Could you be vitamin D deficient?
What is vitamin D and why is it important?
Vitamin D is completely different than most other vitamins. In fact, it’s a steroid hormone produced from cholesterol when your skin is exposed to the sun. For this reason, vitamin D is often referred to as “the sunshine vitamin.”
However, sun exposure rarely provides adequate vitamin D, particularly when we live in a country that often struggles with its weather like the UK! This makes it necessary to obtain it from our diet or supplements. Only a handful of foods contain significant amounts of this important vitamin, and deficiency is very common.
According to the National Diet and Nutrition Survey (NDNS), in the UK, approximately 20% of people have low vitamin D levels, and in IBD the prevalence is even greater at 30-40%. In my clinic, I have found the prevalence to be much higher than this.
Vitamin D is fat-soluble. This means it dissolves in fats and oils and can be stored in our body for a long time.
There are 2 main dietary forms:
Vitamin D3 (cholecalciferol) - found in some animal foods, like oily fish and egg yolks.
Vitamin D2 (ergocalciferol) - found in some plants, mushrooms, and yeasts.
Of the two forms, D3 (cholecalciferol) seems to be almost twice as effective at increasing blood levels of vitamin D as D2 (ergocalciferol), so those on a vegan diet may be at greater risk of deficiency.
Vitamin D has many functions in our bodies, but the main ones are:
It works with calcium and other nutrients to help keep our bones strong.
It helps support our immune system.
It helps to reduce inflammation.
What happens when we don’t have enough?
Symptoms of vitamin D deficiency include frequent colds and infections, fatigue and tiredness, bone pain, impaired wound healing, hair loss, muscle pain, and it may even impact our mood.
We’ve all heard of SAD - a type of depression that comes and goes in a seasonal pattern. Vitamin D and serotonin are linked - we think that the symptoms of SAD may be, in part, due to changing levels of vitamin D, when we are exposed to less sun as the seasons change, which may affect serotonin levels in the brain making us sad!
In IBD, low vitamin D is associated with increased disease activity, inflammation, and more frequent flare ups.
So, what can we do?
Public Health England recommend that adults and children over the age of one should have 10 micrograms (mcg) of vitamin D everyday which means that some people may want to consider taking a supplement, particularly from October to April.
If you suspect you might be deficient, it is really important to test. This can be done easily with your GP and is a simple blood test. The reason why we need to test is to gauge the severity of the deficiency so we can supplement accordingly to correct it.
What can I do if I am deficient?
A plane ticket to the Caribbean will do the trick (!) but for a slightly cheaper option we can get some vitamin D through oily fish, eggs, and fortified foods, but we often also need to supplement. The two brands I often use in my clinic are BetterYou, who do a Vitamin D with K2 spray, and Nutri Advanced, who do Vitamin D with K2 drops (NB: vitamin K2 works with vitamin D to help transport calcium into our bones. It helps to regulate calcium absorption in our bones to prevent calcium building up anywhere its not supposed to like in our arteries).
If you are deficient, a supplement of 10mcg per day as suggested as a maintenance dose by PHE won’t make much difference, you will need a higher dose for a short period of time to help correct the deficiency, but this should only ever be done under the guidance of a nutrition professional as vitamin D can be toxic in very high doses.
If you think you might be deficient or you are struggling with your IBD, please do get in touch.
I have also written a free e-book to help you find a way forward for your everyday life with Inflammatory Bowel Disease. Whether you are right at the beginning of your journey with IBD or have been living with your condition for years and feel like you have tried almost everything, there are things you can do everyday, beyond the medication you are taking, to help you take back control.