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The Forgotten Vitamin

By Bryan Wogen, PA-C

In the world of vitamin supplementation, there is frequently a heavy focus on B-Vitamins as they are the ones that are thought to provide “energy”. Mistakenly though, patient will either self medicate or worse, many times a primary care physician will prescribe even monthly B12 injections to help with fatigue. Routine bloodwork is often disregarded. But if checked, a skilled clinician will find that the patient’s B12 levels are, in fact, well within normal limits. Let's explore a common and grossly underdiagnosed issue in America, and the world at large. Vitamin D deficiency.

Vitamin D is often frequently overlooked and also wildly underdiagnosed. Let’s take a look:

Background:

Recent research has begun to consider Vitamin D as a pro-hormone and less of a vitamin. Although it still maintains its designation as a “vitamin” simply because your body cannot naturally produce it in significant enough amounts to sustain the necessary levels.


For more context, let's look at the definition of a “vitamin”

“ Any of various fat-soluble or water-soluble organic substances that are essential in minute amounts for normal growth and activity of living organisms. They are synthesized by bacteria and plants and are obtained by animals chiefly in their diet


Cool. But what is a “pro-hormone”

These act as a precursor of regular hormones that your body produces. Prohormones generally help in amplifying the effect of existing hormones.

Everyone knows that your body can use sunlight to create Vitamin D, but there is very little evidence to suggest that you can produce enough to maintain healthy levels.


If humans can’t produce enough of it, to sustain normal levels, how did our ancestors get enough Vitamin D?

Great question! Vitamin D is a fat soluble vitamin and found in animal fats along with some plants. By and large though, the greatest source of Vitamin D comes from foods that contain, or are derived from, animal fats. However, by and large, most diets today do not provide enough Vitamin D (i.e. processed foods, low fat diets, etc.)

So what are the symptoms of Vitamin D Deficiency:

A basic search on the internet will show that the most common symptoms associated with Vitamin D deficiency are:

  • Fatigue

  • Depression

  • Bone pain

  • Muscle weakness/cramps.

But there are more subtle warning signs/symptoms that most medical journals do not reference and are easily identifiable by anyone at home.

Here’s what you should watch for:

  1. Dry and easily cracked skin despite frequent application of hydrating lotions is a major warning sign.

  2. Dry and brittle hair that doesn’t seem to “grow anymore” is another……. And all too often complained about! This is especially common in breastfeeding mothers as your breastmilk is transferring the vitamin from your body to the baby's and depleting your levels.

THESE SYMPTOMS ARE NEVER REFERENCED!

Furthermore, Vitamin D has been clinically correlated to contribute to cardiovascular disease, diabetes, osteoporosis, immune health and much more. Vitamin D deficiency has even proven to be a massive contributor to COVID-19 mortality.

So should I get tested?

Routine testing just to see what your current levels are out of curiosity will not be covered by insurance. There are always private labs where you can get it checked, though, if you really wanted at your expense. But if you do have any of the above symptoms, you should consult your medical provider. Vitamin D testing is likely warranted and covered by insurance. Plus if it’s normal, you will have cued in your physician to something that is wrong and needs further investigation/treatment.

But can I just supplement? Is it safe?

There is a risk of toxicity with vitamin D supplementation. The biggest concern is that too much vitamin D can cause calcium to be deposited in various organs. NOT GOOD! However, research recently performed by the University of Oregon showed that for most people, supplementation of 10,000IU per day or less rarely results in toxicity. For our practice, we usually advocate for a dose of 2,000-3,000IU per day.


My Doctor checked and it turns out my levels are low! He started me on a monthly dose of Vitamin D. That's even better, right?

No! This is part of the paradoxical nature of Vitamin D. If your Vitamin D levels are already low, your body cannot store that large of an amount. You must have normal levels of vitamin D to be able to store it. So, we advocate that you take a daily dose until your levels are normal. Then you can switch to a maintenance monthly dose.

This is all great information. Where can I read more?

Generally speaking, data published by Universities is much more reliable and thorough. Start with this excellent article: https://lpi.oregonstate.edu/mic/vitamins/vitamin-D#toxicity

There are so many options. Do you recommend any specific brand?

While we aren’t affiliated with any particular brand, we do find that NOW supplements are generally cheaper but still maintain good quality.

Try buying it here: https://amzn.to/3sMNfeg

What about other supplements? Do you have any general recommendations?

In general, supplements can be a HUGE waste of money, even multivitamins. You end up just wasting them away through your urine. There are a few that most people could benefit from though. But grab your cup of coffee, these are pretty boring.

  1. Fiber: nearly everyone in America could use more fiber. This is a fairly tried and true product that is cheap. It helps fend off constipation, improves blood sugar for diabetics, and even wards of colon cancer. Try this one: https://amzn.to/3fvRDe0

  2. Protein powder: for quick and easy meal replacement that helps to avoid all the unnecessary sugar and processed foods, this is an easy win. I prefer plant based proteins because they have higher amounts of fiber and are easier on the belly. Try this one: https://amzn.to/3m9NQo2

  3. Want energy? Good ‘ole sleep, water, and a bump of caffeine is usually all that’s needed. But try a lighter roast. Darker roasts burn off most of the caffeine. Just be careful if you have high blood pressure.

Try this one and support some veterans along the way: https://amzn.to/3cHilhW

Hope this helps. Have a great day!

-B

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