As a family practitioner, I not only have the blessing to listen and learn from my patients but the opportunity to be an observer of the results of our distinct American lifestyle. We eat fast, fat, and processed foods all too often, get little regular physical activity, and life’s stresses have a profound effect on our physical and emotional health. For the past few years, I have made it a routine practice to look at vitamin D levels among the patients in my clinical practice. While the literature states that as many as 75% or more Americans do not have optimal vitamin D levels, I find vitamin D deficiency may go beyond that shocking statistic.
I am blessed with a busy practice and have seen only about 1% of my patients test optimal for vitamin D status. What’s optimal? I have studied the work of Michael Holick, MD of the vitamin D research lab at Boston University, the gathered research of the vitamin D research council thanks to John J Cannell, MD, and have listened to experts including Robert Heaney, MD on the topic. While labs have a normal range of usually 26-50 ng/ml when testing vitamin D 3 hydroxy, the European literature states optimal may be 70-100 ng/ml. Dr. Holick has observed the average lifeguard population usually has a vitamin D 3 level of around 100 ng/ml. Could it be that our normal range is too low given the fact that ¾ or more of the American population is vitamin D deficient?
Every one of my patients with chronic pain has low vitamin D levels. And indeed, the research states vitamin D deficiency is linked to chronic pain. Every one of my patient who face cancer or an autoimmune disorder such as multiple sclerosis have a low vitamin D level, usually very low (less than 10 ng/ml). The few patients I have who are healthy and want to remain so test in the 70 ng/ml range for vitamin D. One 80+ year-old-patient states emphatically “I feel better when my vitamin D level is closer to my age.” She must be right; she looks and moves like someone decades younger than her chronological age. Dr. Colleen Hayes at the University of Wisconsin Madison has found the higher the latitude, the more vitamin D deficiency, and believes multiple sclerosis may be vitamin D deficiency in some patients.
Vitamin D more properly a pro-hormone precursor than a vitamin may affect one in ten of our genes. It is essential for proper immune system balance and function. It may be as important if not more important than calcium for bone health and is linked to balance and a lowered risk of falls which is critical for all of us as we age. The lower the vitamin D level, the higher the risk and the more aggressive a growing list of common cancers including breast cancer, prostate cancer, skin cancer, and many more. Vitamin D is linked to brain function, reducing our risk of type II diabetes that is related to carrying our weight around our middle, a reduced risk of the flu, and a reduced risk of gum disease. Vitamin D may also have a relationship to conditions such as autism as well as multiple sclerosis, psoriasis, and rheumatoid arthritis.
I am amazed that no patient has yet to tell me their cancer doctor, their oncologist, has tested their vitamin D level. No patient seeing a rheumatologist for autoimmune disorders has reported their doctor tested their vitamin D either. I sometimes think if I did nothing more for my patients that optimize their vitamin D more than half of them would think I had done something great for their health.
Our bodies are designed to make quantities of about 20,000 IU when exposed to sufficient sunlight for about 20 minutes. That is, it is more difficult to get sufficient sunlight in Boston than in Tampa because of its latitude or distance from the sun. Vitamin D deficiency is unknown at the equator. Because our cell membranes are no longer optimal due to changes in our diet and lifestyle during the last 5 decades, I have concluded that only a small percentage of people optimally produce their own vitamin D in sufficient amounts. Our cells are designed to convert the mechanical energy from the sun to chemical energy. The chemical is vitamin D. However, 85% of Americans are fatty acid deficient according to noted Harvard researchers. Every cell membrane is composed of fat and protein. We replaced the good fats in our diet with lots of bad fats like trans and hydrogenated fats that affected our cell membranes. We also focus on carbohydrates in our diet and very few of my patients get normal amounts of protein (one gram of protein for every two pounds of body weight). It is little wonder even getting some sun exposure every day; too few of my patients have optimal vitamin D blood levels.
The days are getting shorter. Physicians like Norton Fishman, MD have discovered seasonal affective disorder, SAD, may be undiagnosed vitamin D deficiency. Ask your doctor to test your vitamin D hydroxy level and make sure your level is optimal for flu season, cancer protection, and good health.