Mastering Vitamin D: Sun, Labs, Supplements - Ask a Nutritionist

Transcript:

Brandy: Welcome to Dishing Up Nutrition's midweek segment called “Ask a Nutritionist”. I'm Brandy Buro, a Licensed and Registered Dietitian here at Nutritional Weight & Wellness. Today I want to shine a little bit of light on a nutrient that is often overlooked, but absolutely essential for many areas of our health.

Health benefits of vitamin D

And that is vitamin D. You may know vitamin D as the sunshine vitamin, and I think a lot of us know that it's important to help us build strong bones, but it is so much more than that. It plays a critical role in our immune function, our mental health, muscle strength, and reducing inflammation. It even plays a role in coding for genes.

Vitamin D deficiency is common & has detrimental health consequences

And even though it is so important for many areas of our health, over half of Americans are deficient and many don't even realize it. So I wanted to share some practical information about how to determine if you're getting enough Vitamin D and the steps you can take if you have low vitamin D or vitamin D deficiency.

Vitamin D deficiency is a topic that comes up a lot during my counseling sessions with clients, and it's something that I take really seriously. Low vitamin D levels are quite common, and a deficiency has been linked to increased risk of cardiovascular disease, cancer, diabetes, depression, even autoimmune disorders like multiple sclerosis.

Many other health conditions can be traced back to low vitamin D. So if I'm working with a client who's struggling with any of these concerns, or maybe they're experiencing chronic low energy and nothing seems to help, I ask them about their vitamin D levels pretty early on in that conversation and knowing your vitamin D level is so important.

Know your vitamin D level

That way you can take steps to prevent or treat a deficiency and prevent all the complications that come along with it. Testing your vitamin D level is a simple blood test. It can be done at your annual physical, and I encourage you to ask for this the next time you have a doctor's appointment. Once you get that level tested, look at the results, look at the actual value.

Depending on the clinic that you go to, you may not be alerted if your vitamin D is low, unless it's a clinical deficiency, and there's a lot of variation around what's considered a deficiency depending on the clinic or the provider that you go to. Most clinics will say that you have a vitamin deficiency if your level is less than 20 or less than 30 nanograms per milliliter, and you may not hear that you have low levels if it's not lower than that.

However, research is finding that health outcomes improve significantly when vitamin D levels are maintained at 50 to 80 nanograms per milliliter. This is what I and my colleagues here at Nutritional Weight & Wellness consider the optimal range. Many of the clients that I work with find that they just feel so much better when they maintain their levels between 50 and 80 nanograms per milliliter.

Consider supplementing with vitamin D

And many find that they have to take a vitamin D supplement to do it. And this is where a lot of questions start to come up. How much vitamin D should I take? How much is too much? There's been some concerns in the media recently about the risk of vitamin D toxicity, and I think people are getting a little worried about taking a Vitamin D supplement.

I just want to assure you that the risk of vitamin D toxicity or excessively high vitamin D levels is quite rare. Vitamin D toxicity is generally recognized as levels that exceed 150 nanograms per milliliter. So over double what we're considering kind of the sweet spot that optimal range. And this typically only happens if you are supplementing with very high doses for long periods of time.

So you really have to kind of try, you have to work at it to reach the level of toxicity. But it's important to test regularly, know your levels, understand if supplementation is needed, how much to supplement, and how your body is responding to the dose that you're taking on a regular basis.

So I suggest testing at least annually, but twice a year is actually ideal in my mind. So I like to test early spring, like March or April, and then again later in the fall. When it comes to supplementation, I think there's sometimes this misconception that you don't need to take a supplement to prevent a deficiency as long as you're spending some time outdoors.

It is the sunshine vitamin, after all, and I think we know we get some vitamin D from sun exposure, and that is true, but. It's not always the case that you're getting enough vitamin D from sun alone. So next I want to review what conditions are needed to get vitamin D from sun exposure and certain factors that can prevent or promote vitamin D synthesis from the sun. So we're going to take a quick break and we'll be right back.

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Sun exposure & vitamin D: what factors need to be considered 

Welcome back. We have been talking about the importance of vitamin D, aka the sunshine vitamin. Before we took a break, I described why you want to test your vitamin D levels. And now I want to go over how to get enough vitamin D in order to thrive and feel your best. And it is true that we can make vitamin D from sun exposure, but there are many factors that can impact the process.

So first off, when you're getting sun exposure, you want to make sure that your skin is exposed to the sun and how much of your skin is exposed matters. The more skin you expose, the more vitamin D you can make. So if you're outside in the garden with your hat and your long sleeves and your pants on, even if you're out there for several hours, you're probably not making that much vitamin D. If you just have your hands exposed, the potential to make vitamin D is pretty low, so we want to expose that skin.

Sunscreen is something that can also block the sun's rays, which blocks vitamin D production, so be mindful about whether you use sunscreen or not, and I'm not suggesting don't wear sunscreen, but a little bit of sun exposure without sunscreen, about 10 to 20 minutes a day, will give your body a chance to make the vitamin D it needs to stay healthy, and then of course, you know, cover up with, clothing or sunscreen to prevent sun damage.

The time of day and the time of year also comes into play when we talk about how efficient your skin is at making vitamin D from the sun. So the best time to make vitamin D is between 10:00 AM and 2:00 PM. This window is even shorter during the winter months, and that's because of the changes of the angle of the sun.

We're less likely to spend enough time outside with enough skin exposed when the temperatures start to drop. So essentially there's very little potential to make vitamin D in the winter between November and March. At least that's true in the Midwest, and in fact, people that live north of the 33rd parallel, which is about north of Atlanta, Georgia in the United States. And then, you know, following that parallel all around the globe, those people are at an increased risk of developing a vitamin D deficiency because of the way the angle of the sun changes during the winter.

So to sum all of this up, the type of sun exposure you need to make enough vitamin D, you need to have your arms and legs exposed without sunscreen for about 10 to 20 minutes a day between the hours of 10 and two, between April and October. So when I spell all of it out like this for my clients, many people realize that they're falling short of this most days out of the week, especially if they have a job that prevents them from getting outside during the late morning or afternoon.

And this is when we start talking about, you know, the possibility of a supplement and getting their levels tested. A few other factors that can make it more challenging to make vitamin D from the sun include air pollution. You know, anything that's blocking the sun's ray, so that could be smog. Or in the Midwest right now in the Twin Cities, we have a lot of smoke from the wildfires, so, air pollution, it's going to block the sun's ray, similar to sunscreen, similar to clothing, and reduce the potential to make vitamin D from sun exposure.

People with darker skin tones also are not making vitamin D as well as those with lighter skin tones because the melanin acts as a natural sunscreen of sorts, and unfortunately, age plays a role as well. Our ability to make vitamin D from the sun decreases as we get older. So vitamin D testing and supplementation might be even more important for older individuals and those with darker skin tones.

Supplementation with vitamin D is necessary for many people

So as you can see, there is a lot impacting our ability to make vitamin D from the sun, and many people do need to take a supplement to prevent deficiency and feel their best. So to know how much you need to supplement testing your vitamin D level is absolutely key. So again, ask your doctor at your next physical. If for some reason your doctor won't order that test, there are at home vitamin D test kits available.

And I recommend testing your level at least once, if not twice a year. Spring and late fall are good times to do that. So let's say you get your vitamin D tested, you find out your levels are below the optimal range of 50 to 80 nanograms per milliliter, or maybe were diagnosed with vitamin D deficiency, so they're lower than 30 or lower than 20 nanograms per milliliter.

This is when I recommend talking to your doctor, or better yet, talk to a registered dietitian to understand how much you should supplement with and for how long in order to bring your levels up to that optimal range safely. So a safe dose for most adults is between 1,000 to 4,000 international units every day. Many adults need more than this, but I'd say this is a pretty safe range for just about anybody to take, especially if you live in the Midwest.

If you decide to take a supplement be very careful and look at the supplement label to see what units they're reporting in their capsule. It may not be listed as international units. It may be listed as micrograms. So 25 micrograms is the same as 1,000 international units, so there's a big difference there. So 1,000 to 4,000 international units is about the same as 25 to 100 micrograms. So be very careful. It's a small detail, but it makes a big difference.

So again, if you are diagnosed with a deficiency, you may need more than that. You may need possibly 5,000 to 10,000 international units a day. I work very closely with my clients to determine what the correct dose is for them, and we're making it a priority to test and retest their Vitamin D levels to know how effective that dose is, to know how much more or less to supplement based on how they respond and to maintain optimal levels.

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Recap

So to recap, here are some key takeaways from today's episode about vitamin D. Vitamin D is much more than a bone building nutrient. Vitamin D deficiency can increase your risk of certain cancers, heart disease, depression, even autoimmune diseases. So it's really important to test your levels regularly and know what your levels are.

I recommend testing one to two times a year, and if you find that your levels are low, you likely need a supplement. So to recap, here are some key takeaways from our episode on vitamin D. Vitamin D is much more than just a bone building nutrient. If you have a deficiency, you could increase your risk of developing cancer, heart disease, depression, even autoimmune diseases.

So it's really important to test your levels regularly. I would suggest at least one to two times a year. This is the best way to know if your Vitamin D is low, and if you could benefit from taking a supplement. When you get your levels tested, look at the results. Know what they mean. The optimal range for disease prevention and feeling your best is 50 to 80 nanograms per milliliter.

Even though it's known as the sunshine vitamin, relying on sun exposure alone is often not realistic for many people to maintain their levels in that optimal range. And just to recap what those optimal conditions are, we need to be outside with arms and legs, skin exposed between 10:00 AM and 2:00 PM for 10 to 20 minutes a day during the spring and the summer. If that is not possible for you, you probably need a supplement.

Most adults benefit from taking 1,000 to 4,000 international units every day. Many people need more than that to treat vitamin D deficiency and maintain optimal levels. So again, test and retest your levels to know for sure. Talk to your registered dietitian to get personalized recommendations.

Well, thank you so much for listening to today's episode of “Ask a Nutritionist”. If you thought this episode was helpful, let us know. Just leave us a review or a rating so we can help even more people discover the connection between what they eat and how they feel. Let us know what nutrition questions are on your mind.

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