The majority of the patients I see in my practice today (whether obese, anorexic, bulimarexic, or bulimic) are diagnosed with having a vitamin D deficiency by their family physician. Vitamin D deficiency is associated with reduced immune system function, 17 different types of cancer, heart disease, psychological disorders, neurological disorders, diabetes, stroke, hypertension, bone loss, muscle mass loss. Typically, when a patient’s blood test* comes back from the lab showing a deficiency in vitamin D, their physician prescribes them a vitamin D supplement. Is there a difference between the vitamin D supplement that is prescribed, the vitamin D that is sold at health food stores, and the vitamin D we obtain naturally from food and the sun? What is the best source of vitamin D?
If your physician writes you a prescription for vitamin D and you take it to the pharmacy, your pharmacist will hand you a bottle of vitamin D2 (or ergocalciferol). Vitamin D2 is a synthetic form of vitamin D that is derived from fungal sources using ultraviolet radiation; it REALLY shouldn’t be allowed to be called a vitamin, it’s more like a franken-vitamin! Synthetic vitamin D is less biologically active than natural forms of vitamin D; it takes the body 500% longer to convert synthetic vitamin D into a usable form. In addition to prescription vitamin D supplements, vitamin D2 can be found in “vitamin-enriched” foods, such as milk. There has been research done that looked at mortality rates for people who supplemented using vitamin D2 versus vitamin D3; it was determined individuals that supplemented with vitamin D2 had a two percent relative risk increase.
If you go to the health food store and pick up a bottle of vitamin D, you will likely be buying vitamin D3 (or cholecalciferol). Vitamin D3 is a natural form of vitamin D, it’s usually derived from either lanolin or cod liver oil extract. It is much easier for the body to convert vitamin D3 into a usable form. The study that compared mortality rates for those supplementing with vitamin D2 versus vitamin D3, individuals that supplemented with vitamin D3 had a six percent relative risk decrease. The Vitamin D Council recommends vitamin D3 for the treatment of vitamin D deficiency.
It is always best to discuss supplementing with vitamin D3 with your doctor, especially if you have sarcoidosis, tuberculosis, or lymphoma. The Vitamin D Council recommends a daily dosage of 1000 IU of vitamin D3 per 25 lbs of body weight; if you weigh 150 lbs, the recommended dosage would be 6000 IU per day. If your lab test shows that you are vitamin D deficient, each additional 1000 IU will usually producse a 10 ng/ml increase; if you weight 150 lbs, and your vitamin D test shows your vitamin D is 40 ng/ml, you would take 6000 IU per day PLUS an additional 2000 IU to be in the middle of the optimal range. The Vitamin D Council considers:
- a vitamin D level of < 50 ng/ml to be deficient
- a vitamin D level of 50-70 ng/ml to be optimal
- a vitamin D level of 70-100 ng/ml to be ideal if being treated for cancer or heart disease
- a vitamin D level that is > 100 ng/ml to be excessive
In addition to taking a vitamin D3 supplement, there are several other sources of natural vitamin D that you can take advantage of. The best source of vitamin D is exposure to sunlight, but the amount of sun exposure that is considered safe is not usually enough to prevent and treat disease. There are also foods that are rich in vitamin D, such as eggs, organ meats, animal fat, cod liver oil and fish, but if you are vitamin D deficient it may be difficult to get vitamin D to an optimal level with food alone. In order to properly metabolize vitamin D, it is important to make sure you are getting sufficient magnesium, vitamin K, vitamin A, zinc and boron.
*it’s important to make sure your vitamin D levels are checked using a test called 25(OH)D as opposed to 1,25(OH)D. 25(OH)D is a better overall marker of vitamin D status.
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