#314: All About Vitamin D [Supplements Series with Dr. Viegas]

Michelle:
Hello health coaches. Welcome to our supplements expert series. So far we've covered probiotics and then multivitamins, and today we're going to learn all about vitamin D with Dr. Viegas from Full Script. Now this episode is sponsored by Practice Better, the practice management software. I've used myself and always recommend for health coaches because it is literally built for practitioners like us. Practice better handles everything from billing, scheduling, seamless communication with clients, and get this, it actually integrates with fullscript so that you can share supplement options with your clients very, very easily. Sign up for a free trial and you can save 30% off your first three months. A very exclusive discount just for my listeners when you go to healthcoachpower.com/pb. Dr. Viegas, welcome back. I'm so glad you're here. Can you yourself introduce yourself real quick and then we'll talk vitamin D?
Dr. Viegas:
Sure, Michelle, thanks again for having me. So I'm Dr. Eric Viegas. I'm a naturopathic doctor in Ottawa, Canada and I'm a medical product manager at fullscript. Very much versed in supplement quality and my day-to-day is really spent educating healthcare providers on various supplements and quality concerns. Prior to my role at fullscript, I worked for some of the larger supplement companies in Canada in their education department.
Michelle:
We're so glad that you're here. And you mentioned Fullscript and I already mentioned Fullscript, so I'm just going to say real quick that fullscript is a platform where practitioners can earn passive income and save up to 35% on your own supplements. By the way, not just for your clients, but for you too. I know you guys are taking supplements and they've got all your favorite brands. They have over 350 brands. Actually it's completely free to use, so go get more information about that at healthcoachpower.com/fullscript info. I've got a whole writeup for you there. We're going to put a link to that in the show notes by the way. So Dr. Viegas, today we're doing vitamin D. I think that most health coaches probably have heard that vitamin D deficiency is common, especially if you're in North America like we are. That might be about all we know though, and that maybe we should get a little bit more sun exposure to help with vitamin D production. I don't know. Tell us about vitamin D supplementation and why it's important for health.
Dr. Viegas:
Yeah, great question. So vitamin D is a fat soluble, cholesterol based vitamin that helps the body absorb calcium, which can support bone health and it also plays very important roles in immune mood and inflammation support.
Michelle:
I know once it gets to be cold and flu season, my kids are getting vitamin D four. Sure. But to be honest, I never know how much it seems like everybody needs so much. How do we know if we need it and how do we know if that's too much?
Dr. Viegas:
Yeah, great question again. So I would say it is a case to case basis and vitamin D deficiency can actually be identified through a blood test called 25 hydroxy vitamin D, which your clients can typically get through a healthcare provider. They just write up a requisition, they go to the lab, it's a simple blood test, not very cost prohibitive, and they get the results fairly quickly. But if you're looking at symptoms, common symptoms of deficiency include fatigue, bone pain, muscle weakness, and a higher susceptibility to infections. To your point earlier, if your clients have limited sun exposure like me here in Canada or darker skin also like me, they might be at a higher risk for deficiency.
Michelle:
I hear you. It is a cloudy day here in New York. There's no vitamin D production going on at all, so I'm glad I got some of this in my cabinet and that's good to know. There's the test that can tell us where we stand in terms of our vitamin D levels. If we were to take too much because we are overcompensating for that cloudy day, what kind of risks happen if we're taking too much Vitamin D?
Dr. Viegas:
Great question. I would say taking too much vitamin D can lead to toxicity since it's a fat-soluble vitamin like vitamins A, E and K. And typically it could cause high calcium levels, nausea, weakness, and in extreme cases kidney and liver damage. So health coaches should advise clients to stick to recommended dosages and of course encourage them to get their blood levels monitored at least twice a year.
Michelle:
Right, and I think this is an easy one that if you're going in for your physical, have 'EM test your vitamin D levels, most doctors are going to run that for you pretty standards. So that shouldn't be a fight unlike some other things you might ask them to do. So at least get that one Ron and we'll all be on the same page. Good. We want to avoid those risks for sure. Now, I asked you this about probiotics. I asked you this about multivitamins. I'm going to ask you again about vitamin D. What should we be looking for? I know vitamin D comes in different forms just for starters.
Dr. Viegas:
Yes. So vitamin D does come in different forms. Typically you'll see vitamin D three or D two, but prior to actually looking at that, you want to ensure the product is third party tested for contaminants and third party tested for potency, meaning that the dosage on the label matches what's in the bottle. Additionally to that you can look for third party certification of current good manufacturing practices that just ensures that the product is being produced in a facility that's clean. They're taking the necessary safety precautions for their staff, they're training them well, they're also dealing with pests and additionally they're storing products correctly. I typically will recommend vitamin D three also known as Clac Calciferol, which is more effective at raising and maintaining vitamin D levels compared to vitamin D two, also known as ergocalciferol. So D three interestingly is derived from lanolin a sustainable raw material source produced from the shearing of sheep's wool. Would you like me to just go through that process of how it's derived?
Michelle:
Yeah, that's very interesting. When you said lanolin, I thought skin lotion.
Dr. Viegas:
Yeah, yeah, very similar. So it's produced from the shearing of sheep's wool, so that's how the process begins. Lanolin is extracted from the wool through a process called scouring, which involves washing the wool with hot water and detergent to remove the lanolin. After that, the raw lanolin is then purified, resulting in a high purity lanin suitable for further processing. Now just like vitamin D lanin contains cholesterol, which is chemically converted into seven D hydro cholesterol. This is actually the same compound found in human skin that is converted to vitamin D three upon exposure to sunlight. So that's the next step. Seven D hydro cholesterol is then exposed to UVB light in a controlled environment which converts it into Previtt D three and then that previtt D three undergoes thermal isomerization where it's converted into Clic, Calif for all or D three. And then the final step is really just making sure that that vitamin D three is purified and processed into a form suitable for use in dietary supplements. Something else to highlight here with a lot of supplements available on the market, you can personalize that supplement for your client so you can actually recommend products that are liquids, capsules, tablets, chewables, and even gummies to find optimal adherence for your clients.
Michelle:
Well, it's great to be able to give them options and we always want to allow our clients to make a decision for themselves, talk to their doctor, but they might not even know that those options are available. So that's a nice way to be useful as they go about this process. When you're saying that, I was thinking I almost always I think have seen or taken a vitamin D supplement that came in a capsule and there's usually an oil as an ingredient in there to help with absorption. Is that enough though? If I got an empty stomach and I'm popping this thing, it's got that little bit of oil, should I really be having the vitamin D supplement with a meal with something else that's fat in it?
Dr. Viegas:
Yeah, great question. I would say yeah, to be on the safe side, make sure that you take your fat-soluble vitamins, a de and K with a fat containing meal.
Michelle:
See, I like to take 'em first thing in the morning. Now I got to think about that. But no, that's good advice. All right, so we're looking for D three. Is there anything else that we should be looking for on the label? I mean with that in mind, what kind of oil would be in that supplement? Just a question mark in my head, I don't even know which ones they usually use. And typically if you were talking about Lanin, I was just thinking does that mean vegans are not going to want to take vitamin D supplements if they come from wool?
Dr. Viegas:
Great question. There are vegan vitamin D supplements available on the market that are derived from plants. Typically lichen I believe is a type of moss that it's derived from and it's actually I believe vitamin D three. So there are vegan vegetarian alternatives to that.
Michelle:
Perfect.
Dr. Viegas:
And sorry, what was your question before that?
Michelle:
Yes, sorry, I put three questions in one. I was just thinking what else should we look for on the supplement label? What kind of oil is being used or is there anything else that we should be looking for?
Dr. Viegas:
Yeah, of course. Make sure that the dosage is in line with the optimal dose for your client. Look for basically those excipient ingredients or those inactive ingredients. Make sure that it doesn't contain anything like artificial colors, artificial sweeteners, artificial flavors, preservatives. Typically the oil that I've seen in the emulsified liquid vitamin Ds are olive oil. I'm not sure if I've seen anything else though. There might be some products that contain like MCT oil as well, but I haven't seen any other types of oils beyond that.
Michelle:
Just something to look into for those of us that are concerned about the various oils that we're consuming. Oh, so much to think about.
Dr. Viegas:
Yeah.
Michelle:
Now I know we mentioned earlier, briefly we're here in North America, you mentioned depending how dark your skin is, all these things can lead you to not be able to have enough vitamin D inside your system to begin with. What other factors play into our vitamin D needs?
Dr. Viegas:
You covered most of it, so people with darker skin, older adults and those living in northern latitudes may require vitamin D supplementation. To your point, again, it's cloudy here as well, and reduce sunlight exposure will affect that. Also, decreased ability to synthesize vitamin D from the sun in certain populations, like those that are again, darker skin, older adults and supplements can really help to fill that gap.
Michelle:
When you say older adults, now I'm just about to turn 45, would I be fitting into that category of the more mature individual who might need vitamin D? Are you talking even older than that?
Dr. Viegas:
I would generally say usually 60 plus, but again, it's down to a case by case basis. So if you are taking a vitamin D supplement and you feel like I don't really feel like it's having an effect, best course of action there, get your blood levels tested and see, and it might warrant kind of switching products because maybe that specific product doesn't meet your needs for absorption's sake.
Michelle:
Well that's a good point. Alright. They're all a little bit different, aren't they?
Dr. Viegas:
Absolutely, yeah.
Michelle:
Okay, so if we're taking a bunch of other stuff like our probiotics that we talked about in the first episode or multivitamin or taking calcium or whatever, what do we need to know about vitamin D combining with other nutrients?
Dr. Viegas:
Yeah, great question. Typically what comes up when I speak with providers are calcium and magnesium with respect to vitamin D supplementation, excuse me. So vitamin D actually works in tandem with calcium to support bone health and magnesium helps your body utilize vitamin D. So interestingly, magnesium's a co-factor, meaning that it helps with the enzymatic reactions that convert vitamin D into its active form. So this actually requires hydroxylation. So magnesium is needed for both the 25 hydroxylation in the liver and the one alpha hydroxylation in the kidneys, which transform vitamin D into its active form, which is known as Calcitriol, but it also goes by the name of 1 25 dye hydroxy vitamin D. I apologize for all of this nomenclature that I'm kind of throwing at you right now.
Michelle:
Oh, we love it. Keep it common.
Dr. Viegas:
Essentially supplementing with magnesium has been found to enhance the effectiveness of vitamin D supplementation, suggesting that adequate magnesium levels are crucial for maintaining optimal vitamin D status. Now vitamin D is essential for the absorption of calcium and the intestines as well, and by supplementing with both nutrients, vitamin D can actually enhance calcium absorption, which is especially beneficial for people with low calcium intake or at risk of bone loss. So here you can think post-menopausal women, elderly people, and I would advise caution here though, since excess calcium can actually compete with other essential minerals such as magnesium and zinc potentially causing imbalances, and some studies actually suggest that high calcium supplementation, particularly without balancing vitamin D levels, might actually increase the risk of certain health issues like cardiovascular disease. So I think it's important that health coaches that are listening to this episode should explain how these nutrients interact and emphasize a balanced approach that includes adequate intake of all three.
Michelle:
That's a great tip. I mean we have heard, I think for many years, like take more calcium, take more calcium osteoporosis, especially as we get a little bit older, we start to think about these things and our clients could be out there just purchasing various calcium supplements. What about those, I don't know those chocolates that have calcium in them. You got orange juice on the market that's got calcium added to it. I mean a lot of it I think is just marketing bs, but point is worth having that conversation about there could be too much calcium going on and not the right balance.
Dr. Viegas:
Yes, and to your point, for things like chocolates and drinks, make sure that there's not too much sugar in those supplements because you don't want it to be taking more sugar than the actual nutrient though. That being said, also take a look at the form of calcium that might be in there. There are poorer absorbed forms, but something like a calcium citrate might be a good form to look for.
Michelle:
Well, there we go. By the end of these three episodes, I now know exactly which nutrients we have to talk about next time, magnesium, iron, and calcium. So guys, keep listening because chances are we'll be back with those. But for today, thank you so much for helping us better understand vitamin D. And for all of our listeners, go to healthcoachpower.com/fullscript info for more information about fullscript and once you're on the platform, which you can set up a free count, right? Once you're in there, they have tons of educational materials. If you like learning about supplements, that's a great place to go. Not to mention you can save up to 35% on everything you purchase for yourself. You can pass that along to your clients, et cetera. They really all always have the best prices. I'll compare prices on different stores and platforms and fullscript always comes out as the best.
I don't know how they do it. That's going to do it for our supplement expert series, at least for now. If you miss the first two, go back in the archive. Take a listen. We've covered probiotics and multivitamins. This episode has been brought to you by Practice Better, a powerful client management tool for health coaches that integrates seamlessly with fullscript. I used Practice Better with my own clients and still to this day am earning passive income from their recurring supplement purchases. It is super, super easy for you and your clients because of that practice. Better integration, you're going to have billing and scheduling and everything all handled in one place so you can get your free Practice Better trial and save 30% off your first three months at healthcoachpower.com/pb. We'll put that link in the show notes. Of course. Thank you for joining us.