A magic pill?

If a new drug had just been developed that could reduce your risk of dying from cancer by 12% and potentially increase your life expectancy by an estimated 2 years, would you take it? Better yet, what if this drug, when taken at the proper dose, had almost no negative side effects. Does it sound too good to be true? But what if it were true? How much would you be willing to pay for this drug? And how much would you be willing to pay to know the name of this drug, how much of it to take, and where you can buy it?

The fact of the matter is that no such drug exists. There is, however, a non-drug substance that has been shown to reduce all-cause mortality by 11%,[1] reduce the risk of dying from cancer specifically by 12%,[2] and may even have the potential to increase life expectancy by an estimated 2 years. This substance defies uniform classification, at times being referred to as a prehormone, prohormone, preprohormone (not a typo), steroid hormone, essential nutrient, and vitamin.[3] So, what is it? What is this seemingly magical substance whose classification is shrouded in a cloud of confusion? Well, we know it simply as vitamin D.

If the claims I made above are true (and the references cited assert that they are), then you would think that we would be teaching this in every school in America, and that everyone would know about the importance and potentially lifesaving benefits of this humble vitamin. Why is this not the case? Well, probably because vitamin D is not a drug. It can be obtained freely from skin exposure to direct sunlight. And since you cannot patent the sun, there is little profit to be made from something as universal as naturally occurring sunlight. But drugs, on the other hand, can be patented, and if vitamin D were a drug you would probably be hearing about it every night on television advertisements.

How prevalent is deficiency?

One study[4] pegged the overall prevalence rate of vitamin D deficiency in the USA at 42%, with the highest rate seen in blacks (82%), followed by Hispanics (69%). Since vitamin D is primarily obtained through skin exposure to sunlight, it makes sense that those with darker skin require greater sun exposure in order to avoid deficiency.

Another study[5] projected that raising the minimum year-around serum vitamin D levels to an optimal range (40-60 ng/mL) would prevent approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer each year. Such intakes are expected to reduce fatality rates of patients who have breast, colorectal, or prostate cancer by half. The authors went on to state:

There are no unreasonable risks from intake of 2,000 IU per day of vitamin D3, or from a population serum 25(OH)D level of 40 to 60 ng/mL. The time has arrived for nationally coordinated action to substantially increase intake of vitamin D.

A different study,[6] estimated that a shift in vitamin D levels from borderline deficient to optimal (22 ng/mL->44 ng/mL) would increase life expectancy by 2 years. The author of this study concluded by saying:

Increasing vitamin D levels is the most cost-effective way to reduce global death rates, as the cost of vitamin D is very low and there are few adverse effects from oral intake and/or frequent moderate sun exposure.

What is vitamin D and cholecalciferol?

In simple terms, vitamin D is one of four fat-soluble vitamins (the others being vitamins A, E, and K). In children, gross vitamin D deficiency can lead to rickets – a softening and weakening of the bones that results in deformity. For adults, vitamin D deficiency also leads to soft bones (osteomalacia) and is linked with several chronic diseases, including heart disease and cancer. Vitamin D is obtained primarily from direct skin exposure to sunlight but is also found naturally in small quantities in certain foods, mainly fish and some mushrooms. Vitamin D can also be obtained from tanning beds and nutritional supplements, but there are some key distinctions to keep in mind. An increasing body of evidence supports the theory that UV light emitted by tanning beds is not only a potential carcinogen, but a clinically significant risk factor in the development of various skin cancers.[7] As for supplementation, two major forms of vitamin D exist: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Only vitamin D3 is associated with the benefits mentioned earlier. In fact, vitamin D2 supplementation was associated with an increased risk of death by all causes. You have been warned: Not all vitamin D is created equal.

How much to take

If you wear sunscreen, it will almost completely block vitamin D synthesis. Windows have a similar effect. Hence the need for direct skin exposure to sunlight for vitamin D synthesis to take place. About 15-20 minutes of as close as you can get to full-body exposure should do the trick (use common sense and take care not to get sunburnt). Also remember that the darker your skin, the more sun exposure you will need. Moderate sun exposure is the best way to meet your vitamin D requirements, but this may not always be possible depending on geographic location and climate. In these situations, nutritional supplements can literally be a lifesaver. For adults, taking 2,000 IU’s of vitamin D3 daily should prevent deficiency with virtually no risk of overdose or toxicity (provided you purchase your vitamin D3 from a reputable company that takes care to ensure that their product actually contains the amount stated on the label). The tolerable upper intake level (UL) – maximum usual daily intake levels at which no risk of adverse health effects is expected for most individuals – for vitamin D supplementation is 4,000 IU’s per day for adults. I would caution against taking more than this amount unless you are under the care of a healthcare professional who recommends otherwise.

How to check your levels

If you would like to check your vitamin D levels you can order a “Vitamin D, 25 Hydroxy” blood test through our DirectLabs portal – an online laboratory service that allows you to order lab tests for yourself (here’s the how-to video). Once you get your lab results back, you can see if your 25-OH vitamin D levels fall within the optimal range which is conservatively thought to be between 40-60 ng/mL (100-150 nmol/L). If your lab results fall below this range, consider increasing your sun exposure or taking a vitamin D3 supplement. You can purchase professional-grade vitamin D3 supplements through our online supplement shop.

 

[1] https://www.bmj.com/content/348/bmj.g1903
[2] https://www.ncbi.nlm.nih.gov/pubmed/24918818
[3] https://www.vitamindcouncil.org/why-do-we-call-vitamin-d-vitamin-d/
[4] https://www.ncbi.nlm.nih.gov/pubmed/21310306
[5] https://www.ncbi.nlm.nih.gov/pubmed/19523595
[6] https://www.ncbi.nlm.nih.gov/pubmed/21731036
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004589/

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