Vitamin D is good for more than preventing Rickets. It helps offset the lack of sunshine during the winter, cold months when depression or melancholy sets in, and immune cells get sluggish. When physicians talk about vitamin D deficiency, they are invariably talking about low levels of a compound called hydroxyvitamin D 25 or “25 (OH) Vitamin D3” which is inactive. There’s another form in case you didn’t realize it, it’s the “1,25 (OH)” form of vitamin D, which is biologically active.
Our kidney has the lovely task of converting D from inactive 25 form, to the active 1,25 form, and magnesium is necessary for that conversion. Drug muggers that steal magnesium (such as acid blockers, diuretics and steroids) can hinder the conversion process. Additionally, kidney disease or reduced kidney function means suppressed vitamin D activity and thus, reduced 1,25 levels of the active form. As much as I love vitamin D, toxicity can occur if you take very high doses of vitamin D because it uses up your magnesium stores, leading to low levels of magnesium and relatively higher calcium. The picture of this mineral see-saw can trigger heart palpitations, nausea, constipation, kidney stones, memory loss, softening of bones, hyperparathyroidism and body aches.
Today I’ll teach you something new about vitamin D testing.
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As mentioned earlier, most physicians measure your blood levels of vitamin D 25 (which is the inactive form). Keep in mind your cells have receptors on them for vitamin D to attach too. Picture a lock and key where the key is vitamin D and the lock is the receptor on your cell.
The inactive form of D (25) grabs hold of this vitamin D receptor (VDR) and occupies it kind of like a key sitting in the lock (but you can’t turn it). In my example the 25 D renders the receptor inactive. Darn! Now your cell can’t bind the 1,25 form of D which is what you want! All the receptors are occupied with inactive D, rather than active 1,25 form. But docs are measuring the inactive form to get a picture of D levels and I’m saying that you could have sufficient levels of inactive D, and poor conversion which would lead to insufficiency (even in the face of “normal” 25 D levels). If your doctor evaluates your inactive form and makes the assumption you are converting properly and you have all the nutrients on board to convert, that is a rather big assumption.
I don’t advise you supplement based upon low 25 D levels (unfortunately, this is seen on almost all lab tests) because that is only half the picture.
It’s better to evaluate two biomarkers in one blood test (just measure BOTH of these):
1,25 (OH) Vitamin D3: Active
25 (OH) Vitamin D3: Inactive
Your doctor can evaluate both biomarkers and see how much active versus inactive D you have.
Low levels of 1,25 (active) D can occur with kidney disease since the kidneys are unable to activate the inactive 25 form to 1,25 which is active. You would think a high amount of the 1,25 form is desirable but it’s not. It could spell parathyroid disease, sarcoidosis, rheumatoid, fibromyalgia, Lyme and many other infections.
You physician can determine how much D you need, and how much you should supplement with.
Personally, I wouldn’t supplement based solely upon low levels of the 25 D. It’s inactive. It’s what you see on most labs today. The reason is because your active 1,25 levels might be fine, or even high. Keep in mind that just because you take supplements, doesn’t necessarily mean you activate that D either! I think you should get the full picture and evaluate both forms of D. It’s scary that over 100 drugs impact your D and calcium levels. You can read more about nutrient depletions in my Drug Muggers book.
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