Vitamin D Hormone

Vitamin D and Neurologic Disorders

If you have a neurologic problem that is severe enough to see a neurologist, you
are probably not healing your body as perfectly as you once did. Most people who
are suffering from neurologic problems such as headache, chronic pain, tremor,
balance difculties, dizziness, depression, stroke, or memory loss also have
abnormal sleep. Fixing the sleep can often fix the neurologic problem.
Why Vitamin D?

In 2005 one of my patients with daily headache requested a sleep study because
she thought she had sleep apnea. Surprisingly, her headaches went away after a
few weeks of using a sleep apnea mask. Because it worked so well for her, I
started to perform sleep studies on all of my headache patients, and realized that
they all had abnormal sleep studies. Then I began to do sleep studies on my
patients with other neurologic problems such as seizures, back pain, dizziness,
stroke or balance problems, and most of them also had abnormal sleep studies,
sometimes without being aware that their sleep was abnormal. After prescribing
sleep medications and sleep apnea masks for several years, I accidentally
discovered that most of my patients had abnormal sleep because they were
vitamin D deficient. If fixing that deficiency might help them sleep normally Id
like to do that first before relying on sleeping pills, or having to wear a sleep
apnea mask at night.
Vitamin D is not a vitamin:

Weve been taught that Vitamin D is the bone vitamin, but it is really more of a
sun hormone. The word vitamin means something my body needs that I cant
make, so I must get it from the food. D hormone is instead, a chemical that we
make on our skin from sun exposure. It is a hormone like thyroid, estrogen or
testosterone. Using the proper word hormone reminds us that it affects multiple
parts of the body and that it is not extra. It is essential to every cell in the body
and it is not in the food. It is supplemented in milk but as a cup of milk has only
100 IU of vitamin D you would have to drink 100 cups of milk a day to keep from
being D deficient.
Why would we make a hormone from sun exposure?

D hormone is unique among our hormones because we make it on our skin from
a specific wavelength of light, UVB. Our planet is tilted so as we go north or south
from the equator there are seasons. In the summer we are closer to the sun, in

the winter, farther from the sun. Where there are seasons every living thing has
to deal with 6 months of good weather and available food, and six months of
terrible cold and no food. The farther we move away from the equator the less
UVB wavelength there is in the winter light so our D hormone fluctuates with the
seasons; it goes higher in the summer and lower in the winter. Any animal that
can devise a way to eat more and get strong in summer, and eat less and sleep
more in the winter, will have a better chance of survival. Every animal on this
planet; mammals, reptiles, birds, fish and insects use this same chemical, D3
(cholecalciferol), made on their skin from UVB light, to do just that.
D hormone affects our weight and appetite:

In the summer as we have more sun exposure our D hormone level climbs to 80
ng/ ml, we eat more calories, and store less. The high D message is its summer
its time to build our strength. We use our calories to build stronger bodies. We
sleep fewer hours, but more efciently, with a higher percentage of the total
sleep spent in deeper stages of sleep. In the winter there is no UVB light so we
use the vitamin D we made and stored in summer. As it gets used up the blood
level falls. The low D message is; sleep longer, store fat for spring. Our metabolic
rate goes down (we hibernate). As the D level falls the thyroid hormone goes
down, we survive the winter by sleeping more hours and using less energy. The
lower D level appears to affect the populations of bacteria in our intestine. Who
lives in our intestine appears to affect not only our appetite, but also what we do
with the calories we eat. Do we store them as fat or put them into muscle? ( See
The Economist magazine August 18, 2012 The human microbiome: Me myself,
us for a good explanation of how our colonic biome affects our weight.)
Low D goofs up sleep.

Most of the neurological problems my patients have are not directly related to D
hormone, they are related to the fact that D hormone deficiency causes sleep
disorders; insomnia, sleep apnea, REM related apnea, unexplained awakenings to
light sleep, inappropriate body movements during sleep. All of these disorders
keep us from healing our bodies during sleep. When the sleep improves the
headaches, seizures, tremor, back pain, balance difculties, depression, memory
loss, etc. all get better. (See the sleep handout for more detail about why.)
What does D hormone deficiency look like?

D hormone affects the entire GI tract. There are D receptors in our salivary
glands, our teeth, our esophageal sphincter, and the stomach cells that make
acid. When the stomach sphincter is weak the acid moves up into the esophagus,
where it doesnt belong, causing acid reflux. The D we make on our skin goes to
the liver, then into the bile, it keeps the bile acids dissolved, preventing gall

stones from forming. Because there are D receptors in the islet cells of the
pancreas that make insulin, not enough D may contribute to the development of
diabetes. Low vitamin D levels are related to poor stomach emptying as well as
bloating and constipation or irritable bowel. The irritable bowel may result from
losing our happy, helpful bacteria in our lower GI tract. They die off when we
dont supply the vitamin D the bacteria also need to survive. Because those same
colonic bacteria supply 7/8 of the B vitamins we need on a daily basis, some of
my patients have vitamin D deficiency and secondary B vitamin deficiencies. (At
least 2 of the B vitamins, B5 and B12, are needed to sleep normally) So there are
secondary B vitamin deficiencies that may also have to be corrected before the
sleep will return to normal.
Poor sleep causes hypertension, heart disease and stroke:

Fifteen years ago the sleep disorders experts began to report that every
American with high blood pressure had a sleep disorder in the background.
Therefore the real killer in America is not the long term effects of hypertension,
but the long term effects of abnormal, non-restorative sleep. Vitamin D appears
to affect our sleep cycles through D receptors in the lowest part of the brain
called the brainstem, where we control the timing and paralysis of sleep. Sleep
occurs every night to allow us to heal and make repairs. It is during sleep that we
make the chemicals that keep our blood pressure normal during the following
day. While we sleep our arteries repair and stay smooth so they dont have the
cholesterol build up that closes off the vessels leading to heart attack and stroke.
The pacemaker cells in the heart heal so we dont get atrial fibrillation that can
lead to strokes.
Poor sleep causes memory problems and depression:

While we sleep we make permanent memories. During sleep we also make the
serotonin that we use during the day to stay happy and curious, so low D
hormone can cause depression and memory problems.
Low D affects all the blood cells and can cause anemia, autoimmune disease and
cancer:

There are D hormone receptors on the red and white blood cells. When the white
blood cells dont have enough D they get confused, they start attacking our body
by mistake. All of the autoimmune diseases: multiple sclerosis, lupus, rheumatoid
arthritis, psoriasis, and ulcerative colitis, are related to low D hormone. Our own
white blood cells travel through our bodies at night seeking out and killing cancer
cells. Thus, increases in breast, colon and prostate cancer are also believed to be
related to low D. Women with breast cancer who are told they cant take

hormones, (meaning estrogen), should still take D hormone. The right D level (in
addition to normal sleep) helps the bodys own immune system fight cancer.
D hormone, bones and calcium:

Even though most of us have been told we need extra calcium, D deficiency is
what causes osteoporosis. D helps the GI tract absorb calcium and keeps the
calcium from leaking into the urine, (so low D may also cause kidney stones by
dumping more calcium than normal into the urine). If the vitamin D level is kept
6080 calcium is properly absorbed from the diet and Fosamax, Evista, Boniva
are not needed to prevent bone loss.
Low D causes balance difculties and pain:

D deficiency can also be accompanied by leg pain, burning in the feet, and
difculty with balance, probably through secondary B deficiencies of B12, B5 or
B6. Poor sleep results in body pain on awakening; fibromyalgia, arthritis, chronic
low back pain, knee pain, hip pain. Part of the problem relates to the sleep itself:
every moving part of the body must get perfectly paralyzed to repair at night. If
paralysis does not occur correctly during sleep that part of the body doesnt heal
and morning pain can result. The second contributor could be pantothenic acid
deficiency. B 5 or pantothenic acid is a B vitamin made by the intestinal bacteria.
After it is absorbed in the colon pantothenic acid becomes Coenzyme A.
Coenzyme A is the enzyme that is responsible for making our own cortisol in the
adrenal gland. Since cortisone is what is injected by your doctor into arthritic
joints to decrease inflammation it may be that we need those shots only if we
dont make enough of our own cortisol on a daily basis. Therefore there may be
some D deficient patients who have arthritis (joint pain on awakening that gets
better as the day wears on), that is due to a combination of poor sleep and lower
than normal daily levels of cortisol production. B 5 also seems to promote good
sleep but appears in my practice to have a narrow window of effectiveness with
higher doses causing sleep disruption.
Low D causes infertility, polycystic ovary syndrome and endometriosis:

There are vitamin D receptors in the ovaries, the testicles and the fallopian tubes
to help match our reproduction to the amount of food available. As the D level
climbs in the fall, to 80 ng/ml, we make higher estrogen and testosterone levels
that make us want to mate. Because our babies develop over 9 months, the baby
that is conceived in September is born in June. This guarantees that at birth the
baby is in the sun making her own D hormone because there is no D in the breast
milk. Low D suppresses ovulation so that our babies will be born when mom has
food. Polycystic ovary describes an ovary with many eggs that are all trying to
mature at once. Because ovulation is inhibited by the low D, the ovaries are stuck

at the stage of many eggs trying to mature and cysts develop, leading to
abdominal pain, often accompanied by weight gain and acne (the triad of
symptoms called polycystic ovarian syndrome).

Endometriosis results from endometrial tissue going backward up the fallopian

tube into the abdomen instead of out the cervix, (the opening in the uterus),
during menstruation. Because the fallopian tube is open into the abdomen, the
only thing that keeps the endometrial tissue heading out the cervix are wave-like
movements in the fallopian tube pushing toward the uterus. There are vitamin D
receptors in the fallopian tubes that influence the propulsive movements,
promoting or preventing fertilization depending on the D level. Also, once the
endometrial cells have arrived in the abdomen, where they dont belong, the
white blood cells are supposed to find and kill them. Because the low D also
affects the function of the white blood cells the proper elimination of the
endometrial tissue doesnt occur and fixed implants of endometrial tissue appear
in the abdomen, causing abdominal pain during menstruation.
Women bearing babies are the ones who are most affected:

The reason why thyroid disease, gallbladder disease, B12 and iron deficiency,
obesity and sleep disorders (and therefore severe headaches) often occur in
young, healthy women is because theyre the ones having the babies. Each baby
sucks up moms vitamin D using it for development. Unfortunately, each prenatal
vitamin has only 400 IU of vitamin D, which is not nearly enough to provide for
mom and the developing baby. When we all lived outdoors mom would get
pregnant again as soon as she made enough D to sleep normally and get her
body ready for the next baby. Now, each baby uses up moms D and if shes not
out in the sun enough after delivery her D deficit is never corrected between
pregnancies. Each resulting child is more D deficient and each baby sleeps worse
than the last. Mom also sleeps badly, being more D deficient herself with each
baby. The chronic sleep disorder over several years can result in postpartum
depression and occasionally psychosis; (abnormal thoughts and hallucinations). I
believe that once the sleep is very, very abnormal, the sleep switch (which is
designed to be sure that we never dream while were awake) may start to
malfunction, and dream-like experiences (hallucinations) may start to leak into
waking life.
Some commonly used medications prevent REM sleep:

Unfortunately many of the commonly used antidepressants, though they keep

the serotonin up during the day to make us happier, also make the serotonin stay
up inappropriately at night. High serotonin levels at night suppress REM sleep,
paradoxically preventing the very phase of sleep that might give us back normal
production of our own serotonin. Long term REM deprivation is probably the most

common cause of depression. Over the last thirty years there has been a
dramatic increase in the incidence of depression, sleep disorders and vitamin D
deficiency in all of the developed countries of the world, I believe these three
conditions are linked.
Vitamin D and aging:

Even under perfect circumstances, with perfect sun exposure, we dont live
forever. Humans live about 90100 years. Every decade our vitamin D production
(per hour of sun exposure) goes down. At age 7075 the vitamin D production on
our skin goes so low that four complaints become common in the elderly; my
bowels dont work, Ive got rheumatism (I wake up stiff and in pain), I dont
sleep well, and my nose runs all the time. When the sleep starts to fail we
begin to get hypertension, diabetes, high cholesterol, heart disease, stroke or
cancer and die 510 years later. Therefore our ability to sleep normally is linked
to our life span.
What should my vitamin D level be?

How much would my body make normally out in the sun? When we sit in the
summer sun, at noon, with chest, face, and arms exposed we make 10,000 IU of
vitamin D. Whole body exposure produces 20,000 IU in 24 hours. The rate of
production is dependant on the skin color. Darker skinned people make D more
slowly for equal time spent in the sun. Because we dont have fur or feathers
covering our skin, the melanin coloration in the skin keeps us from making too
much D. Lighter skinned humans began to appear in far northern and southern
latitudes because their lighter skin color did not block the D production. They
were stronger and could reproduce in lower sun environments where D was
scarce. However, those bright white or freckled people have a disadvantage
when they move to a high sun environment, they dont have the natural melanin
protection and they burn. When humans are adapted to their latitude with the
proper coloration, and their internal D level is high enough, some of the pro-D
on the skin is converted to D 1,25 OH, the active hormone which goes into the
nuclei of the skin cells to repair the UVB induced DNA damage, thus helping to
prevent skin cancer under normal circumstances.

As most of us dont receive sun D every day, our supplementary vitamin D

requirements are much higher than the FDA recommended 800 IU per day, and
are probably closer to 5,00010,000 IU per day just to stay the same. To sleep
normally the vitamin D blood level must be 6080 ng/ml. The vitamin D25OH that
we measure in the blood is storage D. We make the active chemical; D 1,25 OH
every minute of the day, in each organ in relation to its need. When your doctor
measures your D blood level it should be the D 25 OH, not the D 1,25 OH.

Why FDA recommendations are so low:

Cholecalciferol is a hormone not a vitamin. We would never dream of putting

estrogen or testosterone or thyroid hormone into the milk. Because it was
incorrectly called a vitamin the FDA has been put in the very difcult position of
making recommendations for hundreds of thousands of people who have
different D levels from year to year depending on their lifestyle, where they live
and their skin color. The FDA knows that high vitamin D levels can cause medical
problems and death, they just dont really know why. (I think it is because vitamin
D makes the sleep just as abnormal when it goes over 80, as it does when its
under 60, therefore everything I have described above results from a high
vitamin D just as easily as from a low vitamin D). The FDA has appropriately
recommended a dose of vitamin D, 400800 IU/day, that is unlikely to hurt
anyone. This does not mean that 800 IU is what you need. Each person must find
out what dose they need by measuring their blood level.

Everyone who takes this hormone in bigger doses must follow their vitamin D
blood level. Ask your doctor to measure your vitamin D 25OH level. Most doctors
do not know what the normal D level really is, so ask for the number, it should
be between 6080 ng/ml. Medicare will pay for vitamin D levels four times per
year if a billing code of 268.9 (vitamin D deficiency) is used on the lab slip. If you
dont have insurance www.vitamindcouncil.org will do your level for $75.00. All
your questions about vitamin D are answered at www.vitamindcouncil.org. It is a
site started in 2003 to teach you and me about this hormone. It has thousands of
scientific references linking vitamin D deficiency to various diseases, and
teaching about how to use vitamin D safely and effectively.
What is the right D hormone dose?

For most people the daily supplemental D dose will be 15000 IU per day in
summer, 57,000 IU per day in winter, but if your level is 30 or below and its
winter, I recommend that you take 1015,000 IU for 23 weeks to get your level
back above 50 more rapidly. Then check your level again in 4 weeks to be sure it
is above 60. Over 12 years measure your D levels every 6 to 12 weeks and
make sure that you are taking enough to provide a D level between 6080 ng/ml
all year long. Dont take extra D when youre using a tanning bed or out in the
sun in the summer, youve just made your daily supply on your skin. Never take
doses over 1000 IU/day without checking your levels regularly.
Practical Aspects:

Leg cramps or increase in headaches when youre starting extra D can be caused
by low magnesium, go to www.vitamindcouncil.org and read about magnesium
supplementation or eat a handful of sunflower or other seeds per day if this
happens to you.
What kind of D and why so many kinds?

The largest dose of vitamin D3 locally available, over the counter is 5,000 IU.
Walmart, Sams Club, Drug Emporium all have it. We doctors have been,
incorrectly, taught that its safe to give vitamin D2, (ergocalciferol) as a once a
week pill of 50,000 IU. D2 Ergocalciferol is not the same as D3 Cholecalciferol,
and may be dangerous for some. In fact the majority of my patients felt that it
made their sleep and headaches worse. Make sure what you buy is D3. This
important mistake resulted from using the rat as the experimental model to look
for the vitamin that prevented the bone disease of rickets in the 1930s. Rats
are nocturnal animals. In order to spend their lives in the dark, they had to have a
mutated vitamin D receptor that allowed them to use a different chemical, D2. D2
is a chemical made by fungus that grows on grain. D2 is similar but not identical
to what you and I, and all other animals, make on our skin from sun exposure. D2
does come in the food, (which is why the vitamin word was originally applied).
The rats ability to use this chemical allowed it to be nocturnal, active at night
and able to run about our houses eating our food at night. This is why humans
dont like rats and therefore find experimentation on them less objectionable than
on other animals. Once D2 was discovered it did, in fact, help rickets in children.
The first anti rickets chemicals were D1 and D2, found on grain. Several years
later, D3 was discovered on the skin of pigs, (but only after UVB light exposure).
Because D3 acted similarly to D2 at bone receptors it has been assumed that it
would behave the same at all receptors. D2 appears to act differently than D3 in
the brain, it usually does not improve the sleep, and may make it worse.
I eat a good diet, why would I have other vitamin deficiencies in addition to
vitamin D deficiency?

B12 deficiency and iron deficiency are common secondary deficiencies that also
affect sleep. Vitamin B 12 deficiency results because there are Vitamin D
receptors in the stomach cells that make intrinsic factor. Intrinsic factor is the
chemical that binds to B 12 in our diet and allows us to absorb it. When the D is
so low that the intrinsic factor production also becomes low we are less able to
absorb B12 from our food. I believe B12 also helps produce normal sleep. Iron is a
cofactor in making dopamine, one of the chemicals that runs the timing and
paralysis of sleep, so when D, B12 and iron deficiency all exist together the sleep
becomes especially bad. Those two additional deficiencies usually mean that the
D has been low for many years. Ask your doctor to check your B12 and iron level
when you check the D for the first time. The B12 level for normal sleep is above
500. (Again you want to know the number). If the B12 blood level is below 500 I

recommend a pill of B12 of 1000 mcg/day. Shots are not better than the pills and
it will be absorbed as long as the D dose is increased at the same time.
Do our B vitamins really come from our poop?

Its important to know that 7/8 of the B vitamins that we need daily are supplied
by our intestinal bacteria. This allowed humans and other animals to go several
weeks without food, because they carried with them an internal store of the B
vitamins. The B vitamins are not stored, they are very short acting and eliminated
within 12 days but we need them daily for proper cellular actions throughout the
body. Therefore, it is possible that when the normal colonic bacteria die off we
might become low in some of the B vitamins, despite eating a good diet. If you
have pain, arthritis, irritable bowel, or burning in the hands or feet you may have
pantothenic acid (B5) deficiency. I believe this secondary deficiency develops
after many years of D deficiency because our intestinal bacterial populations
change. Our intestinal bacteria need our vitamin D to thrive. They use the D that
we make on our skin, passed down to them in the bile. When they dont get
enough D to survive, other species of bacteria begin to dominate the gut. ( See
The Economist magazine August 18, 2012 The human microbiome: Me myself,
us to learn about the epidemic of the wrong colonic bacteria and how this
change in our colonic organisms may be contributing to multiple diseases that
are epidemic today.) A normal daily supply of pantothenic acid produced by the
gut bacteria, appears to be necessary for normal sleep. If you feel this refers to
you do not take large doses of the individual B vitamins, take B-50 (B complex
that has 50 mg of each of the 8 B vitamins) daily but only for 3 months.
Supplying enough D and B complex vitamins together allows the right bacteria
to grow back in the gut. For most people it takes 3 months. AFTER 3 MONTHS,
when the intestinal bacteria are making the B vitamins again we need to STOP
THE B 50, as large doses of pantothenic acid appear to disrupt the sleep and will
keep you from getting better. As soon as your bacteria are making the Bs in the
right daily doses your body is receiving a double dose so the pill needs to stop.
Any other vitamins?

Most authors believe that you should always take a multivitamin along with
vitamin D, there are several cofactors that vitamin D must have to do its job
properly and these are all contained in the routine multivitamin, bigger B doses
are not necessarily better, and may actually harm your sleep if your intestinal
bacteria are making the right amounts for you already.(see above)