By Dr. Peter Borten, LAc, DAOM, Acupuncturist and Herbalist at The Dragontree Spa and Creator of Imbue Pain Relief Patch
Wow, it seems there’s a lot to say about joint pain. You can read part one, part two, part three, and part four for background information and many more suggestions for joint pain. Let’s continue our exploration.
Optimize Your Vitamin D Levels.
For decades, vitamin D has been thought of as something of a hormone, with many authorities cautioning against getting too much. As you probably know, all that has changed in recent years, with current estimates putting 60 to 75 percent of Americans in the deficient category. We don’t get outside in the sun much, we wear sunscreen when we do, and it’s hard to get very much of it from food. Also, those who live in the northern latitudes (north of 37 degrees north latitude – or, for that matter, south of 37 degrees south latitude) rarely get exposed to sun that is direct enough to stimulate vitamin D synthesis in the skin. Except during a few months of summer, sun rays that hit the northern states come in at an angle (rather than being perpendicular to the earth) and they have to pass through a lot of atmosphere, which is full of dust that filters the intensity of the light, making it too weak for us to turn it into vitamin D.
Along with a growing recognition of our low levels of this vitamin has come a ton of research showing how critical vitamin D is to our health. Vitamin D deficiency has been linked with low and/or wonky immune function, cardiovascular disease, osteoporosis, depression, gum disease, skin diseases, asthma, diabetes, and, the subject of this article – arthritis.
Low blood levels of vitamin D are associated with an increased risk of both rheumatoid arthritis and osteoarthritis. Studies have suggested a higher incidence of arthritis (particularly rheumatoid) in those living in the north. With rheumatoid arthritis – an auto-immune condition (confusion of the immune system, whereby it attacks the body itself) – this may arise because vitamin D is integral to healthy immune function. (This may also explain why vitamin D deficiency is prevalent in certain other auto-immune disorders, such as multiple sclerosis and psoriasis.) However, an especially interesting revelation of vitamin D research is that receptors for this nutrient appear all over the body – including in the joints. Vitamin D receptors like to be occupied with vitamin D – good things happen when there is sufficient vitamin D to fill them. In the case of our joints, vitamin D appears to be integral to the maintenance of our cartilage. One study on knee ar thritis showed that participants with sufficient vitamin D had significantly less cartilage loss than those who were deficient in D. Cartilage loss is central to the development of osteoarthritis, so vitamin D should be a part of the nutritional regimen of anyone with arthritis.
In addition, when it comes to bone health, vitamin D is instrumental in the absorption of calcium from our intestines. When there is not enough vitamin D, even if we’re eating plenty of calcium, we won’t absorb it. This would lead to low levels of calcium in the blood, but because circulating calcium is vital for cardiovascular and neuromuscular health (including the beating of the heart), the body doesn’t let this happen. Instead, it stimulates glands called the parathyroids to secrete a hormone that causes dumping of calcium from bones into the blood stream. While this is good for the heart, it’s not good for the bones. Most studies show a connection between low vitamin D and osteoporosis. But low doses – like the “recommended daily allowance” (RDA) of 400 international units – don’t seem to help reduce the incidence of fractures. Only big doses, at least twice the RDA, appear to be beneficial in this regard.
As for supplementation, as I mentioned previously, there aren’t many rich food sources of vitamin D. The two primary ones are oily fish and eggs yolks. Eating oily fish is generally a good idea, though some of these fish – tuna, in particular – also tend to be rich in mercury, not a mineral we need more of. Egg yolks are good for you, in moderation, though I recommend only eating eggs from free range chickens. Caged chickens have poor nutrition, and, unsurprisingly, produce eggs that are significantly less nutritious than those from chickens who roam freely and eat grass and bugs. The thing is, even these “vitamin D rich” foods supply only a bit of the stuff. Harvard Men’s Health Watch reported: “You’ll have to eat about 5 ounces of salmon, 7 ounces of halibut, 30 ounces of cod, or nearly two 8-ounce cans of tuna to get just 400 IU. An egg yolk will provide about 20 IU, but since it also contains nearly a day’s quota of cholesterol, you can’ t very well use eggs to fill your tank with D.”
Therefore, most people will choose to take a vitamin D supplement. It’s important to choose vitamin D3 (cholecalciferol) – the form we naturally produce from sunlight, rather than D2 (ergocalciferol), a synthetic form which is less useable by the body. Unfortunately, most fortified foods contain D2. Dose recommendations vary wildly nowadays. Your best bet is to get your blood tested (get the 25(OH)D test). You should not be below 32 (ng/mL); optimal is 50-70. Doctors will often prescribe 10,000 to 100,000 units of vitamin D once a week to correct a verified deficiency. (Since vitamin D is fat soluble, your body can store it and utilize it as needed.) A more common daily recommendation, for both kids and adults, is 35 units of vitamin D per pound of your body weight, up to 5000 units. Please ask your healthcare practitioner what is the best amount for you.
According to Dr. James Dowd of the Arthritis Institute of Michigan, and author of The Vitamin D Cure, vitamin D works best when we have adequate amounts of potassium,
magnesium, and calcium in our diet. So, eat plenty of vegetables while you’re at it.
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Dr. Peter Borten