Feature: Essential Elements: Vitamin D
Read Part One, about iron deficiency, in Vancouver Family Magazine’s September 2017 issue, available online at www.vancouverfamilymagazine.com/archive
ESS e NT I a L EL e M e NTS:
The Health Effects of Vitamin D Deficiency & Replacement Part Two of a Two-Part Series on Vitamin Deficiencies By Nikki Klock
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ast winter, Jennifer Prescott, of Vancouver, experienced a devastating miscarriage that left her depressed and fatigued. The fatigue, she had experienced before. As a college student, she had discovered she was dangerously low on iron and eventually found success with iron supplements. But the depression and new surge of lethargy felt severe enough to discuss with her doctor. “I thought [the fatigue and depression were] due to my miscarriage, and that was part of it. When I went to my primary care physician, he encouraged me to have some labs done.” The result of the labs? Prescott’s vitamin D level was extremely low. Physical and Mental Effects of Vitamin D “Vitamin D plays a role in many organ systems, including the skin, bones, brain, and heart,” says Dr. Omar Naji, a family medicine physician with PeaceHealth in Vancouver. Vitamin D also helps absorb calcium for optimal bone health, and reduces occurrence of the common cold and the flu. Conversely, Dr. Naji says, a lack of vitamin D has been attributed to fatigue, increased risk of bone fracture (especially distressing for the elderly), poor exercise performance, and a significant impact on people’s mood, including, in some cases, seasonal affective disorder, or SAD. SAD, according to WebMD, is a type of depression tied to changes in the seasons, and low vitamin D levels can increase this particular type of depression. “There are plenty of reasons to be sad in winter for sure,” says Dr. Sheryl Wagner, a naturopath with offices in Vancouver and Longview, “but when a person has optimal vitamin D, their neurotransmitters—chemical messengers in the brain responsible for mood—are more stable. Vitamin D helps make dopamine and then norepinephrine, which are your neurotransmitters associated with reward and attention respectively.” Supplementing Vitamin D Because vitamin D helps with such a variety of bodily functions, acquiring it through fortified food, appropriate sun exposure on the skin, and vitamin supplements is vital. “Foods do not contain high amounts of vitamin D unless they are fortified,” says Dr. Wagner.
“Most of the foods that are labeled as containing vitamin D have been fortified. But foods that naturally contain vitamin D are fish, liver, egg yolk, shitake mushrooms and milk products, though milk has also been fortified with more.” For additional boosts of vitamin D, supplements are available either over the counter or in prescription doses. “There are a couple of options for vitamin D supplements: vitamin D2 and vitamin D3,” says Dr. Naji. “Most experts agree there are advantages to using D3 which is the active form. It can be found in varied doses over the counter, but when vitamin D deficiency is diagnosed, it is often prescribed in stronger doses for 8-12 weeks until levels are restored. After normalizing levels, the liver will usually manage to keep the levels in normal ranges if lower doses are used for maintenance.” Prescott’s experience followed this pattern. She started out on a prescribed high dosage of vitamin D, and after 12 weeks was able to switch to the over-the-counter supplement level. Finding the right dosage with the help of a health care provider is important, as, in rare cases, too much vitamin D can cause calcium deposits in soft tissues. Sun Seeking Foods and supplements for increasing vitamin D levels can be simple enough, but the sun exposure can be difficult to find while living in our corner of the Pacific Northwest, where we see precipitation about a third of the time in an average year, and dry cloud cover more than that. Prescott has found that simple ways of letting in the light make a big difference. “I like to take a short walk every day, just to get even a little bit of sunshine,” she says. “I also noticed that I feel better when I make sure to open the blinds in my house and my office at work.” Light therapy (also called phototherapy) is another option for sun seekers. “Commercially available light therapy devices have clinically shown to help with SAD,” says Dr. Naji. He is quick to recommend the guidance of a health care provider in using these devices, as some types of light such as ultraviolet light, full-spectrum light, and light from heat lamps or tanning beds can be ineffective, and even dangerous if used improperly. The use of sunscreen is an important part of continued on page 19
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Vancouver Family Magazine • www.vancouverfamilymagazine.com • October 2017