LifeCare Chiropractic

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vitamin D dosage

Vitamin D: 6 Things Your Doctor Probably Doesn’t Know

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Health benefits of vitamin D
Health benefits of vitamin D

I know, I know. You already know everything about vitamin D (mainly because you ALWAYS read this blog).

Besides, your doctor has already checked your vitamin D and (almost assuredly) told you that your levels were low and you need to take 10,000 of prescription vitamin D once a week. Or maybe he or she just told you to run to the store and buy your own and take 1,000 IUs per day.

And, since you have heard that vitamin D does everything from protect you from cancer to making your lawn greener, you dutifully ran out and complied. But was this the best course?

Here are a few things to note that your doctor might not be aware of:

  1. If your doctor checked your levels, you can rest assured he or she is at least a decade behind the researchers who say not to bother—everyone’s low so just supplement everyone (with very few exceptions).
  2. While the labs say you should be over 20 ng/dl, this is NOT optimal. Optimal is recognized by vitamin D experts as being between 60-100 ng/dl.
  3. The prescription forms of vitamin D (which are usually vitamin D2, NOT the D3 form) just don’t budge blood levels very much. Don’t waste your time, money or health.
  4. If you’ve had your gallbladder out or have had bypass surgery, there is NO way you’re going to absorb a vitamin D that’s not emulsified (and few are).
  5. There are many factors that go into how much vitamin D you should take, but I can almost guarantee that, if your bloodwork has been low, 1,000 or even 2,000 ain’t going to get you to optimal. Most I have come across need 4, 6 or even 10,000 per day to get up to optimal levels.
  6. If you are at optimal levels, you’re in a very, very small elite group. Consider yourself a 1-percenter.

Despite, all the evidence and concern floating around everywhere about vitamin D, how could a mere 1% of the population reach optimal levels??  Before you think it’s unreasonable to think the number is so low, I can count on a single hand how many times I’ve seen patient bloodwork in the optimal range.

This particular study drives this point home. In it, researchers looked at 14,641 men and women aged 42–82 years who were living in England (arguably a less-than-sunny location). They were put into 5 groups based on their initial blood levels of total 25(OH)D (less than 12, 12-20, 20-28, 20-36 and more than 36 ng/dl). Here’s the details of what they found after following them for 13 years:

  • The average vitamin D levels was 23 ng/dl.
  • Participants risk of dying from any cause went lower as the vitamin D levels went higher than the lowest group (16% lower in the 2nd group, 28% lower in the next level up, 29% next and 34% lower risk of dying in the group with the highest vitamin D levels.
  • To put this into perspective, for every 8-ng/dl increase in 25(OH)D in the blood, there was an 8% lower risk of dying from any cause, 4% lower risk of having heart disease, 11% lower risk of being diagnosed with a respiratory disease and 11% lower risk of having a fracture.
  • There was, however, no change in the risk of total cancers (although I would not be surprised, given past research, if we saw a lower risk with certain cancers if looked at individually).
  • Those who had levels above 36 ng/dl where the least likely to die.
  • Less than 1% of the population studied had vitamin D levels above >48 ng/dl.

I think we could run this same study anywhere in the world and get similar results with similar percentages of protection as well as similar levels of very low vitamin D levels.

It’s time to take the 6 factors noted above and take action. In our office, we offer Biotics brand emulsified vitamin D that is ridiculously inexpensive (otherwise I’d be writing this from first class…). Most patients spend around $20 PER YEAR for a top-quality vitamin D and even have to share it with their family so that it doesn’t expire before they use it all.

THAT is a good bang for your buck.

How Much Vitamin D Do I Need to Take to Stop Infections?

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Before we answer to question of how much, we should probably look at whether or not vitamin D can help with infections in the first place.

While vitamin D supplementation has been attributed to any number of health effects, there are a few situation where vitamin D seems to shine. This includes long term (10 years or more) risk of cancer, vascular health (heart disease, stroke, dementia) and immune balance. Vitamin D has also been shown in multiple studies to help with respiratory issues (pneumonia, influenza, asthma), but I’m not sure if the benefit is from an actual effect on the respiratory system, or indirectly from vitamin D’s immune effects. Either way, vitamin D has a pretty solid acceptance to support and balance immune function.

This aspect I find interesting, because every flu season there is a massive, expensive push to get every breathing person vaccinated for influenza, but never is there a mention about how to support the immune system through interventions such as vitamin D supplementation.

Doctors think they are doing the right thing by checking patients’ vitamin D levels. There are three problems with this:

  1. Very, very few patients are at optimal levels (60-100 ng/ml).
  2. Testing, when insurance is billed, is expensive.
  3. Even when patients come back deficient, doctors rarely know how much vitamin D to give and what the best forms to give are.

Between these three, we are wasting money testing patients who have a very high likelihood of being less than optimal and when we spend the money to confirm it, we’re not fixing it correctly. No wonder healthcare is so expensive.

Basically, checking vitamin D levels is getting into the realm of functional medicine (much like checking testosterone). I feel very strongly that no doctor should be checking these values unless they fully understand to nuances that go along with functional testing. Consider the mess we’ve gotten into with testosterone, another lab value that I have had more and more patients come in who have had it tested by his or her primary care doctor. Patients who have low testosterone are given some form of testosterone (injections, cream, pills, pellets) rather than fixing the problem in the first place.

But I digress.

Back to this particular study looking at vitamin D’s ability to lower the need for an antibiotic prescription in a group of 644 Australian residents aged 60–84 years of age who were given monthly doses of a placebo or 30,000 IU of vitamin D3 (1,000 / day) or 60,000 IU D3 (2,000 / day) for up to a year. Here’s what the researchers found:

  • Those taking 60,000 IU were 28% less likely to have had antibiotics prescribed.
  • Specifically, in subjects old than 70 years of age, this group was 47% less likely.
  • In those aged 60-70, they werere only 7% less likely.

When you consider that the senior population, who are the most likely to suffer complications from influenza, benefit the least from the influenza vaccination, it makes the findings of this study even more important.

One last note—2,000 IU / day of vitamin D is still a very low level. This is the dosage I start patients on who already get decent sun exposure and little risk of chronic disease. Makes you wonder how much more powerful the study would have been at levels of 4,000 or 6,000 IU per day.