The Power of D

All vitamins have a function, a power if you will. Unknown Object Vitamins in the B family can ease anxiety, migraines and give the body energy. Vitamin C is an antioxidant that promotes infection resistance. Vitamin D is typically a little lower on the radar but recently, vitamin D deficiencies have been been touted in the press – founded or not. So, what exactly is the power of D? Is the average American getting enough, and how does one know if they are D deficient? East Texas Medical Center neurologist Stasha Gominak, MD; and C. Gilbert Chou, MD, Trinity Clinic rheumatologist; give the real scoop on vitamin D.

WHAT IS VITAMIN D?

First, the most common delusion is revealed: D is technically not a vitamin. Gominak explains further, “Vitamin D is misnamed. Vitamin means, ‘a chemical that I can’t make in my own body but all my cells need.’” Therefore, the body must get it from one’s environment. “This chemical, D3 (cholecalciferol), is a hormone not a vitamin. We make it ourselves; on our skin from a special wavelength of light called ‘UVB’ that is present only in the summer and not in winter,” she explained.

Humans aren’t the only living creatures that manufacture D3. All non-nocturnal animals (fish, birds, reptiles, etc.) make D3 from UVB light. Rats and other nocturnal animals are an exception. “They don’t go in the sun, so they have something very much like D3 from somewhere else,” Gominak said. “Vitamin D has responsibilities in every organ in the body so none of us can live without it.”

Gominak says the most confusing part is the Food and Drug Administration's daily recommended dosage of vitamin D for the average American. Recently, it has even been added to infant formula. In her opinion, it is impossible for the FDA to recommend a daily dose for individuals because everyone’s levels are different. “This is a hormone that each of us makes at a different rate. Each person’s level fluctuates month-to-month and year-to-year; depending on where they live, how dark their skin is and how much they go outside,” Gominak said.

If this is true, she states it is impossible for any public agency to recommend one specific dose for Americans of all ages and races. Furthermore, she says the concept of enriching foods with vitamin D is just as bizarre. “Putting this hormone in the food is as weird as suggesting that we put thyroid hormones or testosterone in the food. Everyone knows that hormones are specific for each individual,” she elaborated. For doctors to get an individual’s D to the right level, they must first know what that level is. Then, it must be measured to ensure it remains at a healthy level.

WHO IS DEFICIENT?

Dr. Chou explains that vitamin D is an essential hormone for regulating calcium in the body. Those at risk for low vitamin D typically take supplements to increase their levels. “Elderly people in nursing homes, people who have no good exposure to the sun, people who have peculiar diet habits and people who have undergone some type of surgery like gastric bypass could have a problem absorbing vitamin D,” Chou explained. However, in Chou’s opinion, just because there has been a recent trend of adding vitamin D to foods, doesn’t mean that everyone is vitamin D deficient.

He also says testing blood for vitamin D has recently been abused by some doctors. If anything, the test is overused versus underused. There has also been a backlash from the overtesting. “That is why the FDA or Medicare recently published a guideline on the proper use of vitamin D testing and vitamin D supplements,” he added. “I think it is overprescribed and sometimes I think it is overdosed.”

WHY IS D OVERPRESCRIBED?

Several factors contribute to its overprescription. Chou says media overexposure, vitamin supplement companies and marketing strategies may all be conducive factors. “Doctors also caught onto the frenzy and too much was believed about the 'magic' of vitamin D,” he said. “First there is no magic; some doctors based on limited research exaggerated it. A lot of doctors, even local doctors, believe vitamin D is a magic thing [and] can do it all – which is not true.” If not monitored correctly, high doses over a long period of time can lead to toxicity.

Yet still, Gominak has another theory why vitamin D has recently received more press. First, she stresses it is crucially important for the body to function. “This is the most important hormone in the body. It bosses all the other hormones of reproduction, energy, metabolism and sleep [around,]” she explained. And since D is a hormone and not a vitamin, it often is overlooked and not supplemented. “The literature on vitamin D has reached a critical mass in the last three to four years,” she said. “The press has popularized it. The patients who are taking it feel better, and they are teaching their doctors.”

IS THERE A D EPIDEMIC?

Perhaps the hype surrounding D deficiency and the current trend of adding it to food stems from humans spending more time indoors, using more sunscreen, and getting less sun exposure. Gominak lectures to other physicians about the recent discovery that may link D deficiency to the epidemic of sleep disorders throughout the U.S. This theory, Gominak says, is supported by the fact that vitamin D receptors are concentrated in the area of the brain that controls your sleep rhythm. Another indicator is since the 80s there have been drastic increases in sleep apnea, fibromyalgia and chronic fatigue – the common denominator being low levels of D. “The epidemic of vitamin D deficiency began to appear in the same time frame as we began to have widespread use of sunscreen, computers, television and air conditioning – and everyone in the population moved indoors,” Gominak attested.

Another odd culprit of D deficiency is air conditioning, Gominak explained. “Populations without electricity (and therefore without air conditioning) do not have the epidemics of young onset sleep disorders, hypertension, diabetes and high cholesterol that exist in the countries where air conditioning is in widespread use.” And exposure to the sun to activate vitamin D in the body is not as time consuming as one might think. Chou says 5 to 10 minutes is probably enough time to activate vitamin D production in the body. And natural sunlight is the best source of D, Chou recommends. “Tanning is too much for vitamin D purposes. Just a few minutes walking outside, a walk in the yard, driving on the highway on a sunny day; that would probably give you enough sun exposure. It doesn’t have to be very long.”

HOW MUCH D IS ENOUGH?

Gominak says the FDA recommended daily dose is not exactly accurate.“Unfortunately, because the FDA has been asked to recommend a single dose of this hormone for every American, they have wisely chosen to err on the side of a dose so low that they will never hurt anyone,” she said. “The dose that we make on our skin, middle of the day, middle of the summer is 20,000 IU [international units],” Gominak explained. “If we don’t go outside, 1,000 IU per day will never replace this. Scientific articles and clinical trials that don’t understand this concept give 400 to 2,000 IU and are focusing on the dose and not the level.”