The Dr. Hyman Show - Do You Need To Take A Vitamin D Supplement?

Episode Date: September 4, 2020

Do You Need To Take A Vitamin D Supplement? | This episode is brought to you by BetterHelp Vitamin D has a huge impact on the health and function of your cells. Among its many functions, vitamin D reduces cellular growth (which promotes cancer) and improves cell differentiation (which puts cells into an anti-cancer state). But what’s even more fascinating is how vitamin D regulates and controls genes. When we don’t get enough it impacts every area of our biology, because it affects the way our cells and genes function. Your body makes vitamin D when it’s exposed to sunlight. The problem is that most of us aren’t exposed to enough sunlight or eating enough of the few natural dietary sources of vitamin D. The good news is that supplementing with vitamin D3 can be an effective way to reverse a vitamin D deficiency. However, it is important to test your vitamin D levels to assess your personalized needs before starting any supplementation. Dr. Hyman recently spoke to this topic in his conversations with Max Lugavere and Dr. Elizabeth Boham. Max Lugavere is a filmmaker, health, and science journalist and the author of the New York Times bestselling book Genius Foods: Become Smarter, Happier, and More Productive While Protecting Your Brain for Life. He is also the host of the #1 iTunes health podcast The Genius Life. Max is excited to release his sophomore book, The Genius Life: Heal Your Mind, Strengthen Your Body, and Become Extraordinary, a lifestyle guide to living happily and healthily with proven, research-based lifestyle tactics, which we dig into more throughout this episode. Elizabeth Boham is a physician and nutritionist who practices functional medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing. Dr. Boham has contributed to many articles and wrote the latest chapter on Obesity for the Rankel Textbook of Family Medicine. She is part of the faculty of the Institute for Functional Medicine and has been featured on the Dr. Oz show and in a variety of publications and media including Huffington Post, The Chalkboard Magazine, and Experience Life. Her DVD Breast Wellness: Tools to Prevent and Heal from Breast Cancer explores the functional medicine approach to keeping your breasts and whole body well This episode is brought to you by Betterhelp. Betterhelp is an app that lets you get affordable counseling anytime, from anywhere. They’ll match you with a licensed, professional therapist based on your unique needs. As a Doctor’s Farmacy listener you can get 10% off right now by going to betterhelp.com/drhyman Find Dr. Hyman’s full-length conversation with Max Lugavere, “How To Fix Your Brain And Live A Genius Life” here:  https://DrMarkHyman.lnk.to/MaxLugavere Find Dr. Hyman’s full-length conversation with Dr. Elizabeth Boham, “Supplements: Useful or Useless?” here: https://DrMarkHyman.lnk.to/Supplements

Coming up on this episode of The Doctor's Pharmacy. Vitamin D is important for the synthesis of serotonin, which is a neurotransmitter involved in mood. A lot of happy chemical. Hey everyone, it's Dr. Mark. I think we can all agree that COVID has presented us with a new kind of stress. And I've talked to lots of friends and patients who've noticed changes in their mental health and their emotional health and these really tough times. Now, of course, our diet and our lifestyle habits are foundational for creating great overall

health, and that includes promoting good mental health. But sometimes we also need personal support to talk through bigger issues, and that's really important. Mental wellness should be a priority for all of us, especially right now. If you happen to hear my episode with our previous Surgeon General, Vivek Murthy, we talked about the rising epidemic of loneliness and how this is a huge threat to public health. Anxiety and depression are also on the rise, but so many people are dealing with these difficult issues and are just suffering alone. It's time for us to break down the stigma of caring for mental health and make it something easy to talk about and seek help for. And that's why I'm really excited to tell you about Better Help. Better Help is an app that lets you get affordable counseling anytime, anywhere. They'll match you with a licensed professional therapist based on your unique needs. With Better Help,

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counseling. If you're ready to take the next step for your mental well-being, I hope you'll really check out BetterHelp. As a doctor's pharmacy listener, you can get a 10% discount right now by going to betterhelp.com forward slash Dr. Hyman. That's betterhelp, H-E-L-P.com slash Dr. Hyman, D-R-H-Y-M-A-N. There's no need to suffer through hard times alone and don't be afraid to ask for help. Now let's get back to this week's episode of The Doctor's Pharmacy. Vitamin D plays a crucial role in our health. It supports our bones and our cardiovascular and immune systems. It affects our cell metabolism. It regulates and controls our genes and much, much more.

Your body makes vitamin D when it's exposed to sunlight. But the problem is that most of us aren't exposed to enough sunlight to produce adequate levels of vitamin D. And most of us are not eating enough of the few natural dietary sources of vitamin D, like fatty wild fish, like mackerel, herring, and cod liver oil. Earlier this year, Dr. Hyman spoke to health and science author Max Lucavera about the importance of having optimal vitamin D levels. Vitamin D deficiency is thought to be a risk factor for developing Alzheimer's disease. There's a review of environmental risk factors that I talk about

in the book, and vitamin D was one of the top. Yeah. Probably 80% of us are deficient or insufficient and that leads to depression. It leads to increased Parkinson's, Alzheimer's, cancer, so many different things. And I think, you know, there's been mixed data about where placing it, fixing it or not. And I think it's complicated because when you're like, you know, people are eating, you know, garbage and they throw a vitamin D in there, it's not going to help them. Yes, correct.

If they're not exercising, they're smoking, they're drinking a lot, they're eating crap, take a vitamin D. It's not going to do anything. But in all things being equal, people who are low in vitamin D have a higher risk of this. And if you clean up your lifestyle and you're still low in vitamin D, it'll make a big difference. Yeah, I'm glad you brought up context

because one thing that very few people know, you could be spending as much time in the sun as you want, frolicking all day, you know, in the, in the, in the beautiful warming rays of the sun or even supplementing with vitamin D. But if you're not getting adequate magnesium in your diet, which 50% of the population does not get adequate magnesium, the enzymes that convert the vitamin D that your skin creates into its active hormone form in the body, all are magnesium dependent. And magnesium, half of us don't consume adequate magnesium. It's found in dark leafy greens, pumpkin seeds, dark chocolate, almonds. And a lot of things cause us to lose magnesium. Stress, coffee, alcohol, sugar, all those things we love.

Exactly. You know, mental health is such a big crisis in this country. One in four people experience major depression in their life. It's the biggest cause of the economic burden of chronic disease, not from direct health care costs, but things like disability, loss of quality of life, not being able to function very well in your life. And vitamin D is one of those things that seems to really impact depression. So you talk about a study in the book that has to do with vitamin D and depression. Can

you talk more about that? Well, vitamin D is important for the synthesis of serotonin, which is a neurotransmitter involved in mood. It's a happy chemical. It's a happy chemical. That's what Prozac does. It increases serotonin, right? It increases serotonin. You know, SSRIs, selective serotonin reuptake inhibitors can boost serotonin at the synapse, which is...

Serotonin is also involved in focus and attention and executive function. But yeah, so vitamin D is important in the synthesis of serotonin from its raw material, raw materials, one of which is tryptophan, an amino acid. So making sure that your vitamin D levels are in a normal, healthy range, important. And you can easily get your vitamin D levels tested from a doctor. It's a very cheap test. The recommendations that I make in the book are to make sure that your levels are somewhere between 40 and 60 nanograms per milliliter, which seems to be a range where we see the lowest risk of all-cause mortality.

Yeah, I mean, I remember reading a study. women who had vitamin D levels less than 45 had a 60% higher chance of having preterm labor. And when you think of the cost of neonatal intensive care and taking care of preterm babies, it's staggering. And you're talking about pennies for a vitamin that can literally prevent preterm labor. So it's really connected to almost everything. And the difference is with vitamin D is that not everybody needs the same amount, right? So what should we be taking?

Correct. Not everybody needs the same amount. Before you start taking vitamin D as a supplement, you ought to get your levels tested. You know, when we make, when we synthesize it from the sun, our skin basically makes what we need and it breaks down the rest. It's really, it's almost impossible to get too much vitamin D from the sun. Although lifeguards can have levels of 150. That's amazing. Yeah. So, and that's not toxic.

Right. I mean, it could increase, it increases calcium absorption. So I always like to recommend vitamin K2 for people that are in, I mean, especially at those levels. But with a vitamin D supplement, I think generally there was a research calculation that suggested that for the general population, 2000 international units a day would be ideal to get the average person to an optimal level. But people, again, have different, you know, people who are older might need to supplement more. People who are overweight might need to supplement more to get the same improvement.

And also, again, if you're... Yeah, people who are overweight tend to be low in vitamin D because it's a fat-soluble vitamin, so it all gets sucked into the fat and it doesn't get into their system that we need. Yeah, it gets sequestered by fat tissue. The same also can occur with other fat-soluble vitamins like A, E, K.

Yeah. I don't know if you read this morning, probably not, because you probably don't read the JAMA Pediatrics Journal every day. Not pediatrics, no. But I do. And I read this morning, probably not, because you probably don't read the JAMA Pediatrics Journal every day. Not pediatrics, no. But I do. And I read this paper this morning that showed that women, when they were pregnant, took 2,800 units of vitamin D compared to 400, which is in the typical prenatal vitamin.

That there was a dramatic reduction in the bad effects on bone when their kids were born. In other words, their kids, their babies had much higher bone density and then their risk later in life of osteoporosis was dramatically reduced. So, and that, you know, that's almost 3,000 units, which most doctors don't even think about recommending. And some people, you know, may need up to 5 or 10,000 if they're not good absorbers and there's genes that affect that. Some people might need only 1,000. But I think 1,000 is minimum for most people. And it takes about 1,000 units to raise your blood level 10 nanograms per deciliter.

So if you're 20, you need at least 3,000 to get up to 50, right? And then you can see how you do. But I think people need to measure it. They need to check it. And they need to make sure they're okay, and if not, take the right supplement. And not the kind that you often get from your doctor, I hate to say, which is vitamin D2, which is not an active form of the vitamin,

but vitamin D3, and you can get that over the counter now, and you can get 1,000 units and others, but you want to make sure you measure it, right? Yeah, I mean, vitamin D2 is the plant-based form of vitamin D. And vitamin D3 is the animal-based form. It's bio-identical to what we create in our own skin. So you always want to make sure that you're taking vitamin D2. I mean, sorry, D3.

Okay, so that brings up a sticky question. So it's usually made from lanolin and other things. You can get it from sheep and stuff. And they're fat. So what if you're vegan? What do you do? That's a good question. I have vegan sources of vitamin D3.

That's hard to get. Yeah, right. Yeah, it's just one more of those nutrients that you're just not really optimizing. And often people don't convert vitamin D2 to D3. And if you're a vegan, you want to make sure you're checking not really optimizing. Yeah, and often people don't convert vitamin D2 to D3. And if you're a vegan, you wanna make sure you're checking vitamin D3. And you can also check D2. So you can see you might have a really high D2,

but a very low D3. There are so many supplements on the market and it can be really confusing to know if you're getting the right type or taking the right amount of vitamins and minerals. Dr. Hyman recently spoke to Dr. Elizabeth Boham, his colleague at the Ultra Wellness Center, about the importance of determining your individual needs when it comes to taking supplements.

They also discussed why we are seeing such high levels of nutrient deficiencies in our population. I think, you know, we're taught that we should really get everything from food, but there's been a lot of problems with our food supply. That's true. You know, we, aside from us eating mountains of processed food, which has got no nutrients, except things that are fortified, right? Enriched.

Why do they enrich it? Because it's impoverished to start with, right? And on top of that, the way we grow our food in soil that's depleted because of industrial farming techniques, because of the fertilizers and chemicals that literally destroy the microbiome of the soil, which is needed to extract nutrients from the dirt, from the soil that the plants can use, which then we eat. We've seen 50% reduction in nutrient levels like magnesium and other minerals in our vegetables over the last 50 years. So if you're eating broccoli today and you ate it 50 years ago, it's a different food. And then you're shipping them over long distances. The average

apple you eat has been in a storage house for a year, right? And they're refrigerated, kept in storage or transported. So they lose nutrition. And we're also living a lifestyle that depletes our nutrients. We're drinking too much alcohol, smoking, eating processed food, which by the way, in order to, let's talk about this, in order to actually metabolize your food, the way your food is metabolized is requiring vitamins and minerals to run that. As cofactors for all those enzymes, to run the food through your metabolic factory. It's like the assembly line. If you don't have the nutrients, you can't run the food through. And so you get more depleted. And then we have all these drugs we take that deplete our

nutrients, medications. And then, so we have all these reasons why we're nutritionally deficient. So let's talk about how we learn in our practice, the Ultra Wellness Center, about what people's nutritional status is. How do we figure that out? Well, so we look at it from multiple different angles, right? First, it starts with the physical exam. What is their waist to hip ratio? How are they holding on to weight in their body? Then we look to look for signs of nutritional deficiencies. Maybe their hair is dry or their skin is dry or they have different spots on their nails, which could indicate zinc deficiency. You know, we look at their diet intake.

Wait, wait, wait. The nutritional physical exam, I just want to pause because you teach that course at the Institute for Functional Medicine. And it's fascinating when you learn as a doctor what the clinical signs are of vitamin deficiencies, right? So we know the obvious ones that, for example, if you have scurvy, you get no gum issues, right? If you have B vitamin deficiencies, you get little cracks in your mouth called chelosis. If you have white spots on your nose,

it might be zinc deficiency. If it's, for example- Bumps on the back of your arms, you know, or dry skin. We think about vitamin A a lot. We think about zinc. Yeah. And my favorite test is a vitamin D test. You know what that one is?

Yes. Tell us about that. So if you bang on somebody's leg and they have pain, then that could be a sign that they're low in vitamin D. Yeah. So if you take your thumb and you press right now, ready to go, press right now on their shin bone. And if it's tender, then it means you're probably vitamin D deficient because it makes your bone soft. Now I take vitamin D, so my bone doesn't hurt at all when I press on it. You're pressing right now. Yeah, mine doesn't hurt either. Yeah, you go. I'm taking my vitamin D deficient because it makes your bones soft. Now I take vitamin D so my bone doesn't hurt at all when I press on it. You're pressing right now. Yeah, mine doesn't hurt either. Yeah, you go. I'm taking my vitamin D. I'm taking my vitamin D. And I think what is really important

to pay attention to with supplements is that when we use them in a personalized approach, when we're testing, when we're using them based on what that individual person needs, not just saying, okay, everybody take this, which sometimes that's helpful too, but really figuring out for that individual person, what are they deficient in? Where do they need to focus? That can make a huge, huge difference for how they feel. It's so true. And it's different for each person, like you're saying, based on our genetic makeup, right? And everything else going on in our body, not just our genetics, but what other diseases we're dealing with, how how we digest and absorb our nutrients i mean so many things impact our nutritional needs yes so someone's for example had like a vitamin d receptor gene that made them

require a high dose of vitamin d and you took a hundred thousand people and you saw them taking vitamin d well you think they're taking enough but it might not be enough for that person and if you actually took that subset and you studied them and you gave them the vitamin D, well you think they're taking enough, but it might not be enough for that person. And if you actually took that subset and you studied them and you gave them the right amount to get their blood levels optimally, it might be different. It will absolutely be different. You can get your vitamin D levels tested through a simple blood test.

Supplementing with vitamin D3 can be an effective way to reverse a vitamin D deficiency, but it can take between six and 10 months for levels to optimize. Dr. Hyman recommends working with a trusted healthcare practitioner to monitor your levels over time and ensure you are getting the right amounts for your particular needs. Thank you for tuning into this episode of The Doctor's Pharmacy. If you enjoyed this episode, please consider sharing it with a friend and

leaving us a comment below. Until next time. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health.

It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger, longer. Hi, everyone.

I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical

or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.