It’s the first Mental Health Monday in June and the sun is shining. Does anyone else notice that they start to hear their coworkers around lunchtime remark, “I’m going outside to soak up some Vitamin D.”?
Speaking of that,
- When is the last time you had your vitamin D levels checked? Were you told they were fine?
- What does fine mean, anyway?
First, we need to understand the ranges used to determine what is “normal." Most labs still use the vitamin D ranges that were established decades ago, when rickets was a concern. Rickets is a weakening and softening of bones that develops with severe and long-term vitamin D deficiency.
Understanding the Vitamin D Numbers
Vitamin D deficiency has been defined by the Institute of Medicine and the Endocrine Society as having a level of serum vitamin D (25−hydroxy) less than 20 ng/mL. Vitamin D insufficiency was defined as a level between 21 and 29 ng/mL. So according to these ranges, anything above 29 ng/mL is “normal”. Or fine. This means you’re out of the woods when it comes to rickets. This does not mean, however, that your levels are adequate enough to benefit from all of the other functions of vitamin D.
Vitamin D is not only important for maintaining calcium and phosphorous levels for bone health, but also for brain health, maintaining estrogen levels, supporting tissues and organs, preventing muscle pain, regulating blood pressure, protecting against autoimmune disease and certain cancers, along with preventing psoriasis and numerous other benefits.
Vitamin D is Important for Your Mental Wellness
Study after study has shown an association between low vitamin D levels and depression. Depression in adolescents, depression in adults, depression in the elderly and depression in postpartum moms. Multiple studies have also shown improving patients’ vitamin D levels can drastically improve depression symptoms.
The takeaway? Don’t just accept the answer that your vitamin D levels are “normal” or “fine”. Ask for the number. The sweet spot for capturing all the benefits of vitamin D is 60 ng/mL.
Sunscreen and Vitamin D
And what about all the fuss about sunscreen or no sunscreen to improve your vitamin D absorption?
All you need is 15-20 minutes per day of non-sunscreen sun exposure on your face and arms to maximize your ability to make vitamin D. Those of us up here north of Boston need to check our levels in October and May, as any vitamin D stores we have built up over the summer get depleted in the winter. During our winters the sun is not strong enough for us to manufacture vitamin D via our skin.
Your Diet and Vitamin D
Healthy sources of vitamin D can also be obtained through the diet. My favorite healthy sources are fatty fish like salmon, cod liver oil, herring and sardines. Egg yolks from chickens allowed to roam and naturally forage are also high in vitamin D.
What If Supplements Aren't Improving Your Vitamin D Number
If you’ve been supplementing with vitamin D for 8 weeks or more and your levels aren’t budging, a number of things can be at play including malabsorption or a genetic variation that affects vitamin D’s ability to be utilized by the vitamin D receptors on cells. Standard testing of 25-hydroxy will tell you your vitamin D serum levels, but further testing can reveal the activity of vitamin D in its active hormone state, known as 1,25 hydroxyvitamin D.
I always remind patients that optimal nutrition is not just what we eat or supplement with, it is also how well our body breaks down, absorbs, utilizes and eliminates what we eat. These factors need to be considered when assessing vitamin D levels and patient need. So even though summer is right around the corner, knowing your vitamin D levels is still important.
If you or your child have an issue with vitamin D levels or are unsure about how much and for how long to supplement, I can help. Contact me to request a consultation.
