By Dr. Mercola
A robust and growing body of research clearly shows that vitamin D is absolutely critical for good health and disease prevention.
Vitamin D affects your DNA through vitamin D receptors (VDRs), which bind to specific locations of the human genome. Scientists have identified nearly 3,000 genes that are influenced by vitamin D levels, and vitamin D receptors have been found throughout the human body.
Is it any wonder then that no matter what disease or condition is investigated, vitamin D appears to play a crucial role?
This is why I am so excited about the D*Action Project by GrassrootsHealth.1 It is showing how we can take action today on known science with a consensus of experts without waiting for institutional lethargy.
It has shown how by combining the science of measurement (of vitamin D levels) with the personal choice of taking action and, the value of education about individual measures that one can truly be in charge of their own health. In order to spread this health movement to more communities, the project needs your involvement, your health activism. This is an ongoing campaign during the month of February, and will become an annual event.
The D*Action Project
I believe this is a truly critical project that is already having an enormous impact not just on your own health and those participating, but the health of people everywhere through the growing community involvement as well as individual participation.
Since vitamin D affects virtually every aspect of your health, from bone health to heart health to the prevention of cancer and much more, determining the optimal serum levels for disease prevention for you could quite literally result in a health revolution. It requires two measurements:
- Vitamin D serum levels, and
- Health status
With these two measurements, you can effectively begin to measure vitamin D performance, and discover how vitamin D affects your health. For example, at which vitamin D level will you achieve maximum protection against pain? Colds and flu? Heart disease and cancer? Once this is established, taking a great degree of control of your health will be as simple as getting your vitamin D levels tested, and if you find you're too low, you'll have the tools to optimize your levels.
The key to turning our crippled health care system around is to shift from disease management into disease prevention and health optimization mode.
D*Action is an important step in a MAJOR health movement with the power to change our flawed medical paradigm, which right now is married to the pharmaceutical industry via the revolving doors between Big Pharma and our regulatory agencies. The individual is left powerless in this paradigm, because, aside from expensive pills (which kill over 106,000 people each year when taken as prescribed), it has little more to offer.
This health movement has already begun.
D*Action has multiple concurrent vitamin D programs going on. The D*Action International project is open to anyone, any age, anywhere in the world. The Protect our Children NOW! campaign is geared toward using the results of randomized trials to take action now to reduce preterm births and other complications of pregnancy.
This program is already coalescing into community political action groups, so that when the study in any community (a 24 month project) is completed, they can use the information obtained to push for public health recommendations that will benefit ALL pregnant women and their children. And, the Breast Cancer Prevention project, another subset, is open to women 60 and over with no current cancer or current treatment.
So, I encourage you to participate in the D*Action Project. Not only will you be able to take control of your own health by participating, you'll also become part of one of the most profound public health projects of the 21st Century.
Why Measuring Vitamin D Performance Matters
Measuring vitamin D performance is about more than just getting your vitamin D levels tested every few months. It's also about discovering the impact of vitamin D on your health at various serum levels, and setting goals for your health. How can D*Action help you get healthier?
Let's consider an analogy: If you want to win a bike race, you record the start time, the end time, and measure the time it took you to get from point A to point B. You can also measure how many revolutions per minute you make with your pedals to determine the revolution rate required to achieve your timed result. Without these measurements, you won't know what kind of effort it took to get you to the finish line, or how long it took you to get there.
Without these measurements, you're not in charge because you don't know what it takes to achieve the desired result. Now, let's say you want to improve your race performance. If you already know how many revolutions per minute you needed to make it from start to finish line in a certain amount of time, you now know how much faster you have to pedal in order to beat your own time. There is a growing demand to be able to know how to improve and control your own health, and to do this, you need to know:
- What factors can be measured
- How to measure them
- How to affect change or alter that which is being measured
- How to get feedback on the changes, both at individual and group levels, and
- The true cost, weighed against the benefit of the measurement
This knowledge, and the related tools, must be made available to everyone, as these pieces are required to be successfully in charge of health behavior. Now, let's apply these five criteria to the vitamin D performance measurements, to get an idea of how it can benefit you:
- The vitamin D serum level can be measured with reasonable accuracy, and the serum level is the measure associated with health effects. You can also measure the vitamin D status of many different health conditions at different points in time, to correlate vitamin D status with improved or worsened condition.
- Vitamin D is measured using a blood test, which can be done via a dried blood sample or a blood serum sample. A structured health questionnaire is used to track changes in health status.
- The actions that can be taken to affect change in vitamin D status would be a combination of UVB exposure (sun or safe tanning bed) and oral vitamin D3 supplementation.
- After measuring both your vitamin D level and your level of health (such as improvement or decline of a health condition or disease), you'll be able to get personalized feedback on how one affects or relates to the other. New software applications are in development now to allow participants quick access to their own health performance information and recommendations.
Many measures of health are most useful when both individual scores and group scores are kept--an individual has only one picture of health conditions and can't necessarily answer questions about a condition not his/hers without a group picture. For example, the question "What's my chance of getting (a particular disease) at this serum level?" can only be answered from group information.
- The cost/benefit picture for vitamin D testing is extremely compelling. More than 75 percent of the world's population is vitamin D deficient and most don't know it! It is estimated that roughly 35 percent of health care costs could be reduced by having a serum level in the 40-60 ng/ml range.
The cost of healthcare per person in the US was $13,710 in 2011. If that was reduced by 35 percent, that would amount to $4,798-worth of savings. The cost of the vitamin D measurement and feedback systems per person is $130 per year, equating to a net 37-times' return on investment.
Optimizing Vitamin D is One of Your Most Cost Effective Health Strategies
Many families have seen a rise in the proportion of their income spent on healthcare expenses. For many, the costs now exceed what they spend on food! Measuring your vitamin D performance and taking steps to optimize your level is one of the easiest and least expensive things you can do for your health, and could help you rein in out-of-control health care expenses.
GrassrootsHealth D*Action is an integrated set of performance and feedback systems to give you complete control of your individual vitamin D performance systems, which will help you gain a total picture of your health. There's no doubt in my mind that the D*Action programs can be a major key to help turn the current health paradigm from 'treatment' to 'prevention.'
It's truly exciting to consider that, within our lifetime, we will be able to prevent the majority of breast cancer, for example.
The D*Action Breast Cancer Prevention project began last year, and is a major step in that direction. While it still needs four more years' worth of data to be complete, the women enrolled in the project are already exhibiting fewer cases of breast cancer than would be expected within the general population. To learn more about this breast cancer prevention project, please see this previous article. (Women 60 and over with no current cancer or current treatment are eligible for the breast cancer prevention study. You can sign up here if you're eligible.)
Tens of Thousands of Studies Attest to Vitamin D's Health Impact
According to a January 17 press release by Orthomolecular Medicine,2 3,600 medical papers with vitamin D in the title or abstract were published in 2012 alone, bringing the grand total to 33,800. That's a lot of studies on vitamin D. The Top 16 vitamin D papers of 2012 selected by a panel of vitamin D experts focused on vitamin D's beneficial impact on:
Pregnancy outcomes (reduced risk of Cesarean section and pre-eclampsia) Autism Childhood language impairment Cardiovascular disease Type 1 diabetes Type 2 diabetes Bacterial and viral infections Cancer Falls and bone fractures All-cause mortality
Our Healing Sun — Beyond Vitamin D
Interestingly, sun exposure in and of itself is starting to experience a revival, as researchers are taking another look at the health benefits of sunshine, over and beyond vitamin D. For example, according to one 2012 study3:
"The number of studies reporting on the association between sunlight exposure, vitamin D and cancer risk is steadily increasing. We reviewed all published case-control and cohort studies concerning colorectal, prostate, breast cancer, non-Hodgkin's lymphoma (NHL) and both sunlight and vitamin D to update our previous review and to verify if the epidemiological evidence is in line with the hypothesis that the possible preventive effect of sunlight on cancer might be mediated not only by vitamin D but also by other pathways.
We found that almost all epidemiological studies suggest that chronic (not intermittent) sun exposure is associated with a reduced risk of colorectal, breast, prostate cancer and NHL. In colorectal and to a lesser degree in breast cancer vitamin D levels were found to be inversely associated with cancer risk. In prostate cancer and NHL, however, no associations were found...
[I]t is concluded that the evidence that sunlight is a protective factor for colorectal, prostate, breast cancer and non-Hodgkin's lymphoma is still accumulating. The same conclusion can be drawn concerning high vitamin D levels and the risk of colorectal cancer and possibly breast cancer. Particularly in prostate cancer and NHL other sunlight potentiated and vitamin D independent pathways, such as modulation of the immune system and the circadian rhythm, and the degradation of folic acid might play a role in reduced cancer risk as well."
As discussed in a recent article by Sayer Ji4, five noteworthy properties of sunlight exposure, beyond vitamin D production, include the following. (There are many more, however. To learn more, see this previous article.)
- Pain-killing (analgesic) properties
- Increased subcutaneous fat metabolism
- Regulation of human lifespan (solar cycles appear to be able to directly affect the human genome, thereby influencing lifespan)
- Daytime sun exposure improves evening alertness
- Conversion to metabolic energy (i.e. we may "ingest" energy directly from the sun, like plants do)
In the following TED Talk, dermatologist Richard Weller discusses recent research by his team, which shows that nitric oxide, a chemical transmitter stored in huge reserves in your skin, can be released by UV light, and confer great benefit for your cardiovascular system.
Revised and Updated Recommendations for Optimizing Your Vitamin D Levels
Research on vitamin D is moving swiftly, so you'd be well advised to stay on top of the latest developments as recommendations are refined and updated. I will review some of the most important recent developments here, so you may want to share this article with your friends and family. First, it's important to remember that sun exposure is the best way to optimize your vitamin D levels as your body has built-in "fail-safe" mechanisms that prevent detrimental side effects from occurring.
Last year, I created a video to help you determine if you can get enough vitamin D from sun exposure in your area at different times of the year. Based on additional information received, I now believe that my previous position was too strict... The good news is, you can likely get vitamin D under far less ideal conditions than previously suggested.
The radiation from the sun that reaches the earth's surface (and hence your body) is partially filtered out by the atmosphere. I had previously stated that UVB rays will only penetrate the atmosphere when the sun is above an angle of about 50° from the horizon, and that when the sun is lower than 50°, the ozone layer will absorb vitamin D-producing UVB-rays while allowing the longer, and more harmful, UVA-rays to get through, which would defeat the purpose of spending time in the sun.
This recommendation is likely too strict. According to experts in the field, you can likely get sufficient amounts of UVB radiation when the sun is as low as 30 degrees above the horizon, or whenever the temperature is warm enough to expose large amounts of skin.
I thank John Hochman, MSME, for bringing this to my attention. According to Dr. Ola Engelsen with the Norwegian Institute for Air Research, the creator of a calculator5 that takes a number of factors into consideration give you an estimate of how many minutes of exposure you need to produce the equivalent of 1,000 IU's of vitamin D, the sun must be more than 15 degrees above the horizon during cloudless conditions.
If You Take Vitamin D Supplements, Remember to Take Vitamin K2
Second, based on the latest investigations by Carole Baggerly, director of GrassrootsHealth, there is a chart showing the average adult dose required to reach healthy vitamin D levels based upon the measured starting point. Many experts agree about 35 IU's of vitamin D per pound of body weight could be used as an estimate.
Here, it's important to remember that if you're taking high dose vitamin D supplements, you ALSO need to take vitamin K2. The biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove calcium from areas where it shouldn't be, such as in your arteries and soft tissues. Vitamin K2 deficiency is actually what produces the symptoms of vitamin D toxicity, which includes inappropriate calcification that can lead to hardening of your arteries. The reason for this is because when you take vitamin D, your body creates more vitamin K2-dependent proteins that move calcium around in your body. Without vitamin K2, those proteins remain inactivated, so the benefits of those proteins remain unrealized.
So remember, if you take supplemental vitamin D, you're creating an increased demand for K2. Together, these two nutrients help strengthen your bones and improve your heart health.
While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Dr. Kate Rheaume-Bleue, author of Vitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life, suggests that for every 1,000 IU's of vitamin D you take, you may benefit from about 100 micrograms of K2, and perhaps as much as 150-200 micrograms (mcg).
Individual Variables that Affect Your Vitamin D Levels
Now, going back to optimizing your vitamin D through sun exposure, the production of previtamin D3 in your skin varies depending on several factors, such as:
Antioxidant levels and diet in general Age Skin color and/or current tan level Use of sunscreen Latitude and altitude (elevation) Cloud cover and pollution Ozone layer Surface reflection Season Time of day Weight
Keep in mind that while 35 IU's of vitamin D3 per pound of body weight per day may put you closer to the ballpark of what most people likely need, it is impossible to make a blanket recommendation that will cover everyone's needs due to the multi-variable factors listed above. The only way to determine your optimal dose is to get your blood tested. It's the serum level that really matters, and ideally, you'll want to maintain a vitamin D serum level of 50-70 ng/ml year-round.
Besides location, which has a major impact on how much vitamin D you can produce, your skin color is another really important factor. African Americans are actually at greater risk of vitamin D deficiency, because if you have dark skin, you may need as much as 10 times more sun exposure to produce the same amount of vitamin D as a person with pale skin!
Yes, You have to Show Some Skin...
Many people are under the mistaken idea that you can get enough vitamin D just from exposing your forearms and face for a few minutes a day. This claim is patently false, as clearly demonstrated in a recent study6. As reported by the Vitamin D Council7:
"[R]esearchers in South Korea... studied the effect of brief sun exposure on vitamin D levels in 20 young women for four weeks. The study was conducted between October and November at latitude 37 degrees north, about the latitude of Washington DC. Initial mean 25(OH)D levels were 11 ng/ml and no woman had levels greater than 20 ng/ml to begin the study. The women were told to get 20 minutes of midday sun exposure on their hands, forearms and face every weekday for four weeks. Facial sunblock and sunglasses were permitted.
Guess how much 25(OH)D levels increased after a month of daily sun exposure? Vitamin D levels did not increase at all; in fact, they were a little lower than when the study began!"
For most of us, exposing face and forearms is grossly inadequate to move vitamin levels into a healthy range. For optimal benefit, strive to have at least 40 percent of your skin uncovered.
If you have light-colored skin, you can use the color of your skin to tell you when you've had enough sun and it's time to get in the shade (or cover up using a long-sleeved shirt, pants, and a hat). Stay out just long enough so that your skin turns the very lightest shade of pink. Continuing UV exposure beyond the minimal dose required to produce skin redness will not increase your vitamin D production any further. In Caucasian skin, this equilibrium will typically occur within 20 minutes or so of ultraviolet exposure during ideal conditions. It can take 3 to 6 times longer for darkly pigmented skin to reach the equilibrium concentration of skin vitamin D.