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Thoughts on Cholesterol Management and Vitamin D

Over the weekend, I reviewed some blood work for a longtime friend, and in sharing feedback with him, I was reminded of a few points that many people don't typically hear about from their primary care provider.

First, one of ways in which our endocrine system regulates cholesterol is by converting it to vitamin D - the first step of this process occurs in the skin, where UV-B rays in sunlight act on cholesterol to create a form of vitamin D that is stored in our fat cells - whenever we need the active form, conversion happens in the liver and kidneys.

When we don't get sunlight, this conversion of cholesterol in our skin to vitamin D doesn't happen.

It's worth noting that over winter months, UV-B rays don't make it to areas above 35 degrees latitude north and below 35 degrees south, so if you live too far north or too far south of the equator, during colder seasons, you're unable to make vitamin D from cholesterol in your skin.

Regardless of where you live, it's to your benefit to get some exposure to sunlight on a regular basis. But you'll want to regulate how much you get to ensure you don't burn, taking into factors like the fairness of your skin, proximity to the equator, and the quality of your diet - those who eat more heavily processed foods that are rich in seed oils, and less richly pigmented plant foods that are abundant in antioxidants tend to have more free radicals floating through their skin, which puts them at higher than average risk of experiencing sunburn.

All other factors being equal, responsible exposure to sunlight will help optimize your endocrine health and lipid profile.

Second, eating too much sugar can cause your body to generate more LDL and triglycerides - chronically elevated levels of both increase risk of experiencing heart disease and stroke.

Third, regular exercise that increases or maintains muscle tissue helps your body regulate blood lipids, as muscle tissue soaks up and stores sugars that you eat, which helps maintain ideal insulin sensitivity - the result is less generation of LDL and triglycerides.

The fact is we need cholesterol to be optimally healthy. Among many functions, cholesterol does the following for us:

1. Contributes to cell membrane rigidity and strength.

2. Serves as a precursor to hormones that help us deal with stress, as well to make sex hormones.

3. Gets converted to vitamin D, which is essential for proper growth, healthy bones, a healthy nervous system, muscle tone, and proper immune system function.

4. Is used to make bile, which is needed for digestion of fat in our foods.

5. Acts as an antioxidant, actually protecting us against cellular damage that leads to heart disease and cancer.

6. Helps maintain a healthy intestinal lining, offering protection against autoimmune illnesses.

One note on vitamin D: being a fat-soluble micronutrient, it can accumulate in our adipose tissue, our fat cells. So if we get too much of it from supplementation, we can experience symptoms of toxicity.

This is the beautiful point of getting some or all of our vitamin D from sunlight reacting with cholesterol in our skin: vitamin D made in this way is only made to a level that meets our needs, and once this level is reached, our bodies know not to make more.

When supplementing with D-3 to meet our needs, my general views are as follows:

The optimal range for 25 hydroxy D appears to be 50 to 60 ng/mL (U.S. units). Some vitamin D experts feel that one can go higher, even up to 80 ng/mL. But my suggestion is to err on the side of caution and aim not to go higher than 70 ng/mL.

Every 1,000 IU of D-3 that is ingested daily via supplementation raises 25 hydroxy D by about 10 ng/mL. So if your level is at 20 ng/mL and you want to get up to 60 ng/mL through supplementation over winter months, 4,000 IU of D-3 daily is the right amount.

Primers on cholesterol and vitamin D can be found at the following pages:


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