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A while back a patient came into my office with the strangest request. He said he had been trying to move to Colorado for a few years but couldn’t because of health reasons. After some job hunting visits, he noticed he didn’t feel well here and was diagnosed with very high blood sugar levels – but only when he was in Colorado. Upon his return home, his blood sugar levels would normalize in just a couple of days. This happened repeatedly.
Let’s call him Mr. C (short for Colorado). Mr. C scheduled a consult with me after seeing a long list of medical doctors and various other health practitioners with no success. He explained how frustrated and desperate he was. He and his family were waiting for him to get better so they could move to Colorado where he had received a job offer. Basically, he had blood sugar issues in Colorado, but nowhere else!
What do you think Mr. C’s problem was?
After evaluating Mr. C, it was clear that something unusual was happening, as every system I normally check was okay. His digestion, blood sugar, lymph and bile flow were fine. The integrity of his intestinal villi and stomach acid production were good. He wasn’t overly stressed and was generally in good health. When I evaluate a patient and they don’t fit into any of the common systems of imbalances and their symptoms just do not make sense, I immediately think: check for deficiencies.
The Deficiency Reconnaissance Mission
There are a handful of deficiencies we should all be aware of that I call, Deficiencies That Effect More Than Half the World’s Population. Deficiencies are not really on our American radar because 85 years ago we started fortifying foods with the nutrients we are most likely to become deficient in, such as iodine, vitamin D, calcium, vitamin B12 and others. But in the past 30 years things have changed radically.
- Americans have 50% less iodine in their blood than they did 30 years ago.
- 78% of Americans and 97% of Canadians (4) are deficient in vitamin D in the winter.
- As we age, our digestion weakens, our diet becomes more simple and we become B12 deficient.
- Since 1948 when synthetic fertilizers were introduced, nutrient content in foods have continued to plummet. Even organic foods are depleted. 99% of all Americans are deficient in at least 1 mineral according to a well-publicized 1936 report entitled Document 264 from the Department of Agriculture.
- Environmental toxins compromise digestive and detox pathways, which leads to deficiency risk.
- A vast amount of foods eaten in America are processed, rendering them nutritionally vacuous.
- From 1940-1991, trace minerals in fruits and veggies have declined by up to 70% according to the Journal of Complimentary Medicine in 2001.
Mr. C is a middle aged African American corporate executive. I decided to check his vitamin D levels. Highly pigmented skin can require 2-3 times more vitamin D than less pigmented skin to achieve optimized vitamin D levels. In fact, the body’s only regulator for vitamin D levels produced by the sun is varying amounts of skin pigmentation. Thus, folks with darker skin living in the north are more likely to become vitamin D deficient.
Mr. C’s blood test results were below 20ng/ml for vitamin D, which is very low. I typically recommend that everyone have blood levels between 50-80ng/ml. I suggested he take 10,000 IU of vitamin D3each day for 3 months, then 5000 IU each day for 2 months, and then retest.
In my clinic we have a Home Vitamin D Test Kit that you can do conveniently at home without needing to make a doctor’s appointment. With that test, I include a suggestion for how much vitamin D you will need to optimize your levels.
Months went by and I didn’t hear from Mr. C. Then his wife came in as a patient and told me they had finally moved to Colorado. With great relief she said, “You were right, his vitamin D deficiency was the cause.” After a couple of months of supplementation, he was able to tolerate his visits to Colorado, maintain stable blood sugar, and ultimately, successfully move to Colorado.
Vitamin D and Blood Sugar Levels
While researchers are not entirely clear about the exact mechanisms for vitamin D regulation of insulin metabolism and blood sugar balance, there is no doubt that vitamin D plays an important role in this area of bodily function. Vitamin D levels have been associated with insulin secretion by the beta cells of the pancreas as well as insulin activity once it is released into the bloodstream. (1)
Please note: The case of Mr. C was a rare and unique case, and by no means do I see such results or expect to see these results on a regular basis.
Why did Mr. C’s blood sugar levels crash only when he was in Colorado?
This is still really a mystery, but anyone who lives here in Colorado quickly realizes that the environment is harsh. It is a high desert, and it can be a challenge for certain body types to live here, such as Vata (winter) types, or anyone with a nervous system imbalance. A severe deficiency can quickly lead to a host of imbalances when under stress.
Which Vitamin D Should I Take?
Many of my patients are confused as to which vitamin D supplement to take: vitamin D2 or D3.
Vitamin D2 (or ergocalciferol) is created by plants when they are exposed to sunlight. It is really for plants, invertebrates and fungi.
Humans make vitamin D3 (or cholecalciferol) when the skin is exposed to UVB rays from the sun. The evidence is overwhelming that vitamin D3 is the best vitamin D for human supplementation.
Vitamin D2 is a plant-based vitamin that was never found in humans until we put it there as a supplement. It seems to be the wrong vitamin. In fact, in 2006, the American Journal of Clinical Nutrition argued that D2 should no longer be considered as a nutrient “suitable for fortification or supplementation,” given the strong hormonal advantages of D3. (2)
Vitamin D3 is an Essential Hormone
At optimal levels, vitamin D3 begins to act like a hormone rather than a vitamin. In fact, vitamin D3 is considered by the Vitamin Council to be a powerful steroid hormone in the human body. Steroid hormones play a key role in regulating metabolism, immunity, inflammation, blood pressure, and the balance between water and salts in the body.
This hormonal activity is optimized only when vitamin D3 blood levels are between 50-80ng/ml, according to the Vitamin D Council.
By contrast, vitamin D2 never acts like a hormone.
Vitamin D2 is the Wrong Vitamin
After testing thousands of patients for vitamin D, I have yet to see a patient in my practice who was prescribed high doses of vitamin D2 that was able to reach optimal blood levels for vitamin D – even at doses as high as 50,000 IU a week for 16 or more weeks. Patients on these high doses of vitamin D2 tend to have blood levels around 30ng/ml, no higher.
Vitamin D2 has lower bioactivity, poorer stability, and shorter duration of action, resulting in approximately 33% lower potency compared with vitamin D3. (3)
Are Vitamin D2 Fortified Foods Really Fortified?
Unfortunately, all the milk and orange juice that is labeled as “Vitamin D fortified” is fortified with, you guessed it…. the wrong vitamin: D2 (ergocalciferol). Pharmaceutical companies patented the process of synthesizing vitamin D2 in the 1930?s and, though it is effective enough to prevent rickets, it is not the vitamin the sun intended us to have. Only in the past 10 years has the unbridled truth about vitamin D3 potency taken most of the research community by storm. However, the pharmaceutical companies have not all yet switched from vitamin D2 to the more potent form of D3.
The bottom line is that if you take any living organism away from the sun, it will wither and die. For the last 100 years or so, we have been slowly withering with chronic health concerns, much of which may be attributed to lack of sunshine. In our modern world, even with great sun exposure in the summer, most of us may become deficient in the winter. This is a huge health risk we simply cannot allow to continue.
How to Optimize Your Vitamin D Levels
After many years of clinical observation, I have realized how extremely difficult it is to optimize our vitamin D levels to the range suggested by the Vitamin D Council, which is 50-80ng/ml. Almost everyone is 35ng/ml or below – with an astonishing number of patients in the teens – unless they are taking around 5000 IU of vitamin D3 per day through the winter. In one study, 97% of Canadians were deficient in vitamin D. (4) Surprisingly, about half of the patients I have tested this fall are below 25ng/ml, which is dangerously low.
Why Are So Many People Deficient?
Here are a few reasons why so many people are too low in such an essential vitamin:
- The sun may not be enough UVB exposure, even in the summer.
- UVB radiation is inconsistent, even in the summer.
- Only midday summer rays will deliver UVB radiation, which varies from day to day (typically 10am – 2pm).
- It takes about an hour for UVB radiation to convert cholesterol on the skin to pre-vitamin D. Wait at least an hour before taking a shower or jumping into a body of water after spending time in the sun.
- We live in houses, work in buildings and commute by cars where we get zero UVB radiation.
- Up until 100 years ago most humans spent the better part of the day outside in the fields. Genetically, we are still totally dependent on the sun.
- Traditionally diets in the northern latitudes included cold water fish, fish oil and organ meats which are high in vitamin D – but rare in today’s society.
- We have been told for 25 years that the sun is dangerous and have thus avoided it like the plague.
- Sunscreens for the past 25 years have blocked only the good UVB vitamin D-making rays and let in all the UVA skin-cancer causing rays.
Do You Know Your Vitamin D Levels? Don’t Keep It A Guess!
The research is too compelling. Everyone should have a very good sense of their vitamin levels. Are you between 50-80ng/ml?
I recommend that my patients get tested in the spring to determine an optimal summer dose and again in the fall to determine an optimal winter dose. After these two tests most patients can supplement safely without testing for years and maintain optimal levels. Get tested this fall in your home with our Vitamin D Test Kit (without a doctor’s visit or prescription) and receive a free vitamin D supplement protocol.
Summer: 1000 – 2000 IU per day, depending on midday sun exposure
Winter: 4000 – 5000 IU per day