Why I like to see a vitamin D result for my clients

'I already take vitamin D.'

This is great. But how much do YOU actually need? And why does it matter?

August is a good time to check your vitamin D. If your levels are low, it can take several weeks or months to restore them, so checking now gives you time to get your levels where they need to be before autumn and winter colds and flu are circulating.

Vitamin D has important roles throughout the body. It's essential for calcium absorption and bone health, supporting normal muscle function and immune function. It also plays a role in brain health and cognition, cardiovascular health, and normal cell function.

For women, there’s a particularly good reason to pay attention to vitamin D as we move through midlife. As oestrogen declines through perimenopause and menopause, bone loss accelerates, making adequate vitamin D status increasingly relevant to maintaining bone health.

Vitamin D status is also relevant in thyroid disease, and low vitamin D is seen alongside a number of chronic health conditions, including fibromyalgia. That’s another reason I like to know what a client’s level actually is, rather than simply assuming that taking a supplement means their vitamin D status is where it needs to be.

Nutrients are the building blocks of health.

Our bodies don't work in separate compartments. We are living, breathing chemistry. The processes that keep our bones, muscles, immune system, thyroid and energy production working properly are all interconnected, and they depend on the nutrients needed to make those processes happen.

When something is out of balance, whether that’s vitamin D or another nutrient, the effects aren't necessarily confined to one area. They can have knock-on effects elsewhere in the body, sometimes creating a collection of seemingly individual symptoms that can be surprisingly difficult to put your finger on!

So I really want my clients to have adequate vitamin D.

But, there’s a big difference between taking vitamin D and having an adequate vitamin D level.

Two people can supplement very different amounts and end up with the same blood result. One may be taking enough to increase their level, while another may be taking a 'maintenance' dose that is simply maintaining an inadequate level.

That’s quite an important distinction.

Over 50 nmol/L is often described as sufficient or adequate for most people, and that is the threshold you'll commonly see quoted.

But 'adequate' doesn't necessarily mean 'optimal'.

Functional medicine tends to look beyond a basic sufficiency threshold and favour higher vitamin D levels when considering optimal health and, in particular, robust immune and bone function. So I don't necessarily see a result that has just crossed the conventional sufficiency threshold as the end of the conversation.

If someone is taking vitamin D but their level is still inadequate, we investigate.

Are they taking enough? Are they taking it consistently? Are they absorbing it properly?

What form are they taking? What's the most suitable form for them, tablet? Mouth spray?

Do they need to consider vitamin K2, or are they one of the people for whom this would be contraindicated?

Could there be individual factors, including genetics, affecting how well they are able to maintain their vitamin D levels?

It isn’t one-size-fits-all, so we test, not guess.

Seeing the 25-hydroxyvitamin D result gives us a useful snapshot of vitamin D status and, importantly, gives us something objective to work from.

Where does vitamin D actually come from?

Our bodies can produce vitamin D when our skin is exposed to UVB rays from sunlight. The difficulty is, that this only happens when the sun is high enough in the sky for sufficient UVB to reach us. A useful rule of thumb is when your shadow is shorter than you are.

Cholesterol is a precursor to vitamin D, so medications that significantly reduce cholesterol synthesis, such as statins, could potentially affect how much vitamin D your body can make. Dietary fat is also important for absorbing vitamin D, so a very low-fat diet could affect vitamin D status too.

For many people, particularly in the UK, getting enough exposure at the right time of day simply isn't realistic all year round.

There aren't many naturally rich food sources of vitamin D, so getting enough from diet alone can be difficult.

The UK government recommends that everyone considers taking a daily vitamin D supplement during the autumn and winter months, and many people are advised to take one all year round. This is partly because it can be difficult to get enough vitamin D from food alone, particularly during the months when sunlight isn't sufficient for our bodies to make much vitamin D.

The government recommendation is general population guidance, though. It isn't an individual assessment of whether your vitamin D level is adequate or whether the dose you're taking is right for you.

Because vitamin D is fat-soluble, your body stores it in tissues. It isn’t a case of taking more and simply peeing out whatever you don't need. Excessive intake over time can lead to vitamin D toxicity and cause calcium levels in the blood to become too high.

So more isn't automatically better either.

Here’s another reason I like having the result: low vitamin D status doesn't always announce itself.

You might feel tired, have muscle aches or simply not feel quite yourself, but those symptoms can have plenty of other explanations too.

You can't reliably look at someone and know what their vitamin D level is.

So rather than guessing from symptoms, supplements or what someone else is taking, I’d rather see the number and work from there.

Getting that number doesn't necessarily have to be difficult or expensive.

If your GP is unable to provide vitamin D testing, a private 25(OH)D blood test is readily available. It’s one of the more straightforward things to check, and for me, the information it gives you can be far more useful than simply taking a supplement and hoping for the best.

For me, it comes down to this: test, understand your result, and then make decisions based on what your body actually needs.

Charlotte

Want to investigate or discuss your vitamin D level?

Whether you already have blood results, need private testing, or would like a broader look at your health with a Health MOT, get in touch and I can help.