HORMONE ISSUES

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These are medical problems related to hormone excess or deficiency.

VITAMIN D DEFICIENCY & REPLACEMENT

Dr Chad Edwards Rickets Vitamin DYou’ve likely heard of Vitamin D. You may have even heard of the disease that is caused by a Vitamin D deficiency – rickets. This is a disease characterized by soft bones due to insufficient calcium in the bones because Vitamin D increases calcium absorption in the gut. Increasing Vitamin D resolves rickets. In fact, the Recommended Daily Intake set by the US Government is set at an intake 10% over the amount needed to prevent rickets.

But the amount of Vitamin D required to prevent rickets is NOT the optimal intake of Vitamin D for optimal function!

The active form of Vitamin D is 1,25-dihydroxycholecalciferol. It is responsible for the regulation of Calcium & Phosphorus levels but has also been suggested to have a role in hypertension, diabetes, insulin resistance, multiple sclerosis, and cardiovascular disease as well as some cancers.

The ‘normal’ range of Vitamin D is 30-74 ng/mL.

I PREFER THAT MY PATIENTS HAVE LEVELS BETWEEN 70 AND 100.

I have yet to see a patient who is not supplementing with Vitamin D have a level above 40 and most of them range between 20-35. This is horrible!

SUN EXPOSURE

The BEST way to improve Vitamin D levels is through sun exposure. If you get enough sun exposure to produce a light pink coloration to the skin (1 minimum erythemal dose) produces 10,000-25,000 IU of Vitamin D. Additionally, the Vitamin D that is produced through sun exposure seems to last longer (longer 1/2 life).

The problem is that most of us, especially my patients since we live in Tulsa, Oklahoma, live well north of the equator and do not have year round sun exposure. Even during the summer we aren’t getting enough sun exposure. There are a few reasons for this. We live and work primarily indoors and so we don’t get adequate sun exposure. Even when we do work or play outside we often use sunscreen which prevents 97% of Vitamin D conversion.

I recommend putting sunscreen on 10-15 minutes AFTER going out into the sun. Yes, I know what the dermatologists are saying and that probably is the best advice for the SKIN. However, I don’t treat skin. I treat patients and patients need Vitamin D!

NUTRITION

Dr Chad Edwards Vitamin D3 (cholecalciferol) 10,000 IUThe other way to get Vitamin D is through dietary sources or supplementation. You can eat food sources that are high in Vitamin D or take a supplement. There are 2 forms of Vitamin D available for supplementation: D2 & D3.

D2 (ergocalciferol) is the plant form and D3 (cholecalciferol) comes from animal sources. D3 seems to be a better source for supplementation. Your doctor may prescribe a Vitamin D supplement (Ergocalciferol) at 50,000 IU. This form does not seem to be as effective as the D3 form. Some sources say that D3 is 3x more potent.

Here is an article  from the Journal of Clinical Endocrinology & Metabolism entitled Vitamin D2 is Much Less Effective Than Vitamin D3 in Humans. And an article from the American Journal of Clinical Nutrition –The Case Against Ergocalciferol As a Vitamin Supplement.

If you are currently taking a prescription of Ergocalciferol then you should consider stopping it and taking Vitamin D3 (Cholecalciferol) instead. If you are one of my patients and I have prescribed Ergocalciferol in the past, switch to Vitamin D3 30,000 IU per day for a total of 8 weeks and then we will re-check your labs at that time.

IF YOUR VITAMIN D LEVEL IS:

  • <20 – take 30,000 IU of Vitamin D3 daily for 8 weeks and then we will repeat a Vitamin D level
  • 20-30 – take 20,000 IU of Vitamin D3 daily for 8 weeks and then we will repeat a Vitamin D level
  • 30-50 – take 10,000 IU of Vitamin D3 daily for 8 weeks and then we will repeat a Vitamin D level
  • 50-100 – take 5,000 IU of Vitamin D3 daily
  • >100 – consult your physician for recommendations

You can get Vitamin D3 from Sam’s Club for pretty cheap. The picture above is the one I recommend. You can also use the 5,000 IU version and just take more of them to make the correct dose.

Also, remember that Vitamin D is a fat-soluble vitamin meaning that it is distributed throughout your fat tissues. If you are obese then you are at higher risk for Vitamin D deficiency because you have a bigger ‘tank’ to fill. This also means that you need to take your Vitamin D with some form of fat in a meal to ensure optimal absorption.

Bear in mind that a healthy gut is essential to ensuring appropriate absorption of all nutrients. See the Paleo Diet for more information on how to heal your gut!

GOOD FOOD SOURCES OF VITAMIN D ARE:

  • Fish liver oils, such as cod liver oil. 1 TBSP (15 ml) = 1,360 IU of vitamin D
  • Cooked wild salmon. 3.5 oz = 360 IU of vitamin D
  • Cooked mackerel. 3.5 oz = 345 IU of vitamin D
  • Sardines, canned in oil, drained. 1.75 oz = 250 IU of vitamin D
  • One whole egg = 20 IU of vitamin D
  • Porcini mushrooms 4 ounces = 400 IU of vitamin D

You can read more about the structure, function, and synthesis of Vitamin D on the Vitamins page.

ADRENAL FATIGUE

The Adrenal glands are small glands located just above the kidneys. They produce a number of hormones and are vital to normal function.

The adrenals have an outer layer (cortex) that produces mineralocorticoids, glucocorticoids, and sex hormones.

The inner layer (medulla) produces catecholamines (epinephrine, norepinephrine).

Glucocorticoids (one of the primary glucocorticoids is Cortisol) are essential for numerous functions.

The adrenal glands work on a ‘use it or lose it’ fashion. This means that if you are getting steroid injections or oral steroids then your adrenal glands will decrease their production. When you stop getting the steroids (pills or injections) your adrenals may take some time to ramp up production enough to be able to meet demands. While there is no evidence, this MAY make you more susceptible to adrenal fatigue after stopping the medications.

The adrenal glands help regulate your body’s response to various types of stress whether it be from physical, emotional, or psychological sources. When the adrenal glands can no longer adequately meet the demands of these stressors adrenal fatigue results.

Adrenal fatigue can result from a major surgery, severe illness, lack of sleep, etc. (physical stress). It can result from an emotional crisis such as a loss of a job, house, loved-one, etc. (emotional stress). Any type of constant stress require a response from the adrenal glands.

Adrenal fatigue is the inability of your body to respond to these multiple and repeated stressors. They are typically functioning and responding but inappropriately or inadequately. If you think about weight lifting, you may be able to lift a certain amount of weight 20 times with no problem but you may really start to slow down at 50 reps.

Some symptoms of adrenal fatigue are:

  1. Tired or fatigued for no apparent reason
  2. Trouble getting out of bed even though you had an adequate amount of rest/sleep
  3. Feeling tired, rundown, or overwhelmed
  4. Difficulty bouncing back from an illness or other stress
  5. Craving salty or sweet snacks
  6. Feeling more alert & energetic after 6pm than you felt all day
  7. Feeling better after working out but then crashing
  • There is a website (www.adrenalfatigue.org) that has a pretty good ‘quiz‘ that you can take to help you determine if adrenal stress is a problem for you. You can click here to do the quiz.

Diagnos-Techs Logo

Most standard cortisol tests are done in the medical lab by drawing blood. The problem is that it only gives you a one-time serum level of cortisol.

I use Diagnos-Techs for my adrenal testing. Some insurances cover the test but some do not.

Here is an article on the 7 Stages of Adrenal Fatigue.