Vitamin D is a pro-hormone with a fundamental role in the balance of our body, helping us to maintain an optimal state of health. It has two natural forms, both fat-soluble: vitamin D₃ (cholecalciferol) and vitamin D₂ (ergocalciferol). 

The vitamin D₃ It is made in the skin of humans and other animals, from a cholesterol derivative (7-dehydrocholesterol) influenced by the sun's UVB rays, so sunlight in the early morning and late afternoon hours are ideal for generating our vitamin D, as long as our diet is rich in monounsaturated fats or fatty healthy.

Instead, the vitamin D₂ It is produced in plants, fungi and yeasts by solar irradiation from the sun. ergosterol. Both vitamin D compounds are biologically inactive, so when they are absorbed and metabolized to produce active metabolites, we can take advantage of their benefits. 

Comparatively, between the two forms of Vitamin D, it is the vitamin D₃ the one with the greatest activity and absorption, on the other hand the vitamin D₂  Only 10 to 15% is absorbed in the intestine, so not only do we have insufficient absorption but it also has less biological activity. Therefore, both the consumption of vitamin D in the diet and the "sunbaths” at the right times with the protection indicated according to our skin phototype.

Of these biologically active metabolites we can mention the calcidiol (25-hydroxyvitamin D [25(OH)D] ), which is produced in the liver from either of two forms, either vitamin D₂ or D₃. One of the most important metabolites is calcitriol (1,25-(OH)2-D3), produced in the kidney. so the liver and kidney health are linked to the levels of active or functional metabolites of vitamin D

Why is it important to do this analysis?

The balance of the levels of each nutrient, hormone or substance provides health. So some of the functions of Vitamin D are:

• It has a fundamental role in the absorption of calcium, one of the main substances necessary for strong bones. 
• Prevents osteoporosis, which is a disease that causes deterioration of bone micro-architecture, which causes brittle and weak bones, with a tendency to pathological fractures.
• It has an essential function so that the immune system can fight the bacteria and viruses that attack it.

It is very important to know if we are in a vitamin D deficiency, in order to correct said nutritional status.

Who is this analysis recommended for?

It is recommended for anyone suspected of having the following conditions:

• Diet devoid of foods rich in Vitamin D.
• Little sun exposure due to geographic location, either due to latitude that can generate seasons such as winter, due to the type of climate (constant cloudy) or polluted fog (smog). 
• By skin phototype (brown and dark skin).
• Senile (aged) skin where the cells are already histologically worn and do not perform the same functions. In this way we can evaluate the levels of vitamin D and thus, if there is a deficiency, we can know it. 
• People with disorders that limit the absorption of fats: Crohn's disease, celiac disease or ulcerative colitis. As vitamin D is absorbed in the intestine together with fats. In this way, if the body has problems absorbing fats, it will also have problems absorbing vitamin D. 
• People who suffer from obesity or who have had gastric bypass surgery. These people often need more vitamin D than others.

Sunlight through windows, solarium or in the shade is not useful in the production of Vitamin D, that is why it is important to protect yourself adequately with a suitable sunscreen for our skin and thus be able to take "sunbaths" for 15 to 20 minutes in the first three hours after sunrise and in the last hour before sunset.

When can we observe the altered results?

The established minimum requirement is 800 IU which applies to healthy people with a balanced diet with good sun exposure and without any type of deficiency. Now, in people with Vitamin D deficiency, the use of supplements is recommended after the diagnosis of Vitamin D deficiency, with doses of 2000 IU and even 4000 IU.

Foods high in Vitamin D 

Remember that the absorption of vitamin D at the intestinal level is only from 10 to 15%, so if we consume 100 gr. of fresh Salmon we will only absorb 42 to 48 IU of the 280 to 320 IU that this amount of food provides us. We can guide ourselves in some foods that can provide us with high amounts of Vitamin D:

cod liver oil	10,000 IU/100 mL
Fresh bonito, herring, tuna	800 – 1000 IU/100 g
fresh atlantic mackerel	360 IU/100g
Fresh anchovies, sardines, salmon	280 – 320 IU/100 g
Canned tuna, mackerel, sardines in oil	220 – 330 IU/100 g
Shrimp	720 IU/100g
Chicken's liver	80 IU/100g
calf liver	15 – 50 IU/100 g
unfortified milk	3- 40 IU/100 g
unfortified butter	30 – 32 IU/100 g
non-enriched yogurt	2.4 IU/100g
old manchego cheese	80 IU/100g
Cheese Ball	7.2 IU/100g
Mushrooms exposed 30 minutes to the sun	400 IU/100g

Vitamin D levels in the blood

We can guide ourselves according to:

• Toxic values: ≥150 ng/mL.
• Recommended values: 30-60 ng/mL (75-150 nmol/L).
• Relative deficiency: 21-29 ng/mL (52-72 nmol/L).
• Vitamin D insufficiency or deficiency: ≤20 ng/mL (37.5-50 nmol/L)
• Severe deficit: ≤5 ng/mL.

Where 40 International Units (IU) of vitamin D₃ they are equivalent to 1 μg/ml, that is to say 0.001 mg. Therefore, if we have a deficit of 10 ng/mL, we must consume approximately 6,000 to 8,000 IU, remembering that of these 8,000 IU we will absorb only 800-900 IU, which is equivalent to the 20 ng/mL necessary to make up for the stated deficiency.

Most of the population has insufficient levels of vitamin D, and those over the age of fifty are at greater risk of vitamin D deficiency because as we age, the skin loses its ability to synthesize, and the kidneys have less capacity to convert the metabolite to its active form.

Do you want to know what your vitamin D levels are?

At Enevia Health we collaborate with the main laboratories in Spain and abroad, offering our members the best prices.

Symptoms associated with Vitamin D deficiency

Some of the warning symptoms to consider taking vitamin D tests, in order to improve our diet and/or take supplements are:

• Bone pain.
• Muscular weakness.
• Fatigue.
• General discomfort.
• Decreased bone mass or density.
• Growth retardation in children.
• Clubfoot or bowing of the legs or feet.
• Delay in the birth of baby teeth and caries.
• Osteomalacia or osteoporosis in adults.
• Rickets in children.
• Weakness in the bones, osteopenia.
• Muscle spasms.
• Repeated infections.
• Viral infections frequently or recurrence.

Therefore, it is recommended to take a test and see your doctor preferably to establish an adequate diet and the amount of supplement to take daily.

Analysis methods

In order to diagnose the levels of Vitamin D, a sample is taken from either venous blood or capillary blood (dried blood) and with it the aim is to measure or quantify the serum concentration levels of the active metabolite, thus detecting the calcidiol (25-hydroxyvitamin D [25(OH)D] ), which must be ≤20 μg/ml to establish a diagnosis of Vitamin D Deficiency.

Do not forget to go to your doctor frequently, performing biannual or annual check-ups.

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