Surprise!  Vitamin D & Hormones

Surprise! Vitamin D & Hormones

As we head into the darker months many people begin to supplement with vitamin D.  In many cases this is a good step in maintaining mood, immune and bone health.  In fact many people don’t realize that every cell in the body has a vitamin D receptor.  Hundreds of genes and their expression are influenced by this important nutrient.  Muscle and cell growth also requires adequate levels of vitamin D.

Up to 70% of our population may be deficient.  This is largely due to diet and lifestyle factors that need to be addressed.  Supplementation alone is not the solution.  Given that deficiency is so common and linked with so many of our chronic, modern diseases its understandable why supplementation has become so popular.

What you didn’t expect about Vitamin D

In recent years high dose supplementation has become commonplace.  What you may not expect is that high levels of vitamin D in the body can be as harmful as low levels. As a fat soluble vitamin we need to consider the consequences of toxicity.  Evidence shows an increase of cardiovascular incidents, kidney stones, headaches, nausea, vomiting, diarrhea, loss of appetite, and even low bone density.

It’s great that more doctors than ever are testing vitamin D levels. However, like many nutrients, vitamin D follows a U-shaped curve, meaning that both low levels and very high levels are associated with negative health outcomes (16).

Deficiency Linked to all the big ones

With an increased risk of heart attack, cancer, diabetes, asthma, and autoimmune disease there is real cause for concern.  Unfortunately, few practitioners are aware of the dangers of vitamin D toxicity.  Many are testing serum vitamin D once and recommending a daily 5,000 or 10,000 IU supplement.  Ongoing monitoring during supplementation along with other interventions is what we need to see.

Testing Vitamin D

Vitamin D status is measured by 25(OH)D in blood. This is the precursor to active vitamin D and is generally considered the most accurate single marker to assess vitamin D status. The laboratory reference range for adequate 25(OH)D is 30 to 74 ng/mL.

But a large body of evidence in the medical literature strongly suggests that optimal vitamin D levels might be lower than these figures. There is little to no evidence showing benefit to 25(OH)D levels above 50 ng/mL

Sunlight has Hormonal Benefits

Sunlight induces relaxation and increases pain tolerance via a natural opiod called beta endorphin.  A 20-year study following 30K subjects found that those individuals avoiding sun exposure were twice as likely to die from all causes.  This is because peptides like substance P and calcitonin gene are stimulated by UV rays reducing oxidative stress, vascular inflammation and hypertension.  Libido is increased and cortisol is lowered by two hormones that also reduce appetite and regulate the immune system.

Exposure to bright light during the day activates neurons in the suprachiasmatic nucleus of the hypothalamus, which sends signals to the pineal gland that regulate melatonin production. Our circadian rhythm is associated with mood, cognition, and metabolic health.

Parathyroid Hormone 

We can use parathyroid hormone (PTH), calcium, and active vitamin D3 as markers for a more complete picture of vitamin D status. Dr. Chris Masterjohn suggests that serum PTH levels above 30 pg/mL may be indicative of biological vitamin D deficiency when 25(OH)D levels are borderline low. Conversely, if 25(OH)D levels are borderline low or even slightly below the laboratory reference range (e.g., 25 to 30 ng/mL), but PTH is less than 30 pg/mL, it is unlikely that vitamin D is deficient. Therefore more vitamin D is not necessarily better.  For optimal calcium and bone health we want to see parathyroid levels suppressed adequately. Ask your doctor to test PTH if you have concerns about bone health.

Conclusion

The functional range for 25(OH)D is between 35 to 60 ng/mL. This is variable though.  For example the optimal range may be a bit lower for those with darker skin pigmentation. Anyone with autoimmune disease may need to tend on the higher end of the range to maximize the immune benefits of vitamin D.

  1. Don’t just supplement Vit D without knowing your level
  • less than 20 ng/mL: Combine with daylight exposure, cod liver oil, and even a vitamin D supplement at this level.
  • 20 to 35 ng/mL: If your parathyroid hormone is less than 30 pg/mL then supplementing is likely unnecessary.
  • 35 to 50 ng/mL: Your current diet and lifestyle is maintaining adequate vitamin D levels.  Continue on course.
  • greater than 50 ng/mL: Reduce your vitamin D supplements.  Ensure you are getting adequate amounts of the other fat-soluble vitamins to protect against toxicity
  1. Test and Retest
    Your diet, lifestyle, or supplements changes can mean that retesting after three to four months makes sense.  We want to see if what we are doing is working or working too well in some cases.
  1. Sunlight is the primary source of vitamin D
    Reap the many benefits of sunlight beyond just subcutaneous production of vitamin D, and reduce your chance of achieving toxic levels. Spend about 15 to 30 minutes, or about half the time it takes your skin to turn pink, in direct sunlight. Sunscreens not only block production of vitamin D, but also all of the other beneficial photoproducts produced in the skin in response to UVB.
  1. Micronutrients from food sources are safer
    Cod liver oil is a good source of vitamins A and D. Pastured butter and dairy can provide adequate vitamin K. Sweet potatoes, bananas, plantains, and avocados all contain significant amounts of potassium. Magnesium is a safe micronutrient to supplement as we can’t get enough from food due to soil depletion.

 

Don’t Supplement with These Five

Don’t Supplement with These Five

Using food to get essential nutrients is always best and this is why a varied diet is ideal.  This is especially important when it comes to a five key nutrients which can have serious health complications when taken in a concentrated form.
Calcium
Supplementation with this nutrient was long believed to be important for reducing risk of fracture in an aging population.  Studies now confirm that supplementing calcium can lead to increased calcification of arteries, kidney stones and does not increase bone health.  Most people get enough calcium through diet and the RDA (recommended daily allowance) is 1000- 1200 mg/day.  Absorption of this important nutrient increases on a higher protein diet.  Fat soluable vitamins K2 and D are essential for proper use of calcium in body.  Specifically K2 transports calcium to be used in the bones, otherwise it will build up increasing the risk of cardiovascular disease.  Eating fortified foods without enough of the synergistic vitamins can be problematic.  All multivitamins have calcium as do many breakfast cereals, breads and non-dairy milks.  Orange juice also is fortified with calcium.  Please check labels and reduce your intake of these fortified foods while increasing Vitamin K2 and D.  Vitamin D from adequate daylight and sun exposure is best. If supplementing 35-60 ng/mL is enough.  (Mega dosing vitamin D is not safe but I will address that in another post.) The highest food sources for calcium are sesame seeds, sardines or salmon with the bone in, dairy, leafy greens and almonds.

K2 is found in grass-fed dairy and fermented foods.  Current research indicates that there is no toxic upper limit for K2 and those with osteoroporosis can have as much as 30-45 mg/day.  For others a dose of 100-1000 mcg/day is adequate.

 

Regular weight-bearing movement stimulates the human growth hormone which is an important way of prevent fracture.
Beta-Carotene 
This is the inactive form of Vitamin A.  The active form is retinol.  Studies have found that too much beta carotene may decrease Vitamin A levels overall.  For this reason it is important to moniter beta-carotene intake and ensure enough retinol in the diet. Just eating more carrots for eyesight isn’t enough.   The liver has a storage bank of retinol so those on vegans diets may thrive for a number of years and then see a series of health concerns emerge that may be connected with Vitamin A deficiency as the storage bank is used up.  Cod liver oil at 1 tsp/day or 4 ounces of liver/week provides the active form of Vitamin A.  Fish head soup and liver pate are great ways to up your intake.  The indigenous people of the of BC fed an early explorer who had become blind some fish head soup to nurse him back to health.  Remember this is a fat soluable vitamin so fat increases absorption and also it is stored in body. Too much is not safe but enough is essential. Supplementing with beta carotene has been linked with a higher risk of cancer and heart disease when combined with other lifestyle factors like smoking or drinking heavily.
Vitamin E
Here is another potent fat-soluble.  It is anti-inflammatory protecting from free radicals.  But supplementing with any of the three forms (phenols, tocopherols and tocotrienols) increases mortality of all kinds.  Trout, nut/seeds, avocado, apricots and tomato sauce are all good sources.
Folic acid 
Folate is anther nutrient that has been misunderstood.  It is especially important in pregnancy and fetal development however the form it needs to be in is folate. Supplementing with folic acid can lead to a deficiency of B12 by masking B12 levels.  Low B12 has a long list of serious health consequences and is common in vegetarian and vegans.  Folate is available through organ meats like liver, dark leafy greens, lentils, beets and cauliflower.
Iron 
This is absorbed in the same place as B12 and is often low in pregnancy or breastfeeding. It can also be high in situations like hypothyroidism or gut infections.  Supplementing is not recommended without first checking several markers and  addressing these through diet changes.  One can increase absorption through adding Vitamin C to meals higher in iron.  Functional ranges for iron are much lower than conventional due to the risk that even a mild elevation can have on optimal health.

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