In this episode, Dr. Lisa and Dr. Toni are back together again, discussing: how to test for vitamin D; what an optimal level is; how to enhance absorption, and all the health benefits it has on the body and mind. Vitamin D isn’t just needed for bone health; could low vitamin D be the cause of your aches, pains and low mood?

Vitamin D deficiency is still underdiagnosed, under prevented and under treated in between 60-90% of the worldwide population. In Canada 59% of population are vitamin D deficient (below 75 nmol/L). 

Vitamin D is a fat soluble vitamin and is best absorbed as a supplement when taken with food. 

What increases your risk of experiencing vitamin D deficiency?

  • Dark skin
  • Obesity
  • Older age
  • Malabsorption
  • Inflammatory Bowel Disease (due to malabsorption and inflammation)
  • Sunlight overprotection and/or deprivation
  • Chronic use of prednisone and other anti-inflammatory steroid derivatives, anticonvulsant medications (due to upregulation of liver detoxification, promoting excretion of vitamin D and metabolites)

Why should you care about vitamin D?

Vitamin D plays many roles in the body! It’s not just for bone density, which can decrease as estrogen decreases in perimenopause and menopause.

Vitamin D is known as a pro-hormone synthesized in the skin and activated in the liver and kidneys. Cholesterol is its precursor.

Why do you need vitamin D in your body?

  • Reduces cellular growth
  • Improves cell differentiation
  • Regulates and controls genes
  • Reduces inflammation, risk of cancer, autoimmunity
  • Reduces muscle aches/pain, fibromyalgia
  • Improves mood (and energy)
  • Enhances bone health

“The most common manifestations of vitamin D deficiency in adults is:



Chronic Pain”

  • Alex Vasquez (vitamin D monograph available at

Low vitamin D status or deficiency can manifest as:

  • Bone and muscle pain 
  • Fatigue
  • Depression
  • Infections/dysbiosis
  • Frequent falls and cognitive impairment
  • Statin intolerance and myalgia
  • Preterm birth 

How does vitamin D support your vagina?

Research shows that vitamin D supports the proliferation of vaginal epithelium in postmenopausal vaginal atrophy. After using a suppository with 1000IU vitamin D over 8 weeks, vaginal pH decreased, while vaginal dryness and pain significantly reduced.

You can think about your skin and mucous membranes (including epithelial cells and immune cells) are like bricks in a wall, with tight junction proteins acting like mortar and weather proofing or waterproofing provided by antimicrobial peptides, as well as lysozyme and secretory IgA, on surfaces. 

Mucous membranes are present in your mouth, digestive tract, genitourinary tract and respiratory tract. Strengthening your exterior barrier defenses prevents infection.

Research shows that people with low vitamin D levels are 27-55% more likely to get an upper respiratory tract infection. Higher doses of vitamin D are more protective, improves lung function and decreases inflammation. 

Synergistic nutrients for vitamin D include:

  • Magnesium – cofactor in the synthesis of vitamin D from both exposure to sunlight and dietary sources
  • Vitamin K2 supports getting calcium into bones and teeth

Vitamin D3 (cholecalciferol) produced in skin and consumed in diet, preferred form for supplementation.

Food sources provide low amounts: fatty wild fish like mackerel, herring, sardines, trout, salmon, cod liver oil, egg yolk, milk, soy milk, fortified foods, beef liver, cheese

Vitamin D2 (ergocalciferol) produced by irradiating fungi and mushrooms, less efficient precursor to biologically active 1, 25 dihydroxyvitamin D (calcitriol), also potentially less effective and more toxic. 

Some examples of research using cod liver oil as a source of vitamin D:

  • study with 10 patients with multiple sclerosis over 2 years, daily supplementation of 1000mg calcium, 600mg magnesium and 5000IU vitamin D (from 20g cod liver oil) reduced number of exacerbations with an absence of adverse effects
  • studies with cod liver oil showed significant reductions of type 1 diabetes, while a study of more than 10,000 infants (less than 1 year of age) and children with 2000IU of vitamin D daily reduced incidence of type 1 diabetes by almost 80%

How do you know if you’re getting enough vitamin D?

Get your blood tested!

Reference ranges for serum 25 (OH) vitamin D3 in adults can vary:


Deficiency: <20 ng/ml (50 nmol/L) 

Insufficiency: 20-40 ng/ml (50-100 nmol/L)

Proposed optimal: 40-65 ng/ml (100-160 nmol/L)

Excess: >80 ng/ml (200 nmol/L)

Proposed updated ranges:

Depletion: <20 ng/ml (50 nmol/L) 

Insufficiency: <32 ng/ml (80 nmol/L) 

Marginal sufficiency: 30-40 ng/ml (75-100 nmol/L)

Sufficiency: 40-50 ng/ml (100-125 nmol/L) 

Proposed optimal physiologic range: 50-90 ng/ml (125-225 nmol/L) – based on levels found in pregnant rural Africans, lifeguards in USA/Isreal, farmers in Puerto Rico

Supraphysiologic: >100 ng/ml (250 nmol/L)

Potentially toxic: >150 ng/ml (325 nmol/L)

Pharmacologic dosing: 200-300 ng/ml (500-750 nmol/L)

What else is vitamin D good for?

Blood Sugar Balance:

  • Low vitamin D associated with insulin resistance and beta cell dysfunction in diabetics and young adults who are apparently healthy
  • Healthy adults with higher vitamin D levels had better insulin sensitivity than those who were vitamin D deficient
  • HIgher vitamin D status related to 60% improvement in insulin sensitivity (vs. 13% by metformin)

Cardiovascular Disease:

-risk of heart attack twice as high for those with vitamin D less than 34 ng/ml (85 nmol/L) than for those with vitamin D status above this level

– patients with congestive heart failure recently found to have markedly lower levels of vitamin D than controls

-vitamin D deficiency as a cause of heart failure has been documented in numerous case reports


It has been demonstrated that blood pressure is higher in the winter than the summer, increase at greater distances from the equator and is affected by skin pigmentation – all consistent with a role of vitamin D in regulating blood pressure

  • When treated with UV light 3x/week for 6 weeks, patients with hypertension increased vitamin D levels by 162% and blood pressure fell significantly
  • 800IU of vitamin D3 for 8 weeks lowered both blood pressure and heart rate


Vitamin D is known to have antidepressant effects by impacting neurotransmitter and neurologic function, as well as inflammation

Seasonal affective disorder (SAD) – for more info, see Episode ?

-recently, a dose of 100,000IU of vitamin D was found superior to light therapy in the treatment of SAD after one month

Polycystic Ovarian Syndrome (PCOS): 

-condition characterized by polycystic ovaries, irregular menstrual cycles, increased hair growth, insulin resistance and obesity – for more info, see Episode ?

-study of 13 women with PCOS showed vitamin D deficiency was highly prevalent and supplementation with 1500mg calcium daily and 50,000IU vitamin D2 weekly normalized menstruation and/or fertility in 9 women with PCOS-related menstrual irregularities within 3 months of treatment

Cancer Prevention and Treatment:

-vitamin D has anti-cancer effects mediated by anti-proliferative and pro-apoptosis mechanisms

-researcher Grant proposed that adequate exposure to UV light and/or supplementation of vitamin D could save more than 23,000 American lives per year from a reduction in cancer mortality alone

-more research needed at higher levels and longer durations

New research shows that physiologic requirement of vitamin D supplementation is 3000-5000IU/day and blood levels plateau only after 3-4 months of daily supplementation. 

Dr. Toni’s next HypnoBirthing monthly info session for expecting parents looking to trust their instincts and their body during labour and birth. Join her at

Dr. Lisa’s Wild Collective begins again in 2022. You can get on the waitlist at

Today’s Mama Must Have:

Dr. Lisa is a big fan of board games for lots of family fun, including Despicable Me Minion Game of Life, Mousetrap and Don’t Make Me Laugh. 

Dr. Toni loves her emulsified vitamin D drops by NFH plus vitamin D/K for the whole family.

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Stay safe and healthy everyone!

Disclaimer: The information provided in this presentation is not meant to replace treatment with a licensed health care practitioner. It is for informational purposes only. Consult with a Naturopathic Doctor or other licensed health care professional to determine which treatments are safe for you.