Vitamin D is a fat-soluble vitamin that can be ingested through food or supplements or produced when ultraviolet (UV) rays from the sun hit your skin. It’s important to get enough Vitamin D because it plays a role in your musculoskeletal system (including bone health), immune system, and nervous system. It also helps to reduce inflammation in the body. Inflammation is responsible for causing many health issues, including Alzheimer’s disease and dementia, cardiovascular issues (stroke, heart attacks/disease/failure, arrhythmia, and more), rheumatoid arthritis, depression, asthma, inflammatory bowel disease (IBD), and many others.
Sources of Vitamin D
Sun Exposure
Now that the weather is getting warmer, we may naturally find ourselves going outside more frequently. While you’re out there, you may want to consider increasing your chances of getting enough Vitamin D naturally. For those of us north of the equator, staying outside in the sun for 15-20 minutes from 10 am – 4 pm at least a couple days a week between April and October may be enough to meet your requirement. However, there are several factors that influence how well your body can convert that sunshine into the Vitamin D you need. This includes:
- Cloud cover. An increased number of clouds will significantly reduce the number of UV rays that will be able to penetrate your skin.
- Smog. Much like cloud cover, higher levels of smog or air pollution will reduce the UV rays that can reach your skin.
- Skin melanin content. Research has shown that people with higher melanin content (darker skin) produce less Vitamin D from sunlight (Batai et al, 2021). This means it is important for those people with darker skin, especially African-Americans, to get more sun exposure or supplement with diet or pills.
- Older age. Older people are also less able to produce Vitamin D from sunlight (Meehan and Penckofer, 2014). This is due to changes in the skin, as well as changes in lifestyle. As we get older, we need more sun exposure or Vitamin D supplements to reduce the risk of metabolic disease that often occurs in older populations that are Vitamin D deficient.
- Sunscreen use. Sunscreen and sunblock are intended to block the UV rays; therefore, using sunscreen will inhibit your ability to produce Vitamin D from the sun. It’s important to ensure you don’t burn if you plan on being outside for longer periods of time in the sun; because lotions tend to require application before being out in the sun, you may want to take a Vitamin D supplement when using sunscreen or sunblock.
Diet
There are several foods that are a good source of Vitamin D. These include:
- Fatty fish like salmon, canned tuna, sardines, swordfish, herring, and mackerel
- Egg yolks
- Beef liver
- Mushrooms
- Cod liver oil
- Vitamin D fortified foods and drinks, such as cow’s milk, many plant-based milks, cereals, and orange juice
Supplements
If your doctor tests your Vitamin D levels and finds that you are deficient or low, they may recommend taking a supplement. Because Vitamin K2 helps with the absorption of D3, they may recommend taking both. Your doctor is the best one to determine how many International Units (IUs) you need to take. This is based on your test results, weight, and other health factors.
A recent study has suggested that people with a Body Mass Index (BMI) of 25 or higher may have a diminished response to Vitamin D supplementation (Tobias, Luttman-Gibson, and Mora, 2023). Additionally, the authors mention that previous research has suggested a variety of other hypotheses to explain lower Vitamin D levels in those with a higher BMI, including the idea that these individuals may sequester Vitamin D in adipose tissue, which impacts its absorption and use in the body. While more research needs to be done, if you have a higher BMI, your doctor may choose to give you a higher dose of Vitamin D.
You may also want to consider taking a whole-food based supplement; these types of pills have been shown to be more easily absorbed by the body compared to synthetic (made in a lab) pills. Talk to your doctor about what option or brands they recommend.
Vitamin D and Chinese Medicine
When it comes to Chinese Medicine, we acupuncturists take a slightly different view of Vitamin D deficiency or insufficiency. Because the sun is considered to be “yang” and a source of “qi” (energy), this may lead someone to have Yang or Qi Deficiency. They may also have patterns of disharmony that include dampness, or poor liver or kidney qi. This can present as fatigue, feeling of heaviness in the limbs or sluggishness, excess weight, cold hands/feet, joint pain/stiffness, depression or irritability, which correspond to many of the symptoms seen in people with deficient or insufficient levels of Vitamin D.
In Chinese Medicine, we use diet, needles, and herbs to tonify the kidneys and liver, as well as the overall yang and qi of the patient. When combined with supplementation and/or sun exposure, your system can more easily be brought into a state of dynamic balance.
Summary
Sufficient levels of Vitamin D are critical to your overall health and vitality. While labs currently recommend levels of at least 30 ng/mL, many health experts now suggest that optimal levels are 40-70 ng/mL. Test results below 20 ng/mL are considered deficient and may be supplemented with IV doses of Vitamin D. Results ranging between 20-29 ng/mL are considered low or insufficient. Half of the entire global population has insufficient Vitamin D, and up to 42% of Americans are Vitamin D deficient. Talk to your doctor about getting tested if it’s been more than a year since your last bloodwork. It could be one of the most important things you do for your health this summer.
References
Batai, K., Cui, Z., Arora, A., Shah-Williams, E., Hernandez, W., Ruden, M., Hollowell, C., Hooker, S., Bathina, M., Murphy, A., Bonilla, C., & Kittles, R. (2021). Genetic loci associated with skin pigmentation in African Americans and their effects on vitamin D deficiency. PLOS Genetics, 17 (2). https://doi.org/10.1371/journal.pgen.1009319
Meehan, M. & Penckofer, S. (2014). The role of Vitamin D in the aging adult. J Aging Gerontol, 2(2). https://doi.org/10.12974/2309-6128.2014.02.02.1
Tobias, D., Luttman-Gibson, H., & Mora, S. (2023). Association of body weight with response to Vitamin D supplementation and metabolism. JAMA Network Open, 6(1). https://doi.org/10.1001/jamanetworkopen.2022.50681
Note: This article was originally published in a local magazine for their May 2023 issue. For citation references, please contact Dr. Yocum at https://jenyocum.com/contact/
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