Prevention and Vitamin D
Just like my in-depth article on B12, this piece on vitamin D is not short 'n sweet, and this is for two reasons: 1) There's some misinformation about vitamin D, and clearing up misconceptions about health issues is one of the things I do, and 2) It's vitally important that you have correct information about the things that can have a huge impact on your health, your quality of life, and your longevity, and vitamin D is one of those things.
There has been a lot of buzz about vitamin D's role in cancer prevention. This has actually been known for a long time but only now are there studies to back it up. The statement that sunshine is a requirement of vibrant health is viewed by some as nonsense because we all know that sunshine causes skin cancer, right? Wrong! Sunshine is not only not the primary cause of skin cancer, but the vitamin D produced in your body from sun exposure helps your body to stay ahead of cancerous cells so that you never get a diagnosis of cancer. But these diagnoses make a lot of money for some very powerful and influential industries, and the burgeoning markets for cancer prevention drugs (that "may" help prevent cancer) only add to the importance of keeping the information on natural ways to prevent cancer away from the general public.
But the truth is out
there for those open-minded enough to hear. Listen to what one of the
researchers has to say about vitamin D and cancer, and about a "more
rational approach to cancer screening".
Imagine, screening for disease by looking for nutritional deficiencies! This "pre-actionary" approach is in stark contrast to today's reactionary medicine which says wait until you find something either through testing or symptomatic expression and then manage it with medications, surgeries, and therapies.
Studies have shown
sufficient vitamin D levels are linked to a reduced risk of a variety
of cancers. Vitamin D is important for healthy cell growth and for cellular
communication which reduce the risks for some types of cancer. The American
Journal of Public Health reported that researchers searched the Pub Med
database and found a number of observational studies of vitamin D status
in relation to cancer risk dating from 1966 to 2004. Thirty of those studies
focused on vitamin D and colon cancer, 13 on breast cancer, 26 on prostate
cancer, seven on ovarian cancer, and several that assessed the association
of vitamin D receptor genotype with cancer risk. After their review, the
researchers concluded that the majority of the research demonstrated a
protective relationship between sufficient vitamin D levels and a lower
risk of cancer. The key word there is "sufficient". The amounts
of vitamin D that are added to fortified foods are only enough to help
prevent rickets (more on this in a moment), they are not enough to provide
that protective mechanism described above.
If you are living in accordance with your biological imperatives which means among other things that you are getting sufficient vitamin D your chances of being diagnosed with cancer are dramatically reduced, often to zero. When the average American is tested for vitamin D, they come up short; they are deficient in this vital nutrient, even though many processed foods are fortified with vitamin D. Vitamin D is a nutrient that cannot be obtained from natural, unprocessed, healthy foods the foods that we are designed to eat. This is because vitamin D was expected to come from sun exposure, and who knew that one day people would be living in geographic regions where this was not possible during a portion of the year, or that even during warm, sunny weather people would be spending a majority of their time indoors instead of outdoors, and that scare tactics would be used to discourage people from getting adequate sunshine during the warmer months. So if vitamin D plays an important role in cancer prevention, and most people are deficient in this nutrient, then the result would likely be a predisposition to cancer (and other diseases) which is exactly what we have today. This result has become big business for various industries, but it's bad news for those who suffer from it. Unfortunately in this country the bottom line is "profits before people" (not my words)*. The good news is: now YOU know about the benefit of vitamin D in the prevention of cancer. Put it to good use, and pass it on. (In a moment I'll outline a prudent vitamin D strategy.)
Even Whole Foods unknowingly perpetuates the disinformation.
(Sun is great for skin because D and other nutrients are made in the skin! Just don't burn.)
But what else is vitamin
D good for? It's a well known fact that without sufficient vitamin D,
all the calcium in the world wouldn't be enough to keep you from getting
osteoporosis; vitamin D being necessary for good bone health. And vitamin
D also plays a role in the prevention of other chronic, degenerative diseases.
And that's something to think about: these conditions are all very slow
in getting to the point where you become aware of them. A vitamin D deficiency
is not like an oxygen deficiency, which you'd know about immediately.
So we go through life slowly degenerating and assuming that it's simply
part of getting older, and that it's nothing unique or personal because
it happens to everyone. But if everyone is sub-clinically deficient in
vital nutrients, and if everyone is not supporting their body's efforts
in staying ahead of serious illness, and if everyone is doing the things
that unknowingly cause these diseases, then it's only natural that everyone
would degenerate over time and get that dreaded diagnosis of something
serious at some point. So if vibrant health is something you'd like to
invest in and experience, it's crucial that you trash any notion that
serious disease is inevitable, because this can become a self-fulfilling
prophecy for people who believe it.
It's interesting how all the recent health care reform discussions have shed light on the fact that we here in the USA are doing far worse than folks in other countries (who have a better health care system than we'll likely ever have). The U.S. is 19th in infant mortality, we're 35th in average life expectancy (out of 191), we're the most overweight country in the world, and not surprisingly we're the sickest people when it comes to the preventable diseases of lifestyle. And mostly you have a for-profit ill-health management system to thank for this, because a true health care system would include education that would make it perfectly clear that a high fat diet and insufficient exercise, sunshine, and sleep are public health enemy number one.
True Health-Care is Self-Care
When I find myself among those discussing the current health care issues, I'm often asked what I think is the best health care system. Knowing what I know about the health care system we've had and will likely continue to have*, and knowing what I know about disease avoidance and health creation, there is no contest: the absolute BEST health can only be had when you take responsibility for your own health care. And yes, that places the care of your health on you, but if you place your health, your quality of life, and your life itself in the hands of those not properly educated in health creation and disease avoidance, you will likely get what the average customer of the traditional health care system gets: a life expectancy less than your actual longevity potential, and a quality-of-life in the "winter" of your life that is far less than what it could be. And telling yourself that this is what most people experience isn't going to make it feel any better. When I'm in the last fifth of my life, I want to feel as great as I did when I was in the first fifth, and I'm willing to do what it takes to accomplish this. And the good news is, what it takes is both enjoyable and delicious.
And since death is
inevitable, I want to die of non-specific organ failure, i.e. "natural
causes", not some all-too-common serious disease accompanied by diminished
quality-of-life. Natural causes or "old age" was once the major
cause of death. You went to bed one night at a ripe old age, in reasonably
good health, and simply didn't wake up the next day. That's for me! But
we've been conditioned to believe that serious illness is the norm and
is unavoidable. But this is simply not true.
Vitamin D "How To's"
How do you make sure your vitamin D level is providing optimal protection? Simple; live in the tropics. If you do, there's not much to think about regarding vitamin D (unless you wear too much clothing or don't spend enough time outdoors). But for those who can't get adequate sunshine all year-round sunshine strong enough to produce vitamin D and the other sun-provided nutrients here's a sound vitamin D protocol for those times when you can't get your D and other nutrients from the sun via daily sunbathing (more on these other sun-provided nutrients in a moment).
1. Get tested. See what your D level is currently. It's good to have a baseline, and not good to simply assume you are low. You don't want to supplement with vitamin D (or any nutrient) if you don't need to. The test to get is called a 25-Hydroxy-Vitamin D test, sometimes referred to as 25(OH)D or Vitamin D, 25-OH, Total. The test you don't want is 1,25-dihydroxy-vitamin D and, unfortunately, about 20% of U.S. doctors order this test thinking that by measuring the most potent steroid in the human body, calcitriol, they are getting useful information, but they are not. 1,25-dihydroxy-vitamin D is an adaptive hormone; it goes up and down with calcium intake. So if 1,25-dihydroxy-vitamin D is normal or high, these docs tell their patients that they are okay on vitamin D when in reality they may be vitamin D deficient, increasing their odds of cancer and other degenerative disease.
The test result range you are looking for is between 50-80 ng/ml. Unfortunately there are some docs who see a reading of 30 ng/ml as being "okay", but current research shows that this is too low. Some researchers have a more conservative range of 40-60 (this may be due to a concern that D is fat soluble, and therefore taking too much and having too high a level can result in vitamin D toxicity; more on this in a moment). But all my research suggests that if you keep tabs on your D level, the range of 50-80 ng/ml is a safe one to shoot for (and this does not require weekly or even monthly testing).
And just to point out how there can be misinformation even about something that should be well settled, and is not a matter of opinion, here are some of the various recommendations you will find when researching the "okay" vitamin D range...
As Dr. Garland in the above video suggests, get tested through a health care professional, or get a self-test kit and do it yourself. I would add that if you are supplementing with a meaningful amount of vitamin D, since it is prudent to test every two months until you find what dose gets you in the 50-80 range while supplementing, it is important to get tested using the same lab or with the same test kit each time so you are comparing apples-to-apples. There is a through-the-mail test kit available here, and a more accurate test can be done at a lab where blood is drawn, and in most states in the US you can do this without a doctor's order by buying the test from here (and I have no affiliation, financial or otherwise, with these companies or the vitamin D manufacturer that I recommend).
Besides getting a baseline, a better reason to test for your D level before you start supplementing is to see just how deficient you are if you are deficient. If you're only a little deficient ("insufficient"), then the dose of your D supplementation could follow the guidelines in this article (maintenance dose). But if you are seriously deficient, you'd want to know this because your initial dosing of D should probably be more along the lines of a therapeutic dose which will taper down to a maintenance dose as your levels come up.
2. If low, raise it (enough but not too much) If you are low in D and you can get out in strong enough sunshine, do so. Just don't get burned.
If you can't get out in the sun because it isn't strong enough, I'd consider getting a phototherapy device (artificial sun lamp array) which is the best option. The other option is supplementing with vitamin D3 (but it only provides D and not the other essential nutrients that the sun provides). D comes in drops, which might be preferable over tablets when taking 6,000 IUs; just make sure not to get drops that use fish oil (coconut oil is preferable). The drops you can get here. And Vitashine's D3 that is claimed to be a vegan D3 is here. But again, a D supplement is not the best option if you want optimal health.
A well-designed narrow band phototherapy device is the SolArc model E720M-UVBNB shown here. (Note: I do not sell these items, nor do I make any money from their sale if you buy them via these links.) This phototherapy device is a "starter" unit that can be added on to as finances allow (reducing exposure time requirements). And one benefit it has over the sun is that it maximizes the nutrient-producing wavelengths and minimizes the wavelengths that cause burning. Expensive you say? Think of it as an investment in your future health. Plus, how "costly" is a diagnosis of a life-threatening disease? Just say'n.
Although not the best option, we still must talk about how much supplementary D to take. That is the million-dollar question. There is some controversy on this issue, which is why I highly recommend that you monitor your levels until you discover the dose that gets you in the range you should be in (50-80 ng/ml, 125-200 nmol/L). Unlike water soluble vitamins, like vitamin C, you can get symptoms of vitamin D toxicity if you take too much (a list of which I include at the end of this article). Obviously this is to be avoided, but avoiding it by taking only the dose recommended on the bottle or by the USDA or some other agency may not yield the amount of vitamin D that your body needs to effectively prevent disease, both chronic (like cancer and osteoporosis) and acute (like a cold or the flu). And emerging research indicates that current mainstream recommendations are indeed too low. (Same goes for using a phototherapy device; test your D level after two months of consistent use to see if the amount of time you're using it brings your D level into the optimal range.)
If you're not getting any meaningful sunshine (sunshine that could burn you if you over-did it), and you don't have a phototherapy device, the current recommendations by the Vitamin D Council are "healthy children under the age of one year should take 1,000 IU per day; over the age of one, 1,000 IU per every 25 pounds of body weight per day; healthy adults and adolescents should take at least 5,000 IU per day. Two months later, have a 25-hydroxy-vitamin D blood test" (to ensure you are in the 50-80 ng/ml range). Those are the recommendations I follow. But at the other end of the spectrum is the IOM (Institute of Medicine) recommendation of 600 IUs a day (up from 400 IUs because rickets has made a come-back).
Keep in mind that sunshine can deliver 10,000 to 40,000 IU per day of vitamin D without the risk of overdosing. If you feel that supplementing with 5,000-6,000 IU per day sounds too high, being that the vitamin D bottle says 2,000, it would certainly be prudent to take 2,000 per day and see if that amount raises your level into the 50-80 ng/ml range. If it doesn't, increase to 3,000 a day and test again in two months, etc. If you decide to follow the above recommendations of 5,000 per day for adults and adolescents, be sure to test no later than two months after starting supplementation. If you get a reading over 80 ng/ml, adjust your D intake down accordingly and re-test in two months.
Okay, all that being said, I will tell you that at doses of 6,000 IU per day, I have never seen any symptoms of vitamin D toxicity. But if you experience any (see below), discontinue D supplementation until symptoms disappear, keeping in mind that the long half-life of vitamin D approximately 30 days would result in the side effects taking a while to disappear after you stop supplementation. It is not uncommon for side effects to fade slowly over the course of a few weeks. A standard protocol in the case of vitamin D overdosing is to not only avoid vitamin D supplements, but also vitamin D fortified foods, sunshine, and calcium supplements for a few weeks, while increasing water intake and physical demands (through vigorous exercise). Remember that healthy, natural foods (fruits and green leafy vegetables) contain no vitamin D. Also, I'd advise getting an immediate 25-hydroxy-vitamin D test to see just where your levels were when you started experiencing symptoms. Besides being good data to have in cases of deficiency and excess, the test is an especially good idea if the symptoms you are experiencing are not actually being caused by vitamin D toxicity. This comes under the heading of being an educated consumer, and when it comes to symptom diagnostics, you don't want to be misdiagnosed, which happens more often than you might imagine (remember, some docs believe a reading of 30 is good, and some misdiagnose symptoms of low D).
Vitamin D's Co-workers
One last word about over-doing vitamin D supplementation: If you become symptomatic, it may not be that you are getting too much D, it may be that you are not getting enough magnesium and other "companion nutrients" of D. There are other nutrients that need to be present in sufficient quantities for vitamin D to do its job, like zinc, vitamins C, A, and K2, boron, and magnesium. Magnesium is the most important of these co-factors where it concerns D. In fact, it is common for rising vitamin D levels to exacerbate an underlying magnesium deficiency, increasing "neuromuscular hyperexcitability" of which its primary cause is the magnesium deficiency, not the increase in D. So if you're experiencing problems when you start supplementing with vitamin D, a magnesium deficiency could be the reason why. The best way to ensure that you are getting enough magnesium (and zinc and boron, etc) is to take a high quality worthwhile multi. I take this.
Not to put too fine
a point on this, but, a vitamin never works alone; it has various relationships
with other vitamins in order to work properly. And if you're deficient
in magnesium, you could be taking an otherwise "okay" dose of
D but still experience D deficiency symptoms such as headaches, insomnia,
jitteriness, muscle cramps, anxiety, heart palpitations and/or constipation,
and your D level might not improve when taking the D supplement. Those
who are eating a healthy diet that contains lots of uncooked fruits, non-sweet
fruits, and green leafy vegetables may be getting enough magnesium (assuming
enough was in the soil that fed those crops as they grew), but those eating
a Typical Western Diet may not (probably not) be getting enough. As I
said, to ensure an adequate supply of magnesium, and the other D co-factors,
a high quality multivitamin may be a good idea; I am not an advocate of
buying a bottle of magnesium tablets any more than I advocate buying bottles
of chromium (which is vital in the proper regulation of blood sugar metabolism),
but you may have to do this when correcting a very low D level. Why? The
increased D will increase D utilization which will require above normal
amounts of D's companion nutrients for a while... amounts that are higher
than food can normally supply. This unnatural scenario is only because
of the unnatural D deficiency which would have never happened if you had
been living in your natural environment.
Overdosing by doctors
If you have your 25-hydroxy-vitamin D test done by a health care professional, and the results are very low, he or she may prescribe 50,000 IUs once a week. This has been shown to be a potentially problematic dose, and is ill-advised in my opinion; it would be better to simply adhere to the dosage recommendations of 5,000-6,000 IUs a day and re-test in two months.
Enough D from Fortified Foods?
When it was discovered that rickets softening of the bones was caused by a severe vitamin D deficiency, it was mandated that sufficient vitamin D be added to processed foods to prevent this disease among our population. While those amounts that are added to processed foods will prevent rickets, it is now obvious that these amounts are inadequate to help prevent the more chronic, degenerative diseases that vitamin D insufficiency contributes to. And if you're like the many people who are discovering that processed foods are not a healthy part of the human diet, and are avoiding them mostly or totally, you need to be vigilant regarding the nutrients that you are now no longer getting from those processed foods, and that do not come from the healthier foods you are now eating, like vitamins D and B12. D is supposed to come from sunshine, and a healthy body is supposed to manufacture all the B12 it requires. These are the two "problematic" nutrients. (I address the B12 issue in my book.) And by-the-way, rickets is making a comeback! And you can thank computers and their social networks, and Game Boys, and Play Stations for this (kids are spending less time outdoors than ever). The fix? Government is recommending that the 400 IU amount added to fortified foods be raised to 600 IUs which may help to eliminate rickets once again but obviously does little to lower the risks for all the other diseases where insufficient D is a contributing factor.
Get your vitamin D from sunshine when you can, and when you can't, keep your levels in the "sufficient" range.
This doctor sums it up nicely:
It is understandable that a doctor would see vitamin D as a "medical intervention". I see adequate D as simply a necessary part of normal human existence, and if we as a population would recognize adequate D, B12, and all the other nutrients as an important part of a healthy lifestyle (and would pay equal attention to all the other basics of health), the need for medical facilities would be primarily for emergency, poison, burn, and trauma care because the incidence of chronic, degenerative disease would reduce dramatically. And this starts by dramatically reducing the risk factors for you. Invest now for your future health!
P.S. I did think it ironic that the first video sports a photo of a woman drinking a glass of milk in the opening and closing graphics, because dairy products are a poor source for adequate vitamin D and they are a rocket-fuel for the very cancers that this research is hoping to prevent. More on milk's role in cancer here.
* Watch Bill Moyers Journal "Profits over People" where former insurance insider Wendell Potter speaks candidly about health care reform. A must-see video! http://video.pbs.org/video/1178899944/
Symptoms of Overdose
Typically, initial vitamin D overdose symptoms can include headache, nausea, fatigue, and/or red areas on the face. What follows is a more comprehensive list. If you experience any of these symptoms after starting vitamin D3 supplementation, follow the recommendations above.
Early symptoms of overdose (emerge within days or weeks of starting vitamin D supplementation)
Mild sensitivity in
teeth to hot or cold substances
Late symptoms of overdose (emerge within weeks or months of starting supplementation)
High blood pressure