Think you can’t be vitamin D deficient if you live in Ibiza? Think again.

It’s easy to think that living on an island with year-round sun would mean your levels of vitamin D (AKA ‘the sunshine vitamin’) are taken care of. But you might be surprised. Recently, I shared with one of my Ibiza clients the findings of her recent blood test results. Your vitamin D is low. We need to get you on a high strength supplement to bring that back into an optimal range.’

‘How am I deficient?!’, she replied ‘I walk the dog every day. I’m outside all the time. I live in Ibiza… Not London!’

As a nutritionist I am a big advocate for testing. (You can take a look at my article on navigating health testing in Ibiza for more on this). I like to have detailed insight into my client’s state of health so that I can provide tailored recommendations. After years of practicing in London, I am in the habit of adding vitamin D to all blood test requests. Given that most of our vitamin D is produced when our skin is exposed to the sun, it’s no wonder that grey-skied London inhabitants are usually deficient unless they were supplementing. But on moving to Ibiza, I’ve been surprised to see just how many of my clients here are deficient too. 

Deficiency is a big problem globally. An estimated one billion people in the world have vitamin D deficiency or insufficiency and low levels can wreak havoc with your health. Not only do symptoms include low energy levels and frequent coughs and colds, evidence links deficiency to autoimmune diseases, cancer, cardiovascular disease, depression, dementia, musculoskeletal decline, and more.

But you can be deficient in vitamin D without experiencing any noticeable symptoms at all. 

Why is vitamin D so important?

Optimal levels of vitamin D are vital for good health. Vitamin D regulates calcium and therefore is essential for strong and healthy bones and teeth. It’s necessary for healthy functioning immune and cardiovascular systems and for healthy cognitive function to name just a few.

How to tell if you are deficient 

A simple blood test can determine your current vitamin D status. I recommend running a comprehensive blood test at least once a year and including vitamin D. If your doctor is referring you for a blood test, always ask for them to include vitamin D.  

Who is at risk of deficiency?

Certain groups of people are at a greater risk of deficiency. People who are housebound or rarely go outside and people over the age of 65 years are especially at risk. Skin colour also plays a role. The darker a person’s skin, the lower their ability to synthesise vitamin D. That said, I see plenty of Caucasian clients with low  or borderline levels of the vitamin. You can fit none of the above criteria and still be deficient. I personally have genetic traits that mean I’m predisposed to deficiency so I take a high strength supplement year round.

What should your level be?

A review of evidence into vitamin D status in relation to a variety of health outcomes concluded that: for all endpoints, the most advantageous serum concentrations of vitamin D begin at 75 nmol/L (30 ng/mL), and the best are between 90 and 100 nmol/L (36-40 ng/mL). These are the levels you should be looking to achieve.

How to top up your levels

If you have low levels, you’ll need a loading dose to correct this. To correct deficiency, it’s advised we consume 280,000 - 300,000 IU over a period of six to 10 weeks. This can be supplemented as:

• 50,000 IU once a week for 6 weeks (300,000 IU in total)
• 20,000 IU twice a week for 7 weeks (280,000 IU in total)
• or 4000 IU daily for 10 weeks (280,000 IU in total)

Higher strength doses are available at pharmacies while you can find daily dose strengths at health food shops like Natural Point in Santa Eulalia.

Supplements are available in two forms: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Most experts agree that D3 is the preferred form. Humans synthesise vitamin D3 in response to sunlight and therefore it is the most natural form to supplement. Vitamin D3 is more bioavailable and significantly more effective at increasing blood levels than vitamin D2. Vitamin K is required for vitamin D absorption so some brands combine both vitamins for enhanced absorption. 

If remembering to take supplements isn’t your strength, you might wish to consider an injection instead. Speak with your doctor or book in with one of our nurses.