Vitamin D Deficiency Signs and Symptoms

By Dr. Justin Marchegiani

We call it a vitamin, but vitamin D is actually a hormone made by the body utilizing the sunlight that touches our skin. Conventionally, we thought vitamin D’s only purpose was to help with calcium and phosphorus regulation, but in the past ten to twenty years, we’ve discovered that vitamin D has so many other benefits, including regulation of over 800 different genes. It also benefits immune function, weight loss, and our sex hormones.

Vitamin-D Deficiency

How Does Your Body Make Vitamin D?

Our skin contains precholesterol, a vitamin-D precursor. When the sun’s UVB radiation hits our skin, it combines with that precholesterol (this process is called synthesis) and makes vitamin D3. Vitamin D3 then passes through the liver and is converted into 25-hydroxyvitamin D (what we measure on lab tests). The 25-hydroxyvitamin D then passes through the kidneys and gets converted into 1,25-hydroxyvitamin D, or active vitamin D.

Vitamin D Functions in our Bodies

Balances the Immune System

The Journal of Immunology cites that autoimmune conditions are the number-three cause of death. It’s not the autoimmune condition, like lupus or Hashimoto’s, but it’s the inflammation from those conditions that predisposes us to cancer and heart disease and diabetes that lead to death.

Essentially, chronic inflammation is the underlying mechanism for all disease. So whatever we can do to reduce inflammation will help us feel better, live longer, and add more quality to our years. Making proper amounts of vitamin D will help us achieve this.

Leaky Gut and Autoimmune Disease

leaky gut

Leaky gut is often the first domino of autoimmune disease. When we have leaky gut, we’re predisposed to Hashimoto’s, an autoimmune condition of the thyroid. We also have type 1 diabetes and various neurological brain diseases, such as MS and Parkinson’s.  Intestinal diseases, such as Crohn’s, ulcerative colitis, and celiac disease are included, too.

Vitamin D needs to be the first thing you look at right next to diet to help balance the immune system.

If you have an autoimmune condition and you haven’t addressed the vitamin-D component, feel free and click here to get more information from me.

Stimulation of Sex Hormones

infertility

There are vitamin D3 receptors all around the body, especially in the sex organs. It is shown that vitamin D can actually stimulate the biosynthesis of sex hormones. In males its impact on testosterone can improve mood and muscle growth. In females, its impact on estrogen can improve neurotransmitter function (by helping with the reuptake of neurotransmitters, such as dopamine, GABA, and serotonin), which can allow us to feel better and more relaxed.

To access high quality vitamin D, click here!

Promotes Weight Loss

High levels of insulin shuttle excess sugars and carbohydrates into our muscles and liver. And once those are saturated, it converts those extra sugars and carbohydrates to fat. High levels of C-reactive protein (CRP) increase inflammation, cortisol, and adrenalin, thus raising our blood sugar. Higher blood sugar, inflammation, and core diet increase insulin.

Vitamin D promotes weight loss by decreasing insulin levels. It also decreases CRP levels, reducing inflammation.

Vitamin-D Lab Testing

Vitamin-D levels are checked using a 25-hydroxyvitamin D test.

Traditionally, a deficiency in vitamin D was associated with rickets in children, a bone disease that causes bowing of the legs. The traditional lab values showed that if you were around the 20 range, you were safe from rickets.

Today we know we need vitamin D not just to prevent rickets but also for widespread benefits throughout our body.  Newer lab ranges show above 30 is the minimum. Above 30 is about 30 to 100.

If you have an autoimmune condition, keep it closer to the 100 side because vitamin D has natural antibacterial benefits; it produces an enzyme called cathelicidin, which helps lower bacteria levels.

Some will use what’s called the Marshall protocol, where they’ll look at both 25-hydroxyvitamin D (calcidiol, stored vitamin D) and 1,25-hydroxyvitamin D (calcitriol, active vitamin D).  However, research shows that 25-hydroxyvitamin D is the better way to test because stored vitamin D is a better marker than active vitamin D.

Vitamin-D Supplementation

Optimal vitamin D is made by the sun, but in some regions (such as northern regions with latitudes in the 40 range) of the United States and at certain times of the year, optimal sunlight may not be an option. Even in sunny southern regions, if you don’t spend enough time outside, you won’t get adequate vitamin-D exposure.

Also, you have to expose your skin to the sun.  If you’re just going out with T-shirt and shorts, you’re not getting enough skin exposure. You really have go out there with the goal of sunbathing, exposing as much skin as possible. If this much sun exposure isn’t possible, supplementation may be the key for you.

Vitamin D3 and vitamin D2 are the two supplementation options. Vitamin D3 is shown to absorb better, so that’s the one I recommend. Vitamin D taken on a daily basis seems to do better with vitamins K and A. So if you’re eating grass-fed meat or grass-fed butter, you will get adequate amounts of vitamins K and A.

If your vitamin D is super high and vitamins A and K are low, that’s not good. We want to make sure our diet has these vitamins to assure our vitamin D is effective.

Vitamin D3 comes in pills or a liquid. Some patients do really good with 5,000 units per day with the K2 in it, or if they’re deficient, we’ll go up to 20,000 units a day. This parallels with the 20,000 units you would naturally make with the maximum saturation of sun exposure.

Tips for Sun Exposure and Supplementation

  • How do you know you’ve maxed your sun exposure? Your skin will start to look a little pink, not burned. That’ll be right around 20,000 units.
  • Don’t shower right after you get sun. Wait at least an hour so the vitamin-D3 precursor hormone that’s on your skin absorbs into your bloodstream.
  • The darker your skin, the longer you need to be in the sun. So if you’re African-American, for example, you will need more vitamin-D supplementation.
  • If you get enough sun in the summer but not enough in the winter, supplement in the winter.
  • If you’re in an area of the world where you never get enough sun, or you simply aren’t able to spend time sunbathing, supplement year round.
  • If you’re low on the vitamin D scale, say around 20, supplement with 20,000 units the first month, cut it in half the second month, and cut it in half again the third month.
  • If you have an autoimmune condition, supplement more.
  • Get tested so you’ll know where to start.

If you need help with getting a vitamin-D test, feel free and click here, and I will get a test ordered specifically for you.

Photo credit: Feature photo from Monarch Blog

References:

  1. https://www.hairlossrevolution.com/vitamin-d-deficiency/

Vitamin D – Lab Testing and Supplementation – Podcast #30

Our body naturally produces vitamin D primarily though sunlight exposure or we get it from diet and supplementation. This vitamin which is also a hormone affects our body’s natural antibiotics, regulates our genes and boost up our immune system to stave off disease.

In this podcast, Dr. Justin Marchegiani and Dr. Baris Harvey talked about the mechanism of Vitamin D, its different health benefits, the risks factor of vitamin D deficiency, lab testings as well as how to optimize one’s vitamin D intake to improve health and reduce the likelihood of chronic diseases.

In this episode we cover:

05:25   Vitamin or a hormone?

16:04   Calcidiol and calcitriol

18:07    Vitamin D lab testing

26:59   Vitamin D deficiency symptoms

32:20   Vitamin D supplementation

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youtuve

 

 

Podcast: Play in New Window|Download

 

Baris Harvey: Welcome to another episode of Beyond Wellness Radio. Before we go to today’s show I want to tell you guys about the newsletter. Go to beyond wellness radio.com and hit the newsletter signup. By doing this, you will never miss out on an episode. Be the first one to hear it as it is sent out to your inbox each week. One thing more, right above there is tab on justinhealth and that is where you can go straight to Dr. Justin’s website and he has a free consultation available for you guys that want to get a much deeper look. He also has a free video series on thyroid health. So make sure you guys dive in it. Also we would love for you guys to go ahead and give us a review on ITunes. That will be awesome. But to it prove to you that we deserve that review, we are going to give you some awesome stuff today. So, first of all, how is it going today, Dr. Justin?
Justin Marchegiani: Baris, it is going great today, man. It is right in the middle of winter and Austin, Texas has great weather. It is 75° and it is beautiful and sunny. And I know, being a Boston boy growing up, I got like three or four feet of snow this month alone. So, feeling really happy I am not in the North East.
Baris Harvey: Oh, yes definitely. I have the same thing here. It is really warm. I was thinking that it would be a good thing to have some rainfall but, I mean I am kind of spoiled out here. I know people in New York, they are a little chilly right now in that snow. So, I cannot complain.
Justin Marchegiani: Exactly.
Baris Harvey: Yes. So, in today’s episode we are going to talk about Vitamin D. It covers so much, whether that is hormone influence or immune system. We are going to be a little bit more particular on the immune boosting benefit. But we are basically going to breakdown vitamin D, make sure we are answering mostly asked questions on it and getting that kind of foundation. But before we go into that, what did you eat for breakfast?
Justin Marchegiani: Baris, today was just kind of a simple day, man. It was just four eggs, sunny side up. I know this is kind of my Friday when we record the podcast tends to be similar. A little bit of collagen, some eggs that were sunny side up, a piece of pasture-fed bacon, and some coffee with butter and MCT. And I am rocking it. Right now, I am stacking up my supplements a little bit differently. I am using a combination of Ashwagandha and Eleuthero at relatively higher dosage. I am also on a brain program where I am adding in 5-HTP and L-tyrosine and my brain just feels amazing. And I am going to admit this to everyone I have not been good this week. I have been getting about six to seven hours night sleep. So, I know I preached get an eight and get to bed before above and I have been off. So, even I can make mistakes. But I have been feeling darn good where in the past I would not have felt this good in the morning. And I really attributed it to, I think, adding in these new adaptogenic herbs. But also adding in the brain program, adding in some of the sulphur amino acids and the combination of 5-HTP and L-tyrosine together really has made a big difference for me.
Baris Harvey: Yes. Yes, it is funny that you say that because I was just, you know, especially at that last interview that you guys, you know, we have been hearing, we are really into like the brain stuff and the brain supplementation and how we can improve that. We preached that you should be getting eight hours of sleep but this past week I have not been the best all night, either.
Justin Marchegiani: Yes.
Baris Harvey: There have been some days that I have been getting more sleep but when going to sleep pretty late we are making sure that okay, how do I, kind of whatever I might have lost, you are never going to get as much as you could with sleep. But how could I try to make sure that I maximize the nutrients that I put in my body that would give me maybe some that I already got when I slept, you know what I mean?
Justin Marchegiani: Exactly.
Baris Harvey: So, try to level it out and then when you do get that full 8-hour sleep and then put that on top of it, it’s just icing on the cake.
Justin Marchegiani: Love it. Love it, man.
Baris Harvey: Definitely. So, myself, I do not want to just, you know, keep it boring because again I did not eat breakfast. But I am going to tell you what I am about to eat after. I will have some organic beef sausages with some eggs and that will probably it, and it really is as simple as like that. Mornings are simple because you know you got stuff to do to get things out of the way. So, if you do not have like any allergy to eggs, eggs are amazing.
Justin Marchegiani: Exactly, man. Love it.
Baris Harvey: And you know what else? They have a fair amount of vitamin D.
Justin Marchegiani: Absolutely, on that note.
Baris Harvey: So, on that note, I have been hearing some things with vitamin D. People try to put it into a certain category. Maybe it does not even need to be stuck into one category but is it a vitamin or is it a hormone? What is going on with that?
Justin Marchegiani: So I would consider vitamin D or vitamin D3 as like a pre-hormone. Vitamin D, activated vitamin D or calcitriol is going to be a hormone for sure because it has some hormone like effects. It is going to affect essentially various immune cells. It up regulates this microbial/antimicrobial peptide called cathelicidin which is really cool. It has effects on about 800 different genes, right? I think we only have like 20-24,000 genes. So, it is kind of like a, you know, a pretty big effect on about 5% of your genes. That is pretty awesome. So it affects your natural antibiotics in your body. It affects your immune system. It affects your genetics. And one of the big things of vitamin D is it is going to be a hormone even though it is a vitamin. And what is happening is we are taking the vitamin D3 through our skin and through supplements and we are converting it to be our liver and kidneys.
Baris Harvey: Uh-huh. Is that conversion still happening? Is it the same when it is through our skin? Does it still being converted to our liver?
Justin Marchegiani: Well, these various sterols that get secreted when you are getting sunlight versus the supplement. So if we are taking the supplement, we are just getting vitamin D3 or cholecalciferol. That is vitamin D3. Now we have vitamin D2 which is ergocalciferol that is more synthetic, kind of made in the lab, plant-based kind of thing. Like your vegans and stuff are going to be more on the vitamin D2 but you are going to get better absorption with vitamin D3 and also it is the same vitamin D3 that is made by the sun. Now with the sun though, I am going to recommend sun being the best. But let us just face it; it is not going to be practical for a lot of people especially if the maximum time frame to get vitamin D is between 10 am to 2 pm, right? That is where the angle of the sun and maybe through March and October are the prime parts of the year. So if you are outside those parts of the year or if you are in the area with a higher latitude, you know, not everyone can live in sunny Sta. Cruz, right?
Baris Harvey: Yes.
Justin Marchegiani: And let us say you are going to work like everyone else here does in the world then you may have to be relying on a vitamin D3 supplement.
Baris Harvey: Uh-humm. Yes, definitely. It kind of saddens me to say this but because Sta. Cruz is so amazing but I recently just moved back to the Bay Area so just for the listeners, to let you guys know that yes it is beautiful. And like you said, sometimes it is hard if we are supposed to be outside kind of going along with this paleo concept. Like we have evolved to kind of be one with the sun and the sun powers everything on this planet, including humans. Right? And it is hard when most of us are inside a facility working somewhere, whether that be a desk job or inside of a building or even at home, from those peak hours. Unless, you might get an hour lunch right between there but for the majority of the people, like you mentioned we cannot just go to work shirtless.
Justin Marchegiani: Exactly. Exactly. So, getting back to vitamin D, Baris, I kind of wanted to just breakdown the physiology and the biochemistry of what is happening here.
Baris Harvey: Yes. Definitely. So break it down. And Justin what is the next step?
Justin Marchegiani: So, when we are getting the sun, right? We are taking the cholesterol in our skin and we are turning it into pre-vitamin D3 and that Vitamin D3 is going to get converted by our liver in the 25-hydroxyvitamin D or calcidiol. So we can call it calcidiol just to keep it simple. And that calcidiol gets converted by our kidneys to 1,25 dihydroxyvitamin D or just to keep it simple we have calcitriol which is the active one. So we have pre-vitamin D3 going to the liver making calcidiol going to the kidneys and spitting out calcitriol. And again we are going to be making some other different sterols and such when we get sun. So sun is going to be your ideal exposure. Just when we are getting sun, just get your skin pink do not get burned. The scientific literature has got this funky word called median erythemal dose and basically we just convert that in the layman’s speak just get a little bit pink. And now obviously, you got darker skin, Baris so that may not happen for you.
Baris Harvey: Uh-huh.
Justin Marchegiani: But I am fair-skinned so just a little bit pink. Just curious with yourself, do you see a pigment change at all when you know you are saturated?
Baris Harvey: I get dark.
Justin Marchegiani: Okay.
Baris Harvey: Luckily I have a nice balance of where I can basically accumulate a very nice tan. It basically depends. I probably got burned in my life two or three times. You know, one of the times was being on Lake Tahoe. It was overcast you cannot really tell. You know there’s water all around reflection, all the reflection. I got burned then pretty bad. But for the most part I can be outside for a fair long amount of time without worrying about it too much.
Justin Marchegiani: Yes and then just kind of talking about pigment, right? The whole idea of how we evolved pigment on our skin, it is just based on how we evolve on the equator.
Baris Harvey: Right.
Justin Marchegiani: So I evolved in areas that probably were higher latitude therefore, my body was like, “Alright, we need to have just enough melanin so we can make vitamin D.” And you evolved in a place probably closer to the equator and you have more melanin. So just think of melanin or the pigment on your skin as just a natural sunblock.
Baris Harvey: Exactly.
Justin Marchegiani: Some people have more sunblock because they evolved in hotter environments with a kind of more UV radiation from the sun and they are at a lower latitude. And then some people like myself evolved, let us say, Austria, Italy, Irish kind of genes that at higher equator level, not quite as intense sun so therefore I do not have as much of my internal sunblock if you will.
Baris Harvey: Yes, you can almost think of it almost like, would that be the iris of the eye or the aperture of a camera. How much light are you allowing to go in, right?
Justin Marchegiani: Yes. Exactly.
Baris Harvey: So, like if you are in a place where there is not that much light, right? The same way when it is dark outside your pupils, they get bigger to try to accept light, “C’mon! Come in light! I need more so that way I can see. Whereas if you are getting an excess of it, there is too much exposure you know. You go from barely waking up and you turn the lights on your eyes you can see then kind of re-adjust or re-calibrate. You know, people with darker skin they have that natural sunblock. And it is always funny to me how some people will tell me, “Oh, well, see that is why you have a higher chance at getting skin cancer because you do not notice it. You got to put it on; you do not notice because you have darker skin you would not get burned right away but you are going to get skin cancer in not putting sunblock on. And I have not really heard too many people with darker skin getting skin cancer. I mean, there are other traits from my descent that I worry about.
Justin Marchegiani: Uh-hum. Uh-hum.
Baris Harvey: Maybe like high blood pressure and some other things I might run in my genealogy. But skin cancer is generally not one of them.
Justin Marchegiani: Yes and people do not really understand, you know, the mechanism of skin cancer. So, if we are getting excessively burned, yes we are going to have a risk of skin cancer. But then the question is what kind, right? This is like the devil is on the details. So when you get burned more you are going to be at a higher risk for squamous or basal cell carcinoma. Guess what? Basal and squamous cell carcinoma really do not kill people. Very easy to treat. Just go to the dermatologist. They just cut it out, you are pretty darn good. It is going to be the melanoma that you got to worry about. And guess what? When it comes to melanoma, it tends to occur on areas that never even get exposed to the sun.
Baris Harvey: Yes, and it is a little bit more different that the squamous cells which are closer to the higher areas like you mentioned. Melanoma is not really that direct sun, that kind of thing. Yes.
Justin Marchegiani: Yes. Tend to be in the areas that never get exposure. And there is also, in some research out there, some epidemiological research and again this cannot prove causation. But they are just finding the more sun exposure the less melanoma. And the hypothesis behind that really is just vitamin D. I think we can say that vitamin D is definitely a causal in decreasing cancer. Because we have so many other studies showing the decreased cancer risk factors with higher vitamin D. We were able to show the ability to control genes with vitamin D. How it affects your T-regulatory cells which helps balance your immune system. This antimicrobial peptides, cathelicidin it helps with your immune response. So we know that cancer is an immune issue, right? Our immune system cannot control these cells. It cannot create apoptosis which is program cell death. So if these cells go out of control they start growing then you are going to start seeing, you know, over 5 or 10 years maybe even longer, a tumor. So, if we can keep our immune system super smart or from Boston, I will just say wicked smart. (Laughs) We are going to keep our immune system in check which will then keep or cells in check, just be at apoptosis. And then also, the diet stuff. We will touch upon the diet in this podcast. But again, they have done studies. I have it on one of my blogs that if you consume glucose you are going to decrease your immune system 50% for up to 5 or 6 hours-that is for 100 grams of glucose. What if you have a coke and then maybe have your cereals and then an orange juice or something all within a couple of hours, then your immune system is shut down for days. And what if you live your life this way? Then you are doubly screwed.
Baris Harvey: Yes. Exactly. So with that being said, because you kind of mentioned a little bit of the pathways, right? You take it mostly from the sun through our skin but also dietary intake. We are getting some from our, actually how do we get it dietarily besides supplements?
Justin Marchegiani: Well, we are not going to get too much dietarily. We get a little bit from fish, a little bit from mushrooms, a little bit from cod liver oil, and things like that. You are not going to get a ton, dietarily. Like at the most, I want to say you can get probably maybe 1000iu if you are on point. But again, that may not be enough if you are severely deficient or could not get outside much or it is the winter. I mean, we know seasonal affective disorder and vitamin D are connected, right?
Baris Harvey: Oh, yes.
Justin Marchegiani: That is why you are feeling blues in the winter time, those winter blues.
Baris Harvey: Exactly. And another thing you mentioned with the consumption amount that is like optimal rates, right? And even if you are getting outside and it is sunny, we are not walking outside naked, right?
Justin Marchegiani: I know, right.
Baris Harvey: Like we are still, for the most part like, maybe we have a short sleeved shirt maybe not. Maybe we are dressing in our dress clothes, right? To go to work or something like that and we have our head and our hands exposed but there is so much more body area that is not getting any hit. So, it will really have to be on like optimal conditions to get it through your food and also the sun.
Justin Marchegiani: Exactly. Exactly, man. And the thing with vitamin D is, you know we got to talk about the amounts, too. So we kind of like have our general levels which should be like right around 50. I want to say it is ng/ml. I always get the reference range a little bit confused, but I think it is ng/ml. So 50 is a pretty good level for your average person. If you have an autoimmune condition or you have any family history of cancer you just want to be, you know, careful. I recommend getting it closer to 70 to 100 if you have any of those risk factors. I do not think there is any issue with safety on that. Vitamin D Council recommends up to 100 with certain people with autoimmune condition. So that is a pretty good reference range to go by.
Baris Harvey: Uh-humm. Definitely. Now, so that means how could someone get this tested?
Justin Marchegiani: Great question. So there are a couple of ways. We already talked about the calcidiol and the calcitriol aka 25-hydroxyvitamin D and 1,25 dihydroxyvitamin D. So in general, 25-hydroxyvitamin D is going to be your gold standard for blood test to see where your vitamin D is at. Now, if you have parathyroid issues or maybe you have chronic infections or just chronically ill, getting the 1,25-dihydroxyvitamin D will also be helpful to look at. Because you want to make sure your 25 hydroxy and your 1,25-dihydroxy are relatively about the same. So, if you are pumping out about 50 to 60 units on the 25 hydroxy, you want to be about the same 50 to 60 on the 1,25. Now the 1,25 dihydroxy or the calcitriol, if you will, is going to be your active form of vitamin D. Okay? So one thing that we see with people having infection or are chronically ill, we see the 1,25-dihydroxyvitamin D skew up. I had a patient just last week, we ran 25 and 1,25-dihydroxy, we saw the 1,25 super high. So, the question is, what is happening? So what is happening essentially is there is vitamin D receptor site down regulation. So it is kind of like what insulin resistance. The receptor site becomes resistant to the hormone, meaning you need more insulin to bring blood sugar into the cell. Well, the same thing happens with vitamin D. We need more of 1,25-dihydroxyvitamin D to have the same receptor cell effect. So, we will see when we run 25 we will see it at 40 or 50 and then we will see the 1,25 up well into the 100’s. We see this big, big skew with the immune system. And the body is doing that because it is not having the immune effect of that vitamin D hitting the receptor site and allowing it to do what it needs to do.
Baris Harvey: Yes. Definitely. I would probably think of a better analogy right now. But one thing that I may think of kind of, I mean the same thing as the insulin. But when a certain receptor cell is not, almost not, accepting of the nutrient that is being provided, it is almost like when you are feeding the baby and they are just like so resistant they keep turning their heads like, “No, I do not want to eat, I do not want to eat”. But that does not mean you do not have enough of this certain substrate, you know what I mean?
Justin Marchegiani: Exactly.
Baris Harvey: So, that is kind of the thing that first, you know maybe I will get better at one more, we are fine. But the first thing, well, like a little kid that is like rejecting food. It is there, right? And then you want to make sure that you are getting the test in. For the most part, I know there are definitely some in home testing and testing that you can run with your functional practitioner. But could you get this from your normal medical doctor? Just you know…
Justin Marchegiani: Yes, you can probably ask. Yes, you can probably ask. And most of them, they are getting a little more hip to it.
Baris Harvey: Yes.
Justin Marchegiani: Like when you deal with conventional medicine, they tend to be, you know, I want to sound straight and they tend to be 10 or 20 years behind the curve.
Baris Harvey: Yes.
Justin Marchegiani: But the nice thing is if you are having a hard time, just feel free to reach out to me. These tests are pretty inexpensive even if you are doing cash, I mean, I can do these tests for 30 or 40 bucks. And it is totally worth it. Definitely worth getting it done once a year just to make sure you are on point.
Baris Harvey: Yes, definitely. And I know like you mentioned earlier the vitamindcounsel.org I am pretty sure they have links to where you can get in home testing. But normally, yes your doctor usually has, sometimes it is even baseline nowadays where you can get a vitamin D test. So when you do your normal checkup, it is probably a good idea to go ahead and do that. Now the reference range, you know might be a little different, you know. Have this really wide array of what is considered acceptable. But as long as you are getting it done, you know where you need to be, you can see it on paper.
Justin Marchegiani: Exactly.
Baris Harvey: But let us say like 15 or 20 they might not think it is necessarily and issue.
Justin Marchegiani: Exactly. So I just want to touch back upon the 1, 25 25 hydroxyvitamin D. So I kind of talked about this vitamin D receptor numbness or down regulation, okay?
Baris Harvey: Uh-humm.
Justin Marchegiani: If you are a person and you are taking vitamin D and then you are testing your vitamin D and it is not moving upward there is a chance that your 1,25 is shooting up and your 25 is not, you are not building a reservoir with the 25 because it is all going downstream to the 1,25 or from the calcidiol to the calcitriol. So it is very possible that is the case. We see that with inflammation and these chronic infections. So, if that is the case, make sure you are running the 1,25-dihydroxyvitamin D along with the 25 because that way you are not going to be continuing to push more and more vitamin D thinking that that is going to be the right solution.
Baris Harvey: Right. You cannot just get more stuff down the toilet and expect it to hit the flush. You got to actually fix the problem and what is going on.
Justin Marchegiani: Yes. So the deeper question is why?
Baris Harvey: Why?
Justin Marchegiani: So we know that infections, right? Inflammation these things these are going to cause that receptor site to be more numb. So, moving forward, if we want to look at intracellular infections, right? Infections in the blood, infections in the body that could be creating or deforming that vitamin D receptor. So, we know for instance, one infection mono or Epstein Barr. Epstein Barr virus is one of the viruses that in cytomegalovirus, CMV is one of the viruses that cause mononucleosis. So this research showing that it will actually derange the vitamin D receptor site. There are also some researches showing that resveratrol which is like this antioxidant bioflavonoids will actually help the vitamin D receptor site. So one school of thought out there is you know giving some extra resveratrol to help the vitamin D receptor site so it can work better. That is kind of like palliative, in my opinion. It is like a Band Aid over, you know. It is like an ice pack on your head because you are just slamming it into the wall every day.
Baris Harvey: Yes.
Justin Marchegiani: The question will be why did the receptor site down regulate? We have to go back to the inflammation and the infection. So, the underlying cause, like it is always the best thing to be at the underlying cause. The underlying cause is to get the infection treated.
Baris Harvey: Uh-humm.
Justin Marchegiani: But in that process, I see it being totally okay adding some resveratrol, some of these antioxidant bioflavonoids to help kind of get the receptor site back into action so it can work a little better.
Baris Harvey: Yes.
Justin Marchegiani: I have not seen too much on blood work. I have looked at it a few times. I have not seen it worked, you know, terribly well where you see a drop in it. But I think there are some evidence in the scientific literature, I actually posted this on my Facebook. You know, one of these scientific articles that is over a year and a half ago. And just want to touch upon it now. We could be in the winter, and I did a couple of videos on vitamin D recently and I want to add this element to it. The infection element and the vitamin D receptor cell down regulation. There are things you can do: 1. Resveratrol. 2. Address the infection, address the intracellular infection.
Baris Harvey: Yes. Definitely. See what is super important about what you mentioned right there is that it is not just one or the other. And I know that often, sometimes people, you know think, they go to their Western Medical doctor and it is like, “Okay, I am just getting a Band-Aid.” But then they might go here to the functional medicine and say, “Oh, I am going to get to the root cause but in the meantime feel like crap.” But no, that is not the case, you want to make sure that we do want to find what is the deepest bottom thing, you know, that is causing, wreaking havoc because you do not want to just keep, you know, repeating that the thing is broken. We want to make sure that we solve it and we solve it for good. But in the meantime, like while you are doing all that digging you want to have some help and some relief so that way you do not have to just kind of withhold the negative symptoms whatever that might be. So, a lot of people might think off the bat and this is something that is being said. We do not naturally take those negative symptoms, that they are not obvious, if I can say that. Because most people they will say, “Oh, vitamin D deficiency? Rickets. But that is like hitting rock bottom, right? We do not want to wait until it gets that bad or some people when they are really young. Until we say, “Hey, maybe we should check out this vitamin D thing like.”
Justin Marchegiani: Exactly.
Baris Harvey: What are some of the other symptoms we might be noticing if we have deficient vitamin D levels?
Justin Marchegiani: What else could you notice? Well, it is really hard to say because vitamin D has an effect on so many things. I will just give you an example. My father during December came to me and said, “Justin, I want to let you know I have actually lost 10 pounds this month.” And I said, “That is great!” You know. “I noticed you have been eating a little bit of bread, this and that and you have been cutting your carbs and getting your insulin levels.” Then he said, “No, my diet, I have kept it exactly the same. My routine is exactly the same. And I have lost 10 pounds this month just by upping my vitamin D 10,000 IU per day.” I go, “Really!” So then I go on PubMed and I am like Googling and I am like, “Oh, wow!” There was a study six to nine months ago in the American Journal on Clinical Nutrition on postmenopausal females. And what they found was when they supplemented their Vitamin D levels up to 2000iu per day, controlling for exercise and controlling for diet, the group that got the modulatory, the higher level of vitamin D lost the most weight and were able to keep it off. And I am like, “This is interesting.” So, I did go on a little bit deeper into vitamin D and what could it be doing in, you know, it can have an effect on hormone synthesis. It can affect testosterone. It can affect estrogen levels. When we are dealing with these things it is going to have a modulatory effect. You are not going to like super saturate your hormones but like you would if I was giving you topical testosterone or topical estrogen. We are not going to have that kind of effect. But there is a modulating, boosting effect we see with testosterone. We also see an effect on insulin resistance. Meaning, it makes your cells more sensitive to insulin. So, that is pretty cool. So I am like, “Alright, Dad, you are a not post-menopausal female.”
Baris Harvey: I was just going to bring that up. (Laughs) So it works on post-menopausal men as well? (Laughs)
Justin Marchegiani: ”You are not a post-menopausal female, thank God. But, it makes sense. The mechanisms are in place in the literature. And there are some researches on it affecting testosterone. I do not think it is a giant leap to make the connection that it is having a similar effect on your body, you know, on the testosterone and on the insulin-resistant side and that is probably the reason why you are having this weight loss.”
Baris Harvey: Yes. Definitely. Like you mentioned, do not go out there and just assume that if you work out and you want to get super big that you have to take an extreme amount. But what we are saying is that we do see a correlation and a connection. And even when you look at your hormone pathways we see one of those beginning stages of your hormone pathways is guess what? Vitamin D and cholesterol. And you need those as building blocks as foundation. Now you mentioned there are probably some boosting but not like a super saturated form but like in a modulating type of way in which you kind of rebound and tell your body like, “Hey, this is the way that we are supposed to be running efficiently.”
Justin Marchegiani: Yes. And I have read the abstract of this rat study. Again it’s a rat study that you got to put it out there. But they found, vitamin D increased the synthesis by the testes making more testosterone in some of these rats. I was like, “That is really interesting!” And it makes sense. That mechanism is more than likely happening in humans at some level. And we know it is happening in some of the females. We know it is having the insulin resistance effect. So, I mean, make sure your vitamin D, it is just another reason why you want to use vitamin D. So, if you are not motivated by the immune boosting and natural cancer benefits, well, get motivated by some of the esthetic benefits, right?
Baris Harvey: Right. Exactly. Yes. And like you mentioned because it affects our hormones, it affects our skin and all these other things, it is hard to pin down like, “Hey! I am having these symptoms. Do I have vitamin…”, like we cannot kind of immediately do that. And that is probably why it is important to make sure that, hey, just you know, get a test. It is not that expensive if you go into your doctors. Make sure to say, hey, just make sure your vitamin D is getting tested and it probably would not cost you anything extra. And if you have to go outside of your doctor, it would not cost you that much, right?
Justin Marchegiani: Yes, what I will do is, I will put a link in on the show notes, just a way to my store where you can get vitamin D done super cheap. I think it even comes with C-reactive protein, too. So I will put a link in. So if you want it and you cannot get it from your doctor or you cannot find a decent price you can always get it here pretty easily.
Baris Harvey: Yes. Exactly. So now we have a kind of like a baseline of what is kind of happening? Where do we mostly get it from? And then now it will probably be a good idea to understand how do I dose it, right? If I am noticing that I am low or even if I am at baseline like how much should I be internally taking in if am taking a supplement? And with the supplement, is there a superior form? Should I be taking it mixed with some vitamin K? Should I be taking it in a liquid form? What are some of the things when it comes to supplementation that you might tell some of your clients?
Justin Marchegiani: So when it comes to vitamin D, off the bat vitamin K2 is going to be beneficial. I typically would not recommend it with vitamin K2 unless my patients have osteoporosis, they are females or if they are just avoiding like butter. Like if you are getting grass-fed butter in your diet, like I just had a tablespoon or two on my coffee, right? I do not need vitamin K2 supplementation. I am getting lots of grass fed butter on my diet. I am eating ghee. I am eating good quality meats that are going to have other fat soluble nutrients. But if I am looking at someone’s diet and I am not seeing vitamin K2 dietarily, then I will put it in there. So, I always want to make sure it is either coming in supplementally or it is coming in dietarily. Or if people just have a concern for bone health, we will just add some extra vitamin K in there. So that is kind of step one off the bat. So if you feel like you are not eating butter and things like that or definitely you are pure vegan, right? You want to get the vitamin K2 in there. But on that note, I typically recommend the vitamin D3 drops mixed in the Beta MCT oil. So with the MCT, you are going to take that up enterohepatically. Meaning, you do not need bile salts to break it down. Because it is a fat soluble nutrient, right? Vitamin A, D, E and K. So, you are going to be able to take it up naturally via the lymphatic system and not have to break it down with bile. So you get really good absorption. So the vitamin D drops are great. I will put a link in on a couple of my favorite products. I like one by Thorne that has got the vitamin D3 and the vitamin K2. That is a really a good one if you want the vitamin K2 as well. There is also a really good one by Designs For Health called the Emulsi-D. I will put that on the show notes. That is just the more concentrated form of vitamin D. Very good. I am right now, hitting up about 10,000 units a day. But a good general recommendation, go liquid if you can. If not do the pill but make sure your digestion is working. And a good recommendation off the bat is about 1000 IU per 25 pounds of body weight. So if you are right around 100 pounds, 4,000 IU will be great for the first month to start. If you are around 200 pounds that is right around 8,000 IU will be a pretty good place to start. And that is just the starting point. I do not recommend keeping that dose longer than a month. Just a good starting place. Again, Dr. Holick, he is a researcher out of BU, a prolific vitamin D researcher. He says that your body needs just about 2000 IU of vitamin D per day just at baseline. Just to kind of keep things level. So, if you are kind of on the fence and you are like, “I do not know but I have been taking vitamin D and I have not been.” Well, 2000 IU would just be a great baseline. And if you really are uncertain and you are not ready to get tested yet, 2000 will be a great place to start if you are uncertain.
Baris Harvey: Yes. Definitely. And this would probably be, especially for people that maybe overweight or people that are older like you mentioned earlier of if you have darker skin you might need a little bit more, you are at a high risk of being deficient. Another thing that you have mentioned and I do not think that we have mentioned much on the show before is the route. Because these are fat soluble with the liquid, explain to people what you mean it does not need bile salts to breakdown and kind of what is happening when you take a sublingual like a fat soluble tincture versus taking something in? Because somebody could just think, “Oh, what if I just like swallow the liquid?” They might not kind of catch it right off the bat. So, tell us real quick about that pathway?
Justin Marchegiani: Okay. Well, there are some thought that we can absorb some of this if it is liquid sublingually, so kind of through our sublingual tissue and have it go right to the blood stream. And also we know that when we take things like coconut oil or medium chain triglycerides, these are fatty acids that are 6 to 12 carbons longs. And essentially these molecules can be taken up by our lymphatic system. Okay, our lymphatic system is kind of the intermediary between the tissue and the blood. Big thing is when we typically take in fats like if you have a bolus of butter or bolus of meat, your body is going to have your pancreas produce some enzymes, right? Like lipase, etc. And then also your gallbladder is going to spit out some bile.
Baris Harvey: Bile which becomes…
Justin Marchegiani: Which is going to emulsify and breakdown the fat. So, we got some lipase coming from the pancreas, we got some bile coming from the gallbladder and this is going to help breakdown that fat. Essentially emulsify it so then we can absorb it. The nice thing is when we do something on the medium chain triglyceride side of things we can absorb it enterohepatically, meaning just take it up through the lymph glands. We do not need this whole bile output. And this is great because I cannot tell you how many patients I see these days that do not have gallbladders.
Baris Harvey: Yes.
Justin Marchegiani: They do not have gallbladders and their digestion stinks because they got gut infections and they are not absorbing the nutrients. So I am a little more biased towards the vitamin D. Again you got people out there like the drug industry and conventional medicine starting to get hit with this. They are just doing 50,000 IU one time per week. Not really a fan of that because you typically would not just go outside and just get your bolus of vitamin D just at one time, right? Because the most you can make at about one unit is about 20,000. So I do not like to go over 20,000 unless it is an acute issue like an infection. So getting it daily is going to be a better thing. And I am a bigger fan of doing it in the morning. Well, it kind of makes sense.
Baris Harvey: Yes.
Justin Marchegiani: Because vitamin D is made with the sun so why would you get a whole whack of vitamin D at 9-10 o’clock at night when the sun is down. I know there are a lot of protocols out there that say, “Hey, do your vitamin D at night, it will have a calming effect.” But I just like to use my noggin a little bit and say, “Well, will our body normally make vitamin D at 10 o’clock at night?”
Baris Harvey: Yes. Exactly. I kind of think the same thing. I take a sublingual vitamin D there okay. I take the Thorne. So there is not going to be that much in the afternoon. But there is a heavier amount in the morning. And they did that in that specific reason. There is kind of this expectation of what our body is expecting and what naturally occurs. Then you kind of want to do as best you can to match up with nature. Unless, I guess you work the night shift then you know you might benefit from doing it the opposite way.
Justin Marchegiani: You may. That is a good point.
Baris Harvey: Yes. Basically what you are saying is like let us see about this and also try to match up to try and follow nature as much as possible even if that is supplementing.
Justin Marchegiani: Exactly.
Baris Harvey: These are natural things that us as humans have built but we, you kind of coexist with this technology. So the stuff that we have that we know is good, you know, try to much our technology with what is natural. So one of the best things you can do is to take that in the morning and that is the same way, same time I supplement my vitamin D.
Justin Marchegiani: That is smart, man. That is really good. And I just want to summarize everything. I think we went on to the show being like, “Oh, we are going to talk about vitamin D and immune boosting support but I think there is so much to talk about. We are just going to keep this podcast just focused to vitamin D and I think we will do a part 2 talking about other ways to kind of boost the immune system outside of vitamin D next week.
Baris Harvey: Yes. That sounds perfect.
Justin Marchegiani: Is there anything else you want to touch upon, Baris?
Baris Harvey: I think we got most of it. For the listeners out there, send us any of the questions that you may have about vitamin D and maybe we can throw that in. I am going to make sure that I take that down, questions about vitamin D. So you can go to beyondwellnessradio.com and there is this place right there that you can click and ask away. And you ask your questions so we can go ahead and put it on the show. So, yes I think we got most of it. And if there are other questions, well just make sure you guys go ahead and send that in so that way we can get those answers for you.
Justin Marchegiani: Great.
Baris Harvey: And with that being said, I think we really did a good job in breaking down in giving our listeners a foundation. Anything else that maybe you want to add?
Justin Marchegiani: Well, I just want to set people up here so that if they got a little glossy eyed with all the big words and just it kind of made it, maybe it was a little bit over their heads. I am going to just break it down so they listen to this quick 30 seconds here they will get all of the key points.
Baris Harvey: Yes.
Justin Marchegiani: Alright. So vitamin D3 in your supplements coming in converted to the liver the 25 hydroxyvitamin D, calcidiol and then converted by the kidneys to calcitriol, your active vitamin D. Vitamin D up regulates 800 different genes, cancer protective. Vitamin D has shown that people with higher vitamin D levels are resistant to the flu. It helps balance your TH1 and TH2 immune system, right? Your TH1 are like the Special Forces that go out to go kill everything off the bat. Your TH2 are the forces that stay behind and come out in about a week. Those are your antibodies. It helps your TH3 system, your T-regulatory cells that really balance out your immune system. And if your vitamin D levels are not going up, look a little deeper. There could be an infection. You could be having vitamin D receptor site down regulations. We want to run that 1,25-dihydroxy D. If our 25-hydroxy D is not going up with supplementation let us take the 1,25-dihydroxy D. A good starting point if you are uncertain is 2000 IU per day or anywhere between 5,000 to 10,000 IU depending on body weight for the first month. And if anyone listening is uncertain and wants to get tested, check out below the show notes to get more information on how to easily do that. I think that is it, Baris.
Baris Harvey: Yes. We went over a lot stuff in that time. So thank you so much guys for listening. We always appreciate it. With that being said, next time on the show we will get into the immune system part of it. We will go ahead and break that stuff down for you guys and get you guys as much as you guys need. So again, go to beyondwellnessradio.com and hit that subscribe to the newsletter. This will keep you up-to-date as much as possible. Also we would greatly appreciate if you went to ITunes and write us a review. With that being said, you guys have a good one. Thank you for coming on, Dr. Justin. We had a good one.
Justin Marchegiani: Thanks, Baris.

Vitamin D Lab Testing and Supplementation – Podcast #30

Vitamin D In today’s show Dr. Justin and Baris will review the benefits of vitamin D, how to test for vitamin D, resistance and infections. The best way to supplement vitamin D and what to do if your vitamin D lab values aren’t increasing even though you are supplementing it.
Vitamin D lab testing

Don’t know the difference between vitamin D, D2, and D3? Dr. Justin breaks it down for the listeners and now we know the difference between calcidiol and calcitriol. Know more about light and dark skin pigments and why it’s important to take vitamin D supplementation. You’ll get some infromation from Baris and Dr. Justin about skin cancer as well in this podcast. You can also find out how much Vitamin D dosage you ought to be getting.

In this episode, topics include:

8:40 Vitamin D physiology and biochemistry

15:54 How to get vitamin D dietarily

17:58 How can we get tested for vitamin D

26:45 Symptoms of deficient vitamin D levels

31:49 Vitamin D dosages

 

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Baris Harvey:  Welcome to another episode of Beyond Wellness Radio.  Before we go in today’s show, I wanna tell you guys about the newsletter.  Go to BeyondWellnessRadio.com and hit the Newsletter Sign Up.  By doing this you will never miss out on an episode.  Be the first one to hear it as it is sent out to your inbox each week.  You want even more?  Right above there’s a tab for Just In Health and that’s where you can go straight Dr. Justin’s website and he has a free consultation available for you guys that wanna get much deeper look.

He also has a free video series on thyroid health.  So make sure you guys dive in.  Also we will love for you guys to go ahead and give us a review on iTunes.  That would be awesome.  But to prove it to you that we deserve that review, we’re gonna give you some awesome stuff today.

So first of all, how’s it going today, Dr. Justin?

Dr. Justin Marchegiani:  Baris, it’s going great today, man.  It’s right in the middle of winter and Austin, Texas has a great whether.  It’s 75 degrees and just beautiful and sunny, and I know being a Boston boy growing up, it’s–I got like 3 or 4 pedis now this month alone, so feeling really happy I’m not in the Northeast.

Baris Harvey:  Oh, yeah, definitely.  The same thing here.  It’s really warm.  I’m think–thinking to myself, you know, it would be a good thing to have some rainfall but, I mean, I’m kinda spoiled out here, and I know people in New York–

Dr. Justin Marchegiani:  Oh, yeah.

Baris Harvey:  They’re–they’re a little chilly right now in that snow, so I can’t complain.

Dr. Justin Marchegiani:  Exactly.

Baris Harvey:  Yeah.  So in today’s episode, we’re gonna talk about vitamin D and not only, I mean it covers so–so much, whether that’s, you know, hormone influence or your immune system.  We’re gonna be a little bit more particular on the immune boosting benefits.  But we’re–we’re gonna break–basically break down vitamin D by Mindy, make sure we’re answering, you know, most of you guys’ questions on it, getting kind of that foundation.  But before we go into that, you know, what did you eat for breakfast?

Baris Harvey:  Baris, today was just kind of a simple day, man.  It was just 4 eggs, sunny side up.  I know this kind of, you know, my–my Fridays tend to be–because this is when we record the podcast–tend to be similar–little bit of collagen, some eggs that were just sunny side up, a piece of pasture-fed bacon and some coffee with butter and MCT, and I’m just–I’m rockin’ it.  I took some–right now I’m stacking up my supplements a little bit differently.  I’m using a combination of Ashwagandha and Eleuthero at relatively higher doses and I’m also on a brain program where I’m adding in 5 HTP and L-tyrosine, and my brain just feels amazing like I’ve been getting–and I’m gonna admit it to everyone.  I haven’t been good this week.  I have been getting about 6-7 hours’ night sleep, so–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  I know I preach getting 8 and getting to bed before 11, I’ve been off.  So even I can make mistakes but I’ve been feeling darn good where in the past I wouldn’t have felt this good in the morning and I really attribute it to I think adding in these new adaptogenic herbs–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  But also adding in the–the brain program, adding in some the sulfur amino acids and the combination of the 5 HTP and L-tyrosine together really has made a big difference for me.

Baris Harvey:  Yeah, yeah.  It–it’s funny that–that you say that because I was just, you know, especially that–that you guys, you know, will be hearing, really into like the–the brain–the brain stuff and the brain supplementation and how we can improve that in, like you–you said, well, you know, we preach that you should be getting 8 hours of sleep but this past week, I haven’t been the best on that either.

Dr. Justin Marchegiani:  Yeah.

Baris Harvey:  There have been–there have been some days I’m getting more sleep but if we’re going to sleep pretty late we’re making sure that, okay, how do I–kinda whatever I’m–I might have lost, you know, you’re never gonna–you’re never gonna get as much as you could with sleep, but how could I try to make sure I maximize the nutrients that I put in my body?  That would give me maybe something I would have got when I slept, you know I mean?  So–

Dr. Justin Marchegiani:  Exactly.

Baris Harvey:  So try to level that and then when you do get that full 8 hours of sleep and then put that on top of it, it’s just icing on the cake.

Dr. Justin Marchegiani:  Love it, love it, man.

Baris Harvey:  Definitely.  So myself, you know, I–I don’t wanna just, you know, keep it boring because again I didn’t keep breakfast, but I’ll tell you what I’m about to eat after.  I will have some organic beef sausage with some–with some eggs and that will probably be it.  It’ll probably be something simple like that.  I mean, morning–mornings are simple because, you know, you got stuff to do, you gotta get things out of the way, so if you don’t have allergy to eggs, like eggs are amazing, and they don’t have to be just for breakfast food, so.

Dr. Justin Marchegiani:  Exactly, man.  Love it.

Baris Harvey:  And you know what else?  They have a fair amount of vitamin D so–

Dr. Justin Marchegiani:  That’s the bet, absolutely, on that note.

Baris Harvey:  On that note, I–you know, I’ve been–been hearing some things with vitamin D.  People try to put it into a certain category and maybe–maybe it doesn’t even need to be stuck into one category but is it a vitamin or is it a hormone?  What’s going on with that?

Dr. Justin Marchegiani:  So I will consider vitamin D or vitamin D3 as like a pre-hormone.  Vitamin D, activated vitamin D or calcitriol is gonna be a hormone for sure.  It’s gonna have hormone-like effects.  It’s gonna effect essentially various immune cells.  It upregulates this microbial, anti-microbial peptide called cathelicidin which is really cool.  It has effects on about 800 different genes, right?  I think we only have like 20,000-24,000 genes.  So it’s kinda like a–you know, a pretty big effect on about 5% of your genes.  That’s pretty awesome.  So it affects your natural antibiotics in your body.  It affects your immune system.  It affects your genetics and, you know, one of the big things with vitamin D, it’s gonna be a hormone even though it’s a vitamin and what’s happening is we’re taking vitamin D3 through our skin and through supplements and we’re converting it via our liver and kidneys.

Baris Harvey:  Uh-hmm.  And is that conversion still happening?  Is it is the–the same when it’s through our skin?  Is it still getting converted through our liver?

Dr. Justin Marchegiani:  Well, there’s various sterols that get secreted when you’re getting sunlight versus the supplement.  So what–you’re taking a supplement, we’re just getting vitamin D3 or cholecalciferol, that’s vitamin D3.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Now we have vitamin D2 which is ergocalciferol, that’s more synthetic, kinda made in the lab, plant-based kinda thing.  Like your–your vegans and stuff are gonna be more on the vitamin D2 but you’re gonna get better absorption with vitamin D3, and it’s also it’s the same vitamin D3 that’s made by the sun.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Now with the sun though, I’m gonna recommend sun being the best but let’s just face it.  It’s not going to be practical for a lot of people especially if the maximum timeframe to get vitamin D between 10 a.m. and 2 p.m., right?  That’s where the angle of the sun and maybe through March and October are the prime parts of the year, so if you’re outside of those parts of the year or if you’re in an area with a higher latitude, you know, that–not everyone can live in sunny Santa Cruz, right?

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  And let’s say you gotta work like everyone else here does in the world then you may have to be relying on a vitamin D3 supplement.

Baris Harvey:  Uh-hmm.  Yeah, definitely.  And it–it kinda saddens me to–to say this but because Santa Cruz is so amazing, but I–I recently just moved back to the Bay Area, so just for the listeners, I’ll let you guys know that–

Dr. Justin Marchegiani:  Ah.

Baris Harvey:  But yeah, that–it is beautiful and like you said, sometimes it is hard if we’re supposed to be outside, kinda you know, going along with this–this Paleo concept like we evolved to kinda be one with the sun and the sun powers everything on–on this planet including humans, right?  And it’s hard when most of us are inside a facility working somewhere whether that be a desk job or inside of a–a building or even at home from those peak hours, well, unless you know, you might get an hour lunch right between there, but for the majority of the people that you mentioned we can’t just, you know, go to work shirtless.

Dr. Justin Marchegiani:  Exactly, exactly.  So getting back to vitamin D, Baris, I kinda wanted to just break down the physiology and biochemistry of what’s happening here.

Baris Harvey:  Yeah, definitely.  So–so break it down, we in–ingest it and what–what’s the– what’s the next step?

Dr. Justin Marchegiani:  So when we’re getting sun, right?  We’re making–we’re taking the cholesterol in our skin and we’re turning it into pre vitamin D3 and that vitamin D3 is gonna get converted by our liver into 25-hydroxyvitamin D or calcidiol.  So we can call it calcidiol just to keep it simple and that calcidiol gets converted by our kidneys to 125-hydroxyvitamin D or just to keep it simple, we have calcitriol which is the active one.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  So we have free vitamin D3 go into the liver, making calcidiol, going to the kidneys and spitting out calcitriol.  And again we’re gonna be making some other different sterols and such when we get sun.  So sun’s gonna be your–your ideal exposure, just when we’re getting sun, just get your skin pink.  Don’t get burned.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  The scientific literature’s got this funky word called median erythemal dose and basically we just convert that into layman speak, just get a little bit pink.  And now obviously you got darker skin, Baris, so that may not happen for you.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  But like I’m fair skin, so just a little bit pink.  Just curious with yourself, are you–do you see a pigment change at all when–when you know you’re saturated?

Baris Harvey:  I get–I get dark.

Dr. Justin Marchegiani:  Okay.

Baris Harvey:  I’ve–luckily I have a nice balance to where I can basically accumulate a very nice tan.  It–it does–it basically depends.  I–I probably got burnt in my life 2 or 3 times.  You know, one of the times was, you know, being on Lake Tahoe.  You know, it’s overcast.  You can’t really tell, you know, there’s a–water’s all around, all the reflection.  I got burnt then pretty bad, but for the most part I can, you know, be outside for a fair amount–long amount of time without worrying about it too much.

Dr. Justin Marchegiani:  Yeah, and just kinda talking about pigment, right?

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  The whole idea of how we evolved pigment in our skin–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Is just based on where we evolved on the equator, right?

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  So I–I evolved in areas that probably were higher latitude, therefore,  my body was like, “Alright, we need to have just enough melanin so we can make vitamin D,”  and you evolved at a place probably closer to the equator–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  And you had more melanin.  So just think of melanin or the pigment in your skin is just natural sunblock.

Baris Harvey:  Exactly,

Dr. Justin Marchegiani:  So some people have more sunblock because they evolved in hotter environments with, you know, a–a kinda more UV radiation from the sun.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  You know, they’re at–at a lower latitude and then some people like myself evolved, you know, let’s say Austria, Italy, Irish kinda genes–

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  At a higher equator level, not quite as intense sun so, therefore, I don’t have as much–much of my internal sunblock if you will.

Baris Harvey:  Yeah, you can almost think of it almost like whether that be the iris of your eye or aperture of a–a camera, how much light you’re allowing to go in, right?

Dr. Justin Marchegiani:  Yeah, exactly.

Baris Harvey:  So like if you’re in a place where there’s not that much light, right?  The same way when it’s dark outside, your–your pupils they–they get bigger to try to accept light.  “Come on, come in, light.  I need more so that way I can see.”  Whereas if you–if you’re getting an excess of it, there’s too much exposure, you know, you–you go from barely waking up and you turn the lights on, your eyes you can see them kind of readjust and recalibrate, you know, people with darker skin, you know, they can–they have that natural block and it’s always funny to me how some people will–will tell me, “Oh, well, see that–that’s why you’ll have a higher chance of getting skin cancer because you don’t–you don’t notice it that–you know, you gotta put in on, you don’t notice it because you have darker skin, you won’t get burnt right away, but you’re gonna get skin cancer not putting sunblock on,” and I’m like, “I haven’t really heard too many people with darker, you know, skin getting skin cancer.”  I mean there’s–there’s other traits from my descent that I worry about–

Dr. Justin Marchegiani:  Uh-hmm.

Baris Harvey:  Maybe like high blood pressure and–and some other things that might run in my genealogy but skin cancer is generally not one of them.

Dr. Justin Marchegiani:  Yeah, and people don’t really understand, you know, the mechanism of skin cancer.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  So if we’re getting excessively burned.  Yeah, we’re gonna have a risk of skin cancer but then the question is, what kind, right?  Like this is, like the devils are on the details.  So when you get burned more, you’re gonna be at a high risk for squamous or basal cell carcinoma.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Guess what?  Basal and squamous cell carcinoma really don’t kill people.  They’re very easy treat.  You just go to the dermatologist.  They just cut it out.  You’re pretty darn good.  It’s gonna be the melanoma that you gotta worry about.  And guess what?  When it comes to melanoma, it tends to occur on areas that never even get exposed to the sun.

Baris Harvey:  Yeah.  And–and it’s a little bit more given that you–your squamous cells which are a closer to–to the higher areas like you mentioned like melanoma’s not really that direct sun–

Dr. Justin Marchegiani:  Yeah.

Baris Harvey:  Kinda thing.  So yeah.

Dr. Justin Marchegiani:  It tend to be in areas that never get exposure and then there’s also, you know, some research out there.  Some epidemiological research and again this can’t prove causation but they’re just finding the more sun exposure, the less melanoma and the hypothesis behind that really is just vitamin D and I think we have, I think we can say that vitamin D is definitely a causal in decreasing cancer because we have so many other studies showing the decreased cancer risk factors with higher vitamin D.  We’re able to show the ability to control genes with vitamin D, how it affects your T regulatory cells which helps balance your immune system, it helps with this–these anti-microbial peptides, cathelicidin.  It helps with your immune response so we know that cancer is an immune issue, right?  It’s–our immune system can’t control these cells, right?  It can’t create apoptosis which is programmed cell death, so these cells go outta control.  They start growing.  Well, you’re gonna start seeing, you know, over 5 or 10 years, maybe even longer a tumor.  So if we can keep our immune system super smart or if I’m from Boston, I’ll just say wicked smart–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  We’re gonna–we’re gonna keep our immune system in check which will then keep our cells in check, just via ap–apoptosis and then also, you know, the diet stuff and we’ll touch upon the diet in this podcast but again they’ve done studies.  I have it on my blogs that you consume glucose you’re gonna decrease your immune system 50% for up to 5 or 6 hours and that’s a 100 grams of glucose.  What if you have a Coke and then maybe have your cereal and then an orange juice or something, all within a couple hours, then your immune system will shut down for days.  And what if your–what if you live your life this way?  Then you’re doubly screwed.

Baris Harvey:  Uh-hmm.  Yeah, exactly.  So with that being said, because you kinda–kinda mentioned a–a little bit of–of the pathways, right?  So you know, we take it mostly from the sun through our skin but also dietary intake we’re getting some from–from our meat–actually we didn’t–how–how do we get it dietary besides supplements?

Dr. Justin Marchegiani:  Well, we’re not gonna get too much dietarily.  We’ll get a little bit from fish, a little bit from mushrooms, a little bit from cod liver oil, like things like that.  You’re not gonna get a ton dietarily.  Like at the most, I wanna say, you can get probably, maybe 1,000 IUs if you’re on point.  But again that may not be enough if you’re severely deficient or–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  If you’re not getting outside much or it’s the winter.  I mean, we know Seasonal Affective Disorder in vitamin D are–are connected, right?

Baris Harvey:  Oh, yeah.

Dr. Justin Marchegiani:  That’s you feeling blues in the wintertime, those winter blues.

Baris Harvey:  Exactly.  And another thing you mentioned with the, you know, the consumption amount, that’s–that’s like optimal rates, right?  And even if you are getting outside and its–it’s sunny, how–we’re not walking outside naked, right?

Dr. Justin Marchegiani:  I know, right?

Baris Harvey:  Like we’re still–we’re still for the most part like maybe we have a–a short sleeve shirt, maybe not, maybe we’re, you know, we’re dressed in–in our dress clothes, right?  To go–go to work or something like that and–and we get–or we have our head and our hands exposed but there’s so much more body area that’s not getting–getting hit so it would really have to be like on –on optimal conditions to–to get it through your food and also from the sun.

Dr. Justin Marchegiani:  Exactly, exactly, man.  And that’s the thing with vitamin D is, you know, we gotta talk about amounts, too.  So we have like our general levels which should be like right around 50, I wanna say it’s NG per mL, I always get the reference range a little confused but I think it’s NG per mL.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  So 50 is a pretty good level for your average person.  If you have an autoimmune condition or you have any family history of cancer, you just wanna be, you know, careful, I recommend getting it closer to 72 to 100 if you have any those risk factors.  I–I don’t think there’s any issue with safety and on that.  The Vitamin D Council recommends up to 100 with certain people with autoimmune conditions, so that–that’s a pretty good reference range to go by.

Baris Harvey:  Uh-hmm.  Definitely.  Now so with that being said, how could someone get this tested?

Dr. Justin Marchegiani:  Great question.  So there’s a couple ways.  We already talked about the calcidiol and the calcitriol aka 25-hydroxyvitamin D and 125-hydroxyvitamin D, so in general 25-hydroxyvitamin D is gonna be your gold standard blood test to see where your vitamin D is that.  Now if you have parathyroid issues or you have maybe chronic infections, or just chronically ill, getting a 125-hydroxyvitamin D will also be helpful to look at because you wanna make sure you’re 25-hydroxy and your 125-hydroxy are relatively about the same.  So if you’re pumping out about 50 or 60 units on the 25-hydroxy, you wanna be about at the same 50-60 on the 125.  Now the 125-hydroxy or the calcitriol if you will is gonna be your active form of vitamin D, okay?  So one thing we see when people have infections or are chronically ill, we see the 125-hydroxyvitamin D skew up.  I had a patient this last week, we ran 25 and 125-hydroxy, we saw the 125 super high.

Baris Harvey:  Oh, yeah.

Dr. Justin Marchegiani:  So the question is what’s happening?  So what is happening essentially is there is vitamin D receptor site downregulation so it’s kinda like with insulin resistance, the receptor site becomes resistant to the hormone, meaning you need more insulin to bring blood sugar into the cell.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Well, the same thing happens with vitamin D.  We need more 125-hydroxyvitamin D to have the same receptor cell effects.  So we’ll see when we run 25, we’ll see it at 40 or 50 and then we’ll see the 125 up well into the 100s.  We see this big, big skew with the immune system and the body’s doing that because it’s not having the immune effect of that vitamin D hitting the receptor site and, you know, allowing it to do what it needs to do.

Baris Harvey:  Yeah, definitely.  I’ll probably think of a better analogy right now, but one thing that made me think of kind of, I mean the same thing as–as the insulin, but when a certain receptor cell is like not almost not accepting of the–the nutrient that’s being provided, it’s almost like when you’re trying to feed a baby and they’re just like so resistant, they keep turning their head like, “No, I don’t–I don’t want it.  I don’t wanna eat.  I don’t wanna eat.”  But that doesn’t mean you don’t have enough of the certain substrate, you know what I mean?  So-

Dr. Justin Marchegiani:  Exactly.

Baris Harvey:  That–that’s kinda the thing that–first, you know, maybe I’ll get a–a better one more refined but the first thing I possibly think, “Oh, like a little kid that’s like rejecting food.”  It’s there, right?  And then so you wanna make sure that you are getting the–the right test.  And for the most part, I know there–there are definitely some–some in-home testing and–and testing that you can run with your functional practitioner but could you get this from your–your normal medical doctor, just so you know–

Dr. Justin Marchegiani:  Yeah, you can probably ask–

Baris Harvey:  You walk in there and ask for it.

Dr. Justin Marchegiani:  Yeah, you can probably ask but most of them, they’re getting a little more hip to it.

Baris Harvey:  Uh-hmm.  Yeah.

Dr. Justin Marchegiani:  Again like when you deal conventional medicine they tend to be, you know, I don’t wanna sound–

Baris Harvey:  It’s behind.

Dr. Justin Marchegiani:  They tend to be like 10 to 20 years behind the curve.

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  But the nice thing is if you’re having a hard time, just feel free.  Reach out to me.  These tests are pretty–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Inexpensive even if you’re doing cash.

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  I mean, I can get these tests done for $30 or $40 bucks–

Baris Harvey: Uh-hmm.

Dr. Justin Marchegiani:  And it’s totally worth it.  Definitely we’re getting it done–

Baris Harvey:  Yeah,

Dr. Justin Marchegiani:  Once a year just to make sure you’re on point.

Baris Harvey:  Yeah, definitely.  And I know–I know, like you mentioned earlier the VitaminDCouncil.org, they–I’m–I’m pretty sure they have links to where you can get in-home testing and–but normally links or you can get in on tested and but normally yeah, your doctor usually has–has that sometimes, it’s–it’s even baseline nowadays where you can get a vitamin D test.  So when you do your normal check-up, it’s probably a good idea to go ahead and do that.  Now the reference range, you know, might be a little bit different, like you know, have this really wide array of what’s considered acceptable but as long as you’re getting it done, you know where you–you need to be.  You can see it on–on paper.

Dr. Justin Marchegiani:  Exactly.

Baris Harvey:  But–but if you’re–you’re, you know, listed at like 15 or 20, they–they might not think it’s necessarily an issue.

Dr. Justin Marchegiani:  Exactly.  So I just wanna touch back upon the 125, 25-hydroxyvitamin D.  So I kinda talked about this vitamin D receptor numbness or downregulation–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Okay, so, if you’re a person and you’re taking vitamin D and then you’re testing your vitamin D and it’s not moving upward, there’s a chance that there’s–your 125 is shooting up and your 25 is not–you’re not building the reservoir with the 25 because it’s all going downstream to the 125 or from calcidiol to the calcitriol.  So it’s very possible that is the case and we see that with inflammation and these chronic infection.  So if that’s the case, make sure you’re running the 125-hydroxyvitamin D along with the 25 because that way you’re not gonna be continuing to push more and more vitamin D thinking that that’s gonna be the right solution.

Baris Harvey:  Right.  You can’t just stuff more stuff down the toilet, expected to get the flush.  You gotta actually fix the problem that’s going on.  So–

Dr. Justin Marchegiani:  Yeah, so the deeper is why.  So we know that infections, right?  Inflammation, these things are gonna cause that receptor site to be more numb.  So moving forward, we wanna look at intercellular infections, right?  Infections in the blood, infections in the body that could be creating or deforming that vitamin D receptor.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  So, we know for instance, one infection, mono or Epstein-Barr, Epstein-Barr virus is the–is one of the viruses, that and Cyto-MegaloVirus (CMV), is one of the viruses that causes mononucleosis.  So there’s research showing that it will actually derange the vitamin D receptor site and there’s also some research showing that resveratrol, which is like this antioxidant bioflavanoid, will actually help the vitamin D receptor sites.  So one school of thought out there is, you know, giving some extra resveratrol to help the vitamin D receptor sites so we can work better–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  That’s–that’s kinda like palliative in my opinion.  It’s like a Band-Aid over, you know, it’s–or it’s like an ice pack on your head because you’re just slamming it into the wall every day–

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  The question would be, well, why did the receptor site downregulate?  And we have to go back to the inflammation and infection, so the underlying cause, right?  It’s always the best thing to be at the underlying cause.  The underlying cause is to get the infection treated.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  But in that process I see it being totally okay adding some resveratrol, some of these antioxidant bioflavonoids to help kinda get the receptor site back into action so we can work a little better.

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  I haven’t seen too much on blood work.  I’ve–I’ve looked at it a few times.  I haven’t seen it worked, you know, terribly well where you see a drop in it but I think there’s some evidence in the scientific literature and I actually posted this on my Facebook.  You know, one of the–one of these scientific articles and this–over a year and a half ago and just wanna touch upon it now with it being in the winter and I did a couple of videos on vitamin D recently and I wanna add this element to it, the infection element and the vitamin D receptor cell downregulation and just things you can do, right?  Number one, resveratrol.  Number two, address the infection, address the intercellular infection.

Baris Harvey:  Yeah, definitely.  See and what’s super important about what you mentioned right there is that it’s not just one or the other and I know that often sometimes people, you know, think, you know they go to their–their Western medical doc and it’s like, “Okay, I’m just gonna get a Band-Aid,” but then they might go over here to the functional medicine and say, “Oh well, I’m gonna get to the root cause but in the meantime feel like crap.”  But no, that’s not the case.  We wanna make sure that we–we do wanna find what’s the–the deepest bottom thing, you know, that’s causing–wreaking havoc because you don’t wanna just keep, you know, rinsing and repeating that the thing is broken.  We wanna make sure we solve and we solve it for good.  But in the meantime like while you’re doing all that digging, you know, you want some help and some relief so that way you don’t have to just kinda–withhold the negative symptoms whatever that might–might be.  So with that being said, a lot of people might think off the bat–oh this is–this is something that’s being said, we don’t naturally take, you know, those negative symptoms.  That–they’re not that obvious, if I can say that.  Because most people don’t say, “Oh, vitamin D deficiency?  Ricketts.”  But that’s like–kinda like that’s when it’s hitting rock bottom, right?  Like we don’t wanna wait until it gets that bad or you know, some people it’s when they’re really young, until we say, “Hey, maybe we should check out this vitamin D thing, like–

Dr. Justin Marchegiani:  Exactly.

Baris Harvey:  What are some of the other symptoms we might be noticing if we have deficient vitamin D levels?

Dr. Justin Marchegiani:  What else could you notice?  Well, it’s really hard to say because vitamin D has an effect on so many things.  I’ll just give you an example.  My father during December came to me and he said, “Justin, I–I wanna let you know I’ve actually lost 10 pounds this month.”

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  I said, “That’s great.”  You know, I–I noticed you’ve been eating a little bit of bread and this and that, and you’ve been cutting your carbs and getting your insulin levels and he said, “No, my diet–I’ve kept it exactly the same.  My routine’s exactly the same and I’ve lost 10 pounds this month just by upping my vitamin D 10,000 units, international units, per day.”  I go, “Really?”  So then I go on PubMed and I’m like Googling, and I’m like, “Oh, wow!  There was a study, you know, 6-9 months ago in the American Journal of Clinical Nutrition, on postmenopausal females.”

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  And what they found was when they supplemented their, I think their vitamin D levels up to 2,000 IUs per day, controlling for exercising, controlling for diet, the group that got the–the modulatory, the higher level of vitamin D lost the most weight–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  And were able to keep it off.  And I’m like, “This is interesting.”  So then I Google a little bit deeper into vitamin D and–and what could it be doing and, you know, it can have a–an effect on hormone synthesis.  It can affect testosterone.  It could affect estrogen levels and when we’re dealing with these things, it’s gonna have a modulatory effect.  You’re not gonna like super saturate–

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  Your hormones but like you would if I was giving you topical testosterone or topical estrogen.

Baris Harvey: Uh-hmm.

Dr. Justin Marchegiani:  We’re not gonna have that kind of effect but there’s a modulating boosting effect we see with testosterone.  We also see an effect on insulin resistance meaning it makes your cells more sensitive to insulin, so that’s pretty cool.

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  So I’m like, “Alright.”  I’m like–I’m like, “Alright, Dad, you’re not a postmenopausal female–

Baris Harvey:  I was just–I was just gonna bring that up.  I was like, “Well, so, it shows that it works on postmenopausal men as well?”

Dr. Justin Marchegiani:  Yeah, you’re not a post-menopausal female, thank God, but there–it makes sense.  The mechanisms are in place in the literature and there’s some research on it affecting testosterone so I think we can–I don’t think it’s a giant leap to make the connection that–that it’s having similar effect on your body, you know, in–on the testosterone and on the insulin resistance side, and that’s probably the reason why you’re having this weight loss.

Baris Harvey:  Yeah, definitely.  So it’s, you know, like–like you mentioned, don’t go out there and just, you know, assume that, you know, if you–if you work out, and you wanna get super big that you have to take an extreme amount, but what we’re saying is that we do see a correlation and a connection, and even when you look at, you know, your hormone pathways, we see, you know, one of those beginning stages of your hormone pathways is guess what?  Vitamin D and cholesterol, and you need those as building blocks, the foundation.  So, like you mentioned, there’s probably some boosting but not like a super saturated form, like in a modulating type of way, in which you can kinda rebalance and kinda tell your body like, “Hey, this is the way that we’re supposed to be running efficiently.”

Dr. Justin Marchegiani:  Yeah and I read the abstract to this rat’s study and again it’s a rat study, I just gotta put it out there, but they found testosterone increased the synthesis, excuse me, let’s back up–Vitamin D increased the synthesis by the testes making more testosterone in–in some of these rats.  And I was like, “Oh, that’s really interesting.”  And it makes sense that mechanism is more than likely happening in humans at some level.  And we know it’s happening in some other females.  We know it’s having the insulin resistance effect, so I mean, make sure your vitamin D, it’s just another reason why you’d wanna use vitamin D.  So if you aren’t motivated by the immune-boosting and natural cancer benefits, well, get motivated by some of the aesthetic benefits.

Baris Harvey:  Right, exactly.

Dr. Justin Marchegiani:  Right?

Baris Harvey:  Yeah.  And–and like you mentioned because it’s, you know, it affects our hormones, it affects our–our skin and all these other, all these–these things are–it–it’s hard to pin down like, “Hey, I’m having this symptom.  Do I have vitamin–” like we can’t kind of immediately do that, and that’s probably why it’s so important to make sure that, “Hey, just, you know, get a test–get a test.”  It’s not that expensive if you go into your–your doctors.  Make sure to say just like, “Hey,” just make sure your vitamin D is getting tested and it probably won’t cost you anything extra and if you have to go outside of your doctor, it won’t cost you that much, right?

Dr. Justin Marchegiani:  Yeah, and what I’ll do is I’ll put a link in–in the show notes, just a way to my store where you can get vitamin D done super cheap and I think it even comes with–I think it even comes with C-reactive protein, too.  So I’ll put a link in, so if you want it, if you can’t get it from your doctor, you can’t find decent price, you can at least get it here pretty easily.

Baris Harvey:  Yeah, exactly.  So, now we have a kind of, like a baseline to like what’s kinda happening, where do we mostly get it from?  And–and then now–now we–it would probably be a good idea to understand what are the–how do I–how do I dose it, right?  If–if I’m noticing that I’m low, or even if I’m at baseline like how much should I be internally taking in if I’m taking a supplement?  And with the supplement, is there a superior form?  Should I be taking it mixed with some vitamin K?  Should I be taking it in a liquid form?  What are–what are some of the things when it comes to supplementation that you might tell some of your clients?

Dr. Justin Marchegiani:  So when it comes to vitamin D, off the bat, you know, vitamin K2 is gonna be beneficial.  I typically won’t recommend it with vitamin K2 unless people–unless my patients have osteoporosis, they are female, or if they’re just avoiding like butter.  Like if you’re getting grass-fed butter in your diet, like I just had like a tablespoon or two on my coffee, right?

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  I don’t need vitamin K2 supplementation.  I’m getting lots of grass-fed butter in my diet.  I’m eating ghee.  I am eating good quality meats that are gonna have other fat-soluble nutrients, but if I’m looking at someone’s diet and I’m not seeing vitamin D, or sorry, vitamin K2–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Dietarily, then I’ll–I’ll put it in there.  So I always wanna make sure it’s either coming in supplementally or it’s coming in dietarily, or if people just have a concern for bone health, we’ll add some extra vitamin K in there.  So that’s kinda–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Step one off the bat.  So if you feel like you’re not eating butter and things like that or definitely if you’re a vegan, right?  You wanna get the vitamin K2 in there.  But on that note, I typically recommend the vitamin D3 drops mixed with–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  A bit of MCT oil.  So with the MCT, you’re gonna take that enterohepatically, meaning you don’t bile salts to break it down, because it’s a fat-soluble nutrient, right?  Vitamin A, D, E, and K.  So you’re gonna be able to take it up naturally via the lymphatic system and not have to break it down with bile.  So you get really good absorption, so the vitamin D drops are great.  I’ll put a link in to a couple of my favorite products.  I like one Thorne that’s got the vitamin D3–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  And the vitamin K2, that’s a really good one. If you want the vitamin K2 as well.  There’s also a really good one by Designs for Health called Emulsi-D.  I’ll put that in the show notes.  That’s just a more concentrated form of vitamin D.  Very good.  And I–I’m right I’m hitting up about 10,000 units a day but a good general recommendation, go liquid if you can; if not, do the pill but make sure your digestion is working and a good recommendation off the bat is about 2,000 IUs per 25 pounds of body weight.  So if you’re 100 pounds, you know, 10,000 off the bat for the first month is–is gonna be okay.  Excuse me, let me just back up.

Baris Harvey:  Sure.

Dr. Justin Marchegiani:  1,000 IUs per 25 pounds.  So if you’re right around 100 pounds 4,000 IUs will be great for the first month to start.  If you’re around 200 pounds, right around 8,000 IUs will be a pretty good place to start.  And that’s just a starting point.  I don’t recommend keeping that dose longer than a month.  Just a good starting place, again Dr. Holick, he’s a researcher out at BU, prolific vitamin D researcher.  He says that your body needs just about 2,000 IUs of vitamin D per day just at baseline, like just to kinda keep things level.  So if you’re kind of on the fence and you’re like, “I don’t know but I’ve been taking vitamin D and I haven’t been.”  Well, 2,000 IUs will just be a great baseline.  If you’re really uncertain you’re not ready to get tested yet, 2,000 will be a great place to start if you’re uncertain.

Baris Harvey:  Yeah, definitely.  And this would probably be especially for people that might–may be overweight or people that are older like you mentioned earlier, if you have darker skin, you might need a little bit more, you–you’re at high risk of being deficient.  So–so these are certain examples, and ano–another thing–thing that you mentioned and I don’t think we’ve mentioned much on the show before is the–the route, because that these are fat-soluble with–with the liquid, explain to people what you mean by, you know, it doesn’t need bile salts to break down and kind of what’s happening when you take a sublingual like fat-soluble tincture versus taking something in, because somebody could just think, “Oh, what if I just like swallow the–the liquid.”  They might not kind of catch that right off the bat, so tell us real quick about that–that pathway.

Dr. Justin Marchegiani:  Okay, while there’s some thought that we can absorb some of this if it’s liquid sublingually, so kind of through our sublingual tissue and have it go right into the bloodstream.  And also we know that when we take things like coconut oil or medium-chain triglycerides, these are fatty acids that are 6 to 12 carbons long and essentially these molecules can be taken up by our lymphatic system.  Okay?  Our lymphatic system is kinda the intermediary between the tissue and the blood.  Big thing is when we typically take in fats, like if you have a bolus of butter or a bolus of meat, your body’s gonna have your pancreas produce some enzymes, right?

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Like lipase, et cetera, and then also your gallbladder’s gonna spit out some fat–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  Excuse me, it’s gonna spit out some bile–

Baris Harvey:  Bile, which is gonna–

Dr. Justin Marchegiani:  Which is gonna emulsify and break down the fat.

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  So, we got some lipase coming from the pancreas.  We got some bile coming from gallbladder and this is gonna help break down that fat, essentially emulsify it so then we can–we can absorb it.  The nice thing is when we do something on the medium-chain triglycerides side of things, we can absorb it enterohepatically meaning just take it up to the lymph glands and we don’t need this whole bile output and this is great because I can’t tell you how many patients I see these days that don’t have gallbladder.

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  They don’t have gallbladders and they just–their digestion stinks because they got gut infections and they’re not absorbing their nutrients.  So I’m a little more biased towards the vitamin D, again you get people out there like the–the drug industry and conventional medicine starting to get hit with this.  They’re just doing 50,000 IUs one time per week.  I’m not really a fan of that because you typically won’t just go outside and just get your bolus of vitamin D just at one time, right?

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  Because the most you can make at about 1 unit is about 20,000.  So I don’t like to go over 20,000 unless it’s an acute issue like an infection.  So–

Baris Harvey:  Uh-hmm.

Dr. Justin Marchegiani:  You know getting it daily is gonna be a better thing and I’m a bigger fan of doing in the morning.  Well, I mean, it kinda makes sense because–

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:   Vitamin D is made with the sun so why would you get a whole whack of vitamin D at 9-10 o’clock at night when the sun’s down.  I know there are a lot of protocols out that say, “Hey, do your vitamin D at night.  They’ll have a calming effect.”  But I just like to use my noggin’ a little bit and say, “Well, would our body normally make vitamin D at 10 o’clock at night?

Baris Harvey:  Yeah, exactly.  And it–I kinda think the same thing like, “Oh, if I–you know, if–if I take a supplement that might have a little bit of vitamin D in there okay, and, you know, I take the Thorne so there’s not be that much in the afternoon but there is a heavier amount in the morning,” and they did that–that same, they did it in that specific reason, like there’s kind of this expectation of–of what our–our body is expecting and what naturally occurs and you kinda want to do as best you can to match up with–with nature.  I mean, unless I guess you work–work the night shift, then you know, you might benefit from–from doing it the opposite way but–

Dr. Justin Marchegiani:  You-you may.  That’s a good point.

Baris Harvey:  So, but yeah, so just you know, let’s basically what we’re saying is like, let’s–let’s be smart about this and then we’ll try to match it to–to try and follow nature as much as–as possible even if that’s, you know, supplementing.  These are–

Dr. Justin Marchegiani:  Exactly.

Baris Harvey:  Natural things that as us humans have–have built, but we’ve been able to kind of, you know, you kind of coexist with the–this technology so the stuff that we had and we know is good, you know, try to match our technology with what’s natural and you know, one of the best things you can do is take that in the morning in that same way, same time I supplement my vitamin D.

Dr. Justin Marchegiani:  That’s smart, man.  That’s really good.  And I just kinda wanted to summarize everything.  I think we went on to the show being like, “Oh, we’re gonna talk about vitamin D and immune-boosting support but I think that we’re having–

Baris Harvey:  We’re having–

Dr. Justin Marchegiani:  So much to talk about, we’re just gonna keep this podcast just focused to vitamin D and I think we’ll do a part 2 talking about other ways to kind of boost the immune system outside of vitamin D next week.

Baris Harvey:  Yeah, that sounds perfect.

Dr. Justin Marchegiani:  Is there anything else you wanna touch upon, Baris?

Baris Harvey:  I think we got most of it.  For the listeners out there, send us any of the questions that you may have about vitamin D and maybe we–we can throw that in.  I’m gonna make sure that I–I take that down, questions about vitamin D.  So you can go to beyondwellnessradio.com and there’s this place right there you can click and ask–ask away.  You can ask questions and we can go ahead and–and put your answer on the show.  So yes–so I think we got most of it and if there’s any other questions, we’ll just make sure you guys go ahead and send that in.  So that way we can get those answers for you.

Dr. Justin Marchegiani:  Great.

Baris Harvey:  With that being said, you know, I think we did–did a really good job kinda breaking down and giving listeners a foundation.  Anything else that you maybe wanna add?

Dr. Justin Marchegiani:  Well, I just wanna set people up here.  So if I got a little glossy-eyed with all the big words and just it kinda made it–maybe it was a little bit over their head.  I’m gonna just break it down so if they listen to this quick 30 seconds here, they’ll get all of the key points.

Baris Harvey:  Yeah.

Dr. Justin Marchegiani:  Alright?  So vitamin D3 in your supplements coming in converted to the liver to 25-hydroxyvitamin D, calcidiol, and then converted by the kidneys to calcitriol, you’re active vitamin D.  Vitamin D has–upregulates 800 different genes, cancer protective, vitamin D is shown to–people with higher vitamin D levels are resistant to the flu.  It helps balance your TH1 and TH2 immune system, right?  Your TH1 are like your–the Special Forces that go out to go kill everything off the bat.  Your TH2 are the forces that stay behind and come out in about a week.  Those are your antibodies.  It helps your TH3 system, your T regulatory cells that really balances out your immune system and if your vitamin D levels aren’t going up, look a little deeper.  There could be an infection.  You could be having vitamin D receptor site downregulations.  We wanna run that 125-hydroxy D.  If our 25-hydroxy D isn’t going up with supplementation, let’s take the 125-hydroxy, and then a good starting point if you’re uncertain is 2,000 IUs per day or anywhere between 5,000 to 10,000 IUs depending on body weight for the first month, and if they–if anyone listening is uncertain and wants to get tested, check out below the show notes to get more information on how to easily do that, and I think that’s it, Baris.

Baris Harvey:  Yeah, we went over a lot of stuff in that time, so–for you, guys.  Thank you, guys, so much for listening.  We always appreciate it.  With that being said, next time on the show, we’ll get into the immune system part of it.  We’ll go ahead and break that stuff down for you guys and–and get you guys as much as you guys need.  So again go to beyondwellnessradio.com and hit that subscribe to the newsletter.  This will keep you up-to-date much as possible.  Also we would greatly appreciate if you went to iTunes and left us a review.  With that being said, you guys have a good one.  Thank you coming on, Dr. Justin.  You have a good one.

Dr. Justin Marchegiani:  Thanks, Baris!


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