Graves’ and Thyroid Disease: The JourneyVitamin D Yung Chen MD

Vitamin D

What is Vit. D Why we need it How to get it Do you need to supplement How much to take

What is Vitamin D

It is not a Vitamin It is a type of hormone synthesized from Cholesterol Hormones are chemical messenger between cells More then 2,700 receptor binding sites in human

genome Vit D is converted to calcidiol in the liver Kidneys convert to calcitriol the biologic active form

Why we need it

Regulates calcium and phosphate to promote healthy bone

Prevent osteomalacia or rickets Reduce rick of death in elderly Prevents premature aging Low levels associated with multiple sclerosis Reduction of influenza infections

How to get Vit D

Ultraviolet (UV) B from sunlight on exposed skin Reduced by skin melanin, sun screen, glass, smog,

Fatty fish like salmon, tuna and fish liver oils 3 oz. Salmon ~300 iu

Supplement with Vit D3 not D2 Vit D2 less potent

Do you need to supplement

Easy blood test via Lab Corp or Quest serum 25-hydroxyvitamin D level Lab normal range is 30 nmol/L to 140 nmol/L What is the optimal level?

My level is between 50-60 nmol/L

How much to take

Depends on your serum level and health conditions <20nmol/L; Take 10,000 iu per day for 2 month then

retest <40nmol/L; Take 5,000 iu per day for 2 month then

retest Monitor every 4-6 months Vit D is fat soluble and takes time to build up reserves Keep levels below 100 nmol/L

Vit D toxicity

Non-specific nausea, anorexia, weight loss, polyuria Kidney and tissue calcification if too much calcium

supp Levels >500 nmol/L is potentially toxic Stop vit D supplement and monitor symptoms Levels drop off slowly due to fat soluble

My clinical observations

Reduction of Upper respiratory infections Reduced joint / bone pain Improved depression Better skin, hair, nail Maybe helpful in weight loss

Conclusion

Get you serum Vit D level tested Get more sun exposure or take Vit D3 Monitor levels on supplement Take extra Vit D3 in the winter months