The Dr. Su Series: Vitamin D

The Dr. Su Series: Vitamin D - Under the Monkey Bars

By guest blogger Dr. Mark Su

As our summer draws to a close (commence the tears and sobbing), you might be wondering whether vitamin D is an ill-timed topic to discuss. Surprisingly, it’s not. Vitamin D is actually a year round challenge for most of us.

Vitamins by definition are beneficial and necessary components in our body’s every day cellular functions. Uniquely, we can make vitamin D via sunlight exposure; the sun’s rays activate enzymes in our skin to generate it for our bodies. But the amount of vitamin D generated is rarely sufficient. We tend to highly overvalue the benefit of the sun exposure we receive from the summertime, much less from seasonal time spent outdoors gardening, walking, or doing other activities. 

Dr. Michael Holick of Boston University is a premier global expert on vitamin D. I once heard him say that it’s not simply a matter of the quantity of time we spend in the sun. Dr. Holick suspects that given the United States’ location on the earth, that the direction of the sun rays may play a role in further inhibiting us from effectively having enough sun exposure to generate sufficient vitamin D. Add in genetic factors and other known or unknown biochemical processes in the manipulation of vitamin D in our body, and the end result is simply that sun exposure alone is inadequate.

The benefits of vitamin D are many-fold. Conventional medicine has historically supported its benefits for bone health, in that vitamin D enables nutritional calcium absorption. Over time, I’ve seen the conventional medical community progressively embrace other touted benefits, including an enhanced immune system, heart health protection, effects on muscles, reducing one’s risk for illnesses (like diabetes, rheumatoid arthritis, and multiple sclerosis), and even certain forms of cancer. No doubt, much research still needs to be done, but given the extremely minimal downsides of taking vitamin D compared to the significant upsides, I advocate to my patients that a vitamin D deficiency is a no-brainer to address.

The “normal” reference range for vitamin D is a level greater than 32. Those who I consider more “in the know” all agree we should aim for a level of at least 50. For individuals with a stronger cancer family health profile, we would recommend perhaps even 70. My professional observation is that in the New England area the typical individual has a level of about 25. 

What does it take to get up to the preferred level of 50? A prescription level of 50,000 IU of vitamin D ingested twice a week for at least 12 weeks, sometimes more. I usually recheck a level after those 12 weeks. If you don’t have access to prescription dosing, I would usually suggest 10,000 IU of vitamin D daily, which would require at least 15 weeks to reach that same end goal. Once the optimal level is achieved, a maintenance dosing is required to keep that level in the proper range-usually that requires 2000 IU per day, sometimes more.

While toxicity is academically possible, it is quite uncommon to rare. Nonetheless, I suggest medical supervision for vitamin D level testing; most doctors are willing to do so for their patients. There are testing kits available through trusted online companies as well, including a partnering lab with the Vitamin D Council non-profit organization. 

Vitamin K2 is a newer finding that becomes an even more important subject with the awareness of vitamin D, and optimizing the latter in our bodies. We’ll talk more about that another time in the Dr. Su Series. Until then, thanks for reading and be sure to get your vitamin D levels checked!

Mark Su, MD is a graduate of Cornell University and Indiana University School of Medicine. He was later the Academic Chief Resident at Tufts University in Boston and received the national Mead-Johnson Award for outstanding scholastic performance in a Family Medicine residency. He has practiced medicine in the north shore of Massachusetts since 2003, opening Personal Care Physicians in 2014. Mark is passionate about basketball, loves his wife, is religious about fitness, is a dutiful father, and is enamored with photography. With four children and his wife in healthcare research, he often feels like he’s barely able to hang on to his own Monkey Bars! Mark defines himself as a patient advocate, a truth seeker standing for justice, and God-honoring.

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