What's the best D supplement? How much should I take? Should I take one with or without Vitamin K? Liposomal? Soft gel? Liquid?
Whoa there!
By now, we all know that it is important to maintain a healthy level of Vitamin D. Usually it’s tested for at our annual exams, and if it’s low, we are told to supplement it, and maybe to get some more sunshine exposure.
But is there more to this picture?
As a matter of fact, there is.
Before I recommend taking something to address a symptom, I like to take a step back into a practical position: WHY is a person deficient in the first place? In this case, we need to talk about Vitamin D itself – how do we get it? Do we make it? What could be getting in the way of that process?
Simply put, Vitamin D is made in our skin, where it is built from the skin’s cholesterol plus sunlight, to be reabsorbed into our system.
But it’s a multi-step, multi-organ process, involving healthy bowel, pancreatic, gall bladder , thyroid & parathyroid, kidney, skin and liver function.
We need:
1. High quality fats.
2. Effective fat absorption.
3. Conversion from fat to cholesterol.
4. Delivery of cholesterol to healthy skin.
5. Cholesterol + sunlight.
6. Reabsorption.
7. Activation.
8. Finally, distribution and circulation.
1. HIGH QUALITY FATS
Fat is what our body makes cholesterol out of. And we NEED cholesterol – for one thing, to make Vitamin D.
Fat gets a bad name these days. And it deserves it, if we are talking about excess body fat, which is toxic and dangerous is many ways. But GOOD dietary fat is vital to our very survival; it is used in every single cell, every single structure, including the nervous system. Our body builds with it, and makes hormones from it.
Quality sources of this in your diet should include organic plant sources such as avocado, olive, walnuts, and pecans. Good animal sources include wild-caught fish; grass-fed, grass-finished beef; wild game; pasture-raised eggs and poultry; rendered fats from clean animals; and clean ghee (butter clarified to remove milk proteins).
Avoid polyunsaturated fats, seed oils, hydrogenated or partially-hydrogenated fats (trans-fats that are good for shelf life and profits, but not good for you).
2. EFFECTIVE FAT ABSORPTION
The Microbiome
So much of our health begins with our microbiome! This dictates the vital health of our “gut.” Among other amazing functions, our “beautiful bacteria” produce Vitamin K, which helps activate and absorb Vitamin D. What keeps our microbiome healthy? For one thing, a diet rich in diverse plants, of all colors.
An activated vagus nerve, that keeps our digestion optimized. Eating in a restful, stress-free manner and environment. Freedom from what kills beneficial bacteria: antibiotics, processed foods, glyphosate (RoundUp), insufficient sleep, smoking, sedentary lifestyle, alcohol, stress, lack of dietary fiber.
The Pancreas
98-99% of pancreatic function is about creating enzymes to help us digest and use our food. Only 2% is intended for blood sugar regulation, although that’s what gets all the attention when talking about this organ. These lipase enzymes are critical in converting dietary fat into healthy cholesterol and sending it to the liver to be utilized in the formation of Vitamin D.
Therefore, a healthy pancreas is also an important consideration before supplementing D. If there is an insufficiency there, it’s worth looking into (perhaps high-quality pancreatic enzymes are in order, short term).
The Gall Bladder
Has yours been removed? Then you’ll need supplemental support here. It amazes me how Western medicine is quick to remove an organ without investigating or trying to correct and heal why it is diseased, and then afterwards no mention is made of supplemental support that is critical to implement after its removal. If you have low bile (which is produced by the liver and stored in the gall bladder, waiting for the signals from your stomach to mobilize), you’ll need ongoing nutritional support to absorb fats well and normalize bowel function. (There is much more to this amazing process, beyond the scope of this post, which I will address in a future post devoted to the gall bladder.)
[NOTE: if your stools are light grey or light tan in color, or they float, you are likely not absorbing your fats well. Read THIS for a description of a healthy stool.]
3. CONVERSION FROM FAT TO CHOLESTEROL
The liver is the hero player here, responsible for manufacturing cholesterol and getting it to the skin for exposure to the sun. (It will also play a role in the later reabsorption, activation and redistribution of the Vitamin D.
Is the liver functioning well or not? What impairs the function of the liver?
Damage from viruses, alcohol, drugs (both prescription and/or recreational), toxic exposure (pesticides, herbicides such as RoundUp, heavy metals, chemicals, etc), parasites, obesity, non-alcoholic fatty liver disease (which is becoming shockingly prevalent in overweight kids now). Alcohol consumption. Nutritional deficiency. Inherited conditions such as hemochromatosis or Wilson disease.
4. SKIN THAT'S READY TO “SUNTHESIZE” CHOLESTEROL TO VITAMIN D
Your skin is your largest organ, typically accounting for 16% of our body weight and covering over 20 square feet! A lot happens there. To be ready for the synthesis of sunlight and cholesterol into Vitamin D in the outer layer of the skin, and then sent deeper, it first needs the cholesterol to be there! If you’ve “over-cleaned” with soaps that are too harsh, or containing detergents, you’ve stripped your skin of its natural cholesterol, and there won’t be any there to interact with the sun.
Most of us Westerners have been acculturated to over-clean our skin, almost treating it as an enemy. I’m not saying to stop washing, but do use gentler cleaning products, and consider whether or not you really need that daily scrubbing. If you’re not sweaty or dirty, consider skipping a day, or rinsing only, to let your natural oils balance out. As one of my clients says, “pits and grits!”
Also important: do not use toxic sunscreens, and get 30 minutes (or more, but don’t burn) of sunlight per day.
I also think there is a place for proper skin detoxification after years of using standard Western soaps and cleaners. I use lifestyle tactics such as dry-brushing, and neutraceutical supplements specific to hair, skin and nails.
5. CHOLESTEROL + SUNLIGHT = VITAMIN D
This process takes place in the top layer of your skin and then the new Vitamin D is pulled down into deeper layers of the skin.
6. REABSORPTION OF THE NEW VITAMIN D
Now the newly formed Vitamin D goes back to the liver to be converted to an even more active form. The liver acts as the body’s chemical processing plant… see above as to what might be impairing this.
7. ACTIVATION
Here come the kidneys to now play their part, enacting the final step in conversion of cholesterol and sunlight into Vitamin D by activating it.
8. REDISTRIBUTION AND CIRCULATION OF THE VITAMIN D TO WHERE IT'S NEEDED
The kidneys now send the Vitamin D out into the body, ready to circulate for its many MANY uses in the body.
It takes a deep, comprehensive look like this...
Adequate levels of Vitamin D depend upon multiple organ systems and healthy lifestyle behaviors. To me, this multifaceted examination represents a beautiful example and reminder of how all levels of our physical being are synergistically interconnected. It is truly impossible to isolate any one component without considering the wholeness of our being.
What Does Vitamin D Do?
Vitamin D carries a “hall pass” to gain entry via a special protein into every single cell in our bodies, where it protects genetic DNA material of at least 1000 genes (so far studied; likely more to be uncovered in the future).
Vitamin D is a “provitamin” that acts as a messenger hormone once it gets activated. It is supportive, protective and productive in building. It regulates calcium and magnesium. It acts in thyroid function, aiding (with the help of phosphorus) calcium absorption into the bones. It supports immune function (especially with its antiviral properties – never more important than now!).
Vitamin D is one of our most important micronutrients to be aware of, and I am glad to see mainstream Western medicine coming on board with that awareness. Of course…Vitamin D has been front and center for Functional Medicine practitioners for decades.
But...How Do You Know You’re Deficient?
How Did You Measure?
When I test for nutritional deficiencies, I use a sophisticated micronutrient analysis test that calculates levels inside the cells, determining levels of 35 different essential nutrients, as well as identifying potential genetic conditions that might be affecting levels. I think isolating one micronutrient is insufficient to gauge a person’s needs, even of Vitamin D.
Below 30 nanograms per milliliter is considered dangerously low. I’m looking for greater than 55. But if there are current health challenges, I think 60-80 is better, and 90-100 in the case of any autoimmune condition.
If my clients present with low levels, beyond investigating underlying causes as previously explained, I often recommend a Vitamin D “loading protocol,” using a high dose of Vitamin D3 to get levels up quickly, and then sustaining it with proper supplementation as needed.
I also use a genetic test when indicated to uncover any genetic insufficiencies to make the Vitamin D receptors on the surface of the cell nucleus.
So only now do we get to supplementation!
What kind of Vitamin D do I recommend?
Besides the form I use for my loading protocol, I use 2: liposomal and my own D-Replete.™
Liposomal Vitamin D “hitches a ride” on a fat molecule to bypass your colon and be absorbed directly into your bloodstream when pumped under your tongue. This is indicated in the cases of constipation, malabsorption, gall stones, gall bladder removal (cholecystectomy), pancreatic or exocrine insufficiency.
D-Replete™ is my own formulation, which is a powerhouse in a tiny softgell: Vitamins D3, A, K1 and K2 to aid in absorption, E, and geranylgeraniol (GG) derived from annatto seeds, which acts like a traffic cop, directing vitamins and minerals to go into the cells where they’re needed, rather than into arteries, where they are not (a critical nutrient for those on statins and biphosphate medications). In addition, I’ve included a quillaja extract (Quillaja Saponaria tree bark) to maximize bioavailability
Like many health questions, asking “what should I take for Vitamin D?” is not as simple as it seems! As a practitioner of Functional Medicine, I go beneath the surface to get the whole picture.
Are you low in Vitamin D? What areas of this process do you think you need help with? Let me know in comments below – I’m here to help! Share with someone who needs to know.
Always here for you,
Dr. Wade
