Getting enough vitamin D is essential to your long-term health. It's relatively easy to get vitamin D through sun exposure most of the year, but that changes come wintertime. So here is Dr. J and Evan discussing why vitamin D matters and how to keep your levels up, even when the days are short and the skies are snowy and gray.
Vitamin D absorbs calcium and helps you maintain healthy bones. It also contributes to the health of your muscles, nerves, and immune system. So if you don't get enough vitamin D, you may be at risk of developing rickets, osteoporosis, other bone disorders, diabetes, hypertension, and cancer. Older adults, people with dark skin, and obesity are more likely to have a vitamin D deficiency.
Dr. Justin Marchegiani
In this episode, we cover:
1:49 The Importance of Vitamin D in Winter
5:15 Viruses in Winter Season
11:20 Vitamin D Supplements and Benefits
14:03 Vegan Vitamin D
19:01 Vitamin D as Epigenetic Regulator
22:55 Respiration Issues and Blood Pressure Issues
Dr. Justin Marchegiani: And we are live is Dr. J here in the house with Evan Brand. Today we're going to be talking about vitamin D to help enhance your immune system is such a good topic because in the winter months, we're exposed to all kinds of viruses and bacteria out there and immune stressors. There's less sunlight, more cold, more sugar, more sweets, more holiday stress. And we really want to make sure that you guys have a strong immune system to be resistant to what's happening in today's environment. Evan, how are we doing today, my man?
Evan Brand: Doing really well. I'm ready for the sunshine to come back. You know, I was looking at my D minder app the other day, and the vitamin D window just opened back up. So and the which, technically, according to the way the earth is tilting, we're actually past the deepest, darkest parts of winter. But you know, late December, because of Northern latitude, and the angle of the sun and all that you literally cannot make vitamin D, even if you're outside, but naked, you just can't. But luckily, according to my app, the vitamin D Window, at least from my latitude, just opened up about six days ago. So if there is Sunshine out from about 12 to one or two, there's a good like two hours a day right now based on my latitude, where I can get adequate vitamin D with enough skin exposure. But the problem is, most people in the middle of the day there may be on their lunch break at their office, you probably can't get outside enough to get the sun. And if it's cloudy, of course that cancels it out? And can you undress enough at your office building to get enough sunshine to get enough vitamin D? So, in general, the answer is no. And this is why I would say 90% of people that we've tested via blood, we're going to see vitamin D deficiency. And this is just something you cannot afford to be deficient in
Dr. Justin Marchegiani: 110%. So in today's environment, with the winter being where it's at, and depending on your latitude and longitude and, and your ability to be outside and expose yourself, getting vitamin D naturally to the sun, and it's forming kind of these pre cholesterol d3, and that d3 being absorbed into your kidneys and liver, right, it's odds are going to be pretty low. So we're gonna have to supplement this time of year, that's going to be without a doubt. And we got to get our vitamin D levels up to an optimal range as well, because we need to be at least above 50 on the United States metric for vitamin D, that's important. If you have an autoimmune issue, if you have any cancer predispositions, you probably want to be even as high as 70, to 100, but at least 50 on the vitamin D side to really maintain optimal immune function.
Evan Brand: And this is something you can actually test at home now, which is pretty cool. So there are some labs that you and I can work with, where we can get people some dried blood spot testing. But if you're working with us clinically, we might as well just run a full blood panel looking into thyroid and everything else. Because if you have other symptoms, you could take vitamin D and not fix yourself, meaning it's great to optimize that. But you could still have other issues. So you could just do the at home blood panel or if we're going to get you to the lab, we might as well look at everything else. And you're not looking at an expensive test. It's kind of hard to believe that this is not standard practice. But you go to your conventional doctor down the road, and they run basic blood work on you, they're not going to run vitamin D, unless you ask for it. And even then they may say, Oh, it's not covered by insurance. So what is your reply? Because it's generally only going to be maybe 20, maybe $50. US max to test this is not an expensive test.
Dr. Justin Marchegiani: No, no, it's definitely not an expensive test. Now in general, and give you guys a couple of markers here in regards to the ranges. So off the bat, I already mentioned 50 to 70 is a pretty good range to be in I think for most people, right? If we have cancer, heart issues, autoimmune stuff, we can go 70 to 100. And the metric we want to look for is going to be nanograms per milliliter nanograms per milliliter. In Europe they do or Canada they do nano moles per liter. And the conversion on that I want to say is about two, you multiply whatever the level is here and you multiply it by about 2.25. And that gives you that conversion, right? So for at about 50 or so on the vitamin D here is sufficient, right? That's the nanogram per milliliter multiply it by 2.25. That's about 125 nano moles per liter if we're talking Europe or Canada so you guys can make the conversion 2.25 All right, so 50 to 70 is ideal 70 to 100 is going to be you know if we have cancer, heart disease, immune issues. Now when we supplement with vitamin D, we want to make sure we're taking d3 if your diets really great, lots of green vegetables, high quality gi butterfat, good kaitou then you're probably fine. You don't need k two if your diets not awesome or not great or you want that extra bit of insurance, you can always do vitamin K to with your vitamin D, just to make sure there's an adequate balance there. A lot of your fat soluble vitamins tend to come and work together vitamin D vitamin K work importantly well because k helps calcium get into the bone D helps calcium be absorbed. From the gut as well, so it's nice to have some k there. So we're really helping to put all that calcium back into the bone that we're now absorbing better in our gut from vitamin D. So it's nice to have that as an insurance policy to make sure we're putting and telling that calcium where it needs to go.
Evan Brand: Yeah, well said, I just put another paper in the chat for you if you want it. This was from 2006. And it was just talking about how there was back in the 1980s, a guy Edgar hope Simpson proposed that a seasonal stimulus was intimately associated with seasonal epidemic, influenza. And long story short, the fancy way of saying, hey, winter comes and then boom, all of a sudden, you know, viruses become more of a prevalent issue. And then long story short, there was this whole interventional study, which there's many, many, many, many on this long story short, vitamin D is reducing the incidence of respiratory infections in children. So this is specifically talking about kids. But there are countless of these for adults. And so what's happening when the vitamin D levels are sufficient, are a multitude of things. But in particular, it's helping to reduce interleukin six, which is one of those inflammatory cytokines that we're seeing get people in trouble. So if you can reduce your cytokines, that's going to be beneficial. And then also another cool benefit is not only as sort of an anti viral, but there's some anti microbial benefit, which I honestly didn't know much about this and start till I started reading these papers here that it can actually activate your immune cells to produce some anti microbials. So sort of like a natural antibiotic, if you will, by upping vitamin D concentration. Now, the question is, well, how do people take it? Is it just an ongoing thing, if you think you're getting into trouble with the illness, do you go high dose of it, I think it depends on what your levels are. So would you say you probably want to get a baseline first to know where you're at and how you should address it or-
Dr. Justin Marchegiani: Baseline first, I mean, I would say the wider your skin is, the more fair your skin is. Probably the more efficient you are going to be at converting vitamin D from the sun, right? The darker your skin is think of your your the darkness in your skin, that's melanin, right, the more melanin you have, so you have kind of different spectrums full on African American, that's the highest amount of melanin, melanin is like your natural UV block, right, it helps block your skin from the sun's rays. So due to evolution, and where we evolved, people that evolved closer to the equator, more UV light based on the angle of the Sun hitting it, they naturally evolved with more melanin in the skin, people that have all further away from the equator, less direct UV light, less melanin in the skin, because it's all about making vitamin D. So the more efficient you are at making vitamin D, you probably are going to be, you'll probably be able to get away with not supplementing as much or as frequent. The more melanin in your skin, the more you have to be on top of your vitamin D, because unless you're going to be outside six to eight hours a day, and you're at a, you know, mid to low 30 latitude, you're probably just not going to be able to ever make enough vitamin D, therefore, you really have to be on top of everything. And you're testing. So lighter skin, I think in general, a good rule of thumb is 1000, I use per 25 pounds of body weight, especially in the fall and winter months. And then if you want to take a break in the summer, that's fine, just make sure you get a test here there to confirm it, the darker your skin is, you may even want to double that in the winter months. And then you may want to follow up and retest come the early spring and see where you're at kind of monitor where you're at. If you're someone that works outside, that's you have to make that adjustment. If you're an office person you're inside all day, you also have to make that adjustment to so in general 1000, I use per 25 pounds of body weight. And then if you have darker skin, you may want to double that for the winter months. And then it's always good to confirm in the summertime in the winter, and sometime coming off the winter, early spring summer to see where you're at. And then we can always adjust accordingly. And if there's any risk of autoimmunity or cancer, we probably want to be testing just a little bit more frequently. Once you kind of know where you're at, you can kind of guess based on how well you're doing. And then in regards to vitamin D, you know, I mean, vitamin K, K2, you probably want anywhere between 100 150 micrograms of K2 is kind of where you want where you're going to be at per day on average. And so if you're doing lots of green vegetables, if you're doing sauerkraut fermented foods, you're doing kaitou from grass fed butter or ghee, you'll probably be fine. And then if you want that insurance policy of about 150 micrograms, you can always just find a good vitamin d3 with that in there. And then that gives you that extra assurance that you're okay there.
Evan Brand: Yep. And the other cool thing about this I mean, in terms of how big of a game changer This is for your health for your immunity, we're talking minor dollars for testing. We're talking minor dollars for actually buying something now, we're still going to advise you to go with the more professional product just because that's what we're going to use clinically. That's what we're going to sell to people so we still do Want you to get a good quality product, but in a pinch, could you get away with something just a typical store brought brand, probably. So we just have a lot of sensitive people. So we're going to want to avoid a lot of the fillers, you'll see soybean oil, sometimes you'll see other things that we don't like, and some of the cheap brands. So we're going to try to get you just like a straight d3, possibly with a little bit of gelatin. But even sometimes we're gonna do like a veggie cap, when you've got maybe a little bit of cellulose but-
Dr. Justin Marchegiani: MCT oil or olive oil, some kind of a healthier fat versus like you mentioned a soy or something more junky or more like polyunsaturated.
Evan Brand: Yeah, but once again, I mean, you're looking at, in general, I know some of the professional brains, you and I use, cost wise, you're looking at, like 50 to 60 bucks for six months. So I mean, you're talking maybe 10 bucks a month, and that's for like professional quality. And there are liquid versions that you can use for children as well. I've got both of my kids taking vitamin D. Now we do give them some different cod liver oils and omega. So you can get some vitamin D naturally from some of the cod liver oils, you can get a few 1000 iu, but we are still doing a little bit of extra K1, K2 and D3 for the kids. And that's easy. And my daughter calls it Hummingbird food, because it's clear just like our Hummingbird food and it tastes a little sweet. So she loves it. It's like her favorite part of the day.
Dr. Justin Marchegiani: Yeah, cuz it's got a tiny bit of stevia in there. Right. And then you also have, you know, it's clear liquid vitamin like the MCT oil in there. That's Yeah, good. Yeah. Excellent. Yeah. So 100% on that, I would say supplementally. Like you mentioned cod liver oil, very good. You can also look at other fat soluble vitamins, the other ones may be vitamin A, right. So if you're doing high quality, ghee or grass fed butter, you're probably getting a good amount of vitamin A in there, especially if you're doing something your tea or coffee in the morning. If you're eating good grass fed grass fed beef and you're doing good quality pasture egg fed egg yolks, then you're going to be set on a lot of that, if you want some additional insurance, you can do some cod liver oil, like I mentioned, you can get a vitamin D that has some vitamin A in it, or just use some of the extra cod liver oil and get some good egg yolks in and you'll probably be totally fine with that. Anything else you want to add?
Evan Brand: Yep. I would just encourage people not to do. Yeah, I would say I just encourage people not to do the conventional D2 supplement that you're going to get from a local doctor. For example, if you ask your neighbor down the road to give you some vitamin D, they're probably going to give you D2. They may give you like a 50,000 iu or possibly even like 100,000 iu that you're going to get from a pharmacy, it's going to be loaded with a bunch of binders and fillers. And we find that just those really high doses for a few days don't really do as much as a lower dose over a longer period of time. So it's not where you just come in and do 100,000 for a week and you're cured. Now you really need to just optimize it over a slower period of time.
Dr. Justin Marchegiani: Yeah, like myself, I'm not gonna lie, I'll do sometimes 40 or 50, once a week, to kind of keep my levels pretty good. But I think it just kind of depends on where you're at. Right. So if if for some reason, you know, you forget to do your vitamin D, I'd rather have people do it like at least once a week. So it's there because it is a fat soluble vitamin. So it will kind of build up in your system. It's not like a B vitamin where you just pee it out. But ideally, every day is good, especially in the morning time because think about it, you wouldn't naturally make vitamin D in the middle of the night or at nighttime, if you're taking it right, you'd make it more in the morning to afternoon. So take it more in the morning and afternoon. Right, that makes more sense to me from a kind of day in day out how vitamin D will be made in general. And then the other thing is, if you miss it or you forget it, I think doing it at least getting it in there once a week as a fat soluble vitamin, just make sure you test make sure you're doing well on that. And like you said having d3 is in the B that's more of the animal version, I think is a lanolin more of a plant version on the D two side. And the thing with it's more synthetic and it doesn't equate to improving your vitamin D levels because as to get converted in the body. So there's a conversion issue that tends to get lapsed on and it won't move your vitamin D levels is good.
Evan Brand: I have seen some like vegan D3, I want to say they're like an algae based product. Yeah, I haven't looked too much into them. I mean, I have had some vegan clients who were like, Hey, I'm just really opposed to any other source of vitamin D. I'm like, okay, fine, we'll get you some of the vegan ones. I think it's a lichen. Maybe a lichen or an algae. I mean, I'm okay with it. But I don't have enough long term evidence to say where I've looked at people and regards to their test results to confirm that their levels we're getting up from the algae or the like and based one, I'm sure if it's D3, and it says 5000. I mean, in theory, it's good enough, but I just haven't I don't have enough data to say whether you should go for that or not. I would just go with your typical D3
Dr. Justin Marchegiani: 100%. Now vitamin D has a couple of different benefits. You already mentioned a couple things, let's kind of go over some of the benefits for the listeners. So we already chatted about the the natural antibiotic that's being produced by vitamin D. It's called cathelicidin. It's a kind of an antibacterial enzyme. That's super helpful at being able to knock down bacteria, okay? It also has antiviral mechanisms as well. It has the antimicrobial peptides, like I mentioned, it also has some antiviral mechanisms. Part of that is it stimulates and can modulate the th one immune response and the th one immune system, that's where you're making a lot of your natural killer cells and your helper cells, which are really good. And then also good helper cell can also help you know that your antigen presenting cell can help make antibodies more efficiently. So you're also going to have better TH2 immune response. So you're going to make antibodies to whatever that infection is, those tend to come a little bit later in the game, but good signaling to make your antibodies is super helpful as well. I would also say as a couple other studies here that we're talking about different things, so we have a reduce in our MMP 9 concentrations, we have a reduction in Brady Keinen storm, and our original reduction in our cytokine storm. So basically, we have a lot of inflammatory molecules that get produced, right, Brady keinen cytokines interleukins, MMP9. And basically these are inflammatory type of chemical messengers. And vitamin D can help modulate that and prevent that from being overproduced, which because the more we over produce those, the more our immune system responds, right, and we can create more cytokine storm issues because our immune system kind of is on this positive feedback loop, responding and creating more issues with these cytokines. So we can kind of modulate and bring these cytokines down a bit. And when there's less cytokines, there's less chance of a cytokine storm, which is basically our immune system responding. And imagine a fight between two people, you know, one person yells, the other person, that person yells back down, then we're pushing them we're shoving, then we're hitting, and the violence escalates. That's kind of what happens with the cytokine storm, with your immune system and all the different cytokines and immune chemical signals, so we can keep that modulating a bit, which is very helpful. And vitamin D plays a really important role in that.
Evan Brand: Awesome. I don't think there's really, really any other mechanisms that are important for this. I mean, I'm sure there's other stuff that we could, we could pick out. But, you know, I would argue that, you know, if you're darker skin in Canada, you're in trouble. If you're in New York, you're in Michigan, you're in Montana, you're in Seattle, Washington, I mean, even, you know extremely fair skinned people, Irish people like me, if you're that far north, and you're not supplementing, I'll bet you $1,000 you're deficient. So it's pretty easy. It's pretty easy. This is so easy. But such a game changer. I wish it were the front headlines everywhere.
Dr. Justin Marchegiani: Well, I would at least kind of convince people here just get on vitamin D, from thanksgiving to spring. Yeah, at least do that right, at least make that investment get on vitamin D supplementation from thanksgiving to spring. Or if you want to come off the rest of the year, as long as you're getting some sunlight, fine, but at least do that that's gonna give you a good bump. And the fat soluble nutrients, you'll get over those four or five months, we'll hang around months afterwards, too, because it takes a while for that for that vitamin D level to build up. Now, what are some symptoms of vitamin D excess. So if you're not testing and you're just doing a lot of vitamin D, well, you may have high levels of calcium, you may notice hypercalcemia hyper calcium iya. So if you run a comprehensive metabolic panel, you may see high levels of calcium. You may also notice you're more nauseous, you're vomiting, you're weak, a lot of urination, bone pain, kidney issues, calcium stones, if you're having any of those symptoms, and you're not really monitoring your vitamin D, you may want to just double check on that. I've also seen clinically that vitamin D toxicity happens less when you have other fat soluble vitamins present. So if you're noticing that you may want to back off a bit, you may want to really focus on getting good vitamin A and good vitamin K in there, as well, just to make sure you're not creating a fat soluble vitamin imbalance, I think is a really good kind of thing out of the gates.
Evan Brand: Yeah, that's pretty easy. Oh, a couple other things I wanted to mention, this is at the top of the the paper you and I were looking at, you already mentioned like benefits for autoimmune diseases like MS. But also in regards to just helping with epigenetic switching. So you know, all this reading here, because it's pretty simple. Vitamin D is a powerful epigenetic regulator influencing more than 2500 genes. So what that tells me is you and I seriously, we don't even fully understand what all this benefits. I mean, we have a clue based on knowing how many genes that can positively influence but who knows, you know, you don't know what you don't know. So how many other beneficial things are we doing? That science hasn't even uncovered yet? Probably a ton.
Dr. Justin Marchegiani: 100% right. So when you talk about the different epigenetic signaling that can happen, that's pretty powerful, right? Because we know that I think 800 900 It's a bunch of different DNA, a bunch of different genes are being affected, and so on. It's important. We don't know all the things that could be affected. But we do know that if you get your vitamin D levels up, you don't really have to worry about everything that you're doing. That's kind of the, that's kind of the important component there, you don't really have to worry about it, you just got to make sure that you're doing the right thing. And you're set. And you're pretty much good to go.
Evan Brand: Yeah, I've got my grandfather testing his now I- Well, I've got my grandfather, he's been on vitamin D for several years now. And I've got his doctor to the point where he doesn't question it anymore. He just runs it. So we've got him up, we just got his blood work back. He's up around 60. And he's doing 5000 units a day, and he's hanging out around 60. It took a little while to get up there. So we did 10 for a while. And then now we're just staying at a baseline of five a day. And he's doing great with it.
Dr. Justin Marchegiani: That's great. So can you repeat the dose again?
Evan Brand: Yeah, we had him at 5000 a day. For a while we went up to 10, because he was only at around a 30 or 40. So we went up to 10 for a little while. And then we backed him down. So now he's at a five. So we went five, up to 10 for a while now he's at a 60. So now we're just going back down sticking with a baseline of 5000 a day with K and it's working really well.
Dr. Justin Marchegiani: So my kids, they get some vitamin D out of the gates every single day, which is helpful. And then we make sure they get some cod liver oil. And then they're also getting some really good fat soluble vitamins via gi and such like that. And so out of the gates here, you know anyone that's supplementing their kids or their family or friends, just make sure you're getting other good fat soluble vitamins along with the vitamin D, and you're going to be pretty darn safe out of the gates. And I would say at least try to do some kind of testing going into the winter and or coming off the winter just to make sure you're on track.
Evan Brand: Yep, and we'll put some links below I believe you've got a professional vitamin D that you use. I've got one that I use, there's liquid, there are different soft gel capsule versions. So we'll put a couple links for people if you want to check them out. Once again, this is one of the most cost effective but most health impacting supplements to be using it this time. And I think it should be in your pantry and your cabinet.
Dr. Justin Marchegiani: Thinks so too. So out of the gates, we talked about all of the immune benefits the immune modulating benefits, we talked about the natural antiviral antibacterial mechanisms. We talked about how they modulate cytokines, decreased chance of a cytokine storm. We talked about the the modulating of all these different chemical messengers. Also important benefits in regarding breathing, right, because we talked about vitamin D can help modulate high levels of angiotensin right. So we have a lot of blood pressure medications, angiotensin converting enzyme medications, right, or ARB right angiotensin receptor site blockers, vitamin D modulates angiotensin two rennen right it modulates it, and that can help with blood pressure. And blood pressure is important, right? Anytime we have respiration issues or breathing issues or blood pressure issues, modulating NAC can help. Alright, I would say the only other thing I really like adding in, especially if I'm having breathing issues outside of vitamin D is throwing either in some Bluetooth ion or some NAC and or both because that can one help reduce mucus when you have less mucus, you have better transfer of oxygen from the alveoli to the bloodstream, right? So you can take oxygen, deoxygenated blood, bring it back in get oxygen, so you just have better transfer of oxygen back into the bloodstream, which is important. And that's going to help you help you breathe better and it's gonna help keep your oxygen levels up. If oxygen levels dropped too much, you're gonna be really fatigued and tired. So the only other thing I would throw in with vitamin D is maybe some NAC and or some glutathione.
Evan Brand: Yeah, well said yeah, oral and or in bigger situations, more problematic situations. nebulised bluetooth ion, we had one client who had a brother who had a lot of issues, got him on the nebulizer with the Bluetooth ion and he was stellar within just a few hours. So I think that is another essential supplement to keep in your pantry.
Dr. Justin Marchegiani: Yeah, I had a patient just last week she'll probably listen to this podcast, but she had some breathing issues due to a winter cold, some significant breathing issues and she had seen my podcasts and video on using lipids omo or shoot using nebulised bluetooth ion and I my little nebulizer right over here. Right under there. And I use the nebulizer to fire on with some saline solution. And she said right away her ability to breathe and respirate improve right right out of the gates. Oh yeah shows that you know getting really good glutathione obviously orally into your body is low hanging fruit. But if you need to get it internally right to your lungs, there's a lot of studies on showing how beneficial that is in helping your breathing and just helping to reduce inflammation in your lungs.
Evan Brand: Yes, absolutely. Yeah. My mother in law she had diagnosis of COPD even though she's never smoked. We think it was due to chemical exposures probably virally. bacterial issues as well. Same thing got her on the nebulizer. She said it's a game changer she got off of her inhaler completely after using the nebulizer so it's pretty unreal.
Dr. Justin Marchegiani: Absolutely. So what we'll do is we'll put some links here we have some vitamin D products and glutathione products that we like and we personally recommend, we'll put some links here below so if you guys are interested and you want to take a peek and you want to support the podcast, that's one way to do so. And again we only we only recommend products that we personally use with our family, ourselves and our patients and because we're in the thick of it rolling up our sleeves dealing with patients clinically every week it's it's into our it's let's say it's part of our best interest to have the highest quality product so we can get the highest clinical outcome.
Evan Brand: Totally, totally well if you need help clinically as well if you need advice, we work around the world with people via FaceTime, Skype, phone etc. You can reach out to Dr. J at Justin Health. JustinHealth.com for Dr. J. Me, Evan Brand at EvanBrand.com and we're available worldwide. So you can use the scheduling links you can book intro calls you can book new client calls, but we are here so please reach out if you need help.
Dr. Justin Marchegiani: Awesome. Hey Evan excellent chatting with you my man. JustinHealth.com, EvanBrand.com. Sharing is caring if you guys enjoy it please send us a review we really appreciate it. JustinHealth.com/iTunes, EvanBrand.com/iTunes we'll put a review link below. We really appreciate you guys. Alright, you guys have a phenomenal day. Take control of your health. Keep your immune system strong during the winter months. Take care y'all. Bye now.
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