Epidemic Low Vitamin D Levels
Contribute to Arthritis, Rheumatoid Arthritis, Lupus and More
Up to 80% of Americans Found Lacking in Sunshine Vitamin
Shockingly, the latest vitamin D research reveals a sub clinical epidemic in the United States. Research findings indicate that up to 80% of Americans may have insufficient levels in their blood. Worse, new evidence ties sub optimal levels of the “sunshine vitamin” as contributing to osteoarthritis, rheumatoid arthritis, systemic lupus and a variety of other autoimmune and degenerative conditions.
Once known only for its bone-building properties, researchers in recent years now cite vitamin D as much more than simply that. The nutrient also contributes to health in a number of other ways.
Can vitamin D prevent arthritis?
Clinical studies and available literature on the benefits of vitamin D are extremely cautious about declaring vitamin D as a prevention for arthritis. While taking a vitamin D supplement may become standard treatment for arthritis sufferers in the future, the jury of conclusive evidence is still out on the issue of prevention.
Many researchers believe that the “sunshine vitamin” may one day play a key role in preventing the development and progression of arthritis and numerous clinical studies have been performed, containing mixed results. Much of this literature can be found on the Vitamin D Council website, where publications looking at the effect of vitamin D on rheumatoid arthritis and osteoarthritis are listed.
Vitamin D for chronic pain symptoms
Helping patients to overcome their chronic arthritis aches and pains may be as simple, economical, and well tolerated as a daily supplement of vitamin D. Yet, this treatment is unknown or overlooked by many health care providers.
According to peer-reviewed clinical research, inadequacies of vitamin D have been linked to chronic musculoskeletal pain of various types, muscle weakness or fatigue, fibromyalgia syndrome, rheumatic disorders, osteoarthritis, hyperesthesia, migraine headaches, and other somatic complaints. It also has been implicated in the mood disturbances of chronic fatigue syndrome and seasonal affective disorder.
The Journal Pain Therapy published a study on Vitamin D Deficiency and Pain on Apr. 28, 2015 see PubMed concerning clinical evidence of low levels of vitamin D and supplementation in chronic pain states. It concluded that while there remains a growing body of both clinical and laboratory evidence pointing to a potential relationship between low levels of vitamin D and a variety of chronic pain conditions, more focused research is necessary.
Current best evidence from vitamin D research demonstrates that supplemental vitamin D can help to resolve or alleviate chronic pain and fatigue syndromes in many patients who have been unresponsive to other therapies. Vitamin D therapy is easy for patients to self-administer, is well tolerated, and is very economical.
Vitamin D deficiency is at epidemic proportions in U.S.
“Vitamin D deficiency is now recognized as an epidemic in the United States,” wrote Michael F. Holick, Ph.D., M.D., in an article, The Vitamin D Epidemic and its Health Consequences,, published in the November, 2005 issue of The Journal of Nutrition.
Vitamin D deficiency has long been associated with the bone deformity rickets in young children and osteoporosis in adults, but it also “has other serious consequence on overall health and well being,” Dr. Holick wrote. “There is mounting scientific evidence that implicates vitamin D deficiency with an increased risk of type I diabetes, multiple sclerosis, rheumatoid arthritis, hypertension, cardiovascular heart disease, and many common deadly cancers.”
Holick advises everyone to be vigilant of their vitamin D status by getting a blood test. “Measurement of vitamin d 25 hydroxy level should be part of an annual physical examination,” he suggests. Dr. Holick is a recognized researcher and professor at Boston University School of Medicine, Section of Endocrinology, Vitamin D Laboratory in Boston, MA.
“The major source of vitamin D for both children and adults is from sensible sun exposure,” Holick said. In the absence of sun exposure, he recommends 1,000IU of a cholecalciferol vitamin D3 supplement be taken daily for both children and adults.
Vitamin D benefits
There are literally hundreds of studies showing the benefits of vitamin D affecting dozens of health conditions. Much of this research is emerging and not yet conclusive, according to the National Institutes of Health (NIH).
The following is a partial list of clinical conditions or diseases that vitamin D plays a preventive or protective role in:
- bone health
- immune health
- blood pressure regulation
- Alzheimer’s Disease
- multiple sclerosis
- Rheumatoid arthritis
- many autoimmune diseases
- asthma in children
- cancer (bladder, breast, brain, liver, lung, ovarian, pancreatic, prostate, more)
- chronic pain
- heart disease
Vitamin D facts
Vitamin D is a fat-soluble vitamin that helps the human body absorb and maintain nutrients like calcium and phosphorus. It’s an important element in the building blocks of organs and tissues, including bones, muscles, and ligaments. Vitamin D is absent from all natural foods except fish and egg yolks, but a number of dairy products, such as cow’s milk, have been fortified with the vitamin.
The sun also provides the body with Vitamin D, thus the ‘sunshine vitamin’ name, but many individuals do not get enough direct sunlight. The sun’s energy turns a chemical in the human skin into vitamin D3, which is carried to the liver and then the kidneys to transform it to active vitamin D.
Discovered in 1920 to cure a childhood bone disease (rickets), vitamin D is not technically a vitamin. Unlike other vitamins, it’s produced in the human body, but must be transformed by the body before it can do any good.
It is one of four fat-soluble vitamins. The others are vitamin A, E and K.
Taking a vitamin D supplement daily may be a logical solution
For a long while, most scientists and most educators assumed that Americans were getting plenty of vitamin D—some even thought we were getting too much—and that we shouldn’t be taking high levels of supplemental D because it’s a fat-soluble vitamin that’s stored in body tissues with potential to reach toxic levels. In the last five to ten years, with extensive new research to back it up, there’s been practically a complete reversal in that thinking.
Taking a vitamin D supplement daily appears to be the logical answer. “Today most experts believe that we need far more vitamin D than we’re getting,” said Janie McManus, MD, Chairman, Medical Affairs and Health Sciences, Shaklee Corporation, Pleasanton, CA. “It has become clear that we’re not getting enough sun exposure to generate the internal production of vitamin D to reach adequate levels as well as to prevent the many health conditions that are associated with deficiency,” Dr. McManus added.
“Research is being done every single day looking at all kinds of roles of Vitamin D, from bone health to preventing some of the chronic diseases of aging. It’s an exciting field of research to be in,” said Dr. Christopher D. Jensen, PhD, MPH, RD, a nutrition & epidemiology research manager of health-related studies at Northern California Kaiser Permanente, Division of Research, Oakland, CA.
Why have we become deficient in the “sunshine vitamin”?
Lack of sun exposure is a major contributor to low vitamin D levels in the body, observed researcher Jensen, whose Kaiser Permanente team is looking for connections to the vitamin for a variety of health conditions. “There are a number of factors to consider because not everybody gets the same sun exposure. For example, dark pigmented skin is less efficient at using the sun’s rays to make the active form of vitamin D, so darker skinned individuals may require more sun than those with lighter skins.”
“Seasonality and where you live are also sun factors,” Dr. Jensen continued. “Our ability to produce vitamin D internally is lower in the winter, spring and fall when there’s less exposure as compared to the summertime, when there’s more sun exposure. Also if you’re covered up from head to toe during the cold months, or you’re using lots of sunscreen during the spring and summer, you’re going to have less opportunity to use the sun’s rays to make vitamin D. If you live in northern latitudes (north of a line drawn from San Francisco, CA to Richmond, VA) the angle of the sun from late fall to early spring is often inadequate to support the internal production of vitamin D.”
Diet, weight, age and exercise are associated factors that affect vitamin D levels in the body, according to Dr. Jensen. “Dietary intake is a major source of vitamin D. Common foods that contain the D vitamin are fortified dairy foods and cereals,” Dr. Jensen commented. “There are so few foods that are great sources of vitamin D that D dietary supplements are an importance source,” he recommends.
“Overweight individuals tend to have lower circulating levels of vitamin D than those who are normal weight,” he continued. “Age seems to be a factor. As you get older you may have increased needs for vitamin D. And exercise may be an issue, as people who do more exercise have generally more of an optimal status of the D vitamin. This could be an independent affect of exercise, or it could be that people who get exercise are simply out in the sun more,” he concluded.
Why do so many Americans have low blood levels of the D vitamin?
For the past 30 years, because of the risk of skin cancer, doctors have advised people to avoid sun exposure and to wear sunscreen. These warnings did not include recommendations for increased vitamin D supplementation. Even low SPF-8 sunscreen blocks 95% of the skin’s ability to make vitamin D. Thus we’ve become deficient in blood levels of the sunshine vitamin.
For optimal D levels, about ten minutes daily of unblocked exposure to direct sunlight is required for fair skin tones. Darker skin tones may need up to three times as much (thirty minutes or more daily). The sunlight has to penetrate onto the skin directly, without sunscreen. Arms should be bare. Skin cancer has become a worry for most of us, so we limit our time in direct sunlight, especially without sun screen.
Up to 80% of Americans have D blood levels less than 32 ng/ml
Most experts on vitamin D today agree that a serum level less than 32 nanograms per millileter (ng/ml) is probably ‘deficient’. Using this as the cut-off, up to 80% of the U.S. population may be deficient.
Most blood testing labs today use a reference range between 30 to100 ng/ml as ‘normal’ year-round. There’s growing evidence suggesting that even 30 ng/ml is too low as a minimum.
In 2010 the Vitamin D Council increased its ‘normal’ blood level range of vitamin D 25 hydroxy lab values from 20-56 nanograms per millileter (ng/ml) to 50-80 ng/ml in both children and adults.
What is a ‘normal’ blood level reference range?
There is disagreement in the medical community on what measurements constitute so-called ‘normal’ blood levels.
According to the National Institutes of Health (NIH) , “There is considerable discussion of the serum concentrations of 25(OH)D associated with deficiency (e.g., rickets), adequacy for bone health, and optimal overall health, and cut points have not been developed by a scientific consensus process.”
Based on its review of data of vitamin D needs, a committee of the Institute of Medicine concluded the following:
- Persons are at risk of vitamin D deficiency leading to rickets in infants and osteomalacia in adults at blood levels below 12 ng/ml.
- Levels between 12-20 ng/ml are not adequate for bone and overall health in otherwise healthy individuals.
- Levels between 21-50 ng/ml are considered adequate for bone and overall health in otherwise healthy individuals.
The government is concerned that variables have occurred in the processes of measuring serum levels of vitamin D. To improve laboratories method-related variability, the NIH reports that a nationwide standard reference material that permits standardization of values across laboratories for 25(OH)D became available in July 2009.
Most of the recognized research experts strongly believe the government’s parameters are outdated and too low.
The Vitamin D Council cited recent studies by Bruce Hollis, Robert Heaney, Neil Binkley and others in which both the parent compound (cholecalciferol) and 25(OH)D levels were measured. They found the following:
- 25(OH)D levels should be between 50–80 ng/ml (125–200 nmol/L), year-round.
- The body does not reliably begin storing cholecalciferol in fat and muscle tissue until 25(OH)D levels get above 50 ng/ml.
- The average person starts to store cholecalciferol at 40 ng/ml, but at 50 ng/ml virtually everyone begins to store it for future use. That is,
- at levels below 50 ng/ml the body uses up vitamin D as fast as you can make it, or take it, indicating chronic substrate (molecule which is acted upon by an enzyme) starvation—not a good thing.
- They recommend that everyone should get a 25-hydroxyvitamin D test and begin a program of vitamin D supplementation.
How much vitamin D should I get every day?
There is considerable controversy concerning vitamin D intake daily.
Until 1997, the NIH recommended dietary allowance (RDA) for vitamin D was 200 international units (IU) for all adults.
Faced with growing evidence of vitamin D deficiencies in Americans, the RDA for 51 to 70 years-old was increased to 400IU, and to 600IU for people older than 70. In 2005, it was increased to 1,000 I.U.
More might sound like better, but the Centers for Disease Control and Prevention still recommend 2,000IU as the “tolerable upper intake per day.”
Is more better? New research suggests that it is, and many authorities are recommending 1800 or even 2,000IU a day or more. Like other fat-soluble vitamins, D is stored in the body’s fat tissue. That means your body can mobilize its own reserves if your daily intake falters temporarily — but it also means that excessive doses of vitamin D can build up to toxic levels. It takes massive overdosing to produce toxicity, and doses up to 2,000IU a day are certainly safe.
So, what's a sufficient level of vitamin D supplementation? In an online article Vitamin D for Chronic Pain by Stewart B. Leavitt, MA, PhD, adapted from his peer-reviewed research report, Vitamin D--A Neglected 'Analgesic' for Chronic Musculoskeletal Pain in June, 2008 the current recommendation for vitamin D (1000 IU per day) is outdated. Dr. Leavitt proposes most healthy adults and children need at least 1,300-1,700 IU/day and people with chronic musculoskeletal pain could benefit from 2,400-2,800 IU or more per day of cholecalciferol vitamin D3 from supplementation of D3 and multivitamin (See Table 5 in above link).
Professor of Pediatrics Bruce Hollis, PhD, at the Medical University of South Carolina has shown pregnant and lactating women need at least 5,000IU/day, not 1,000.
What about vitamin D toxicity
On November 30, 2010 the Institute of Medicine’s (IOM)Food and Nutrition Board (FNB) reported that vitamin D toxicity might occur at an intake of 10,000IU/day.
On Jan. 13, 2011 the Dietary Supplement Fact Sheet on Vitamin D by the NIH says most reports suggest a toxicity threshold for vitamin D of 10,000 to 40,000IU/day.
Concerns about toxicity of the D vitamin are largely unfounded, according to The VitaminD-Council, which takes issue with the IOM’s ceiling of 10,000IU/day. It is possible to take an amount of vitamin D that would eventually be toxic, the Council said, however there has been no evidence of adverse effects unless in excess of 40,000IU/day is taken for a prolonged period.
Excerpt from the book The Vitamin D Revolution recommending supplementation
The following excerpt is taken from the book The Vitamin D Revolution, by Soram Khalsa, M.D., published by Hay House (March 2009):
“In evolutionary terms, humans have evolved from living naked near the equator and migrating to the northern hemispheres to where we cover ourselves with clothing year-round. In comparison to our distant ancestors, we are sun starved and therefore vitamin D starved. Our ancestors, bathed in sun for much of the day, probably had naturally occurring levels of vitamin D in their blood between 50 and 90 ng/ml."
"In my busy medical practice, in five years of testing 25D levels, I have only seen a few people with optimal levels of vitamin D on initial testing."
“Worldwide, it is estimated that one billion people have deficient or insufficient levels of vitamin D. References from a number of studies indicate that in North America and northern Europe, between 40 and 100 percent of elderly people are deficient in vitamin D. The Mayo Clinic Proceedings reported on a study from Minnesota that 100 percent of African Americans, East Africans, Hispanics, and American Indians were vitamin D deficient. In addition, more than 50 percent of postmenopausal women who have osteoporosis bad enough that they required prescription medication had insufficient levels of 25D (below 30 ng/ml)."
"In my experience, counting on patients to get enough sunshine on a regular basis is not enough to help them elevate their vitamin D levels to optimal rates. This is why I recommend supplementation.”
What kind of vitamin D supplement is best?
Non-prescription vitamin D supplements are available in the United States as either Vitamin D2 Ergocalciferol or Vitamin D3 Cholecalciferol. Both are referred to as "vitamin D" although they are different in their origins, metabolism, and potential toxicity.
The preferred form in a dietary supplement is cholecalciferol, or vitamin D3. Cholecalciferol is the naturally occurring form of vitamin D. It is the substance made in large quantities in your skin when sunlight strikes your bare skin. It can also be taken as a supplement. Cholecalciferol is vitamin D; all other compounds are either metabolic products or chemical modifications.
Ergocalciferol (also rererred to as vitamin D2 or calciferol) is derived by radiating fungus. It is not the naturally occurring vitamin D for humans. Ergocalciferol is available to U.S. doctors in prescription strength and is sometimes used in multivitamin preparations—usually at 400IU per pill. Your doctor can write a prescription for 50,000 units of ergocalciferol (brand names Drisdol and Calciferol).
A personal comment
As you may know from other pages on this website, my husband and I have arthritis. For many years we’ve controlled our pain symptoms with three natural products. We’re no longer on pharmaceutical drugs of any kind.
Recently we’ve become aware that most Americans are vitamin D deficient and taking vitamin D supplements may play a considerable treatment role in joint health. This one minute video on my health website, illustrates the vitamin D problem and offers a solution. I think you’ll enjoy seeing it.
To increase our vitamin D blood levels, we’ve added 2,000IU daily by taking a new vitamin D3 supplement with surprising results of diminished pain and knee stiffness. This occurred over time, not immediately.
Featured vitamin D supplement
There are two primary questions to consider when deciding upon a vitamin D3 cholecalciferol supplement :
- Per tablet serving size of IU’s.
- Difference of opinion notwithstanding, the consensus of leading experts is that a minimum of 1,000IU’s should be supplemented daily.
- Which manufacturer or brand to choose.
- In view that the dietary supplement industry is not subject to pre-market testing by the Food & Drug Administration (FDA), nor to proving efficacy of its products, our recommended vitamin D recommend the vitamin D3 supplement made by the #1 natural nutrition company in the U.S..
Their commitment to clinical and scientific research separates them from the competition and has resulted in over 100 scientific papers—90 of them published in peer-reviewed scientific journals. Their Vitamin D3 supplement contains cutting-edge nutrition science. It’s new from this 50+-year-old company and is the culmination of recent scientific research, including two of their own industry-leading vitamin D studies.
It comes in a 90-tablet size, each tablet contains 1,000IU of Vitamin D3 (as cholecalciferol). At one tablet daily this is a three-month supply for less than $10.00.
Of note, this Vitamin D3 supplement is subjected to over 300 tests to guarantee product purity.
This recommended vitamin D supplement is clinically supported and proven to significantly raise blood levels of vitamin D. We highly endorse it. Their 100% product guarantee is ironclad (to read it, click this guarantee link).
Bottom line: always check with your doctor before beginning any method of self treatment and obtain his/her recommendation regarding supplementation of the sunshine vitamin.
Disclaimer: Health statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
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