Saturday, January 24, 2009
Revisiting Vitamin D
On May 4, 2008 I wrote a post on Vitamin D entitled: “Are you deficient in vitamin D? The odds are good and the risk is high…”
I recently received this response from a reader:
“Good afternoon! I read your article on Vitamin D deficiency on the internet. I've taken the prescription of 50,000 units of Vitamin D for 6 months, and my levels are still undetectable. I know someone who successfully treated their Vitamin D deficiency with a Vitamin D shot. Is that readily available in the USA?
Please note: I'm absorbing all other vitamins, calcium, etc Glucose, etc is normal. Only problem is Vitamin D.
I wanted to respond to this post for two reasons:
1. I’m concerned about this individual and want to make sure that he/she gets the help they require.
2. Vitamin D deficiency is truly epidemic in this country and is further exacerbated by malabsorption which, as we know, gluten sensitivity and celiac disease causes.
So let me talk to my reader first:
Vitamin D is a fat soluble vitamin. You don’t tell me too much about your health but I’m assuming that gluten sensitivity or celiac disease is probably a component. With gluten sensitivity comes malabsorption but exactly what you’ll malabsorb and to what degree is somewhat unique to individual patients.
You mention that other vitamins and calcium and glucose are fine. But are these other vitamins water soluble or fat soluble? The villi (fingerlike projection which line the small intestine) help to emulsify and absorb fat. These villi are frequently eroded with gluten sensitivity and fat absorption is thereby compromised. The inability to adequately absorb fat will not only affect absorption of vitamins D, E and A but it will drastically affect hormone production as well. (The list is actually a lot longer but let’s not get too complicated.)
If you’ve been off gluten but are not seeing proper healing of the villi then something else is compromising your small intestine. You may have an intestinal infection or some inflammatory factor that is preventing healing. That cause must be identified and treated quickly.
On a lighter and easier note, perhaps the vitamin D you’ve been taking is of poor quality. Though with that said, one would think that even a poor quality supplement would have had some effect on your blood levels after 6 months. I recommend vitamin D3 (cholecalciferol) for my patients. The absorption is quite good. I could not find any information on vitamin D shots being available in the US. But with the attendant concern re: overall fat malabsorption, simply taking a D shot would not allay my concerns about the integrity of your small intestine and the need to repair it.
If you don’t have a doctor who is providing what you need, write back to me and we can devise a plan to get to the root of this. Having a more in-depth health history will make assisting much easier.
My second point above is simply about driving the point home of how important it is to assess your vitamin D level, especially if you’re gluten sensitive.
Vitamin D is a crucial component of not only healthy bones, but a protector against cancer, diabetes, and a strong immune system booster as well. Despite all these virtues, its common deficiency has gone largely unnoticed.
It’s a simple blood test to take. Get your levels checked, supplement with a high quality vitamin D and then recheck your levels to ensure they are where they need to be.
For more information on this refer to my earlier post on May 4, 20008.
To Your Good Health!
Dr Vikki Petersen