How to Optimize Your Vitamin D Level

What you need to know to keep your vitamin D levels optimal

I use the Sperti D lamp to optimize my vitamin D status. I explain why:

Are You Getting Enough UV Light?

Optimizing your vitamin D status is one of the most important parts of my practice. The links between low vitamin D levels and premature morbidity and mortality are astounding. This is why one of the main focuses of my consultations it to devise a strategy on how to support the optimal vitamin D level.

If you’re tired of hearing about vitamin D and ready to figure out what to do about it, then this post is for you.

First, how to optimize your vitamin D level is a bigger question than, "how much vitamin D do I need to take to achieve a certain level?" Fixing your vitamin D level is akin to fixing the level of oil in your car. If your car ran out of oil every couple of days, would you just keep adding more? Of course not. You would suspect that something was horribly, horribly wrong with your oil pan or your engine, and you would take it to a mechanic. Why do some people need more vitamin D than others, and what is blindly taking more a bad idea? I explain why in this video.

Second, if you are not getting adequate UV light on a daily basis to support healthy levels of vitamin D, then you need to either take a vitamin D supplement or use an artificial UV light to maintain your vitamin D levels. Even though I live in Florida, the UV index in the winter is not adequate to maintain my vitamin D levels year-round from sun exposure alone. I also am frequently called into consultations with patients or business meetings during the middle of the day, when I can get thirty minutes to an hour of intense sunlight outside. Some people will say that you can get your vitamin D from food. This is extremely difficult to do, and I have seen people with low vitamin D levels despite ample fish consumption. I have also seen high levels of mercury in those seeking their vitamin D from fish alone. Some people will tell you to take cod liver oil for vitamin D. I have two problems with this. First, I see people taking fish oil supplements over-shooting their ideal omega-3 level all the time. Contrary to popular belief, there is such a thing as too much fish oil. The fish oil story is a long one that I do not have time for today. More on this later... Second, I am concerned that much of the fish oil out there is rancid. It is extremely difficult to maintain fish oil over time and space without oxidation.

The bottom line is that no matter what method you choose to maintain your vitamin D levels, you should monitor them.

I check vitamin D levels in my patients quarterly until they have normalized. My goal is between 35 and 50 ng/dl. Sun exposure and diet alone can push your levels well into the high 70's, but only high-dose supplements (5,000 IU or more, typically) can push levels over 80. I do not see clinical benefits to maintaining extremely high levels and I am concerned that long-term high-dose vitamin D therapy could cause chronic mineral imbalances that could contribute to disease (specifically of potassium).

What is my favorite means for vitamin D supplementation? Light, and if a patient can't get enough sunlight to maintain an optimal vitamin D level, then I recommend the Sperti (vitamin) D lamp. Learn why in this blog post. Just 5 minutes a day can boost levels well over 50, and it works no matter what the weather is. The further you live from the equator and the less strong UV light you get, the more helpful the Sperti D becomes.

Third, sun exposure in the summer cannot maintain a normal vitamin D level in the winter, unless it is extreme and complemented by a hefty intake of fish in the winter. One pound of pickled herring contains about 500 IU of vitamin D. One pound of salmon contains 3,000 IU. This is a wide variation, so saying “eat fish for vitamin D” is a bit like saying “get sunshine for vitamin D.” You can’t get any vitamin D from the sun in Canada most months of the year, and you get hardly any vitamin D from most fish. What fish you eat, how much, and how frequently all matter to how much vitamin D you are getting. It takes about 2,000 to 4,000 IU of vitamin D daily for most people to achieve ideal circulating levels of vitamin D. Levels of circulating vitamin D are seasonal due to the influence of sunlight, peaking in the Fall and reaching their nadir in late Winter. This drop coincides with peaks in seasonal mortality (the increase in deaths each winter). How about that? The sun really does save lives, which is why I think that telling people to avoid the sun and slather up with sunscreen is outright malpractice. The point is that in the absence of intense ultraviolet light, vitamin D levels drop month after month, and are only maintained with 2-4,000 IU of vitamin D daily. Are you prepared to eat that much fish?

No? I didn’t think so. The other problem we face with getting adequate vitamin D is that modern employers have missed the boat on the importance of sun exposure. They have made their workplaces dark and UV light-free. You are luck if you have 20 minutes to go outside and get some sun during the middle of the day. Imagine stripping down to a swimsuit to work on your tan at a modern office. Short of this, if you work a 9-5 job, you are not going to have optimal levels of vitamin D without either a vitamin D supplement, massive amounts of fish, or a vitamin D lamp. Even if you can spend hours each day outside year-round, you are likely to need some kind of supplementation during the winter months.

This is why I love the Sperti vitamin D lamp. Just 5 minutes per day in front of this lamp provides most people with all the light they need to maintain their vitamin D stores.

Why do I consider the Sperti D superior to vitamin D supplements? There are a few reasons. First, it allows the body to auto-regulate your vitamin D production. Only vitamin D supplements can push vitamin D levels up into toxic ranges. No amount of time in front of the Sperti D will create this problem. Second, I don't have to worry about keeping vitamin D supplements in stock. Third, I have a suspicion that these UV bulbs emit a certain amount of UV-A light. While UV-A does not make vitamin D, it does trigger other hormonal changes and effects. I believe these to be beneficial.

What about tanning booths and beds? I do not usually recommend them. Sometimes, in difficult cases, I have recommended them to help patients cope with depression or a lack of energy. I have generally been unimpressed with the results, which are mild and short-lived. Perhaps there are broader applications, but I doubt it. You can pick up the Fiji tanning lamp from Sperti if you want to experiment, but I would caution anyone against using UV-A light in the absence of red, infrared, and UV-B light. Why? Because these other frequencies protect the body from the harmful effects of UV light.

There are some medical conditions, such as psoriasis and mycosis fungoides, that greatly benefit from local UV treatment. I take these on a case by case basis.

Last, but perhaps most important of all, your ability to tolerate and respond to UV light depends upon what you eat. Likewise, UV light can increase your nutritional requirements (we don't have definitive studies on this, and I suspect this is far more important that people currently appreciate). In environments with abundant UV light, there is always an abundance of colorful fruits and vegetables that are loaded with antioxidants, which naturally neutralize much of the damage done by excessive light. I caution patients to eat the foods the grow around them, in the season that they grow. I recommend a wide range of foods from different food groups, because this way we avoid nutritional deficiencies and allergies. More on this later... All of our cellular responses to light involve nutrients. For example, increased melatonin production in response to photobiomodulation only takes place if you have the nutrients necessary to produce melatonin, such as magnesium, B-6, and tryptophan. Vitamin D production starts with cholesterol and is dependent upon magnesium. Blue and green light trigger opsins in your skin and eyes that contain vitamin A. UV light degrades folate in your skin and, crazy though it may seem, may well be able to compensate for a deficiency of B-12. I could go on, but it truly is a topic that deserves its own post.

UV light is one of our most powerful tools for health. Avoiding it, at least as sunlight, is as dangerous as smoking. The notion that avoiding the sun is a good idea for fear of skin cancer is as silly as avoiding your car for fear of car accidents. It just does not make sense. Vitamin D is only one reason for the health benefits of UV light, and this is why I advise sun exposure beyond what is needed to optimize your vitamin D level, as I detailed in my last post.

Nutrients are vital to the utilization of light. I have also come to believe that excessive light exposure, particularly at night, is causing an epidemic of nutritional deficiencies. This is why I wrote my last blog post, The Rational Use of Nutritional Supplements.

Next time, we will discuss what diet is best, and if there really is one diet to rule them all…

Until then, be well,

Dr. Stillman