The Importance of Vitamin D


The importance of Vitamin D’s function is becoming more and more evident with current research.

We were taught, at one time, that the only purpose of Vitamin D was to increase the absorption of calcium from the intestines into the blood stream.  The increase of calcium blood levels would, in turn, increase bone density.

It was considered most important for post-menopausal women who are at increased risk of osteoporosis because of declining estrogen levels.

A lot of studies have been done over the last 20 years, and we now know that Vitamin D does much, much more.

One of the first studies that I remember hearing about as a young pharmacist was of Vitamin D given to elderly men to see if supplementation would also decrease bone fractures in them.

It turned out that it did, not because they had less fractures after a fall, but because they had less falls.

The study showed that men who took Vitamin D had more muscle tone and balance, and therefore had less falls.  Up to that point, no one ever thought there might be Vitamin D receptors on muscle.  And it turns out there is a lot we didn’t know about what Vitamin D does for our bodies.

What is Vitamin D?

This “vitamin” isn’t really a vitamin at all.  As a cholesterol-based molecule, it is more hormone-like.  In fact, much more like the sex hormones that are cholesterol based: testosterone, estrogen, and progesterone, for example.

Vitamin D isn’t generally a food-based supplement, although it can be found is small amounts in fatty foods like fish and egg yolks.

Most of the time we get Vitamin D when we spend time in the sun.  The UV light hits our skin and turns cholesterol stored under the skin to a Pre-Vitamin D3.  After several other steps in that metabolic pathway through the liver and kidney, the active form is available for the estimated 600+ enzymatic reactions it’s involved with.

What Does Vitamin D Do?

  • Increases bone density
  • Moderates DNA transcription
  • Decreases risk of viral infections including influenza
  • Decreases the risk of respiratory infections and asthma
  • Decreases allergies
  • Has been shown to have a moderate effect on depression and cognition
  • Decreases risk of autoimmune diseases such as Crohn’s, ulcerative colitis, multiple sclerosis, eczema
  • Increased serum levels are associated with a decreased risk of breast cancer and increased survival rate for breast cancer patients
  • Increased cardio-protective effects due to hypertension and other cardiovascular diseases, including heart failure, myocardial infarction, vasculopathy, stroke and diabetes.
  • Creating and supporting brain synapses
  • Much, much more.

Because Vitamin D is a hormone (not a vitamin), it acts as a hormone.  That is, it takes part in hormone signaling and metabolic pathways.  Less than optimal levels have strong associations with immune dysfunction and autoimmune conditions, higher cancer rates, higher rates of dementia and Alzheimer’s, decreased ability to fight infections, and some mental health disorders. 

Vitamin D supplementation should be a part of an over-all plan for dietary changes that allow for weight loss and disease reversal. 

Without the dietary changes, supplementing with Vitamin D to try to fix the above conditions is only trying to treat the symptoms.  Our goal is to treat causes, not symptoms, so dietary changes are foundational.

For more information on dietary changes that will decrease your risk of all diseases, you can read “Keto Diets: Healthy or Harmful?” and the related articles on a ketogenic diet.

Here’s what you need to know about Vitamin D supplementation:

Vitamin D Blood Serum Level Goals:

A few years ago, optimal serum levels were thought to be 30ng/ml.  The latest information shows that minimum serum blood levels should be 40ng/ml.  But sufficient levels and optimal levels aren’t the same thing.

For example, some doctors, trying to optimize levels for their cancer patients have a goal of 70ng/ml and above. 

Others, treating rheumatoid arthritis, have a goal of at least 50ng/ml.

A serum level of between 50-80ng/ml is a good goal for most people.

Supplemental dosing should not be based on recommended daily intake as much as serum blood levels.  In other words, you need to supplement according to what your serum blood levels are (not RDA).

So, of course, you need to have blood work done to know where you stand, and you have to get your levels checked periodically after beginning supplementation.  How much vitamin D you supplement with on a daily basis is dependent on how low your serum blood levels are.

Here’s a good rule of thumb for dosing once you know what your serum level is:  Take your goal number, let’s say 60ng/ml and subtract your current serum level, let’s say 20ng/ml.

Sixty minus 20ng/ml is 40ng/ml.  Multiply that number by 100: 40ng/ml x 100 = 4000 IU daily.

So, you would supplement at 4000 IU daily until your goal is reached.  You’ll only know if your goal is reached if you get you blood work done periodically—at least once a year.

Vitamin D Supplements:

If you are low (and most of us are), there are two options for supplementation: prescription Vitamin D2 (ergocalciferol), or OTC Vitamin D3 (cholecalciferol).

While doctors will be inclined to prescribe Vitamin D2, most people will not be able to efficiently convert prescription D2 to the more active D3.  Studies showing benefit from vitamin D are most often using D3; there are no clinical studies that show that Vitamin D2 supplementation decreases fracture risk.

Over-the-counter Vitamin D3 is fairly cheap, and very effective at raising serum blood levels.  As with all supplements, NEVER use synthetic versions, always natural.

How to Supplement:

When you take Vitamin D3, you will increase the amount of calcium that is absorbed into your blood stream.  That’s good, but it can cause some potential problems especially if you are also supplementing with calcium.

Too much serum calcium has been shown to cause calcification of soft tissues like carotid arteries.

To keep this from happening, it is necessary to also supplement with Vitamin K2 (NOT K1).  K2 causes the calcium to be directed into the bones rather than floating around in the blood, causing calcification of the soft tissues because of high blood calcium concentrations.

Magnesium is also necessary for proper Vitamin D3 function.  In a report released from the American Osteopathic Assoc, Feb. 26th, 2018, researchers cautioned,

“People are taking Vitamin D supplements but don’t realize how it gets metabolized. Without magnesium, Vitamin D is not really useful or safe.”

Without magnesium, Vitamin D tends to get stored in fat reserves in the body in its inactive form.  Magnesium seems to act as a co-factor for Vitamin D activity.

The Vitamin D Supplementation Plan

1) Get serum D levels checked,

2) Calculate your individual need for supplementation using the formula given above,

2) Use OTC Vitamin D3 as supplementation,

3) Take Vitamin K2 (as menaquinone 7 or MK-7 form) 50 to 100 mcg/day,

4) Take a magnesium supplement (which can also help many people with sleep).  For a more in-depth look at magnesium supplementation please read The Importance of Magnesium”,

5)  Take a calcium supplement 500 to 1200mg per day,

6)  Vitamins D and K are fat soluble vitamins, so take them with a fatty meal or your omega-3 supplements to aid in absorption,

Here’s to strong bones, soft arteries, and healthy immune systems!


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