Vitamin D

Q and A with Pam Popper of Wellness Forum Health

What do you do if your vitamin D levels are low and it is winter time? Just wait for sun? Take supplements?

Vitamin D has become a big business – some health professionals test almost all patients and claim that low vitamin D levels are the cause of almost all diseases and conditions and that supplementation with D can help to resolve them. The definition of adequate vitamin D levels has changed over the last several years with some health advisors recommending targets of 75-100 ng.mL.

Here is my advice on how to respond to blood test results for vitamin D levels. “Normal” vitamin D levels, according to the Institute of Medicine, are 20-30 ng/mL. Most people fall within this range, and are able to achieve these levels with sunlight exposure.

If your blood test shows that you are slightly lower than the reference ranges, this does not mean that you need treatment. Reference ranges are the averages for lots of people who are similar to you (age range and sex) who were tested. About 5% of all people test outside the reference ranges, and this does not necessarily mean that they are sick and require treatment.

Sunlight exposure is the best way to produce vitamin D – human beings were designed to produce vitamin D in this way, not to take it orally via fortified foods or supplementation. The body stores vitamin D for use in the winter, so do not be concerned if you live in a northern climate like I do and don’t have access to the sun for 4-5 months per year.

The Institute of Medicine states that supplementation with vitamin D is risky, and that there are few benefits. Lower vitamin D status is observed in many people who have degenerative diseases, but a recent meta analysis of several hundred studies concluded that this is most likely a result of disease conditions, not the cause of them and supplementation has not been proven to improve health.

If your vitamin D levels are low now, you should do several things. If you are overweight, lose weight. And if you have a chronic degenerative condition (type 2 diabetes, arthritis, coronary artery disease, etc.) get some advice from a competent practitioner about how to resolve it. Chronic inflammation, which results from being overweight and sick, results in lower vitamin D levels. Spring will be here soon and you’ll be able to spend some time in the sun in order to increase your levels.

There are some people who benefit from vitamin D supplementation – elderly patients with no access to sun and patients with kidney failure, for example. But most people should not supplement.

Vitamin D testing has been added to my list of disease mongering practices that turn healthy people into sick patients. The easiest way to avoid all of this grief is not to consent to the test in the first place.

Autier P, Boniol M, Pizot C, Mullie P. “Vitamin D status and ill health: a systematic review.” Lancet Diabetes and Endocrinology Jan 2014;2(1):76-89 doi:10.1016/S2213-8587(13)70165-7