 Hi guys, this is Dr. Ahmet Ergen. I am an internist and a necronologist and a diabetes educator located in Florida. We serve entire Florida virtually and entire New York virtually. So today we are talking about something that everybody likes to talk about, vitamin D deficiency. So we are going to talk about risk factors of vitamin D deficiency. Why would you be vitamin D deficient to begin with and what to do about it. So and what are the symptoms and signs? We'll talk all about that today. Let's get started. Guys before we start make sure you leave a comment, ask questions, give a thumbs up for us, spread the word. This is an important topic that all of you need to know. So let's talk about why would you be vitamin D deficient to begin with. Now that's important for diabetics. For if you have type 2 diabetes, vitamin D is extremely important. So if you are watching our channel for diabetes, definitely stick around because we are going to talk about how vitamin D can affect diabetes. But vitamin D is actually a hormone. Most people call it vitamin D but it has so many functions and is actually a hormone. As a result and an oncologist, us we deal with problems associated with vitamin D all the time. So why would you become vitamin D deficient? Well, if you are not a sun person, if you like to stay indoors or if you're just too old or too sick to get out under the sun, you will develop vitamin deficiency easily. Now I'm not saying go get yourself burned out there under the sun because sun can also create sun damage, can make you look older faster. I can give you melanoma and other cancers. So you have to be careful about that. Always wear sunscreen, but you have to have a little bit of a sun exposure. My weekends, I am always out doing water sports. I think I'm going to look old fast. But it's an addiction. I can't give up. So what can you do? The bottom line is if you have a darker skin like mine, actually you are at a little bit higher risk because when you have a darker skin, it's going to have an advantage against the sun damage, but it may not be a great advantage when it comes to producing vitamin D under your skin. So if you didn't know, a lot of vitamin D is produced under your skin, under the ultraviolet lights. Now we don't recommend tanning beds either because we don't know the safety of these UV lights that you guys go just to get that tan under the tanning bed. Yes, your vitamin D levels may go up, but you may die from cancer. So not a good way. Again, you know, we always tell people if you are vitamin E deficient, I don't really recommend going to the beach and get yourself roasted. If it's a lifestyle, if you're at the beach, if you're doing things outdoor, great, but if not, definitely do not just expose yourself out there, especially if you're not used to it. Vitamin D replacement, which we'll talk about in a minute. So what are the signs and symptoms of a vitamin D deficiency? How do you know you can be vitamin D deficient? Now, vitamin D test is very interesting in the United States, especially here, when we order a vitamin D test, patients may get a bill telling that your doctor ordered vitamin D for nothing. Well, that pisses me off all the time. And I'm like, okay, patient has this symptom, that sometimes they don't even accept that. So we have to go by their books and see what they like. But if you tell your doctor what you're feeling, your doctor may be able to choose the appropriate code so you don't get a bill for the freaking vitamin D test, which can cost you upwards of hundreds of dollars, which hard to understand in the United States, everything is freaking expensive. Alright, so you can be getting sick a lot. Now vitamin D has been shown actually to induce macrophages, which is the first defenders in your body. Now, what kind of vitamin D do you need, right? So studies show that if you're really, really deficient, like below 10 vitamin D, that can really be a problem. But if you are between 20 and 30, that's not really that bad. Above 30 is really desirable. But the bottom line is you don't want to also go overboard and go have a vitamin D of 100. So it's really, I think the sweet spot of a vitamin D is around 30 to 40 and maybe 50. But there is really no benefit of going above 50. And I found a study actually, that says that too much vitamin D can increase the risk of mortality. Now too little vitamin D can increase the risk of mortality as well. Like we discussed all the time, too little of something and too much of something is never good. That's like a principle that should be a principle in your life. Any addiction is not good. Anything of too little too much is not good. So you have to find a balance. I think the sweet spot for vitamin D is 30 to 40. Let's move on. So as a result, you know, if you are vitamin D deficient severely, your body may not be able to respond to pathogens and the viruses and the bacteria as good as it does normally when you're vitamin D replete. Now, secondly, you may be feeling very tired and run down if you do not have vitamin D. Now, again, we said about this, we talked about this vitamin D is a hormone it has major functions in your mitochondria, which is the energy producing factory. It has major function in mitochondria. As a result, people with vitamin D deficiency suffer from muscle weakness. That's why people who stay indoor, they get more and more immobile, they start aching all over the place and their bones even can start hurting. It can be like even tender to touch. So you squeeze their bone a little bit like this, they're like, Oh my God, it hurts because vitamin D is very important for your bones. What is the function of vitamin D? Primary function of vitamin D is actually to get the calcium from your intestinal system and keep a balanced calcium levels in your blood. Calcium levels are so important that if you have a very little calcium or too much calcium, actually too much calcium can literally put you in coma and too little calcium can literally trigger a rhythm problem that can stop your heart. So balancing, keeping the balance of calcium in your blood is extremely important. So when you do not have enough vitamin D, what happens? The other hormones kick in. This guy has not done his job or he's not even at work anymore. So I'm gonna have someone in kicking in to get the job done. We call that parathyroid hormone. So as a result, a lot of people with vitamin D deficiency, you can see that their parathyroid hormone is high. So then some doctors will think that there's something wrong with that person's parathyroid hormone regulation. But actually, the problem is with vitamin D. So if your parathyroid hormone is high and your calcium is normal, that is because parathyroid is borrowing calcium from your bone and putting into the blood because your blood calcium has to be tightly regulated. Now what happens as a result, your bones will suffer from that. Your bones is basically giving out calcium. So vitamin D is there. There is no need for parathyroid. So your bones are happy. Your muscles are happy because mitochondria needs vitamin D and so forth. So if you're suffering from muscle and bone pains, if you're suffering from osteoporosis or fragile bones, if you're having fractures, definitely you have to immediately replete, replace your vitamin D levels ASAP. Now number three is insulin resistance. Of course, insulin resistance have a lot of reasons. But if you're vitamin D deficient, you're not really helping yourself. I'm not saying if you just take vitamin D, your magically will lose weight and the whole insulin resistance will go away. But it will help it. Is it 5% of it 10% of it? I don't know. Not that the studies know. But the studies show that people who are having very low vitamin D are typically insulin resistant. Typically, there are more obese overweight. It's a risk factor. So we don't know which one is chicken and egg, but we know that vitamin D deficiency may have a role in insulin resistance. And ironically, some of my patients will report that if they take vitamin D, they feel better, maybe muscle function gets better, maybe they move more, whatever the reason, whatever that the vitamin D does to mitochondria, and then the insulin resistance definitely has a good significant role. So make sure your vitamin D levels are more than 30. If you have diabetes and insulin resistance, that's extremely common among insulin resistant and diabetic patients. Again, that's why a lot of diabetic patients tend to have more bone fractures tend to have more infections. So vitamin D being protective against infections against bone fractures definitely will help you to avoid some of the complications that come with diabetes. Now the next is depression. So as you know, depression is super common. Like you know, you look right, somebody's depressed, you look rough, somebody's depressed, it's kind of everybody has some problems going on. I didn't blame them, you can be depressed, you have the right to be depressed. But you don't want to necessarily ignore yourself and just let things go. And let me talk about B12 in another video that can cause depression, but this vitamin vitamin D is also has been associated with depression. Now if you take vitamin D, will your depression start magically go away? I'm not sure about that. The studies are not sure about that either, but there is definitely an association between low vitamin D and depression. I've discussed about before, you know, people with low vitamin D, they tend to be indoor, they tend to be sicker, they tend to be more overweight, and those people tend to be more depressed too. So is this that or some other thing? We don't really know. But again, if you're depressed, definitely, you know, if you have the initiative for that, at least if you care about yourself a little bit, make sure you know your vitamin D levels are fair enough to. And the next thing is the impaired wound healing. So some of you with diabetes, either already developed a wound from neuropathy, or will develop some one in the future. God forbid, if you do not keep your sugars under control, and neuropathy gets worse and worse, eventually something may happen. Now, if that happens, you know, it's challenging to treat. So it's challenging to treat the wound infections, especially with diabetes, because your immune system is down. And as we discussed, vitamin D helps your immune system a lot. So if you have vitamin D deficiency, studies show that people who are vitamin E deficient have delayed wound healing. So make sure your vitamin D is good enough. Now one more thing that I'm going to talk about is hair loss. Now I get a lot of patients who come in for hair loss, stating that their thyroid is is wrong or something is wrong with them. The things that I check commonly for hair loss is vitamin D number one, I check their iron levels, I check their zinc levels, B12 levels, or the biotin levels. So we do that. And vitamin D deficiency is one of the most common things that I find in people who have hair loss. Now, how do you get vitamin D? You can get the vitamin D in supplements. Most people need at least 1000 units of replacement. If you're deficient, you can go upwards of 2000 or 5000 every day to get your levels a reasonable level. There are pharmaceutical approach to that. You know, we sometimes give 50,000 units if people cannot take or cannot remember taking a vitamin every day, then we just give them 50,000 units once a week. That's not forever because 50,000 can add up quite a bit. So after certain amount of months, like three months, six months, we recheck the vitamin D levels. And we tell them to take a you know, vitamin D is a stored vitamin. So if you're taking, you know, in a week, so it can be once a week, or it can be a couple times a week. But if your total dose is around 5000 to 10,000 units of vitamin D, you are going to be able to maintain your vitamin D pretty well. But if your levels are down to five or eight or something like that, you may need that mega dose to get your levels up there fairly quickly so that you know, you can get where you want to be and then just maintain it. So I think that's the end of the video guys. If you liked it, please share, please give a like, and write a comment. We'll appreciate it and we'll see you in the next video.