Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity.

[Ted Hutchinson]

Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17624643)BACKGROUND & AIMS: Vitamin D deficiency has been recently associated with the metabolic syndrome. However, it is not known whether this possible association of vitamin D deficiency with the metabolic syndrome is still present at very high degrees of obesity, as in morbidly obese patients. METHODS: Transversal, observational study that included 73 consecutive morbidly obese patients (body mass index 40kg/m(2)). In every patient, anthropometric variables were recorded, fasting blood was assayed for 25-hydroxyvitamin D concentrations, lipid profiles, glucose and insulin levels, and insulin resistance was estimated by homeostasis model assessment. RESULTS: Vitamin D deficiency was present in 37 of the 73 patients (50.7%). As defined by revised Adult Treatment Panel III criteria, 46 of the 73 obese patients (63%) had the metabolic syndrome. Vitamin D deficiency was more prevalent in morbidly obese patients presenting with the metabolic syndrome, compared with those who did not achieve the criteria for this syndrome (60.9% vs. 33.3% respectively, P=0.023). When serum concentrations of 25-hydroxyvitamin D were categorized in tertiles, there was an association of the prevalence of the metabolic syndrome with the former (P=0.038). Serum high-density lipoprotein cholesterol concentrations were lower (37.0+/-7.8mg/dl vs. 44.9+/-8.7mg/dl, P=0.003), and triglycerides levels were higher (163.3+/-81.5mg/dl vs. 95.1+/-24.2mg/dl, P=0.001) in the vitamin D-deficient group. CONCLUSION: Vitamin D deficiency is associated with the metabolic syndrome in morbidly obese patients.

Each 400iu/daily D3 raises status 3,6ng/ml -9nmol/l so 2000iu/daily should raise status by 45nmol/l this should be sufficient for anyone wanting to achieve 80nmol/l the level associated with lowest colon cancer incidence. To achieve lowest overall cancer risk reduction 4000iu/daily should enable you to reach 125nmol/l.

[LIZARD]

Hey, Ted. :)

Thanks for this. I still have to read the other abstracts you mentioned, too. Funny...I have about 65 lb left to lose (have lost 90 already), and I just learned of my Vit D deficiency last week. Apparently, my hypothyroid and phenobarbital (for epi) are also to blame. :( I'm so ticked off, because I have worked so hard at getting healthy over the past 2 years, and now, suddenly, I'm completely broken. :( I had about 2-3 months of "Wow...I feel awesome!" and then crash; overnight, I suddenly felt like $h!t all the time. :( Does it usually happen like this??!! Do I need Vit D supplements forever?? Any thoughts?

LIZARD :(

[Ted Hutchinson]

Hey, Ted. :)

Do I need Vit D supplements forever?? Any thoughts?
Your need for vitamin d supplements depends on where you live and how much time you are able to spend in the sunshine.
The total requirement for sufficient vitamin D to ensure you have maximum defence (calcitriol) against cancer depends on maintaining optimal vitamin d status around 125nmol/l. 50ng/ml. as each 400iu of vitamin D raises status by 9nmol/l basic maths should be able to inform you that 125nmol/l requires a total daily intake around 5200-5600iu daily from all sources, diet could if you ate fish daily will contribute 400iu and full body sun exposure produces 1000iu every 5 minutes, however although the process is heat driven it is also self limiting and so you need to limit the time in the sun severely to 15-20 minute session (cover up, go indoors, find shade) to allow your body to absorb that vitamin d before it get processed on into substances that the body doesn't use (http://www.uvguide.co.uk/vitdpathway.htm).
So basically we all need 30 minutes full body sun exposure (when shadow is shorter than height indicating availability of UVB/VIT D) daily or Vitamin d supplements to provide an equivalent quantity of vitamin d3.

As you can buy 50,000iu capsules that would supply 7000iu/daily if you took one a week or 5000iu/daily if you took one every 10days, that is only going to cost a trivial amount of money each year. Even if you use 2000iu and 1000iu capsules to make up the difference between the non availability of sunshine and your optimal vitamin d status it's no exactly a big deal financially. 120 x 2000 cost around $4.50 I take the 5000iu/daily capsules in winter and use sun from April - September when possible but take a 5000iu at night if I didn't get to sunbathe near naked for 20minutes during the day. At the end of Summer I had a Vit d test and my status was 147nmol/l which I was very pleased with.

As Vitamin D3 is fat soluble people who are carrying too much fat have problems with Vitamin D being locked up in the excess fat therefore not available as required.

You may want to consider using a sun tanning lamp or a vitamin d light (http://www.sperti.com/)during the winter. Or if your neighbourhood takes exception to nude/nearly nude sunbathers.Ultra-vitalux 300W 230V E27 (http://www.google.co.uk/product_url?q=http://www.kitkave.co.uk/lighting/lamps/infrared_heat/item_3005.html%3Faffid%3Dfroogle&fr=APjvmg71o1qz_cbw2zpPw3R2sWlMo0LSPAAAAAAAAAAA&ei=Ob5bR7vYNImgiALxz_TpDw&sig2=kSXBaRCa213EX8lqdDJB0w&gl=uk&hl=en&sa=title) I expect there are similar available in USA. Getting tanned ISN'T the idea, a third to half the time required to tan is all that is needed to make vitamin d3. You can be sure that if you actuall burn all the benefit of being under the sun is wasted. Don't burn your toast it is a waste of good bread, don't get sunburnt it wastes the good vitamin d and raises your risk of skin cancer because it has ruined the vit d3/and anti-cancer calcitriol.

[Maggi315]

I am still confused about vitamin d and the measurements. I had a panel done, which had several vitamin d's, including 1, 2, and 3. 1 was high (normal to 60, mine 65), the other two low (20, I think)

What do these different kinds mean? I can't seem to find a good explanation on the net anywhere.

thanks

[Ted Hutchinson]

I am still confused about vitamin d and the measurements. I had a panel done, which had several vitamin d's, including 1, 2, and 3. 1 was high (normal to 60, mine 65), the other two low (20, I think)

What do these different kinds mean? I can't seem to find a good explanation on the net anywhere.

thanksIt is D3 that is converted to calcidiol 25(OH)D this circulates to the tissues where, if required, it can be further processed to calcitriol 1,25(OH)2D3 or 1,25D3, this is the active metabolite that does the work. So this is the number that matters.

We know some people have their Vitamin D2 level raised (with Ergocalciferol) but for whom this has no impact on their health or bone density or muscle strength so the opinion of Vitamin D experts is that D2 is a waste of time and money. (http://www.ajcn.org/cgi/content/full/84/4/694)


You need only worry about the D3 number and the letters after the number are MOST important.
ng/mL or nmol/L
20ng/ml = 50nmol/L
If your current vitamin D3 status is 20ng/mL and you want to raise it to 50ng/ml you will require an extra 3300iu/daily of vitamin D3
If your current vitamin D3 status is 20nmol/l and you want to raise it to 125nmo/l you will require an extra 4500iu/daily.

If you want to raise a further 10ng/ml or 25nmol/l then another 1000-1200iu would be necessary.

At the above levels it will take around 60-90 days to achieve optimal status.

To enable your body to fight cancer or MS it needs to be properly armed with supplies of Calcidiol. Naturally, given regular full body (or as near as possible) short exposures to direct sunlight your body would acquire roughly 10,000iu/daily and maintain a natural level of 60ng/mL or 150nmol/L

If you look at Figure 2 (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1868557&rendertype=figure&id=F2)
Circulating 25(OH)D as a Function of Vitamin D3 Status in Supplemented Subjects (http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17218096) you see that the amount of 25(OH)D doesn't go up in a straight line as vitamin D3 increases. When your body achieves it's optimal 25(OH)D status it maintains that level even if more cholecalciferol D3 is available. So that is the natural level your body is seeking to achieve.
You will see from that paper those people who actually took the cholecalciferol D3 were supplied with 6400iu/daily.
How much you need depends on how much time you are able to spend outdoors when your shadow is shorter than your height, the colour of your skin, how much fatty tissue you have, your body weight etc etc.
But you can be reassured that amount under 10 (http://www.ajcn.org/cgi/content/full/85/1/6),000iu daily are perfectly safe.
If you skip (using the arrows by the slide preview) to
Session 2: Vitamin D Physiology (http://app2.capitalreach.com/esp1204/servlet/tc?cn=asbmr&c=10169&s=20343&e=6950&&) slide 33 you will see a graph of what happens to 25(OH)D levels when people are given 1000iu 5000iu and 10,000iu/daily. Amounts up to 1000iu/daily are as good at raising your status as paying $1000 daily into your bank account while spending $4000 daily whereas taking the same or more daily than your body uses (http://www.ajcn.org/cgi/content/full/77/1/204) (combined with casual sun exposure and diet) does raise status quickly and then maintains that level (the curves flatten out.
Keeping your status at or above 50ng/mL 125nmol/l and up to 60ng/mL 150nmol/l

Remember you are best advised to buy your Vitamin D3 from the discount online vitamin D providers like Iherb Vitaminlife Vitaminshoppe rather than use prescription D2 see Vitamin D2 rip-offs (http://heartscanblog.blogspot.com/2007/11/vitamin-d2-rip-offs.html)

The Vitamin D Council website has a link to a cheap source of 5000IU D3 (http://www.vitamindcouncil.com/links.shtml) taking 5 one week and 6 the next will average 4000iu/daily if you also have regular sun exposure this should be fine. They also sell 50,000iu capsules. If you wanted to raise your status faster then these would be better. Taking ONE of these each WEEK 50,000 divided by 7 = 7100iu daily approx so in just 8 weeks you should have caught up.

[teaser]

Calciferol is a drug with the generic name called ergocalciferol, which is a vitamin D2 that is important for the functioning of calcium in the body and for the absorption of calcium from the stomach.

http://www.drugdelivery.ca/s3293-s-CALCIFEROL.aspx


Thats what i use, some good posts here too!

[Ted Hutchinson]

Calciferol is a drug with the generic name called ergocalciferol, which is a vitamin D2 that is important for the functioning of calcium in the body and for the absorption of calcium from the stomach.

http://www.drugdelivery.ca/s3293-s-CALCIFEROL.aspx


Thats what i use, some good posts here too!This is what I use (http://www.bio-tech-pharm.com/products/d35.html) I'd be interested to know why you use a product that is known to be less effective , less reliable and more expensive?

It is true that having optimum vitamin d status improves your body's control of Calcium. (http://www.europeansunlight.eu/research/uvradvitd/Heaney%20(2005).pdf) This talk by Feldman explains the role of Vit d & calcium in greater detail. Vitamin D: Its Not Just For Bones Anymore (http://med.stanford.edu/medcast/2008/vitamind.html)

[ScarlettOne]

This is very interesting to me, as I always tend to lose weight in the summer, but not in the fall, winter or spring. Then I just maintain the weight even if watching portions and exercising. So now off to buy some Vit D, but they only sell 1000 iu here so will just take four of them a day and see what happens. Then up to 5 a day during the fall, winter and spring.
I've also read that folic acid helps to rev up the metabolism, and as it is a water soluble vitamin, I'm going to take that as well.
I'll check in next week and see if I've lost more than the usualy half a pound despite killing myself on the treadmill and eating next to nothing.
I'll change nothing else and see what happens.
Thanks for the heads up.
*hug

[Ted Hutchinson]

but they only sell 1000 iu here so will just take four of them a day and see what happens. Then up to 5 a day during the fall, winter and spring.Do be aware that 4000iu simply covers your body's daily needs and (unless you get plenty of full body sun exposure (http://thevitamindcure.com/discussion-resources) your body will not reach the level (50ng - 125nmol/l) at which surplus vit d is available to rebuild your stores. It takes roughly 3 months in Omaha supplementing with 5000iu daily to reach that level. So if you live north of Omaha or somewhere with fewer hours of sunshine than Omaha and where milk/cereals are not fortified with Vitamin D (as in UK/EUROPE) as they are in the USA then it will take longer.

Using a 5000IU CAPSULE (https://secure.bio-tech-pharm.com/catalog.aspx?cat_id=2) daily would be better than just using 4000iu and a lot cheaper.
You may also want to consider buying the 50,000IU and taking ONE EACH WEEK. (certainly not 1 x 50,000iu/daily) Using 1x50,000/weekly will average 7000iu/daily and thus more than meet your bodies daily needs and thus allow the stores to be replenished sooner.
EIGHT WEEKS at ONE 50.000IU EACH WEEK should correct Vit d deficiency followed by 5000iu/daily throughout the year.
I am an avid sunworshipper and grab every chance to get as much sun as available in the UK at latitude 52. even so with 5000iu/daily and the maximum possible sun exposure my status has only ever reached 59ng 147.5nmol/l which is fine but the chances are that people at this latitude taking lower amounts and/or getting less sun exposure than I do will not even reach 50ng 125nmol/l.

If you are worried about the waste of money having surplus 50,000iu capsules at hand then read about Stoss therapy and influenza (http://www.vitamindcouncil.org/newsletter/2006-nov.shtml) In my experience (somewhat limited as I don't seem to get colds/flu now) it really helps those I have offered some from my emergency store.

By changing my diet to a low carb eating plan (http://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in) after listening to Gary Taubes (http://webcast.berkeley.edu/event_details.php?webcastid=21216) I have dropped from 14st9lb to 11st6lb since 23rd Jan this year so looking and feeling much fitter now. I think maybe having a Paleo 25(OH)D status as well as eating a paleo style diet maybe the answer. Like you I previously thought my lack of exercise was the reason I was overweight (I have Post Polio Syndrome and too much exercise damages my muscles) however This article by Gary Taubes (http://nymag.com/news/sports/38001/) explains why exercise does not make us thinner.
If exercise does make you thinner then lack of exercise could not be my excuse for getting overweight.
People (as I have done) become more active when they lose weight and less active as they gain weight.

Obesity results in a lowering of your inclination to exercise.

Sloth is the result and not the cause of obesity.

I've lost 2lbs a week without any additional exercise. Now I've lost a lot of weight I find it easier to move about without getting breathless.

Changing my diet to low carb was the key to my weight loss.

[tobeblessed]

One thing I think should be clarified, and I'm not entirely sure I know the answer.

Is it that:

Obese people tend to be vitamin D deficient (obesity helps cause the deficiency because vitamin D is held in the fat);

Or that:

Vitamin D deficiency causes obesity.

As far as I can tell, it is the former. (I went googling around when I was dx'ed with my vitamin D deficiency about 3 weeks ago; my doctor didn't know of an obesity link at all).

Thanks for any clarification you can give.

[Ted Hutchinson]

The main reason why we gain weight is that raised insulin levels allow fatty acids to be stored in fat cells. Unfortunately Vitamin D is fat soluble so circulating fatty acids carry D3 with in with them and thus D3 is locked up in fat cells along with the fatty acids. It is inevitable that people who are overweight will not have the circulating levels of 25(OH)D they should have because as they gain weight they store Vit d in fatty tissue that can only be accessed when insulin levels are low enough to permit those locked up fatty acids to be released back into circulation.

The evolutionary advantage of having a pale skin applies only when we have the kind of Vitamin D status paleolithic man would have achieved. I'm sure you will understand that paleo man did not have a supermarket available or freezers fridges and the food storage capacity currently available. Living outdoors their 25(OH)D would have naturally been around 150-200nmol/l 50 - 80ng. At this level our body stores vitamin d in other places and the amount that gets locked up in fat cells would not be a problem as in those days seasonal food was the only option and it would have been advantageous for the body to store a certain amount of fat at the end of summer, when fruit/nuts/such grains/seeds/pulses as available were ripe). For the rest of the year they would have eaten a low carb diet and thus would have been naturally slim. The hunter gatherer suffering from carbohydrate induced fatigue and brain fog would not have been a successful hunter . Eating a low carb diet sharpens the brain and ensures optimal heart function thus assisting hunting ability.

We will only see a reduction in chronic illness when we understand vitamin d intake needs to = or exceed the body daily requirement. (http://www.ajcn.org/cgi/content/full/77/1/204) Our bodies evolved to take full advantage of full body sun exposure and wearing clothes/sunscreen when outside totally prevents the natural function of our largest peripheral endocrine organ. What other organs are there we can block the function of without serious adverse consequences. 900+ Vitamin D receptor sites are there for a purpose. The 200+ genes dependent on circulating calcidiol to function currently have less than a third of the required D3 circulating (well this is true for the average UK adult who instead of 150nmol/l averages only 50nmol/l throughout the year)

Haven't really time to go into the role of Vit d in metabolic syndrome at the moment. But low 25(OH)D is associated with higher glucose concentrations and reduced insulin sensitivity and may also be associated with an increased risk of developing type 1 diabetes. and also Type 2 (http://vitamindcouncil.org/researchDiabetes.shtml) so it's a bit of a chicken and egg situation.

I hope you are not using the form of Vit d2 usually prescribed but sourced your own D3 of the same iu content.

[tobeblessed]

...Haven't really time to go into the role of Vit d in metabolic syndrome at the moment. But low 25(OH)D is associated with higher glucose concentrations and reduced insulin sensitivity and may also be associated with an increased risk of developing type 1 diabetes. and also Type 2 (http://vitamindcouncil.org/researchDiabetes.shtml) so it's a bit of a chicken and egg situation.

I hope you are not using the form of Vit d2 usually prescribed but sourced your own D3 of the same iu content.

Thank you for the clarification! Do you mind if I print this and give it to my doctor? She was really intrigued at this deficiency being linked to obesity and wasn't aware of what the link was; at the time I saw her I wasn't understanding the exact link either.

I just took the prescription as I wasn't aware of any other options at the time. My level was alarmingly low; I am on 50,000 iu once per week for 8 weeks; then on to an OTC supplement.

Incidentally, I have fibromyalgia and this is why she ordered the test in the first place. The deficiency either contributes to fibromyalgia itself or produces fibromyalgia-like symptoms; not sure which. My pain is gone now that I've been on the supplement for 3 weeks.

[Ted Hutchinson]

If you are going to take anything to your doctor it should be a link to
The Case Against Ergocalciferol as a Vitamin D supplement (http://www.ajcn.org/cgi/content/full/84/4/694).

You cannot blame your GP they only have access to D2 but it would be in the best interest of her patients if she personally bought some 50,000iu (https://secure.bio-tech-pharm.com/detail.aspx?product_id=20&cat_id=2&subcat_id=0) capsules and issued you will 8, One each for the next 8 weeks and told you to buy the 5000iu for daily use thereafter.

D3 is always more effective than D2 there is a study that says at low doses with brand new specially made/tested D2 it can match the performance of D3 but that isn't the real world where off the shelf D2 has been shown to be prone to not performing at all or not doing as well as expected. Why use and expensive product that has a history of being unreliable when there is a cheaper more reliable more effective produce readily available. It just doesn't make sense. When your health and well being are at stake who is going to mind spending a mere $15 every 250days. 8 of those 50,000iu should only cost $3.
We are not talking big money here so lets put the best interests of patients before the best interests of big pharma.
You can boost your Vitamin D status at this time of year by also using sunlight. See the calculator here (http://www.thevitamindcure.com/calculator)for how long to spend in the sun. Remember more skin will be exposed to the sun when you lay down rather than standing up. If you can manage to find a secluded place full body sun exposure means the Vitamin D3 will be created over the entire surface of your body.
If you are worried about skin cancer here is the latest research showing
Progression of malignant melanoma is associated with reduced 25-hydroxyvitamin D serum levels (http://www3.interscience.wiley.com/journal/120086788/abstract) Solar UV-exposure, particularly intensive short-time and recreational sun exposure, is considered to be the major etiologic factor for melanoma. But on the other hand 90% of all requisite vitamin D has to be formed in the skin through the action of the sun – a serious problem due to the fact that new scientific findings convincingly demonstrate vitamin D deficiency to be associated with a variety of severe diseases including various types of cancer (e.g. colon, prostate and breast cancer). According to recent reports sun exposure is associated with a relatively favorable prognosis and increased survival rate in various malignancies, including malignant melanoma. It has been speculated that these findings were related to UV exposure-induced relatively high serum levels of vitamin D which may lead to a more favorable course of melanoma. To prove this hypothesis the present study aimed to correlate the serum level of 25-hydroxyvitamin D (which represents the readily measurable 'storage' precursor form of vitamin D) with tumor thickness at time of diagnosis and course of disease in patients with melanoma. The study population consisted of 212 patients with histologically proven cutaneous melanomas of different stages: stage I (n = 50); stage II (n = 20); stage III (n = 20); stage IV (n = 122). Basal 25-hydroxyvitamin D levels were analyzed (DiaSorin LIAISON 25-OH Vitamin D-Assay) in those patients and compared with a control group (n = 80). Additionally, each participant was requested to fill out a questionnaire about the history of sun exposure. Interestingly, basal 25-hydroxyvitamin D levels were lower in melanoma patients as compared to the control group, although this difference was statistically not significant. Moreover, progression of malignant melanoma was associated with statistically significantly reduced 25-hydroxyvitamin D serum levels. In conclusion, our findings add to the growing body of evidence that 25-hydroxyvitamin D serum levels may be of importance for pathogenesis and progression of malignant melanoma.

And this
1,25-dihydroxy vitamin D3 regulates cutaneous innate immune function (http://www3.interscience.wiley.com/journal/120086776/abstract) Hormonally active vitamin D3 – 1,25-dihydroxyvitamin D3 (1,25D3) – acts as a signalling molecule in cutaneous immunity. In this study we investigated if Toll-like-receptor (TLR) function and antimicrobial peptide (AMP) expression are controlled by 1,25D3 in keratinocytes. The AMP cathelicidin and TLR cofactor CD14 were known to be induced by 1,25D3, and analysis of TLR2 expression revealed this also was increased by 1,25D3. Topical 1,25D3 application to human skin confirmed these results, showing increased cathelicidin, CD14 and TLR2 by immunostaining. Furthermore, the presence of 1,25D3 enabled human keratinocytes to respond to Malp2 (a TLR2/6 ligand) with increased cathelicidin production which was inhibited by neutralizing antibody to TLR2. 1,25D3 also increased the ability of keratinocytes to kill Staphylococcus aureus. Interestingly, keratinocytes surrounding human skin wounds increased expression of CD14 and showed a previously known increase in cathelicidin AMP. Thus, we hypothesized that 1,25D3 was also a signalling molecule during skin injury. Supporting this, we found that CYP27B1, the enzyme that converts 25-hydroxy vitamin D3 (25D3) to active 1,25D3, was significantly increased in wounds and induced in response to factors in the wound micromilieu such as TGFβ1 or TLR stimulation. Blocking the vitamin D receptor, inhibiting CYP27B1 enzymatic activity, or limiting 25D3 in culture each prevented TGFβ1 from inducing cathelicidin, CD14 or TLR2. Furthermore, mice deficient in CYP27B1 failed to increase CD14 in vivo following injury. Thus, this investigation demonstrates how injury initiates the innate immune response; 25D3 is activated to 1,25D3 by enzymatic conversion, a process triggered by microbial products or host factors such as TGFβ1. The increase in 1,25D3 then directly increases cathelicidin release and enables responsiveness to microbial products through induction of TLR cofactor CD14
While you may not appreciate the importance of these abstracts you should understand that sun exposure does far more good than harm. Even people with melanomas do better if they continue to sunbathe (providing of course they never get sunburnt) and the second paper shows how even MRSA could be killed if people raised their vitamin D status by sunbathing or UVB lights so the entire skin surface generated the antimicrobial peptides prior to hospital admission.

[Ted Hutchinson]

The deficiency either contributes to fibromyalgia itself or produces fibromyalgia-like symptoms; not sure which. My pain is gone now that I've been on the supplement for 3 weeks. I agree but I do not think that Vitamin D3 alone will cure the Fibro. I think you will always have the potential for these symptoms and the only way your body will manage them is when your Vitamin D3 (and omega 3 and magnesium) status are optimal.
I suspect as soon as your Vit d drops the symptoms will return.
I had polio as a child.
When I got to about 40 I started having problems with pain, fatigue, brain fog, and lots of other irritating stuff that got me down.It turns out that polio has late effects.
I think fibro could have a viral origin that produces late effects in the same way. It will lurk in your body and when your immune system is low will return to put the boot in and make you feel even worse.
I think the only way out of this scenario is to make sure you keep your anti inflammatory status as high as possible all the time.

That means you and I will be on 5000iu/daily/D3 for the rest of our lives.

Perhaps if we lived in a nudist colony somewhere warm then we could use daily sun exposure to provide the same natural vitamin d3 status but I don't really think the idea of living naked appeals to me so I think I'll stick to the supplements.

[natenkayliesmom]

This makes SO MUCH SENSE to me.

Guess I'm out to buy Vitamin D!