Vitamin D is found everywhere in the body. It is essential for many body functions. It has been shown to be important in helping to

• Avoid complications of pregnancy
• Avoid Parkinson’s disease
• Maintain cognition (this may help reduce the effects of Alzheimer’s disease)
• Prevent cancer of several types
• Prevent type 1 diabetes, especially in babies
• Increase the risk of heart attacks and stroke
• Increase the body’s ability to fight Clostridium difficile infections (that is a nasty infection that is resistant to many antibiotics. Help avoid it by making sure you wash your hands frequently when visiting someone in hospital)
• Increase your response to exercise
• Increase the chances of migraine (possibly)
• Increased risk of fibromyalgia (a painful condition that has sometimes been linked to chronic fatigue syndrome)

There are probably many other health problems possibly associated with not enough vitamin D in the body. Autism has been suggested by some experts as being related to lack of vitamin D, but there needs to be a lot more research done to confirm the link – it might be that the lack of vitamin D is actually the result of something else.

The problem with all of these possible ill effects of not enough vitamin D is that it takes a long time to show the effects of supplementation with vitamin D on the health problem. There is also disagreement over the type of vitamin that should be used for supplementation.

So, how much vitamin D do I need?

Unfortunately, that is not possible to answer in a post – it all depends. How much vitamin D do you actually have in your body? How much sun to you allow to reach your skin (without sun blocker or clothes)? How dark is your skin? How far north (or south) of the equator do you live (the higher the latitude, the less effective sun exposure is in increasing vitamin D levels). How old are you (older people make less vitamin D)? How much vitamin D do you get in your food?

The answer to the last question is actually easy – not much. The only way to know how much vitamin D you need is to have a health care provider request a lab test for you. Once you know the levels, then you can plan for getting more vitamin D. The majority of people in the higher latitudes do not have enough vitamin D, so I can be fairly certain that you will need more.

Options for increasing vitamin D levels

Really, there are only two ways to increase vitamin D levels:

• More sun exposure
• Supplementation

The sun exposure can be difficult – you need about 15-20 minutes of full sun exposure every day during. As I write this post there has been no sun all day! In doing this, you have to be careful to avoid burning your skin. You may need to increase the time if you are dark skinned, and as you get older. See how difficult it is? The amount of vitamin D you can get from food is limited. Maybe a bit from calcium and vitamin D that is added to some orange juice or milk, but that is not a reliable amount.

Supplementation is easier, but you need to work with your health care provider to determine the dose. You don’t need to use a prescription form of vitamin D. What you can buy at the health food store is usually enough. Just make sure you buy a good brand, and have your vitamin D levels checked. Probably at the beginning and end of winter.

Blood levels of vitamin D

Blood levels should ideally be kept above 15 ng/ml (37.5 nmol/L), but less than 200 ng/ml (500 nmol/L) according to the Office of Dietary Supplements. My physician recommends keeping my levels closer to the lower level to avoid side effects. I take 1000 units per day, but some people may need 10,000 units/day, at least for a short time. It is important to work with your health care provider to determine YOUR correct level of supplements.

I often see questions on various forums and in news articles questioning the value of multivitamins.  There is a lot of evidence in the literature that in some cases individual vitamins have been shown to have this or that effect. Often, there is no effect, although in some cases it another vitamin is beneficial. Other times we read that a combination may show some benefit. Calcium and vitamin D is one example. Why should this be?

There are a couple of reasons why we need to look closely at what vitamins we are taking. Firstly, we need to make sure that they are high quality, that they undergo some kind of testing where the results are publicized, so that we can depend on actually getting what the label says we are getting. The FDA does not routinely inspect the places where vitamins are manufactured. They are concerned with whether those herbal remedies contain some form of the drug contained in Viagra, but under the Dietary Supplement Health and Education Act (DSHEA) of 1994, there is no prelaunch approval process for supplements similar to the process for pharmaceutical drugs. FDA will only act if there are problems reported with a supplement; and usually only if there are a lot of problems reported. Particularly if people have died.

The second reason we need to look closely at the vitamins we are taking is that some of them will only work if they are taken together. Like calcium and vitamin D, that I mentioned above. Several of the B vitamins work best if they are taken with other B vitamins. This is a problem with clinical trials – if the trial is of a single vitamin taken alone, how do we know that it will be used effectively by the body? We don’t.

Good combinations of vitamins are quite ‘expensive’ in money terms. However, we can read that the food that we eat is of lower nutritional quality than it was 30 years ago (I did a few weeks ago). This means that we have to replace some of that quality with a good nutritional supplement. Also known as multivitamins. These are different from the herbal ‘dietary supplements’. The manufacturing quality can be controlled to ensure that the amount of each vitamin is close to the amount stated on the label. Did you know that there are manufacturing tolerances for pharmaceutical drugs as well?

So, to ensure that we are getting ‘good’ vitamins, we should pick a company that carries out research into the optimal combinations of vitamins, and manufactures the resulting combinations with as much care as a pharmaceutical company does. That way, we can be sure we are getting value for money.

Do I take vitamin and mineral supplements? Yes. As a result, my blood pressure is lower than the ‘standard’ pressure for my age, I do not have diabetes, and I only rarely visit a doctor other than for check-ups. Could this be the result of eating a healthy diet and exercising? Yes, it probably could. Could it be something in my genes? Sure, but unless I get genetic testing, I am not going to know for sure. Could it be luck? Maybe, but don’t we all create our own ‘luck’ by working hard and eating right? I just prefer the additional insurance that taking vitamins gives me, maintaining Rodshealth at an excellent level.

Think about it.

I posted before that I have sleep apnea. Since the diagnosis, I have learned a lot about the disorder – both from reading about it, and from living with it.

My wife tells me that my snoring scared her when we got married (nearly 16 years ago). At that time she knew nothing about sleep apnea, and there were probably not many doctors that knew much about it, either. So she put up with it. I didn’t know that I snored that much, but I did find that I was getting very tired during the day. I thought that was normal for the kind of work I was doing – sedentary, office-type work. I would try and do some exercise, but then I found I was getting even more tired. Weight was becoming a big problem.

There are many effects of sleep apnea – none of them nice. They include  high blood pressure; greater risk of heart attack and stroke; heart rhythm changes; waking up in the night to use the bathroom (I was lucky, only once a night); headaches (including migraine); daytime sleepiness, even after a ‘good’ night’s sleep; memory and concentration problems; weight gain;  possibly seizures; possibly diabetes; gastric reflux disease; sweating during the night; depression; anxiety; pain; impotence; relationship and job issues; and so on. Enough already? The real danger is that some people fall asleep during the day – the person not moving when the traffic signal has changed to green may have sleep apnea. They need sympathy and education, not an angry blast on the horn.

I have been using my CPAP machine for nearly a year now  and have seen a lot of improvement in my health. I don’t snore, and I am no longer needing to nap during the afternoon at work (a very good thing when the boss is around). I still get tired, but I don’t have the ‘brain fog’ that I used to have. I wake up before the alarm some mornings, and I no longer want to sleep late (after 7-8 AM) on a Sunday morning. I do find that I need to go to bed a little after 9:30 PM, but that is because I get up at 5:00 AM on days when I have to go to work.

The CPAP machine is amazing technology. It is just a little fan that blows air through a hose and into my nose through a mask. These masks are often called interfaces because they can cover the whole face (think Darth Vader), just the nose (a little bit like the masks that come down if there is a loss of cabin pressure in a plane), or just sit under the nose so that there is very little contact with your nose (called nasal pillows).

My personal favorite mask is the nasal pillows. They don’t make my nose sore, and are normally very quiet. They do get a bit noisy when they are not adjusted properly and air is leaking out of the sides.

The air pressure is something people get worried about. It is measured in centimeters of water. Why, I don’t know. If they talked about pounds per square inch (in the US, where I live), the numbers would be very small. Nothing that would blow up a balloon. I got used to the pressure I was prescribed very quickly – it was only 8, although I did have to have it increased to 10 after a couple of months because I was still snoring a bit.

So, sleep apnea is a scary thing – the treatment is not.

An interesting story broke this week in the news – I saw it on Yahoo! News, but it has been on other web sites as well. The story reports a study from the highly respected British Medical Journal with the title: “Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis”.

The researchers took a look at the effect of calcium on the chances of heart attacks and other cardiovascular problems. They did this by looking at the results of 15 large studies in which the patients had taken calcium supplements for more than a year. There had to be more than 100 patients in the study, and the patients were older than 40 years. Altogether more than 11,000 patients were studied.

There was a small  increase in the risk of heart attacks, but the increases in risk of stroke, a combined endpoint (included stroke, heart attack, and sudden death) and death did not reach statistical significance.

I read the article and saw that the authors noted that “Calcium supplements (without coadministered vitamin D) are associated with an increased risk of MI” [heart attacks]. They also say in the methods that trials were only included if vitamin D was given to all patients in the study. They say that the risk of death is reduced with vitamin D supplementation.

So, what does this mean? Calcium is an important mineral for a healthy body. If we are not eating a healthy, balanced diet, we may need supplementation. However, those supplements need to be balanced and in the correct amounts, just like the rest of our diet. Calcium on its own may not be the healthiest way to take calcium.

Clinical trials often report on the use of one supplement on its own, yet we should not be taking supplements in that way. Here at Rodshealth I believe in taking a balanced, healthy dietary supplement and have been taking the same one for years. Not to say they are for everyone, but my holistic medicine physician agrees that the one I am taking is good. During my recent visit to hospital the docs could not find anything wrong in my blood work, so I figure that the vitamins and minerals (including calcium with vitamin D) are not doing me any harm.

Can you say the same about your dietary supplements?

*In the interests of full disclosure, I am a distributor for the dietary supplement mentioned on this page.