Vitamin D Deficiency

If you haven’t yet heard about the importance of maintaining optimal vitamin D levels, which has become more prominent over the past decade, then you need to get on top of it. Vitamin D deficiency is incredibly common in the US, but many Americans mistakenly believe they aren’t at risk because they consume vitamin-D-fortified foods (such as milk). The reality is that there are very few foods that actually have therapeutic levels of vitamin D naturally and even fortified foods do not contain enough vitamin D to support your health needs. Despite its name, vitamin D is not a regular vitamin. It's actually a steroid hormone that you are designed to obtain primarily through sun exposure, not via your diet.

Before the year 2000, very few doctors ever considered the possibility that you might be vitamin D deficient. But as more and more studies were done, it became increasingly clear that vitamin D deficiency was absolutely rampant. For example, according to one of the leading vitamin D researchers, Dr. Michael Holick:

·     The Centers for Disease Control and Prevention (CDC) reported that 32 percent of children and adults throughout the US were vitamin D deficient -- and this is grossly underestimated as they used vitamin D levels that were not consistent with optimal health.

·     The National Health and Nutrition Examination Survey found that 50 percent of children aged one to five years, and 70 percent of children between the ages of six and 11, are deficient or insufficient in vitamin D

·     Researchers such as Dr. Holick estimate that 50 percent of the general population is at risk of vitamin D deficiency and insufficiency

Researchers have also noted that vitamin D deficiency is prevalent in adults of all ages who always wear sun protection (which blocks vitamin D production) or limit their outdoor activities. People with increased skin pigmentation (such as those whose ancestors are from Africa, the Middle East, or India) are also at risk, as are the elderly. It’s estimated that over 95 percent of US senior citizens may be deficient in vitamin D, not only because they tend to spend a lot of time indoors but also because they produce less in response to sun exposure (a person over the age of 70 produces about 30 percent less vitamin D than a younger person with the same sun exposure).

The only way to know for sure if you’re vitamin D deficient is via blood testing. However, there are some signs and symptoms to be aware of as well. If any of the following apply to you, you should get your vitamin D levels tested sooner rather than later.

• You have gastrointestinal issues (bloating, gas, constipation, diarrhea, reflux, etc)- Remember, vitamin D is a fat-soluble vitamin, which means if you have a gastrointestinal condition that affects your ability to absorb fat, you may have lower absorption of fat-soluble vitamins like vitamin D as well. This includes gut conditions like Crohn’s, celiac and non-celiac gluten sensitivity, and inflammatory bowel disease.

• You’re Overweight or Obese-Vitamin D is a fat-soluble, hormone-like vitamin, which means your body fat acts as a "sink" by collecting it. If you're overweight or obese, you're therefore likely going to need more vitamin D than a slimmer person.

• You’re Fifty or older- As you get older your skin doesn’t make as much vitamin D in response to sun exposure. At the same time, your kidneys become less efficient at converting vitamin D into the form used by your body and older adults tend to spend more time indoors (i.e. getting even less sun exposure and therefore vitamin D).

• You Feel Down or Depressed- Serotonin, the brain hormone associated with mood elevation, rises with exposure to bright light and falls with decreased sun exposure. In 2006, scientists evaluated the effects of vitamin D on the mental health of 80 elderly patients and found those with the lowest levels of vitamin D were 11 times more prone to be depressed than those who received healthy doses.

• Your Bones Ache- Many people see their doctors for aches and pains, especially in combination with fatigue, and end up being misdiagnosed as having fibromyalgia or chronic fatigue syndrome. These symptoms can be classic signs of vitamin D deficiency osteomalacia, which is different from the vitamin D deficiency that causes osteoporosis in adults. The vitamin D deficiency causes a defect in putting calcium into the collagen matrix into your skeleton. As a result, you have throbbing, aching bone pain.

Obviously, if your sun exposure is minimal (and you’re like the majority of our patients when they first come in to the office) you can pretty much bet the farm that you’ll test deficient. Your optimal vitamin D level should be in the 50-70 ng/dl range when testing for the 25-Hydroxy form. If we find that this is not the case, then the next steps will be to not only ensure that you’re getting the required sources of vitamin D, but to also make sure that your body is healthy enough to fully process what you’re getting into your system.