Did you know that more than 80% of the population is deficient or insufficient in this vitamin?

Today, there is a widespread belief on this topic that lack of exposure to sunlight is the main cause of deficiency.

From an orthomolecular point of view, we could say that this idea is simplistic and more than obsolete, and below I will detail the real and main reasons on this issue that cause so many diseases and organic dysfunctions in the body.

To facilitate a better understanding, I will explain in great detail, step by step, the processes in which this vitamin is involved, as well as its direct relationship with the liver and its metabolic pathways from an orthomolecular perspective.

Vitamin D is biologically inactive, both its Vit D2 (Ergosterol) and Vit D3 (Cholecalciferol) forms have to be metabolized to become their active form.

This process occurs in the liver through hydroxylation at carbon 25. Do you know who controls this hydroxylation? The cytochrome P450-dependent enzyme CYP2R1!

Those of you with a little knowledge of metabolic biochemistry will understand the importance of these enzymes (or rather, they form a family of hemoproteins, since there are many types of CYPs). When these enzymes are blocked or inhibited, a vitamin D deficiency or insufficiency occurs.

So the question we must ask ourselves is this.

Why do these enzymes have low activity?

The enzymes involved in the transformation of inactive vitamin D into active vitamin D are the same ones used by the liver in its detoxification function (in another article I will explain in detail Phase 1 and Phase 2 of liver detoxification), which means that an excess of both exogenous and endogenous toxins will have a negative impact on the liver, producing a greater liver load and thus generating an inhibition in the correct enzymatic function.

Today we are exposed to countless toxic substances that directly affect the liver, as it is the primary site of biotransformation of foreign substances.

We can assess the biochemical status of the liver with a simple analysis by asking for GGT (Gamma glutamyl transpeptidase), since this enzyme is involved in the synthesis of glutathione (I will briefly explain the importance of this tripeptide below).

Glutathione is a tripeptide composed of glutamic acid, glycine, and cysteine, which acts as an antioxidant and detoxifier. When the GGT enzyme is at low levels (between 7 and 12), it indicates that the liver is overworked and that the enzyme, under so much activity, has been losing its ability to function properly, slowing down (the same thing that happens to hydroxylase, which transforms inactive vitamin D into active vitamin D!), causing a decrease in Glutathione, since this GGT enzyme is vitally important for its proper synthesis and degradation.

Alpha-1 hydroxylase activity can also be reduced by interactions with medications such as glucocorticoids, loop diuretics, and inflammatory cytokines (how many people today have silent chronic inflammation!)

What should we do when we find a patient with 25OH VitD (Calcidiol) deficiency or insufficiency?

The most common recommendation is D3 (Cholecalciferol), when in reality it is still the inactive vitamin that has to undergo hydroxylation in the liver to become active, and it will do little to increase the levels of 25-HydroxyCholecalciferol (Calcidiol).

Then we find a small number of more awake therapists who understand this problem and recommend Calcifediol (Hydroferol), as it bypasses the pathway through which inactive vitamin D is converted into active vitamin D through the metabolic pathway and its corresponding hydroxylation in the liver. In this way, they provide this vitamin with high safety and efficacy, which is reflected in follow-up tests, where values increase quickly and safely.

It is important to carefully dose the amount of Hydroferol (Calcifediol) since we can increase the levels too much and produce toxicity.

What can or should we do in these cases to reverse this dysfunctional enzymatic state that is leading to disaster for the vast majority of the population?

As with any holistic therapy, it is important to find the cause or origin of the problem, since giving Hydroferol (Calcifediol) will be of little use if the problem decreases again in a few months.

Have we understood then that the main cause lies in the accumulation of work and overexertion to which the liver is subjected, which has repercussions at the enzymatic level?

Although deficiency can also be caused by other reasons (low intake of foods rich in vitamin D, poor absorption of fats with the consequent decrease in absorption of fat-soluble vitamins, severe kidney failure, etc.), these are a minority and the main cause to which we should pay greater attention is the one explained in this article.

I'm not going to comment on the issue of sunlight exposure because it seems completely ridiculous to me. If that were the case, people who don't sunbathe regularly and get vitamin D in their diet shouldn't be deficient or insufficient, and that's not the case.

So, if the cause is hepatic (anyone with a minimum knowledge of nutrition and biochemistry should already understand this), we need to focus the therapy on several aspects (nutritional changes, supplementation focused on detoxification, reduction of xenobiotic intake, etc.) to decongest the overloaded liver and facilitate proper enzymatic function.

How could this deficiency or insufficiency have had an impact on the physiological level?

Generally, the analytical requests made to social security and mutual insurance companies only ask for Calcidiol (I have doubts about whether this is to reduce costs or due to ignorance), so the results will only show us if there is a deficiency, but not how it may have had a physiological impact.

We know that the active vitamin D is Calcitriol (1,25OH), so it is absurd to only order Calcidiol without knowing how it may have affected its final active form.

When conducting a complete assessment, it would be important to request at least the following parameters (Calcidiol, Calcitriol, PTH, and Calcitonin) to understand the individual's situation and thus provide a judicious therapeutic approach.

To summarize, I will detail 4 of the most important points that you should take into account in order to obtain vitamin D effectively:

1. Eat organic foods

This way you will avoid introducing chemicals and foreign substances that will affect the liver by decreasing enzymatic activity.

2. Eat foods with all their fat

There is a widespread phobia towards fats (a product of media manipulation), making us believe that they are bad, and the food industry takes advantage of this by producing more and more fat-free and skimmed foods, thus absurdly managing to eliminate fat-soluble vitamins (yes, yes, eliminating fat also eliminates vitamins).

Why don't we use our brains and understand that the best way to eat food is just as nature offers it to us?

Avoid anything labeled as skimmed or fat-free; your health will thank you for it.

3. Avoid or minimize exposure to harmful and/or toxic substances

Tobacco, alcohol, drugs, medications, cleaning products, and household products (unless they are organic)

All of these substances mentioned, when introduced into the body, have to go to the liver to be metabolized, decreasing, as we have mentioned before, the enzymatic activity resulting from an excess of xenobiotics (elements foreign to the organism).

4. Maintain the balance of the microbiota or intestinal flora

It is very important that our digestive system is functioning perfectly, and that our intestinal epithelium and microvilli are functioning optimally.

If, for any reason (tobacco, alcohol, heavy metals, chemicals, poorly digested foods, etc.), damage occurs in the intestine, the epithelium will be damaged, producing greater intestinal porosity known as leaky gut syndrome.

When a person has this problem, any foreign substance (xenobiotics) as well as remains of poorly digested food filter into the bloodstream, producing a burden on liver function, a consequence of this excess of elements that should have been eliminated through the feces but, due to the increase in intestinal porosity, have sneaked in (as if it were a broken sieve), creating countless health problems, one of them being related to the liver.

This should be the starting point when you want to assess the cause of your vitamin D deficiency, because it is most likely a leaky gut that is letting countless chemicals and toxins through, and one of the most affected organs will be the liver (the body's largest laboratory).

Many people today have become chronic vitamin D users because they have been unable to identify the underlying cause of poor absorption or poor conversion of the inactive vitamin to active. Therefore, let's try to apply logic and common sense before blithely recommending supplements that, in many cases, will be unnecessary.