Vitamin D: Are You Deficient?

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This vitamin, or hormone to be exact, is known as the sunshine vitamin. But are you actually getting enough sun exposure to to produce optimal levels of vitamin D?

Vitamin D plays many vital roles in our body. Virtually every cell in the body has a vitamin D receptor, which, when bound to vitamin D, can influence the expression of more than 200 genes. It maintains normal blood levels of calcium and phosphorus, to support proper bone development, it modulates cell growth, support the immune system, reduces inflammation and much more!

Vitamin D Levels:

The optimal level of 25-OH D is 75-100 umol/L (recent research has shown a possible optimal range at 120-150 umol/L), however the current Canadian average of D3 levels is 67.7 nmol/L. This means more than 70% of Canadians are deficient. I have seen patients which much lower numbers than this. Even down to 23 nmol/L! (Higher is not always better though for this fat soluble vitamin. However, most cases of toxicity symptoms are at 25000-60000 IU/day for 1-4 months. This is much higher than the ND recommended dose.)

Where do we get vitamin D?

We synthesize most of our vitamin D from sunlight exposure. It is estimated that 20 minutes, with face and arms exposed, provides 200 IU for people with light coloured skin. A moderate sunburn can produce 10000IU per day. However, sunscreen and sunblocks over SPF 8 prevents formation of D3, and most of us are indoors often throughout the summer and get minimal exposure to sunlight on these darker days of fall and winter. We source some vitamin D from food, with seafood being the most significant source, sardines to be exact! Mushrooms and egg yolk also have small amounts.

This is why it is recommended that most Canadians supplement with vitamin D.

What does Vitamin D effect?

To display the vast effects vitamin D has on the body here is a list of conditions that have been linked to vitamin D levels:

• Fractures and Osteoporosis - Vitamin D along with K2 if needed to increase calcium absorption - D3 supplementation is associated with a 22% decrease in risk of falls

• Depression - D3 deficiency has been linked to increased incidence of depression 

• Autoimmune conditions - D3 deficiencies have shown an increase risk of autoimmune diseases such as MS, psoriasis and rheumatoid arthritis 

• Thyroid health - There is an association between low vitamin D status and autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Graves’ disease

• Poor immune system - Vitamin D helps the immune system adapt and ward off infection, beneficial in cold and flu season

• Metabolic disorders - D3 helps restore beneficial gut bacteria which in these studies has shown to have a key role in diabetes and heart disease 

How much Vitamin D to supplement?

So with all that information you may be wondering how much to actually supplement. This really depends on your individual levels of 25-OH D. As stated early, I’ve seen a patient with levels in the 20s (nmol/L), so they would need a much higher dose of D3 to reach optimal levels, compared to someone that is slightly deficient, let’s say in the 60-70nmol/L range. If you suffer from any of the above health conditions, I advise to get your vitamin D levels tested. The quicker you raise D3 levels if you are deficient, the sooner symptoms will improve. The common recommended dose of 1000-2000IU may not be enough for you! That said, if we were to give higher levels of D3, a dose of 5000-8000IU, it is important to know D3 levels and assess the necessity of vitamin K2 and vitamin A supplementation - all these soluble vitamins play a role with each other to prevent toxicity. Sufficient levels of potassium and magnesium have also been suggested to protect against vitamin D toxicity.

So ask your doctor to test your vitamin D levels, 25-OH D levels to be exact. There is a simple blood test I do in practice to assess your levels. Book in for a blood test visit to get yours tested today!

In health & happiness,

Dr. Karen

The Winter Blues: 5 Ways to Beat Seasonal Affective Disorder and Depression

It always surprises me after the time change in November how dark it can get in the evenings. Every year around this time I have to check in with myself and how I am feeling and every year I realize, after a gentle reminder from those around me, that the darker days do affect my mood. Living in Vancouver for 4 years, where it is raining most of the winter, I would forgot how much happier people were with the sun out, until the skies opened and you get a glimpse again of sunny summer days. The same goes for most of Canada however. When a patient comes to me concerned about their mood, I always ask whether they notice a more depressed mood in the winter...most say yes! 

An important point is that there could be a easy explanation as to why you are feeling depressed and ruling these out first is key. There are a few common reasons I see in my practice, for why people feel depressed. They are vitamin D deficiency, adrenal fatigue, hormone imbalances, hypothyroidism and food allergies/sensitivities. Simple blood work, a health history and/or elimination diet can help decipher if your mood is affected by one of these issues.  However these simple tips can make a drastic change in your mood.

1. Light Exposure:

As the day shorten our circadian rhythm adapts and melatonin production increases. This in turn decreases serotonin production. Unfortunately this combination doesn’t improve sleep. Getting some light exposure in the morning, helps to keep our circadian rhythms in check. Suggestions for this are going for a 20 minute walk in the morning when it is brighter out, in nature is an added bonus, or investing in a sunlamp. I recently learned that the Public Libraries around HRM have these on loan!

2. Vitamin D3:

One of the first vitamins I think about when it comes to mood is vitamin D. It plays an important role in many things, including bone, skin and immune health, but it also contributes to improving mood. There are several studies that show an association with low vitamin D status and mood disorders, including seasonal affective disorder. 30 minutes of full-exposure to sunlight, without sunscreen, can provide between 10,000 to 20,000IU of vitamin D. In the winter, or if we work in an office all year, it is difficult to get enough D3, therefore we need to supplement. I suggest 2000-5000IU/day for mood disorders, however it is recommended to have your vitamin D levels checked to avoid toxicity. 

3. Increase Endorphins:

On these cold darker days we tend to sink into the couch. Exercise, even moderate amounts, have been proven to increase endorphins and serotonin production, ultimately improving your mood. Start by walking 20 minutes in the morning or at lunch if you are just getting back into it, or increase the intensity with HIIT workouts. Massage also has been studied to increase endorphins, or any physical touch for that matter! Our testosterone levels have been shown to increase in the winter so take advantage of the increased sex drive. 

4. B Vitamins:

These vitamins are also important to regulate mood. B vitamins are necessary for every energy reaction in your body, including the production of hormones and neurotransmitters mentioned above. Women on oral contraception become deficient in B6 (and magnesium), therefore it is even more important to supplement in these women. I recommend a multi-B vitamin, with higher amounts of certain Bs depending on the person. 

5. Decrease Sugar Intake:

When our blood sugar spikes then crashes it stimulates a stress response in our body. An increased cortisol level in turns affects other hormones and neurotransmitters and ultimately affects mood. If you are having energy crashes or bouts of fatigue or depression take inventory at how much sugar you are eating in a day. The recommendation is no more than 6g/day! Good quality protein, fat and fibre in the morning will set your day off right so you won’t be craving that 2pm sugary snack. 

As you can see there are many tools to consider to help with SAD and depression. There are other nutrients and botanicals that I would consider in my practice, depending on the person and if they are on medication or not. For a more individualized approach consider booking an appointment with me or your local ND.

In health & happiness,

Dr. Karen

p.s Check out these posts if interested - PMS: Recognizing the Signs, Anxiety: Tried & Tested Tools, Adrenal Fatigue

Healing the Gut: All about the good bugs

Did you know that our body lives symbiotically with many bugs, called the microbiome? Did you know that many chronic diseases, such as allergies, skin issues, depression, obesity, hypertension and more are linked to a disruption of our microbiome? 

We are seeing a plethora of research today showing the benefits of a healthy microbiome, this being the collection of healthy bacteria in our body. The majority of this microbiome is located in our gut, which is why I discuss gut health with so many of my patients! Many of you may be familiar with the word “acidophilus” but that is only one strain of probiotics, or live bacteria, which lives symbiotically with us. Some other strains that are important are lactobacillus, bifidobacterium and saccromyces boulardii. Sound like gibberish? Luckily, it is helpful gibberish. 

A few important roles of probiotics:

1. They protect against pathogens: A spectrum of immune conditions, from simple colds and flus to chronic immune deficiencies, such as Hashimotos and Crohns, can occur if we have a deficiency in probiotics. This is due to the fact that more that 70% of our immune system resides in our digestive tract and probiotics help to strengthen it. Some germs are actually good for us in this case. If we wiped out all those bugs, from over sanitization or antibiotics we decrease our bodies ability to protect us from when we need them the most.
2.  They protect the gut lining itself: Heard of the term “leaky gut?” Our digestive tract is simply one layer of cells, with the blood stream directly beneath it. Therefore, it is quite fragile. An imbalanced flora can lead to permeability of these cells, by up-regulating a protein called zonulin, which has been shown to be correlated with auto-immune conditions, such as celiac disease, and other chronic diseases. This permeability leads to an increase in inflammation in the blood stream. Diagnosed with “IBS”? Probiotics may be the gut protection you need. 
3. They calm the nervous system and affects the mind: I have spoken before about the correlation of depression and anxiety and an imbalanced microbiome. By protecting the gut lining, probiotics decrease overall inflammation in the body. Probiotics have also been shown to stimulate neurochemical production such as GABA and serotonin, our calming signals, and also communicate directly with the brain through the vagus nerve (one of the largest nerve in the body, connecting the brain and the gut.) 

My tips to help your gut: 

1. Focus on Diet. The western-style diet of more carbohydrates and more sugar leads to higher levels of inflammation and gut permeability. They also feed the “bad” bugs, such as yeast and an imbalance ensues. By focusing on eating more vegetables and fibre and eliminating sugar and processed carbohydrates, the gut will thank you. 
2. Get some Vitamin D. This multifunctional vitamin decreases zonulin in the gut, ultimately helping our probiotics to function more affectively. Summer in Nova Scotia is a great time to increase your vitamin D, so get out in the sun...for a reasonable amount of time!
3. Eat your fermented foods. Kefir, kimchi, sauerkraut are all great ways to improve your gut flora with food.  **A note on kefir: Please read the bottle! All kefir is not the same. Avoid the flavoured versions with added sugar (just negates the effects). If you are sensitive to dairy, try coconut kefir, which actually has more probiotics per tablespoon (15 billion vs 2 billion). Finally, increase the dose slowly, starting with 1/2 tbsp, increasing to only 2 tbsp, added to other yogurt or smoothies. Too much all at once may cause more bloating. 
4. Take a probiotic supplement. In my practice I usually start my patients on a supplement form as a larger correction is needed or a certain strain is important. The dose and strain depends on their concern. It may be hard to get enough probiotics in food form before the imbalance is corrected. Ask your ND what is right for you. 

So there you have it, probiotics have several important roles in our body, especially in the gut. If you have any questions on these little bugs please don’t hesitate to ask or reach out to me in a 15 minute free consults. Happy to help!

In health & happiness,

Dr. Karen

(Photo credit: www.mindbodygreen.com) 

5 Ways to Beat the Blues

We have now settled back into a routine after the excitement of the holidays and trying to stay happy, healthy and warm. It is easy however, to get pulled under by the lack of sun and shorter days. It is no wonder why "Blue Monday" exists in January, supposedly the 3rd Monday of the new year. 

Let's boycott Blue Mondays this winter by focusing on these five ways to beat the blues. These are simple things you can incorporate into your life to keep that smile on your face. An important point is that there could be a easy explanation as to why you are feeling a little down and ruling these out first is key. There are a few common reasons, I see in my practice, for why people get the blues. They are adrenal fatigue, hormone imbalances, hypothyroidism and food allergies/sensitivities. Simple blood work, a health history and/or elimination diet can help decipher if your mood is affected by one of these issues. 

But what can you do? 

1. Eating a colourful diet with good protein - Processed, high sugar foods will weigh us down and cause inflammation. This is also true for food allergies/sensitivities. Increased inflammation in the body will lead to increased cortisol levels and in turn, decreased serotonin production. Serotonin is an important "feel good" neurotransmitter, along with dopamine. Good quality protein, such as grass fed beef, chicken, eggs, or beans and nuts, provide necessary amino acids to build those "happy" hormones and neurotransmitters. Greens, such as spinach, kale and parsley, aid in detox, making you feel a little lighter! Try a green smoothie, or bean chili to increase your nutrient intake. 

2. Sweating - On these snowy days we tend to sink into the couch. Exercise, even moderate amounts, have been proven to increase endorphins and serotonin production, ultimately improving your mood. Start by walking 30 minutes at lunch if you are just getting back into it, or increase the intensity with HIIT workouts or at home exercises. 

3. The sunshine vitamin - One of the first vitamins I think about when it comes to mood is vitamin D. It plays an important role in many things, including bone, skin and immune health, but it also contributes to improving mood. There are several studies that show an association with low vitamin D status and mood disorders, including seasonal affective disorder (SAD). Many of us are deficient in vitamin D. 30 minutes of full-exposure to sunlight, without sunscreen, can provide between 10,000 to 20,000IU of vitamin D. In the winter, or if we work in an office all year, that is difficult to get therefore we need to supplement. I suggest 2000-5000IU/day for mood disorders, however it is recommended to have your vitamin D levels checked to avoid toxicity. 

4. B vitamins - The B vitamins are also important to regulate mood. These vitamins are necessary for every energy reaction in your body, including the production of hormones and neurotransmitters mentioned above. Women on oral contraception become deficient in B6 (pyridoxine), therefore it is even more important to supplement in these women. I recommend a multi-B vitamins, with higher amounts of certain Bs depending on the person. 

5. Decrease stress - I've mentioned that increased cortisol can lead to decreased serotonin production, our "feel good" neurotransmitter. When stressed, it is harder to find the joy in things around us, therefore harder to dig ourselves out of the hole. Adequate sleep, yoga, meditation, writing to-do lists, and a good social network are all great stress busters. I have proven all of these! Enjoying the odd snow day off with homemade cookies and a movie can go a long way to improving our mood. 

As you can see, Naturopathic medicine has many tools up its sleeve to help beat the blues. There are other nutrients and botanicals that I would consider, depending on the person and if they are on medication or not. If you feel like your mood is dipping, please consider these options or book an appointment with me or your local ND. We are happy to help! 

In health and happiness, 

Dr. Karen 

(Photo cred: www.pivotcon.com)