What is a symptom and what is the cause? As a functional pharmacist I find it challenging at times to make sure what I am recommending is addressing the cause of a problem rather than the symptoms. Our healthcare solutions keep the lines between what is a symptom and what is a disease hazy at best. Often times I feel more like a detective trying to find out what is really going on. Believe it or not I keep finding different quality literature from reputable sources which I find encouraging. So lets cover 3 things: Why do we need vitamin D? Why do we have a shortage of it? And solid research who should take it and why.

Why do we need vitamin D?

Known as the sunshine vitamin, one of the key roles of vitamin D within our body is to maintain our calcium and phosphorous balance, cardiovascular health, musculosketal strength, and immune function. Our bodies make vitamin D by converting vitamin D2 (ergocaliferol) into D3 (cholecalciferol). Vitamin D3 is the bio-identical form of vitamin D synthesized in the skin following exposure to sunlight. Vitamin D3 is also the form which the body derives from dietary cholesterol (REMEMBER THIS). When calcium and phosphorus levels dip in the body, parathyroid hormone (PTH) is released to increase vitamin D conversion to the active form. D3 is then metabolized to calcitriol, a steroid hormone that helps regulate a variety of genes through the vitamin D receptor (VDR). While vitamin D is available in both the D2 and D3 forms as supplements, studies have found vitamin D3 is the preferable form. According to recent research from human clinical trials, vitamin D3 is approximately 87% more potent in raising and maintaining serum 25(OH)D concentrations, than the vitamin D2 form.1 Vitamin D3 also produces a two- to three- fold greater storage of vitamin D than D2.1

So why do we have a shortage of vitamin D if we have plenty of sunlight?

First not everyone does. A simple $40.00 blood test can help you determine it. That being said, it gets complicated because as it gets hotter outside we are more likely to put on sunscreen and layers on to not get burned. This makes it really hard to get D from the sun. There are also certain medications that deplete our Vitamin D stores including:

• anti-seizure medications (phenytoin)
• bile acid sequestrants
• corticosteroids
• weight loss medications

Depleted levels of vitamin D may interfere with the normal development of teeth and bones, normal cell growth, and contribute to poor regulation of immune and nervous systems. What really peaked my interest in this topic is the fact that low levels of vitamin D have been found in auto immune conditions like lupus, multiple sclerosis, type 1 diabetes. There is really interesting research on to what happens to vitamin d3 within the realm autoimmune conditions and what is the cause of this mutation of the vitamin d3 receptor.

As you can see from the illustration, Vitamin D is highly responsible for your immune cells being created. So even a lower level amount of Vitamin D and your immune system could be at risk for working a little worse than usual. This could increase your likely hood for autoimmune conditions and make you more prone to getting seasonal allergies and viruses.

So who should take Vitamin D?

Vitamin D is so inexpensive and there are so many forms available for so many people. It can be a little overwhelming to make a choice. Here is a chart to make it simple. Next to multivitamin I am not aware of drops that are made for infants as well as seniors. When I see products formulated like this I can’t help to think why should any of us have low Vitamin D? I remember when my kids were infants and thinking I don’t want them to get outside to much because they are at risk of getting sunburns. Well if they are getting limited sun exposure or their skin is covered up by sleeves, hats, or SPF that means they aren’t getting their Vitamin D as well. So here is a case of using infant or children Vitamin D drops. Also when kids are in day school and still developing their immune systems it seems logical to give them D Drops as well. I prefer Vitamin D Drops with DHA for younger kids.

For Children– Vitamin D why? Because if you are mostly indoors once again you aren’t getting your Vitamin D unless you are doing a lot of walking or biking. So it makes sense to take Vitamin D 1,000 if you are in college

For Adults– Vitamin D 5,000 is a great option because it gives every day immune support.

For Adults with cardiovascular disease or concerned about bone health- Vitamin D w/K is a great option because it helps vitamin D. The added benefit is that Vitamin K will help loosen up any calcium deposits in your arteries so it is available to get into your bones. This is a huge benefit if you would like to avoid additional heart disease or heart disease.

Seasonal Support– I like the D3 50,000 for those looking to boost immune system during peak seasons when viruses are running rampant. This isn’t available as a prescription and is only available over the counter. The prescription version of 50,000 units vitamin D is D2. If you remember earlier we looked at d2 and d3 conversion in the liver. If you want to maximize your results vitamin D3 then cholecalciferol 50,000 once weekly is the way to go.

Finally those with a GC rs2282679 SNP (our gene hiccup) I would recommend vitamin D supplementation because Vitamin D delivery to the cells could be impaired.

With 46% of Americans having low vitamin D, it seems like it should be a good habit for most people to include Vitamin D into their supplement regimens