A new study just came out in the Archives of Internal Medicine using vitamin D to treat painful menstrual cramps (dysmenorrhea.) What is really interesting about the study is that instead of giving women daily vitamin D, the researchers instead gave a single large dose—300,000 IU!—and found it worked remarkably well to control cramps.
300,000 IU of vitamin D is a very large dose, one you could only get from a doctor. But vitamin D turns out to be a whole lot less toxic than doctors had always supposed, so that taking a substantial daily dose—as high as 2000 IU per day—is unlikely to have any dangers or side effects; it could help cure menstrual cramps; and, according to the latest research, would probably reduce your risk of cancer and chronic pain, and would also help improve your immune system.
Vitamin D has many effects in the body. It is actually more like a hormone than a vitamin, and so it is not surprising how many different body systems, and symptoms, it helps and affects.
One of the important functions of vitamin D has to calcium metabolism, which is why it is sometimes thought of as “the bone vitamin.” Because calcium and magnesium work together to control muscle contractions in the body, we recommend a combination of vitamin D, calcium, and magnesium, taken consistently to control cramps. We have other suggestions too. While this massive dose of vitamin D for menstrual cramps may work, we think a balanced daily approach is best.
“Do I need more vitamin D?” With the evidence for the benefits of vitamin D for women’s health growing—and really, vitamin D is essential for everyone—this question is common. And while vitamin D for PMS or PMDD treatment isn’t important clinically, we still believe that vitamin D testing is one of the most simple and important things you can do for your health.
There’s some confusion about what vitamin D tests are best, and what the tests mean, so read on to find out what you need to know before you get tested for Vitamin D.
1. The correct test for vitamin D is 25-hydroxy-vitamin D, sometimes referred to as 25-OH Vitamin D. There is another test for 1,25 hydroxy vitamin D, and even though this is the active form that your body actually uses, this latter test is useless for most purposes, and unnecessary.
2. Vitamin D deficiency is indicated by a test result of less than 20 mg/dL. If your vitamin D test is 19 mg/dL or under, the best way to quickly get your vitamin D into the correct range is to take 5000 IU of vitamin D supplement every day for two or three months, at which point you should get retested to make sure your levels are going up. It’s also possible to get higher doses of Vitamin D that are meant to be taken just once per week.
3. If your vitamin D test level is between 20 and 34 mg/dL, you are in the suboptimal range. While this is not ideal, most of the studies that show problems from low vitamin D find it at the deficiency level mentioned above, rather than the suboptimal range. Still, if you have suboptimal vitamin D you should take 2000 IU per day of vitamin D supplement.
4. If your test result is between 35 and 75 mg/dL, we would still recommend you take 2000 IU vitamin D per day, because at this dosage you will almost certainly never get excessive vitamin D. However, if your result is above 50 mg/dL, you can pass on taking vitamin D supplements during the summer months, assuming you spend some time outside. A vitamin D level above 75 mg/dL is rare, but anyone with this amount of vitamin D in their bloodstream doesn’t need to take additional vitamin. It’s impossible to get excessive vitamin D from time spent in the sun.
5. If you are dark-skinned, it is harder for you to make vitamin D from spending time in the sun. So dark-skinned people (African-Americans, Asians, South Asians, and others) need to be more vigilant about getting tested, about taking vitamin D supplements, and about spending adequate time outdoors.
6. You can’t make vitamin D from sunshine if your skin is covered by clothing or if you are wearing sunscreen. Although this is another excellent reason to take vitamin D supplements, you can still make vitamin D and protect yourself from sun damage, while being outdoors in the shade. Or, we recommend you go outside, in the sun, in shirtsleeves without sunscreen for 15-20 minutes before covering up.
7. Lastly, only take vitamin D3 supplements, or cholecalciferol. Vitamin D2, ergocalciferol, is not as well absorbed, and isn’t the natural form your body uses. Vitamin D2 is up to 33% less efficient as a source of vitamin D compared to D3.
We recommend vitamin D for PMS and PMDD if you’ve already taken care of the basics of diet, lifestyle, and nutritional and herbal supplementation. But we recommend you make sure you have adequate vitamin D in your body for its overall benefits.
The more we learn about vitamin D, the better it sounds. The latest study from Denmark was announced this week at the American Heart Association conference. It shows that vitamin D deficiency in women increases the risk of heart attack, heart failure, stroke, and death by 50%. This joins a long list of studies that show that Vitamin D is essential, not just for heart health, but also for proper immune function, bone health, cancer prevention, and more. Although there are no studies yet to prove it, we suspect that there is a Vitamin D-PMS connection as well as a Vitamin D-PMDD relationship.
The best way to get vitamin D is from sunlight. Of course, many people avoid the sun because of skin damage and skin cancer concerns. Did you know, though, that your skin can make vitamin D even when you’re in the shade? The sun rays that allow your skin to make vitamin D can be absorbed when they bounce off of leaves, rocks, and buildings. So spending time outside, even if it is not directly in the sun, will work to boost your vitamin D level. Of course, if you are wearing clothing or sunscreen that blocks sunlight from reaching your skin, this won’t work.
One of most overlooked vitamin D issues is that if you are dark-skinned, for instance Asian, South Asian, African-American, Native American, or otherwise have highly pigmented skin, the melanin (coloring) in your skin prevents you from being able to manufacture vitamin D without being outside, or out in the sun, for a prolonged period of time. This is particularly important in northern climates with long, cold winters.
Although most media sources mention eating fish livers (who does that?!) and drinking milk and orange juice as sources of vitamin D, this isn’t helpful advice. The best way to get vitamin D other than sunlight is from taking vitamin D supplements. It’s too hard, if not impossible, to get adequate vitamin D from food. This is especially true if a test determines you are deficient; if you have dark skin; or if you live in a northern climate.
Since the media doesn’t seem capable of telling the truth about supplements (or, perhaps, of telling truth from fiction when it comes to supplements) here is what a woman needs to know about vitamin D supplements: it is nearly impossible to overdose on vitamin D. We recommend taking 2000-5000 IU of vitamin D per day during the indoor months, particularly if you live in a northern part of the country.
Vitamin D isn’t first line treatment for PMS or for PMDD. But it is essential, and too many women just don’t have adequate an vitamin D level. We’ll be talking more about how to understand lab tests for vitamin D in another post.