The ABCs of Vitamin D

In 1992 I was diagnosed with posttraumatic fibromyalgia. Frequently when I was visiting doctors, they would ask, "Where is your pain?"

"It's easier to tell you where I don't hurt," I would answer. "The tip of my nose and my earlobes do not hurt. Everywhere else hurts."

Then in 2006 I had an appointment with Dr. Scott Grivas for an unrelated problem. I had given up hope of ever feeling better. But Dr. Grivas wanted to do a blood test to determine my vitamin D level. Because I worked outside in my yard almost every day, I didn't believe I could be deficient. I talked my way out of the test. (I don't like needles.)

About six months later my gynecologist drew blood for tests, including the vitamin D level. Dr. Grivas had been right. My vitamin D level was inadequate. We began an aggressive vegetarian vitamin D supplementation program. As my levels came up to the new desirable levels of between 40-50 ng/ml (normal levels are between 32-100 ng/ml), my "fibromyalgia" markedly disappeared. Rarely do I even notice it anymore.


In his editorial in the American Family Physician in January 2005, Dr. James Richardson noted: "Until vitamin D deficiency is quite severe, adults who are deficient in vitamin D may have chronic pain and lower extremity weakness. Indeed, women who are deficient in vitamin D often are misdiagnosed with fibromyalgia or even somatization syndromes." These somatization issues involve converting mental distress such as depression and anxiety into physical symptoms.

Michael Holick, author of The UV Advantage, wrote in 2004 in the American Journal of Clinical Nutrition that "more than 90 percent of 150 [people] who presented with nonspecific muscle aches and bone aches and pains at a Minnesota hospital were found to be vitamin D deficient." Many people labeled as having fibromyalgia and/or chronic fatigue are vitamin D deficient. The original diagnosis may be a misdiagnosis, or there may be more than one diagnosis. But only correct diagnosis can lead to appropriate therapy and improved health.

Dr. Grivas tells of two dramatic cases: "A middle-aged woman diagnosed with fibromyalgia came to me complaining of miserable body aches and pains with no apparent reason. She could barely get around. I drew blood for a vitamin D level test. The results showed that she had so little vitamin D that it was almost undetectable. With oral vegetable-based vitamin D supplementation, her relief was remarkable.

"A second interesting case was a middle-aged female with multiple sclerosis who came to see me complaining of weakness, numbness, and tingling of her right arm. We discovered that she had coincidental vitamin D deficiency. After plant-based oral vitamin D supplementation therapy, hydrotherapy, and anti-inflammatory herbal agents, she dramatically improved. Does she still have MS? Yes, but she is so very much better. Having one diagnosis does not protect us from other diseases or nutritional deficiencies. It may predispose them. This is particularly true with vitamin D deficiency. As a person becomes sicker, the tendency is to stay indoors. That is when what they desperately need is to get outdoors into the sunshine."

Risk factors

Vitamin D deficiency is now a worldwide problem. Depending on which research you cite, in the United States at least 50 percent and possibly more than 90 percent of the population is vitamin D deficient. One European study found that 100 percent of hospitalized patients were vitamin D deficient.

Interestingly, vitamin D is not a vitamin at all, but rather an essential hormone needed by every cell in the body. Without vitamin D, the body can't utilize calcium. And calcium is essential for all nerve and muscle function, as well as bone strength.

Vitamin D deficiency can cause the following problems: rickets in children, osteoporosis, numbness and tingling, muscle cramps, muscle weakness, and in extreme cases tetany (calcium imbalance marked by muscle spasms). Holick cites research suggesting that vitamin D deficiency is also related to increased risk of cancer, diabetes, rheumatoid arthritis, multiple sclerosis, hypertension, cardiovascular disease, systemic lupus erythematosus, inflammatory bowel disease, periodontal disease, and psoriasis. "Every cell needs vitamin D," he explains.

Vitamin D deficiency must be suspected in any person with generalized musculoskeletal pain and/or weakness, people with osteoporosis or bone fragility, any hospitalized patients, and those who are chronically ill.

Who is at highest risk?

The elderly because their skin no longer converts cholesterol into vitamin D as efficiently as it used to. The chronically ill; they tend to remain indoors. The malnourished. The obese. Anyone with limited sunlight exposure: the farther from the equator, the fewer UV rays from the sun can get through. (Clothing and sunscreen prevent direct contact of the rays, as does staying indoors). Persons with darkly pigmented skin?they require three to six times more sun exposure than do fair-skinned people. Persons with a history of kidney or liver disease or impairment. People on certain medications, which can predispose vitamin D deficiency. Babies who are exclusively breast-fed

What can be done?

The cheapest and easiest thing to do is to get more sunshine to more square inches of skin and let nature do its work. Holick recommends five to 15 minutes of direct sun exposure to the arms and legs or the hands, arms, and face two to three times a week between the hours of 10:00 a.m. and 3:00 p.m.

He points out that the American Academy of Dermatology promotes complete abstinence from sun exposure, warning people to use sunblock at all times. However, he promotes "sensible sun exposure," getting limited amounts of time in the sun and increasing the amount gradually. Sunburn can indeed damage skin and create an increased risk for skin cancers. Yet sunshine never creates more vitamin D than a person needs; it does not cause vitamin D toxicity.

W?lfgang Kopcke and Jean Krutmann published the results of their meta-analysis in Photochemistry and Photobiology, March-April 2008, concluding that ingesting beta-carotene (vitamin A) is actually protective against sunburn. After two weeks of getting more vitamin A in their diet, subjects could spend more time in the sun without burning. It is interesting that research suggests that a vitamin deficiency sets us up for sunburn.

More than a hundred years ago, Ellen White wrote: "If all our workers were so situated that they could spend a few hours each day in outdoor labor, and felt free to do this, it would be a blessing to them; they would be able to discharge more successfully the duties of their calling. If they have not time for complete relaxation, they could be planning and praying while at work with their hands, and could return to their labor refreshed in body and spirit" (Gospel Workers, p. 240). She also wrote: "Invalids too often deprive themselves of sunlight. This is one of nature's most healing agents. It is a very simple, therefore not a fashionable remedy. . . . Our own folly has led us to deprive ourselves of things that are precious, . . . which, if properly used, are of inestimable value for the recovery of health" (Testimonies, vol. 2, p. 527).

What do you do in the winter or when the sun is hidden from view?

Deliberately increase sun exposure.
Take oral supplements. Dr. Grivas recommends the plant-
origin vitamin D2, ergocalciferol. The animal-origin vitamin D3, cholecalciferol, is not as healthy or safe. See the sidebar for dosage recommendations.
Eat food containing vitamin D. This is harder than you think, because not many foods contain vitamin D naturally. And most foods that are fortified with vitamin D contain vitamin D3, or cholecalciferol. You really have to read food labels to find vitamin D2, ergocalciferol, but many soy milks, for instance, will specify vitamin D2 in their ingredient list, as will other health products. UV-treated mushrooms are also a good vegetarian source.

By far, sunshine is the cheapest and best method of treatment, as it does not create toxicity. Sunshine also has other beneficial side effects related to mood and general health.

Wise King Solomon said: "Light is sweet, and it pleases the eyes to see the sun" (Ecclesiastes 11:7). So whenever you can, enjoy both the sun that lights our earth and the Son that lights our souls.

Bonnie Gibson Mattheus, R.N., is the president of Bon Herbals and Wonderful Things, Inc. She lives in Collegedale/Ooltewah, Tennessee. A. Scott Grivas, Jr., M.D., is the medical director for Wildwood Lifestyle Center and Hospital in Wildwood, Georgia. He not only cares for patients but also teaches physicians around the world.

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