Hello Everyone! Welcome back to another Friday blog. Today I wanted to take a close look at vitamin D3 - What is it - where do we get it - what does it do - and why is it so important? What happens when we don't get enough? Let's delve in.

Vitamin D is a fat-soluble essential nutrient that we make in our skin and intake from our diet. In the skin, it is made from cholesterol. We also need to eat fat to absorb it - and it is stored in our fat. However, the more obese you are, the more is locked-up in fat and the more you need to run your larger body. The opposite is also true. The thinner and frailer you are, the less you can store and the more you need. Vitamin D shouldn't actually be called a vitamin - because it functions like a steroid hormone - upon binding with its receptor it enters the nucleus where it significantly influences >1,000 genes! It is found in most if not all cells in the body. Understanding this gives us a hint at its importance. It's involved in the function of the immune system, regulation of sleep, muscle and bone health, digestive system, hormones, metabolism, brain function, and so much more.

Our primary source of vitamin D is through sunlight - although we can get some in our diet by consuming fatty fish, eggs, liver and cod liver oil. Unfortunately, most of us aren’t outside enough - and we aren’t consuming enough of these products. We are able to synthesize vitamin D from cholesterol in the skin with exposure to adequate levels of UVB sunlight - but this requires bare skin exposure between 10am-2pm in warmer climates. It also requires cholesterol - so statin drugs inhibit this by stopping the body's ability to make cholesterol. If you’re a lifeguard, windsurfer/surfer - and live in Hawaii, you’re likely getting adequate D3 levels - FYI these individuals have blood levels upwards of 200! However, most of us are working indoors all day and are not getting enough sunshine. If it’s winter, we cover our skin with clothing and in summer we use sunblock when we are outside. Further, the more melanin we have in our skin, the darker our skin is, the older we are, the further north of the equator we live, the less we absorb. We can obtain very little from the diet - so how do we know if we are getting enough for optimal health? We must TEST.

Vitamin D3 has innumerable functions in the body - affecting nearly every aspect of our physiology. When we realize D3 has receptors on practically every cell - and there are ~ 30 trillion cells - we begin to see how things can go wrong if we are deficient. It has been estimated that there are 37 billion trillion reactions per second taking place in our body. 😳 If we are deficient in the nutrients that run and regulate our biology - things don't work correctly and we become unwell. We end up experiencing long-latency deficiency diseases - like cancer, cardiovascular disease, central nervous system degeneration, sleep disorders, osteoporosis and chronic kidney disease. “Alterations in bone and mineral metabolism occur early in the course of chronic kidney disease, and are mainly manifested biochemically by progressive increases in the levels of parathyroid hormone, which leads to skeletal disease and contributes to vascular calcification.” 

Vitamin D deficiency affects ~ 1 billion people globally and > 70% of Americans have inadequate levels. Not only do our levels need to be optimal - but in order to actually work, it must get converted to its active form - then bind to its receptor in the nucleus. This requires adequate levels of minerals - like magnesium and zinc. Most of us are deficient in these as well - as evidenced by how many of us are metabolically unwell ~ 93% of Americans. If you are diabetic, obese, have a fatty liver, have CKD (chronic kidney disease), hormone imbalance, insulin-resistance, dementia, depression, osteoporosis or cancer, you likely have been deficient for a long time. These long-latency deficiency diseases require even more to fill up the proverbial tank and get back to baseline - or homeostasis. Every one of these chronic conditions involve an inflammatory state - and vitamin D is a powerful anti-inflammatory. One can see that optimizing vitamin D could help prevent and even reverse many of these chronic conditions by reducing body-wide inflammation. 

Part of the problem is that MDs don't check your vitamin D3 level on routine blood work. We need to ASK for this test. So, what is the optimal level of vitamin D3 on our bloodwork? After scouring the research, it is evident that levels need to be >50ng/mL for immune function. This is the level at which one can achieve a near-zero risk of death from Covid-19, according to a Meta-Analysis in 2021. But, is this "optimal" - or do we need higher levels like surfers in the 200 range? What if you have osteoporosis? “In vitamin D deficiency, calcium absorption cannot be increased enough to satisfy the body’s calcium needs. Consequently, parathyroid hormone (PTH) production by the parathyroid glands is increased and calcium is mobilized from bone to maintain normal serum calcium levels.” If you have osteoporosis, you’ve had way below optimal levels for a long time - levels need to be 80-100ng/mL - “preferably greater than 75 nmol/L in all patients.” Holy moly!!

Many of us have levels <30ng/mL. This is dangerously low!! In the Journal Nutrients in 2022, researchers report individuals with D3 levels <20ng/mL significantly increased the odds of unhealthy sleep. "In the short run, inadequate sleep may result in cognitive and motor performance impairments, which can lead to decreased quality of life and reduced productivity. In the longer term, cumulative sleep deprivation can serve as a factor in the development and exacerbation of cardiovascular and metabolic diseases, cancer, diabetes mellitus, gastrointestinal disorders, and mental illnesses."  Hmm...no wonder we have so many issues.  Women whose blood levels were >60ng/mL had a decreased risk of breast cancer by >80%!  Sub-optimal levels result in a myriad of symptoms including anxiety and depression, high blood pressure and heart disease, cancer, autoimmune, fibromyalgia and chronic fatigue, bone loss, weight-gain and obesity, getting frequent infections - catching everything that comes along - like Covid and flu - adequate vitamin D levels decreases your risk of getting the flu by 75%! What?!!😲  

Okay, getting our vitamin D3 level up is crucial. How do we do this when we have to work indoors all day? We must supplement...and we must TEST our levels on blood work. We all have different DNA and therefore differing ability to synthesize D3 - as well as producing the vitamin D receptor. Genetically, not everyone is a good converter. The inactive form must be converted to the active form. The skin, liver, and kidneys work together to synthesize vitamin D to its active form. Keratinocytes in the skin respond to UVB sunlight through activation of their hydroxylation enzymes. These enzymes are able to locally convert vitamin D to its active form that regulates epidermal proliferation and differentiation of skin cells. Do you think it may be involved in skin issues like psoriasis if you're deficient? It definitely is.

Once activated, D3 enters the nucleus of keratinocytes where it binds to the vitamin D receptor (VDR). Here it merges with another receptor - that is part of the "steroid/thyroid hormone superfamily of nuclear receptors" - retinoic acid x receptor (a form of vitamin A receptor) to form a complex that binds with small sequences of DNA - setting off a cascade of molecular interactions that modulate transcription or expression of certain genes. So, vitamin D3 and vitamin A work together!!! Some of the inactive vitamin D gets transported through the blood to the liver where liver enzymes perform an initial hydroxylation step - then it is sent to the kidneys for a final hydroxylation step to convert D into the most potent form of vitamin D3. If you have a fatty liver (NAFLD) or chronic kidney disease (CKD) it can impair the ability to convert vitamin D to its most potent form. This is another reason most of us need to supplement the active form of D3.

To make matters worse, the enzymes responsible for hydroxylation in the liver belong to a family of CYP enzymes that are significantly dysregulated by glyphosate. CYP enzymes are also involved in phase 1 detoxification of fat-soluble environmental chemicals and heavy metals. These enzymes work to make harmful chemicals less toxic - meaning more water-soluble for excretion. The inactivation of these enzymes by glyphosate prevents the body from getting rid of toxins - literally making them more toxic. The liver and kidneys are responsible for detoxification of heavy metals, a host of environmental toxins, sex hormones and even vitamin D. When this process is disrupted, we resorb these back into the body. Just looking at estrogen, for example, explains how breast cancer and prostate cancer is on the rise. 

Further, understanding that D3 is fat-soluble tells us we NEED to consume it with fat to absorb it! Eating a low-fat diet is a BAD IDEA!!! We need healthy fat to absorb all the fat-soluble vitamins A, D, E, K. It appears D3 works with - either directly or indirectly - the other fat-soluble vitamins. Both D and E increase T-reg cells - the generals of the immune system - responsible for regulating the function of immune cells. We know it works with vitamin A as we've already discussed - but it also works with vitamin K2 to put calcium into bone. Adequate levels of vitamin D3 allow for intestinal absorption of calcium and phosphate - Then K2 helps to put it in bone and teeth. 

Okay, so how can we get our levels up and prevent all the problems that arise with insufficient vitamin D3? Let's look at strategy - always check with your physician before implementing. 

• Sunshine - Get adequate sunshine - early am sunrise x 20-30 min to set your circadian clock for enhanced sleep - and midday sunshine - minimum 30 min - 1hr on bare skin.
• Vitamin D-rich foods - Consume foods with vitamin D - pastured egg yolks, grass-fed beef liver, butter, cheese, wild-caught fatty fish - herring, kippers, sardines, mackerel, salmon - and mushrooms - particularly wild shiitake.
• Sun your mushrooms before consuming. Mushrooms can synthesize vitamin D. Place them upside down with gills up in midday sun for 20-30 minutes. You can even refrigerate the ones you don't eat that day and they'll maintain their levels. Wild mushrooms will contain more vitamin D.
• Other fat-soluble vitamins - Get adequate levels of all the other fat-soluble vitamins: A, E, K - The active forms are found in animal products - such as retinol - while plant versions require a conversion in the body - beta-carotene, for example, must get converted to retinol. Once again, if you have a fatty liver, genetically a poor converter, or have any of the chronic disease processes we've discussed above - you may not be converting efficiently. 
• Test!! Know your level of D3! - Many foods are "fortified with vitamin D" - but generally, they are using D2 - WAY LESS bioavailable than D3. Supplement to attain adequate levels for your specific needs. If you have osteoporosis, aim high - 80-100. If you get sick all the time, get your levels above 50. I personally shoot for 70-100 and rarely ever get sick. If you are low, you may need to take high-dose D3 for about 3-4 months - 10,000 IUs up to 40,000 IUs. Recheck your level to see how your body is responding - then adjust accordingly.
• Improve your microbiome - vitamin D feeds your microbes and increases their production of B vitamins - and increases Akkermancia (mucus-loving) to help produce the protective mucus layer to prevent leaky gut.
• Consume raw fermented sauerkraut and other fermented foods - not just for the natural probiotics, but the postbiotics as well. Another huge benefit is some acetobacters are able to metabolize glyphosate and aid in its removal/excretion from the body - so helps with detoxification!
• Go organic to limit GMO foods and glyphosate exposure. Avoid foods high in glyphosate - sugar, grains like oats, wheat and corn...
• Stop taking calcium supplements for osteoporosis! Calcium is the body's band aid and will go where there is inflammation - like your arteries causing calcification!!! Vitamin D increases intestinal absorption - then works with K2 to put calcium into bone and teeth. Get your calcium from your food.
• HP-EVOO - (high polyphenol extra virgin olive oil) - EVOO improves absorption of vitamin D - over that of other oils! It also contains vitamins E and K - along with a myriad of flavonoids and polyphenols that feed the mitochondria and microbiome decreasing inflammation and improving health. 

So, until next time my friends…Drink, Drizzle, Digest HP-EVOO at least 4T raw daily, - use more for cooking and drizzling/pouring onto your food - eat the rainbow of organic or wild-sourced or organic veggies (7-9 C) and low-glycemic fruits (to get the rainbow of gut microbes!) - eat wild-caught, pasture-raised, grass-fed - get plenty of sunshine - supplement magnesium, zinc, vitamin D3 + K2 - get your trace minerals and electrolytes with good sea salt - Celtic is hand-harvested and Himalayan was formed before plastics - eat foods high in lutein - drink your body weight in oz of water - get a good pre/probiotic - consume digestible and indigestible fiber for your gut microbes - adaptogens (such as mushrooms) and methylation donors (kale, beets, spinach, cruciferous, lion’s mane…), marjoram, rosemary, oregano, parsley and other herbs to detox, enhance overall health and reverse aging and disease - exercise your body and mind - add a few minutes of mindful meditation to your day to combat stress - take a hot Epsom salt bath and follow with a cold shower/ice plunge - practice “earthing” as an anti-inflammatory - remove EMF (electromagnetic frequency) devices and blue light - use IR (infrared) from incandescent lighting, non-toxic candle or light a fire to enhance sleep and...turn off the light!!   #HP-EVOO