On my way to a graduate seminar on post-medieval Japanese art my right arm started hurting. It ached all the way into the bone and as I thought back on my last Judo session wondering if maybe I had some weird injury I hadn’t noticed prior my breath started shortening. The pain in my right arm was expanding into my back and chest making every step towards the bell tower of my university and class increasingly painful. The morning fog enveloped me and despite the sun promising a warm day ahead I felt as if I was being stabbed by ice. I resolved that immediately after class I would go to the health centre for care.
I genuinely believed I was having a heart attack.
My memory, like that morning, is a bit foggy, but I do remember waking up in the care centre and being told by a doctor that I had made it there under my own power, but had passed out. My mother was, fortunately, still working nearby at this point in our lives and so she drove out to pick me up. I wasn’t in a condition to speak to the doctor myself, but he had tested me on the suspicion that I was simply dangerously deficient in vitamin D and discovered I indeed was. He prescribed a very high dosage of the “vitamin,” for about a month and then advised that I continue to take over the counter supplements for the rest of my life.
So, you might wonder, how did I get to this point?
Vitamin D isn’t actually a vitamin really. It’s … fatty steroids. So you can ingest vitamin d, and supplements really do help, but there’s really no substitute for metabolizing your own. And that you do by catching some sun.
From here things are pretty straightforward. I am extremely light-skinned. I will burn with just ten to fifteen minutes of exposure and whilst attending graduate school in California I knew I would be outside for a reasonable amount of time and therefore my morning routine involved applying sunscreen. Light-skinned people are generally at lower risk for vitamin D deficiency than dark-skinned people because light skin allows for the absorption of more radiation instrumental in the metabolizing of vitamin D, but because I was trying to avoid sunburns I took it too far.
Excessive sun exposure particularly for light-skinned people like me can lead to sunburns, severe dehydration, heat prostration, and even cancer. But you can also die from hyponatremia by drinking too much water. All things in moderation.
1. Vitamin D Promotes a Healthy Immune System and May Even Fight Cancer
There’s no such thing as a cure-all, and you should definitely keep an ongoing, honest, and open conversation with your primary care provider particularly if you decide to take any form of oral supplements. They may seem innocent, but too much of anything is bad, some oral supplements particularly in the US are not well regulated and may actually be harmful, and your doctor will understand how the chemicals in your diet and even “natural” supplements may interact with your individual biochemistry.
With this said, my error in being so proactive with avoiding sunburns lead to my immune system having difficulties protecting me. I would get little colds pretty much constantly. Vitamin D has anti-inflammatory and immunomodulatory effects which will help your immune system to respond appropriately to little assaults and may even make you more resistant to carcinogenesis. This DOES NOT MEAN that vitamin D cures cancer, but it does mean that if you have a reasonable amount of vitamin D, you might be at lower risk for developing cancer.
Additionally, there is an easily observable spike in autoimmune disorders at higher latitudes. Populations that live in areas with less sun have higher rates of things like Multiple Sclerosis, Ankylosing Spondylitis, and Rheumatoid Arthritis. Again, it’s not just the vitamin D; there are genetic and other factors involved, but there is definitely an association between healthy levels of vitamin D and an auto-immune system that isn’t cannibalising your myelin sheaths.
2. Vitamin D Helps with your Energy Levels and Mood
Prior to becoming more proactive with my vitamin D intake I was often clinically depressed and my crisis when I passed out was accompanied by extreme fatigue and muscle pain. This is probably how the doctor pegged me as being vitamin D deficient. This probably wasn’t hard for him. He got a young seemingly healthy woman with super light skin and no tan in his office complaining of extreme fatigue and muscle pain with no history of drug abuse, severe medical conditions like heart disease who then all but passed out in front of him. I vaguely remember him asking me to sit before it all goes dark, so I think I gave him my medical history, sat down and then it was lights out. And I believe he woke me up long enough for me to consent to a blood draw because he did have to confirm the diagnosis, but I only vaguely remember that happening.
After I started taking the vitamin D supplements though everything in my life instantly improved. Everything. I had a better mood all the time, my muscles stopped hurting, and getting through my assignments was considerably easier. This is because vitamin D is pretty crucial not just for your immune system but for your metabolism. It’s kind of a linchpin. If you don’t have reasonable amounts of vitamin D in your system your body cannot metabolize or use other vitamins and that pretty obviously will lead to fatigue and depression.
3. Vitamin D Keeps your Bones Strong
One of the minerals vitamin D helps you metabolize is calcium. And this is actually super crucial. In my case I hope that my deficiency wasn’t so bad that it lead to severe osteopenia or bone loss, but that is a thing which can happen. In infants and toddlers vitamin D deficiency can lead to rickets which is a condition where the bones are too soft to support weight without bending and therefore can cause deformation in the long bones as the child begins to crawl or walk. It used to be something that happened due to swaddling and the use of certain weaning foods and also occurred frequently among populations where children were working in factories early on in life, but it has made a recent return as parents apply sunscreen to their children before they’ve gone out in the sun.
I didn’t initially notice because at the time I didn’t understand what she was doing, but as a small child when we went to an amusement park or the beach or a pool my mother would get me into my swimsuit and instead of applying the sunscreen right away would take it with her. She’d let me play in the sand or next to the pool for about ten minutes and then put sunscreen on me. Only once it was dry was I allowed to go swimming. I was quite annoyed at this imposition at the time, but now I understand she was making sure I got enough sun to be healthy, but not so much that I might burn. Thus my mother kept me safe from rickets.
Unfortunately, she couldn’t really do anything about osteomalacia. I’m pretty sure I don’t have this, but osteomalacia is basically rickets, but for grown-ups. Rickets will affect the appendicular skeleton aka your long bones whereas osteomalacia is primarily apparent in the axial skeleton which includes your ribs, vertebrae and pelvis. It’s painful and can actually cause deformation of the bones.
While I’m framing this as vitamin D’s direct effect on bone health this is actually yet again a metabolic issue. What’s going on is that your bones are alive and will repair the minute little fractures and wear and tear you cause to them by destroying a bit of the bone and replacing it with new bone. If you’re super healthy and athletic you’ll build more bone than you lose. (There’s also conditions that are osteogenic and a few that are both osteopenic and osteogenic, but that’s for another time.) Depending on your sex, biological age, development, and level of activity bone deposition can be largely cortical or more subperiosteal … and there’s different areas of the long bone in particular where you might see less or more deposition.
Basically what I’m saying is you are never too old to exercise.
The issue comes that if your vitamin D levels are low your bone cannot replace itself. If your body needs say calcium or phosphate it might naturally destroy some of your cortical bone, but if it doesn’t have vitamin D it cannot then replace that bone. This causes you to end up with premature bone loss possibly leading to full blown osteoporosis and soft bones which are not nice at all.
My point in bringing this all up at this juncture is that we are headed into a very cold winter worldwide in which a number of populations have been asked to self-isolate and quarantine. Some of you may already be feeling the ill-effects. Fortunately, we also live in an era where you can actually get what are effectively little pills of encapsulated sunlight. Your own naturally created vitamin D is the best so a healthy diet which includes fish as well as reasonable and safe exposure to sunlight is my primary recommendation. I also recommend that you put in a call to your care provider before you start taking oral vitamin D because they will be able to recommend dosage and possibly even brands.
Paying attention to your vitamin D level may help you get through the next several months to a year that we are going to have to survive before a vaccine is available. It is not a miracle cure and while it can help your immune system it will not make you immune to diseases most notably COVID-19. But it could elevate your mood and help with your energy levels, and it absolutely will improve your bone health.