VITAMIN D IN PERIMENOPAUSE - YOUR ULTIMATE GUIDE

We all know vitamin D as the sunshine vitamin that gives us healthy bones – but there is so much more to this nutrient! In fact, it’s one of the most critical nutrients for those in perimenopause.

Unfortunately, low vitamin D is all too common these days. And that can not only increase your risk of pesky perimenopause symptoms – it can also have serious consequences for your long-term health. So let’s explore why you want to stay on top of your vitamin D levels.

WHAT IS VITAMIN D?

This fat-soluble vitamin is actually a family – it includes the different forms D1, D2 and D3. And while it is a fat-soluble vitamin in the food we eat, it is also a hormone produced by the body. Hormones are substances the body creates that act like messengers in the body, travelling and telling other cells and organs how to act.

Vitamin D is needed for many functions in the body, including:

• Maintaining bone health and increasing bone mineral density
• Absorption of calcium from food
• Supporting immune health (both against infection and autoimmune conditions)
• Regulating mood & reducing the risk of developing depression and anxiety
• Optimising muscle strength
• Reducing inflammation and increasing anti-inflammatory compounds
• Regulating blood pressure and protecting heart health
• Supporting energy levels and brain function
• Influencing production of stress hormones and sex hormones

In fact, there are multiple vitamin D receptors in every cell in the body. So while we don’t know everything that it does yet, we do know that it’s incredibly important for our health.

WHY IS VITAMIN D ESSENTIAL IN PERIMENOPAUSE?

I’m sure you can already gather that this vitamin is pretty essential for us all. But why does it matter even more when you’ve reached perimenopause?

First up, we know that there is a link between vitamin D and perimenopausal symptoms. Research has found that the higher your vitamin D levels, the fewer symptoms you’re likely to experience.

But as you can tell from the list of functions, there are specific perimenopause symptoms that can be exacerbated by low vitamin D. We’re talking:

• Mood swings, depression and anxiety
• Fatigue
• Immune issues such as allergies and frequent illness
• Brain fog and reduced concentration

So no matter what symptoms you’re dealing with, addressing your vitamin D is an easy step to take.

Some of these symptoms may be worsened by vitamin D’s impact on hormones. Low levels can interfere with both testosterone and oestrogen production. And as we know, the oestrogen rollercoaster is a big driver behind perimenopause symptoms!

In fact, there may be a two-way street between oestrogen and vitamin D. Oestrogen increases the activity of the enzyme that activates vitamin D in the body. So the natural oestrogen drop you experience throughout perimenopause increases your risk of low vitamin D.

Then there are the long-term considerations. Most of us are aware that vitamin D is protective against osteoporosis, but it’s not the only chronic condition it protects against! Healthy levels reduce your risk of heart disease, which is particularly important as this risk skyrockets at menopause thanks to the oestrogen drop. Plus it works on regulating blood pressure, cholesterol and inflammation, which are all involved in heart disease.

We also need to look at calcium. After all, vitamin D is critical for getting calcium into the body, so low vitamin D = low calcium. And low calcium comes with its own list of impacts! Some of the biggest mechanisms when it comes to calcium and perimenopause are:

• Nerve and muscle function
• Regulating heart rhythm
• Insulin secretion and balancing blood sugar levels
• Triggering the release of brain chemicals such as dopamine
• Supporting bone health and maintaining bone mineral density
• If your vitamin D is low, all of these can be disrupted due to lowered absorption of calcium.

And are we even talking about health if we don’t talk about the gut? Yes, you guessed it – vitamin D can influence your gut health. Some evidence suggests that low vitamin D could lead to gut inflammation, increased gut permeability (aka leaky gut) and impacts on the gut microbes.

YOU’RE PROBABLY DEFICIENT – THIS IS WHY

Of all the nutrients, vitamin D is one that almost all of my clients are deficient in to start with! And there are specific reasons why your levels are low, particularly as a woman going through perimenopause.

Some of the key drivers of low vitamin D include:

• High body weight – there is a strong link between obesity and low vitamin D. While the mechanisms are still up for debate, we do know that it is ‘diluted’ by the greater volume of the body, reducing its availability
• Age – the older you are, the lower the level you have of the substance that is responsible for vitamin D production via UV
• Organ function – there are many organs involved in vitamin D! They include the liver, digestive tract, skin and pancreas. So if one or more of these is not functioning optimally, your vitamin D is at risk
• Insufficient exposure – we were taught to slip, slop, slap, but it’s coming back to haunt us now! Sunscreen, sunglasses and being indoors does prevent sunburn, but it also stops UV from penetrating the skin and activating the vitamin D precursors.
• Low-fat diet – yet another reason I am not a fan of this approach! As vitamin D is fat-soluble, it needs dietary fat to be produced and absorbed
• Low oestrogen – as we touched on earlier, oestrogen plays a role in activating vitamin D in the body. So less activation = higher risk of deficiency
• Location – for those of us who are in the southern states of Australia/NZ, this is a big one! The further you are from the equator, the less exposure you get to the UV rays needed for vitamin D. That’s why over winter, I often recommend a supplement to maintain levels
• Skin colour – melanin competes with UV rays in the skin, so those with darker skin need more exposure to produce the same amount of vitamin D

HOW TO OPTIMISE YOUR VITAMIN D LEVELS

So now that you know why it’s so important, how can you get your levels up? There are a few simple ways to achieve this, depending on your current levels and the drivers behind why your levels are less than optimal.

MONITOR YOUR LEVELS

This is the first step for a reason! The more you get to know your levels, particularly throughout the seasons, the easier it is to adjust your diet and lifestyle to suit.

This includes testing your vitamin D regularly (I recommend aiming for 100nmol/L). But you can also use apps such as D-Minder to estimate how much vitamin D you’re getting through sun exposure. D-Minder can also tell you the times of day that you can and can’t produce vitamin D.

GET SUFFICIENT EXPOSURE

It seems simple, but it’s your best bet! The amount of exposure does depend on your location, time of year and skin colour.

If you’re Australia-based? Check out this handy map that gives you recommendations on sun exposure based on where you live.

INCREASE YOUR VITAMIN D RICH FOODS

While most of your D will come from the sun, you can still get some in your diet. But I don’t recommend the fortified foods like margarine (ick!) Instead, reach for:

• Fatty fish including mackerel, tuna, salmon and herring
• Eggs (the yolk specifically)
• Liver

PS – you can also give your mushrooms a boost naturally. Pop them out in the midday sun for 15 minutes (gills up), and you’ve got yourself vitamin-D boosted mushies!

CONSIDER SUPPLEMENTATION

Now I will say: not everyone needs a vitamin D supplement. If you’re a tradie in Darwin, you’re unlikely to need to take extra! But there are many people who do need to consider supplements.

Here are a few things to ask yourself if you’re considering a vitamin D supplement:

• Do I have multiple risk factors for being deficient? For example, you might work indoors and live in Melbourne.
• Am I currently deficient? When in doubt, get tested – and if your doctor is not willing to test, you can ask your friendly naturopath about testing (although it won’t be covered by Medicare)
• Do I have access to a good vitamin D supplement? They aren’t created equal, particularly if you need a higher dose! That’s why working with a practitioner can help.
• Do I have someone who can prescribe the right dose for my needs? While it’s rare, vitamin D toxicity can occur. But there are also plenty of people who have taken vitamin D at such low dosages that it doesn’t make a dent in their deficiency! That’s why you want to work with a qualified professional who understands correct dosages.

SICK OF STRUGGLING WITH THE SYMPTOMS AND SIDE EFFECTS OF LOW VITAMIN D?

Don’t settle for feeling crummy 24/7 – let’s uncover the drivers and get you feeling amazing again! Book in for a free discovery call today. Together, we can explore how I can help you to support a healthy hormone balance and smooth the transition through perimenopause.