Do You Need To Take A Vitamin D Supplement?

Coming up on this episode of the Doctor's Pharmacy.

Vitamin D is important for the synthesis of serotonin, which is a neurotransmitter involved.

In mood, a lot of happy chemical.

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Vitamin D plays a crucial role in our health. It supports our bones and our cardiovascular and immune systems. It affects our cell metabolism, it regulates and controls our genes, and much, much more. Your body makes vitamin D when it's exposed to sunlight. But the problem is that most of us aren't exposed to enough sunlight to produce adequate levels of vitamin D. And most of us are not eating enough of the few natural dietary sources of vitamin D, like fatty wild fish, like mackerel, herring, and cod liver oil. Earlier this year, Dr. Hyman spoke to health and science author Max Lugavere about.

The importance of having optimal vitamin D levels. Vitamin D deficiency is thought to be a risk factor for developing Alzheimer's disease. There's a review of environmental risk factors that I talk about in the book, and vitamin D was one of the top.

Yeah, probably 80% of us are deficient or insufficient, and that leads to depression, it leads to increased risk for Parkinson's, Alzheimer's, cancer, so many different things. And I think, you know, there's been mixed data about replacing it, fixing it or not, and I think it's complicated because when you're like, If people are eating garbage and they throw a vitamin D in there, it's not going to help. Yes, correct. If they're not exercising, they're smoking, they're drinking a lot, they're eating crap, taking vitamin D is not going to do anything. But in all things being equal, people who are low in vitamin D have higher risk of this. And if you clean up your lifestyle.

And you're still low in vitamin D, it'll make a big difference. Yeah, I'm glad you brought up context because one thing that very few people know, you could be spending as much time in the sun as you want, frolicking all day in the beautiful warming rays of the sun, or even supplementing with vitamin D, but if you're not getting adequate magnesium in your diet, which 50% of the population does not get adequate magnesium, the enzymes that convert the vitamin D that your skin creates into its active hormone form in the body, all are magnesium dependent. And magnesium, half of us don't consume adequate magnesium. It's found in dark leafy greens, pumpkin.

Seeds, dark chocolate almonds. And it's a lot of things cause us to lose magnesium, stress, coffee, alcohol, sugar, all those things we love.

Exactly.

You know, mental health is such a big crisis in this country. One in four people experience major depression in their life. It's the biggest cause of the economic burden of chronic disease, not from direct healthcare costs, but things like disability, loss of quality of life, not being able to function very well in your life. And, you know, vitamin D is one of those things that seems to really impact depression. So, you talk about a study in the book that has to do with vitamin D and depression. Can you talk more about that? Well, vitamin D is important for the.

Synthesis of serotonin, which is a neurotransmitter involved in mood. It's a happy chemical. It's a happy chemical. That's what Prozac does.

It increases serotonin, right?

Increases serotonin. SSRIs, selective serotonin reuptake inhibitors, can boost serotonin at the synapse, which is serotonin is also involved in focus and attention and executive function. But yeah, so vitamin D is important in the synthesis of serotonin from its raw materials, one of which is tryptophan, an amino acid. So making sure that your vitamin D levels are in a normal healthy range, important. And you can easily get your vitamin D levels tested from a doctor. It's a very cheap test. The recommendations that I make in the book are to make sure that your levels are somewhere between 40 and 60 nanograms per milliliter, which seems to be a range where we see the lowest risk of all-cause mortality.

Yeah, I mean, I remember reading a study. It was incredible that women who had vitamin D levels less than 45 had a 60% higher chance of having preterm labor. And when you think of the cost of neonatal intensive care and taking care of preterm babies, it's staggering. And you're talking about pennies for a vitamin. It can literally prevent preterm labor. So it's really connected to almost everything. And the differences with vitamin D is that not everybody needs the same amount, right? So what should we be taking?

Correct. Not everybody needs the same amount. Before you start taking vitamin D as a supplement, you ought to get your levels tested. When we synthesize it from the sun, our skin basically makes what we need and it breaks down the rest. It's almost impossible to get too much vitamin D from the sun.

Although lifeguards can have levels of 150.

That's amazing.

And that's not toxic.

Right, I mean it could increase, it increases calcium absorption. So I always like to recommend vitamin K2 for people that are in, I mean especially at those levels. But with a vitamin D supplement, I think generally there was a research calculation that suggested that for the general population 2,000 international units a day would be ideal to get the average, you know, the average person to an optimal level. But people again have different, you know, people who are older might need to supplement more. More people who are overweight might need to supplement more to get the same improvement. And also, again-- yeah, people who are.

Overweight tend to be low in vitamin D because it's a fat-soluble vitamin. So it all gets sucked into the fat and it doesn't get into our system that we need.

Yeah, it gets sequestered by fat tissue. The same also can occur with other fat-soluble vitamins like A, E, K. Yeah.

I don't know if you read this morning, probably not, because you probably don't read JAMA Pediatrics Journal every day.

Not pediatrics, no.

But I do. And I read this paper this morning that showed that women, when they were pregnant, took 2,800 units of vitamin D compared to 400, which is in the typical prenatal vitamin, that there was a dramatic reduction in the effects on, bad effects on bone when their kids were born. In other words, their kids, their babies had much higher bone density and then their risk later in life of osteoporosis was dramatically reduced. So, and that, you know, that's almost 3,000 units, which most doctors don't even think about recommending. And some people, you know, may need up to five or 10,000 if they're not good absorbers and there's genes that affect that. So, people might need only 1,000, but I think 1,000 is minimum for most people and it takes about, a thousand units to raise your blood level 10 nanograms per deciliter. So if you're 20, you need at least 3, 000 to get up to 50. Right. And, and then you can see how you do. But I think people need to measure it, they need to check it, and they need to make sure they're okay. And if not, take the right supplement. And not the, the kind that you often get from your doctor, I hate to say, which is vitamin D2, which is not an active form of the vitamin, but vitamin D3. And you can get that over the counter now and you can get thousand units and others, but you want to.

Make sure you measure it, right? Yeah, I mean vitamin D2 is the plant-based form of vitamin D. And vitamin D3 is the animal-based form. It's bioidentical to what we create in our own skin. So you always want to make sure that you're taking vitamin D2. I mean, sorry, D3.

Okay, so that brings up a sticky question. So it's usually made from lanolin and other things that you can get it from sheep and stuff. And they're fat. So what if you're vegan? What do you do?

That's a good question. I've vegan sources of vitamin D3. That's hard to get. Yeah, right. It's just one more of those nutrients that you're just not really optimizing for. Yeah, and often people don't convert vitamin.

D2 to D3, and if you're vegan, you wanna make sure you're checking vitamin D3. And you can also check D2, so you can see you might have a.

Really high D2, but a very low D3. There are so many supplements on the market. and it can be really confusing to know if you're getting the right type or taking the right amount of vitamins and minerals. Dr. Hyman recently spoke to Dr. Elizabeth Boham, his colleague at the Ultra Wellness Center, about the importance of determining your individual needs when it comes to taking supplements. They also discuss why we are seeing.

Such high levels of nutrient deficiencies in our population. I think, you know, we're taught that we should really get everything from food, but there's been a lot of problems with our food supply. That's true. You know, we aside from us eating mountains of processed food, which has got no nutrients except things that are fortified, enriched. Why are they enriched? Because it's impoverished to start with. And on top of that, the way we grow our food in soil that's depleted because of industrial farming techniques, because of the fertilizers and chemicals that literally destroy the microbiome of the soil, which is needed to extract nutrients from the dirt, from the soil, that the plants can use, which then we eat, we've seen 50% reduction in nutrient levels like magnesium and other minerals in our vegetables over the last 50 years. So if you're eating broccoli today and you ate it 50 years ago, it's a different food. It's a different broccoli. And then you're shipping them over long distances. The average apple you eat has been in a storage house for a year, right? And they're refrigerated, kept in storage, they're transported, so they lose nutrition. And we're also living a lifestyle that depletes our nutrients.

Yep.

We're drinking too much alcohol, smoking, eating processed food, which by the way, in order to, let's talk about this, in order to actually metabolize your food, the way your food is metabolized is requiring vitamins and minerals to run that.

As cofactors for all those enzymes.

Right.

To run the food through your metabolic factory, you can't, like the assembly line, if you don't have the nutrients, you can't run the food through. Right. And so you get more depleted. And then we have all these drugs we take that deplete our nutrients, medications, and then so we have all these reasons why we're nutritionally deficient. So let's talk about how we learn in our practice, the UltraWellness Center, about what people's nutritional status is. How do we figure that out?

Well, so we look at it from multiple different angles, right? First it starts with the physical exam, you know, what is their, waist-to-hip ratio, how are they holding on to weight in their body? Then we look to look for signs of nutritional deficiencies. Maybe their hair is dry or their skin is dry or they have different spots on their nails which could indicate zinc deficiency. We look at their diet intake.

Wait, wait, wait. The nutritional physical exam, I just want to pause because you teach that course at the Institute for Functional Medicine and it's fascinating when you learn as a doctor what the clinical signs are of vitamin deficiencies. So we know the obvious ones, for example, if you have scurvy, you get no gum issues. If you have B vitamin deficiencies, you get little cracks in your mouth called kelosis. If you have white spots in your.

Nose, it might be zinc deficiency. For example, bumps on the back of your arms or dry skin, we think about vitamin A a lot.

We think about zinc. And my favorite test is a vitamin D test.

You know what that one is? Yes.

Tell us about that.

So, if you bang on somebody's leg and they have pain, then that could be a sign that they're low in.

Vitamin D. Yeah, so if you take your thumb and you press right now, ready to go, press right now on their shin bone, and if it's tender, then it means you're probably vitamin D deficient because it makes your bone soft. Now, I take vitamin D, so my.

Bone doesn't hurt at all when I press on it.

You're pressing right now?

Yeah, mine doesn't hurt either. Yeah, you go. I'm taking my vitamin D. I'm taking my vitamin D. And I think what is really important to pay attention to with supplements is that when we use them in a personalized approach when we're testing, when we're using them based on what that individual person needs. Not just saying, okay, everybody take this, which sometimes that's helpful too, but really figuring out for that individual person, what are they deficient in? Where do they need to focus? That can make a huge, huge difference for how they feel.

It's so true.

And it's different for each person, like you're saying, based on our genetic makeup, right? And everything else going on in our body, not just our genetics, but what other diseases we're dealing with, how we digest and absorb our nutrients. I mean, so many things impact our nutritional needs.

Yeah, so someone for example had a vitamin D receptor gene that made them require a high dose of vitamin D, and you took 100,000 people and you saw them taking vitamin D, well you think they're taking enough, but it might not be enough for that person. And if you actually took that subset and you studied them and you gave them the right amount to get their blood levels optimally, It might be different.

It will absolutely be different.

You can get your vitamin D levels tested through a simple blood test. Supplementing with vitamin D3 can be an effective way to reverse a vitamin D deficiency, but it can take between six and 10 months for levels to optimize. Dr. Hyman recommends working with a trusted healthcare practitioner to monitor your levels over time and ensure you are getting the right amounts for your particular needs. Thank you for tuning in to this episode of the Doctor's Pharmacy. If you enjoyed this episode, please consider.

Sharing it with a friend and leaving.

Us a comment below.

Until next time.

Hey, everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff, from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays, nothing else, I promise. And all you have to do is go to drhyman.com/picks to sign up. That's drhyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you My favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Hi everyone.

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