Are you suffering from chronic fatigue, mild depression, generalized muscle aches and weakness, sleep disturbances, or poor concentration? You may be surprised to hear that you could have a vitamin D deficiency. I know that I was! I had been complaining about my extreme tiredness and lack of energy for quite a while. No matter how many cups of coffee, green tea, or vitamin drinks I drank, I was still foggy and tired. No matter how many hours of sleep I got, I still felt that I could lay in bed all day and sleep. I think that I would be asleep right now, if I didn’t have little kids to raise. So my primary care physician (PCP) decided to run some lab tests, and voila, low vitamin D levels!
Interesting Medical Mumbo-Jumbo:
The role of that vitamin D plays in the body used to be limited to bones and skeletal deformities, most notable is rickets. There are numerous new studies and research projects being published, that are giving us a glance at just how valuable this “sunshine” vitamin is. Recent immune data on vitamin D3 deficiency help to more clearly understand chronic fatiguing illnesses, such as autoimmune disorders, cancer, and chronic fatigue syndrome (CFS). A new study has shown that providing treatment for vitamin D deficiency considerably improves women’s depression in moderate and even severe cases. In addition, according to MedicineNet.com, various researchers have claimed that Vitamin D benefits are associated with the following:
- Prevention of osteoporosis and osteopenia
- Lowering blood pressure in people with hypertension
- Lowering incidence and severity of cardiovascular disorders
- Decreasing the incidence of type 2 diabetes: Research has shown that those with blood vitamin D levels over 25 ng/mL had a 43% reduced risk of developing type 2 diabetes compared with those with levels under 14 ng/mL.
- Decreasing inflammation: Research has shown a decrease in levels of C-reactive protein, a marker of inflammation, with increased levels of vitamin D to just below 21 ng/mL.
- Reducing risk of allergies in children and adolescents: A nationwide study of over 6,000 individuals showed that allergic sensitization was more common in those with vitamin D levels under 15 ng/mL versus those with levels 30 ng/mL or more.
- Decreasing dental cavities: A 47% reduced risk of cavities was found with vitamin D supplementation.
- Prevention and treatment of depression: Receptors for vitamin D are present on many areas of the brain including the cingulate cortex and hippocampus, which have been implicated in the pathophysiology of depression. Vitamin D is involved in numerous brain processes, making it biologically likely that this vitamin might be associated with depression and that its supplementation might play an important part in the treatment of depression.
- Regulating cholesterol levels in the blood: It has been shown that without adequate sun exposure, vitamin D precursors turn to cholesterol instead of Vitamin D.
- Decreasing mortality rate from certain cancers: In 1941, U.S. pathologist Frank Apperly published geographic data that demonstrated for the first time an inverse correlation between levels of UV radiation in North America and mortality rates from cancers. This means that more exposure to UV radiation (sun) leads to fewer deaths from cancers. In the meantime, since this was published, it has been confirmed that there is an association between increased risk of dying of various internal malignancies (for example, colon, breast, ovarian, melanoma, and prostate cancer) and decreasing latitude toward the equator.
- Decreasing risk of osteoarthritis: Vitamin D deficiency may increase the risk of osteoarthritis.
- Possibly helpful in prevention of fractures, improving balance, and reducing the risk of falls in the elderly: There has been some evidence suggesting that Vitamin D supplementation may have these benefits, but more research needs to be done to confirm it.
How low is to low?
So how low is too low and how do you find out? All it takes is a simple blood test, that your doctor will have to order, to find out if you are deficient in Vitamin D. Talking with your primary health care provider will be your first step. It is generally called a Serum Vitamin D Level (Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations). The National Health Institute (NIH) defines serum Vitamin D levels as follows (measured in ng/mL, or nanograms per milliliter):
- Less than 12 Vitamin D DEFICIENCY
- 12-20 Vitamin D INADEQUATE
- 20-50 Vitamin D ADEQUATE
- More than 50 Vitamin D EXCESSIVE
My vitamin D level came back at 16! No wonder I wanted to sleep, ALL-THE-TIME. I was blaming my tiredness on being a new mom and working the night shift, which I am sure contributed to it. It had not even occurred to me that I may have a vitamin deficiency driving my fatigue. How in the heck did this happen?
What Causes Vitamin D Deficiency?
It may surprise you to know that an estimated 1 billion people are deficient or insufficient in vitamin D. This is estimated because undiagnosed vitamin D deficiency is common worldwide. According to the NIH:
- Nutrient deficiencies are usually the result of dietary inadequacy
- Impaired absorption and use of Vitamin D
- Increased requirement, or increased excretion.
- A Vitamin D deficiency can occur when usual intake is lower than recommended levels over time
- Exposure to sunlight is limited
- Use of SPF 30 sunblock decreases vitamin D synthesis by 95%
- The kidneys cannot convert inactive Vitamin D to its active form
- Absorption of vitamin D from the digestive tract is inadequate.
- Vitamin D-deficient diets are associated with milk allergy, lactose intolerance, ovo-vegetarianism, and veganism.
For me specifically, it was a combination of poor diet and lack of sunlight (due to working nights and sleeping days). I had been working the night shift as a registered nurse for the last 4 years and I never really adjusted to sleeping well during the day. Plus, my diet was not the best it could have been. There were lots of after-shift breakfasts with co-workers at all-you-can-eat pancake restaurants (*snickering*). AND my sleep and diet situation did not get any better after the birth of first child. I felt like I was in survival mode.
How Do I Fix It?
I am extremely lucky to have found such an awesome primary care doctor. Yes, he did the standard doctor things, like order tests and write prescriptions. BUT he also just listened to me and gave me other non-pharmacological (drug-free) options. He prescribed a prescription strength vitamin D supplement that I took once a week, for 8 weeks. Once my vitamin D level was with the “adequate” range, I started to take an over-the-counter (OTC) vitamin D3 supplement daily. He also suggested that I read The Depression Cure: The 6-Step Program to Beat Depression Without Drugs by Dr. Stephen Ilardi. There are great sections about the use and roles of vitamin D and vitamin D3 supplements, Omega 3 Fatty Acids (fish oil supplements), and sunlight exposure. It is a fairly easy read, and had lots of great information.
The major source of vitamin D comes from exposure to sunlight. The NIH states:
Approximately 5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D synthesis and that the moderate use of commercial tanning beds that emit 2%–6% UVB radiation is also effective.
Vitamin D3 Supplements and Natural Food Sources
Individuals with limited sun exposure need to include good sources of vitamin D in their diet or take a supplement to achieve recommended levels of intake. The recommended dietary allowance (RDA) for vitamin D is as follows:
- 600 IU/day for ages 1 to 70
- 800 IU/day for over 70 years of age
- 600 IU/day for pregnant and lactating women
Many experts feel that these recommendations are too low and that these should be the minimum. I have found vitamin D3 supplements ranging from 200 IU/serving to 10,000 IU/serving, with everything in between! It is always best to check with your physician or other qualified health care practitioner before beginning or changing your medication and supplement regimen!
BETTY KOVACS, MS, RD (Registered Dietician), from Medicine.Net says; A few foods naturally contain vitamin D, and other foods are fortified with it. The amount found in food is not enough for treating a deficiency and may not be enough to maintain adequate levels unless combined with sun exposure. The amount of vitamin D in foods is as follows:
- 1 tsp cod liver oil has 400 to 1,000 IU/vitamin D
- 3.5 oz salmon, fresh (wild) has 600 to 1,000 IU/vitamin D
- 3.5 oz salmon, fresh (farmed) has 100 to 250 IU/vitamin D
- 3.5 oz salmon, canned has 300 to 600 IU/vitamin D
- 3.5 oz sardines, canned has about 300 IU/vitamin D
- 3.5 oz mackerel, canned has about 250 IU/vitamin D
- 3.5 oz tuna, canned has 236 IU/vitamin D
- 3.5 oz shiitake mushrooms (fresh) has about 100 IU/vitamin D
- 3.5 oz shiitake mushrooms (sun-dried) has about 1,600 IU/vitamin D
- 1 egg yolk has about 20 IU/vitamin D
- 8 oz fortified milk or yogurt has 100 IU/vitamin D
- 8 oz fortified orange juice has about 100 IU/vitamin D
- 3 oz fortified cheese has about 100 IU/vitamin D
It was certainly clear that I was not meeting my daily vitamin D requirements, and according to some major studies, a majority of America isn’t meeting the requirements either. Avoiding sunlight to protect ourselves from the risks of skin cancer has definitely decreased most American’s vitamin D levels. BUT the NIH’s recommendation of 5 to 30 minutes only 2 times a week sounds doable! AND when sun is limited, like during wintertime or on a night shift, a daily vitamin D3 supplement can be very beneficial! If you think that you may be deficient in vitamin D or have inadequate levels, check with your doctor or appropriate medical practitioner. (See our Disclaimer) Remember, a blood test ordered by your doctor is the best way to determine if you are deficient in vitamin D, and if you are deficient, follow up with your doctor!
Good luck and good health!