.png)
The Wellness Blueprint: With Dr. Caleb Davis
Welcome to The Wellness Blueprint with Dr. Caleb Davis, where we uncover the secrets to living a long, active, and pain-free life. Hosted by Dr. Caleb Davis, an orthopedic surgeon and fitness enthusiast, this podcast is your ultimate guide to musculoskeletal health, injury prevention, and wellness.
Dr. Davis combines his expertise as a shoulder and elbow specialist with a passion for empowering people to take charge of their health. From deep dives into cutting-edge restorative medicine to practical tips on avoiding surgery and optimizing recovery, The Wellness Blueprint offers valuable insights for anyone seeking to preserve their body and thrive at every stage of life.
Join us each week for professional guidance, fascinating medical discussions, and actionable strategies that help you move better, feel stronger, and stay functional for years to come. Whether you're an athlete, a weekend warrior, or someone looking to age gracefully, The Wellness Blueprint provides the tools to design a healthier you.
The Wellness Blueprint: With Dr. Caleb Davis
Episode 19: Vitamin D: Unlocking Strong Bones, Mighty Muscles, and Immune Power
Unlock the secrets of vitamin D and its profound impact on your health. Imagine a world where a single nutrient could transform your bone, muscle, and immune health—it's not science fiction, it's vitamin D. Join us as we journey from the streets of 1600s England, where rickets was rampant, to the modern-day fortification of foods, unraveling the history and significance of this vital nutrient.
But vitamin D isn't just about maintaining strong bones. We shine a light on its crucial role in muscle function and its surprising connection to chronic diseases like diabetes. Learn how vitamin D enhances insulin sensitivity and supports muscular health, particularly in older adults. While every health expert touts the benefits of vitamin D, we weigh its importance against other healthy habits like exercise, sleep, and hydration. The multifaceted benefits of vitamin D are undeniable, and understanding its role could be a game-changer for your health.
Finally, delve into how vitamin D modulates the immune system, enhancing everything from macrophage activation to the production of antimicrobial peptides. With its historical use in treating tuberculosis and its potential to mitigate cytokine storms during the COVID-19 pandemic, vitamin D is more relevant than ever. We wrap up with practical tips for maintaining vitamin D levels, peppered with humorous anecdotes about everyday habits and the whimsical idea of a band called "Cytokine Storm." Embrace a humble, happy, and healthy lifestyle and share these insights with friends who might benefit from extra vitamin D in their lives.
Instagram @WellnessblueprintPodcast
X @CalebDavisMD
TikTok @WellnessblueprintPodcast
Hey everybody, welcome back to the Wellness Blueprint. I'm your host, dr Caleb Davis, and as usual I'm joined by the lovely, bubbly, excellent and well-tanned Nicole Davis.
Speaker 2:Well-tanned. I'm not well-tanned yet, Dr Big Guy.
Speaker 1:We haven't gone on vacation yet. We're about to go to the beach, so you might get a little tan.
Speaker 2:Yeah, I am hoping, so you know what I want to get at the beach.
Speaker 1:What, outside of delicious drinks on the sand, is some vitamin.
Speaker 2:D. You already spoiled the intro. No, no, you got it.
Speaker 1:No, we're going to be talking about vitamin D today. I think a lot of people know what vitamin D is. I, at least, have a general sense of what it is. I think a lot of people also know it's important and know that it comes from the sun, or at least it requires sun for your body to correctly synthesize it. But today we're going to explore a little bit of the history, the biology and some of the important impacts that vitamin D can have on your health. What we're going to try to cover today is the history of vitamin D, from discovery to modern day use, how it's synthesized and metabolized in the body, its vital roles in bone health, muscle function, cardiovascular health, diabetes prevention and how it helps your immune system. We'll also talk a little bit about the diseases that might be caused by too little vitamin D. We'll also talk about toxicity, meaning if you take too much vitamin D and who might benefit from a little extra vitamin D. We'll talk about in broad terms what your recommended dosage might be, food sources rich in vitamin D and some of the stats on deficiencies.
Speaker 1:This will be a fairly technical and comprehensive episode, but Nicole, as always, will try to help me from getting too much in the weeds. So let's start by traveling back to the 1600s. In England, Children in the more urban areas began developing a strange disease called rickets. Nicole, have you ever heard of rickets?
Speaker 2:Ooh, I have heard of it. Couldn't tell you what it is, though, but it makes me think of rickety legs.
Speaker 1:That's it, that bow-legged appearance. So it causes severe skeletal deformities. Bowed legs is probably the most commonly thought of deformity in rickets. It also has thickened wrist bones and thickened ankle bones and soft skulls. Rickets got its name from the old English word ricken, meaning to twist, and that is how that name came about. So if you fast forward now to the early 20th century, scientists began noticing a connection between rickets and sunlight exposure, began noticing a connection between rickets and sunlight exposure. Sir Edward Mellenby in 1919 demonstrated that cod liver oil helped at least in some part reduce the severity of rickets or cured rickets, and this led to the identification of vitamin D as the missing nutrient that was linked to rickets, or at least the general form of rickets that we all think of.
Speaker 2:I do kind of wonder, you know, does somebody stare at a fish and say, hey, fish, I want what's in your liver, let me eat that stuff up and then see what happens. Like, how do people get to that from point A to point B?
Speaker 1:You're always asking the most important questions. I don't know how that came to be. A lot of different types of medicines were cure-alls or take this magic elixir and it's going to make you all better and I think on accident some things were discovered. Maybe they thought there was an association between cod liver oil and some other disease and some doctor somewhere made an observation that this was actually helping something. I think that happened a lot. A lot of different medicines were discovered purely on accident. Certain blood pressure medications were discovered because they were rat poisons and then they found out that there were side effects that were actually beneficial.
Speaker 2:That's a strange one. I was not aware of that one.
Speaker 1:Yeah, Maybe I didn't summarize that the best way, but there's all sorts of things that had one purpose and then they accidentally discovered a better application for the medicine or the chemical.
Speaker 2:I kind of wonder if there's some lady out there who's a husband killer and's you know sitting in court and she's like, oh well, I thought I was helping his blood pressure when I fed him that rat poison. Judge, I swear.
Speaker 1:Yeah, it's probably been done before.
Speaker 2:Yeah, I'm sure it has.
Speaker 1:Don't get any ideas no.
Speaker 2:I would never.
Speaker 1:My blood pressure is fine, at least it was before this episode. So shortly after the discovery that cod liver oil was helping with rickets, a doctor named Adolf Windhaus was awarded the Nobel Prize in Chemistry in 1928 for his work on the chemical structure of vitamin D. And by the 30s, vitamin D fortification programs, like adding it to milk, began in the US and Europe, leading to dramatic declines in rickets. So that was the big rise of vitamin D and its first major application. In the mid-20th century, scientists expanded their understanding of vitamin D beyond just bone health. The development of synthetic vitamin D allowed much more detailed research into its mechanisms, and it led to the discovery of its roles in the immune system as well also cardiovascular health and different chronic disease prevention. Since the 19th century both environmental sources like sunlight and dietary sources like cod liver oil they were recognized as treatments for tuberculosis. The discovery of vitamin D's role in inducing antimicrobial peptide gene expression further expanded the importance for immune health.
Speaker 2:Okay, that part peptides what.
Speaker 1:We'll get into a little bit more into detail. You know how they always say vitamin D is good for your immune system. No, you never heard that, not even during COVID. Everyone's talking about how important vitamin D was and how people were having worse outcomes in COVID if they had vitamin D deficiencies. Where have you been?
Speaker 2:Yeah, well, I must have just been sleeping all of 2020. No I vaguely remember that now. People were saying a lot of things during COVID.
Speaker 1:I know saying things like antimicrobial peptide gene expression is a mouthful, but the reason I bring this up is because I'd always read vitamin D is good for immune system. Vitamin D is good for immune system. I said, okay, let's break it down and actually talk about why it is and see if it's actually real, because so many people claim that X product is good for immune system. So I want to get in a little bit of the weeds on that. So I'm sorry for using the words.
Speaker 2:Except I don't know what those words meant that you said I'm going to get into it more.
Speaker 1:I'm going to get into it more. Before we get into the nitty gritty of peptide gene expression, let's talk about rickets a little bit more, because I found that interesting and I think a lot of people probably don't even know what it is anymore because it's so uncommon. But we do see it in orthopedics from time to time in children who have maybe some unfortunate social situations. So, as we've discussed, rickets is a disease caused by a deficiency of vitamin D, calcium or phosphate, but vitamin D deficiency is the most common cause. The underlying problem is a failure of your body to be able to properly mineralize bone matrix.
Speaker 1:Physiologically, vitamin D helps regulate calcium and phosphate in your bloodstream, and if you don't have vitamin D or if it's deficient, calcium absorption is decreased from the gut, meaning that any calcium you eat is not being absorbed adequately into your bloodstream. When your body says I don't have enough calcium, then it takes the calcium out of your bones. A gland called the parathyroid gland releases a hormone called parathyroid hormone no, that's not one that's too hard to remember and this leaches calcium from your bones to help it get back into the blood. And if you're not getting enough from your diet, then it has to suck it out of your bones, essentially to create homeostasis, and we all know how important electrolytes are in lots of different bodily functions. So it has to keep calcium at a very precise level. And then there are some children with malabsorption conditions, such as cystic fibrosis or celiac disease, where the body just can't absorb calcium from the diet very efficiently. Nicole, when you think of vitamin D, what do you think of first? What's its function? Why is it important? Why do you take it?
Speaker 2:I think of my need to get more sunlight in my life and how, since I largely live indoors and participate in activities that are primarily indoors, I'm not getting enough vitamin D through the sun, and so I need to supplement that.
Speaker 1:What I mean by. Why is it important to get vitamin D in your mind? You're telling me how you get vitamin D by getting more sunlight, but you think, oh, I need more vitamin D. The question would be why do you need more vitamin D In your mind? What does vitamin D do for you? Or is it just you've just heard vitamin D is good for you, so you want vitamin D.
Speaker 2:Yeah, it's probably just that. I mean, I could tell you very basic like oh, it's supposed to help with your energy levels and your immune system, I guess, because COVID and I was like that's all I can think of.
Speaker 1:Okay, all right, that's fine. If you don't know why vitamin D is good for you, maybe this is a great episode for everybody. Maybe no one knows why it's good for you. So vitamin D's primary role in bone health is to maintain calcium and phosphorus levels in a healthy level. So calcium absorption vitamin D stimulates the production of calcium binding proteins in the intestines and that helps increase absorption by 30 to 40%. As we mentioned before bone mineralization also, vitamin D helps deposit calcium and phosphate into the bone matrix, making your bones harder and stronger. And then it helps with parathyroid hormone regulation. By maintaining adequate blood calcium levels, vitamin D helps prevent excessive release of parathyroid hormone, which can weaken your bones. Inadequate vitamin D levels can lead to osteomalacia in adults, which is a condition where bones become soft and brittle.
Speaker 2:Like Mr Glass.
Speaker 1:Yes, mr Glass. Yeah, Was that his problem?
Speaker 2:Well, he had some sort of thing where his bones were so brittle that anyone touched him and they broke apart.
Speaker 1:That sounds like osteogenesis imperfecta, which is a genetic disease causing brittle bones, no matter how much vitamin D you have.
Speaker 2:Yeah, it's pretty cool that you knew that.
Speaker 1:I am a bone doctor, that's true.
Speaker 1:When I think of vitamin D, especially as an orthopedic surgeon, I think primarily of bone health, so we've covered that. But what is not so much of a focus is muscular health. So vitamin D isn't just about bones. It's also crucial for muscle health too. So here's how it works Skeletal muscle cells have vitamin D receptors, which help regulate muscle protein synthesis and contraction strength of muscles. So vitamin D is directly linked to having bigger, stronger, more functional muscle tissue. Calcium is also involved in a crucial mechanism for allowing muscles to contract, and vitamin D ensures that calcium is available for muscle contraction.
Speaker 2:Quick side note I feel like I've seen in a lot of vitamin D supplements that it also includes calcium.
Speaker 1:Yeah, they often go together because you're taking vitamin D and then it helps absorb calcium from your diet, so you take calcium pills too.
Speaker 2:I've read some claims that taking vitamin D on its own is ineffective and you have to pair it with something else.
Speaker 1:Well, there may be an idea that it's absorbed into your bloodstream better if it's taken with food rather than just in a pill form, but it doesn't have to be taken with calcium necessarily.
Speaker 1:I recommend most people take vitamins and supplements with food anyway, just so it doesn't upset their stomach. I recommend most people take vitamins and supplements with food anyway, just so it doesn't upset their stomach. Studies have actually shown that vitamin D supplementation improves muscular strength, especially in older individuals, and reduces the risk for falls in older adults by enhancing neuromuscular function, meaning a connection between the nervous system and the muscle. And, as we've already noted, good vitamin D levels help with better muscle contraction, so vitamin D could actually save your life. If you're older, so vitamin D deficiency can lead to muscle weakness, cramps and even sarcopenia, which is a word that I've used repeatedly in the podcast, talking about extreme low levels of muscular density. This is usually an age-related loss of muscle mass, although it can occur in younger people as well. You'll see this most often in older people, manifesting as difficulty from rising up from a chair, from a seated position or climbing stairs, especially in older adults.
Speaker 2:Yeah, I feel like I've known a lot of older people who have sarcopenia, or at least they seem to. Yeah.
Speaker 1:Yeah, so we've covered bones and muscles. Let's talk about chronic diseases like diabetes or cardiovascular disease. So in diabetes, vitamin D can influence your insulin sensitivity and secretion, and we all know that insulin is a key player in diabetes. Insulin helps shift blood glucose out of the blood and into cells, and if you have insulin problems, like in type one or type two diabetes, the blood sugar stays high and isn't getting into the cells where it needs to go.
Speaker 2:Low levels of vitamin d are associated with an increased risk of type 2 diabetes and poor glycemic control, meaning that your blood sugar is chronically elevated and you have a hard time getting it back to normal levels okay, but see, in all these different podcasts that we've done, we've talked about all these ways to prolong your life, improve your life, improve your wellness, and it seems like there are a lot of things that I would prioritize over taking vitamin d like tell me more like exercising, better sleep, hydration those things I think of as more of a priority than oh.
Speaker 2:I better make sure I take my vitamin D supplement for the day.
Speaker 1:Right.
Speaker 2:Like how significant or severe is it if you're just the average American who gets in their vehicle, goes to work, goes to the grocery store, takes their kid to the park? They're getting minimal daylight in the day.
Speaker 1:If you're going to the park, you're doing better than I am. I get no sunlight at all.
Speaker 2:Yeah, that's what I like. I mean medical workers. You guys are like vampires.
Speaker 1:I don't have windows anywhere. I work.
Speaker 2:Yeah, it's depressing.
Speaker 1:Well, Microsoft windows, but not like real windows.
Speaker 2:So I wonder, where does it rate on the significance of severity?
Speaker 1:That's a great question. You've probably heard me talk about this a lot. If you don't sleep well, if you don't eat well, if you're drinking lots of alcohol, you're smoking cigarettes and you're eating fast food, you're right, taking a vitamin D supplement probably doesn't really fall high on the hierarchy of needs and importance of how you should be getting your life together if you want to live a functional, long life. I'm not trying to judge anyone for their life choices, but all of those things I just listed are not a good recipe for a happy, healthy, functional life and, as you know, we all want to be humble, happy and healthy.
Speaker 1:So the thing that I would focus on is if your vitamin D levels are low and it's a very simple blood test that you can get done and check then I say why not take a vitamin D supplement? Super easy to do, very cheap, over the counter, and so I just say it's a very easy thing to do and could generally impact your health in a significant way. But you're right, if your house is on fire, then getting a teaspoon of water and throwing it on there is not the best idea. Maybe you should take something else other than vitamin D, do some other intervention, but I think that this is something that could be very helpful for people and has some pretty significant health impacts if their life is generally in order.
Speaker 2:Yeah. So my other question is for multivitamins. A lot of times it incorporates vitamin D. When I said the vitamin D plus calcium supplement earlier, I was thinking of the bottles that are marked vitamin D.
Speaker 1:Yeah.
Speaker 2:Because I was looking in the grocery store for you the other day. And the multivitamins. It incorporates vitamin D, so is that adequate or do you think people need to take both.
Speaker 1:It's usually too low of a dose in a multivitamin. If you take just a multivitamin with all the different vitamins that are marketed, the vitamin D dose is going to be inadequate in most cases.
Speaker 2:Okay, so take a multivitamin plus the.
Speaker 1:You may want to consider taking a vitamin D on top of a multivitamin.
Speaker 2:But you can overdose, you can.
Speaker 1:We'll get to that. So we covered type 2 diabetes. Low vitamin D might increase your risk of getting type 2 diabetes. Cardiovascular health might increase your risk of getting type 2 diabetes. Cardiovascular health vitamin D also plays a role in that. It's been proposed that vitamin D has an anti-inflammatory property that might reduce arterial stiffness and lower blood pressure.
Speaker 1:Deficiency of vitamin D is also linked to an increased risk of heart attacks, strokes and other cardiovascular events. Some studies even suggest that vitamin D improves endothelial function, which is critical for maintaining healthy blood vessels. The endothelium is the inner lining of arteries, so that's part of that arteries getting injured or thickened, causing plaques and clots and heart attacks. So this is also linked to heart disease. Now, not to make this seem like a panacea, meaning vitamin D is good for everything, but there's growing evidence that vitamin D plays a number of roles in the body in terms of your health, but in terms of cancer, there is some emerging evidence that suggests that low vitamin D levels might be associated with higher risks of certain cancers, including colorectal cancer and breast cancer, and this is proposed that vitamin D might have the ability to help regulate cell growth and induce cellular death in places where the cells need to die instead of turning into cancer cells. There's not as much hard evidence on this topic, but it is interesting to think about.
Speaker 2:Sounds like we've created a society for ourselves that inherently kills us. We have this industrialized society where we don't value going outside and mess stuff up. We end up getting cancer, that's deep I know.
Speaker 1:That's deep, deep man. Are you turning into an nihilist? You're going to say burn it all down, we're all gonna die, so why bother?
Speaker 2:is that what's about to happen?
Speaker 1:no, no yeah, I think cancer is sort of nature's off switch. You know, they say if you live long enough you'll get cancer for men it's prostate, for women it's breast cancer as cells eventually quit replicating correctly and then you get cancer. That's a very common way to go, even if you're the healthiest person on earth and live to be 105. So the thing that I'm most interested in today, since I just got over a horrible case of the flu, is how does vitamin D influence the immune system? And I do have low vitamin D levels, by the way, so I have to supplement with vitamin D. I'm very pale, I don't get out in the sun very often, so it's definitely something that I have to supplement with every day. So vitamin D is a powerful modulator of the immune system. It enhances the innate immune response by activating macrophages known as white blood cells and increases the production of antimicrobial peptides, meaning different types of proteins that can help fight infections.
Speaker 2:Is that where we're going to get into peptide gene therapy?
Speaker 1:Peptide gene expression. Excuse me expression, yeah expression just means that your body's making more of it.
Speaker 2:Oh, it's not trying to express itself?
Speaker 1:No, it's not like an emotional appeal to the bacteria. They're making peptides which are then fighting the bacteria.
Speaker 2:Okay.
Speaker 1:Vitamin D has also been known to modulate T cells, so peel to the bacteria, they're making peptides which are then fighting the bacteria. Vitamin D has also been known to modulate T cells, so not just macrophages but also T cells, which a lot of people have heard of, T cells, which are part of the immune system. I think most people think about T cells because those are the cells that drop when you have HIV, and so there's another part of your immune system.
Speaker 2:I think a lot of people being people in the medical field. I couldn't tell you anything about T cells after ninth grade biology.
Speaker 1:You never heard people talking about T cell counts in HIV patients.
Speaker 2:Well, I mean, I don't personally know a lot of people with HIV. I do know some, but I don't know.
Speaker 1:This is my medical bubble speaking. I just think everyone knows about T cells. I'm like T cells. Are you talking about Mr T, or is it like someone's going to come in here with, like I'm pretty the fool who drives a good bacteria in my?
Speaker 2:bloodstream yeah exactly.
Speaker 1:Yeah, we're going to have to take that off.
Speaker 2:No, no, no, that's got to be on there. That was gold.
Speaker 1:So the theory behind T-cells and the way that vitamin D help modulates it there's been theories helps reduce the risk of autoimmune disease, and if you know anything about autoimmune disease, it's when your own immune system is attacking normal, healthy tissue. So it's been proposed that vitamin D might help reduce the risk of multiple sclerosis, rheumatoid arthritis, lupus and other autoimmune-type diseases. It can help suppress inflammatory responses, which help promote regulatory T-cell activity and helps maintain an immune tolerance. Historically, vitamin D was also used to treat tuberculosis. Tuberculosis is another one of those diseases. We don't see that often in the United States anymore, although I have treated patients with tuberculosis.
Speaker 2:Isn't TB the one you take that test and if you get the welt on your arm and if it raises, then they quarantine you pretty quickly.
Speaker 1:That's a TB test. Tb is very contagious and so they take it very seriously. It used to be a huge, huge problem across the world, but it's not nearly as much of a problem anymore.
Speaker 2:Is it the same thing as consumption?
Speaker 1:I believe it is. Yeah, I think that is what they used to call TB.
Speaker 2:Yeah, I think Edgar Allan Poe's wife died of consumption and I always thought that meant she drank too much. Overconsumption, yeah, but no, no, it had to do with tuberculosis.
Speaker 1:Yeah, yeah, yeah, that's a different thing. Epidemiologists have studied that populations with lower vitamin D levels experience more severe outcomes in respiratory illnesses. This might be due to vitamin D's role in modulating cytokine production. Again, cytokines are part of the way your immune system fights infection and it helps reduce the likelihood of cytokine storms. I don't know if you remember that phrase that was being thrown around during COVID.
Speaker 2:I remember the phrase cytokine storms, because it sounds really cool, that's pretty epic.
Speaker 1:That would be a cool band name Cytokine storm.
Speaker 2:Yeah.
Speaker 1:Yeah, like punk rock or like heavy metals.
Speaker 2:I think more like punk rock.
Speaker 1:Yeah, yeah.
Speaker 2:Okay, but I couldn't tell you what it is.
Speaker 1:So I'm going to say it really plainly Imagine your body has artillery guns and those are cytokines, and they just start firing their artillery rounds all over your body and it's this huge mess and it's just destroying everything. It's not targeted at all, it's just like carpet bombing your body and these cytokines are going all over your bloodstream and eventually it kills you. And what I'm saying is vitamin D can help regulate that down so it's not having such a huge over effect from your immune system.
Speaker 2:How often are people really having cytokine storms?
Speaker 1:Well, it was suggested that during the Spanish flu back in the early 20th century, cytokine storms might've been what were killing so many young people. And also it was happening during COVID-19, where people were getting COVID and they were having these cytokine storms and that was what was really killing them. So that was a big big thing that they were discussing during the biggest parts of the pandemic. We could go on and on about infection prevention. There's lots of studies that show this type of bacteria, this type of virus, have increased risks of infection and severity with people who have low vitamin D levels. We'll go ahead and cut it short, because I think I've made the point. Nicole, do you take vitamin D every day?
Speaker 2:No, I try to remember. I'm not very consistent about doing anything every day.
Speaker 1:Except maybe pooping Hold on.
Speaker 2:Hold on 28 minutes 28 minutes in the recording, just for you.
Speaker 1:Thank you 28 minutes and the first time poop's been mentioned. I think that's a new record.
Speaker 2:I think it must be.
Speaker 1:Yeah, yeah, you did it on purpose, though I did think that's a new record. I think it must be. Yeah, yeah, you did it on purpose, though I did I did it wasn't natural. Yeah, yeah, so that makes me dirty, I'm sorry. Yeah, you're disgusting. We're going to talk about dosages of vitamin d in different food sources now. So just to reminder everybody, I'm not your doctor, I'm not telling you. This is not a prescription for you on how much vitamin d to take. These are general guidelines. So take all that with a grain of salt or with a grain of.
Speaker 2:Electrolyte powder mix yeah.
Speaker 1:So the recommended dosage from the FDA? They recommend 600 IU, which is international units, for adults up to age 70. 800 IU for those over 70. Although, as we've talked about before, the FDA is not always to be trusted. A lot of experts argue that these levels are way too low, and I'm one of those people who argues that it's way too low. Some people suggest that you should be getting 1,000 to 2,000 IUs daily for adults, and there may even be an argument that the tolerable upper level would be up to 4,000 IUs per day. Now, if you're going to be taking 4,000 to 5,000 IUs a day, I do recommend, at least twice a year, getting your blood levels checked. You can get too much vitamin D, although it's pretty difficult. Out of my time as a doctor, I think I've only seen one patient with too much vitamin D in their blood.
Speaker 2:How does that present?
Speaker 1:Well, we'll talk about that.
Speaker 2:Man, you're making me wait.
Speaker 1:We'll get to it. We'll get to it. It's in the notes. It's in the notes, we'll get to it. So deficiency is pretty common. In the United States alone, approximately 42% of the population is vitamin D deficient.
Speaker 2:That's a large number. So I know vitamin C deficiency which is scurvy right.
Speaker 1:Yeah, that's pretty obvious. When somebody gets scurvy, well, there's severities, but yes, it's also incredibly uncommon.
Speaker 1:Well, I just wonder if there's like uh hey, it's obvious, you don't have enough vitamin d, you know well, just look at me but you're also like swedish lineage, so yeah, that's true you're pretty pale so 42 of the us population is vitamin D deficient, and the rate can be higher in African Americans and Hispanics, with African Americans estimated to be up to 82% and Hispanics up to 69%. So it's quite, quite high and globally it's estimated about 1 billion people have vitamin D deficiency. So let's talk about where you can get vitamin D in your food. Fatty fish like salmon and sardines are the richest natural source of vitamin D. Salmon is pretty common and popular. I don't know how many people are eating sardines.
Speaker 2:Yeah, I mean, I guess we could order a pizza with sardines.
Speaker 1:I'm good. Okay, I'm good, thank you. Egg, yolks and beef liver also contain some amounts of vitamin D. In general, there's not a lot of vitamin D in most food sources, so most people choose to supplement it or get it from the sun when they can.
Speaker 2:Yeah, I'm still hung up on this whole idea of when did people decide that eating organs of other animals was like, hey, this is a great idea, let's do this.
Speaker 1:Well, I imagine people have been eating animals since the dawn of time.
Speaker 2:Yeah.
Speaker 1:And I imagine you eat everything to be more conservative and use what you have. So I imagine people have been eating organ meat since the dawn of time.
Speaker 2:I guess I'm one of those kids that grew up only buying rotisserie chickens.
Speaker 1:Yeah, I think that's a newer thing.
Speaker 2:Yeah.
Speaker 1:Processed industrialized meats. I think that's a newer thing, if you had to go out and hunt and kill an animal.
Speaker 2:I bet you use all the parts. Well, yeah.
Speaker 1:So you're weird for not eating liver and spleen and heart and whatever.
Speaker 2:You know, I have had some stuff like chicken heart.
Speaker 1:Yeah, chicken heart's not bad, it's a little chewy.
Speaker 2:Yeah, but then I got like really really ill after eating chicken heart and pig intestines and stuff, because I was in Brazil.
Speaker 1:I wouldn't eat pig intestines.
Speaker 2:Well, I did.
Speaker 1:Anyway.
Speaker 2:I got very, very ill.
Speaker 1:The next day coming home, that's what you get.
Speaker 2:Yeah, I guess so.
Speaker 1:I have eaten beef tongue. That's pretty good.
Speaker 2:That's disgusting. That's almost as bad as beef tartare. Who eats beef tartare?
Speaker 1:I do, I know I do.
Speaker 2:You're just asking for mad cow disease, man. Fun fact, that was one of my favorite halloween costumes in college mad cow disease yeah, I remember that costume. Yeah, yeah, it was not sexy, but it was great.
Speaker 1:Yeah, but I still love you thank you, you're beautiful, thank you so, and now we've talked a whole lot about disgusting meats and livers and and everything. So let's give the. Let's give a little shout to our vegan friends. There is some vitamin d that you can get from vegan sources, although it's pretty uncommon. The only real reliable source of vitamin D that I could find in vegan sources is the D2 version of vitamin D. We'll talk about that in just a second. It's found in mushrooms that have high exposure to sunlight. You can get about 100 to 200 IUs from a large serving of mushrooms exposed to sunlight, and then a lot of people artificially fortify vegan-based foods with vitamin D. So that's an artificial supplementation. Let's talk about D2 and D3 a little bit, because you'll see that on bottles in the store, d3 is called cholecalciferol that's the real name for it and it's better absorbed and more effective at raising blood levels of vitamin D. And then there's D2, which is called ergocalciferol, and I would generally recommend people take D3 if they're going to supplement from a bottle from the store, because it's just more effective.
Speaker 1:So, to break all this down, people with a vitamin D deficiency, you're going to want to go for a little bit higher dose than what the FDA recommends. Again, this is not a personal recommendation, but you might consider ranging from 5,000 to 10,000 units daily, although I wouldn't do that for long. If you're going to go that high, you're going to want to do it under supervision, get your levels tested and perhaps drop down when the levels increase, and that can restore it pretty quickly. Most people can probably do 1,000 to 2,000 IUs daily of vitamin D. All right. Now we're getting to the stuff Nicole wanted to talk about Vitamin D toxicity, which is pretty uncommon, but it can happen. We think about vitamins as fat-soluble and water-soluble, so the fat-soluble vitamins can be stored in your fat cells. Water-soluble vitamins tend to just be excreted when you have too much of them, so it's not as much of a problem.
Speaker 2:Like vitamin C, is water-soluble.
Speaker 1:Correct. So the fat-soluble vitamins off the top of my head, I believe, are K, a, d and E, so D would fall into that fat-soluble column. So excess amounts of vitamin D are stored in fat tissue rather than excreted through the kidneys. This can lead to toxicity. If taken in very high doses it can lead to hypercalcemic and vascular calcification. It can lead to kidney damage. The typical levels of vitamin D found in the blood are 30 to 50 nanograms per milliliter. Toxicity is really rare, but that's usually when it reaches around 150 nanograms per milliliter, which is quite high. Lethal doses are rare, but doses exceeding 50,000 I use daily over several months can lead to toxicity and death. Although I've never seen it, I imagine it's a very rare occurrence, only seen in scientific literature occasionally.
Speaker 2:Can you get a vitamin D toxicity from being in the sun too much?
Speaker 1:I think you'd probably die of a massive sunburn before the vitamin D. I think I don't know the answer to that, actually, but I would assume that your body, since you're creating the vitamin D yourself, has a way of regulating its own production rather than taking it exogenously, exogenously, sorry.
Speaker 2:Taking it outside of the Exogenously.
Speaker 1:Sorry, taking it outside of the body like in a pill form. My bad.
Speaker 2:Yeah, come on, you think we all have an MD after our name. But another weird question how similar are we to plants? Because plants have the whole photosynthesis thing going on. It sounds like we're sort of like plants.
Speaker 1:What's photosynthesis?
Speaker 2:You know what? You're not supposed to ask me that I went to music school, okay.
Speaker 1:So did I. You went to a better music school. Photosynthesis. I'm not a botanist, but photosynthesis-.
Speaker 2:You were in the Forest Ecology Club, though.
Speaker 1:I was State champions.
Speaker 2:Yeah, and you were the captain, weren't you?
Speaker 1:Yeah, I was. Yeah, yes, I was.
Speaker 2:That club, though I was state champions, yeah, and you were the captain, weren't you? Yeah, it was. Yeah, yes, it was still fun. That's still really great.
Speaker 1:Yeah, still really I shouldn't really be talking about that in public, but it is what it is. Nicole always likes to bring up embarrassing things on the podcast yeah like forest ecology and pooping. Uh, photosynthesis refers to a plant's ability to create sugar out of sunlight, so it's not the same thing, although if you want to break down the etymology of the word, I guess we are synthesizing things using sunlight. But when people talk about photosynthesis, it's usually a food source that plants are producing out of the sun, so it's not technically the same thing.
Speaker 2:It's sort of food for our parathyroid, though, because if our parathyroid doesn't get it, then it's going to munch on our calcium from our bones.
Speaker 1:However, you want to think about it.
Speaker 2:Yeah, so I am kind of right, do you?
Speaker 1:think of like Pac-Man going in there, like eating up all your calcium.
Speaker 2:Yeah.
Speaker 1:Going through your arteries and taking it all. Well, nicole might not think it's important to take vitamin D because we're all going to die of cancer anyway, but I personally think that vitamin D is very important. It's affordable, it's available, most people are deficient in it, or at least a very large number of people are deficient in it. I think it's definitely something that people should consider implementing into their daily routine. As we've covered, vitamin D is a cornerstone of health, influencing everything from bones to muscle, to immune system and to chronic diseases like diabetes and heart disease. So I would strongly suggest people at least consider supplementation. While supplementation can help, I do always recommend that you consult a healthcare provider and would definitely recommend at least once or twice yearly blood work to keep a close eye on things, to make sure you're not overdosing on it. Nicole, do you have anything else to add before we wrap up?
Speaker 2:No, I think that about covers it.
Speaker 1:Do you think you're going to start taking your vitamin D intake a little more seriously?
Speaker 2:I will do my best.
Speaker 1:All right, well, let's take some vitamin D together. Thanks for joining me on this deep dive into vitamin D. Please consider sharing this episode with any of your sun-deprived friends. And remember be humble, be happy, be healthy. We'll see you next week.
