The Vitamin D Solution: A 3-Step Strategy to Cure Our Most Common Health Problems (Anglais) Broché – 22 février 2011
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What Is Vitamin D?
Is it a hormone or a vitamin?
Somewhere along the equator a ten-year-old girl is growing up with- out the luxuries most of us enjoy on a daily basis. She will never learn how to use a computer, order a pizza to be delivered, or drive a car to the mall for clothes and cosmetics. She spends most of her days playing outside near her farming parents, and soon she will join them in tilling the soil. She will never learn to read or write. She will endure periods of poor nutrition and poverty. And she knows nothing about sunblock and probably never will.
Now let’s sail north to the United States or Europe, where another ten-year-old girl leads an immensely different life. She is maturing into a savvy user of electronics, passes the majority of her days indoors at a rigorous school, has access to the best nutrition and all the beneﬁts that modern medicine can provide, and will know what SPF means long before graduating from high school and pursing higher education.
If both girls continue on their separate paths, the equatorial girl will be at least half as likely to get cancer during her lifetime as her northern counterpart. She also will have an 80 percent reduced risk of developing type 1 diabetes in the ﬁrst thirty years of her life. In fact, barring any freak accident or untreated medical condition, her longevity overall will be 7 percent greater.
The northern girl, on the other hand, faces a host of increased health risks throughout her life, from breast and ovarian cancer to depression, obesity, type 2 diabetes, osteoporosis, arthritis, high blood pressure, heart disease, and stroke. She will be more susceptible to upper-respiratory-tract infections, dental cavities and gum disease, and infectious diseases like the ﬂu and tuberculosis. As a group, she and her girlfriends will break their arms 56 percent more often than their peers did just forty years ago. Because she was born in northern latitudes and has lived there for the ﬁrst ten years of her life, for the rest of her life she has a 100 percent increased risk of developing multiple sclerosis no matter where she chooses to live in the world after age ten. She would likely lose in a jumping contest with her equatorial sister, who can jump higher and with more force. If she complains of muscle weakness and wide- spread muscle and joint pain later on in adulthood, her doctor will likely diagnose ﬁbromyalgia or chronic fatigue syndrome when tests don’t turn up anything speciﬁc. The equatorial girl might never experience such debilitating aches or chronic pain and in fact may develop into a much stronger, leaner, and more fertile woman. If both women become pregnant, the equatorial mom-to-be won’t have to worry as much about serious complications like preeclampsia. And she won’t have trouble giving birth the old-fashioned way. The northern mom-to-be, however, will have a much higher risk of having an unplanned C-section and of giving birth to a child who will suffer from schizophrenia.
By the time the northern girl reaches midlife and her later years, chances are good that she’ll have been treated for an internal cancer (breast, colon, ovarian, pancreatic—take your pick) at some point and been prescribed multiple drugs to combat chronic ailments like hypertension, osteoporosis, arthritis, depression, obesity, type 2 diabetes, dementia, Alzheimer’s, and perhaps even insomnia. Because of a signiﬁcant loss of bone mass, she will be terriﬁed of falling and fracturing a bone, and therefore will have limited some of her favorite outdoor activities, such as tennis, skiing, horseback riding, and golf, signiﬁcantly cutting back on physical activity. And because she will have lost a considerable amount of muscle strength, her biological age will be much older than she really is. The equatorial woman not only may outlive her northern counterpart, but she’ll also be less prone to chronic diseases that afﬂict her northern counterpart. For this reason, the equatorial woman may, overall, enjoy a higher quality of life—even when advanced age sets in.
What’s going on here? The answer lies in the difference between these two girls’ exposure to natural sunlight, which is our main source of vita- min D. Obviously, I’ve taken some liberty in letting a few assumptions go. The equatorial girl’s limited access to health care and preventative medicine has its own basket of risks, but let’s focus for a moment just on the difference in exposure to sunlight and the conclusions that can be drawn from that single fact. Let’s also assume that these girls grow up to exhibit vastly different levels of vitamin D in their systems, which is not a stretch given the documented records of vitamin D deﬁciency patterns across the globe. If I were to test each of these girls’ vitamin D levels, I would not be surprised to ﬁnd the northern girl’s levels terribly low as compared to her equatorial counterpart. And that difference means everything.
The sun is as vital to your health and well-being as food, shelter, water, and oxygen. I’m going to prove it to you through a comprehensive exploration of vitamin D. What does vitamin D have to do with aging and disease?
More than we ever imagined.
Our Most Common Health Challenge
When I tell people that vitamin D deﬁciency is our most common health challenge globally, the response I get is pretty much the same in wealthy, developed nations: “Well, that can’t happen to me or anyone else in my country; besides, we have great health care.” And when I remind people that the best way to ensure healthy levels of vitamin D is through sensible sun exposure two to three times a week, a common thread is heard in the response, which is along the lines of, “You can’t be serious. The sun is the demon of cancer and aging. No way am I going to consider sunlight as medicine. It’s just not possible.”
The statistics proving otherwise speak volumes, and you’re going to hear about them throughout this book. Increasing numbers of studies are conﬁrming the link between vitamin D and optimal health, and attitudes are beginning to shift. Researchers have long known that the “sunshine vitamin” boosts bone strength by encouraging the body to absorb calcium, but only recently have we begun to see just how far- reaching vitamin D is in maintaining the health of every system and cell in the body’s intricate machinery. Vitamin D may be as vital to your heart and brain health, for example, as it is to your bone health. As noted in the introduction, increasing the amount of vitamin D in the body can prevent or help treat a remarkable number of ailments, from high blood pressure to back pain, from diabetes to arthritis, from upper-respiratory- tract infections to infectious diseases, and from ﬁbromyalgia to cancer. It also seems to improve fertility, weight control, and memory.
The evidence is clear: just as we require a little fat and salt for survival, we need the sun in moderation, too. I’ll add to that the following fact, which will be fully explored in chapter 8: there is essentially no substantiated scientiﬁc evidence to suggest that moderate sun exposure signiﬁcantly increases risks of benign skin cancers or, and more importantly, the most deadly form of skin cancer, melanoma. In fact, if you were unfortunately to develop melanoma, you would be more likely to survive it if you had adequate sun exposure as a child and young adult. And if you had adequate sun exposure as a child, you would have a 40 percent reduced risk of developing lymphoma as a young adult.
In the past ﬁve years alone there has been a breakthrough in our understanding of why sun exposure beneﬁts health in so many ways, something that was not fully comprehended until now. This breakthrough has forced people to take a closer look at the value of sun exposure. I am proud to say that I have been at the forefront of this research.
Groundbreaking new research has linked a wide array of disorders that afﬂict up to two hundred million Americans to a single common factor—vitamin D deﬁciency or insufﬁciency, the most common medical condition in the world with sometimes devastating, if not fatal, consequences.
And the research keeps coming from various labs around the world investigating vitamin D. As I write this, doctors at the University of Pennsylvania have revealed that vitamin D can prevent or forestall the irreversible decline in respiratory function over time that leaves many asthmatics even more vulnerable when they suffer an asthma attack. At the same time, scientists at the Moores Cancer Center at the University of California at San Diego have raised the possibility that low vitamin D may be the root cause of cancer. No doubt we will continue to see remarkable studies emerge, and you’ll be reading about some of the more fascinating and profound studies in the upcoming chapters. It’s no wonder that this vitamin made Time magazine’s list of the top ten medical breakthroughs of 2007. So if you can dramatically decrease your risk of illness and age-related disease and live a healthier, happier life— without its costing you a penny—wouldn’t you want to do that?
Centuries of Problem Solving
When you put the vitamin D story into the perspective of human history, it begins with the Industrial Revolution. As the revolution began to sweep across northern Europe in the mid-seventeenth century, doctors reported seeing a new disease that afﬂicted young children with a constellation of physical signs and symptoms, notably deformities of the skeleton, such as bowed legs, misshapen pelvis, enlarged head, prominent knobby projections along the ribs, curvature of the spine, poor teeth, and weak and ﬂabby legs. The disease had devastating consequences. It not only retarded growth and carried serious risk of upper- respiratory-tract infections including tuberculosis and inﬂuenza, but it also had far-reaching effects into adulthood and impaired these children’s ability to function throughout their lives. Women with a distorted pelvis often had difﬁculty with childbirth and were at high risk of dying or giving birth to an unhealthy child.
Several theories about the cause of this debilitating disease called rickets surfaced in the early 1900s, including infection, lack of activity, poor nutrition, and an inherited disorder. Although cod liver oil (high in vitamin D) appeared to be effective in preventing the disease, it was principally used on the coastlines of the Scandinavian countries and the United Kingdom and was not widely used elsewhere. The disease continued to plague the industrial centers of the world.
What was happening was that as people began to congregate in Great Britain and northern Europe, they erected cities whose tightly placed buildings closed off to sunlight the alleys where kids were hanging out and living. Compounding the problem was the gathering pollution from coal burning, which thickened the air and blocked the sun’s rays. When these kids started to show signs of bone deformities, doctors began to take note.
“Water works wonders, air can do even more, but light works best of all.”
In the 1820s, a Polish doctor named Jedrzej Sniadecki observed that children who lived in the city of Warsaw had a much higher prevalence of rickets than youngsters who lived in the Polish countryside. Dr. Sniadecki thought it was probably the lack of sunshine in the cramped conﬁnes of Warsaw that was to blame for this widespread condition. He was able to successfully treat the afﬂicted city kids by taking them into the country- side for sun exposure. But he wasn’t taken seriously. It was inconceivable to the scientiﬁc community at the time that exposure of skin to sunlight could have any impact on the skeleton. Indeed, it would take another seventy years before the British Medical Association in 1889 reported that rickets was rarely seen in the rural districts of the British Isles but was prevalent in large industrialized towns, suggesting that lack of sun exposure was responsible for the high incidence of rickets.
A year later, a British doctor collected clinical observations from a number of his colleagues throughout the British Empire and the Orient and found that rickets abounded in the industrialized centers of Great Britain, whereas the impoverished cities of China, Japan, and India, where people lived in squalor and had poor nutrition, were spared from this bone-deforming disease. But like Dr. Sniadecki, this early visionary’s ﬁndings weren’t taken seriously. Although the exact relationship between sunlight and bone development was not yet understood, a health movement was pioneered by Arnold Rikli at the end of the 1800s with this motto: “Water works wonders, air can do even more, but [sun] light works best of all.”
It was difﬁcult for the scientiﬁc community to embrace the concept that the simple remedy of exposure to sunlight could cure this bone-de- forming disease, and little was done to use these insightful observations for the prevention and cure of rickets. When scientists began investigating the connection between sunlight and health, it was initially believed that the warmth generated by the sun conferred the health beneﬁts. It was Sir Eve- rard Home, who, in the late 1700s and early 1800s, deduced that it wasn’t the heat of the sun’s radiation but rather the occurrence of a chemical effect on the body caused by the sun that produced sunburn. Home also showed that dark-skinned people had a natural resistance to sunburn.
By 1900, it was estimated that 80 percent of the children living in the industrialized cities of northern Europe and the northeastern United States were afﬂicted with rickets. Almost one hundred years after Dr. Sniadecki’s ﬁrst report, a German physician by the name of Kurt Huldschinsky reported that exposure to ultraviolet radiation from a mercury arc lamp was an effective method of curing patients with severe rickets. He cleverly demonstrated that the effect of phototherapy was not a direct effect on the skeleton, inasmuch as exposure of one arm had an equal and dramatic effect on the cure of rickets in both arms. People thought he was nuts for irradiating sick kids with a mercury arc lamp (mind you, this was long before skin cancer became part of the conversation), but some took his idea to heart. Two years later, in 1921, two New York doctors (Hess and Unger) exposed eight children suffering from rickets to sunlight on the rooftop of a New York City hospital. They showed through X-ray examination marked improvement in each child. Finally, the scientiﬁc community was ready to listen.
In the early 1930s, the U.S. government set up an agency that recom- mended to parents that they put their children outside for a reasonable amount of sun exposure. Several manufacturers also began to produce ultraviolet (UV) lamps that were then sold in local pharmacies through- out the 1930s, ’40s, and ’50s. I know, difﬁcult to believe given today’s attitude on ultraviolet radiation.
Heliotherapy Takes Hold
By the beginning of the twentieth century, scientists had determined that it was the UV radiation in sunlight that stimulated the production of vitamin D in the human body. They deduced that this was important for a variety of health reasons. Based on ﬁndings that the vitamin D created by sun exposure improved bone health, the dairy industries of Europe and the United States started fortifying milk with vitamin D.
A craze was under way, and vitamin D fortiﬁcation was being touted by food and beverage manufacturers ad nauseam. Products as varied as Bond bread, Richter’s hot dogs, Twang soda, and even Schlitz beer were sold with the promise of delivering vitamin D.
The ﬁrst few decades of the twentieth century were the heyday of photobiology and heliotherapy. Photobiology is the branch of science that investigates the effect of natural and artiﬁcial radiation on all life forms; heliotherapy focuses on the sun’s abilities to heal the sick. Photobiologists and heliotherapists were credited with developing effective treatments for rickets, tuberculosis, and the skin disorder psoriasis. Hospitals all over Europe and the United States built solaria and balconies so they could offer their patients a pleasant place to enjoy the sun’s healing rays. In Boston, the then Children’s Hospital put rachitic children on a boat and had them exposed to direct sunlight, which they could not get in the crowded, polluted downtown air. This gave rise to the Boston Floating Hospital, which still exists today (as the Floating Hospital for Children) at Tufts Medical Center. In 1903, photobiologist Dr. Niels Ryberg Finsen won the Nobel Prize for medicine after successfully demonstrating that exposure to sunlight cured many diseases, including lupus vulgaris, or tuberculosis of the skin.
Rickets on the Rise
It’s hard to imagine a government recommending the deliberate exposure of children to sunlight. But our government did just that in 1931 when it set up an agency to encourage parents to expose their children to sunlight to prevent rickets. But there’s been a 180-degree turn in just the last forty years. Today, parents are likely to be accused of child endangerment or abuse if they let their kids roam sunscreen- free in playgrounds and at the beach. This all comes with a serious consequence.
Rickets is not a thing of the past. It’s been on the rise lately, and in cities like Boston we see half a dozen cases a year. The main reason this is happening is that human breast milk today hardly contains any vita- min D, and without adequate sun exposure or a vitamin D supplement, infants are at a high risk of developing rickets. In fact, in one of my studies we looked at forty newborn babies whose mothers were seemingly doing everything right before giving birth. Seventy percent of them took prenatal vitamins, 90 percent drank fortiﬁed milk, and all ate ﬁsh—one of the best dietary sources for vitamin D—regularly during their pregnancy. Upon giving birth, 76 percent of the moms and a full 81 percent of the newborns were vitamin D deﬁcient.
In all, 90 percent to 95 percent of most people’s vitamin D requirement comes from casual exposure to sunlight.
Another reason rickets is cropping up again with increasing frequency is that many kids these days spend too much time indoors and out of the sun or are slathered in sunscreen and made to wear protective clothing before they go out to play. Even more alarming is a new epidemic in which bone formation in children appears normal but is actually much softer than it should be. Girls today break their arms 56 percent more often than their peers did forty years ago. Boys break their arms 32 percent more often. Just last year, the American Academy of Pediatrics felt compelled to double its recommended daily vitamin D intake for newborns, children, and adolescents, citing concern over rising levels of rickets as well as the explosion of new evidence demonstrating that higher vitamin D intake may help prevent a wide variety of diseases. Eventually, even the American Academy of Dermatology, which had been having the hardest time accepting recent statistics on rickets and accompanying literature on vitamin D, chimed in.
In July of 2009, the American Academy of Dermatology issued a “revised position statement on vitamin D after an updated review of the increasing body of scientiﬁc literature on this vitamin and its importance for optimal health.” While still extremely gun-shy about endorsing sensible sun exposure (in fact, the statement plainly reminded members about the dangers of UV radiation in the development of skin cancer, saying, “Vitamin D should not be obtained from unprotected exposure to ultraviolet radiation”), the academy urged its members to remain vigilant about the importance of vitamin D and to pay attention to patients who are at high risk of deﬁciency. It said that those who are at risk for a deﬁciency should be encouraged to up their vitamin D intake through diet and supplements—not through sun exposure. I am happy to see this baby-step forward, even though the academy still cannot fathom sensible sun exposure as an option that could be more effective and beneﬁcial overall. I was amused to learn that when dermatologists in Australia had their own vitamin D levels checked, 87 percent of them were deﬁcient! Indeed, the proof is in their own pudding. The doctrine of dermatology will take time to rewrite, but in the meantime, each one of us can establish and follow our own canon of health.
Poor bone health and childhood rickets is just the tip of the vitamin D iceberg. Increasing numbers of adults are developing a vitamin D deﬁciency–related bone condition known as osteomalacia (pronounced os-tee-oh-muh-LAY-shuh), sometimes called “adult rickets.” Unlike the brittle-bone disease osteoporosis, which doesn’t cause bone pain and is more common in older adults, osteomalacia is characterized by vague but often intense bone and muscles aches and is frequently misdiagnosed as fibromyalgia, chronic fatigue syndrome, or arthritis. The “ﬁbromyalgia epidemic” that some doctors refer to may actually be a massive increase in vitamin D deﬁciency–related osteomalacia (see chapter 3 for more on this important subject). I’ve estimated that 40 percent to 60 percent of patients who have been diagnosed with fibromyalgia or chronic fatigue have a vitamin D deﬁciency and suffer from osteomalacia. One such patient who eventually found me was pain free after just six months of treatment to raise her blood levels of vitamin D. Her ﬁbromyalgia simply vanished and her bone density improved by more than 25 percent after the ﬁrst year.
As I chronicled in the comparison of the two ﬁctional ten-year-old girls at the start of this chapter, a vitamin D deﬁciency sets one up for myriad health risks across the board and throughout one’s life. If you are vitamin D deﬁcient in childhood, you are more than twice as likely to develop type 1 diabetes. If you live above 35 degrees north latitude (roughly the latitude of Atlanta and Los Angeles), you are twice as likely to develop multiple sclerosis. Living at higher latitudes also means a higher risk of Crohn’s disease, infections, and high blood pressure.
There’s evidence to suggest that if you raise your level of vitamin D to a certain amount (and I’ll explain exactly what those levels are in chapter 2), you can reduce your risk of colorectal, ovarian, pancreatic, prostate, and breast cancer by as much as 30 percent to 50 percent. You can also reduce your risk of hypertension, stroke, and heart attack by as much as 50 percent. If you’re a woman contemplating pregnancy, healthy vitamin D levels can improve fertility, prevent an unplanned C-section, and ensure a healthier baby who will enjoy a healthier life. Women may lower their risk of rheumatoid arthritis by 42 percent, and decrease their risk of multiple sclerosis by more than 40 percent. And with adequate levels of vitamin D you will live longer.
A Hormone, Not a VitaminNaturally, we’re disposed to think about vitamin D as a vitamin—a sub- stance that we get from our diets, like vitamin C or niacin, and that participates in biological reactions to help the body operate optimally.
But despite its name, vitamin D isn’t really a vitamin, and as I’ve said, you can’t rely on diet to obtain it; you do, however, make it in your skin. Vitamin D is in a class by itself; its far-reaching effects on the body are aligned with how hormones act to inﬂuence metabolic pathways, cellular functions, and the expression of myriad genes. Vitamin D’s active metabolic product in the body, in fact, is a molecule called 1,25- dihydroxyvitamin D (let’s call it 1,25-vitamin D for simplicity), which is a secosteroid hormone that directly or indirectly targets more than two thousand genes, or about 6 percent of the human genome. (I’ll be talking about vitamin D’s two different forms—vitamin D2 and vitamin D 3. For the purposes of the book I’ll be discussing vitamin D2 or vitamin D 3 as vitamin D, and I’ll only refer to speciﬁc forms of vitamin D where appropriate.)
Generally speaking, vitamins are organic compounds that cannot be made by the body but are necessary for proper functioning. (The term vitamin comes from “vital amine”—a substance that is essential for health but cannot be made by the body.) Obtained through the diet or supplementation, vitamins are vital to growth, development, and metabolic reactions. Hormones, on the other hand, are synthesized in the body from simple precursors and go to distant tissues where they have an intended effect and make multiple metabolic improvements. In the case of the manufacture of vitamin D, which requires the help of an outside source to trigger a sequence of events, the precursor of a cholesterol-like molecule found in the skin cell (7-dehydrocholesterol; provitamin D3) starts the process by absorbing just the ultraviolet B portion of sunlight to create what’s called previtamin D3. Previtamin D3 quickly rearranges itself with the help of the body’s heat to give birth to vitamin D, which immediately exits the skin cell for the bloodstream. The fact that vitamin D is made in living skin cells explains why it is not possible to wash off vitamin D when you bathe after being exposed to the sun.
Before vitamin D can act as a hormone, however, it must go through two steps of activation—one in your liver and another in your kidneys. I’ll be taking you through the details of how vitamin D gets made in your body from sunlight to its active, circulating form in the next chapter. The process is yet another example of how our brilliant bodies operate and self-regulate to ensure optimal health.
If you apply a sunscreen with an SPF of 8 into your skin, it will absorb about 90 percent of UVB radiation and decrease your ability to make vitamin D in your skin by about 90 percent. An SPF of 30 reduces your ability by 99 percent. While it’s true that most people don’t put sunscreen on properly, people are now using sunscreen with an SPF of 45 or above, so even if you put on half or one third of the recommended amount, you’re still getting an SPF of 15 and reducing your ability to make vitamin D in your skin by about 95 percent. Farmers in the Midwest who had a history of nonmelanoma skin cancer were told to always use sun protection, and they did. When we measured their blood levels of vitamin D at the end of the summer, most were deﬁcient.
Most humans obtain from sun exposure their vitamin D requirement between the hours of about 10:00 A.M. and 3:00 P.M. and mainly in the late spring, summer, and early fall. Because vitamin D is fat soluble, it’s stored in body fat and released throughout the winter months, allowing you to be vitamin D sufﬁcient throughout the year.
Hormones are more sophisticated, complex molecules than vitamins. They can act in two ways: ﬁrst, they can simply enter the cell and travel through the sea of cellular cytoplasm until they reach the nucleus—the brain of the cell—and inﬂuence its activity; second, they can bind to a receptor on a cell membrane and thereby transmit a signal to the cell, telling it to change what it is doing in any number of ways. Activated vitamin D mainly works by interacting with its receptor within the cell’s nucleus.
From Bone Health to Brain Health
Contrary to what was previously believed—that vitamin D receptors were only in bones, intestines, and kidneys—we now know that vitamin D receptors are everywhere in the body. There is even proof that vita- min D receptors exist in the brain and that the active form of vitamin D stimulates the production of mood-elevating serotonin. This explains how it may help reduce depression (or just a chronically foul mood). Fat cells, too, have vitamin D receptors, and fat cells can be more metabolically active (burn more calories) if they have more vitamin D. People tend to think that fat cells are like inanimate blobs of lard when in fact they are active participants in the process by which your brain learns that you’re full and don’t need to take another bite of food. When you’ve had enough, fat cells secrete a hormone called leptin that allows you to push away from the table. A lack of vitamin D will interfere with this appetite-suppressing hormone whose job it is to regulate your body weight. And we all know what an unchecked appetite can lead to: weight gain and a higher risk of developing type 2 diabetes. Speaking of which, vitamin D deﬁciency has also been shown to exacerbate type 2 diabetes, impair insulin production in the pancreas, and increase insulin resistance.
The fact that every tissue and cell in your body has a vitamin D receptor raises a question: why would those receptors be there if they weren’t meant to have an effect? Many of us in the science community think that vitamin D acts as a sentinel for your health in that it can control cell growth. This means it can affect the instigation of cancer. If a cell begins to lose control of its own growth and is on a path to becoming a malignant cancer cell, activated vitamin D can come to the rescue by either turning on genes to control cell growth or inducing apoptosis—a process whereby the cell kills itself. If the tumor takes hold and begins to grow, active vitamin D has one more trick up its sleeve: it prevents blood vessels from forming to supply nutrition that the cancer needs to survive. Once the malignant process begins, unfortunately, cancer cleverly develops systems to become resistant to the beneﬁcial effect of the active form of vitamin D. This is why it is so important to be vitamin D sufﬁcient throughout your life. Just as a gap in your car insurance coverage leaves you vulnerable to costly accidents, a period of time when your body lacks sufﬁcient vitamin D to act on those ubiquitous receptors leaves you vulnerable to disease. In fact, it is known that if you have lung cancer detected in the winter, you are likely to die more quickly than if you had been diagnosed in the summer. Could that be a coincidence, or does lung cancer have something to do with vitamin D?
Sufﬁce it to say that in some respected medical circles, sunlight is being described as a “wonder drug.” Dr. William Grant, director of the Sunlight, Nutrition and Health Research Center in San Francisco and a highly respected scientist in the ﬁeld, has suggested that increased sun exposure would result in 185,000 fewer cases of internal cancers (speciﬁcally, cancers of the breast, ovaries, colon, prostate, bladder, uterus, esophagus, rectum, and stomach) every year and 30,000 fewer deaths in the United States alone. Other researchers have taken this a step further and looked at the global impact. University of California researchers estimate that 250,000 cases of colon cancer and 350,000 cases of breast cancer could be prevented worldwide by increasing intake of vitamin D. Sunlight has a similarly dramatic effect on high blood pressure, one of the leading causes of heart attack and stroke. People who spend time in the sun or on a tanning bed experience a blood pressure–lowering effect similar to that of standard medications that have unpleasant side effects. In my studies, backed by those of others, I’ve found that sun- light has a beneﬁcial effect on heart health on par with the beneﬁts of exercise. Put those two things together—physical ﬁtness and UVB exposure—and you’ve got a magical alchemy of health beneﬁts.
Benefits of Vitamin D in Brief
- Bone health: prevents osteopenia, osteoporosis, osteomalacia, rickets, and fractures
- Cellular health: prevents certain cancers, such as prostate, pancreatic, breast, ovarian, and colon; prevents infectious diseases and upper-respiratory-tract infections, asthma, and wheezing disorders
- Organ health: prevents heart disease and stroke; prevents type 2 diabetes, periodontitis and tooth loss, and other inﬂammatory diseases
- Muscular health: supports muscle strength
- Autoimmune health: prevents multiple sclerosis, type 1 diabetes mellitus, Crohn’s disease, and rheumatoid arthritis
- Brain health: prevents depression, schizophrenia, Alzheimer’s disease, and dementia
- Mood-related health: prevents seasonal affective disorder, premenstrual syndrome (PMS, also known as premenstrual tension), and sleeping disorders, elevates the sense of well-being
And then, of course, there’s bone health. Sun exposure helps build and maintain bone density and reduces fractures, one of the main causes of death and disability among senior citizens. Humans also need sunlight to control their biological clocks, which regulate mood, and appropriate sun exposure is responsible for keeping down rates of depression associated with seasonal affective disorder (SAD) and premenstrual syndrome (PMS).
Let’s not forget that sunlight plain old makes you feel better—not something to be dismissed in the high-stress world in which many of us live. Those who heed warnings to avoid the sun because “sunlight is dangerous” are robbed of the life-sustaining beneﬁts of sun exposure—and the idea that sunlight is dangerous denies basic evolutionary science.
The Complexities of a Modern Epidemic
To say that our fear of sunlight and our excessive use of sunscreen have put a serious damper on our ability to maintain sufﬁcient levels of vita- min D is one thing. But there are other variables that make today’s deﬁciency epidemic a unique challenge. Age, gender, race, geographic location, cultural factors, diet, drugs, and even certain health conditions like obesity, liver disease, intestinal disease, and kidney disease all factor in. People who have undergone bariatric surgery to gain control of their weight have added challenges.
For starters, skin color has a tremendous impact, which is evident in studies done to identify patterns of deﬁciency. My team did a study in Boston at the end of the summer—a time when you would expect blood levels of vitamin D to be the highest—and found that 40 percent of Hispanics, 34 percent of whites, and a breathtaking 84 percent of African-American adults over the age of ﬁfty were vitamin D deﬁcient.
The darker your skin, the harder it is to make vitamin D, because melanin, your skin’s pigment that gives it color, acts as a natural sunscreen; African Americans have to spend at least two times (and as much as ten times) longer in the sun to make the same amount of vitamin D as a person of Irish or Scandinavian descent (more on this later).
The vitamin D deﬁciency in this community may help explain why there’s a health disparity between whites and blacks, with a disproportionate number of African Americans suffering from hypertension, heart disease, type 2 diabetes, deadly cancers, and stroke, as compared to Caucasians. Another study my colleagues and I published showed that 36 percent of healthy white men and women in Boston (medical students and doctors) ages eighteen to twenty-nine were vitamin D deﬁcient at the end of winter. This was despite the fact that they often took a multivitamin, drank at least one glass of fortiﬁed milk a day, and ate ﬁsh at least once a week. The problem is worse the older you get—42 percent of other- wise healthy Boston-area adults over the age of ﬁfty who participated in the study were found to be vitamin D deﬁcient. The older you are, the harder it becomes to synthesize enough vitamin D. A seventy-year-old has only a quarter of the vitamin D–making capacity that a twenty-year- old has. The good news is that if you expose older people to sunlight a few days a week, they—like anyone else—can maintain adequate levels. But a lot of our elderly are not getting the bare minimum time they require in the sun— sans the sunscreen and ﬂoppy hats—to literally get their vitamin D blood running.
That’s not to say, though, that youths are likely to have adequate levels of vitamin D. Another study in nine- to eleven-year-old girls in Bangor, Maine, revealed that 48 percent were vitamin D deﬁcient at the end of the winter. Seventeen percent remained vitamin D deﬁcient at the end of the summer. When the Centers for Disease Control and Prevention did a study in the United States at the end of the winter, it found that 48 percent of African American women, in their childbearing years (ﬁfteen to forty-nine years of age) were vitamin D deﬁcient. Dr. Catherine Gordon and her colleagues at Boston’s Children’s Hospital reported that 52 percent of adolescent Hispanic and African American boys and girls tested were vitamin D deﬁcient throughout the year. The ﬁrst national assessment of this crucial nutrient in young Americans came out in August of 2009, broadcasting more mind-boggling statistics. About 9 percent of those ages one to twenty-one, or roughly 7.6 million children, adolescents, and young adults, are deﬁcient, while an additional 61 per- cent (50.8 million) have levels low enough to be considered insufﬁcient.
This was confirmed by another study reporting that 50 percent of children one to five years of age, and 70 percent of children six to eleven years of age, were either vitamin D insufficient or deficient. This was new evidence that low vitamin D levels could be putting our nation’s next generation at an increased risk for heart disease and diabetes, two of our biggest health problems worsened by the epidemic of childhood obesity. In fact, it was recently reported that teens who were vitamin D deficient or insufficient had a more–than–200 percent increased risk of high blood pressure and high blood sugar and a 400 percent increased risk of having pre–type 2 diabetes (also known as metabolic syndrome), compared to teens who were vitamin D sufficient.
This theme is played out whether you live in Florida or Alaska. It’s pervasive, in fact, in all parts of the world. It’s natural to assume that Floridians, for instance, would have no problem keeping their vitamin D levels up. But one study demonstrated that their blood levels defy their geography; vitamin D deficiency among Floridians was still 42 percent.
After performing a study on themselves, doctors in India reported that 90 percent of Indian physicians—whether they lived in Bombay or New Delhi—were deficient. They now have reported that 50 percent to 80 percent of adult Indians are vitamin D deficient. More than 50 percent of children in New Delhi are vitamin D deficient. Even in places like Cape Town, South Africa, and Riyadh, Saudi Arabia, vitamin D deficiency has been shown to be a problem.
If you compare your skin’s vitamin D synthetic activity in the summer to what it is in the winter, you’ll see an 80 percent to 100 percent reduction in vitamin D synthesis in the winter—even in a place like Florida. If you live farther north than Atlanta, Georgia, you essentially can’t make any vitamin D in your skin from about November through March. In the early morning or late afternoon, even at the equator with the sun shining, you’re still not making vitamin D, because the zenith angle of the sun is so oblique that most of the UVB photons that make vitamin D are absorbed by the ozone layer.
In later chapters I’ll delve more into these as well as other factors that compound this epidemic, but in brief I want to mention one of the more misunderstood features of this problem: the link between vitamin D deficiency and obesity. Because vitamin D is stored in fat cells, you’d think that people with excess fat would have plenty of extra vitamin D on hand to make up any shortage. As it turns out, that thinking is wrong, and a parallel relationship exists between vitamin D deficiency and obesity. The fatter you are, the higher your risk for a deficiency. Why? The vitamin D essentially gets locked inside the fat cells, unavailable for use.
In one of my studies, we exposed obese and nonobese individuals to the same amount of UVB radiation and showed that obese people can only raise their blood levels of vitamin D by about 45 percent com- pared to a normal-weight person. Obese people (defined as those with a body mass index, or BMI, above 30) often need at least twice as much vitamin D to satisfy their body’s needs. With the majority of Americans overweight or obese these days, it’s not a stretch to understand why a similar number of people are vitamin D deficient. The two epidemics have worsened in unison.
What’s more, obesity and osteomalacia often go hand in hand, trip- ping a vicious cycle that worsens the obesity, the osteomalacia, and the vitamin D deficiency like a perfect storm. As I described, osteomalacia is characterized by extreme bone and muscle pain and weakness. Being overweight predisposes a person to osteomalacia because the excess fat absorbs and holds on to the vitamin D from the sun and diet so that it cannot be used for properly mineralizing the skeleton or for main- taining cellular health. In addition, obese people are frequently vitamin D deprived because they go outside much less, for practical and self- esteem-related reasons. This only perpetuates the problem. When an obese person has osteomalacia, the bone and muscle pain and weakness make it virtually impossible to participate in any sort of physical activity that might help the individual take control of his or her weight. As a result, the individual remains obese or perhaps gains more weight, which in turn worsens his or her vitamin D status and exacerbates the osteomalacia.
Treating a person’s vitamin D deficiency can cure osteomalacia and open the world of exercise up to an obese individual. A study I participated in showed that it was possible to increase obese people’s vitamin D levels by exposing them to UVB radiation, in this case from a tanning bed, or giving them more vitamin D in supplement form. These treatments may have benefits other than enabling the patients to exercise. Recall that I explained how being vitamin D deficient interferes with the secretion of an appetite-suppressing hormone called leptin, which signals the brain when a person has consumed enough fat.
Building the vitamin D in a person’s bloodstream to normal levels will restore that process. Those three elements alone—lessening bone pain, making exercise easier by improving muscle strength, and rebalancing the appetite hormone—can combine to have a dramatic effect on an individual’s effort to put an end to the obesity and adopt a healthier life. Much more research needs to be done, but I think there is enormous potential for UVB exposure from the sun or artificial sources to be used to treat people with obesity.
But I Consume Lots of Fortified Milk, Cereal, and Juice, and I Take a Multi!
When people express doubt over the possibility that they are vitamin D deficient because they don’t fall under any of the usual high- risk categories, I remind them that it’s nearly impossible to meet the requirements through diet and a daily multivitamin. As I’ll explain further in chapter 10, the current recommendations are inadequate.
Look at your multivitamin’s packaging: I bet it contains 400 IU of vitamin D and indicates that this is “100%” of your recommended dietary allowance (the USDA’s current recommendation, which is twice the 200 IU recommended by the Institute of Medicine [IOM] for all children and adults up to fifty years old). This is not even half of what you should be getting. And you can’t just double or triple up on your multivitamin. This can be dangerous due to the level of vitamin A you’d be ingesting.
People assume that if you have a well-balanced diet, you’re getting all the nutrients you need. There is very little vitamin D from dietary sources. It’s principally found in oily fish, mushrooms, or sun-dried mushrooms, and in fortified foods like milk, orange juice, yogurt, some cheeses, and some cereals. But there are only 100 IU in a glass of milk or vitamin D–fortified juice or food per serving. (Trivia: Mushrooms are the only source of natural vitamin D in the produce section. Similar to the way that humans absorb sunlight and convert it to vitamin D, mushrooms contain a plant stool—ergosterol—that converts to vita- min D when exposed to light. An increasing number of mushroom growers around the world are now exposing their product to ultraviolet light that produces even more natural vitamin D.)
What about fish? A serving (3.5 ounces) of wild salmon can impart 600 to 1,000 IU, but few people eat wild salmon most days a week. A serving of cod liver oil can provide 400 IU per serving, but even that’s too low, and few people enjoy downing multiple servings of cod liver oil every day. It’s simply not a practical way to get your vitamin D, and you can get too much vitamin A (cod liver oil not only contains vitamin D but also vitamin A, similar to a multivitamin).
The sad state of commercial fishing can also lead us astray. A few years ago we compared farmed salmon to salmon caught in the wild. Because wild salmon get vitamin D from the food chain in nature, where there is plenty of vitamin D because phytoplankton and zooplankton photosynthesize it, wild salmon contain high levels of vitamin D. Farmed salmon, on the other hand, are fed pelleted food that has very little basic nutritional value. There is essentially no vitamin D in it. When we compared wild-caught to farmed salmon, we found that farmed salmon had 10 percent to 25 percent of the vitamin D content of wild-caught salmon—not enough to boost levels to an adequate state. (For a list of dietary sources of vitamin D and their approximate content, refer to the chart on page 227.)
To eat a sufficient amount of vitamin D (1,000 to 2,000 IU), you’d have to consume three cans of sardines, drink ten to twenty glasses of fortified milk, gulp down ten to twenty bowls of cereal, snack on fifty to a hundred egg yolks, or eat seven ounces of wild salmon for dinner every night.
Many Problems, One Solution
The inescapable fact is that humans have evolved in such a way as to be dependent on sunshine for life and health. Sunlight is the fuel that enables your body to manufacture vitamin D. When your body is unable to obtain sufficient sunlight, it can’t make enough vitamin D on its own. Why does this matter? The short answer is that the benefits of vitamin D to human health are many, varied, and profound. As mentioned in the introduction, it’s estimated that anywhere from 30 percent to 80 percent of the U.S. population is vitamin D deficient or insufficient. In my opinion, the percentage of vitamin D–deficient or –insufficient citizens is at least 50 and probably closer to 90 percent.
The notion that we have to protect ourselves from the sun all the time is misguided and unhealthy. This sun phobia explains why so many people are suffering from conditions related to sun deprivation. When the body doesn’t have what it needs to optimize cellular functions and sustain life, the inevitable decline that follows often manifests itself in exactly the kinds of illnesses and diseases that we hear and read about (and fear) daily, such as heart disease, cancer, diabetes, arthritis, osteoporosis, and dementia, to name just a few. These ultimately lead to a loss of independence and a lower quality of life.
I’ve touched upon a lot of issues in this chapter in broad strokes as a swift prelude to the balance of this book, which will take you deeper into the vitamin D story. What I haven’t mentioned, however, is that we can trace our relationship to vitamin D back millions of years to a time when humans had yet to make an appearance on the planet. Vitamin D’s legacy begins when earth and its inhabitants looked vastly different from how they look today. Casting back to that time period allows us to see why and how we evolved the way we did and admire the ingenious making of not only the human body, but every body that sports a spine.
Revue de presse
“Dr. Michael Holick has been a hero of mine for many years. How thrilling to have his ground-breaking research on vitamin D in one easily accessible book. This information can save your life. Really."—Christiane Northrup, M.D., ob/gyn physician and author of the New York Times bestsellers: Women's Bodies, Women's Wisdom and The Wisdom of Menopause
“Dr. Holick shows us why if you do one thing for your health beside eating well and exercising it MUST be getting more vitamin D through sun or supplements. Vitamin D deficiency affecting 200 million Americans is not just important for building strong bones but is absolutely needed to prevent and treat our chronic disease epidemic including heart disease, cancer, diabetes, depression, obesity, and autoimmune disease. The Vitamin D Solution, written by the world’s leading authority on vitamin D will surprise and delight you.”—Mark Hyman, MD, leading authority on nutrition and health and four time New York Times best-selling author including The UltraMind Solution and winner of the Linus Pauling Award.
“Dr. Michael Holick's The Vitamin D Solution is an essential guide for women and men of all ages. As the leading vitamin D researcher in the country, Dr. Holick provides clear, practical, and scientifically based advice to help you improve your vitamin D nutrition and overall health.”—Miriam E. Nelson, Ph.D., associate professor, Friedman School of Nutrition Science and Policy, Tufts University and the author of the bestselling "Strong Women" book series
“I'm very pleased with the information presented in Dr. Holick's The Vitamin D Solution…[he] provides an understandable, well-written, and highly informative presentation about this unique vitamin, its history, its very important functions, problems with deficiency, and the steps to rebuild Vitamin D levels.”—Diane Kress, R.D. CDE, author of The Metabolism Miracle
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Holick has dosage advice for pregnant mothers, children, and adults. He talks about how much he advises his patients to take when they are very low, and how much to take when they have got their levels up to healthy levels. He even says how much he personally takes.
Dr. Holick discusses the different ways Vitamin D can be absorbed -- sun, supplements, food, and Vitamin D lamps.
He also explains how common health problems (obesity); skin color (dark); location (north); season (winter); age (elderly); gut health (poor); drugs (prednisone); and rare diseases interfere with Vitamin D absorption. It is surprising to read he recommends obese people take 2-3 times the Vitamin D of non-obese people. Does the Government do that? No. Why? He does the research and it doesn't.
Holick believes the Recommended Daily Allowance (RDA) of Vitamin D is far too low; it's based on poor outdated research from 50 years ago. Government employees and average doctors are extremely ignorant about Vitamin D, unfortunately. Fortunately, however, they do blood tests for their patients, and then they're converted.
You may not know that the effectiveness of the sun for Vitamin D depends on where it hits your body and how much of your skin is exposed to the sun. Your face is the least effective part at absorbing the sun for Vitamin D; so all those walks in the spring, fall, or winter you might take aren't as valuable as you might think. (I'm thinking of getting a new Vitamin D lamp that Holick has tested.)
The good news this book gives is it doesn't take a long time or cost a lot to fix the very common health problem; rather, it's fairly quick and inexpensive to get your Vit-D level up. In as little as two months through sun (free) or supplements ($25) you could get healthy Vit-D levels. Furthermore, high levels in the summer can take you through the entire winter.
If you already have Holick's first book like I do and are wondering about getting the new one, I suggest you get it. This one has new material because Holick is still on the cutting edge of Vitamin D research. You can never know too much.
I'm not sure Holick mentioned it (don't recall reading it in his book, and it's not listed in the Index), but there is some research that indicates Vitamin A taken with Vitamin D can lower Vitamin D absorption.
Despite being so knowledgeable about Vitamin D and ahead of just about everyone, Holick is behind on the research about bright light boxes for circadian rhythm and SAD therapy. New research has shown they can cause eye damage. It can takes years before the blindness comes. The elderly are at greater risk. Green light therapy has been shown to be safer than bright light and blue light but just as effective. (The military did its own tests and is now using green; Google green light therapy to learn more.)
Michael Holick, the world's leading expert on vitamin D, is your guide on this journey of discovery. His pioneering efforts in that field go back to his days as a graduate student when he synthesized the active form of vitamin D, finding it to have extraordinarily powerful therapeutic effects. His contributions as both a scientist and practitioner have made profound advances in every aspect of vitamin D research. Dr. Holick has been a tireless researcher, advocate, author, educator, and legendary lecturer for over 30 years. He stands as the most prolific author of articles published in peer-reviewed medical journals including the prestigious New England Journal of Medicine.
I have a few predictions. The latter 2/3 of the 20th century will become known as the dark ages, when they demonized the sun, a situation that led to untold suffering and literally millions of largely preventable deaths. Dr. Holick will emerge as a central figure ushering in a new age where sunlight and vitamin D (along with other well-known lifestyle changes) eradicate millions of needless cases of chronic disease. Mainstream medicine will embrace the preventive and therapeutic power of vitamin D, and for his pivotal role bringing about the sea change in the practice of medicine, Dr. Holick will earn a well-deserved Nobel Prize. You heard it here first.
Dr. Holick contends that vitamin D deficiency is the most common medical condition in the world. Being both a researcher and clinician gives him tremendous insights to fortunate readers of this excellent reference. The book opens with two hypothetical pre-teen girls, one living in poverty near the equator and the other living a typical middle class American lifestyle. The list of diseases and medical conditions that are far more common for the middle class girl is shocking. It is no longer debatable that sunlight and vitamin D play major role in preventing a long list of serious chronic diseases, a reality that is becoming more and more accepted by the medical community.
Ideally you should read the entire book in linear fashion, but even if you open the book to random pages you'll find useful information everywhere, such as a new model of cancer that can't grow in a vitamin D-rich environment (page 87); the role of vitamin D in preventing Parkinson's and Alzheimer's (page 140); how vitamin D repairs pancreatic beta cells and thus is an important tool in the fight against diabetes (page 97); the only accurate way to test for vitamin D deficiency (page 147); and a new perspective on what killed the dinosaurs (page 28). I can't go over all 300 pages in this review but I hope you get the idea there is a lot of important information we all need to learn. The book is easy to read, devoid of oppressive jargon, easily accessible to the curious layman, covers the subject reasonably well, and would make an extremely good addition to the library of anyone who understands that good health comes from wise lifestyle choices. For these reasons, I am D-lighted to give the book a solid 5-star rating and the heartiest possible endorsement.
One of my favorite anecdotes involves a baby gorilla on the brink of death when Dr. Holick was called in to help. Classic symptoms of rickets led to an infusion of 5000 IU of vitamin D per day. The patient staged a remarkable recovery and Dr. Holick was the guest of honor at Kirmani's first birthday when she was clearly a happy, healthy, active gorilla. When Dr. Holick presented this story at a vitamin D conference in San Diego (complete with before and after photos) the audience burst into applause. I was there and can attest it was a magic moment. Read about it on page xxiv.
Another amazing story involves a lawyer who supplemented with vitamin D, developed symptoms of overdose, and called Holick to state he was planning to file a malpractice lawsuit. Dr. Holick had the lawyer send him the bottle of capsules which he thoroughly tested, only to find that due to a horrific manufacturing error the lawyer was actually taking over 1,000,000 IU a day. So instead of facing a grueling lawsuit, Dr. Holick acquired an important body of data since vitamin D overdoses are exceedingly rare. (Read about it on page 47.) The lawsuit was dropped, the lawyer quickly recovered, and we have valuable information about diagnosing and treating vitamin D overdose. Everyone wins.
Are there any negatives or downsides to this book? All my comments speak to the controversial nature of vitamin D where experts disagree in many areas. For instance, Holick states that D2 is equally as effective as D3 (page 217), yet the vast majority of researchers state that D3 is more bioavailable and stays in the system longer. On page 251 Holick states magnesium is unrelated to the uptake of vitamin D, which directly contradicts other experts. Holick generally avoids the details of studies that lead to various conclusions, which could be viewed either as a plus (easier to read) or a minus (lack of supporting evidence). There are more like this but I don't want to dwell on minutae. No two vitamin D experts see eye-to-eye on all aspects of this complex, confusing, confrontational subject. But this book contains so much solid, essential information it would be recommended reading for anyone even if they have minor disagreements here and there.
On page 214 Dr. Holick touches on a subject of utmost importance: Why can't the Institute of Medicine get it right when determining recommended vitamin D supplementation levels? The problem lies primarily in the guidelines of evidence-based medicine that only allows input from research reported in peer reviewed medical journals. Because pharmaceutical companies have no incentive to support research costing tens of millions of dollars to prove the value of an extremely inexpensive supplement, vitamin D studies tend to be of the lower-credibility observational type. Because medical science views this as a lack of compelling evidence the industry is hesitant to actively endorse vitamin D, and we all suffer as a result. I wish this flaw was exposed in a more forceful way but I'm glad at least was mentioned to give readers of this book some valuable insights. As a side note, The Institute for Functional Medicine promotes a system that sidesteps the flaws inherent in evidence-based medicine, and Dr. Mark Hyman, their most visible spokesman, provided a strongly supportive testimonial appearing on the back cover.
Here's the good news: You don't have to wait for the Institute of Medicine, the medical profession, or even your family doctor to jump onboard in order to benefit from the magic of vitamin D. However, you need to do your homework and that's where The Vitamin D Solution comes in. Dr. Michael Holick has done a superb job presenting information that will help you achieve optimal health. Read, it, study it, think about it, understand it, and most importantly, put it into action to get your 25(OH)D level above 50 ng/mL. (For most people that requires daily regimen of about 5000 IU.) The life you save may be your own.
Although it's referred to as a "vitamin," the reality is Vitamin D isn't a vitamin at all. It's actually a hormone that directly impacts so many areas of the body that it just makes sense to get your D3 levels up. Upwards of 200 million Americans are walking around with a severe Vitamin D deficiency and don't even know it. They've been told by well-meaning doctors that they have fibromyalgia, depression, genetic tendencies, and more. But if you check the D3 blood work, I would venture to guess that nine times out of 10 their Vitamin D levels are probably on the low to extremely low end of the spectrum. My own wife Christine dealt with this a few years back when she was experiencing excruciating joint and muscle pain as well as fits of depression and panic attacks only to find out here D3 came in at a dismal 9 ng/mL! If you don't know what that means, let's just say it's not good at all. She began taking 10,000IU D3 gel caps for a year and was able to raise her levels to 52 ng/mL. Now she has no more joint and muscle pain and she came off of a 10-year reliance on Paxil to control panic attacks. That's the miracle of Vitamin D and the stuff is dirt cheap, too! Yes, knowing your Vitamin D levels is a big deal.
So how in the world did we suddenly become so Vitamin D deficient? Lack of sunlight exposure, poor nutrition, and inadequate or severely lacking sources of it in supplements and fortified foods (like milk) are most of the problem. But regardless of how we there, the good news is there is a solution just waiting for those people who are dealing with any number of health ailments that cannot be explained by modern medicine or the symptoms are simply being masked by risky drug therapies. What is it? GET MORE VITAMIN D! How do you do that? Well, it depends on where you live, but sun exposure may not be enough if you live north of Atlanta or San Diego and you can't get enough of it in the foods you consume either (it would take 50 egg yolks to get adequate amounts of Vitamin D-talk about an eggfest!).
Dr. Holick says he prefers you get your Vitamin D from the sun first and foremost and to only use supplementation as an added aide to get your levels increased to where it needs to be. What level do you want your 25-vitamin D level to be? Ideally between 30-100 ng/mL according to Dr. Holick with the sweet spot landing in the middle around 60-80 ng/mL. Below 20 ng/mL is considered deficient while below 30 ng/mL is insufficient. Again, upwards of two-thirds of the American population is Vitamin D deficient right now. This is directly impacting health to the extent that ailments like osteoporosis, heart disease, cancer, autoimmune diseases, insomnia, arthritis, diabetes, chronic pain, psoriasis, autism and so much are likely a direct result of these deficiencies in something you can buy a big bottle of for around $10 at Sam's Club along with adequate sunlight exposure.
In The Vitamin D Solution, Dr. Holick includes a "self-test" in Chapter 7 to see what level of deficiency you may be experiencing. Things like sun exposure, where you live, what vitamins you consume, what kind of foods you eat, what beverages you drink, your nationality and race, your age, whether you are overweight or obese, your pain tolerance, your energy and strength, medications you are taking, and specific diseases you are dealing with will help you know even before having a Vitamin D blood test conducted whether you have a susceptibility to being deficient. Of course, the best thing you can (and should) do is get tested. What you need to have run by your doctor is the 25-hydroxyvitamin D test, aka the 25(OH) D test. It will show you how much circulating Vitamin D you have in your body. Beware of doctors ordering the wrong test and thinking your Vitamin D levels are fine. And don't get fooled into filling that useless prescription for a once-a-week 50,000IU Vitamin D2 pill that costs an arm and a leg (although Dr. Holick believes it will help "fill an empty Vitamin D tank!"). What you want is D3 which is very affordable from virtually any drugstore, pharmacy, or Wal-mart in varying doses as low as 100IU capsules to 5000IU gel caps. Get tested and respond accordingly!
The good news Dr. Holick brings with this book is that there is a real "solution" to your Vitamin D deficiency that is as easy as setting aside time for deliberate sun exposure, making sure you are consuming adequate amounts of calcium in your diet so that the Vitamin D can be maximized for health, and making up the difference in your Vitamin D needs through supplementation. And lest anyone, medical professionals especially, warns you of Vitamin D toxicity, Dr. Holick is quick to note that your body cannot manufacture a toxic level of Vitamin D from simple sun exposure no matter how much sun you get. And supplementation isn't a problem unless you are taking super-high doses well above 10,000IU for longer than six months. The bottom line is to make sure you are taking every measure possible to increase your D3 levels to ward off any potential negative effects on your health.
The Vitamin D Solution is arguably the most comprehensive book on the subject of Vitamin D today and Dr. Holick certainly knows from whence he speaks. He's been trumpeting the case for Vitamin D awareness for a very long time and is just now receiving the critical acclaim he rightly deserves. My favorite part of this book is in Chapter 13 which is the "Q&A" session that answers anything and everything you can possibly think of regarding the subject of Vitamin D. He also provides a resource guide for finding good sources of Vitamin D supplementation as well as a bibliography of other Vitamin D experts and researchers he cites in support of the conclusions he draws throughout his book. Needless to say, I'm a big fan of Vitamin D and the positive effects it can have on your health. My own Vitamin D levels increased from 42 ng/dL to 68 ng/dL taking 10,000IU D3 gel caps in just six months, so it is indeed possible to overcome many chronic health problems with a concerted effort to make it happen naturally. Isn't it time to stop suffering needlessly from Vitamin D deficiency?
Vitamin K is essential not only for preventing potentially deadly blood clots but also for bone building (including delaying tooth decay) and maintenance. Perhaps most important - K has powerful anti-cancer effects. It is known to be helpful for cardiovascular disease, varicose veins, brain health problems, including dementia and even prevents infectious diseases such as pneumonia. Some claim that most people need daily vitamin D3 of at least 2000 IU with 3000 IU of vitamin A and 100mcg of vitamin K2. The synergy between them is vital as there is evidence that the safety of high dose vitamin D is dependent on vitamin K, and that vitamin D toxicity (although very rare with the D3 form) is actually caused by vitamin K2 deficiency.]
Of the 8 books on vitamin D I've now read, this is now my favorite pick. It's practical and he has a way with words: "vitamin D deficiency is our most common health challenge globally", "vitamin D is in a class by itself; its far-reaching effects on the body are aligned with how hormones act to influence metabolic pathways, cellular functions, and the expression of myriad genes", "in some respected medical circles, sunlight is being described as a 'wonder drug'". At 300 pages I also found it thorough and I specially liked the straightforward explanation that sunshine, when it's strong enough, is always better than supplementing with Vitamin D.
Dr. Holick is a professor of medicine, physiology and biophysics at Boston University Medical Center in the USA who has studied vitamin D for over 30 years and has received awards relating to health research and nutrition. He explains that he lost his teaching position as a Dermatologist in 2004 because he refused to agree with his boss and with the Dermatology profession generally that even the tiniest amount of UV/sunshine is bad for us. Unlike most of the other books, which recommend only vitamin D3, he says that either vitamin D2 or D3 is fine.
Of the other books, "The Vitamin D Revolution" by Soram Khalsa was previously the one I preferred while "Vitamin D Prescription" by Eric Madrid is also good and of the 2010 books "Vitamin D" by Rona and "Power of Vitamin D" by Zaidi are both brief but quite good. "The Vitamin D Cure" by James Dowd is not basic, comprehensive or practical. Then there is "Vitamin D" by Michael Merrill which was too brief and simply inadequate. At the other extreme is the comprehensive but somewhat technical "Sunshine and Vitamin D" by Frank Murray - mainly brief compilations of hundreds of studies but no practical guidelines, so not really suitable for the layman who wants to experiment with high-dose vitamin D.
There are more and more books - and a great deal of media fanfare - on the recently discovered almost miraculous properties of vitamin D. It's also worth noting that over a decade ago several books were already lauding the much-overlooked benefits of sunshine, the best way to get vitamin D, although the further away from the equator, the less effective. Anyone living above the 35th parallel is highly likely to have a sunshine/vit D deficiency that can also lead to many common symptoms. (Those who react badly to Vitamin D and/or sunshine may have a rare disease called sarcoidosis.)
According to most of these books, the vast majority of us are deficient in vitamin D whereas adequate levels can alleviate chronic pain, stroke, osteoporosis, heart disease, cancer, autoimmune diseases, depression, arthritis, diabetes, gum disease, psoriasis, fibromyalgia, autism and much more. Perhaps it's just my cynicism from decades of reading endless books singing the praises of so-called miracles such as DMSO, MMS, DHEA, vitamin C, magnesium, iodine, omega 3 EFAs, breathwork, oxygen therapy, hydrogen peroxide, water, thyroid hormone, adrenal hormone, liver cleanses, detoxes, fasts, exercise, neutralising electromagnetic stress, juicing, mangosteen, noni juice, superfoods, organic foods, wholefoods, celiac diets, dairy-free diets, veggie diets, protein diets, carb diets, food combining, acid-alkaline balancing diets, Glycaemic Index diets, high fibre diets, raw food diets, candida/fungus elimination, parasite cleansing - oh dear, the list of my gullibility seems endless.
Yes, I've tried all of these; yes, thoroughly and sometimes repeating them in various combinations and on each occasion with enthusiasm and bright-eyed hope but I saw no measurable benefits. "Trick and Treat" by Groves explains in detail just why so many of my efforts were doomed. Nowadays, when I read about health wonders, I wonder how many claims of success are made up or at least tweaked - and I wonder what proportion of actual patients were successful in any way, much less miraculously so, as is always claimed by books touting single strategies.
I was startled to learn in this book that about a third of the population has kidney disease (which never gets diagnosed until too late and allegedly little can be done for it apart from horrible treatments like dialysis) and that about the same number are obese (hello... anyone making a connection here?) and that their bodies may not be able to produce enough activated vitamin D: as compared to the non-obese, vitamin D levels rose only 50% as much in the blood levels of the obese when using a tanning bed or getting a dose of 50,000iu of vitamin D. The obese get a lot of blame for what is not actually their fault: studies now show that calcium also plays a key role in reducing obesity (elsewhere I have seen studies showing large weight loss in about 30% of obese women who take both calcium and vitamin D).
Holick is the only author who makes it clear that there are many whose bodies have difficulty converting vitamin D into the active form, such as older people or those who have a wheat/gluten intolerance (much more common than realized). Based on my personal experience of taking 10,000iu daily of vitamin D3 for 6 months (but Rona's book mentions Norm Shealy, a physician who has taken 50,000iu per day for 18 months), I'm not convinced that vitamin D supplementation of the non-prescription kind is a panacea, as so many of the books are claiming - and I am not convinced that all these authors got the unanimously fantastic results they allege. While I believe that vitamin D supplementation at 5,000 ius daily is beneficial, too many single-strategy books have a way of sounding a little overzealous, attributing every malady to whatever deficiency they're tackling and proposing it as the magic solution across the board. Further, not one of these books on vitamin D explains that vitamin D cannot work without magnesium, and that anyone with a chronic health issue is magnesium deficient, as explained in "Treatment Essentials" by Dr Mark Sircus.
LATER NOTES: I eventually was diagnosed, by a metabolic specialist, with serious adrenal fatigue and serious low thyroid issues. The thyroid issue had been getting worse for 2 decades, whilst "standard" medicine denied I had either, repeatedly assuring me all their tests "proved" this. Turns out you have an 80% chance of one or both, if you have a chronic health issue. Visit the Broda Barnes Foundation website for a list of the few thyroid-sympathetic doctors in your state: click on the "educational info" button on the left. It's also worth knowing about "The Calcium Lie II" an intriguing book plausibly claiming to explain the root cause of most illnesses and which shows how taking calcium with vitamin D is actually dangerous and that the increased cancer and medical problems related to "vitamin" D hormone deficiency are more likely related to D hormone suppression from intracellular calcium excess thus leading to adrenal suppression with a resulting increase in illnesses.