If I can have a vitamin D deficiency story, then trust me, anyone can. I wanted my husband, a physician, to write this blog post (see below) on how a vitamin D deficiency can occur even if you are supplementing with a high dose of 5,000 IU’s. But first, for those of you who may be new to Clean Cuisine, I just wanted to give you a quick background story. Hopefully it will help you see that if I can be deficient in vitamin D, then just about anyone can be.
If you know my clean eating story, you know I was diagnosed with multiple sclerosis (MS) in 1998 at the age of twenty-two. I radically overhauled my diet and lifestyle after my diagnosis and have managed my disease without the need for the powerful disease-modifying MS medications for two decades now.
Although I consider the nutrient-dense, plant-rich and anti-inflammatory clean eating diet to be the most important component of the natural treatment plan I follow, nutritional supplementation, along with exercise, meditation (by the way, this is how I learned how to meditate) and stress management have all played a very big role as well.
Over the years, I have tweaked many things about my diet, supplements and exercise regimen (you can read my 19-year clean food diet journey here), but I have consistently supplemented my diet with vitamin D for at least 15 years. I know for sure it has been at least that long because in the very first book I wrote with my husband, The Gold Coast Cure, published in 2005, vitamin D supplementation was an essential component of the anti-inflammatory diet plan we recommended. We based our recommendations on a study published in the journal Neurology that showed women who supplement with at least 400 international units (IUs) of vitamin D daily were more than one-third less likely to develop multiple sclerosis.
Initially I was supplementing with only 1,000 IU’s of vitamin D, but the more we learned about the importance of vitamin D and it’s impact on the immune system, the more we realized 1,000 IU’s was probably not enough. Over the years I have bumped my vitamin D supplementation up to 2,000 IU’s and in more recently as high as 5,000 IU’s. In fact, I was supplementing with 5,000 IU’s at the time I was diagnosed with a vitamin D deficiency just recently. That’s why I say, if I can have a vitamin D deficiency story, then anyone can.
I should also point out that I did switch vitamin D brands. For years I was taking our own brand of Clean Cuisine supplements that we private labeled through a pharmaceutical-grade nutrition supplement company called ProThera. I took our own line of supplements for at least 4 years and never had a problem. We had to discontinue our Clean Cuisine brand line of supplements earlier this year when ProThera underwent company changes that no longer enabled us to private label the AM/ PM vitamin, mineral and essential fat supplements we recommended in our Clean Cuisine nutrition book. As many of you know, the supplement industry is not regulated and my suspicion is that the vitamin D supplement brand I switched to might not have contained what the label said it did.
I don’t want to name the brand because I don’t know for certain that was the case (as you will read in my husband’s article below, other factors could have definitely contributed.) However, I can’t ignore the fact that I have never had a vitamin D deficiency until now. And the vitamin D deficiency occurred despite supplementing with 5,000 IU’s a day.
One last thing…we live in sunny south Florida, where I am exposed to “the sunshine vitamin” (vitamin D) on a daily basis. I admit I do not purposely sunbathe anymore like I did in my teens, but it’s almost impossible to completely avoid the sun living in south Florida. Again, that’s why I say, if I can have a vitamin D deficiency story, then so can anyone….
Ok, I’ll let my husband fill you in on how he thinks this might have happened….
Ivy knew she wasn’t feeling “herself” for the good part of the summer. Initially we blamed the cause on the stress of completing and marketing what we hope will be our best, most informative and most beautiful book ever, The Clean Cuisine Cookbook. At 42-years old, Ivy also knew she had some hormonal changes going on (she even recently created a new recipe, the “Brain-Fog Busting/ Hormone-Balancing Smoothie” and started supplementing with DIM, an estrogen balancing supplement.)
All the while she has continued to eat well, exercise, and take supplements to optimize our health. One of the most important vitamins is vitamin D and vitamin D deficiency is known to be associated with low mood, low energy, weak muscles and weak bones as well as a host of serious medical conditions. As Ivy mentioned above, vitamin D deficiency has even been implicated as a risk factor for the development of multiple sclerosis.
It is no wonder Ivy cares so much about having optimal vitamin D levels, so much so that she was taking 5,000 IU’s daily of a popular brand name supplement. Imagine our disappointment when we went to a nutritional health physician and had multiple lab tests drawn and then, alas, Ivy was found to be deficient in vitamin D, so deficient that the doctor insisted on supplementation. We had to remind her we were already supplementing.
Ivy’s Vitamin D Deficiency Story: What Went Wrong?
Well, with vitamin D deficiency many things can go wrong….
Vitamin D Is Hard to Get Through Diet
We always encourage people to start with their diet with any nutrient deficiency, including vitamin D. The best natural sources of vitamin D are fish (fatty cold-water fish in particular), liver, egg yolks, and mushrooms and we strongly encourage the consumption of these foods. These alone are not adequate.
Other foods have been artificially fortified with Vitamin D, but the two primary Vitamin D-fortified foods are milk and breakfast cereal, which contain dairy and gluten, and cause their own whole set of health problems.
Nature Intends for Us to Get Sunlight
Nature intends for us to primarily create vitamin D through exposure to sunlight. We both have fair skin and we live in Florida and now that we are in our 40’s and early signs of sun damage have started to appear, Ivy has become more concerned about sun exposure causing wrinkles, “sun spots”, and even cancer. As a physician, I can tell you some of this concern is not relevant and is the unfortunate result of bad science and misguided public information campaigns. The risks of vitamin D deficiency are life long and significantly affect quality of life and overall health in many ways while skin cancer is mostly an inconvenience that can be removed surgically or treated with radiation. The most severe type of skin cancer, melanoma, is far more related to genetics or to a malfunctioning immune system than it is to sunlight exposure.
Regarding blemishes and wrinkles, it is true the sun will damage your skin from a cosmetic standpoint. Having said that, you have to weigh the significant risks associated vitamin D deficiency against the benefits of keeping “perfect skin” into old age. I have told Ivy it is reasonable to allow her back or legs to be exposed to direct sunlight for 15 minutes a day while covering the places most likely to show sun damage, such as the face, neck and hands.
How Can a Vitamin D Deficiency Occur If You Are Supplementing with Vitamin D?
The next question is why would supplementation with 5,000 IU of vitamin D, a fairly high dose daily, not help?
First of all, make sure the supplements you take are vitamin D3 as opposed to D2. The D3 version is the biologically active version. Vitamin D is fat soluble just like vitamins A, E, and K and is therefore unlike many other vitamins which are water soluble and can be taken just fine on an empty stomach. For this reason make sure you take vitamin D3 with food, in particular with fatty food. Just making the effort to take your vitamin D3 supplement with your largest and fattiest meal each day has the effect of increasing active levels in your body by 50 percent.
Not All Vitamin D Supplements Are Created Equal
As Ivy mentioned above, another concern is that the vitamin D supplement she was taking might not have had what the label said it had. For what it is worth, ever since learning about Ivy’s vitamin D deficiency, we have switched back to buying vitamin D through the company we used to work with, ProThera, which has since been renamed Klaire Labs (see below). I know for certain that this brand is third-party tested, GMP certified and all products are manufactured in one facility in Reno, Nevada.
The problem is, Klaire Labs only sells to physicians. Since we no longer carry our own Clean Cuisine brand line of vitamins, Ivy called Klaire Labs and found out that they do sell online to only one authorized Amazon seller, FortressBrand Wellness. So, if you really want to make certain you are getting what you pay for with your vitamin D3 supplements, my recommendation would be to get your vitamin D3 through your physician or order directly on Amazon, but only from FortressBrand Wellness (otherwise you don’t know for sure what you are getting.) You can buy Vitamin D3 from Ritual Health on Amazon HERE.
***Note: Vitamin D is a fat soluble vitamin it gets stored in our body and too much can build up over time. If you are supplementing with high doses (over 5,000 daily IU), I recommend that you get your blood levels checked every 3 -6 months while supplementing.***
What Else Might Have Gone Wrong?
Ivy’s vitamin D deficiency could have also been caused by malabsorption. Anyone with bowel disease caused by celiac allergy or celiac disease, inflammatory bowel disease, chronic diarrhea, food allergies causing leaky gut or diarrhea, or irritable bowel syndrome will absorb vitamin D poorly. This applies whether the vitamin is taken orally as a supplement or taken as a food source by eating salmon or egg yolks. The only solution is to expose yourself to sunlight and to allow the body to treat the vitamin D deficiency naturally. Supplements can help some people but not people with malabsorption.
Consider Adding a Digestive Enzyme Supplement
If you have a history of gastrointestinal issues, including Celiac disease, gluten sensitivity, gallbladder removal, or any other intestinal issues that reduce your ability to absorb fat and therefore Vitamin D, I suggest you take a high quality digestive enzyme that aids in the breakdown and digestion of fats, proteins, and starches. This, in conjunction with your Vitamin D supplement, will help you achieve optimal levels of Vitamin D.
For the reasons mentioned above, if you decide to supplement with a digestive enzyme you want to make sure you get what you are paying for. I recommend Klaire Labs brand digestive enzymes, which you can purchase from Amazon.
Avoiding Another Vitamin D Deficiency Story. What Is Our Plan Moving Forward?
We are both now committed to spending 15 minutes in the sun daily as often as possible. Ivy is going to expose her back, arms, and legs so sun related damage is avoided on her chest and face. Keep in mind, the darker your natural skin color the more sun you need. Fortunately, vitamin D has a long half-life so if you make the effort to expose yourself all summer long you may be okay for the winter so long as you really make the effort when the weather cooperates. The risks of having chronically low vitamin D levels (to your bones, cancer, heart disease, dementia, diabetes, and MS, etc.) are far higher than any risk associated with reasonable amounts of sun exposure.
Test yourself and ask your doctor or nutritionist to test you. If you are deficient or borderline deficient in vitamin D you should by all means supplement. A 5,000 IU dose such as what Ivy was taking daily is adequate IF it is being absorbed and IF the supplement you are taking really has the amount it says it does. You will need to take a good quality supplement for at least two months then go back to the doctor or nutritionist and be re-tested for your blood vitamin D level.
If your blood level is still low then you need to switch to another brand of supplement and you should also consider being tested for malabsorptive syndromes such as those mentioned above (a gastroenterologist could perform these tests). If you do have gastrointestinal issues, I would also suggest supplementing with a high quality digestive enzyme and taking both my vitamin D supplement and digestive enzyme together with a high-fat meal.
This episode of fatigue and unusual stress sensations was a wake up call for us and I’m glad to report Ivy is already feeling better after switching vitamin brands and committing to sunlight exposure. In general we believe vitamin levels should be tested regularly and deficiencies addressed once they are identified. If you are not feeling right please look into the root causes. I am glad we did and I am glad we were able to find a natural approach to better health. Vitamin D, the “sunshine vitamin”, is in short supply in our modern world and vitamin D deficiency should be looked at as a potential cause for numerous health problems then treated aggressively if necessary. I hope Ivy’s vitamin D deficiency story helps remind you of how important this essential vitamin is to our well being. Here’s to lasting good health!