Vitamin D deficiency has become big news in recent years as it was found that many people are deficient, and that the vitamin is for far more than just bone health and preventing rickets and osteoporosis. Vitamin D, a fat soluble vitamin, is essential for bone health. The body needs vitamin D to absorb calcium, therefore one must have sufficient vitamin D for strong bones, preventing rickets, osteopenia and osteoporosis, and periodontal disease. Low blood levels of vitamin D have been associated with other diseases, such as cancer, respiratory illnesses, severe asthma, increased risk of cardiovascular disease, autism, Parkinson’s disease, multiple sclerosis, type II diabetes, anemia and even preeclampsia. 

Clinical manifestations of a vitamin D deficiency include: lowered immunity, a sweaty head, muscle pain and weakness, fatigue, depression, bone pain, respiratory illness, cardiovascular disease, kidney disease, chronic pain, and psoriasis. These symptoms fall into Chinese medicine patterns of general Qi deficiency, Lung Qi deficiency, Spleen Qi deficiency, Kidney Qi deficiency and Heart Qi deficiency. Signs of Lung Qi deficiency are spontaneous sweating, shortness of breath, lowered immunity, skin problems and rashes, and potentially a weak voice or weak cough. Signs and symptoms of Spleen Qi deficiency include fatigue, muscle weakness, bloating, reduced appetite, nausea, pallor and a weak pulse. Kidney Qi is responsible for the bones and controlling the kidneys. Heart Qi deficiency manifests as palpitations, spontaneous sweating, fatigue, depression, pallor, and a weak pulse. Vitamin D deficiency would often be seen as a combination of at least two of the organ deficiencies. Because the body needs vitamin D for the health of so many organs and systems, it is easy to see how these organs fall out of balance without sufficient vitamin D from the sun or through our diets.

The least expensive, easiest, and perhaps arguably, healthy way to treat vitamin D deficiency, is to get it from the sun. Vitamin D3 is synthesized from the photo-transformation of cholesterol when UVB rays from the sun hit the skin. Vitamin D3 absorbs into the bloodstream, and then, like a hormone, is delivered to the liver, and then the kidneys. In the kidneys it is converted into the activated form of vitamin D, where it can be used by the body. Sunscreens block this transformation, so spending time out in the sun for 10-15 minutes without sunscreen is ideal. Vitamin D deficiency can also be treated with supplementation of D2 or D3 (often a multivitamin has sufficient amounts), vitamin D2 fortified foods (orange juice, milk, breakfast cereals), or eating more of the few foods in which it occurs naturally. Foods that contain vitamin D include some types of fish, fish liver oil, and egg yolks. A healthy and balanced diet with plenty of fresh produce, whole foods, and some fish and egg are important for vitamin D levels, along with adequate sun exposure. Unfortunately many modern humans do not get enough sun exposure nor do they eat an adequately healthy diet. Vegetarians and vegans are at more risk of not receiving enough vitamin D through diet because it only occurs naturally in animal products.

For those who need to supplement due to inadequate sun exposure, dietary restrictions, or low blood levels of vitamin D - what is better to supplement with -  vitamin D2 or D3? The difference between D2 (ergocalciferol) and D3 (cholecalciferol) is how they are structured. Vitamin D receptors prefer D3, making it a better choice for increasing blood levels of the vitamin. Other differences are negligible. A general dosage recommendation for an adult with a healthy diet and some sun exposure is only 600 iu per day, what is typically in a multivitamin. Fat soluble vitamins have the potential of overdose, as vitamin excessive to what the body needs is not excreted through urine, as it is with water soluble vitamins. Fat soluble vitamins, which include vitamins D, A, and E, are stored in the body and can reach toxic, even fatal, levels. Excessive consumption of vitamin D can cause too much calcium to be stored, creating calcium deposits in the organs. Excessive vitamin A can cause liver problems. Too much vitamin E can cause vitamin K deficiency and bleeding problems. 

Doctors worry that too many people are supplementing with vitamin D without understanding the risk of overdose. It is not recommended to supplement with more than 4000 to 5000 iu daily unless under the supervision of a doctor. Doctors who do work with chronic illness and treat with higher doses of vitamin D typically give vitamins D3 and K2 in combination. Vitamin K2 is a perfect partner to vitamin D. Vitamin K carboxylates osteocalcin to support properly mineralized bones and prevents inappropriate calcification caused by high doses of vitamin D. 

To keep healthy and maintain adequate vitamin D levels, follow these few recommendations: go outside for 10-15 minutes daily without sunscreen (then apply if you will be outside for longer periods) and without clothing covering most of your skin, eat a healthy and balanced diet including some fish and egg yolks, and supplement with vitamin D3 and K2 in the winter months if you live further from the equator. Some people may have a need for supplementation throughout the year depending on their circumstances. If you are experiencing frequent infections or illnesses, a sweaty head, muscle pain and weakness, fatigue, depression, bone pain, cardiovascular disease, kidney disease, or chronic pain, a simple blood tests for vitamin D levels can be very helpful in helping you find out if these troubles can be helped with simple supplementation or enjoying more time outdoors.