I am writing this on a train, and as I look out of the window I can see the British West Country go by. It is bathed in sunlight. And this stunning day reminds me of the last few days we’ve had here in the UK that have been cold, wet and grey. The general lack of sunlight during the winter months can put a bit of a dampner on our mood. It can also make it darn difficult to maintain adequate levels of vitamin D.
Just this morning I was talking to a friend for whom vitamin D levels and sunlight exposure appear to have a profound effect on his life. A year ago (almost to the day) he developed quite disabling muscle pain. A battery of conventional tests revealed nothing untoward. He has been maintained on medium doses of steroids, and has simply been unable to wean himself off these because as he reduces the dose, his pain returns with a vengeance.
Awhile back I asked him if he was aware whether his muscle pain was made worse or better by anything. It turns out he has complete resolution of his pain during a summer holiday this year in Rhodes. One of the things that occurred at the time was perhaps my friends problems might be related to vitamin D or sunlight exposure. Low levels of vitamin D can lead to muscle pain and weakness. His GP obligingly tested his vitamin D levels and informed him that they were normal. I recently had sight of these test results. They were ‘normal’. But actually, his vitamin D levels were only marginally above the reference range of vitamin D. And the test had been done in June ” when blood levels of vitamin D would be expected to be relatively high compared to other winter time (his symptoms started in the winter).
In light of all this, I suggested John took steps to get his vitamin D levels up. A couple of weeks ago he started on some vitamin D supplements (5000 IU per day). In addition to this I recommended that he see what effect some sunbed sessions have. Over the last two week, he has had twice weekly sunbed sessions, for 4 minutes at a time. He has found that immediately after the session he feels no different. However, the following day he told me he feels significant relief from his pain. Today he told me that in the first time in a year, he has been able to get out of the bath without pain and weakness in his arms that caused him to have to crawl out rather than stand up.
Now, this response suggests some benefit from vitamin D because on exposure to sunlight, the skin makes vitamin D, but it believed to take a day or two to absorb ‘systemically’ (into the system).
Now of course my friend’s response to sunbed sessions might be nothing but an overblown placebo response. However, the fact that he does not feel immediate relief from the sessions suggests this is not the case. Even if, in reality, it is a placebo response, I suspect my friend won’t care (neither do I, for that matter).
Anyway, I’ll be interested to see how my friend gets on in the longer term. If he continues to improve and is able to wean himself successfully off the steroids, it seems this will have been the result of getting his vitamin D levels up. It’s quite satisfying to think that something so simple can make such a profound difference to someone’s quality of life.
Another good post John.
It seems to me that refcerence ranges are based on the premise that 95% of the general population are healthy, when in fact if you look at the general population this doesn’t appear to be the case.
Vitamin D is one area where it would appear that a high proportion of the population have sub-optimal if not downright low levels of vitamin D. TSH may be another area.
Curiously one area wher modern medicine seems to ragard an avearge level as being unhealthy, and abnormal, is the measure of cholesterol, where the advise is to seek ever lower numbers.
From memory I believe the average cholesterol reading in the UK is 5.6. Its higher in France and Switzerland where coincidentally or otherwise heart disease is less prevalent.
As I understand it choleseterol is a pre cursor to vitamin D. Would a normal repsonse to low vitamin D levels be a higher availability of cholesterol?
How goes your own attempts to raise your vitmain D levels? I think I like a number of readers have suggested you needed, at least initially, a higher intake than you had, and maybe are taking.
Your blog is always an interesting read.
Can sun beds increase vitamin D or is it placebo? Not clear from this article. I am interested since I have osteoporosis and my Microscopic Colitis makes it possible that it is difficult for me to absorbe vitamin D via the gut. Thanks, Ant
And 5,000iu/day of Vitamin D3 (the amount I take as I’m an “indoors” person) costs only 3p a day if you buy gelcaps from the USA.
My own experience with taking a vitamin D supplement each day for some months now is that it has dramatically improved the muscle strength in my arms and very noticeably in my upper thighs so that it is not now the monumental struggle to get up from a chair that it used to be.
As regards pain, many pains, particularly chronic pains, become less severe when intake of salt and salty food is minimised.
Great post John
I had a similar experience with a ‘patient’ of mine not more than a couple of months ago. A house-bound solo mum with 2 young kids coming off a New Zealand winter contacted me in a panic after having her sclera turn blue & having what appeared to be rheumatoid arthritis type symptoms – hands all twisted & she couldn’t hold anything to feed her two young kids. She had 3 days of little sleep due to the pain by the time she got hold of me (she had been to her doctor & was sent home with advice to take lots of paracetamol).
Suspecting an RA-type of reaction & knowing that low vitamin D has an association there, the time of year it was, & thinking that a solid vitamin D would at the least have an anti-inflammatory effect, I got her to take 50000IU of vitamin D over 48 hours.
She contacted me the next day to say that she had had the best sleep that night with little pain. And she had managed to get through a bigger part of the day before the pain came back & she lost function. Three trips to her GP, and despite my request, her literally laughed at her on the suggestion vitamin D might be implicated & refused to test.
She had paracetamol, voltaren, prednisone… the latter took th eedge off it, but little else. A sunny weeked came along & she spent a couple of days sunbathing – plenty of relief. In the meantime I had kept her on 5000IU of vitamin D. A referral to a rheumatologist & a battery of tests revealed nothing out of the ordinary (according to them). I picked up low serum calcium & phosphate.
To this day, her ‘flare’ remains a mystery. But the vitamin D & sunlight (placebo or otherwise) had the biggest impact on her improvement.
Jamie Scott – Nutritionist
Jamie,
I’m from New Zealand, living in the UK at present. I had my Vit D level tested in New Zealand earlier this year, I went and saw a practitioner at a local Health Shop and she wrote the request for the blood test which I took to a local laboratory. It took about 3 days and cost around $45.00.
Maybe your friend could try this.
Kristine
The skin makes vitamin D via a process initiaited by utra voliet light: it can come from Sunlight, or from a sunbed or indeed from certain types of lamps (I believe). Glass blocks out the ultra violet conponent of sunlight, hence the reason you cannot normally produced vitamin D indoors, or in a car of train for that matter.
Wow – I really hope your friend heals for the long term. I have been reading a lot of studies on Vitamin D and how incredible they are and really, how vital! I know for sure I need to take them. I get some aches and pains (minor stuff) and use my Topricin natural pain cream for it. Again – hoping your friends stays well.
Dr. Briffa,
A neighbor of mine recently purchased a sunbed that was recommended by the Votamin D council, and he has graciously allowed me the chance to use it during the Winter time to help keep my vitamin D levels up over those months.
After receiving regular midday exposure (approximately 15 minutes or so) throughout the late Spring, Summer, and a fair portion of the Fall, I have since begun using it 3 times a week for 6 minutes per session (it is a stand-up/wall-mounted model, so I expose each side for 3 minutes), for a total of 18 minutes per week (the unit apparently gives off roughly 90 percent UVA and 10 percent UVB along with visible red light in the 633nm range).
Obviously tests are needed to confirm D levels, but do you feel this is a safe and reasonable way to help keep D levels up? (my mutli-vitamin also has 500 IU cholecalciferol, and I also have wild Alaskan Salmon once or twice a week as funds permit)
And if it is a sensible way to keep D levels up, should I be mindful not to wash large portions of my body in the shower after exposure to the rays, in order to prevent interfering with systemic absorption?
Pilot study of the effect of ultraviolet light on pain and mood in fibromyalgia syndrome During the initial 2 weeks when subjects received both UV and non-UV exposures, the 11-point Likert scale pain score decreased 0.44 points after exposure to UV from pre-exposure levels
Additionally, UV exposure resulted in greater positive affect, well-being, relaxation, and reduced pain levels when compared to non-UV (control) exposure(
I would sure be interested in research that looked at specific frequencies of light with this question. Many modern lights are not only a partial-spectrum, but literally remove whole color-blocks from the spectrum (such as yellow) to make the light ‘brighter’. After having a serious suicidal-level depression radically changed by several days of a ‘full-spectrum’ bulb a friend sent me when I lived in Seattle years ago, my willingness to consider the effect that light has on eyes, skin, etc. has increased greatly.
@ Jack
The UV Guide offers a detailed explanation of the way UVB generates vitamin D in our skin.
From this you can see that this occurs UNDER the skin surface. Therefore most of the vitamin d made will remain inside your body.
But Vitamin d is fat soluble and sweat (from running or vigorous outdoor activity) contains some oil, so it is potentially possible some vitamin d to be brought to the surface and may be removed by washing/towelling.
However your body’s response to UVB either from UVB lamps or from sunlight is unique to you. There is no way anyone can predict your vitamin D status from your UVB exposure or degree of tanning.
This paper details instances of
Low vitamin D status despite abundant sun exposure.
That is why whatever method you use it’s worth having regular
Grassrootshealth D Action twice yearly checks
Would love to have a link to the site that sells 5000 iu gelcaps cheapish, my ones are only 500iu. thanks…
I find Iherb are pretty good$5 discount code WAB666.
Keep order value BELOW £18 or you end up paying import duty +Post Office extortion fee £8 to collect the £3 tax.
Women taking 400 IU/day, as exists in prenatal vitamins, had double the pregnancy complications of the women taking 4,000 IU/day. If you click that link you will see that even at latitude 32 where Hollis conduct that research 4000iu/d was insufficient to ensure babies were born vitamin D replete. Certainly in the UK 5000iu is the level to start at. Check with a 25(OH)D test after 8~12 weeks though to see if it’s sufficient to keep you above 55ng/ml 137.5nmol/l.
Vitamin D and Multiple Sclerosis reported in Observer Newspaper 6th Dec 2009.
Has your friend tried LLLT (low level light therapy)? Perhaps it’s too old an injury to be treated by this method of infrared light, but it could be worth a try? LLLT is acclaimed to speed up tissue healing and reduce pain. There have been many positive trials and much information is available on it’s success.
http://www.KosherVitaminShop.co.uk sell a great Maxi Health 5000iu Vitamin D