Vitamin D deficiency is a common issue not just locally, but globally, as there are around three billion people worldwide who are deficient in this critical vitamin. There are many factors that contribute to this deficiency and, here, we’ll explore some of the main reasons. But let’s start with why we need this vitamin – it’s not just to protect from rickets!
Vitamin D plays a central role in the immune system, muscle function, bone strength, cardiovascular function, respiratory system, and brain development. Once activated, it works by managing calcium in your blood, bones, and gut. It also helps cells all over the body communicate properly. Another not-so-well-known benefit is that it’s a pro-hormone, which means it is needed for the production of hormones – especially sex hormones like estrogen and testosterone – and has a role in fertility. I believe my low vitamin D was a contributor to my unexplained infertility and I wish I knew more 15 years ago!
How can you tell if you have vitamin D deficiency?
There are some signs and symptoms that indicate that vitamin D levels are deficient or suboptimal (suboptimal means it is within normal range, but not at an optimal level for your body). Here are seven such signs that you need more vitamin D:
- Chronic pain in muscles, joints, and back
- Mood swings
- Depression – you might have heard about winter seasonal depression, but this could also happen even if you’re living in year-round sunny regions due to a lack of vitamin D
- Feeling fatigued and sleepy during the day
- Osteoporosis or stress fractures, which are tiny cracks in the bones
- Frequent illnesses, like getting colds and flu or feeling you can’t easily shake off a cold
For a detailed review of vitamin D and signs of deficiency, you can refer here.
What causes a vitamin D deficiency?
Your skin makes vitamin D when it is exposed to a pinking dose of sunlight. How much vitamin D you make depends on age, genetics, how much skin is uncovered, and skin tone. Without sunblock and with arms and legs exposed, your skin will typically make 10,000 to 15,000 units of vitamin D in one pinking sun exposure, on average.
Where you live (latitude) also has an impact based on how much radiation from the sun for vitamin D production is available. Even environmental pollution affects how much radiation you can get from the sun. As you see, there are so many different factors, and today, I will focus on two critical factors that most people overlook when trying to increase their vitamin D levels.
The body uses nutrients in a symphony – not solo! Vitamin D works with vitamins A, k2, and magnesium. Thus, relying on vitamin D supplements or booster injections alone will not resolve your issues in the long term, and often supplementing with a high dosage would tip your body into an imbalance as it tries to handle the sudden increase in intake without having enough of the supporting synergistic nutrients it needs.
Magnesium is required for the body to convert vitamin D into its final, usable form. It’s also a very common nutrient deficiency, especially for those with cardiovascular or blood sugar control (e.g. diabetics). Many factors deplete our magnesium reserves, such as stress and taking certain medications like acid suppressants and birth control pills. And we’re not likely to get enough magnesium from food because of soil erosion from modern agricultural practices.
So, if you find yourself getting low vitamin D levels every time you test, then focus on boosting your magnesium levels even before starting with vitamin D supplementation. You can use Epsom salt foot or bath soaks, or use a supplement. However, keep in mind that there are eight different types of magnesium, and your overall health determines what type works best for you to get the benefits you’re looking for and avoid issues from using an inappropriate type. Please don’t hesitate to ask if your doctor if have questions about the most effective or reliable tests for gauging your sufficiency or what forms of these nutrients are most bio-available.
Insufficient Healthy Fats
Many people, unfortunately, fear fat and are not consuming enough, which affects their hormones, digestion, the health of their cells, and absorption of fat-soluble vitamins such as vitamin D! Incorporating healthy fats into your daily meals would boost your absorption to improve your vitamin D levels. These include salmon and other fatty fish, avocado, ghee, and butter (animal-based, not made of or mixed with vegetable oils), olive oil, nuts, and seeds.
How can you boost your vitamin D naturally?
The best source of vitamin D is, of course, exposure to sunlight (specifically UVB). Here’s how you can maximise your vitamin D3 production from sunlight.
- Body exposure: You need to expose at least 35% of your body to get sufficient exposure, so make sure your face, arms, and lower legs are uncovered (wear a tank top and shorts, for example).
- Duration: How much time you need to spend in the sun depends on your skin tone and is explained below.
- Light skin = 15-20 minutes daily
- Medium skin = 25-30 minutes daily
- Dark skin = 40-45 minutes daily
- Time: The best time to get sun exposure depends on the latitude and season. According to a study done for Riyadh, Saudi Arabia, the optimum time to get sun exposure for vitamin D3 production during summer is from 9am and before 10:30am, as well as after 2pm until 3pm, while during winter it’s from 10am until 2pm. UAE is in close proximity, so similar timing would work.
- Sunscreen: Keep in mind that wearing sunscreen, even an SPF of 30, would limit your body’s ability to make vitamin D and reduce it up to 95-98% according to several studies. Practically speaking, you can sunbathe without sunscreen initially, up to the duration recommended above, and then apply the sunscreen if you will be spending more time. The key point is that your skin should not actually burn, so do wear protective clothing or apply mineral sunscreen if you’re staying longer in the sun. Note: mineral sunscreens use zinc oxide or titanium dioxide as the main ingredients versus other types of sunscreens, which use toxic chemicals that remain circulating in your bloodstream.
Some foods are also considered sources of vitamin D, however, the amount in food is not high enough to fully rely on just it. Here are examples of food sources highest in vitamin D:
- Salmon and fatty fish provides around 100 IU per 30 grams of fish
- Chicken or beef liver provides 25-50 IU per 100 grams of meat
- Egg yolk provides 20-40 IU per egg yolk
- Mushrooms are known to be a source of vitamin D, but you only get 1 IU per a medium-sized mushroom, so it is far from a practical choice!
When it comes to diet, as mentioned earlier, make sure you have sufficient magnesium levels and that healthy fats are part of your diet.
How would the functional medicine approach solve your deficiency?
A functional medicine approach is different from traditional allopathic medicine because it views the body as one whole interconnected unit, and every organ and function in the body needs to be at an optimal state for healthy vibrant wellness. Applying this to testing, the notion of a marker being in the “normal range” is not good enough. These normal ranges were calculated based on statistical norms, including an unhealthy population. Tested levels are best to be at optimal levels (not just normal range), and that optimal level depends on the marker and what is sufficient for each unique person.
To clarify this point, vitamin D’s normal level starts from 30ng/mL. However, levels below 40ng/mL are linked to twice the risk of heart attacks, increased high blood pressure, and three times the risk of multiple sclerosis, while levels above 50ng/mL have shown a 50% reduction in breast cancer and decreased risk of all solid cancers. And some people feel their best when their vitamin D level is at 70ng/mL. Of course, as always, too much of anything can have adverse effects, and clinical research is starting to uncover that significantly elevated vitamin D might have many negative consequences. Thus, there’s no one clear value that is best for everyone and functional medicine builds on this to take a very personalised approach.
From adorable infants through to our beloved elderly ones, everyone should have their vitamin D level checked at least once a year, preferably twice, as that is the only way to determine actual levels. Testing is the only way to know for sure if you are getting enough vitamin D. We also have varying levels of vitamin D receptor sensitivity in our cells, so paying attention to your symptoms and overall wellness is also key to understanding when your body needs support. All these factors would be taken into consideration when determining what dosing is right for you.
Those with digestive issues may need specific forms or higher doses to gain optimal blood levels, but generally speaking, daily dosages in liquid or softgel form supported by the other synergistic vitamins are better absorbed and gentler on the body, such as this supplement from Seeking Health brand, which is a combination of vitamins D3 and k2. Be sure to consult your practitioner for your unique needs and always repeat testing after two to three months of using supplements to gauge the change and map out a maintenance plan.