Why Boosting Your Vitamin D Could Change Your Life

Foreign this is open mind. Today we're diving into a topic that's really essential for your overall health and yet mostly overlooked in medicine. Vitamin D. Now, we hear about it all the time and all the benefits of vitamin D. But what exactly is vitamin D and what does it do in our bodies? Because you should know, it's really important as a fat soluble vitamin. Vitamin D needs to be absorbed with fats from our diet and then it's stored in our body, in our fat tissue, in our liver, similar to other fat soluble vitamins like A, E and K. This episode will help you understand the crucial role that vitamin D plays in in our health and why maintaining adequate levels super important. Now, vitamin D is best known for its critical role in bone health and an immune system function. It enhances calcium absorption, which is really important. That's how calcium gets in your body with the help of vitamin D. And that's why a deficiency in vitamin D leads to bone deformities, things like rickets in children and osteoporosis in adults. But vitamin D does so much more than just support our bones. It's a powerhouse for our immune system. It helps fight inflammation, it helps reduce the risk of bone. All chronic diseases which we suffer from, from obesity, type 2 diabetes, to heart disease and dementia and autoimmunity. And I could go on and on. Mental health, depression, I mean, the list goes on. Now, despite its importance, many people are really deficient or insufficient in this vital nutrient and they miss out on many of the protective benefits. So let's explore why vitamin D deficiency is so common and how it impacts our health and also what we can do to ensure we're getting enough of this essential vitamin. Hi, I'm Dr. Mark Hyman and welcome to Health Hacks. Vitamins are not like drugs that have a single action on a single receptor with a single effect for a single disease. Vitamin D and other vitamins are what we call pleomorphic. They have many, many, many effects in the body and that's what makes them so amazing. And they're very safe and effective. And they have no side effects because they're the things your body uses to do its job. And so you just need to have optimal levels. Not overdose, obviously, but the optimal levels. Now, it even plays a role in lowering the risk of autoimmune conditions and reduces your risk of infection. And this is really crazy data. But the COVID pandemic highlighted the importance of vitamin D and immunity, with many studies showing that low levels of vitamin D increase the risk of severe Infection, hospitalization, and death. In other words, if your vitamin D was low, you are more likely to end up with a severe infection in the hospital or die. Now, beyond bone health and immunity, vitamin D has a lot of jobs, including thyroid and many, many other things. It affects the expression of over a thousand genes. It's more like a hormone than a vitamin. And it supports the brain really critically by aiding in cognition, helping with memory, mood and depression. And it also helps protect against really bad things like neurodegenerative diseases like Alzheimer's and Parkinson's. Now, we all hear about the benefits of vitamin D, but what exactly is it and what does it do in our bodies? Well, as I mentioned, vitamin D is a fat soluble vitamin, which means it must be absorbed with fats from our diet like other fat soluble vitamins like A, E and K. And it's stored in our body's fat tissue and liver. So let's, let's sort of dive into bone health and immunity, which are the most well known effects, but there's many, many more. Vitamin D is obviously known for its critical role in bone health and in supporting immune function. And how does it work? Well, enhances the absorption of calcium, which is why deficiency is linked to all kinds of bone deformities like rickets and osteomalacia, which is bone softening and osteoporosis in adults. In fact, if you want to do a cheap vitamin E test, you just stick your thumb on your shin and push in hard. And if it hurts, you are likely either insufficient or vitamin D deficient. So just try that now, but not if you're driving, okay? In addition to bone health, vitamin D is a super powerhouse when it comes to supporting our immune system and fighting inflammation. And that's why having sufficient levels is associated with low risk of so many chronic diseases that are all inflammatory diseases, things like obesity, type 2 diabetes, heart disease, and so forth. And also diseases like autoimmune disease, which includes multiple sclerosis, rheumatoid arthritis, type 1 diabetes. But that's not all. Vitamin D is also a key player in reducing the risk of infection. In fact, if your vitamin D level is adequately elevated, I mean, it's in the high normal range, not like what the reference range is, but optimal levels, your risk of getting the flu is 75% lower. That's better than the flu vaccine, guys. So this is really cheap, really inexpensive, and it's really safe. It also helps support our immune system and it protects us from just getting sick and colds. And I, I Get my vitamin D levels up and I never get sick. I really, I don't remember last time I had a cold because I just take my vitamin D every day and it just does its job and I'm good to go. Now it does this by modulating the production of immune cells and immune molecules or messengers like cyt. It regulates T cells and B cells. T cells are your immune cells, like your lymphocytes and natural killer cells. B cells make antibodies and these play a critical role in our innate and adaptive immune systems. The ancient immune system, which is the innate immune system, it's been there forever and is sort of a general, all purpose but not specific immune system. And the adaptive immune system is really the specific targeted immune system that sort of makes laser guided bombs. Like you get antibodies to Covid. Well, that's a target against Covid. That's what your immune system does. Now the COVID 19 pandemic shined a very much needed light on the impact of vitamin D on immunity. We learned from countless studies that low vitamin D levels increase the risk of severe infection, hospitalization and death. And this is just scratching the surface. Like if you look at the data, it was quite striking. Israel, if your level of vitamin D was over 50 nanograms per deciliter, we're going to get talking about what the level should be when that, that's probably the optimal level. If your level was 50 or more, your risk of death from COVID was zero. Like zero. That's amazing. And if your vitamin D levels are low, you are 70% more likely to end up in the hospital, end up in the ICU or die from COVID Now what else does vitamin D do for the body? Well, it's an incredibly powerful vitamin that affects, as I mentioned, over a thousand genes. Now, most people agree it's actually more of a hormone than a vitamin. It impacts all kinds of cellular functions across all of our organs and tissues. For example, the brain uses vitamin D to support cognition to mood and mental health. You've heard of seasonal affective disorder or SAD or the winter blues. Well, that's vitamin D deficiency, folks. That's why they say use a UV light, because UV light makes your body make vitamin D. But you can also just take vitamin D. It also protects against neurodegenerative diseases like Alzheimer's and Parkinson's. It also plays a role in hormone health and fertility. And our gut health is also affected by beneficially modulating the gut microbiome and enhancing overall digestive health. And just more, there's just More. It's a long list. I could. This would be a 10 hour podcast. There are whole books written on this. But I encourage you check out Michael Hollock's work and his book. He's quite good on this topic. And Robert Heaney. They were both really profoundly deep vitamin D researchers. So if you want to get geeky on it, you should go check that out. Now, the problem is that many people are deficient or insufficient. The difference is what's the reference range of the lab versus what's the optimal range? Right? So if you take a bunch of Americans who are all working, living inside, who put on sunblock all the time and who don't really get much sun exposure, the quote, normal level in the population of vitamin D will be on the low side, like 20 or 30. That's not the optimal level. What if we're all running around like hunters and gatherers in our loincloths and out the sun all day and we're getting all the vitamin D we need? We'd probably be like 50 to 100 lifeguards who are sitting out on the beach all day. They get levels of up to 250 and it's safe for them. It's just from the sun, not from taking vitamin D supplements. So when you're insufficient or deficient, you're missing out on all the protective benefits. Exactly. How many people are really deficient? Now, hang on your hats, folks, because I think it's about a billion people. Now, the reference, the references are in the show notes, but a billion people, that's a lot of people. In the US alone, 70% of people have suboptimal levels, which is a lot of people. That's, you know, seven out of 10 people. And I think partly that's probably why Covid hit us so hard. Aside from the fact that we're all metabolically unhealthy and have chronic disease, which didn't help. But all that partially is linked to vitamin D insufficiency or deficiency. Now, this widespread deficiency highlights just how important is to ensure that we're getting enough vitamin D for optimal health. So what, what are the symptoms? How do you know if you're deficient? Well, there's some clues, right? You might get sick a lot. You might have muscle aches or joint pain. In fact, one of the things that vitamin D deficiency can cause is fibromyalgia or muscle aches and pains. Not just soft bones or painful bones or aches, but actual painful and impaired muscle function. You might have a history of A fracture, osteoporosis or brittle bones, Right. That can be a clue. You might have things like depression or anxiety or mood or memory issues. Maybe you'll have also hair loss, fatigue, hormonal balances like pcos. In fact, vitamin D is so critical for thyroid function. Without vitamin D, you can't actually bind the thyroid hormone to the receptors on the nucleus of your cells to do what it's supposed to do. And so you end up with poorly functioning thyroid. So the list goes on and on. Now, if any of these symptoms sound familiar to you, you might want to get your levels checked. In fact, scratch that, everybody should get their vitamin D level checked. Just baseline, like your blood pressure or your blood sugar or your cholesterol, you got to know your vitamin D level. But for some silly reason, I don't know, sort of because maybe nutrition is considered a four stepchild of medicine, vitamin D is not included in your regular routine lab test. So you're probably going to have to ask your doctor for it. Now, this is partly why I started Function Health. Now this is a company I co founded, which is a health platform that allows people to get access to their own lab data. We test vitamin D and lots of other biomarkers, over 110 biomarkers, to give you a full picture of your health. We look at nutrients, not just vitamin D, but lots of nutrients, hormones, cardiometabolic health. And we can see where you added out of, out of whack. We see that 67% of people are deficient in one or more nutrients at the minimum level for deficiency disease, not the optimal level for health. So when we broaden the aperture and we look at what the optimal levels are, it's probably like 90% or more. Now, conventional medicine just doesn't look at this. They look at biomarkers in isolation. They don't do a full workup of your hormones, your lipids, your autoimmune markers to get a deeper look at what's going on beneath the surface. So that's really why I co founded Function Health, to help you get access to your own lab data. So to get your vitamin D levels checked and start becoming the CEO of your own health, just go to functionhealth.com mark to skip the 300,000 person wait list and learn more. All right, so let's talk about vitamin D and diseases. What chronic diseases are associated with vitamin D deficiency? Now there's this really important concept that I learned from Dr. Robert Heaney, who was one of the leading vitamin D researchers and Let me just explain this for a mirror. These are, these are, these are nutritional diseases that don't occur in the short run, but occur in the long run. For example, if you are vitamin D deficient in an acute way as a child, you get rickets. If you have chronic low levels of vitamin D, not enough to get rickets, but you might need 30 units a day to not get rickets. You might need 5,000 units a day to not get osteoporosis. You might need more than 10 times the dose. And in the case of vitamin D, the long latency deficiency disease is osteoporosis, or it could be even things like heart disease or cancer or diabetes or dementia, right? These are long latency deficiency diseases. They develop over a long period of time due to chronic nutrient deficiencies. Not just vitamin D, but all kinds of nutrients. Now, these might not show symptoms right away, but over time they lead to serious health issues like osteoporosis, cardiovascular disease, cancer. So maintaining adequate levels of your nutrients is really key for long term health and disease prevention. So let's discuss a few of these chronic diseases and their association with these suboptimal levels. And I'll go through the reference ranges. I'll explain all that in a minute. But I want you just to get this is. Now there's a reference range which is what's normal for a population. If you were a Martian and landed American today, it's normal to be overweight, right? Because 75% of us are overweight. Not optimal, it's just normal, which is a statistical calculation based on two standard deviations from the mean in the population, has nothing to do with what's optimal or biological optimization. It just has to do with what's normal in a population. Right? So vitamin D helps protect against cancer, which is a big one. It does this by regulating the growth division and killing bad or damaged cells. We call this apoptosis or programmed cell death. Basically where cells sort of have a self destruct button, which is good. You don't want your old decrepit cells around. You want to get rid of the old ones and recycle the parts and build new ones. It also enhances immune function and helps reduce inflammation, which is decreasing the likelihood of all sorts of things, including cancer, which is an inflammatory disease. And because of this, not having enough vitamin D is associated with certain cancers like breast, prostate cancer, ovarian and lung and pancreatic cancer, and even skin cancer. On the other hand, that means that adequate levels of vitamin D are associated with protection, which is supported over and over again in the research. For example, A study in 2018 found that women with vitamin D levels of over 60 nanograms per milliliter. Just to be clear, most reference ranges on labs out there are 20 or maximum 30 nanograms per milliliter. And we're talking about double that, right? At least double or even triple that number. If they had a level over 60, which is where I think most people should be, they had an 82% lower risk of breast cancer incidence compared with those who had a level of under 20 nanograms per milliliter. That's a big deal. In another study, breast cancer patients who had a higher vitamin D level at the time of their diagnosis had a significantly lower risk of death related to their cancer than those with lower levels. So even if you get cancer, your likelihood of dying from it is lower if your vitamin D level is adequate. Okay, now let's jump to autoimmune disease and infectious disease. Well, vitamin D also help protect against against autoimmune disease because they're involved in the production of something called T reg cells. These are T lymphocytes, which are also known as T regulatory lymphocytes. So they're really important in regulating the immune system and preventing the immune system from attacking the body's own tissues. Right. That's what an autoimmune disease is. Your body is creating antibodies against your own tissue. And this is why higher levels of vitamin D are associated with a lower risk of psoriasis with lupus, inflammatory bowel disease, rheumatoid arthritis, and Sjogren's syndrome, and especially multiple sclerosis. This is actually how we first found this out. We saw people living in northern latitudes seem to have higher risk of Ms. Or multiple sclerosis. And we found that in part it was due to a low level of vitamin D because they don't get sun exposure. It's also why the symptoms of these conditions experience some improvement after you take vitamin D supplementation.

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The same rules apply for infectious disease and Covid was a perfect example of this. So let's go down into the COVID rabbit hole here for a minute. I was just talking about COVID 19, but I'm just telling you this is anything, any infection, any virus, any bacteria, whether it's the flu or a cold or COVID 19 or monkeypox or whatever the latest and next variation of a virus that we have to deal with the next pandemic. You got to get your vitamin E levels up. This is life and death, folks. This is literally life and death. If your risk of dying from COVID 19, which killed a lot of people, was zero, if your level was over 50 nanograms per milliliter, you better get your level up over 50. Now we learned that early on that vitamin D deficiency had an insufficiency increase the risk of COVID 19 infection and severity and mortality. As I mentioned, and I kind of alluded to this before, but a study published in JAMA found a 77% increased risk of a positive COVID test in those who had vitamin D deficiency. Another study reported 59% increased risk of severe infection in people with vitamin E levels of less than 30 nanograms per milliliter. And this was the one from Israel. A large scale study in Israel found a 14 fold. Okay, folks, that's 1,400%. Okay, this is not trivial. You know, we say, oh, it's correlation, whatever. If you see a result like that, that's like smoking and cancer, this is a highly predictive result. A 1400% or a 14 fold increase in severe Covid in patients with vitamin D deficiency less than 20 nanograms per deciliter compared to those who had levels of over 40. That's remarkable. Vitamin D also played a major role in protecting against Covid by enhancing immune cell function and inhibiting some of the inflammation or that thing we used to call the cytokine storm that made COVID 19 so bad. All right, let's jump into brain health now and I can just go on and on because this is such a cool topic. This is important. You want your brain to be healthy. So listen up. Low vitamin E levels have been associated with lots of brain problems like depression, anxiety, Alzheimer's, and it more than doubles the risk for dementia. So, wow, think about that. About half the people over 85 have dementia. And if your vitamin E level is low, but which probably is, if you're older, your risk of getting dementia doubles. That's a 200% increase. Right. So what is the mechanism behind the link? Well, it's involved in the production of these feel good neurotransmitters like serotonin. It also helps combat brain inflammation we call neuroinflammation and also helps reduce oxidative stress, which is like rusting in the brain. It helps calcium channel signaling in the brain, which is really important because calcium signaling is how your neurons fire and communicate together. Vitamin D supports neuroplasticity and neurogenesis, which essentially the the connections and the rewiring of neural networks and increases the neurogenesis, which is the actually creation of new brain cells. And yes, my friends, you can create new brain cells. This by what you might have heard growing up. This tells us that vitamin D plays a really key role in keeping our brains healthy and strong. Now, when we don't get enough, it's sometimes one of the first places we can feel the consequences. For example, we call it SAD or seasonal affective disorder. It's kind of the winter blues, right? This is when the weather gets cold and days get short. It's winter time and you have less time outside in the sun. It means we're not making a vitamin D. And people call this low depressed feeling they get this time of year, the winter blues. But the research shows that it's easily corrected by vitamin D levels. So just getting your vitamin D up is going to fix it, right? Super easy. For example, one small study found that taking 5,000 units right, which is probably 10 times what is in most multivitamins. Just to be clear, taking 5,000 units a day and it should be vitamin D3 during the wintertime, significantly reduce women's symptoms of seasonal affective disorder. Also use the light box like UV light or UVB light therapy. Now, UVB light therapy is the most effective type of light therapy for seasonal effects disorder because it mimics natural sunlight, which helps to regulate the body's circadian rhythm and improve mood. All right, what else does vitamin D do? Well, hormone balance and cardiovascular disease. So in addition to improving our brain health, vitamin D helps regulate the production and the function of androgens, meaning male hormones, estrogens and progesterone. Also, it's critical in thyroid function, in insulin and metabolic health, and in cortisol and the stress response, pretty much all the major hormones. Now, low levels of vitamin D also raise our risk of heart disease and cardiovascular issues like heart attack, stroke, high blood pressure, and even cardiovascular death. Now, a report from the Framingham Offspring cohort found a significant link between low vitamin D levels and heart disease. And Framingham study was just like, you know, thousands, hundreds, thousands of people followed over decades and decades and decades tracking their blood and their diseases and see what happens. That's how we first figured out the cholesterol was a problem. And they looked at vitamin D in the same way, and they found levels below 15 were linked to a 62% greater risk of cardiovascular events, and a level below 10 was linked to an 80% increased risk. So what's responsible for the relationship between low vitamin D and high blood pressure? For one, vitamin D regulates this special blood pressure system. It's a bunch of chemicals in your body called the renin angiotensin aldosterone system essentially regulates our blood pressure. Now, being deficient in vitamin D can cause the system to become overactive, and that leads to high blood pressure. And two, sunlight exposure also increases nitric oxide, which is a vasodilator. That's what Viagra does. You know what happens when you take that? You get increased blood flow. So sunlight exposure increases nitric oxide from our skin cells into our bloodstream, which relaxes our blood vessels and lowers our blood pressure. Now, a lack of sunlight can result in nitric oxide deficiency and also we call endothelial dysfunction. Now, what the heck is that? Your endothelium is literally the hundreds of thousands of miles of lining of your blood vessels. All of your blood vessels are lined with these cells that form something called the endothelium, and these cells become dysfunctional, and that causes problems, and that causes heart attacks, at least your blood vessels to constrict. And it can lead to what we call hardening the arteries or atherosclerosis and damage to your arteries. Now, lastly, vitamin D deficiency causes calcium deposits in the arteries, as vitamin D plays a key role in calcium metabolism. When you get calcium deposits in the arteries, it causes plaque formation. Basically, calcium is the body's band aid, and wherever there's inflammation, calcium goes. That's why you see people with gnarly arthritis and swollen joints, because that's all inflammation. That happens on the inside, too. Okay, so why are we so deficient? Well, now, that we know everything about vitamin D and what it does. Well, not everything because it's textbook, basically, but I gave you the Reader's digest version. Let's talk about a few reasons why we're deficient. First, reason one, your doc ain't testing your level, so you don't have a frigging clue what your numbers are. And you don't know how to treat it. And you're probably walking around with a low level. You can't correct what you don't know. So ask your doctor to check your vitamin D levels at your next annual visit so you can know if you're at risk or if you're having trouble. Your doctor says it's not necessary or says just take vitamin D, it doesn't matter. Go through our health platform where I'm a co founder of Function health. Go to functionhealth.com/jump the 300,000 person wait list and know your numbers. The second reason is most people aren't meeting the rda, which is the Recommended Dietary Allowance set by the government. Now this is way too low, this number. But what is it? Right? For kids it's 600 to 1,000. For pregnant or breastfeeding women and people up to 70, it's 600 to 2,000. And for adults over 70, it's 800 to 2,000. Because you become less efficient at absorbing vitamin D and also not good at synthesizing it because your skin ain't so good. That's not really the optimal levels on top of not meeting that level because even though it's recommended, we still don't meet it. It's ideal. It's the minimum amount you need to not be deficient. Right. On top of that, not meeting the rda. The RDA is set for the general public and it's likely way too low. The RDA is meant to prevent deficiency diseases like rickets. It's not designed to support optimization health. And this is true for all nutrients. When you see the Recommended Dietary Allowance or the rdi, the reference dietary intake, these are just based on what you need. So you don't get a vitamin deficiency disease like scurvy or rickets, Right? And of course these were developed early when people were really deficient. I mean, a lot of Americans were very nutritionally deficient and had severe nutritional deficiency diseases before we discovered vitamins and started fortifying food and so forth. So milk is fortified with vitamin D and flour is fortified with B vitamins and so forth. Now the Recommended Dietary Allowance doesn't really take into account skin Color or the melanin content of your skin, how dark your skin is, because that has an effect on our ability to produce vitamin D from the sun. And so if you're African American, if you're Asian, if you're Indian or East Indian or Hispanic, you might have trouble actually getting enough vitamin D from the sun unless you're out there all the time. Now, the third reason is that there are limited food sources, right? It's almost impossible to get enough from food. And here's why. People don't eat foods high in vitamin D, which includes fatty fish like herring or cod liver oil, right? Who's going to drink that? Beef liver, egg yolks, which have a little but not that much, and certain mushrooms like porcini mushrooms, but you need a lot of these to get up to those levels. Now, there are food sources we have that have enough vitamin D in it to prevent a deficiency disease, but not for optimal health. For example, a 3.5 ounce serving of salmon can maybe have anywhere from 350 to 700 units of vitamin D. 3. Wild caught salmon tend to have higher levels than farmer's. Now what are the other food sources? Well, fortified foods, right? They're only fortified because they're so impoverished in the first place. But they'll add vitamin D, things like milk or orange juice, which you shouldn't be eating, or cereal, which you shouldn't be eating, and plant based milk sometimes, which are okay, but you got to watch out for the sugar and all the thickeners and emulsifiers, which are bad. So it's not easy. Now, this isn't really the kind our body usually can easily absorb and use. It also is usually a form of vitamin D2, which has to be converted to the active form, which then, you know, reduces the whole effectiveness. The third reason we're low in vitamin D, we get enough sun and we're all worried about skin cancer, which I guess we should be, but if you cover your face and put your body out, you should be okay. And most skin cancers, other than melanoma, which is not necessarily sun dependent, are generally local and can be treated. Now, According to the EPA, we spend up to 90% of our time inside, which means less time in the sun, less exposure to the sun rays, and means less vitamin D. The fourth reason, my friends and I hate to say this, because I get it, is we're wearing sunscreen, a lot of sunscreen. And studies show that using SPF 15 can reduce our skin's ability to produce vitamin D by up to 99%. So my advice is slather up your face with sunscreen, the right kind, that's non toxic, and go to skin Deep from me, the Environmental Working Group EWG.org to kind of look at what are safe sunscreens without all kinds of crap in them. But definitely cover up your face because you don't want skin cancer on your face. But you should not cover your body and get some sun exposure when you're out there in the sun. Or on the other hand, just don't worry about it and take vitamin D, which is what I do. For too long, the focus has been on the sunlight causing skin cancer. But research shows that low vitamin E levels at the time you get diagnosed with melanoma, which is the deadliest skin cancer, are actually linked to high mortality. So you want your vitamin D level up by hook or by crook. I wonder, focusing too much on the dangers of sun exposure could be causing more harm than good. Maybe. I don't know. Are we overlooking the health benefits we get from the sun? I think we are. So how do you get safe sun exposure? How can you get the benefits of vitamin D from sunlight exposure safely? Well, here's a few here ideas. First of all, the sun exposure guidelines should be personalized. The current recommendations for public focus on wearing sunscreen and staying out of the sun to reduce skin cancer risk. However, the science doesn't actually support this. In a large cohort study, researchers analyzed 29,000 women in Sweden and found that avoiding sun exposure actually led to higher what we call all cause mortality rates. That means death from all causes. In fact, among avoiders of the sun, their risk was almost twofold, or 200% higher compared to the sun exposure group. That's a big deal. You're twice as likely or more to die if you don't get sun exposure, right? This teaches us that sun avoidance is not necessarily a good thing. We need to reach a happy medium where we're not getting burnt, but we're being exposed to sunlight. And we want to avoid obviously the burning and be careful. But it's really important to get sun exposure now. Everybody's different and we all have different kind of skin types and different color skin, which is why the amount of sun should be personalized. If you're darker skin, for example, you have more melanin, which prevents their skin from burning. But it also means they need more sunshine to produce the same amount of vitamin D as someone with fairer skin. And that's why African Americans have the lowest rates of skin cancer, but the highest risk of vitamin D deficiency, which puts them at risk for all these other cancers and heart disease. If you have fair and olive skin tones, which are more likely to burn when exposed to sun for longer than a few minutes, then that can be a problem because most people get their sun light only in bursts or intermittently like during the summer or on a vacation. And going from no sun to exposure to a lot of sun exposure all at once can cause our skin to burn, which then damages our skin. And that, that does increase our risk for cancer. So you don't want to burn. So we should aim for a little unprotected sun exposure every day to gradually build up our tan to protect us from burning. And those with fair skin who burn easily, who are out for longer periods, should definitely wear a mineral based sun sunscreen. Now go outside, get sunshine on your skin between 10am and 3pm on your arms, back and legs and your trunk, probably not your face. You can use sunscreen there. The key is not to burn, but to gradually build up a little color in your skin. And people with lighter skin tones should aim for maybe 10 or 15 minutes. People with darker skin skin tones, they can go 25 to 40 minutes. Also you got to consider latitude and the time of year. Where are you, are you in, you know, Greenland in the middle of winter? Well, that's not going to work, right? Or are you in like, you know, Costa Rica? Probably, you know, it's very different. Some areas are exposed to less sunlight year round due to where they're located. In winter, for example, the sun is higher in the sky and it's much of the UV light is filtered out by the atmosphere. And so we need take supplements or try light therapy or do both. And bottom line, you know, we really should probably be just taking supplements and not to worry about it. Now if you, if you have light or fair skin tone, well, use a non toxic mineral based sunscreen to help you avoid burning if you're out in the sun for longer than a few minutes in the spring and summer. Now the problem with many sunscreens is they're full of toxic chemicals, they can get in your bloodstream and they mess with your hormones. My basic rule for anything you put on your skin is if you wouldn't eat it, you shouldn't put it on your skin because everything gets absorbed through your skin. That's how we deliver medicines. When someone comes into the ER with a heart attack, the first thing we do is we take a tube of nitroglycerin paste like a toothpaste. Tube, we squirt on their chest, we put a cover over it, and that nitroglycerin goes through their skin and saves their life. Or hormone patches or fentanyl patches you've heard of. We can get a lot of things through our skin. So just because you think it's a sunblock, it's not getting through your skin. And it is even makeup, all that. That's why the Skin Deep database from the Environmental Working Group is so good, because it helps you figure out what you should use and what you should avoid. These chemicals are in. Most sunscreens are bad for your skin, they're bad for the environment, they're bad for your health, and they also block vitamin D production. So use a mineral based sunblock. That's great. The Environmental Working Group actually has a guide to sunscreens which is really great. It's a great resource. Helps you find clean, non toxic sun sunscreen. And if you use sunblock all the time, you might want to consider supplementing with a vitamin D all the time. Or basically, I think everybody needs vitamin D. So, you know, what am I saying? Okay, it's kind of bottom line. It's like, it's like, you know, taking vitamin D, fish oil just should be basic health practice for everybody. Now, who else is at risk for vitamin D deficiency that should consider being on vitamin C? We already talked about how people with darker skin tones like African Americans, Hispanic, Asians are at high risk because they have darker skin, more melanin, which reduces the skin's ability to produce vitamin. And people who live in northern latitudes, with northern latitudes, you know, like above Atlanta, I would say, and have limited sun exposure, maybe the Pacific Northwest, Seattle, Salt Lake City, Chicago, Boston, Europe, all are at risk also. Who else is at risk? Well, the elderly. Why? Because their skin doesn't work so well at producing vitamin D. And people who are obese or have chronic illnesses also need a lot more vitamin D because they don't spend a lot of time outdoors and also because body fat holds onto vitamin D, so you need a lot more to fill the tank. People with gut issues also may need more vitamin D because some gut issues can affect fat absorption. And they. And then vitamin D absorption. If you have celiac Crohn's, colitis, irritable bowel, all of those can affect your absorption. There actually are vitamin D shots too. You can take, believe it or not, gallbladder problems. If you're a gallbladder issue. Well, why? Because bile is needed to absorb fat soluble vitamins and, and that's important. And also certain medications. If you're taking medications, they can deplete vitamin D levels like steroids or glucocorticoids, acid blockers like Prilosec or Nexium or AS effects. These are called PPIs, blood pressure medications, the diuretics, particularly thiazide diuretics, certain any convulsants, and a medication that was used for weight loss called orlistat, which I don't think is used anymore. So how do you know if you should take a supplement? Well, spoiler alert, folks, everybody should. I'm going to say that again. Everybody should. But there's a few people who really have to make sure they do right. Unless you're a lifeguard. You need to take vitamin D as a recap for people who should take it. One, if you have darker skin tones and have a lot of melanin, you have fair lighter skin and wear sunscreen all the time. And spend your time indoors if you're older, if you live in the north latitudes with less sun exposure, if you have a chronic disease, if you're on certain medications or if you have all kinds of other stuff like high blood pressure, mood issues, hormone balances, or you get sick a lot, pretty much this describes everybody. I think you should consider taking a vitamin D supplement that helps get your levels to the optimal range. And this is key. You will not know how much you need unless you test right. Some people might need 1,000 units a day. Some people might need 10,000 units a day. How do you know you have to test, don't guess. That's my motto. Test, don't guess, know your baseline. So measure your serum 25 hydroxy vitamin D. That's the right test to do. Again, many lab orders, many requisitions that doctors use are old and outdated and they don't actually measure the right vitamin D. They might measure vitamin D2 or 125 vitamin D. You got to measure 25 hydroxy vitamin D. And then you monitor your levels over time to see what's happening and how much you actually need a supplement. And then you adjust your dose so you want to get your level between 45 to 75 nanograms per milliliter. But like I said, over even 100, 150 is safe. But 45 to 75 does the trick. The dose can range, as I said, from a thousand to five thousand, even up to ten thousand, depending on your levels. There was one study where they gave healthy young men vitamin D. 10,000 units a day for three months and there were no adverse effects at all. So make sure, when you supplement, make sure you take it with a food that has fat because that's how you'll absorb it. Now, to know if your dose is working or whether or not you just need to adjust it, it's really important to check your levels every three to six weeks, months. Now, if your levels don't get better, you might need genetic testing because there are variations called SNPs or single nucleotide polymorphisms. It's sort of a variation in your gene that affects certain vitamin D related genes and can affect absorption and many other things. Now one thing people don't know, and I've seen this a lot in my practice, is that low vitamin D can create other problems besides the ones we talked about already. One of them is called hyper para thyroidism. Now parathyroid is, is basically the four little glands in the back of your thyroid. They have nothing to do with your thyroid in terms of function. They regulate calcium metabolism, but they're just geographically located in the same spot. That's why they're called parathyroid. Okay, but hyperparathyroidism can be from a tumor or it can be from low vitamin D. And we see this. So if you have a high parathyroid hormone, which we'll check on a lab test, your vitamin D level is really important to check as well. And why is it important? Well, vitamin D plays a key role in the regulation of calcium metabolism. Phosphate metabolism is closely linked with the function of the parathyroid gland. Should you be worried about over supplementation? Is there such a thing? Yes, there is. Vitamin D is not like vitamin B12 or other water soluble vitamins where you can take tons of them. They're not toxic because you pee them out. The fat soluble vitamins do accumulate and that can lead to toxicity. Now I've never seen it. I've been prescribing vitamin d for almost 40 years and I have never seen it. But, but it can happen. And often. The one time I heard about it was because there was a mistake on the pill bottle from the manufacturer and it had like 10 or 20 times the dose that was supposed to be in there. Now a study of healthy young adults, as I mentioned, for three months taking vitamin D showed no adverse effects. Another study showed that lifeguards had levels over 200, likely from sun exposure. They probably weren't taking vitamin D because young people usually don't worry about their health. If their vitamin D level of over 200 was from sun exposure, we Know if those blood levels that were raised naturally from the sun might have a different impact than blood levels that are raised from supplements? We don't know that yet, so we kind of need more research on that now. What are the symptoms of vitamin D overdose or toxicity? Well, you can get nausea, vomiting, weakness, kidney damage from high calcium in the blood. And you can easily measure this. And the way to test for this is just by checking your vitamin E levels regularly and looking at the markers of your liver and kidney function. So how does vitamin E interact with other vitamins and minerals? Well, it works synergistically with calcium and magnesium. For calcium, for example, your dietary calcium is low. Co supplementing with calcium and vitamin E can help bring up your levels, especially for people at risk of osteoporosis. But I would say this supplementing with calcium is not necessarily advised for everybody because calcium, as I mentioned, is the body's band aid and it can cause plaque deposits if it's not done the right way. Also, you want to take vitamin K2 along with it to ensure calcium is deposited in the right places, like your bones and your teeth and not your arteries, causing a heart attack. Vitamin D also interacts with magnesium, which is really essential in converting vitamin D into the active form in the body. So you should definitely have a dose of magnesium as well, probably about 500 milligrams a day. I like magnesium glycinate for most people. How do you get all these nutrients working together? Well, you have to eat a balanced diet rich in leafy greens, nuts, seeds, whole foods. But I call the Pegan diet all that's going to get things working. And you do need vitamin D supplementation. All right, my friends. Well, that wraps up today's episode of Health Hacks. I hope you found enlightening and full of action actionable insights about the incredible importance of vitamin D. We've uncovered how this fat soluble vitamin plays a critical role in all sorts of bodily functions, from bone health and immunity to brain health and hormone balance. And understanding the science behind vitamin D I believe can help empower us to make informed decisions about our health and take proactive steps to maintain optimal levels. We also learned that vitamin D deficiency is really common and insufficiency is even more common, affecting a billion plus people worldwide. Now, this deficiency can lead to a range of health issues, as I mentioned, from frequent illnesses and infections and fatigue to more serious things like osteoporosis and all sorts of chronic illnesses, autoimmune disease. Remember, get your levels checked regularly. Be mindful of supplementation to make sure you're getting enough of it. Probably about 2 to 5,000 a day is the dose for most people, but you got to check your levels. Remember, you can't manage what you don't measure, so staying informed about your health metrics is important. Test, don't guess right if you enjoyed this episode. Don't forget to rate, review and follow wherever you listen to health facts. Your support makes all the difference. So thank you. Stay healthy, stay informed and I'll catch you next Tuesday for another episode of Health Hacks.

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