer have a strong association with low levels of D and lack of sunlight.
Activated vitamin D in the adrenal gland regulates tyrosine hydroxylase, the rate limiting enzyme necessary for the production of dopamine, epinephrine and norepinephrine. Low D may contribute to chronic fatigue and depression.
Seasonal Affective Disorder has been treated successfully with vitamin D. In a recent study covering 30 days of treatment comparing vitamin D supplementation with two-hour daily use of light boxes, depression completely resolved in the D group but not in the light box group.
High stress may increase the need for vitamin D or UV-B sunlight and calcium. People with Parkinsons and Alzheimers have been found to have lower levels of vitamin D.
Low levels of D, and perhaps calcium, in a pregnant mother and later in the child may be the contributing cause of “crooked teeth” and myopia. When these conditions are found in succeeding generations it means the genetics require higher levels of one or both nutrients to optimize health.
Behavior and learning disorders respond well to D and/or calcium combined with an adequate diet and trace minerals.
VITAMIN D AND HEART DISEASE
Research suggests that low levels of vitamin D may contribute to or be a cause of syndrome X with associated hypertension, obesity, diabetes and heart disease. Vitamin D regulates vitamin-D-binding proteins and some calcium-binding proteins, which are responsible for carrying calcium to the “right location” and protecting cells from damage by free calcium. Thus, high dietary levels of calcium, when D is insufficient, may contribute to calcification of the arteries, joints, kidney and perhaps even the brain.
Many researchers have postulated that vitamin D deficiency leads to the deposition of calcium in the arteries and hence atherosclerosis, noting that northern countries have higher levels of cardiovascular disease and that more heart attacks occur in winter months.
Scottish researchers found that calcium levels in the hair inversely correlated with arterial calcium – the more calcium or plaque in the arteries, the less calcium in the hair. Ninety percent of men experiencing myocardial infarction had low hair calcium. When vitamin D was administered, the amount of calcium in the beard went up and this rise continued as long as vitamin D was consumed. Almost immediately after stopping supplementation, however, beard calcium fell to pre-supplement levels.
Administration of dietary vitamin D or UVB treatment has been shown to lower blood pressure; restore insulin sensitivity and lower cholesterol.
THE BATTLE OF THE BULGE
Did you ever wonder why some people can eat all they want and not get fat, while others are constantly battling extra pounds? The answer may have to do with vitamin D and calcium status. Sunlight, UV-B, and vitamin D normalize food intake and normalize blood sugar. Weight normalization is associated with higher levels of vitamin D and adequate calcium. Obesity is associated with vitamin-D deficiency. In fact, obese persons have impaired production of UV-B-stimulated D and impaired absorption of food source and supplemental D.
When the diet lacks calcium, there is an increase in fatty acid synthase, an enzyme that converts calories into fat. Higher levels of calcium with adequate vitamin D inhibit fatty acid synthase while diets low in calcium increase fatty acid synthase by as much as five-fold. In one study, genetically obese rats lost 60 percent of their body fat in six weeks on a diet that had moderate calorie reduction but was high in calcium. All rats supplemented with calcium showed increased body temperature indicating a shift from calorie storage to calorie burning (thermogenesis).
THE RIGHT FATS
The assimilation and utilization of vitamin D is influenced by the kinds of fats we consume. Increasing levels of both polyunsaturated and monounsaturated fatty acids in the diet decrease the binding of vitamin D to D-binding proteins. Saturated fats, the kind found in butter, tallow and coconut oil, do not have this effect. D-binding proteins are key to local and peripheral actions of vitamin D. This is an important consideration as Americans have dramatically increased their intake of polyunsaturated oils (from commercial vegetable oils) and monounsaturated oils (from olive oil and canola oil) and decreased their intake of saturated fats over the past 100 years.
In traditional diets, saturated fats supplied varying amounts of vitamin D. Thus, both reduction of saturated fats and increase of polyunsaturated and monounsaturated fats contribute to the current widespread D deficiency.
Trans fatty acids, found in margarine and shortenings used in most commercial baked goods, should always be avoided. There is evidence that these fats can interfere with the enzyme systems the body uses to convert vitamin D in the liver.
VITAMIN D THERAPY
In my clinical practice, I test for vitamin-D status first. If D is needed, I try to combine sunlight exposure with vitamin D and mineral supplements.
Single, infrequent, intense, skin exposure practitioner to UV-B light not only causes sunburn but also suppresses the immune system. On the other hand, frequent low-level exposure normalizes immune function, enhancing NK-cell and T-cell production, reducing abnormal inflammatory responses typical of autoimmune disorders, and reducing occurrences of infectious disease.
Thus it is important to sunbathe frequently for short periods of time, rather than spend long hours in the sun at frequent intervals.
BENEFITS OF VITAMIN D THERAPY
Patients on vitamin-D therapy report a wide range of beneficial results including increased energy and strength, resolution of hormonal problems, weight loss, an end to sugar cravings, blood sugar normalization and improvement of nervous system disorders.
A paradoxical transient and non-complicating hypercalciuria (more calcium in the urine) may occur when the program is first initiated. This resolves quickly when adequate calcium and other minerals are consumed. Two other temporary side effects may occur during the first several months of treatment. One is daytime sleepiness after calcium is taken. This usually resolves itself after about one week. The other condition is the reappearance of pain and discomfort at the site of old injuries, a sign of injury remodeling or proper healing, which may take some time to clear up.
Vitamin programs usually omit vitamin D because of concerns about toxicity. These concerns are valid because vitamin D in all forms can be toxic in pharmacological (drug-like) doses. The dangers of toxicity have not been exaggerated, but the doses needed to result in toxicity have been ill defined with the unfortunate result that many people currently suffer from vitamin-D deficiency or insufficiency.
Toxic levels of vitamin D are indicated when blood levels exceed 56 ng/ml or 140 nmol/l for extended periods of time. Levels of 200-300 nmol/l or higher have been seen in several studies using supplementation and quickly resolve when supplementation is stopped. In such cases no long-term problems have been found. Long-term supplementation, without monitoring, can have serious consequences.
Before 1993, there was no affordable and available blood test for vitamin D. Now there is. To avoid problems, anyone engaging in high levels of vitamin-D supplementation (more than 2,000 IU) should have periodic blood tests. Don’t forget to calculate your total vitamin-D intake from all sources – sunlight, food (including vitamin D in milk) and supplements, including cod liver oil.
Dr. Vieth suggests that critical toxicity may occur at doses of 20,000 IU daily and that the Upper Limit (UL) of safety be set at 10,000 IU, rather than the current 2,000 IU. While this may or may not be the definitive marker for safety in healthy persons with no active liver or kidney disease, there is no clinical evidence that long-term supplementation needs to be greater than 3,000-4,000 IU for optimal daily maintenance. This level would be somewhat lower when combined with exposure to UV-B.
Doses used in clinical studies range from as little as 400 IU daily to 10,000 – 500,000 IU, given either as a single onetime dose or daily, weekly or monthly. Such large doses are given either as a prophylactic or because compliance is considered a problem. There seems to be some evidence that vitamin D works better, when given in lower, more physiologic doses of 2,000-4,000 IU daily rather than 100,000 IU once a month. However, a single monthly dose of 100,000 IU did replete low levels of vitamin D in adolescents during winter.
In my experience, high, infrequent dosing to thrive, even during periods of stress, can lead to problems. In one recent study, blood levels rose from low to extremely high, (more than 300 nmol/l) 24 hours after a 50,000 IU oral dose, and then slowly returned to pretreatment suboptimal levels. Clearly this must disrupt normal feedback mechanisms in D and calcium regulation.
Historically, our requirements for vitamin D were satisfied by daily exposure to sunlight and/or daily intake from food. Lowfat diets and lack of seafood in the diet further contribute to the current worldwide insufficiency of vitamin D.