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Vitamin D!

It’s not cold and flu season, it’s Vitamin D deficiency season! Vitamin D is such an important nutrient - way more than the bone building and immune-boosting properties. Unfortunately, one of America’s major medical academies, the Endocrine Society, is not interested in ensuring we have adequate levels of it. It recently published clinical guidelines that recommended against regular testing for Vitamin D levels. “…Based on the absence of supportive clinical trial evidence, the panel suggests against routine 25(OH)D testing in the absence of established indications. These recommendations are not meant to replace the current DRIs for vitamin D, nor do they apply to people with established indications for vitamin D treatment or 25(OH)D testing. Further research is needed to determine optimal 25(OH)D levels for specific health benefits.”


Basically, since there are no specific values that are linked to specific outcomes or even improve quality of life, then they don’t recommend testing at all. Never mind that the article does state that there have been myriad documented benefits of Vitamin D on various aspects of health, there just aren’t enough randomized controlled trials (RCTs) to prove that getting tested regularly is a good idea. The problem is that now your insurance policy will be less likely to cover the cost of a blood test.

But I know you are smarter than that! A search in Plos-One reveals about 36,000 citations about Vitamin D, but I guess they are not the data they were looking for? Physicians who were paying attention during the pandemic knew that optimal Vitamin D levels were an important factor in disease severity for those infected with SARS-Cov2. Here's a recent review article that provides more evidence. 


We may not know the specific level of Vitamin D that is ideal for every specific disease, but we DO KNOW that levels of 60-80ng/dL are recognized as generally optimal for wellbeing. The reported "normal" range of most labs is between 30-100ng/dL. Maintaining a level of 30 is what you need to not get rickets, but absence of disease is not the same thing as having optimal health. 


While most consider Vitamin D important for, healthy levels are protective of so many other chronic health conditions such as cancer prevention, mood, weight, pain management, and so much more! People with adequate levels of Vitamin D fared much better in fighting their Covid19 infection (even in the initial and delta waves) In fact, and you probably already know this, but Vitamin D is actually a fat-soluble hormone!


Therefore, we can and should test our Vitamin D levels to make sure you’re getting enough is a good idea. The cash price is only about $20. Then proper adjustments to sunlight and supplementation can be made. My basic recommendation is that from about October until March, people in Indiana should be supplementing with Vitamin D because we are not getting anything from the sun at that time. 


Factors influencing absorption:

  • Geography: the further away from the equator, the less you absorb - check out d-minder for more information.

  • Skin color: darker skin means less absorption

  • Air pollution: decreases absorption

  • Sunscreen: decreases absorption

  • Weight: heavier people need more Vitamin D

  • Age: older people absorb less

  • Illness: can inhibit absorption - liver function overdrive in acute or chronic illness decreases Vitamin D processing.


Five things you might not know about Vitamin D (see Dr. K's Five-a-Day)

  1. The lab reference lower range of 30ng/dL is the level at which one is not likely to get rickets

  2. It is a fat-soluble hormone (not a vitamin)

  3. Helps improve mood (another great reason to supplement in the winter)

  4. Reduces risk of cancer

  5. Helps manage pain


There's SO MUCH more to this wonderful compound. But we don't have to understand it all to reap the benefits! 

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