Veg Mastery Program: Q&A 11 With Michael Klaper, MD. Topic: Vitamin D. Copyright 2011 by The Vegetarian Health Institute Trevor: Hi, this is Trevor Justice. After listening to this Q&A call, please review it. You’ll find a review box at the bottom of this page. Or, if you’re listening on your iPod or MP3 player, just return to the page you downloaded the recording from. Feel free to critique the advice, the audio quality or anything else. To keep improving our content, we will redo any Q&A call that doesn’t get excellent reviews. If you want transcripts of all fifty Q&A calls, please visit www.veghealth.com/transcripts . Today’s topic is Vitamin D and today’s guest expert is Dr. Michael Klaper. How are you doing, Dr. Klaper? Dr. Klaper: I’m fine, Trevor. Good to be with you again. This should be an interesting discussion. It’s an important vitamin. Trevor: Yeah. I got that from the lesson you wrote, which was really good. Would you like to take five minutes and do a recap on the key points? Dr. Klaper: Medicine has changed so much. I’ve been a physician for thirty-seven years. When I graduated in 1972, Vitamin D was very simple to understand. Vitamin D is responsible for allowing us to absorb calcium through the intestinal wall and into our bloodstreams. That’s what Vitamin D did and that’s all we needed to know. It was called the sunshine vitamin. When sunlight falls on substances in our skin, it can create Vitamin D. That was about all we needed to know about where it came from. Well, like so many other things in medicine, the story is much more complex. As technology improved we began to see that Vitamin D is a major player in many important reactions in the body and many organ systems. It turns out that there are receptors for Vitamin D in most of the important organs in the body. There are Vitamin D receptors in the brain, bones, heart, genitals, prostate gland and white blood cells. Vitamin D plays major roles in the immune system, preventing cancer growth, repairing tissues, and signaling cells to each other. Vitamin D is a multi-faceted vitamin. Our original viewpoint was very simplistic. Today, our understanding of Vitamin D is greater, as well as our need for it. Because we spend all day indoors as a society, 400 international units just isn't enough for everyone's daily requirements. The majority of people have low levels of Vitamin D. Trevor: Let me interject right there. When you say the majority of people, are you talking about vegetarians and meat eaters alike? Dr. Klaper: Both. Surprisingly, shockingly and sadly. Again, our ancient ancestors out in the African plains spent all day naked out in the sunshine. I’m sure they had no problem making enough Vitamin D. 1 Then again, I’m sure their skin was cracked and dried from sun damage by the age of forty. Of course, that wouldn't matter much since most of them were eaten by lions by the age of fifty. For those of us living into our seventies and eighties, if we want to be free of melanoma and skin damage, we can't use skin as the sole organ of Vitamin D production. Besides, we're indoors with clothing on, so we don't get much sun anyway. There’s a general deficiency of Vitamin D throughout the population. This may be a contributing factor for everything we're seeing arise today. Osteoporosis, immune problems, increased fracture rates, and increased cancer rates may all be in part due to lack of Vitamin D. Vitamin D turns out to be a very important molecule. I’ve learned to be very aggressive in making sure I get enough Vitamin D every day. If I’m not out in the sunshine that day then I take 1000 units of it orally. I’ll be having my Vitamin D level checked soon. It’s going to be higher than it was before, which was quite low. Trevor: That’s good. I used to hang out with a lot of raw food folks who are very into natural hygiene. They try to get their nutrients from nature in full form – whether it’s in food or sunshine – rather than from supplements. My question is: If someone wants to get Vitamin D from the sun, but they’re north of Atlanta, Georgia in terms of latitude – Is that a possibility? Can twenty minutes out in the sun with no sunscreen daily be enough? Dr. Klaper: Unfortunately, the answer seems to be no, for a number of reasons. The key factor you mentioned is that they are north of the latitude of Atlanta, Georgia. At that angle, the sun’s rays simply do not come in with enough power to generate sufficient Vitamin D in the skin. There are any number of factors that can lower a person's ability to get Vitamin D from the sun. Air pollution and sunscreen are two common issues. Also, darker skin is not only more resistant to sun burning, but also to Vitamin D absorption. We find Vitamin D deficiencies in greater numbers the further north one goes in latitude. So alas that twenty minutes out in the sunshine that we used to dispense as advice really isn’t useful for people in northern latitudes. Trevor: I'm glad you were able to tell us that. A question has come in from Ronald. He says: “Does it really matter if a supplement is Vitamin D2 or D3?” The lesson says that Vitamin D3 could come from sheep’s wool or fish oil. I've also learned that it can come from pig's skin or cow's skin. There’s really no way to know what the source is of Vitamin D3. Dr. Klaper: Well, that is correct in what you said. If it is Vitamin D3 cholecalciferol then it is coming from an animal source. These days there is no telling what that animal source really is. 2 Ergocalciferol comes from plants, also known as Vitamin D2. Ergo as in energy. Trevor: If you’re looking on a container of Tropicana orange juice or breakfast cereal, it won't say “ergocalciferol” or “cholecalciferol” on it. It will say Vitamin D2 or D3. Dr. Klaper: Right. Vitamin D2 is plant-derived. There has been a general assumption that plant-derived Vitamin D2 wasn't as potent as Vitamin D3, but now Dr. Hollak and other researchers say they’re absolutely equivalent. Vitamin D supplements are very low toxic vitamins so I don’t have a problem using an abundant amount of either of them. If I’m going to prescribe Vitamin D2 or D3 for someone with a low blood test number, I usually prescribe 2000 international units of either D2 or D3 and they both will do the trick after a week or three. Both D2 and D3 bring the levels up. There’s no real danger of overdose at 2000 units of Vitamin D. If a person comes back with a low number – below 30 – on their blood test, they should take 2000 units of Vitamin D2 for about a month and then drop it down to 1000 units daily for another couple of months. Then they should have their levels rechecked. Trevor: I’m imagining that almost anyone listening is thinking, “I don’t want to buy any foods that are fortified with Vitamin D3 since there’s a chance it could be coming from the skin or cows or pigs.” I want to mention that I took a trip to my local grocery store to see which foods were fortified with Vitamin D3. Dannon and Yoplait yogurts are fortified with Vitamin D3, and the milk which says “Vitamin D” on it, contains Vitamin D3. Tropicana fortified orange juice has D3. Cheerios, Kix and Total cereals had Vitamin D3 as well. I also checked some soy milks, rice milks, almond milks and oat milks, all of which had Vitamin D2, the plant-based Vitamin D. If you’re buying any kind of packaged food that says it’s fortified, and you want to see whether it's Vitamin D2 or D3, check the ingredients. Dr. Klaper: Good advice. Well said. Trevor: Let me ask you a question about Vitamin D2, which is plant-based. The lesson says mushrooms, algae and a few other plants make the ergosterol. Dr. Klaper: Ergosterol, yes. Trevor: Ergosterol becomes the Vitamin D2 when irradiated by the sun’s rays. Does this mean that if someone eats specific types of mushrooms or algae that they could get D2 directly from that food source? Dr. Klaper: That’s a very important question. It would be nice if that were the case. The algae and the mushrooms make the substance ergosterol. In order to turn that into Vitamin D2, you’ve got to really blast it with ultraviolet light. 3 This is done in a production plant. They really amp up the voltage on the ultraviolet rays to produce Vitamin D in industrial amounts. That’s how it’s done. If you were to eat these mushrooms and algae, you’ll get just the tiniest traces of Vitamin D2 that’s been produced naturally. Alas, just eating the mushrooms is not going to give you anywhere 1000 i.u. of Vitamin D every day. Trevor: Well, then that brings me to the next question.