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Super D to the Rescue. A Vitamin or Superhero?

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July 30, 2008
	Dr. Gary Huber : Head Medical Ego

No, Super D is not the newest rap artist, Super D is vitamin D and it’s one of the hottest topics in medicine right now.  This plain ol’ vitamin by day has been turned into a superhero overnight.  In fact it has been given a promotion from “vitamin” to “pro-hormone.”  Vitamins are great and they work as co-enzymes in hundreds of biochemical reactions in our body but a hormone actually enters cells and strolls right up to the cells DNA and starts shouting orders.  Vitamin D is able to turn genes off and on, which is part of what makes it a superstar.  For example you may have family history of cancer but if your vitamin D stores are adequate then it can affect your gene expression and impact cell growth, differentiation, and apoptosis (cell death) which may prevent a cancer cell from ever turning into a tumor.  On top of that it can affect active cancer cells and by promoting your immune system, aggressively attacks active cancer.

Allow me to back up just a bit to give you the bigger picture.  One of the features that makes vitamin D a pro-hormone is the fact that we actually make vitamin D.  When ultraviolet B light from the sun touches our skin we convert 7-dehydrocholesterol into cholecalciferol or D3.  So yes, that 7-dehydroCHOLESTEROL is made from cholesterol that our liver produces, which is a reminder that not all cholesterol is bad (a topic for another day).  We can also eat vitamin D3, which primarily comes from one source, fish, who get it from eating algae which is a plant that like us, makes D3 when exposed to the sun.  Now here is where it gets interesting.  If we don’t get enough vitamin D3 from our diet or from sun exposure then the little bit we have is used up just trying to manage our calcium absorption and bone development.  Without adequate vitamin D stores we can only absorb about 10 to 15% of all the calcium that goes through our digestive tract.  So if you are spending your money on calcium supplements to get that ever precious 1200mg of calcium to save your bones then you may be wasting your time if the D3 is not there.  But back to my point . . . If your lowly vitamin D stores are occupied just managing the whole ‘bone thing’ then there is not enough to go around and you won’t get all of the other fabulous benefits that D3 has to offer.

Vitamin D acts as an immune modulator and can help balance an overactive immune system which is the real problem behind all of the autoimmune disorders such as rheumatoid arthritis, lupus, type 1 diabetes, multiple sclerosis, and psoriasis.  It can even help prevent organ transplant rejection.  It aids type 2 diabetes by making the insulin receptors more sensitive.  It has been shown to reduce the risk of heart disease by slowing the rate of coronary artery calcification.  It is a vital component in soft tissue regeneration and repair of tendon, ligament and cartilage injury.  And of course it helps you avoid osteoporosis and osteopenia.  As stated above it is also a cancer killer and has been shown in studies to have an impressive impact on colon, breast and prostate cancer.  All this and more . . . BUT . . .  (and this is a big BUT) you will not receive any of these benefits if your level of D3 is in the bare minimum range.  There has to be enough left over after calcium and bone management to spill over into these other areas.

In my office we measure everyone’s vitamin D levels and we find that 90% of our patients are deficient in vitamin D.  The lab range for “normal” is between 20 and 100, and we find most people are in the 15 to 25 range.  Some will be lucky enough to be at 35 or so and less than 1% are actually at 50.  Guess what the ideal level is . . . go ahead . . . guess!  Studies are showing that the full compliment of benefits from D3 are not present unless you get the level up to approximately 50.  And don’t forget what “RDA” stands for “Really Dumb Advice.”  So what should you do?

If you are fair skinned, scantily clad, young, standing at the equator and not wearing sun screen then your body will make 20,000 units of vitamin D in about 20 minutes. I don’t know about you but I don’t meet any of the above criteria and I do not look good in a thong. So for the rest of us, here is my personal recommendation.  First of all if you put on a sunblock lotion with an SPF of 8 (and most of you use a 30) it will block 95% of the UVB rays from the sun that you need to make you skin produce D3. So if you are going outside for less than one hour I do NOT recommend sun screen.  If you are going to be out for more than one hour then by all means wear your sunscreen.  Here’s a fun fact.  Adequate D3 has been shown to reduce the risk of skin cancer and you can’t make D3 if you are wearing sunblock. Your dermatologist will have a fit if you show her this newsletter, but I speak the truth.

Your other very intelligent option is to take vitamin D3 every day AND get your blood level checked. Any doctor and any lab can do this test, it is very simple and straightforward. Have your doctor check your level, if it is around 20 then take 5000 IU of vitamin D3 once a day and recheck it in one month. If it is still below 50 then take 2000 to 5000 more units and recheck a level in another 30 days. The toxic dose is around 50,000 IU per day and I have frequently given 20,000 units per day to prostate patients (for short periods of time) and had exceptional results. Enlarged prostates respond very well to large doses of vitamin D.

Finals notes and caution: vitamin D3 is a fat soluble vitamin and can be toxic at high levels so act responsibly and get your blood level checked, don’t just start gobbling D3 blindly. Secondly, as you go outdoors more in the summer your need for vitamin D will be less so realize that the dose you take now may need to increase once the fall winds begin to blow and you head back indoors.  And for those of you that want to eat your vitamin D naturally and avoid supplements then be prepared to swallow 4 tablespoons of cod liver oil a day to get 5000 units, or eat 48 ounces of whole salmon per day, or 250 whole eggs. I feel full (and a little gassy). Final caution:  sarcoid patients need to be very careful with vitamin D as they tend to over produce it.  If you have not been diagnosed with sarcoidosis then party on.