How to Optimise Your Vitamin D Level

There are two major forms of vitamin D from two different sources.

  1. Vitamin D3 (cholecalciferol) is our main source (80-90%) and it is produced in the skin following sunlight exposure but it is also found in foods of animal origin. Technically this makes vitamin D a pro hormone.
  2. Vitamin D2 (ergocalciferol) is found in foods of vegetable origin and supplements

In the UK our main dietary sources of vitamin D are food of animal origin, foods fortified with vitamin D and supplementation. Naturally rich food sources include egg yolk and oily fish such as salmon, mackerel, herring and sardines.

Absorption

We probably absorb between 62 to 92% of our dietary vitamin D. It is fat soluble and absorbed in the small intestine from where it is transported via the lymph into the circulation. Vitamin D produced under the skin enters the fluid between our cells (extracellular) before defusing into the circulation and being transported to the liver.

Common food sources of vitamin D

Food sourcesInternational Units (IU)
Salmon 140g408
Sardines canned 140g184
Mackerel 140g476
Mushrooms 80g (enriched)128
1 egg64
Tuna 140g60
Beef mince 100g24
Lamb 90g20
Butter 10g4
Vitamin D content is taken from British Nutrition Foundation ‘Vital vitamin D’ resource sourced  from McCance and Widdowson's The Composition of Foods: Seventh Summary

Total vitamin D production depends on a combination of factors:

The body appears to store vitamin D in adipose tissue (fat cells) and possibly muscle tissue. Studies suggest that levels of vitamin D decline as our body mass index (BMI) increases, and increase as BMI decreases. However the ability of the body to access these stores is unclear and it may be sequestered rather than stored.

There are in fact, a whole lot of factors that affect how much vitamin D our bodies can make including:

Role in the body

The main role of vitamin D is to help regulate the absorption and metabolism of calcium and phosphorus from the gut. To a lesser extent it also regulates magnesium absorption.

Vitamin D is therefore vital for bone mineralisation, bone growth and bone health. Without it bones will be soft, malformed, and unable to repair themselves normally. This results in the disease called rickets in children and osteomalacia in adults. Vitamin D also plays an important role in musculoskeletal health and neuromuscular function because of its’ role in calcium homeostasis.

However evidence is emerging of other roles for vitamin D including:

Measurement

Both vitamin D2 and vitamin D3 are converted by the liver to 25-hydroxyvitamin D written in shortform as 25(OH)D and then to the active hormone 1,25 dihydroxyvitamin D. Tests measure 25(OH)D to estimate the status of vitamin D in the body because it is the most useful indicator. It remains in the blood longer and is present at much higher concentrations than the active form.

Picture source https://www.anhinternational.org/campaigns/test-take-vitamin-d/

Vitamin D blood levels

The National Osteoporosis society (NOS) guidelines (UK, 2013) and the Institute of Medicine (US) classify vitamin D results as follows:

The Scientific Advisory Committee Report (SACN) report (2016) considers levels in the UK below 25 nmol/L to be inadequate with an increased risk of rickets and osteomalacia.

However the Endocrine Society Task Force concluded 50 nmol/L as the cut off for deficiency and recommended that concentration “should exceed 75 nmol/L” for maximum benefit on calcium, bone and muscle metabolism. Other researchers have proposed thresholds between 50-120 nmol/L to reduce the risk of adverse non-skeletal outcomes.

Dr Damien Downing, president of the British Society for Ecological Medicine and vitamin D expert, recommends a vitamin D blood level of at least 75 nmol/L for immune support and levels over 100 nmol/L to lower your risk of cancer and autoimmune disease.  Grassroots Health (vitamin D global expert Group) suggest anything below 100 nmol/L is inadequate and recommend optimum levels of 100-150 nmol/L.

Your magnesium and vitamin K2 intake can also influence your vitamin D absorption. Magnesium is required for the conversion of vitamin D into its active form. If your magnesium level is too low you may store vitamin D in its inactive form.

How to supplement if blood levels are low

Low blood levels of vitamin D may mean that you are not getting enough exposure to sunlight or enough dietary intake or that there is a problem with its absorption from the intestines.

In the UK most people should be able to obtain enough vitamin D from sunlight from the end of March to the end of September.

During autumn and winter as many of us don’t get enough sun exposure a supplement may be required.  The best way to determine your requirement is to measure your vitamin D (https://www.vitamindtest.org.uk/) level and then use the Grassroots vitamin D calculator to work out the correct dose. https://www.grassrootshealth.net/project/dcalculator.

Grassroots Health also suggest taking 600mg of magnesium and supplemental K2 of 90 mcg for women and 120 mcg for men daily. This helps to support bioavailability of your vitamin D as well as conversion to the active form.

Elderly people, those with darker skin tones, overweight or obese individuals or those exposed to limited sunlight have a much higher risk of becoming deficient. The Department of Health and Social Care recommends a daily supplement containing 10 micrograms (400IU) of vitamin D for higher risk groups like these.

You can also get some idea of where your level might be by using the D Minder Pro app from the App Store. This app is expertly designed to help you track and manage your vitamin D levels. It also provides other useful data related to your geographical location.

How much to supplement

Official recommendations on how much to supplement vary widely. In the UK it's 400 IU (international units) or 10mcg (micrograms). The EU and many countries go for 400-600 IU, the exception is Italy's 2000 IU (50 mcg), in the USA its1000 IU (25 mcg). Some vitamin D researchers and experienced clinicians, such as Professor Hollick, recommend 4000 to 5000 IU (125 mcg) for daily maintenance.  A general guideline for adults over the age of 18 is between 50-100 mcg (2000 – 4000IU) for the colder months. It is recommended to work with a healthcare practitioner before supplementing at these levels.

Which form of vitamin D to supplement

Clinicians usually recommend vitamin D3 for supplementation as D2 isn’t so effective at raising vitamin D levels in the blood.

Toxicity

Commercially vitamin D is synthesised by UVB irradiation of 7DHC (from sheep wool) and ergosterol (from fungi).  Prolonged sunlight doesn’t cause excess production but high dose supplementation can be toxic and can cause hypercalcaemia (soft tissue deposition of calcium). High levels will usually reflect supplement intake.

To evaluate how your sun exposure and/or supplement dose is working for you it’s a good idea to re measure your vitamin D level after three to six months.

N.B. 1 microgram of vitamin D is equal to 40 International Units (IU). So 10 micrograms of vitamin D is equal to 400 IU.

References

Alliance for Natural Healthhttps://www.anhinternational.org/campaigns/test-take-vitamin-d/

Bikle, D.D. (2009) Vitamin D and immune function: understanding common pathways; Curr Osteoporos Rep; Jul; 7(2); pp.58-63. doi: 10.1007/s11914-009-0011-6.

Haddad, J.G. et. al (1993) Human plasma transport of vitamin D after its endogenous synthesis; Journal of Clinical Investigation; June; 91(6) pp.2552-5. doi: 10.1172/JCI116492.

Holick, M.F. (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline; J Clin Endocrinol Metab; July; 96(7); pp.1911-30. doi: 10.1210/jc.2011-0385.

Ovesen, L. et. al (2003) Geographical differences in vitamin D status, with particular reference to European countries; Proceedings of the Nutrition Society; Symposium on optimal nutrition for osteoporosis prevention; 62 pp. 813-821.

SACN (2016) Vitamin D and Health; The Scientific Advisory Committee on nutrition; Available from https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition. (SACN)

Supporting immunity

I am receiving lots of enquiries about how to support their immune system and health through the winter season. I’ve put together some information on key nutrients to consider for support and why, together with some practical suggestions of what and how much to take. There is no substitute for eating a healthy nutritious diet but if you regularly suffer from colds, flu or infections over the winter season this extra support may be useful. As always please consult your GP or health practitioner if you are already taking medication or supplements to ensure there are no contraindications.

Vitamin D3

Recent studies show vitamin D3 supports the immune response to infection and protects against respiratory tract infection especially in vitamin D deficient people1,3. UK NHS guidelines recommend 400 IU per day 2 but many researchers recommend more especially if you aren’t getting at least 10 minutes sunshine per day. I usually recommend 1000 IU but it’s always a good idea to test first. Finger prick tests are available. I use a company called FORTH but you can also ask your GP to test. Use this link to benefit from my discount code:

https://www.biomarkertracking.com/p/store/DNRMAXWELL/2/

Zinc

Has been shown to stimulate antiviral immunity 4.  Best taken with copper, 15mg per day should be sufficient for prevention 4.  Lower serum concentration of both vitamin D3 and zinc have been detected in patients suffering with moderate Covid 19 symptoms as compared to mild or asymptomatic patients5.

Propolis

Propolis honey bee resin is formed from the resins which the bees collect from trees which form part of the plants natural immune system. It contains more than 300 naturally derived bio-active compounds. These flavonoids and phenolics are what make Propolis a powerful natural defence which may soothe sore throats and support upper respiratory tract infections.

Mushrooms

Mushrooms are fascinating powerhouses of nutrients and compounds that provide many positive health promoting actions including antiviral and antibacterial.  We share 40% of their DNA making them more similar to us than plants. Many mushrooms have anti-viral properties and can inhibit viral replication. They can improve T-lymphocyte proliferation and increase Natural Killer cell activity to increase our natural defences against cancer and provide immunomodulatory benefits 6.

Quercetin

Quercetin is a flavonoid found in plants such as onions, brassicas, apples, grapes and berries. It is known to stimulate the immune system to generate aniviral activity and decrease pro-inflammatory cytokines and inflammatory mediators. It has also been shown to reduce the incidence of upper respiratory tract infections (URTI) due to exercise and can be utilised in URTI’s such as asthma and allergic reactions. 7

Ginger

Ginger has been shown to possess anti-inflammatory benefits and positive effects on acute respiratory distress syndrome.8

Ginger tea - take a large palm sized piece of ginger and cope into a few pieces.  Bash each piece to release the flavour better or grate it and boil in 1 litre of water for 30 minutes.  Optional - add 1/2 tsp of ground turmeric and a tiny pinch of cayenne pepper. Once it has cooled a little you can add the juice of 1/2 a lemon about 3 tbsp. Strain if desired and pour the liquid into a flask to drink when desired.

Get in touch for more information on nutrition to support your health and immunity. Call 07740 876233 or email me at helen@helenmaxwellnutrition.co.uk. https://helenmaxwellnutrition.co.uk/contact-2/

Please use this link to access product information and immune boosting juice and smoothie receipes

https://www.dropbox.com/s/qxd4bx7lynr4ucu/IMMUNITY%20.pdf?dl=0

References1 Calder, P.C. et al. (2020) Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections Nutrients 12(4) p1181. 2 https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ 3 James, P.T. et al. (2021) The Role of Nutrition in COVID-19 Susceptibility and Severity of Disease: A Systematic Review. The Journal of Nutrition;151 pp.1554-1878. 4 National Academies Press (US) (2001) Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Institute of Medicine (US) Panel on Micronutrients. Washington (DC) 5 Golabi, S. et al. (2021) The Association between Vitamin D and Zinc Status and the Progression of Clinical Symptoms among Outpatients Infected with SARS-CoV-2 and Potentially Non-Infected Participants: A Cross-Sectional Study Nutrients 13(10) pp. 3368.6 Chan, G.C-F. et al. (2009) The effects of beta-glucan on human immune and cancer cells; Journal of Hematology and Oncology 2(25)   DOI: 10.1186/1756-8722-2-25 7 Micek, J. et al. (2016) 7 Nyguen, H.A. et al. (2020) Quercetin and its anti-allergic immune response; Molecules 623; doi:10.3390 8 Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials 12(1) 157 https://doi.org/10.3390/nu12010157

Breathing-pattern - could it be the missing link?

The way we breathe is intricately linked to the way our body functions on both a physical and psychological level. When we breathe correctly we oxygenate our organs to maximise their function.

Between 50-80% of the general population have some level of breathing-pattern disorder

The researcher and professor of physical therapy, Kiesel (2017), has found that between 50-80% of the general population have some level of breathing-pattern disorder.  The Oxygen Advantage® programme is designed to reset and optimise your breathing-pattern to improve your overall health and well-being.  It also works specifically on performance for sports and exercise.

Signs and symptoms that your breathing is disordered

Signs that your breathing may be disordered or that you need to improve your breathing include.

Why consider learning to breathe correctly?

Correcting how you breathe may be the missing link in your health journey.  For example if you wake up tired or struggle to focus in the morning this may because of how you breathe during the night. 

When we learn how to breathe properly we can impact all kinds of health issues such as:

DigestionImmune function
Weight lossEnergy levels
AnxietyChronic fatigue
AsthmaExercise induced breathlessness
ConcentrationFocus
Sleep problemsSnoring
Sports performanceCOPD

How is breathing connected to weight loss, energy levels, chronic fatigue and anxiety?

There is a close link between breathing and metabolism which is connected to energy and weight. There seems to be a relationship between the amount we eat and over breathing. Exercises designed to stimulate the para sympathetic nervous (PNS) system seem to bring the body back into balance. This PNS stimulation helps to lower anxiety levels, reduce emotional eating and appetite as well as improve the basal metabolic rate. This is through complex interactions between respiratory rate, heart rate, and the increased capacity of the blood to carry oxygen.

What about asthma and breathing difficulties?

This is one of the key reasons people undertake the programme.  The mechanics and depth of how we breathe affects the amount of air and blood in our lungs. If we breathe well our lungs will protect us against pulmonary infections and we will generate an important molecule called nitric oxide. This molecule is generated in the nasal passages and is our first line of defence against foreign particles. Nitric oxide is anti-inflammatory, anti-bacterial and anti-viral and it dilates our airways and blood vessels to enhance delivery of oxygen and micronutrients to the tissues. Generating nitric oxide has been found to have significant health benefits especially with regard to chronic and age related disease.

By learning to breathe correctly, improving oxygen uptake and controlling the amount of air you breathe asthma symptoms may reduce or resolve and the need for medication can diminish.

Why does our breathing affect our digestion and our immune function?

Our gut membrane is the barrier between our internal and external world. It is the vital link between what we eat and the nutrients our body digests and absorbs. It’s surface area is as big as two tennis courts but it is delicate, only one cell thick and half the width of a human hair. Most of our immune system is situated just behind this membrane which starts in the sinuses and runs all the way down our throat to the stomach and intestines. It works to protect us from any unwanted substances we may ingest.

Many of us eat on the run, in a rush or whilst feeling stressed.  When we learn to breathe correctly we oxygenate our gut so it can relax, digest and function optimally which in turn supports our immunity.

How can changing how we breathe improve our exercise performance?

Many of us gas-out too soon when we exercise.  This breathlessness can actually put us off exercising.  We instinctively think this is because we can’t get enough oxygen. It has much more to do with being unable to tolerate the build up of carbon dioxide and lactic acid in the body combined with weak respiratory muscles. This chemical oversensitivity can be retrained and reset so the body can do more with less.  We can also retrain the mechanics of breathing to improve the strength of our diaphragm, and the inspiratory and expiratory muscles.

What is the Oxygen Advantage® programme ?

The Oxygen Advantage® programme teaches you the science and the practice of breathing right.  You learn the science of breathing and the ‘how to’ practical part which has two stages. The first stage is to assess your breathing and then learn how to retrain and repattern this for optimal function.  The second stage of the programme uses exercises which simulate high altitude training.  This teaches the body to do more with less, improving athletic performance for both recreational and professional sports people. 

Once you have learnt the exercises and reset your breathing receptors you simply incorporate it into your daily activities.

Benefits

The physiological benefits will depend on how your body responds to the core benefits of:

We pay little attention to the way we breathe because it’s such an automatic process. The Eastern philosophies such as yoga and Tai Chi have always taught that it is a key component of health.  We have never been taught to address it but with the Oxygen Advantage® programme you will learn the science and the practice from a fully qualified instructor.

You can read more about the Oxygen Advantage® programme here.

Helen Maxwell

www.helenmaxwellnutrition.co.uk

Helen@helenmaxwellnutrition.co.uk

07740 876233

References

Kiesel, P.T. et al (2017) Development of a screening protocol to identify individuals with dysfunctional breathing. The International Journal of Sports Physical Therapy 12(51), DOI: 10.16603/ijspt20170774

Djupesland, P.G. et al. (1999) Nitric oxide in the nose and paranasal sinuses – respiratory tract physiology in a new perspective; Tidsskr Nor Laegeforen 119(27); pp.4070-4072.

Bryan NS, et al. (2017) Oral microbiome and nitric oxide: the missing link in the management of blood Pressure. Current Hypertension Reports:19(4):33.

Stephan BCM, et al. (2017) Cardiovascular disease, the nitric oxide pathway and risk of cognitive impairment and dementia; Current Cardiology Reports: 11;19(9):87.

Enter 'The zone'

An air of mystery surrounds ‘The Zone’, a near mythical state of mind-body alignment which athletes seek but few master. Rupert Sheldrake (author and biologist) suggests that sport may be one of the few remaining ways for people to experience an altered state of consciousness.  Sport requires: total concentration on the ‘present’; dedication; discipline and a will to explore and stretch beyond normal physical and mental capabilities. These qualities are all elements of committed spiritual practice potentially leading to similar experiences.

HeartMath® research suggests that this flow state is about heart-brain synchronisation achieved by connection with your intuitive heart.  When we do this over and over, with intention, it gradually becomes easier. We begin to understand it’s not a one-shot experience but a place we can train ourselves to enter at will.  There is a formula to get there to become physically, mentally and emotionally coherent. When we are coherent we are present, we think clearly, react intuitively and can play great sports.

The biofeedback from HeartMath® technology helps to build awareness of how our different emotional states affect the rhythmic pattern of heart activity.  It gives real time information on your heart rate variability (HRV) which is a measurement of the time intervals between consecutive heartbeats. 

Physically active individuals tend to have a higher HRV and this is associated with better health status. Athletes (recreational and professional) with a high HRV can respond, flex and adapt to the demands of their training and sport more easily.  But like most things in life it’s about balance and sport has a positive and negative relationship with HRV.  Your heart-beat is affected by your respiratory/cardiac cycle known as respiratory sinus arrhythmia or RSA. The sympathetic nervous system (fight or flight) is activated to cope with the demands of sport or exercise. If this exceeds available resources then vagus nerve function will diminish, negatively affecting our RSA and HRV. 

Teaching people to sustain positive emotions facilitates emotional and psychological coherence, enhancing mind-body co-ordination and shortening reaction time.  Tiger Woods was once asked during a championship game if there was a specific area players should look out for.  His response “No, not really.  I think the guys who are really controlling their emotions are going to win”.  I remember some years ago watching my son play football and thinking how much time and energy the players were wasting on emotions like frustration and anger at referee’s decisions or missed goals.  At the height of competition the ability to manage emotional reactions, make clear decisions and trust your intuition is often the difference between winning and losing.

Studies have shown that coherence can spread through entrainment, so team chemistry may result from a kind of collective team coherence or resonance. Perhaps a shared sense of energy, rhythm and intuitive knowing occurs to generate interaction and a successful team outcome. High school teacher and basketball coach Beth McHamee included HeartMath®  techniques in their training.  Before each game the team did a Heart Lock -in® and they used Quick coherence® on court and at half time. They ended the season with a record 15 wins compared to the previous six.

In Sweden hockey players trained in HeartMath® have used the techniques to switch from a chaotic to coherent emotional state when they are in the box watching the game.  This has improved their game observation ability but in addition they improved their physical stamina. Master Kelly (World Martial Arts Champion) also found benefits outside of his sport.  He used

HeartMath® techniques to maintain his edge to fight whilst competing in a younger competition category. He also used them to relax and handle stress from competition and travelling as well as to overcome injury setbacks and spark creativity and focus when writing his book.

HRV training and biofeedback have also been shown to play a useful role in the psychological response to injury and the rehabilitation process. The techniques can help them to deal with their roller coaster of emotions and the inevitable pain catastrophising which can become predictive. Compared to controls the HRV trained subjects lowered their respiration rates and improved on all psychological outcomes.  Their perceived level of control increased with the opportunity to become an active participant in their treatment.

Get in touch to learn how to use the Heartmath® biofeedback technology and techniques to tackle those situations where you react emotionally rather than respond intelligently. 

Experience science-based technology and coaching for taking charge of your life.

Proven to help you reduce stress and anxiety by increasing your inner balance and self-security.

Learn to access your heart’s intuition to become the best version of yourself more often.

“The brain thinks, but the heart knows” Joe Dispenza (neuroscientist) 

Helen Maxwell

HeartMath® certified coach

www.helenmaxwellnutrition.co.uk

Helen@helenmaxwellnutrition.co.uk

REFS

Perry, J., et al. (2018) Effectiveness of athletes’ mental strategies in maintaining high heart rate variability: Utility of a brief athlete-specific stress assessment protocol, ‘Journal of Clinical Sport Psychology’, DOI: https://doi.org/10.1123/jcsp.2017-0016

Ravi, S., et al. (2018) Heart rate variability: biofeedback and controlled breathing, competitive and recreation sport athletes, 2nd International conference on lifelong education and leadership for all, Latvian Academy of Sport Education, pp.413-418.

Rollo, S., et al. (2017) Effects of a heart rate variability biofeedback intervention on athletes psychological responses following injury: A pilot study; International Journal of Sports and Exercise Medicine, 3(6) DOI: 10.23937/2469-5718/1510081.

Sheldrake, R., (2019), Ways to go beyond and why they work: 7 spiritual practices for a scientific age, Hodder and Stoughton Ltd.