Three years ago, I experienced tiredness like never before. There were days where I could barely manage to get off the couch on the weekend, because the fatigue was simply so overwhelming. I finally decided to go to the doctor and requested they run some labs. Because my fatigue was so significant, they also ran a vitamin and hormone panel. The results were astounding. While the Institute of Medicine recommends that Vitamin D levels fall between 20-40 ng/dL, mine was 12 ng/dL. TWELVE! One week of intensive vitamin D supplementation and I was back to feeling like myself again.

I’m not certain that the Vitamin D supplementation alone was responsible for my fatigue. I was a mom of two under 7, it was a very busy/stressful time for me on the faculty, etc etc. It could have very well been a placebo effect (ie, “a beneficial effect produced by a placebo drug or treatment, which cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient’s belief in that treatment”), given that a big study in the New England Journal of Medicine (one of the premier journals in academic medicine) published a study indicating that a more appropriate cutoff might be closer to 12.5 mg/DL, based on the analysis of blood samples from hundreds of thousands of individuals. 

So why is it possible that my potential vitamin D deficiency may have led to such extreme tiredness??

Well, Vitamin D is not frequently found many of the foods humans consume. Furthermore, we typically get Vitamin D from the SUN! So, if you don’t consume many of the foods that contain vitamin D, or consume them in quantities large enough to provide the Vitamin D levels your body needs, AND/OR you don’t get a lot of sun exposure, then it possible you could be vitamin D deficient. Since I wasn’t getting Vitamin in my food and getting very little sun exposure, it’s likely that the combination of those two things led to my deficiency.

So, what are some of the foods that contain Vitamin D naturally??

• Fatty fish, like tuna, mackerel, and salmon
• Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals
• Beef liver
• Cheese
• Egg yolks

At that time in my life, I didn’t eat eggs, I didn’t drink milk at all, I rarely ate salmon or tuna, definitely did NOT eat beef liver (although no judgement of those who do!!), and didn’t consume orange juice fortified with Vitamin D. Furthermore, this time of year three years ago also meant that I had been wearing lots of layers, and likely hadn’t spent much time outside because it’s winter. Also, it’s flu season and hello! Best to stay indoors. 😀 All that to say, I now consume a lot more salmon, and definitely take the Vitamin D dosage my physician prescribed.

Studies suggest that people most at risk for Vitamin D include:

• people with anorexia nervosa
• people who have had gastric bypass surgeries
• people who suffer from other malabsorption syndromes like celiac sprue
• people who have dark skin
• people who wear total skin covering (and therefore absorb less sunlight even when they are outdoors for extended periods of time) 

 What are some of the symptoms of Vitamin D deficiency??

Some people have no symptoms at all. Others experience tiredness or fatique (like I did), others experience muscle aches. Extreme and prolonged (that lasts a long time) vitamin D deficiency can lead to brittle or misshapen bones.

If you have vitamin D deficiency, and have questions about what to do or what to take, definitely consult with your healthcare provider about an appropriate dosage if you’re not already getting it in your diet or you’re not in the sun a lot. Oh, but don’t forget, if you’re in the sun, WEAR SUNSCREEN because, hello, skin cancer. 😦

For more information, visit the following sites which include significant information about this topic!

https://www.health.harvard.edu/blog/vitamin-d-whats-right-level-2016121910893

https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

https://ods.od.nih.gov/factsheets/VitaminD-Consumer/

JoAnn E. Manson, M.D., Dr.P.H., Patsy M. Brannon, Ph.D., R.D., Clifford J. Rosen, M.D., and Christine L. Taylor, Ph.D. Vitamin D Deficiency — Is There Really a Pandemic? New England Journal of Medicine

Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism 2011

Heaney RP, Holick MF. Why the IOM recommendations for vitamin D are deficient. Journal of Bone and Mineral Research

Bouillon R, Van Schoor NM, Gielen E, et al. Optimal vitamin D status: A critical analysis on the basis of evidence-based medicine. Journal of Clinical Endocrinology & Metabolism.

Cauley JA, Greendale GA, Ruppert K, Lian Y, Randolph JF Jr, Lo JC, Burnett-Bowie SA, Finkelstein JS. Serum 25 hydroxyvitamin D, bone mineral density and fracture risk across the menopause. Journal of Clinical Endocrinology & Metabolism, May 2015.