You might have an idea why vitamin D could be considered “Best Winter Biohack”. I define biohack as the single most important health intervention, with the most tremendous benefits, that can be easily implemented at any one time.
Optimising our Vitamin D status during the cold months is definitely one hell of a biohack: vitamin D is required for the performance of almost every cell type in our body (neurons, cardiac cells, immune system cells, muscle cells etc) and low blood levels of this nutrient can result in anything from depression, anxiety, low energy, decreased immunity, disturbed sleep, to weak, brittle bones & poor muscle function, as well as paving the way to a host of chronic illnesses since vitamin D modulates the behaviour of over 3,000 genes in our body and is key for the stability of our entire genome.
If you want to perform at your best, you need to check your vitamin D status and make sure you’re always in the sweet range of optimum serum vitamin D levels. Which is what this article is all about so please read on.
How’s your D status?
Let’s see: your vitamin D status depends primarily on the production of vitamin D3 in the skin under the influence of ultraviolet radiation (UV-B). Apart from sunshine exposure, other factors that play a role are: skin-covering clothes, the use of sun block, skin pigmentation, the amount of cholesterol in the skin, ozone depletion, urban pollution, and most importantly, latitude.
Let’s take Berlin as an example: it’s winter, we’re being deprived of sunshine for months on end and even if we had sunny days, we still wouldn’t be able to synthesise any vitamin D in our skin due to the latitude we live in. According to this Harvard source, if you live north of the line connecting San Francisco (37.7749° N) to Philadelphia (39.9526° N) and Athens (37.9838° N) to Beijing (40.2374° N), odds are that you don’t get enough vitamin D. Berlin is at 52.5200° N and London at 51.5074° N. This means no sun-derived Vitamin D production until April at least. Many studies show that several life-threatening chronic conditions such as cancer, cardiovascular diseases, and diabetes mellitus increase with increasing latitude, hence the importance of checking your vitamin D status regularly.
No matter where you live though, study after study show that vitamin D deficiency is a global phenomenon. Worldwide, an estimated 1 billion people have inadequate levels of vitamin D in their blood, and deficiencies can be found in all ethnicities and age groups. This article published in JAMA tested an urban sample of healthy young adults in the US for vitamin D status and the majority were found to be severely deficient.
The UK doesn’t fare much better. This study concluded that ” the prevalence of hypovitaminosis D in the general UK population was alarmingly high during the winter and spring, which warrants action at a population level rather than at a risk group level”.
As to how vitamin D-optimised we are in Germany, this study done at University Medical Center Hamburg-Eppendorf detected vitamin D deficiency–associated bone mineralization defects in a cohort of 675 healthy German adults (“healthy” in this context means they didn’t have a clue they had a problem). This study showed that vitamin D deficiency is a major public health issue in Germany due to the fact that:
- overall solar exposure is not sufficient to synthesise 25(OH)D from 7-dehydrocholesterol in Germany
- even in summer, there is insufficient solar exposure in Germany to synthesis enough 25(OH)D in the skin
- Germany, unlike the situation in the US, UK & the Scandinavian countries, it is largely prohibited to fortify food with vitamin D
The Risks of Developing a Vitamin D Deficiency
Vitamin D’s role in the body cannot be overemphasised and research conducted over the past decade suggests that this essential nutrient actually plays a much broader disease-fighting role than once thought.
Before we proceed, a small clarification: there are two forms of vitamin D, D3 (or cholecalciferol, the sun-derived form also found in oily fish) and D2 (or ergocalciferol, the plant-derived, weaker form). For many reasons that this article explains in detail, you want D3, not D2, especially when it comes to supplementation. Also, whenever I mention vitamin D throughout this article, I’m basically referring to D3.
To give you just a quick lowdown on its many health implications: vitamin D is more of a hormone than a regular vitamin and it determines the behaviour of an astounding number of genes in the human body, modulating gene transcription factors which result in either the induction or repression of specific messenger RNAs (Source). Judging by the fact that there are D3 receptors almost everywhere in the body (in diverse tissues such as brain, pancreas, pituitary, skin, muscle, placenta, immune cells and parathyroid), we can safely conclude that a vitamin D deficiency could be implicated in just about any disease.
More to the point, here’s a list of conditions associated with low vitamin D status in observational studies, according to this literature review published in BMJ (2016;355:i6201):
- Cardiovascular—Myocardial infarction, ischaemic heart disease, congestive heart failure, hypertension, venous thromboembolism
- Gastrointestinal—Inflammatory bowel disease, chronic pancreatitis
- Infection—Infections, sepsis, hepatitis C
- Metabolic—Type 1 and type 2 diabetes, obesity, metabolic syndrome, dyslipidaemia
- Mortality—All-cause mortality, cardiovascular mortality, cancer mortality
- Musculoskeletal—All fractures, hip fractures, falls, osteoarthritis, rheumatoid arthritis, muscle strength, physical performance
- Neurological—Multiple sclerosis, Alzheimer’s disease, cognitive decline, Parkinson’s disease, mood disorders and depression
- Pregnancy related—Gestational diabetes, pre-eclampsia
- Respiratory—Respiratory infections, tuberculosis, lung function, asthma, bronchiectasis
- Cancer—Breast cancer, colorectal cancer
At the same time, clinical research shows that optimising Vitamin D levels is a possible preventive factor for a wide array of chronic diseases, including cardiovascular disease, various cancers, type 2 diabetes, multiple sclerosis and other autoimmune diseases, chronic obstructive pulmonary disease, as well as such as and the bone demineralisation that leads to osteoporosis (which can occur in young adults as well, osteoporosis is not a disease of old age as you might think!).
As an aside, almost any deficiency of any of the micronutrients (folic acid, Vitamin B12, Vitamin B6, niacin, Vitamin C, Vitamin E, iron, or zinc) is bad news in that it damages DNA by causing single- and double-strand breaks, oxidative lesions, or both (for more info, this article highlights the connection between micronutrient deficiencies and cancer).
But back to vitamin D…To sum it all up, vitamin D is critical for the health of your brain, heart, immune system and the stability of your genome as this article points out. Now to the question that’s probably on your mind right now…
Are You Vitamin D Deficient?
If you live in Berlin or anywhere at a high latitude, there is a very high probability that you are.But I wouldn’t advise you to start taking supplements randomly, without knowing the right dose for you or how long you need to supplement for in order to optimise your D levels.
My recommendation is that you do a test for serum vitamin D status first. And you don’t even have to run to the doctor: home tests using capillary blood instead of venous blood are accurate, easy to use and good value for money. At the moment I’m negotiating with various test providers and supplement companies to get everyone at Factory Berlin a handsome discount. If you’re not part of this community, I’m still able to help so do get in touch.
Vitamin D Supplementation – How much?
For some time there was quite a bit of scientific debate as to how much vitamin D people need each day and this 300- page Health Report for the UK Gov gives you the rationale behind general recommendations.
Suffice it to say that in 2010 The Institute of Medicine recommended tripling the daily vitamin D intake for children and adults in the U.S. and Canada to 600 IU per day. The report also recognised the safety of vitamin D by increasing the upper limit from 2,000 to 4,000 IU per day and acknowledged that even at 4,000 IU per day, there was no good evidence of harm.
Still, according to functional medicine practitioners who are concerned with optimal health, even the new guidelines are overly conservative about the ideal intake as they don’t give enough weight to some of the latest science on vitamin D and health. For optimum health and chronic disease prevention, most people probably need more vitamin D than what the official guidelines recommend.
Dr. Heaney, who has been doing vitamin D research for over 40 years, explains the difference between conventional requirements (RDI – Recommended Daily Intake) and optimal levels of nutrients: “These requirements are the least you can get by on without overtly developing a disease. But if you take an approach based on physiology, you end up with different numbers”.
He also states: “Every minute of every day, our cellular machinery is constantly renewing itself […] but without vitamin D, the cell cannot access the information in its own DNA library […] because part of the apparatus that opens up the genome is the active form of vitamin D”. Click here for an interview with Dr Heaney for more info.
Also, when taking a vitamin D supplement, it is important to boost your intake of vitamin K2 through diet or a supplement.
What Is Your Optimal Vitamin D Status?
We all vary in our needs for vitamin D and one answer as to how much we personally need is in our genes.
Research shows that variations in the CYP2R1 and GC genes can affect your risk for low circulating 25-hydroxy vitamin D. This is by the way the form of vitamin D that serum Vitamin D tests measure.
How does this genetic influence happen? In short, the CYP2R1 encodes for an enzyme that activates vitamin D from its pre-formed type and turns it into a metabolically active compound. A certain variant of this gene does a much poorer job and has been associated with an increased risk of low circulating levels of vitamin D. In other words, two people with the same sun exposure and dietary intake of vitamin D will have different levels of circulating vitamin D in their blood, depending on which gene variant they possess.
The GC gene on the other hand encodes the vitamin D-binding protein, a molecule that binds vitamin D and transports it to tissues. Similarly, a variant of this gene has been associated with an increased risk of low circulating levels of vitamin D.
This genetic information comes as part of your Nutrigenomix Test, and when combined with the results of your serum vitamin D test, will give you the most personalised recommendation as far as this vital nutrient is concerned.
Why You Should Do a Serum Vitamin D Test First
Because it’s always better to know where you stand health-wise, rather than guess. We live in the 21st century and we have amazing medical technology at our disposal, why not take advantage of it?
Another reason to do a test first concerns your finances. While the medical evidence says you don’t need to worry about vitamin D toxicity at supplementation levels below 30,000 (IU) a day, it is important to test your Vitamin D levels in order to make sure you’re only supplementing the right amount and not wasting your money on unnecessary supplements.
This research study indicates that the optimum range of Vitamin D, for both health maintenance and prevention of disease, is between 60-80ng/ml. Thus if your test indicates a value in this range you don’t need to supplement at all.
If your vitamin D value is lower than the optimum range, the exact value shown by the test will determine your personal vitamin D intake necessary to reach the desired range.
Dr Mercola mentions research by GrassrootsHealth with the suggestion that adults need about 8,000 IUs per day to achieve a serum level of 40 ng/ml and refers to these ranges for diagnosing deficiency and excess.
So how do we calculate exactly how much you need based on your vitamin D test? It’s easy: we know that the lower your starting value is, the more vitamin D will be absorbed from the intestines. The same study shows that, at a starting value of 10ng/ml, the mean increment that would be expected to be produced by an additional 1,000IU/d is 11ng/ml, whereas at 30 ng/ml it is 8ng/ml, and at 50ng/ml, it is only 5ng/ml.
Therefore we can calculate with precision the exact level of supplementation you need. This is how personalised nutrition works: instead of supplementing at random with nutrients that are “good for you” based on general recommendations, we can find out exactly the right amount for you, saving you money and also providing more certainty: you will now know for sure if vitamin D deficiency is one of the reasons you’re not feeling that great or if you need to look elsewhere for what might be wrong.
The best current test for vitamin D status is serum 25-hydroxyvitamin D. A 25-hydroxyvitamin D level <25 nmol/L is classified as vitamin D deficiency. Classifications of vitamin D sufficiency vary, ranging from ≥50 nmol/L to ≥80 nmol/L.
The Antioxidant Club Runs OPTIMISED – A New Health Awareness Campaign
As a registered nutritional therapist, I can offer you both genetic testing and serum vitamin D tests at best prices.
If you’d like to take advantage of this Health Initiative and get personalised health advice about your vitamin D requirement as well as benefit from discounts on tests and supplements, do get in touch by email at firstname.lastname@example.org
And check out this useful VITAMIN D TRACKING APP: it tells you how many units of vitamin D you’re making and when to get out of the sun to avoid burning. Don’t forget UVA blocks vitamin D production in the skin so it’s not smart to stay in the sun for too long. If you live in Berlin, don’t hold your breath, no vitamin D production in the skin until April!!
More Facts about Vitamin D3 (cholecalciferol)
- a lipid soluble vitamin that acts as a hormone (it is a steroid hormone precursor)
- synthesised when skin is exposed to ultraviolet B radiation
- dietary sources are limited and include oily fish, egg yolk, red meat, liver
- it stimulates intestinal calcium absorption and is important in maintaining adequate phosphate levels for bone mineralization, bone growth, and remodelling
- it is involved in the regulation of cell growth proliferation and apoptosis (programmed cell death)
- it is involved in the modulation of the immune system and other functions
- in adults, severe vitamin D deficiency can cause osteomalacia: a syndrome of impaired bone mineralisation, bone fragility, and proximal myopathy
More about Individual Variation in Our Vitamin D Requirements
This article in The Journal of Steroid Biochemistry and Molecular Biology talks about the concept of the personal vitamin D response index which describes the efficiency of the molecular response to supplementation with vitamin D.
The concept is based on the fact that vitamin D3activates (via its metabolite 1α,25-dihydroxyvitamin D3) the transcription factor vitamin D receptor and thus has a direct effect on the epigenome and transcriptome of many human tissues and cell types (epigenome & transcriptome basically refer to the regulation of genetic expression based on external factors, such as vitamin D in this case).
Thus, individuals can be distinguished into high, mid and low responders to vitamin D via measuring vitamin D sensitive molecular parameters, such as changes in the epigenetic status and the respective transcription of genes of mobile immune cells from blood or the level of proteins or metabolites in serum.
Darker Skin Pigmentation – Are You More at Risk?
Recent research indicates that skin pigmentation does not appear to negatively affect vitamin D status: while racial pigmentation has a photoprotective effect, it does not prevent the generation of normal levels of active vitamin D metabolites. Persons with dark skin also compensate for low 25(OH)D by rapidly converting it to the active 1,25(OH)2D metabolite, thus allowing them to maintain adequate vitamin D status.
Light Therapy for SAD?
Seasonal affective disorder (SAD) describes a subtype of major depression which has a seasonal pattern (usually winter depression and remission or hypomania during spring and summer). It includes atypical symptoms such as hypersomnia, carbohydrate craving and weight gain.
This clinical review about SAD mentions 20 randomised controlled trials that compared light therapy (ranging from 176 lux to 15 000 lux daily) with waiting list control management, “attentional” control (eg, sham light box), or active treatment controls (eg, cognitive behavioural therapy [CBT], fluoxetine). Light therapy showed superior effectiveness, however this was questioned as being “more than a placebo effect”. What is more worrying is the list of unwanted effects of light therapy: eye strain or visual disturbances (in 19-27% of patients), headache (13-21%), agitation (6-13%), nausea (7%), sweating (7%) and sedation (6-7%).
Cities, Latitudes and Your Risk of Vitamin D deficiency
As an idea, the rule of thumb goes: if you live north of the line connecting San Francisco to Philadelphia and Athens to Beijing (above 40° N), odds are that you don’t get enough vitamin D, according to this Harvard source.
However, living below 40° N doesn’t guarantee your vitamin D status is optimal, either due to lifestyle factors (such as 9-5 office-based jobs or indoor living) or due to poor overall health. The latest thinking on the pandemic of low 25(OH)D is that this is a consequence of chronic disease processes, provoked by persistent intracellular infection and chronic systemic inflammation, rather than the cause. Either way, having low vitamin D levels is bad news, and you would be wise to have yours checked.
Here’s a list of cities above 40° N:
|39°55′N||116°23′E||Beijing||N/A||People’s Republic of China|