Vitamin D

 

 

The term “vitamin D” is a misnomer.  That is because vitamin D is in reality a hormone, not a vitamin.  The definition of a vitamin is “an essential nutrient that must be obtained from the diet.”  This definition fails to apply to “vitamin” D, since it can be synthesized in the human body, specifically in the skin.  Known as the “sunshine vitamin,” the D hormone, as it should be renamed, is synthesized as a consequence of the interaction of ultraviolet light with skin cells.  When the light rays strike the skin, they provoke the synthesis of vitamin D from cholesterol, the latter being located in large quantities within the skin’s oil glands.  Once synthesized, the vitamin is absorbed into the blood or may remain within the skin.  As little as one half hour of sunshine per day may fulfill an individual’s vitamin D needs.  In contrast, deep dark tans may actually diminish vitamin D production, since excess sun exposure damages the skin cells which produce this nutrient.

 

            Ideally, vitamin D should be included in the diet, even if the individual gets an adequate amount of sunlight.  top dietary sources include milk, egg yolks, cheese, sardines, mackerel, herring, salmon, tuna, halibut, and fish liver oils.

 

            Unfortunately, over the last 30 years seemingly as much emphasis had been placed upon the potential toxicity of vitamin D as its benefits.  As a result, the medical profession has neglected to emphasize the crucial role played by this substance in human nutrition.  Only in the past decade have  physicians and researchers begun to give it the credit it deserves.  Recent research has revealed that vitamin D is of value in the treatment of psoriasis, eczema, osteoporosis, arthritis, hypertension, kidney disease, prostate disorders, and many food supplements and the type currently added to milk, may be toxic in high dosages, the natural forms are essentially nontoxic.  One major reason for this is the fact that it is virtually impossible to achieve toxic dosages of vitamin D from eating food.  There is an exception to this rule: cod liver oil.  While the vitamin D in it is natural, one can overdose on it.  However, the epidemic problem is vitamin D deficiency, not excess.  In fact, recent research indicates that there is more reason to be concerned about the synthetic vitamin D added to milk products than the extra amounts individuals might be getting from cod liver oil or other natural vitamin D supplements.  Even so, a teaspoonful of cod liver oil per day is a sufficient dosage for most adults.

 

            There is another type of vitamin D of which to be wary: ergocalciferol.  This synthetic version has the greatest toxicity of all types of vitamin D.  It is produced in chemistry labs via the irradiation of cholesterol.  Do not use supplements containing it.  Look for cholecalciferol instead.  The latter type is essentially the same as the one produced within the skin.

 

            All of the vitamin D synthesized in the body is made from cholesterol.  Therefore, diets low in cholesterol may cause and/or contribute to vitamin D deficiency.  This brings into question the value of low cholesterol diets.  Cholesterol is an essential nutrient without which a variety of normal physiological functions become impaired.  In fact, Vitamin D is one of numerous essential compounds produced form testosterone, aldosterone, vitamin K, and cortisone.  In the case of a cholesterol restricted diet, deficiencies of all of these life giving substances are bound to occur.  Individuals placed on reduced cholesterol diets who are also taking cholesterol lowering medications, such as Questran, Pravachol, or Lovistatin, are at the greatest risk for the development of cholesterol deficiency and, therefore, vitamin D deficiency.  Tens of millions of Americans currently adhere to low cholesterol diets, and many of these individuals concurrently take cholesterol lowering medications.  All are at a high risk for disease due to cholesterol deficiency, including cancer, diabetes, dementia, osteoporosis, ;lupus, adrenal insufficiency, immune deficiency, prostatitis, and even heart disease itself.  One of the greatest ironies in “ modern nutrition” is the fact that recent evidence indicates that a fanatical restriction of dietary cholesterol may actually increase the risk of heart disease, particularly in women.  This is thought to be due to a severe reduction in the production of certain cholesterol dependent hormones, especially vitamin D, progesterone, and estrogen.  Additionally, vegetarians and macrobiotic adherents frequently develop cholesterol land vitamin D deficiencies, since their diets usually  omit or restrict meats, fish, milk products, and eggs, the primary natural sources of these nutrients.   There are not vegetable sources of vitamin D. 

 

            Vitamin D is the missing link in the prevention of osteoporosis.  It also helps prevent arthritis and may be useful in the treatment of this dreaded condition.  Its role in these and other bone disease is based upon the fact that vitamin D is the key nutrient for stimulating the absorption  and metabolism of calcium.  However, there is much more at stake as a consequence of vitamin D’s control over calcium metabolism than maintaining strong bones.  After all, it is calcium which stimulates the firing of the nerves.  It is calcium which modulates the contraction of muscles, notably the heart muscle.  It is calcium which maintains strong teeth.  It is calcium which helps keep the blood clotting mechanism on schedule so that blood is neither too thick nor thin.  It is calcium which helps control the growth of the cells.

 

            In respect to its role in cellular growth there is mounting evidence that vitamin D helps prevent colon cancer.  Researchers at the University of California discovered that people who consume vitamin D in their diets, in this instance by drinking milk, were 30% less likely to develop colon cancer compared to people with similar diets who drank no milk.  The researchers emphasized the vitamin D content of milk as the likely reason for this lowered cancer risk.

 

            Vitamin D's role in vision was recently discovered by New York ophthalmologist Arthur A. Knapp.  He gave a group of patients the nutrient for several months.  The result was that nearsightedness declined in over a third of his patients, and in many patients it was completely corrected.  Dr. Knapp’s conclusions were that deficiencies of both vitamin D and calcium potentiated visual decline as well as the formation of cataracts.

 

            Vitamin D deficiency is common in the United States and in certain high risk groups it is virtually guaranteed.  These groups include invalids, mentally deranged individuals and/or inmates of mental institutions, nursing home patients, pregnant women, strict vegetarians, individuals with chronic kidney disease and/or dialysis patients, people living amidst heavy smog, and individuals who have been bedridden for prolonged periods.  All of these groups have in common reduced vitamin D synthesis from a lack of exposure to sunlight and/ or lowered dietary intake.  Other high risk groups include allergic individuals who avoid eggs or milk products (milk products are a prime source of vitamin D) and individuals who rarely consume fatty fish.  Additionally, the absorption and metabolism of vitamin D declines dramatically with age.  Thus, it is usually advisable that individuals over 50 years of age take a daily dose of supplemental vitamin D, preferably from fish liver oil, this especially being true for those who fail to get adequate sunlight.  As little as one half hour of sunlight daily may be sufficient to generate the minimum requirement for vitamin D.  The best food sources of Vitamin D include yogurt, cheese, butter, liver, and fatty fish.   (Warning – be wary of consuming cod liver oil that has an excessively fishy odor; it may be rancid.  If fresh, the smell will not be overpowering.  Be sure to refrigerate the oil after opening.  to prevent rancidity, add 400 I.U. of vitamin E to the bottle.

 

Which of these apply to you?

 

1. insomnia

2. irritability

3. rapid heartbeat and/or irregular heartbeat

4. nearsightedness

5. nosebleeds

6. chronic diarrhea

7. bone pain, especially in the legs

8. chronic upper or  lower back pain

9. aching in the teeth

10. frequent fractures

11. cataracts

12. psoriasis and/or eczema

13. scoliosis

14. muscular rigidity

15. muscle twitching

16. muscle cramps and/or spasms

17. convulsions and/or seizures

18. vague or migrating joint pain

19. easy bruising

20. soft teeth and/or tooth decay

21. thinning of the bones (osteoporosis)

22. chipping and/or cracking teeth

23. arthritis

24. delayed wound healing

25. bruxism (grinding of the teeth)

26. Do you have psoriasis and/or eczema?

27. Are you bedridden or were you bedridden for prolonged periods in the past?

28. Do you have fair skin?

29. Do you avoid eating fatty fish such as salmon, halibut, mackerel, sardines, and herring?

30. Are you a vegetarian?

31. Do you avoid milk products because of allergy or other reasons?

32. do you have heart arrhythmia?

33. Do you have colon or prostate cancer?

34. Do you have high blood pressure?

35. do you have acne, pityriasis, and/ or rosacea?

36. Do you get little or no exposure to sunlight?

37. Do you have liver or pancreatic disease?

38. do you take Dilantin or phenobarbital (epilepsy drug)

39. Do you live in a area where there is heavy air pollution?

40. Are you bowlegged?

41. do you have an excessively high or low serum calcium level?

42. Do you have a low serum phosphorous level?

43. do you adhere to a low fat, low cholesterol diet?

44. do you have a history of duodenal ulcer, or has your duodenum been removed?

45. Do you take Tagament, Zantac and/or antacids on a regular basis?

46. do you have celiac disease or gluten intolerance?

47. do you suffer from muscular weakness?

48. do you have difficulty walking or climbing stair?

49. Do you have a history of congestive heart failure or enlarged heart?

50. Do you have gallstones and/or have you had your gallbladder removed?

51. Do you have chronic kidney disease?

52. do you have a cholesterol level below 155 mg/dl?

53. Have you been diagnosed with  Osgood-Schlatter disease?

54. Do you have bone cancer?

55. Do you have a concave (“pigeon”) breast?

 

Your Score ______

 

1 to 9 points     Mild vitamin D deficiency:  Eat foods rich in vitamin D on a daily basis and take a multiple vitamin containing vitamin D.  Be sure to get sun exposure daily.

 

10 to 21 points     Moderate vitamin D deficiency:  Follow the previously mentioned advice and take an additional  400 I.U. of vitamin D daily.  Eat a can of sardines or herring every day.  Be sure to get regular sunlight exposure; at least one half hour per day and no more than 4 hours per day would be ideal.  Wear appropriate protective clothing; do not sunbathe for prolonged periods.

 

22 to 34 points     Severe vitamin D deficiency:  Consume hefty helpings of foods rich in vitamin D (fortified mild products, fatty fish, and eggs) and take 800 I.U. of vitamin D each day.  Or, take one tablespoon of cod liver oil daily for one or two months, reducing this dosage to a teaspoonful daily.  Eating fish rich in vitamin D is preferable to consuming cod liver oil, as the oil may become rancid with time.  Be sure to get on half hour or more of sunlight each day.

 

35 or above     Extreme vitamin D deficiency:  Warning – you are at risk for osteoporosis and may suffer spontaneous bone fractures.  Softening of the skeleton already may be evident.  Furthermore, a long term vitamin D deficiency greatly increases the risk of cardiac disease, neuromuscular disorders, colon cancer, and bone cancer.  Since fat malabsorption is the most common cause of extreme vitamin D deficiency, take the following supplements to improve fat absorption:  Lipase 4 capsules (500 mg) with each meal; biotin 5 – 10 mg three times daily; Inositol 1 gm three times daily; granular lecithin on a daily basis.  In addition, take 2,000 I.U. of vitamin D daily for at least two months, reducing the dosage to 1,000 I.U. as a maintenance dosage.  Try to get a minimum of one hour of sunlight daily.