This time of year we all enjoy abit more sunlight, feeling the kiss of the sun on our skin can feel so good. We all know that our bodies synthesize vitamin D from sunlight, which is true. However, we all make vitamin D at different rates according to our genetics. And while the sun does deliver vitamin D, it also brings a sunburn so most of us lather up with sunscreen when outside.
Problem is, vitamin D is synthesized from UBV rays, which are blocked by sunscreen. Some vitamin D production still occurs, albeit less. You can also get vitamin D from foods such as fish and mushrooms. However, in my experience as a family medicine doctor and functional medicine consultant, most of us need more.
The American Endocrine society just released new recommendations on vitamin D stating that practitioners should no longer be screening vitamin D levels. The only populations they say are appropriate for vitamin D screening are infants under the age of 1 year, pregnant women, prediabetics, patients with known osteoporosis and patients over the age of 75 years old. They also stated that people should not consume more than 600 IU’s of vitamin D for adults, no more than 400 IU for infants under the age of 12 months. I think they are wrong and here’s why. The Endocrine Society stated that doctors don’t know what to do with vitamin D levels when they get them back. This is surprising since the federal nutrition board published serum vitamin D levels, what is deficient, what is recommended, and what is too high, see table below.
In this table the federal nutrition board recommends a serum vitamin D level ideally greater than 50 nmol/L for ideal health benefits. They clearly state that levels over 125 nmol/L can become dangerous. Cases of pancreatitis at this level have been reported greater than 150 nmol/L as vitamin D is a fat soluble vitamin and stores in the pancreas. I shoot for an optimal vitamin D3 level of 60-100 nmol/L in my practice as I find patients experience the most benefit at this level. The next reason listed for advising doctors not to check vitamin D levels was the cost of the test itself to medicare and insurance companies.
In my experience prevention will always save more money than developing chronic disease. I check vitamin D levels on my patients every six months to a year depending on the patient. We know that low vitamin D levels can cause bones to form improperly, poor immune health, increase the risk of autoimmune disease, depression, and increased muscle pain. It makes sense to me to ensure my patients have optimal vitamin D levels before they develop osteoporosis, not after!
During the COVID pandemic, doctors learned that higher vitamin D levels indicated a better prognosis with COVID infection. Basically if your vitamin D level is robust when you get COVID you are less likely to get as sick! I treat conditions such as depression, osteopenia, fibromyalgia and chronic pain with healthy doses of vitamin D to ensure my patients’ vitamin D levels are over 60. Finally, the Endocrine Society states there is a paucity of long-term placebo-controlled studies that prove vitamin D screening can prevent long term chronic disease.
In a quick search I found over 1000 studies relating to the health benefits of vitamin D from bolstering our immune health to strengthening our bones, improving how muscles contract and recovery from injury, even lifting depression and helping seasonal affective disorder.
How much vitamin D should you take, you may be asking? Again, that depends, which is why you should have your level checked. Generally, most people need 2000 IU to 5000 IU daily. So, eat your fish and mushrooms, enjoy the kiss of the sun a bit, but don’t be afraid to take daily vitamin D3 (cholecalcipherol). If you have kidney insufficiency or disease, you should take vitamin D2 (ergocalcipherol).
