Gimme a D!

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Okay, I know that this is supposed to be the Vegan Month of Food, but I wanted to take one of these days to talk about vitamins. There are two in particular that vegans may be at a little more risk of being deficient in, because they’re not found abundantly in plant foods. One is Vitamin B12, and the other is Vitamin D. I’ve had deficiency in both, in a relatively short time of being vegan. I talked a lot about Vitamin B12 some time ago, so I won’t go into much there. My levels are now normal, and I now just use a 1000 mg supplement a few times per week, in addition to a multivitamin. My levels are fine now, so that was an easy fix.
Vitamin D, on the other hand, has not been. Truth be told, vegans aren’t even close to being the only ones deficient in this vitamin; an awful lot of omnivores are as well. Especially for those of us who live in places where it’s not sunny and warm all the time (or those of us who are religious about their use of sunblock) the risk is higher than you probably think. As a species, we humans are meant to be able to make our own Vitamin D. We synthesize it from the sun. It’s been theorized that part of the difference in skin pigment, hair and eye color have to do with our ability to best absorb Vitamin D through our skin- and people with blue eyes, pale skin and red hair are supposed to be the best able to absorb it, since people with that coloring tend to come from climates far from the equator. Hi!
Okay, most of the red in my hair comes from henna leaf, but there is some natural red in there too. :-)
Clearly, I’m not absorbing it from the sun. Then again, I have such a history of bad sunburns, that I cover up when I’m outside. I’d rather take a supplement than get skin cancer. Supplementation can get tricky though, on a number of levels. There are two major types of Vitamin D available over the counter- D2 and D3. D3 is an animal product, typically from sheep. D2 is not. There seems to be some evidence that D3 is better absorbed than D2, so we vegans may need to take a little extra of the D2 to compensate. But that’s only part of the trickiness.
I was diagnosed with a deficiency of Vitamin D back in the spring. Nobody suggested that I have my levels drawn because I’m vegan or because I was displaying any symptoms. I had routine labs drawn, and I noticed something a little odd with two values. My Alkaline Phosphate level was flagged as high. At first I didn’t think anything of it, because I know it has to do with bone growth. It’s normal for it at times to get a little elevated- it’s usually only concerning if other values associated with the liver are off, which was not the case. But then I noticed that my calcium level was just barely above the low end of normal. We don’t have a lot of calcium freely in our blood, but it’s one of those things that is absolutely necessary for life (not just strong bones!). So I had a thought- what if my body is breaking down my bones to get the calcium that I need in order for my muscles to move and my heart to beat?
Turns out, it wasn’t such a bad theory. May not be entirely right, but it lead to me getting my Vitamin D level drawn, which turned out to be scary low. So I started taking 1200 International Units of Vitamin D daily (well, when I remember, probably 5 out of 7 days per week). Then I had it measured again several months later. Even lower.
That’s right, even lower. Turns out, when you have an actual deficiency of Vitamin D (as opposed to an “insufficiency”), you initially need mega-high doses of Vitamin D to correct it, then you take supplementation in the amounts that I was talking about. Did you know that? I didn’t. My doctor apparently didn’t. Neither did my nutritionist- and we’re all well-educated health professionals.
I don’t have all the answers for myself yet, and there’s always the possibility that there’s something more wrong with me that contributes- but looking at the research, it’s probably not anything more serious. It’s just not something that people- medical people, even- are all that aware of.
So what does that mean for you? Well, if you live in Southern California and sunbathe weekly, probably nothing (though a trip to the Dermatologist may be in order). If you live in Northeast, spend most of your time indoors working or studying, and slather on the sunscreen when you do go out, you probably aren’t at the level where you should be- even if you’re not vegan. The only food that Vitamin D is found abundantly in naturally is fatty cold-water fish, and small amounts are found in eggs. Even most omnivores don’t eat enough of those to make a difference. It is added to some foods, notably milk and soymilk (and other non-dairy milks), but again, most people don’t drink enough of those to get all that they need.
So if you think you’re at risk of being Vitamin D deficient, you probably are. Ask your doctor about getting tested. If I hadn’t, I wouldn’t have known. I probably could have gone well into middle age without it ever being recognized as a problem, because I don’t look like someone who might have problems with my bones. And correcting this now, I probably won’t. It’s one of the few things that being overweight is actually good for- but for people who don’t have “sturdy frames,” the damage may already be happening. Get checked. And take a supplement- you don’t have to trade osteoporosis for skin cancer.
[Note, many of the links here require subscription access to Up to Date or journals. If you need some information you can’t get, leave a comment and I’ll see what I can do for you.]
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One Response to Gimme a D!

  1. Crazy Vegan Mom says:

    I have really low D levels as well. I had been taking 2,000 IU a day, but did not see an improvement, so I have been taking 10,000 a day (like you, most days- when I don't forget) and am being tested next week.
    There is a Dr who is a big Vit D proponet, his twitter address is http://twitter.com/RobertBakerMD

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