When NOT to take VITAMIN D

welcome back this is dr jin sung where clinical excellence meets excellent results today we're going to talk about a very important topic about vitamin d or when not to take vitamin d oftentimes you get blanket statements of taking high doses of vitamin d to help viral replication or immune system support and so forth however i'm always the proponent of checking your vitamin d levels to make sure you're taking the right dosages so let's get into the facts of why not to take high doses of vitamin d or when to be careful when taking vitamin d so let's get right into it when not to take vitamin d so let's go into some of the lab markers right your typical lab marker is 25 hydroxy vitamin d and in the lab it will say 30 to 100 nanograms per milliliter and that is measuring the inactive form of vitamin d now the inactive form in excess will store in your fat tissues one 25 hydroxy vitamin d the range is 19.9 to 79.3 picograms per milliliter and that is the active form of vitamin d and oftentimes this form is not checked on the blood work so the vitamin d council says deficiency is 0 to 40 nanograms sufficient level is 40 to 80 and high normal is 80 to 100 okay so this is measuring 25 hydroxy vitamin d now when you get sun exposure it triggers production of vitamin d oral consumption right of vitamin d typically d2 or d3 [Music] so if you impact the skin the vitamin d will go to the liver there's a hydroxylation process and then goes to the kidney and does another hydroxylation process and the kidney is what produces 125 hydroxy vitamin d or the active form of vitamin d so increased vitamin d levels helps to reduce the risk of certain cancers right deficient vitamin d increases the risk for autoimmune disease and is associated with hypertension and cardiovascular disease so it's got a cardiovascular effect it also has an immune modulating effect with autoimmune disease contributing factors for deficiencies in vitamin d one is age we're not able to convert your vitamin d or there's the dysfunction in the kidney and the liver where you're not producing enough of the active forms of vitamin d less sun exposure intake where you're not taking in enough vitamin d the latitude so if you live near the equator versus in the northeast you're going to have different sun exposures complexion so darker skin people will tend to have less production of vitamin d that can be somewhat controversial it's oftentimes the cholesterol in the skin that will help production of vitamin d malabsorption syndromes gut issues crohn's disease irritable bowel inflammatory bowel disease overuse of antacids [Music] liver and kidney disease because the hydroxylation process occurs through the liver and kidney for the production of active vitamin d so when you have kidney disease it can be problematic one clinical pearl is if you have kidney disease and your gfr is very low vitamin d may not be efficient the d2 or d3 you might have to take the active form of vitamin d which is calcitrol if you have kidney disease also a gallbladder function so vitamin d is a fat soluble vitamin therefore you need proper gall bladder function in order to absorb fat soluble vitamins okay so let's get into the facts of why or when not to take extra vitamin d okay so here so when not to take vitamin d so when you have a healthy individual who comes into the office right and we take that healthy individual goal we're going to check your vitamin d level their vitamin d level might be low but their active form is normal so the 125 hydroxy vitamin d is normal so that's a healthy population so 25 hydroxy vitamin d is very important for promoting immune regulation or immune modulation right it's kind of the referee that helps the immune system 25 hydroxy vitamin d or the active form of vitamin d activates the inflammatory response right it can actually increase the inflammatory response because you're increasing the immune response and t cell response okay now when you have an unhealthy individual who comes into the office or an inflamed patient who comes into the office they might have low vitamin d but they may have an elevated level of the active form of 125 hydroxy vitamin d and this can be occur because this patient might be inflamed and they're converting the inactive form to active forms at high levels to have the immune response or inflammatory response so if you take a healthy individual unhealthy individual here they may have a vitamin d receptor problem or a issue with receiving the vitamin d at the cells [Music] this can occur with people who have autoimmune disease right these are genetic problems or polymorphisms where the vitamin d receptor is not working correctly so sometimes you're taking a lot of vitamin d to overcome this another one is inflammation the inflammatory response will suck up the inactive vitamin d convert it to the active form to help the inflammatory response also with autoimmune disease you might see this and definitely with infections or stealth infections even when your normal crp or esr is within range right it's not elevated but you could have an issue with the vitamin d so here's the clinical pearl right if you have an unhealthy individual and they have low vitamin d that's what we checked for let's say and you give them 10 000 units 15 000 units 20 000 units of vitamin d and the vitamin d level here does not go up then you need to check for the active form of 125 hydroxy vitamin d so you're supplementing really hard right here but it moves very minimally or doesn't move at all or actually drops then you need to check for the active form of vitamin d and often times what you'll find is an elevated active vitamin d the reason is is trying to have that inflammatory response right it's trying to fight off the infection however sometimes it can promote inflammatory responses so that that's where you need to be careful if you're supplementing a lot here it doesn't go up it's still low or actually drops you need to check the active form of vitamin d those are the patients when you do not want to give them vitamin d right you have to go find the underlying mechanism of why they have elevated 125 hydroxy vitamin d you have to find the inflammatory process you have to find the autoimmune disease you have to find an infection right in order to correct that problem where it's over converting to the active form of vitamin d so those are the patients when you have to be careful not to take too many bite too much vitamin d and you have to be careful not to perpetuate the inflammatory response now what are some safe levels of taking vitamin d 2 000 to 5 000 international units of d3 is what i recommend you need to monitor if you're taking over 5 000 international units of vitamin d if you're taking high levels at 10 000 and 15 000 and this does not really go up right the 25 hydroxy vitamin e does not go up it'll get you have to check for the active form of vitamin d the 125 hydroxy because it can perpetuate the inflammatory response this is a very important lecture because oftentimes there are blanket statements from you know commenters on on youtube videos about vitamin d and saying oh i should take you know ten thousand fifteen thousand twenty thousand units of vitamin d and my vitamin d is only 50 right it's not going up so you have to understand the underlying mechanisms of why that can occur and when not to take vitamin d or you have to be monitored by someone who understands what's going on to keep you at a safe level i know there are co-factors that you should take with vitamin d obviously you have to take magnesium k2 and so forth but the purpose of this lecture is to show you that it's not a a blanket statement that people should make when you take vitamin d of taking you know 10 000 20 000 units per day all right it's very important to understand the physiology and when something is not working is to go deeper and figure out the underlying mechanisms of why this might occur all right my name is dr jin sung where clinical excellence meets excellent results and we'll see you guys next week on the healthy side have an awesome day

Channel: Dr. Jin W. Sung

Views: 527,775

Keywords: calcitriol, vitamin d, 25-OH Vitamin D, 1 25 OH vitamin d, inflammation and vitamin d, autoimmune and vitamin d, vitamin d and virus

Id: PboG6rrA-jc

Length: 10min 48sec (648 seconds)

Published: Tue Mar 08 2022