The Science Behind Vitamin D – Why You NEED More of It

There are times when your body goes into an altered production between the liver form and the kidney forms, and you might increase or maybe even decrease the hydroxylation that the kidney is doing. Hey, it's Dr. A. Thanks for joining the channel today. I've been teaching, writing, researching in the integrative naturopathic medical communities for 30-plus years, and I've been Practicing a long time, and I answer questions here, whether it's patients or people on YouTube or practitioners, et cetera. So let's get into this. The first thing is that vitamin D, like a couple of other things in nutrition, is a little bit misclassified. So vitamin D is considered a fat-soluble vitamin because it is, it's fat-soluble. A, D, E, and K are the fat-soluble vitamins, but also its structure is of a steroid hormone. So the steroid hormones, they're also fat soluble, come from cholesterol. So steroid comes from the cholesterol molecule that then gets converted into other steroids like cortisol, cortisone, other steroid reproductive hormones, and vitamin D. So it's a nutrient because we can get it from nutrient pre-sources. You also can take it as a supplement where it's pre-made for you, but it really is in the family of steroid hormones. And when you understand that vitamin D is in the family of steroid hormones, then all of the non-calcium-involved vitamin D activities make a little bit more sense. So you might hear things, and we've done other content about this, like vitamin D is helpful in immune function. Or vitamin D is helpful in reproductive function, or vitamin D is helpful in brain function, or any other type of function. And you think, well, how does this vitamin that I learned in grade school helps me with calcium get involved in my immune system or my hormone system or some other thing? Well, it's partly because it's a complex molecule that is really a steroid hormone. The next thing is that vitamin D is made in steps because these big complex molecules, And so, you know, all vitamins are molecules that are either more or less complex. Some are really simple, some are really complicated. But when you get into the sterols, the steroid hormone molecules, they are fairly complex looking molecules. If you ever look at, you know, cholesterol or any derivative thereof, and to make it from cholesterol into active vitamin D takes a couple of important steps. So the conversion is important. The next thing we hear is, well, vitamin D is a sunlight vitamin, and the reason for that is that there's a precursor to vitamin D, 7-deoxycortisol. So it's a cortisol substrate that comes from cholesterol. It gets converted to 7-deoxycortisol, and then that encounters ultraviolet light in your skin and is converted over to a pre-vitamin D 3 that is going to be converted a number of times to become activated. So then the next step after ultraviolet light is a liver step, and that one uses an enzyme called 25-alpha hydroxylase, which makes 25-alpha hydroxycholecalciferol, or 25-OHD3. This is the kind of vitamin D you usually get tested on blood tests for vitamin D because it's the preactive D3. So the Post liver, post hepatic, post 25 hydroxy enzyme is 25 OHD3, but it's not active yet. Okay, that form is ready to be activated, but doesn't do too much in the body. The next step goes to other organs, which are kidneys. So the skin's involved with ultraviolet light, and the liver's involved with hydroxylation at the first go around, and then that 25 OHD3 goes to kidneys. Now, at the kidneys, you actually make two active forms of vitamin D3. And we normally talk only about one of them, but there's really two. Remember, we had a 25-hydroxy enzyme up here at the liver. At the kidneys, we have a 1,25 enzyme and a 24,25 enzyme, and they make two different forms of active D3. The active form that's most commonly measured because it's the most potent form, etc., is 1, so 1,25-OHD3. So the liver one is 25- 5-OH-D3, renal post-kidney one, 1,25-D3. And then there's also a 24,25-D3 as well. And that gets into a lot about bone metabolism, using those 2 to balance and counterpoint each other. Quick interruption from the regular video. If you are a healthcare practitioner and you have an interest in this topic, we're going to put a link in the description below to my CE website and specifically the webinar that is about this topic. We'll see you over there. Thanks. So in order to get to the active form, and from here on out we're going to assume you know that 24, 25 is there, but we're talking about 1,25 because it's the most commonly kind of spoken about, you have to know that you're converting not only from the skin the deoxycortisol over to the pre-vitamin D and then down through the liver to 25-OHD3, but also that you're going to the kidneys and making active 1,25. So most of the receptor activity of vitamin D3 that's active is mediated through 1, 25 vitamin D. So that's after your kidneys. So you might think to yourself, well, if that's the real active one, then why do my healthcare providers measure the liver one, 25D3? That's because for the most part, if your body's working correctly, you don't have cancer or some chronic disease, measuring the 25, the post-liver one, is a good representation of your vitamin D status as far as a nutrient goes. Okay, now when would testing Both the 25-OH and the 1,25 be helpful. There are times when your body goes into an altered production between the liver form and the kidney forms, and you might increase or maybe even decrease the hydroxylation that the kidney is doing. So a time we would see this and be suspicious clinically is you got your 25, your liver one, the 25-OHD3 tested, and then it was low or low normal, and they told you, okay, take 5,000 or 10,000 units of vitamin D, and you take that for 3 months or 6 months, and they retest it, and it's no higher. Now, you could have a malabsorption problem. So you're taking the vitamin D, it's not getting higher. But we've also seen this with people where they maybe had missing parts of their digestive tract from surgeries and stuff. So you give them injections of vitamin D, and 6 months later, the level still hasn't risen. And you know it didn't go through their digestive system. You've been injecting the vitamin. What happens? Well, under normal circumstances, if your body is not chronically inflamed, you don't maybe have an active cancer or autoimmunity or some other problem. If I give you through any form vitamin D and you take it long enough, your 25D should go up in your blood. But if it doesn't and you don't have a malabsorption problem and/or maybe we're injecting it, the next thing that you need to do is check the 1,25 because you can actually put vitamin D in somebody. And their body can say, we need vitamin D over here at the 125 stage, and it'll suck it all through the 25, and it'll go from normal to low 25, and it'll all increase at the 125. There's research about this that goes back a long time, but kind of the big research around it started about 2014. And the first thing that they attributed this to was chronic infectious disease, which kind of makes sense because chronic infectious disease is a chronic stressor on the body, and the body uses 125. 125 as opposed to 25. Body uses 125 as an anti-inflammatory. Well, then they found out this hyperconversion also goes on in some active cancers, autoimmunity, as we said, chronic infections, and other pro-inflammatory states. You can also see it in pro-inflammatory states like long COVID, for example, which is also a post-infectious illness. So if you have normal health and you're just monitoring your vitamin D and you have decent absorption, The regular test for 25-OH-D3 is fine. Nothing wrong with that. If you've been supplementing and the 25-OH-D3 is not going up, you probably should have the 1,25 tested because you may be hyperhydroxylating, so pushing it through, and that might indicate some other type of chronic process going on. Now, dosing can kind of be all over the map for people. There are some times when doctors will give a large dose once a week. It's fat soluble, and that can work. For people, I usually just give it to people on a daily basis at a lower dose. As I said, it can be given by injection, and we usually reserve that for people with absorptive problems or a real big need for the vitamin D. And so the dosing, like I say, kind of is all over based on your body size, how deficient you were, and what the needs are. Average oral doses for non-maintenance, meaning I need to raise my levels, are going to be somewhere between 2,000 and 10,000 international units of vitamin D3. Every day, and generally, like I say, it'll be retested. Now, reason you want to retest it is it can go high if you're taking too much vitamin D, and it's fat soluble, so it does tend to build up in the body. So it is one of those that you want to test periodically. In non-critical cases where your blood calcium is working fine and everything else is good and you don't have a chronic illness, you can usually check it at every six months till you know its level, and then once a year is totally fine. If we have one of these cases where the person is taking. A lot and the 25 doesn't rise or even goes down. Check the 1,25 and it's super high. We'll take them off vitamin D in that case and let those 2 kind of balance out. But the more important thing is to treat whatever the underlying problem is that's causing the body to convert too much active vitamin D. All right, I'm Dr. A. I want to thank you all. So many people joining the channel, so many people subscribing. We really appreciate it. Share it with your friends. We're here to answer questions, and I'll see you on the next YouTube video. While you're waiting, check out some of these other videos I'm gonna link to here.