Are you low in the Sunshine Vitamin?

As we head into the cooler months here in Australia, vitamin D is front and centre in my mind as a complementary healthcare professional - primarily due to its important role in maintaining healthy immune function.

It is estimated that around one in every three Australian adults may have a mild, moderate or even severe vitamin D deficiency, yet when it comes to conventional healthcare and screening, I often hear the dismissive comment that “most people are deficient anyway, so why bother testing”… but who is telling most people to go and get a vitamin D supplement to maintain their levels, especially through winter? Plus, if your levels are super low, you may need higher doses of vitamin D supplements initially in order to restore levels faster.

One of my biggest health gripes is that vitamin D is so important for our wellbeing and yet there is an absolute lack of public health messaging to advise the general population to do anything about this common deficiency. It is such a missed opportunity for both everyday wellbeing and preventative healthcare.

Have your levels actually been tested?

Vitamin D is generally not routinely screened in Australia unless there is a significant indication to test it. This is largely because Medicare tightened up on vitamin D testing criteria back in 2014.

WHY IS VITAMIN D IMPORTANT?

Vitamin D is important for many bodily functions, but is most renowned for its role in bone health and maintaining bone density. Not to be underestimated though, vitamin D is considered to act as a pro-hormone that enhances the function of the immune, cardiovascular and endocrine systems and is also linked with health outcomes in the areas of metabolic health, mood and pain.

SIGNS AND Symptoms of Vitamin D Deficiency

Symptoms of vitamin D deficiency are often hard to spot because they can overlap with many other nutrient deficiencies and conditions. If symptoms do present, they may include fatigue, muscle pain, low mood, hair loss and increased susceptibility to bacterial and viral infections. Deficiency is also linked with cardiovascular issues and increased risk of cancer, as well as bone density concerns including osteopenia, osteoporosis and increased risk of fracture. Low vitamin D commonly presents in correlation with many autoimmune conditions too.

WHO’S MOST AT RISK?

You may have an increased risk of vitamin D deficiency if you are elderly, obese, avoid the sun, wear clothing that covers the skin extensively, or have a darker skin tone. If you have liver or kidney disease, this may also impact vitamin D conversion and lead to lower levels.

In humans: cholesterol

+

sunlight exposure

= cholecalciferol

(vitamin D3)

Vitamin D production via Sunlight exposure

Vitamin D is made from cholesterol when the skin is exposed to sunlight and then further converted to its active form via the liver and kidneys. Even with adequate sun exposure to the skin, additional factors such as magnesium deficiency, genetic variations, liver and kidney issues can negatively impact vitamin D conversion in the body and are some additional considerations if you have persistent low levels despite sufficient sun exposure.

You can use an app like D-Minder to estimate the best times to convert vitamin D from the sun in your location, as variables such as the angle of the sun at different times of the year will impact how much vitamin D can be produced via sun exposure. The Healthy Bones Australia website also has some great information about safe sun exposure and vitamin D, with easy to understand infographics.

FOOD SOURCES OF VITAMIN D

We can consume vitamin D3 (cholecalciferol) via some animal foods such as salmon, sardines, mackerel, tuna, eggs, Swiss cheese and butter. Cod liver oil is also a source of vitamin D3.

Vitamin D2 (ergocalciferol) is found in some mushrooms. It is made from ergosterol on exposure to sunlight, which is similar to cholesterol (notice they both end in ‘sterol’). Shiitake mushrooms have also been found to produce vitamin D3. Placing mushrooms in the sun, gill-side up increases the surface area exposed and is more effective at increasing levels. Try sunbathing your mushrooms for 15 minutes to increase vitamin D content. You may have even seen prepackaged mushrooms at the supermarket labelled ‘vitamin D mushrooms’ - these have been exposed UV light to increase their vitamin D content.

Mushroom magic: in m

ushrooms: ergosterol +

sunlight = ergocalciferol (D2).

Try sunbathing your mushrooms gill side up for 15 minutes to increase their vitamin D content!

CAN WE GET ENOUGH VITAMIN D FROM FOOD?

It is unlikely that you’ll get adequate vitamin D from food sources alone. It is estimated that approximately 90% of bioavailable D3 in the body is produced via exposure to UVB rays from the sun.

Get it Checked

You must be proactive when it comes to your vitamin D status, as it takes time to restore levels. It is important to understand your risk factors, check your current levels, consider whether you can realistically convert enough naturally via sunlight exposure and then determine an appropriate supplemental form & dose if required for repletion or maintenance.

You may have seen that self-test kits for nutrients like vitamin D have recently become available at your local supermarket or pharmacy. They may be a cheaper option than going in for a proper blood test, but keep in mind that they generally don’t tell you your actual level - just an indication of whether you are ‘deficient’, ‘insufficient’, or ‘sufficient’. If you want to take matters into your own hands and get a proper blood test, you can opt to order and pay for your own testing through online services like iScreen or iMedical, or arrange a private referral through your Naturopath.

Supplements

Standard supplements are usually in the form of vitamin D3 (cholecalciferol), although occasionally you will see a vegan/mushroom vitamin D2 via online sellers. In Australia our supplements are usually measured in international units (IU), however vitamin D may also be referred to in micrograms (mcg or μg) in other countries, which can be confusing! For reference: 1mcg = 40IU.

Recently we have also seen the introduction of an activated vitamin D (calcifediol) available via practitioner prescription. This form bypasses the liver and kidney activation steps and may restore levels more rapidly. In other cases where gastrointestinal absorption may be impaired (such as inflammatory bowel disease, Coeliac disease or in those who’ve had gastrointestinal surgery removing part of the small intestine), it may be appropriate to opt for a spray or liposomal form that is absorbed via the oral membranes inside the mouth.

As your practitioner, I will assess your blood test results, health status and risk factors to determine which form and dose is best for you.

Did you know…

Most vitamin D supplements are derived from lanolin - yep, that waxy substance found in sheep’s wool! Vegan vitamin D supplements are usually from an algae source.

UNSURE ABOUT YOUR your vitamin D levels?

If you’re wondering what blood tests to get, how to read them for optimal ranges and which supplements are best suited to you - book your appointment for personalised advice and a tailored treatment plan from Mel!