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Can I take Vitamin D supplements?

Hi John,
I tested low for Vitamin D 25(OH) and 1,25 di-hydroxy Vitamin D at 89.7 and was told to start supplementing Vitamin D. I am a Type 1 diabetic with Lyme disease. What do you think?
– Jess

Dear Jess,
This can be a very confusing issue.  While it is one of the greatest things for the health of the nation that Vitamin D deficiencies have moved into the spotlight, most health care professionals don’t understand all of the issues involved.  I have personally explained the Vitamin D issues to several MD’s who have called to question me about testing that I have done on their patients.

Athough the Vitamin D test done by your other health care provider is indeed low, it is only one relevant test.  The test done was a 25(OH) Vitamin D, the more common test that measures the storage form of Vitamin D in the body.  Most labs report results of over 32 ng/dl as “normal”.  While this may be adequate for protection and creation of healthy bones, we need much higher levels to support immune function.  I place “normal” at 55-60 ng/dl because that is the typical level achieved by lifeguards and in cultures that get traditional amounts of sunlight exposure.  When serum levels of Vitamin D fall under 30 ng/dl there has been shown a proven increase in diabetes, 15 forms of cancer, Parkinson’s disease, Multiple Sclerosis, and several other neurodegenerative diseases.

It is virtually impossible to have too high a level of the storage form of Vitamin D, so very few people need to be concerned.  However, you are one of the people who must be concerned.  Anyone with very high levels of inflammation should get both vitamin D tests.

The test that I order for the more bioactive form of Vitamin D is called 1,25 dihydroxy Vitamin D or calcitriol.  This is the form that directly activates the immune system.  This is a very powerful hormone that can cause significant damage if the levels are elevated.

The body produces cytokines which are chemicals that attract the other immune cells, such as the white cells in the bloodstream, to infection sites.  This is a very important process.  With inflammatory disease conditions the body often produces an overabundance of cytokines and will even lose it’s ability to turn off the reactions.  These excess cytokines can then block the vitamin D receptor sites, tricking the body into thinking it needs more of the “active” Vitamin D.  The body then over converts the storage to active forms, which can be a very serious problem. Your 1,25 di-hydroxy Vitamin D (calcitriol) level is too high at 89.7.  The “normal” range at Labcorp is 10-75.  This will cause a lot of inflammation and even increase osteoporosis risk if it stays high.

You should not take any vitamin D supplements until this goes down, as you will over-convert from the 25(OH) Vit D in the supplements to this active form. The cytokine storms from your infections are likely blocking the vitamin D receptor sites. Although you need vitamin D to activate the immune system, getting this calcitriol level down would take priority. Even sun exposure could be a bit problematic at this time.

Be Happy!

– Dr. John Nieters, L.Ac. DAOM, FABORM

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