D is for… (a cure for winter blues?)

D is for deadline.
D is for done
D is for delight, and dancing, and divine joy.
D is for “dang, it’s nice to be here again.”

d is for

D is for many things. Not just dragonfly.

 

D is for a few other things, too:

Dog hair, of which we have too much.
Drama, which my children offer in copious amounts.
Dude, where’s my car? A film I have not seen.

D is also a vitamin. Vitamin D is the “it” vitamin lately. Actually, it is not really a vitamin at all, but a hormone. But never mind that. Do you hear about vitamin D all the time? Because I hear about it all the time. If you live near me, you surely have heard much about it lately;  during our public radio station’s last fund drive, literally hours and hours of physician interviews about vitamin D were played over the airwaves.

Winter is hard for me. I get tired, I get sick, I grow weary. Colds come and go. It is dark early. When it is not dark, it is gray: trees, skies, the earth: all of it. Days stretch on. Some mornings, it is hard to get out of bed.

Almost a year ago, I mentioned on this blog that we had all been sick. Sick as dogs, I said.  Anna, one of my favorite commenters, suggested that we should get our vitamin D levels checked. Because D is often for “deficient,” which apparently the vast majority of us are, particularly those of us who live in places with dark, cold winters.

Could this deficiency be related to my wanting to take to my bed during the cold winter months, like some tragic character in a Victorian novel? Maybe. And maybe it could do much more than that.

Every time I hear another study about vitamin D, I’m all, “No way. Nuh-uh. don’t believe it..” Because sometimes D is for dubious.

But as we hurtle toward another New England winter — one that is surely going to be filled with viruses — I started looking into the vitamin D connection, and I have to say: D can also be for dumbstruck. Because the research — I’m talking peer-reviewed research, mind you — suggests that a little boost to my vitamin D could go a long way toward curing the winter blues. And so much more.

Our bodies, these amazing things of ours, convert sunlight to vitamin D. That vitamin D helps us absorb calcium, as well as to regulate cells. But even in the best of circumstances many of us don’t get much sun in the winter — especially not when our latitude is roughly the same as that of Toronto, Canada. Way up here, the sun never gets high enough in the sky for its ultraviolet B rays to penetrate the atmosphere. Literally: some of us live way up here where the sun don’t shine. even in the warmer months, we have office jobs, homework, meals cooked in indoor kitchens, teevee time, car trips, and so forth. Suddenly it’s not hard to understand why 70% of children and even more adults and teens are deficient in the stuff.

So our vitamin D in the winter months is limited. If we could boost our D-levels, we could probably reduces mood disorders, like PMS, depression, seasonal affective disorders, and other mood disorders. But that’s just the beginning.

Mind you: D is for doctor, which I am decidedly not.

And also: D is also for dietitian. Again, I am not.

But.

Just start scanning some of the almost 47,000 peer-reviewed studies, and you will find that having sufficient vitamin D levels is associated with lower risks of overall and cardiovascular mortality, cancer incidence and mortality, and autoimmune diseases such as multiple sclerosis. Can I just repeat that for a minute? The research suggests that Vitamin D lowers your risk of cardiovascular disease, cancer, and autoimmune disorders.

It can also other things, like lower your risk of diabetes.

Or boost your respiratory health.

Or heal chronic lower back pain.

Or boost your cognitive function.

If you’re elderly, it can reduce your risk of falls. Not just aid your bones when you do fall, mind you, but actually reduce your risk of falling in the first place. (really? wow.) It might mitigate the effects of Alzheimer’s Disease.

Look, I know there’s a ton of junk science out there, but we’re talking peer-reviewed literature here. Even if only some of what they say is true, it’s still pretty darned impressive.

So here’s my question: what are we to do about all of this? Most of us need to increase our vitamin D levels. Got it. But by how much?  And how? Some say more sun is the answer, but then dermatologists remind us of that pesky skin cancer thing. There’s also food: sardines, salmon, cod, fish liver oils, and eggs, but even that seems to be not enough for most people. Meanwhile, your vitamin D levels have everything to do with how much sun you get, what your latitude is, how dark your skin is, what you eat, your weight, age, and other lifestyle factors. Which is to say: I don’t know what you you need.

The best bet is to get your D-levels tested; ideally by a physician. I say this, but of course I haven’t actually done it yet. Because sometimes D is for “Do not,” as in “I do not follow my own advice.” You can just go ahead and start taking supplements;  one article published in the British Journal of Dermatology said that “At present, most experts in the field agree that the evidence to date suggests that daily intake of 1000-2000 IU vitamin D could reduce the incidence of vitamin D-deficiency-related diseases with minimal risk in Europe, the US, and other countries.” Note that that was published just this month. Because sometimes D is for “Date,” as in “Up-to-date.”

Be careful, though: you can take too many supplements, leading to a build-up of calcium in the blood. Sometimes D is for don’t go overboard, please.

Me? I’ve started taking 1,000 IU of vitamin D3 each day. At some point, I’ll get my levels tested, too. I’m also trying to boost my fish consumption (in the words of Bruce, the evil/kind shark from Finding Nemo, “I’m having fish for dinner tonight!”). Will I maintain my winter-time mojo this year? Maybe. I will let you know.

Anyhow, here’s the comment from Anna that first kicked off my research:

Have you had your Vit D levels checked? Unless you get/make enough Vit D all summer, you don’t make any Vit D during the winter in your neck of the woods. Everyone of my Upstate NY family has tested this winter as severely deficient in Vit D, including the 13 and 15 yo nieces, one of whom has spinal bone issues. Everyone except my dad (he listens to me) avoids the sun, uses a lot of sunscreen, thought the D2 additive in their skimmed milk was adequate, and/or relied on a puny amount of D2 in a multivitamin. Additionally, D in cheaper tablets is not well absorbed; D3 in oil capsules or drops is far superior. Low fat diets also hinder Vit D absorption from food and supplements. All foods that contain natural Vit D also come with fat, btw.

I’m not terribly into taking vitamins (I prefer nutritious food instead). But it’s hard to get enough Vit D3 from our food, since we evolved to get it from sun (not D2 the synthetic additive in milk, but rather D3, the same molecule we make in response to midday unfiltered sun exposure on our skin). Even living in So Cal, with indoor lifestyles, some use of sunscreen to prevent sunburns, clothing, etc., most people I know who have tested their levels were deficient or very low in the reference range without adequate supplementation. Even with a high amount of the foods that do naturally contain D3 (egg yolks from outdoor chickens, grass-fed whole milk, liver from outdoor mammals, poultry, as well as wild caught fish liver, etc. – in other words, not CAFO food).

When it comes to Anna, D is for Darned Smart.

Want more? There’s a nice article on vitamin D, authored by an MD (though not, I will point out, peer-reviewed) in Mother Earth News.

And now, d is about to be for darn, I really need another cup of coffee.

 

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14 Responses to “D is for… (a cure for winter blues?)”


  1. 1 Fairly Odd Mother November 12, 2009 at 5:19 pm

    Wow, my sister was just talking to me about this! I had read something about being careful you don’t take too much Vitamin D but it sounds like the level you are taking is reasonable. I wonder if young children can take this? I plan to ask our pediatrician when we’re there later this month. . .

  2. 2 Ali November 12, 2009 at 5:49 pm

    FOM – I’d be curious what your pediatrician says. I’m asking Merrie’s doc on Tuesday. My kids’ vitamin (Animal Parade) has 400 IU. Winter doesn’t seem to slow them down, of course…

  3. 3 Anna November 12, 2009 at 8:11 pm

    D is for Dynamically Delivers, which this post on Vitamin D certainly does! Wow, you really made my day with the thorough way you attacked this subject.

    The mass media reports on Vitamin D often discourage me because a) the research is too often dumbed down and made overly simplistic to the point of being worthless; b) the recommendations are too often based on outdated/disproven research and present supplementation guidelines that are overly cautious/too low, leaving people confident about their intake but with still deficient/insufficient 25 (OH)D levels; and worst of all, c) the writing formula used by freelance article writers *nearly always* tries to “balance” the article with interviews or quotes that conflict with the best research (arrgh!), which ultimately confuses readers or dilutes the important points. I no longer pay much attention to the info about Vit D in the popular media sources. I try to go “to the trenches” by watching UCTV and Stanford University TV & audio seminars given by the leading Vit D researchers(on Youtube, on iTunes, on http://www.grassrootshealth.net) and from informed bloggers in medicine or research. They are almost always enlightening, relatively easy to understand (they are usually speaking to health practitioners). I’ll often listen to the broadcasts on my phone’s mp3/video player while driving, folding laundry, doing dishes, early meal prep, or most enjoyably, laying out in the midday sun for 15 minutes on each side in my garden ;-).

    If the peer reviewed literature on Pubmed is a bit too dense for non-scientists, there are other places to read good information on Vitamin D, including a growing number of doctor and/or researcher bloggers who do a great job of deconstructing and sifting the science for the rest of us without dumbing it down or diluting it. Dr. Davis of the Heart Scan blog has written extensively on his experience with Vitamin D & 1000s of his patients and Track Your Plaque members. Dr. T’s Nephropal blog also has some great posts on Vit D with clear explanations and great visuals of the biochemical processes. Dr. John Briffa in the UK has good blog that often touches on Vitamin D topics, and so does Stephan Guyenet, Ph.D. (Whole Health Source – be sure to catch his recent series of posts on malocclusion (crowded and crooked dental bites), which is directly related to Vit D levels and other critical fat soluble vitamins). I also really like Dr. Art Ayers blog, Cooling Inflammation, another researcher up on the latest Vit D discoveries. There are many more, including Mark Sisson’s Mark’s Daily Apple blog and Dr. Mike Eade’s Protein Power blogs (the Drs. Eades’ book Protein Power Lifeplan book was what first sparked my interest in Vitamin D, after years of avoiding the sun after I had a basal cell skin cancer removed). I also have read several books written by Vit D researchers, including Dr. Holick’s excellent book The UV Advantage and Dr. James Dowd’s The Vitamin D Cure.

    All of these blogs I mentioned have numerous reader comments about their experiences with their own Vit D supplementation and 25 (OH)D testing, which is useful for developing a sense of what our own Vit D3 requirements might be (though Vit D levels/doses are somewhat idiosyncratic and individual testing twice a year is the best way to hone in an appropriate dose, as we all manufacture, absorb and utilize Vit D at different rates). With the exception of one UK woman (a reader of many of the same blogs I read) who had high levels of 25 (OH)D despite a low D3 dose, due to her diet that includes a daily tremendous amount of oily fish (some oily fish can contain significantly more Vit D than other food sources), it is unlikely most people will build up toxic levels of 25 (OH)D from supplementing at a daily rate of about 1000iU for each 25 pounds of body weight, especially if they also are ingesting enough of the other fat soluble “team players” like Vit A (not the beta carotenes from plants that need to be converted first, but real preformed Vit A from animal foods like pastured egg yolks, liver, and grassfed cream &butter and other pastured animal organs & fats) as well as Vit K2 (not the same as K1 from leafy greens that we inefficiently convert, but K2 that is more efficiently converted by ruminants and bacteria and is found in grassfed whole milk, cream, butter, aged cheese, animal fats/organs, and natto).* A balance of all these critical “synergistic” nutrients is very important and protects against toxicity of Vit A & D. In my opinion, the concerns about overdosing and Vit D toxicity are greatly exaggerated, especially if the diet also includes ample amounts of the other fat soluble vitamins and magnesium (that are involved in calcium uses in the body). Testing 25 (OH)D is the best way to be sure, though, and there are some convenient and less expensive ways to test if a doctor’s visit and lab draw are a problem (www.grassrootshealth.net).

    Vitamin D status is likely a significant factor during the “flu season”, which we know is on everyone’s mind this year. Like many places, our local schools and businesses are experiencing high rates of absenteeism due to illness and flu (and supposedly some is confirmed as H1N1, but I don’t know how much is rumor or truth). Sickness even hit our home this past week – my husband and I were flat out sick with what might have been a flu virus (I don’t think I’ve ever had the flu before and I’ve only ever had one flu shot a few years ago). We didn’t have a cold (no respiratory symptoms) but we both had fever, chills, body aches, malaise, lack of appetite, and lower GI symptoms. We didn’t take any meds, but we both doubled our Vitamin D dose (10,000iU for me and 15,000 iU for my husband). We’ve never had an illness simultaneously and we were completely bed or sofa-ridden slugs for nearly the entire 2 days – no, even slugs have more energy. Thank goodness our son is now old enough to look after himself, but the poor kid fed himself cottage cheese and apple sauce for two days, maybe he cooked himself an egg or two. But unlike our many neighbors and friends who have been sick lately, we were only down for the count 2 days, and when it was over, it was over “cleanly” with no lingering effects – once we were eating again, we regained our energy and bounced back quickly. I’ve got to wonder if maintaining our Vit D levels over 60 ng/mL (& preferably 70-80) and increasing our D3 dose dramatically at the first sign of illness was a factor in how much less hard we were hit? I won’t ever know for sure, but I do wonder.

    * do you notice all these naturally fat-rich foods (& if raised correctly on natural pastured diets are also vitamin-rich) are the very same traditional foods the diet authorities have told us everyone over the age of 2 yrs should avoid or strictly limit??? Yet 50+ years later (despite margarines, reduced fat processed products, and other imitation foods) we still have high CVD incidence rates (even if we are better at saving people after they develop CVD), and we see increasing rates of chronic degenerative diseases like diabetes (Type 1 & II), autoimmune diseases, cancer, Alzheimers & other dementias, osteoporosis/osteopenia, obesity, kidney disease, mood & psychiatric disorders, autism spectrum disorders, ADD/ADHD, and so on. Even rickets is on the rise, and that was considered practically eradicated in the developed nations early in the 20th century after air pollution was reduced and small amounts of Vit D were added to milk (about 98 iU per 8 oz, so you’d have to drink far more than usual to even raise 25 (OH)D modestly, but also consider that in low fat or non-fat milk, it might not even be absorbed!).

    Now it’s approaching noon and the weather is pretty mild today, so I think I’ll pop outside to do a bit of gardening while setting my “internal clock”, even if the sun rays are unlikely to produce much Vit D this time of year.

  4. 4 TC November 12, 2009 at 8:17 pm

    The first thing I thought as I read this is the “light therapy” thing so many people swear by for dealing with Seasonal Affective Disorder (yes, SAD) during the winter months. I wonder if that helps boost vitamin D…(TC toodles off to Google before hitting ‘submit’)…and, no. Never mind. (Sigh…and here I thought I was about to solve all your problems. But I’ll still post this, because maybe light therapy would help you IN ADDITION to Vitamin D?)

  5. 5 Kelly November 12, 2009 at 8:38 pm

    It’s good to see you here! I have been taking D3 and giving it to the four year old. The vitamins say for kids 4 and up though and I don’t know if I should give it to the two year old or not.

  6. 6 Frances November 12, 2009 at 9:54 pm

    I remember that nonstop vitamin D commentary during the fund drive. Every time I tuned in!

    And your post is timely because in fact I was told — by a doctor, no less — that I have a vitamin D deficiency. I dutifully purchased a supplement and have been downing it ever since. Hopefully it’ll stave off depression, but in the meantime, I’m going to dive into your links (which will be a nice diversion from design).

    Ugh, sorry!

  7. 7 Nicole November 12, 2009 at 11:43 pm

    Dude, I am SO glad you are back. In case you are wondering, “Who the hell is this?” I’m someone who has been reading your blog for years (wow, that is pretty weird) but never ever leaves comments (cause I’m lame like that). But D is for Damn, that is a good blog post, I really Do have to leave a comment…
    -n

  8. 8 Vikki November 13, 2009 at 4:45 pm

    I could definitely use some improvements in my cognitive function. D is for improvement. See what I mean? I get easily confused.

  9. 9 Toby Lee November 14, 2009 at 2:12 pm

    Take a look at http://www.vitaminD3world.com for all the data on vitamin D.
    the site also offers a good newsletter and has recently launched a new micro-tablet version of D3

  10. 10 dani poppins November 14, 2009 at 6:35 pm

    I’m chronically low so I had the kids, the Man and I all on D supps for about a month now. Just had a go-round with H1N1 this past week and we all fared VERY well; my daughter got the worst of it (fever never went over 102), the Man and I got it very mildly and son barely had a fever and was nauseous for a day and that was it. Vit D is super duper stuff. (Carlsons makes drops, 1 drop = up to 2000iu per day and is tasteless!) PS… glad to see you blogging again. ~ a lurker

  11. 11 Janine November 14, 2009 at 9:02 pm

    D is for DELIGHTED that you posted again! I know you have been crazy busy on good stuff- but I have SO missed your blog. Been down with the flu for three days now and am thinking I must send a minion out for some D3 vitamins and D-rich foods. Great stuff, great to have you back at CPC

  12. 12 Robin November 15, 2009 at 6:28 pm

    Ali,
    I was below basement level when I was first tested a year ago. My doc has me on perscription strength D pretty much forever, I think. Apparently, I was so low it was impossible to get up with over the counter stuff.

    I went off of them over the summer (and I was in the sun A LOT) and my levels FELL markedly. What’s up with that? So, back on them as of this week. Curiously, my bout of the flu improved dramatically the day after I took my D dose. I love the stuff. It makes my fingernails grow long and pretty.

  13. 13 Anna November 17, 2009 at 9:10 pm

    Robin,

    The prescription dose of Vitamin D is 50,000 iU D2, also called ego-calciferol(usually taken once weekly for 12 weeks), which is a synthetic version (made from irradiating plant sterols) – NOT the bioidentical D3 cholecalciferol (usually made from fish liver oil or sheep lanolin) that is the same molecule humans/animals make from UVB radiation. Drug companies can’t patent the bioidentical D3, but they can patent synthetic D2 in high doses and sell it as a Rx drug for a lot more $$$, even though it isn’t as efficiently used by the human body.

    Many doctors (like Dr. Wm. Davis of the Heart Scan blog) who have tested 1000s of patients on various varieties of Vit D find that D-deficient patients don’t convert the D2 into the bioidentical D3 very well. More people do better on a high dose of cheaper D3 (in oil capsules or powder capsules, not hard tablets). My sister’s doctor prescribed the expensive high dose 50,000iU/wk D2 for her 25 (OH)D deficiency (her level was 13 ng/mL) but her teenage daughters’ doctor said they could take a high dose of OTC(both were under 20 ng/mL) – on 5,000iU/day OTC oil gelcaps they raised their levels faster and higher with much cheaper D3 than she did with the Rx D2.

    I take Bio-Tech 5000iU D3, which is only about $8 for 100 capsules (no affiliation). My husband and son take Carlson’s versions of D3 in 2000iU or 4,000iU per drop or capsule (no affiliation). Most of the OTC versions that are carried in drug stores and grocery stores are only 400 or 1000iU per capsule, and those tiny doses are just a drop in the bucket for nearly all people who live, work, or go to school indoors and otherwise get little midday sun; wear typical clothing; live north of Atlanta (in the Northern hemisphere); live in urban/suburban areas with polluted air; use sunscreen; but especially for people anywhere who know they are deficient from testing their 25 (OH)D level. I think it was Dr. Cannell of the Vitamin D Council (www.vitamindcouncilp.org) who said that the body uses Vit D faster than it can be realistically replenished by most supplement doses or sun exposure if the 25 (OH)D level is under about 50 ng/mL.

    And some people don’t absorb any dietary/supplemental Vit D very well due to gut absorption issues/damaged instestinal villi (gluten-induced damage, IBS, Crohn’s, etc.) so they will need very high doses of D3, whether it is prescription D2 or OTC D3. People with these issues probably also don’t absorb Vit A, E, K2 or fat and minerals well, either and can be malnourished even if they have a “good” diet. If we don’t absorb it, we can’t use it.

    To further complicate things, as we age, our skin thins and we don’t synthesize D3 as well from UVB sun rays as when we are were younger, so those over 40 yo might not be able to make enough from sun alone without running around naked at noon (which would likely land one in jail, a sure place to become deficient in Vitamin D, eh?). Air pollution and ozone also block UVB rays. And consider that D3 is synthesized from cholesterol and sooooo many people are now convinced that their cholesterol level needs to be super low, and it’s easy to see some might not even have the raw materials to make D3 even if they are young and get some regular midday sun.

    I have experimented with my own levels and supplements and find I need 5000iU daily year round to keep my level up where I want it 76-80 ng/ml). Even living in So Cal, having a flexible schedule so I can get at least 15 minutes midday summer sun exposure many days, I have found my 25 (OH)D level will drop to near the bottom of the 25 (OH)D reference range 30-100 ng/mL) if I don’t supplement at a fairly high dose (I’m 47 yo, fair skinned, and I don’t have low cholesterol). My husband *and* our 11 yo son als need fairly high doses (8000iU and 4000iU respectively). The poor air quality here could be a factor, too. The smog haze is especially bad in the summer.

  14. 14 Robin November 18, 2009 at 12:08 am

    Thanks Anna. Unfortunately, I can’t tolerate D3 as I get terrible headaches from it. My doc says that happens. The good news is that I tolerate the prescription D and it’s working. I get my levels checked every three months.


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