Let’s Talk About Vitamin D

Vitamin D
A lot of doctors have been making a fuss about vitamin D as of late, while for years those in the nutrition and alternative fields have been discussing the benefits of vitamin D. Many doctors are now doing a serum vitamin D test at each physical. Though, most of us with diagnosis of autoimmune disease have a vitamin D test done as part of our routine lab testing.

Well along with Vitamin D being needed for the body to use calcium there seems to be a connection with the immune system. In a 2008 study in China on 290 patients with Lupus 96% of the patients had low levels of vitamin D, those who had more severe symptoms of Lupus has even lower levels of vitamin D (Mok, et al. 2012). “The active form of vitamin D produces and maintains self-immunologic tolerance, some studies show that 1,25(OH)2D inhibits induction of disease in autoimmune encephalomyelitis, thyroiditis, type-1 diabetes mellitus, inflammatory bowel disease (IBD), systemic lupus erythematosus, and collagen-induced arthritis and Lyme arthritis.” (Ginanjar, Eka 2007).

The National institutes of Health Office of Dietary Supplements Vitamin D fact sheet gives range amounts for Serum 25-Hydroxyvitamin D [25(OH)D] concentrations and with health status  (NIH, 2014 Chart 1)
125 nmol/L Emerging evidence links potential adverse effects to such high levels, particularly >150 nmol/L

This chart surprised me because even after having my D[25(OH)D] levels checked multiple times I was always under the impression that as long as the results were  30nmol/L or greater it was a healthy range….at least that is what the labs that my tests have been ran at have down for their range. But here in their fact sheet they state that vitamin levels are inadequate at levels under 50nmol/L. So it looks like we potentially need more vitamin D than thought.

Now how do we get vitamin D?

Sun exposure allows our bodies to naturally make vitamin D. I’ve been told by multiple professors in my classes that if we shower right after sun exposure we  lose some of the vitamin D synthesis, more if we use soap when we bathe. This tidbit of info from them really stuck in my head. Because most of my sun exposure is typically spent at the beach or working in the garden. So what is the first thing I do when I am finished at the beach or in the garden? I come inside and wash the dirt and sand off of myself. If you are one who has reactions to sun exposure you are likely not getting much vitamin D this way. So you will have to get most of your vitamin D from other sources.

We can get vitamin D from a few food sources. Cod liver oil has the highest amount of vitamin D. Most oily fish have vitamin D in them, primarily in their skin. Beef liver and egg yolks also contain a small amount of vitamin D.  And for vegetarians, the only unprocessed vegetarian food containing vitamin D in it that I know of is mushrooms. You can find vitamin D added in many foods, for instance fortified milk, added into orange juice, and fortified breakfast cereals. But if you are eating foods in their unprocessed state you won’t be eating foods that are vitamin D fortified.

And then of course there are vitamin D supplements. Which if you’ve had you vitamin D tested and are low, your doctor has probably already recommended taking supplements and has likely given you a recommended amount to supplement with.

If you’ve been faithful with following your medical provider’s recommendations and are supplementing and your doctor still continues to tell you that your levels are low there are a few things that you could look into.. Check into the medications you are on, some will interfere with vitamin D absorption, for instance prednisone will interfere with both calcium and vitamin D. Also magnesium deficiency can prevent us from assimilating our vitamin D since it is needed to utilize the vitamin D. So that could be another direction to discuss with your medical care provider.

Now a tasty recipe full of vitamin D rich mushrooms.
For those of you doing paleo, AIP, grain free or low carb and are missing stroganoff here is a tasty one I came up with in the kitchen today. For a vegan version use vegan oil for your oil choice and substitute the meat with either more mushrooms cut into strip sized pieces, tempeh (not paleo) or your choice of meat alternative

1 tsp of oil/fat of choice. I used grease from preservative free bacon

8 oz package of portabella mushroom

3 cloves of garlic

1/4 onion

Sauté until onion is translucent.

Add in

1- 2 finger pinch of sea salt

1/4 tsp crushed peppercorn

1 tsp chopped fresh rosemary

1/2 tsp dried dill

1 tsp dried parsley

1 tsp lemon juice

1/2 cup of whole fat coconut milk (if you want to keep the fat content down and are eating dairy nonfat Greek yogurt would be a good alternative)

Simmer until everything is soft

Take 1/2 of the sauce and put in a blender and do 2-3 quick pulses to make it creamy. If it is too dry just add a little bit more of coconut milk.

Pour the blended portion back into the pot

Add in 1 cup of meat of choice. I used a mixture of ham and bacon (unpreserved). if I had some on hand scallops and shrimp would be tasty as well as would beef, or just strips of mushrooms if I wasn’t feeling like eating meat.

Toss with “noodled” veggies of choice and heat until veggie is warm. I used Zucchini that I used the potato peeler on and made wide slivers because I wanted it to be fettucine pasta sized.
Since I tossed it with zucchini and zucchini weeps a lot I kept the sauce on the thicker side. And if I had fresh herbs I would have used that instead of dried and used 2-3 times as much.

Ginanjar, Eka. 2007. Vitamin D and autoimmune disease. Acta Med Indones. 2007 Jul-Sep;39(3):133-41. Accessed from http://www.ncbi.nlm.nih.gov/pubmed/17699936  on 5/3/2015

Mok, Et al. 2012.  Vitamin D levels in Chinese patients with systemic lupus erythematosus: relationship with disease activity, vascular risk factors and atherosclerosis.  Rheumatology (2012)   51  (4):  644-652. Accessed from http://rheumatology.oxfordjournals.org/content/51/4/644.  on 5/3/2015

NIH. 2014.Vitamin D Fact Sheet for Health Professionals. Accessed from http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ on 5/15/2015