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The Miracle of Vitamin D

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Health Topics - ABC's of Nutrition

Written by Krispin Sullivan, CN

2000-Dec-30

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Read this article in: Dutch

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Notes:

After reading this article, please also read the Vitamin A,
 Vitamin D and Cod Liver Oil: Some Clarifications section in our
 Cod Liver Oil Basics and Recommendations article.

Be sure to read the Winter 2000 and Fall 2002 updates to this
 article, at the end of the original article.

In April of 2000 a clinical observation published in Archives of
Internal Medicine caught my attention. Dr. Anu Prabhala and his
colleagues reported on the treatment of five patients confined to
wheelchairs with severe weakness and fatigue. Blood tests revealed
that all suffered from severe vitamin D deficiency. The patients
received 50,000 IU vitamin D per week and all became mobile within six
weeks.1

Dr. Prabhala's research sparked my interest and led to a search for
current information on vitamin D, how it works, how much we really
need and how we get it. The following is a small part of the important
information that I found.

Any discussion of vitamin D must begin with the discoveries of the
Canadian-born dentist Weston A. Price. In his masterpiece Nutrition
and Physical Degeneration, Dr. Price noted that the diet of isolated,
so-called "primitive" peoples contained "at least ten times" the
amount of "fat-soluble vitamins" as the standard American diet of his
day.2 Dr. Price determined that it was the presence of plentiful
amounts of fat-soluble vitamins A and D in the diet, along with
calcium, phosphorus and other minerals, that conferred such high
immunity to tooth decay and resistance to disease in nonindustrialized
population groups.

Today another Canadian researcher, Dr. Reinhold Vieth, argues
convincingly that current vitamin D recommendations are woefully
inadequate. The recommended dose of 200-400 international units (IU)
will prevent rickets in children but does not come close to the
optimum amount necessary for vibrant health.3 According to Dr. Vieth,
the minimal daily requirement of vitamin D should be in the range of
4,000 IU from all sources, rather than the 200-400 currently
suggested, or ten times the Recommended Daily Allowance (RDA). Dr.
Vieth's research perfectly matches Dr. Price's observations of sixty
years ago!

Vitamin D From Sunlight
-----------------------

Pick up any popular book on vitamins and you will read that ten
minutes of daily exposure of the arms and legs to sunlight will supply
us with all the vitamin D that we need. Humans do indeed manufacture
vitamin D from cholesterol by the action of sunlight on the skin but
it is actually very difficult to obtain even a minimal amount of
vitamin D with a brief foray into the sunlight.4,5

Ultraviolet (UV) light is divided into 3 bands or wavelength ranges,
which are referred to as UV-C, UV-B and UV-A.6 UV-C is the most
energetic and shortest of the UV bands. It will burn human skin
rapidly in extremely small doses. Fortunately, it is completely
absorbed by the ozone layer. However, UV-C is present in some lights.
For this reason, fluorescent and halogen and other specialty lights
may contribute to skin cancer.

UV-A, known as the "tanning ray," is primarily responsible for
darkening the pigment in our skin. Most tanning bulbs have a high UV-A
output, with a small percentage of UV-B. UV-A is less energetic than
UV-B, so exposure to UV-A will not result in a burn, unless the skin
is photosensitive or excessive doses are used. UV-A penetrates more
deeply into the skin than UV-B, due to its longer wavelength. Until
recently, UV-A was not blocked by sunscreens. It is now considered to
be a major contributor to the high incidence of non-melanoma skin
cancers.7 Seventy-eight percent of UV-A penetrates glass so windows do
not offer protection.

The ultraviolet wavelength that stimulates our bodies to produce
vitamin D is UV-B. It is sometimes called the "burning ray" because it
is the primary cause of sunburn (erythema). However, UV-B initiates
beneficial responses, stimulating the production of vitamin D that the
body uses in many important processes. Although UV-B causes sunburn,
it also causes special skin cells called melanocytes to produce
melanin, which is protective. UV-B also stimulates the production of
Melanocyte Stimulating Hormone (MSH), an important hormone in weight
loss and energy production.8

The reason it is difficult to get adequate vitamin D from sunlight is
that while UV-A is present throughout the day, the amount of UV-B
present has to do with the angle of the sun's rays. Thus, UV-B is
present only during midday hours at higher latitudes, and only with
significant intensity in temperate or tropical latitudes. Only 5
percent of the UV-B light range goes through glass and it does not
penetrate clouds, smog or fog.

Sun exposure at higher latitudes before 10 am or after 2 pm will cause
burning from UV-A before it will supply adequate vitamin D from UV-B.
This finding may surprise you, as it did the researchers. It means
that sunning must occur between the hours we have been told to avoid.
Only sunning between 10 am and 2 pm during summer months (or winter
months in southern latitudes) for 20-120 minutes, depending on skin
type and color, will form adequate vitamin D before burning occurs.9

It takes about 24 hours for UV-B-stimulated vitamin D to show up as
maximum levels of vitamin D in the blood. Cholesterol-containing body
oils are critical to this absorption process.10 Because the body needs
30-60 minutes to absorb these vitamin-D-containing oils, it is best to
delay showering or bathing for one hour after exposure. The skin oils
in which vitamin D is produced can also be removed by chlorine in
swimming pools.

The current suggested exposure of hands, face and arms for 10-20
minutes, three times a week, provides only 200-400 IU of vitamin D
each time or an average of 100-200 IU per day during the summer
months. In order to achieve optimal levels of vitamin D, 85 percent of
body surface needs exposure to prime midday sun. (About 100-200 IU of
vitamin D is produced for each 5 percent of body surface exposed, we
want 4,000 iu.) Light skinned people need 10-20 minutes of exposure
while dark skinned people need 90-120 minutes.11

Latitude and altitude determine the intensity of UV light. UV-B is
stronger at higher altitudes. Latitudes higher than 30° (both north
and south) have insufficient UV-B sunlight two to six months of the
year, even at midday.12 Latitudes higher than 40° have insufficient
sunlight to achieve optimum levels of D during six to eight months of
the year. In much of the US, which is between 30° and 45° latitude,
six months or more during each year have insufficient UV-B sunlight to
produce optimal D levels. In far northern or southern locations,
latitudes 45° and higher, even summer sun is too weak to provide
optimum levels of vitamin D.13-15 A simple meter is available to
determine UV-B levels where you live.

Vitamin D From Food
-------------------

What the research on vitamin D tells us is that unless you are a
fisherman, farmer, or otherwise outdoors and exposed regularly to
sunlight, living in your ancestral latitude (more on this later), you
are unlikely to obtain adequate amounts of vitamin D from the sun.
Historically the balance of one's daily need was provided by food.
Primitive peoples instinctively chose vitamin-D-rich foods including
the intestines, organ meats, skin and fat from certain land animals,
as well as shellfish, oily fish and insects. Many of these foods are
unacceptable to the modern palate.

For food sources to provide us with D the source must be sunlight
exposed. With exposure to UV-B sunlight, vitamin D is produced from
fat in the fur, feathers, and skin of animals, birds and reptiles.
Carnivores get additional D from the tissues and organs of their prey.
Lichen contains vitamin D and may provide a source of vitamin D in the
UV-B sunlight-poor northern latitudes.16 Vitamin D content will vary
in the organs and tissues of animals, pigs, cows, and sheep, depending
on the amount of time spent in UV-B containing sunlight and/or how
much D is given as a supplement. Poultry and eggs contain varying
amounts of vitamin D obtained from insects, fishmeal, and sunlight
containing UV-B or supplements. Fish, unlike mammals, birds and
reptiles, do not respond to sunlight and rely on vitamin D found in
phytoplankton and other fish. Salmon must feed on phytoplankton and
fish in order to obtain and store significant vitamin D in their fat,
flesh, skin, and organs. Thus, modern farm-raised salmon, unless
artificially supplemented, may be a poor source of this essential
nutrient.

Modern diets usually do not provide adequate amounts of vitamin D;17
partly because of the trend to low fat foods and partly because we no
longer eat vitamin-D-rich foods like naturally reared poultry and
fatty fish such as kippers, and herring. Often we are advised to
consume the egg white while the D is in the yolk or we eat the flesh
of the fish avoiding the D containing skin, organs and fat. Sun
avoidance combined with reduction in food sources contribute to
escalating D deficiencies. Vegetarian and vegan diets are
exceptionally poor or completely lacking in vitamin D predisposing to
an absolute need for UV-B sunlight. Using food as one's primary source
of D is difficult to impossible.

Vitamin D Miracles
------------------

Sunlight and vitamin D are critical to all life forms. Standard
textbooks state that the principal function of vitamin D is to promote
calcium absorption in the gut and calcium transfer across cell
membranes, thus contributing to strong bones and a calm, contented
nervous system. It is also well recognized that vitamin D aids in the
absorption of magnesium, iron and zinc, as well as calcium.

Actually, vitamin D does not in itself promote healthy bone. Vitamin D
controls the levels of calcium in the blood. If there is not enough
calcium in the diet, then it will be drawn from the bone. High levels
of vitamin D (from the diet or from sunlight) will actually
demineralize bone if sufficient calcium is not present.

Vitamin D will also enhance the uptake of toxic metals like lead,
cadmium, aluminum and strontium if calcium, magnesium and phosphorus
are not present in adequate amounts.18 Vitamin D supplementation
should never be suggested unless calcium intake is sufficient or
supplemented at the same time.

Receptors for vitamin D are found in most of the cells in the body and
research during the 1980s suggested that vitamin D contributed to a
healthy immune system, promoted muscle strength, regulated the
maturation process and contributed to hormone production.

During the last ten years, researchers have made a number of exciting
discoveries about vitamin D. They have ascertained, for example, that
vitamin D is an antioxidant that is a more effective antioxidant than
vitamin E in reducing lipid peroxidation and increasing enzymes that
protect against oxidation.19;20

Vitamin D deficiency decreases biosynthesis and release of insulin.21
Glucose intolerance has been inversely associated with the
concentration of vitamin D in the blood. Thus, vitamin D may protect
against both Type I and Type II diabetes.22

The risk of senile cataract is reduced in persons with optimal levels
of D and carotenoids.23

PCOS (Polycystic Ovarian Syndrome) has been corrected by
supplementation of D and calcium.24

Vitamin D plays a role in regulation of both the "infectious" immune
system and the "inflammatory" immune system.25

Low vitamin D is associated with several autoimmune diseases including
multiple sclerosis, Sjogren's Syndrome, rheumatoid arthritis,
thyroiditis and Crohn's disease.26;27

Osteoporosis is strongly associated with low vitamin D. Postmenopausal
women with osteoporosis respond favorably (and rapidly) to higher
levels of D plus calcium and magnesium.28

D deficiency has been mistaken for fibromyalgia, chronic fatigue or
peripheral neuropathy.1;28-30

Infertility is associated with low vitamin D.31 Vitamin D supports
production of estrogen in men and women.32 PMS has been completely
reversed by addition of calcium, magnesium and vitamin D.33 Menstrual
migraine is associated with low levels of vitamin D and calcium.81

Breast, prostate, skin and colon cancer have a strong association with
low levels of D and lack of sunlight.34-38

Activated vitamin D in the adrenal gland regulates tyrosine
hydroxylase, the rate limiting enzyme necessary for the production of
dopamine, epinephrine and norepinephrine. Low D may contribute to
chronic fatigue and depression.39

Seasonal Affective Disorder has been treated successfully with vitamin
D. In a recent study covering 30 days of treatment comparing vitamin D
supplementation with two-hour daily use of light boxes, depression
completely resolved in the D group but not in the light box group.40

High stress may increase the need for vitamin D or UV-B sunlight and
calcium.41

People with Parkinsons and Alzheimers have been found to have lower
levels of vitamin D.42;43

Low levels of D, and perhaps calcium, in a pregnant mother and later
in the child may be the contributing cause of "crooked teeth" and
myopia. When these conditions are found in succeeding generations it
means the genetics require higher levels of one or both nutrients to
optimize health.44-47

Behavior and learning disorders respond well to D and/or calcium
combined with an adequate diet and trace minerals.48;49

Vitamin D and Heart Disease
---------------------------

Research suggests that low levels of vitamin D may contribute to or be
a cause of syndrome X with associated hypertension, obesity, diabetes
and heart disease.50 Vitamin D regulates vitamin-D-binding proteins
and some calcium-binding proteins, which are responsible for carrying
calcium to the "right location" and protecting cells from damage by
free calcium.51 Thus, high dietary levels of calcium, when D is
insufficient, may contribute to calcification of the arteries, joints,
kidney and perhaps even the brain.52-54

Many researchers have postulated that vitamin D deficiency leads to
the deposition of calcium in the arteries and hence atherosclerosis,
noting that northern countries have higher levels of cardiovascular
disease and that more heart attacks occur in winter months.55-56

Scottish researchers found that calcium levels in the hair inversely
correlated with arterial calcium—the more calcium or plaque in the
arteries, the less calcium in the hair. Ninety percent of men
experiencing myocardial infarction had low hair calcium. When vitamin
D was administered, the amount of calcium in the beard went up and
this rise continued as long as vitamin D was consumed. Almost
immediately after stopping supplementation, however, beard calcium
fell to pre-supplement levels.27

Administration of dietary vitamin D or UV-B treatment has been shown
to lower blood pressure, restore insulin sensitivity and lower
cholesterol.58-60

The Battle of the Bulge
-----------------------

Did you ever wonder why some people can eat all they want and not get
fat, while others are constantly battling extra pounds? The answer may
have to do with vitamin D and calcium status. Sunlight, UV-B, and
vitamin D normalize food intake and normalize blood sugar. Weight
normalization is associated with higher levels of vitamin D and
adequate calcium.61 Obesity is associated with vitamin-D deficiency.62-64
In fact, obese persons have impaired production of UV-B-stimulated D
and impaired absorption of food source and supplemental D.65

When the diet lacks calcium, whether from D or calcium deficiency,
there is an increase in fatty acid synthase, an enzyme that converts
calories into fat. Higher levels of calcium with adequate vitamin D
inhibit fatty acid synthase while diets low in calcium increase fatty
acid synthase by as much as five-fold. In one study, genetically obese
rats lost 60 percent of their body fat in six weeks on a diet that had
moderate calorie reduction but was high in calcium. All rats
supplemented with calcium showed increased body temperature indicating
a shift from calorie storage to calorie burning (thermogenesis).61

The Right Fats
--------------

The assimilation and utilization of vitamin D is influenced by the
kinds of fats we consume. Increasing levels of both polyunsaturated
and monounsaturated fatty acids in the diet decrease the binding of
vitamin D to D-binding proteins. Saturated fats, the kind found in
butter, tallow and coconut oil, do not have this effect. Nor do the
omega-3 fats.66 D-binding proteins are key to local and peripheral
actions of vitamin D. This is an important consideration as Americans
have dramatically increased their intake of polyunsaturated oils (from
commercial vegetable oils) and monounsaturated oils (from olive oil
and canola oil) and decreased their intake of saturated fats over the
past 100 years.

In traditional diets, saturated fats supplied varying amounts of
vitamin D. Thus, both reduction of saturated fats and increase of
polyunsaturated and monounsaturated fats contribute to the current
widespread D deficiency.

Trans fatty acids, found in margarine and shortenings used in most
commercial baked goods, should always be avoided. There is evidence
that these fats can interfere with the enzyme systems the body uses to
convert vitamin D in the liver.80

Vitamin D Therapy
-----------------

In my clinical practice, I test for vitamin-D status first. If D is
needed, I try to combine sunlight exposure with vitamin D and mineral
supplements.

Single, infrequent, intense, skin exposure to UV-B light not only
causes sunburn but also suppresses the immune system. On the other
hand, frequent low-level exposure normalizes immune function,
enhancing NK-cell and T-cell production, reducing abnormal
inflammatory responses typical of autoimmune disorders, and reducing
occurrences of infectious disease.26;67;68-71 Thus it is important to
sunbathe frequently for short periods of time, when UV-B is present,
rather than spend long hours in the sun at infrequent intervals.
Adequate UV-B exposure and vitamin-D production can be achieved in
less time than it takes to cause any redness in the skin. It is never
necessary to burn or tan to obtain sufficient vitamin D.

If sunlight is not available in your area because of latitude or
season, sunlamps made by Sperti can be used to provide a natural
balance of UV-B and UV-A. Used according to instructions, these lamps
provide a safe equivalent of sunlight and will not cause burning or
even heavy tanning. Tanning beds, on the other hand, are not
acceptable as a means of getting your daily dose of vitamin D because
they provide high levels of UV-A and very little UV-B.

If you have symptoms of vitamin-D insufficiency or are unable to spend
time in the sun, due to season or lifestyle or prior skin cancer,
consider adding a supplement of 1,000 IU daily. Higher levels may be
needed but should be recommended and monitored by your health care
practitioner after testing serum 25(OH)D. 1,000 iu can be obtained
from a concentrated supplement or from 2 teaspoons of high quality cod
liver oil. Both Carlson Labs and Solgar make a 1,000 IU vitamin-D
supplement naturally derived from fish oil. (Do not attempt to obtain
large amounts of vitamin D from cod liver oil alone, as this would
supply vitamin A in excessive and possibly toxic amounts.)

Supplementation is safe as long as sarcoidosis, liver or kidney
disease is not present and the diet contains adequate calcium,
magnesium and other minerals.

Adequate calcium and magnesium, as well as other minerals, are
critical parts of vitamin D therapy. Without calcium and magnesium in
sufficient quantities, vitamin-D supplementation will withdraw calcium
from the bone and will allow the uptake of toxic minerals. Do not
supplement vitamin D and do not sunbathe unless you are sure you have
sufficient calcium and magnesium to meet your daily needs. Weston
Price suggested a minimum of 1,200-2,400 mg of calcium daily. Research
suggests that 1,200-1,500 mg is adequate as a supplement for most
adults, both men and women. (Magnesium intake should be half that of
calcium.)

Two excellent sources of calcium in the human diet are dairy products
and bone broths.2 If the diet does not contain sufficient amounts, you
will need to add supplements. Bone meal, dolomite powder or calcium
and magnesium tablets (Solgar or Kal), or calcium carbonate or lactate
(Solgar, Kal, Now or Twinlab) are good calcium sources, inexpensive
and safe.74 All of these brands have been tested and found to be free
of lead and other heavy metals.

In my experience, the forms of calcium given in supplements should be
equivalent to those found in food—bone meal as in the broth, calcium
lactate as in milk products and dolomite as in lime used to process
cornmeal products. These forms work most efficiently and with the
least cost for bone repletion and general repletion of serum calcium
status.75 If your diet is high in protein, calcium lactate or
carbonate is probably a better source of calcium.

Read the label carefully to see how much elemental calcium is
contained in each dose or tablet and make sure to take the right
amount. If the label says a serving size is three tablets and contains
1,000 mg of calcium, you must take the full serving size to get that
amount.

Higher amounts of calcium are important for anyone diagnosed with bone
loss. Total daily calcium as a supplement may range from 1,500 mg to
2,000 mg depending on current bone status and your body size. Make the
effort to split up your daily dose. Do not take all your calcium and
magnesium once a day. A higher percentage of the calcium dose is
absorbed if delivered in smaller, more frequent amounts.82

Expensive "chelated" calciums are not necessary if vitamin-D status is
adequate. Taking calcium without sufficient D may cause other
problems. Vitamin D controls the production of some calcium binding
proteins, which are critical to normal calcium utilization.

Patients on vitamin-D therapy report a wide range of beneficial
results including increased energy and strength, resolution of
hormonal problems, weight loss, an end to sugar cravings, blood sugar
normalization and improvement of nervous system disorders.

A paradoxical transient and non-complicating hypercalciuria (more
calcium in the urine) may occur when the program is first initiated.
This resolves quickly when adequate calcium and other minerals are
consumed. Two other temporary side effects may occur during the first
several months of treatment. One is daytime sleepiness after calcium
is taken. This usually resolves itself after about one week. The other
condition is the reappearance of pain and discomfort at the site of
old injuries, a sign of injury remodeling or proper healing, which may
take some time to clear up.

Toxicity Issues
---------------

Vitamin programs usually omit vitamin D because of concerns about
toxicity. These concerns are valid because vitamin D in all forms can
be toxic in pharmacological (drug-like) doses. The dangers of toxicity
have not been exaggerated, but the doses needed to result in toxicity
have been ill defined with the unfortunate result that many people
currently suffer from vitamin-D deficiency or insufficiency.

Abnormally high levels of vitamin D are indicated by blood levels
exceeding 65 ng/ml or 162 nmol/l for extended periods of time and may
be associated with chronic toxicity. Levels of 200-300 nmol/l or
higher have been seen in several studies using supplementation and
quickly resolve when supplementation is stopped. In such cases no
long-term problems have been found. Long-term supplementation, without
monitoring, may have serious consequences.

Before 1993, there was no affordable and available blood test for
vitamin D. Now there is. To avoid problems, anyone engaging in levels
of vitamin-D supplementation above 1,000 iu daily should have periodic
blood tests. Don't forget to calculate your total vitamin-D intake
from all sources—sunlight, food (including vitamin D in milk) and
supplements, including cod liver oil.

Dr. Vieth suggests that critical toxicity may occur at doses of 20,000
IU daily and that the Upper Limit (UL) of safety be set at 10,000 IU,
rather than the current 2,000 IU. While this may or may not be the
definitive marker for safety in healthy persons with no active liver
or kidney disease, there is no clinical evidence that long-term
supplementation needs to be greater than 4,000 IU for optimal daily
maintenance. This level would be somewhat lower when combined with
exposure to UV-B.3;76

Doses used in clinical studies range from as little as 400 IU daily to
10,000-500,000 IU, given either as a single onetime dose or daily,
weekly or monthly. Such large doses are given either as a prophylactic
or because compliance is considered a problem. There seems to be some
evidence that vitamin D works better, without toxicity, when given in
lower, more physiologic doses of 2,000-4,000 IU daily rather than as
100,000 IU once a month. However, a single monthly dose of 100,000 IU
did replete low levels of vitamin D in adolescents during winter.77

In my experience and that of other researchers, high, infrequent
dosing can lead to problems. In one recent study, blood levels rose
from low to extremely high, (more than 300 nmol/l) 2 to 4 hours after
a 50,000 IU oral dose,65 and then slowly returned to pretreatment
suboptimal levels. Clearly this must disrupt normal feedback
mechanisms in D and calcium regulation.

Vitamin A can be administered in large, infrequent doses from
consumption of animal or fish liver (or injections, used in third
world countries to prevent blindness) because we have storage capacity
for vitamin A in our livers. Vitamin D is different. It has only a
small storage pool in the liver and peripheral fat. Our ancestors most
definitely did not get vitamin D in large, infrequent doses. While
vitamin D is stored in body fat, storage is not sufficient to maintain
optimum blood levels during winter months.78 A single exposure to UV-B
light will raise levels of vitamin D over the next 24 hours and then
return to baseline or slightly higher within 7 days. Historically our
requirements for D were satisfied by daily exposure to sunlight and/or
daily intake from food. Lowfat diets and lack of seafood in the diet
further contribute to the current worldwide insufficiency of vitamin
D.

Sunlight on the Inside
----------------------

If any nutrient incorporates the properties of sunlight, it is vitamin
D. The healthy "primitive" peoples that Dr. Price observed not only
had broad, round, "sunny" faces, they also had sunny dispositions and
optimistic attitudes towards life in spite of many hardships. Typical
food intakes for peoples who have not been "civilized" range from
3,000 IU-6,000 IU. Modern intakes are paltry in comparison. The
standard American diet provides vitamin D only in very low quantities.

The first step towards redressing some of the ills of civilized
life—from depression to road rage, from cavities to osteoporosis—would
be to get more light, inside or outside. Vitamin D adds sunlight to
life from childhood through the golden years. In nonagenarians and
centagenarians high levels of vitamin D in the blood and normal
thyroid function were the strongest markers of health and longevity.79

Whether in the form of sunlight or dietary vitamin D from food and
fish oils, optimal levels of the sunshine vitamin allow your body and
mind to thrive, even during periods of stress.

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Sidebar Articles

Food Sources of Vitamin D

USDA databases compiled in the 1980s list the following foods as rich
in vitamin D. The amounts given are for 100 grams or about 3 1/2
ounces. These figures demonstrate the difficulty in obtaining 4,000 IU
vitamin D per day from ordinary foods in the American diet. Three
servings of herring, oysters, catfish, mackerel or sardines plus
generous amounts of butter, egg yolk, lard or bacon fat and 2
teaspoons cod liver oil (500 iu per teaspoon) yield about 4,000 IU
vitamin D—a very rich diet indeed!

Cod Liver Oil
Lard (Pork Fat)
Atlantic Herring (Pickled)
Eastern Oysters (Steamed)
Catfish (Steamed/Poached)
Skinless Sardines (Water Packed)
Mackerel (Canned/Drained)
Smoked Chinook Salmon
Sturgeon Roe
Shrimp (Canned/Drained)
Egg Yolk (Fresh)
(One yolk contains about 24 IU)
Butter
Lamb Liver (Braised)
Beef Tallow
Pork Liver (Braised)
Beef Liver (Fried)
Beef Tripe (Raw)
Beef Kidney (Simmered)
Chicken Livers (Simmered)
Small Clams (Steamed/Cooked Moist)
Blue Crab (Steamed)
Crayfish/Crawdads (Steamed)
Northern Lobster (Steamed)

10,000
2,800
680
642
500
480
450
320
232
172
148

56
20
19
12
12
12
12
12
8
4
4
4

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The Many Forms of Vitamin D

There are two types of vitamin D found in nature. Vitamin D2 is formed
by the action of UV-B on the plant precursor ergosterol. It is found
in plants and in was formerly added to irradiated cows milk. Most milk
today contains D3. Vitamin D3 or cholecalciferol is found in animal
foods. Both forms of vitamin D have been used successfully to treat
rickets and other diseases related to vitamin D insufficiency.

Many consider D3 the preferred vitamin, having more biologic activity.
Vitamin D3 as found in food or in human skin always comes with various
metabolites or isomers that may have biological benefit. Dr. Price
believed that there were as many as 12 metabolites or isomers in the
vitamin D found in animal foods. When vitamin D is taken in the form
of fish oil, or eaten in foods such as eggs or fish, these metabolites
will be present. Both D2 and D3 can be toxic when taken
inappropriately in large amounts.

When humans take in vitamin D from food or sunlight, it is converted
first in the liver to the form 25(OH)D and then in the kidney to
1,25(OH)D. These active forms of vitamin D are available by
prescription and are given to patients with liver or kidney failure or
those with an hereditary metabolic defect in vitamin-D conversion.

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Assessing Vitamin D Status

Blood Testing: Currently there are two tests available for physicians
to assess vitamin-D status. One is for the somewhat biologically
active precursor 25(OH)D and another for 1,25(OH)D, the most active
form, which is converted in the kidney and other organs. The latter is
often normal in the blood even when the precursor 25(OH)D is low or
deficient. The precursor is a better marker of vitamin-D status (or
reserves) than the most active 1,25(OH)D form. It is the optimum level
of 25(OH)D that is most strongly associated with general good health.
(The test values given in this article are for 25(OH)D.) For many
years the acceptable level of 25(OH)D has been at least 9 ng/ml (23
nmol/l). Some researchers believe that 20 ng/ml (50 nmol/l) should be
the lower acceptable limit72 but Dr. Vieth presents a large amount of
data to support his claim that this is far from optimal.3 Optimal
levels are certainly at least 32 ng/ml (80 nmol/l) and preferably
closer to 40 ng/ml (100 nmol/l).

Salivary pH Testing for calcium sufficiency: A method of assessing
ionized calcium levels has been used by Weston Price, DDS and Carl
Reich, MD and has confirmation in current research.73 After
determining your serum-D status (testing) and undertaking a program of
supplementation with vitamin D, calcium and magnesium, morning
salivary pH should read 6.8-7.2. Lower values may indicate
insufficient vitamin D (retest), or low levels of calcium in the diet.
Look for pH paper with a range of 5.5-8.0 and increments of 0.2. PH
papers with 0.5-degree increments are not sensitive enough to monitor
progress. (Note: Do not take more than 1,000 IU of vitamin D without
testing and supervision by a knowledgeable healthcare practitioner.
Calcium can be adjusted within the ranges suggested. Several months of
supplementation may be required to show positive results if the
deficiency is severe and prolonged.)

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Sources

UV-B Meter: Sunsor, Inc. (800) 492-9815 Sunsor

pH Testing Papers: Pike Agri-Lab Supplies (207) 684-5131 or This
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Carlson Labs Vitamin D: (888) 880-3055 www.vitaminshoppe.com

Solgar Vitamin D: L & H Vitamins (800) 221-1152

Sperti Sunlamps: (800) 544-3757 www.sperti.com

---------------------------------------------------------------------

References

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30. Kyriakidou-Himonas M, Aloia JF, Yeh JK. Vitamin D
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32. Kinuta K, Tanaka H, Moriwake T, Aya K, Kato S, Seino Y. Vitamin
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33. Thys-Jacobs S. Micronutrients and the premenstrual syndrome: the
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34. Garland CF, Garland FC, Gorham ED. Calcium and vitamin D. Their
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35. John EM, Schwartz GG, Dreon DM, Koo J. Vitamin D and breast
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36. Miller GJ. Vitamin D and prostate cancer: biologic interactions
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42. Sato Y, Kikuyama M, Oizumi K. High prevalence of vitamin D
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45. Taylor AN. Tooth formation and the 28,000-dalton vitamin
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46. Price, Weston A. Primitive Control of Dental Caries. Nutrition
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50. Boucher BJ. Inadequate vitamin D status: does it contribute to
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53. Watson KE, Abrolat ML, Malone LL et al. Active serum vitamin D
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54. Sugihara N, Matsuzaki M, Kato Y. Assessment of the relation
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56. Williams FL, Lloyd OL. Latitude and heart disease letter.
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  Ultraviolet B and blood pressure letter. Lancet 1998;352:709-10.

59. Jorde R, Bonaa KH. Calcium from dairy products, vitamin D
  intake, and blood pressure: the Tromso Study. Am.J.Clin.Nutr.
  2000;71:1530-5.

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  1997;30:150-6.

61. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC. Regulation of
  adiposity by dietary calcium. FASEB J. 2000;14:1132-8.

62. Bell NH, Epstein S, Greene A, Shary J, Oexmann MJ, Shaw S.
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63. Buffington C, Walker B, Cowan GS, Jr., Scruggs D. Vitamin D
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66. Bouillon R, Xiang DZ, Convents R, Van Baelen H. Polyunsaturated
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67. Garssen J, Norval M, el Ghorr A et al. Estimation of the effect
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68. Amento EP, Bhalla AK, Kurnick JT et al. 1
  alpha,25-dihydroxyvitamin D3 induces maturation of the human
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  mononuclear cell factor. J.Clin.Invest 1984;73:731-9.

69. Aslam SM, Garlich JD, Qureshi MA. Vitamin D deficiency alters
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70. Corman LC. Effects of specific nutrients on the immune response.
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71. Muller K, Bendtzen K. 1,25-Dihydroxyvitamin D3 as a natural
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72. Barger-Lux MJ, Heaney RP, Dowell S, Chen TC, Holick MF. Vitamin
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73. Rehak NN, Cecco SA, Csako G. Biochemical composition and
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  Process Citation. Clin.Chem.Lab Med. 2000;38:335-43.

74. Talbot JR, Guardo P, Seccia S et al. Calcium bioavailability and
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76. Chesney RW. Vitamin D: can an upper limit be defined? J.Nutr.
  1989;119:1825-8.

77. Duhamel JF, Zeghoud F, Sempe M et al. Prevention of vitamin D
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  100,000 IU of vitamin D3 (see comments). Arch.Pediatr.
  2000;7:148-53.

78. Davies PS, Bates CJ, Cole TJ, Prentice A, Clarke PC. Vitamin D:
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  Britain published erratum appears in Eur J Clin Nutr 1999
  Jul;53(7):584. Eur.J.Clin.Nutr. 1999;53:195-8.

79. Mariani E, Ravaglia G, Forti P et al. Vitamin D, thyroid
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  immunity in healthy nonagenarians and centenarians published
  erratum appears in Clin Exp Immunol 1999 Jul;117(1):206.
  Clin.Exp.Immunol.

80. Enig, Mary G. Modification of Membrane Lipid Composition and
  Mixed-Function Oxidases in Mouse Liver Microsomes by Dietary Trans
  Fatty Acids. 1984. University Microfilms International. Ann Arbor,
  Michigan.

81. Thys-Jacobs S. Vitamin D and calcium in menstrual migraine.
  Headache 1994;34:544-6.

82. Heaney, RP et al. J of Bone and Mineral Research, 5:11;1990 p.
  1135-1137.

---------------------------------------------------------------------

Vitamin D Update, Winter 2000
-----------------------------

Note: This update appeared in Wise Traditions in Food, Farming and the
Healing Arts, the quarterly magazine of the Weston A. Price
Foundation, Winter 2000.

Since the publication of "The Miracle of Vitamin D" in the last issue
of Wise Traditions, some clarification is necessary. The action of
vitamin D, whether from food, supplements or sunlight conversion, is
that of a "pro-hormone," rather than of a vitamin.

According to the dictionaries, a hormone is a substance, usually a
peptide or steroid, produced by one tissue and conveyed by the
bloodstream to another. Hormones affect physiological activity, such
as growth or metabolism. More generally, a hormone is one of various
similar substances found in plants and insects that regulate
development. By contrast, vitamins are various fat-soluble or
water-soluble organic substances essential in minute amounts for
normal growth and activity of the body. They are obtained naturally
from plant and animal foods.

Hormones are powerful regulators that can have both good and bad
effects. With progesterone, DHEA, estrogen, thyroid or any other
hormone, including vitamin D, there can be a profound cellular
response when levels are altered by supplementation. Vitamins and
minerals are elements used by the body to make enzymes, bone, immune
fractions and other substances in the human body, but they are not
regulators.

As a pro-hormone, vitamin D can be dangerous because too much has the
potential for great harm as does too little. That is why testing is
important for those on vitamin-D therapy. When you take thyroid
hormones, you are instructed to test first and retest to make sure the
amount you are taking is correct. So, too, with vitamin D. The rule is
test, treat (if necessary) and retest until you find the right amount
to meet your daily need. According to our current levels of knowledge,
there are no obvious symptoms of vitamin D overdose until the overdose
is nonreversible. Testing can alert us not only to deficiency but also
toxicity. Fortunately, we now have tests for vitamin D status that are
not expensive.

In my practice, I am discovering that some people may need upwards of
4,000 IU daily to maintain optimal blood levels. Others may find that
anything over 200-400 IU puts them in a situation of overdose. This is
a problem of genetics. Some people utilize vitamin D better than
others. Before the days of travel and great population migrations, the
process of natural selection created population groups that best
responded to the levels of vitamin D available through exposure to
sunlight and in the diet. Migration, immigration and intermarriage
make it impossible to determine needs without testing.

Once you test and determine the level of D from sunlight, food and
supplements that maintains optimum levels of vitamin D in your blood,
then you know the "dose" that you will need as long as you live at
that altitude and latitude. You should test twice a year as in many
locations the need for D may vary greatly from summer to winter.

For detailed information visit my website sunlightandvitamind.com

---------------------------------------------------------------------

Vitamin D Update--A Warning, Fall 2002
--------------------------------------

Note: This update appeared in Wise Traditions in Food, Farming and the
Healing Arts, the quarterly magazine of the Weston A. Price
Foundation, Fall 2002.

I have reported in this magazine on the substantial benefits that can
be gained from vitamin D therapy (Wise Traditions, Fall 2000).
However, my own clinical experience and the research of others is
clearly showing chronic subclinical vitamin D toxicity is possible,
from both supplements or tropical sunlight. Elevated levels of serum
vitamin D can cause significant bone loss and calcification of soft
tissues.

If you are using supplements of vitamin D (natural or synthetic) or
are light skinned and have had significant sun exposure in tropical or
subtropical areas and haven't done so before, it is very important to
test your blood levels of D.

Optimal values of 25(OH)D are 40-50 ng/ml
Acceptable values of 25(OH)D are 35-55 ng/ml
Levels above 55 ng/ml will be toxic for some individuals.

There is no good reason to maintain levels of D in this higher range
and strong evidence showing potential harm.

You need to TEST. The correct test to order is 25(OH)D, also called
25-hydroxyvitamin D. Make sure this is the test you get. Labs often
give the test for 1,25-dihydroxyvitamin D, the active hormone. This
test is the wrong test as it offers no meaningful data regarding D
status.

Lab One offers the least expensive testing I have found nationwide and
is available in most states. Your physician can reach them at
1-800-646-7788. The test is 25-hydroxyvitamin D. The Lab One test
number, just to be sure you get the right test, is #3247. Rarely does
insurance cover the cost for this test, which is about $60 including
lab fees. Other labs I have queried charge $100-180 for the same test.

The important thing to remember if you are doing vitamin D therapy, or
spending lots of time in the sun, is to TEST!

---------------------------------------------------------------------

Instructions for physician monitoring of vitamin D, calcium and
magnesium repletion are available from www.sunlightandvitamind.com or
by contacting Krispin at krispin (at) krispin.com or 1-415-488-9636.

This article appeared in Wise Traditions in Food, Farming and the
Healing Arts, the quarterly magazine of the Weston A. Price
Foundation, Fall 2000.

About the Author

Krispin SullivanKrispin Sullivan, CN, is a Clinical Nutritionist in
private practice in California. She has been practicing Clinical
Nutrition since 1968. In 1988 she received her certification and
licensing from the National Institute of Nutrition Education. She is
licensed to teach nutrition in California post-secondary schools and
is a frequent lecturer at schools, community centers, hospitals and
medical centers. She has written the book, Naked at Noon,
Understanding Sunlight and Vitamin D and is working on her second book
about fertility, pregnancy, nursing, and nutrition.

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feedSubscribe to this comment's feed Deficient
written by ThursdaysAngel, Mar 03 2010
Fantastic article! I have been researching this pretty extensively
because my Dr. said I am deficient in Vitamin D. My first results were
Total Vitamin D - 14 and Total D2 -

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written by Victoria, Feb 27 2010
Wow! Thanks for a great article, "The Miracle of Vitamin D". Your
article was by far the best I found on the subject. I was just told I
have a deficiency (9 on the blood test.) I'll use this data to
supplement wisely between now and my next test. Thanks again!

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