Sunshine please come our way! Got Vitamin D?

As we head into the tenth month of a global pandemic, most of us are weary and even teary, but please don’t lose your way! We have learned a lot from this disease and have shown how adaptable we are as humans in the process. As the scientific community works on solutions to tackle this disease, you can become empowered to protect yourself and others, together. Working on your own personal stress, boosting your immune system and healing your body through exercise and proper nutrition (to reduce inflammation) are key factors in not becoming a statistic. Instead, you can then fight this disease with a calming strength & robust resiliency. Today I want to discuss a powerful “Vitamin” that you may reading about in mainstream media, it’s called Vitamin D. Are you one of those who avoids sun exposure to prevent skin cancer and wrinkles? Are you one who says “It’s Colorado and I get plenty of sun so I am sure my Vitamin D level is just fine”? Do you struggle with Allergies & Asthma? Are you concerned about your immunity and resiliency as we head into these Winter months? The Journal of the American Osteopathic Association estimated that nearly a billion people across the world may have insufficient or deficient levels of vitamin D!! Most of us know that Vitamin D is needed to absorb calcium to protect our bones, but it has been less publicly known for its role in supporting our immunity, until recently that is. With the onset of the COVID19 virus spread and the research coming out related to finding those who are at risk and have worsening disease progression than others, research has started to shine a light on the immunological benefits of Vitamin D and how it can protect us. I wrote to you about the key nutrients for your immunity back in March, but I wanted to take a “deeper dive” into Vitamin D and the many benefits you would enjoy in your health when you optimize your levels in your body. How do we get it? Sunlight and food! Unlike other vitamins, only about 10 percent of Vitamin D that the body needs can come from food, so the rest comes from the sun. The specific amount of time necessary to be spent in the sun hinges on one's idiosyncratic skin pigmentation and geographic location. Light skin synthesizes larger amounts of vitamin D than dark skin. Sunscreen with a sun protection factor (SPF) of 8 based on the UVB spectrum decreases vitamin D synthetic capacity by 95%, and SPF 15 decreases it by 98-99%. Therefore, one should not apply sunscreen during a 15-minute sun session, which should be meant to boost vitamin D levels. Of course, sunscreen is protective against harmful UV Rays and has helped reduce skin cancer risks and skin aging, however too much of a good thing is not a good thing either! Isn’t it all about balance? What is Vitamin D? Vitamin D is a fat-soluble secosteroid, which is considered a “prohormone”, not simply a Vitamin, as it has been named. Prohormones are substances that the body converts to other hormones in a natural process. Hormones are chemical substances that travel throughout the body and have a direct impact on tissues dependent on the Endocrine system for growth and development, energy production, metabolism, response to injury, stress, immunity and more. Vitamin D has receptors in areas such as the adrenals, bones, brain, breasts, colon, epididymis, hair follicles, intestines, lungs, muscles, the pituitary gland, parathyroid, testis, ovaries, uterus, thyroid and more!!! Vitamin D also regulates the functions of over 200 genes! There are two forms of vitamin D. Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Cholecalciferol is the naturally occurring form of vitamin D that is synthesized in the skin from endogenous exposure to sunlight or form dietary cholesterol and foods. How does it work? When Vitamin D is taken in from the sun, it is carried in the bloodstream to the liver, where it is metabolized and then converted into the prohormone calcifediol. Circulating calcifediol is then converted into calcitriol, the biologically active form of vitamin D. A secondary metabolic process then happens in the proximal renal tubules of the kidneys which converts Vitamin D to 1,25-dihydroxyvitamin D3, which is the active form of this hormone in the body. Now that Vitamin D is in its active form, which is called “calcitriol”, it then mediates its biological effects by binding to the Vitamin D receptor (VDR), which is principally located in the nuclei of target cells. Vitamin D has its effects by binding to a protein (called the vitamin D receptor). Just about every cell in the body has vitamin D receptors and it therefore affects many different body processes. This is precisely why vitamin D plays a vital role in the body's functions ranging from immune system functionality to the minimization of inflammation, cell growth modulation and beyond. Vitamin D receptor belongs to the nuclear receptor superfamily of steroid hormone receptors, and VDR’s are expressed by cells in most organs, including the brain, heart, skin, gonads, prostate and breast. The VDR activation in the intestine, bone, kidney and parathyroid gland leads to the maintenance of calcium and phosphorus levels in the blood to maintain proper bone content. Vitamin D deficiency has been linked to a variety of health concerns. For instance, too little vitamin D makes an individual more prone to infections and illness, cardiovascular disease, and mental illnesses, including mood disorders like Depression. Researchers have found that vitamin D helps regulate adrenaline, noradrenaline (also called norepinepherine), and dopamine production in the brain, as well as helping to protect from serotonin depletion. For this reason, low vitamin D levels increase an individual's risk of depression significantly. Studies also show that people who have low vitamin D levels are more likely to be obese, which we know is a risk factor for poor outcomes with COVID19 and other disease processes. How does it work on our immune system? The VDR regulates cell proliferation and differentiation (controls cancer cells) and it also affects the immune system. The VDR receptors are expressed in several white blood cells, including monocytes and activated T and B cells. Vitamin D functions to activate the innate immune system yet dampens the adaptive system with antibacterial, antiviral and anti-inflammatory effects. Vitamin D can inhibit pro-inflammatory pathways, including nuclear factor kappa B (NF-KB) and Interleukin-6 (IL-6) and tumor necrosis factor (TNF). It can also suppress and over exaggerated cytokine release storm that has been implicated in COVID19. VDR receptors also alter the transcription of genes into intracellular and systemic Ca2+ homeostasis and in proliferation of cells. (sorry a bit technical but necessary to understand how deep this nutrient goes in creating cellular changes in our body). Disease that can be treated with Vitamin D Allergies Asthma Autoimmune diseases Depression Diabetes Epilepsy Hypertension Inflammatory conditions Migraine headaches Musculoskeletal pain Osteoarthritis Osteoporosis/Osteopenia Polycystic ovary syndrome Functions in your body (to name a few) Aids in absorption of calcium from the intestinal tract Helps the body assimilate phosphorus Helps the pancreas release insulin Necessary for blood clotting Necessary for growth and development of bones and teeth Necessary for thyroid function Stimulates bone cell mineralization Inhibits pro-inflammatory pathways Benefits of Vitamin D Anti-Aging Cardiovascular Disease Cancer Immune Function Multiple Sclerosis Reduces bone fracture risk Parkinson’s and Alzheimer’s Diseases Causes of deficiency Aging (making less Vitamin D from sun) Decreased fat absorption (from medications and malabsorption in the gut for example) Fat-blocking medications and over-the –counter fat blockers used for weight loss Prednisone VDR genetic mutation affecting absorption Factors that may also reduce the amount of vitamin D an individual will synthesize from sunlight include the following7: • Living closer to the polar regions, particularly during winter months • Use of sunscreen • Darker skin pigmentation • High levels of air pollution • Dense cloud covering Treatment The Sun! The best way to get Vitamin D is to have 15 min every day (even 3x week is helpful) of unprotected sun to your arms and legs and don’t shower right away so it has time to absorb. If you have a VDR genetic SNP- you may not be able to absorb Vitamin D as easily and people tend to have much lower levels in their blood Food sources Canned Sardines Salmon (or similar fatty fish) Shrimp Butter (grass fed preferably) Beef Liver Sunflower seeds Liver Eggs (especially the yolk) Fortified milk Mushrooms (Portobello) Natural Cheese Supplementation This varies greatly per individual. I will give you estimations on dosing below, but truly testing is critical in managing your Vitamin D level and appropriate doses accordingly as too much of Vitamin D can become toxic. It is generally accepted that anything over 100 can be problematic and therefore the upper range should be just under 100. When supplementing, Vitamin D3 is the most biologically active form oppose to the ergocacliferol form (D2), which is the traditional western prescription form as well as used as a food additive in milk for example. Therefore, I personally recommend finding a professional strength Vitamin D3 for optimal absorption. Because it’s a fat soluble “vitamin”, it is best be taken with food and often the liquid sources are in an oil base. I also recommend finding one that has Vitamin K2 as well, as this Vitamin helps you take the calcium and shuttle it into bones instead of the arteries. The Recommended Daily Allowance of Vitamin D is daily 600 iu young adults and 800 iu older adults, however I rarely see that dose supportive enough to increase blood levels of Vitamin D to sufficient levels. Most adults need somewhere between 2000-5000 iu daily Children typically need 800-2000 iu Young adults typically need 2000 iu to 3000 iu daily These are simply averages so once again, testing is critical to know how much your body needs. Vitamin D overdose causes hypercalcemia (excessive calcium) which can lead to a loss of appetite, nausea, vomiting, insomnia, skin itching, increased thirst, urination and muscle cramping. If hypercalcemia is not treated, it can result in excess deposits of calcium in soft tissues and organs such as the kidneys, liver, and heart, resulting in organ damage. If you have kidney disease- you must discuss this with me or your PCP before optimizing your Vitamin D level. Also, if you have Hyperparathyroidism, you may be more sensitive to Vitamin D and develop hypercalcemia. It is always good to test for calcium (such as a CMP) at the same time of a Vitamin D test to be sure there is not excessive calcium in your blood. Vitamin D is best absorbed when you have proper Magnesium levels as well. Unfortunately, most of us are also deficient in Magnesium so make sure to eat Magnesium rich foods, which are; almonds, bananas, beans, broccoli, brown rice, cashews, egg yolk, fish oil, flaxseed, green vegetables, milk, mushrooms, other nuts, oatmeal, pumpkin seeds, sesame seeds, soybeans, sunflower seeds, sweet corn, tofu, and whole grains. If you replace Magnesium, typical dosing is based on your body weight in Kg x10 (example 150lb /2.2= 68kgx10=680mg per day Magnesium Glycinate is the best well rounded form of Magnesium November Monthly Special

Because we are entering into the “Cold & Flu” season and because we want to protect ourselves against COVID-19, I am also suggesting working hard over these next few months to get your levels therapeutic so you are prepared. I am suggesting Intramuscular Injections at our “Shot Bar” at a frequency of once per week for 4 weeks, then retesting your levels. 4 pack of Vitamin D 100,000 injections for $80! (normally $35 each and 4 pack is $140 so it’s a $60 saving) Testing I can provide a lab order for you, or you can order your own labs from certain companies if you pay cash. The reference range on blood testing is typically 30-100 ng/ml However, you need to aim for a level of at least over 50 but closer to 60-90 is best. Yes, blood testing is necessary as you can become “toxic” by this fat-soluble ‘Vitamin’. I test most clients when doing blood work, but here are some ideas to test on your own Vitamin D 25 Hydroxy (OH) is the basic and most common test At home finger prick- https://www.everlywell.com/products/vitamin-d-test/ $49 Life extension $47 blood draw https://www.lifeextension.com/lab-testing/itemlc081950/vitamin-d-25-hydroxy-blood-test May you feel the sunshine penetrate your skin and your spirit during these darker times and find the light within yourself to keep on keeping on! Yours in health and wellness, Carrie Ballas

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