Functional Medicine Bitesized | Vitamin D & Covid 19

Practical Tips to Reduce Risk of Covid 19 with Functional Medicine Practitioner Pete Williams

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Functional Medicine Bite Sized is the podcast where Functional Medicine practitioner Pete William chats to experts in the field of functional medicine and health, giving you the listener pearls of wisdom to apply on a daily basis.

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In a recent episode, Pete chatted with Senior Nutritional Therapist, Sarah Sharpe from Nutri Advanced, about Vitamin D. You will hear them discuss the basic functions of this Vitamin, why we need it, how much we need and why certain individuals and populations may need more or less. They turn specifically to the role of Vitamin D in relation to Covid 19. Using a functional medicine perspective, they provide you with the knowledge and tools to optimise your Vitamin D levels throughout the year.

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Listen to the podcast episode here, or find the written transcript below.

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Welcome, everybody. Welcome to this episode of Functional Medicine Bite Sized. It’s a great podcast today because, again, I'm going to be interviewing one of my old muckers Sarah Sharpe. 

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Pete: Now just let me give you a little bit of background on Sarah. Sarah is one of the senior nutritional therapists at Nutri Advanced and just a brief on Nutri Advanced - they've been around for 40 years. So this is a nutraceutical company in the UK, that have a wealth of experience. And Sarah, you know, I mean, me and Sarah go back a long way, don't we? It's been at least 15 years that we've been working together. We talked about that time that we stood in front of all those personal trainers 15 years ago on a winter's day, my son, Tom, he was only a baby at the time, wasn't he? So we go back a while, don't we? I think the key for this is that, you know, we're sort of getting a bit older now when you've been purely in the nutrition area for over 20 years. 

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So you've got this real wealth and depth of experience on nutrition, which is why we're having a conversation today because the conversation today is really just around the fundamentals around vitamin D. But also a sort of just I want to sort of utilise that regards to where we are with going into the winter with COVID and with flu. And sort of extrapolate into that. So welcome! Thanks for coming on board. As you say, it's been a while since we've done something together, isn't it? So I'm chuffed that you're on. So look Sarah . Again, I don't want to overcomplicate things here, but I think they're how the world understands vitamin D. We used to think it was just for bones. But we're certainly learning that that's absolutely not the case at all. So so why don't you just give us the expanded view, if you like of where we are with vitamin D. Why is it so important? And why are we so deficient as well, I think that's a really good thing to start with. So all yours.

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Sarah: Firstly, thanks for the intro. Vitamin D is such a huge, huge area. And there are so many different research papers and things like that, that are all you know, coming out. And especially with, you know, the immune factors at the moment, we've seen so much explosion of interest in Vitamin D. But the origin of sort of like getting into understanding vitamin D, like you say is from bones. So the research behind understanding, it prevented rickets back in the day. So with vitamin D, its primary function is to help us to absorb calcium it from the diet. So that's its, its number one kind of function. And then once it's in the body, we need other things to help us use it. Use that calcium. So that's really where the history of understanding vitamin D is important for our bones came from. 

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However, now we're really exploring vitamin D in a new way and looking at how it gets right into every single cell it unlocks the potential in our DNA. And it plays a role in so many different aspects of human health. But like you say, one of the problems is that we as a nation, we are quite deficient in Vitamin D we just don't seem to get the same you know, levels that we used to have and that's for a huge number of reasons really so the ways that we can get vitamin D is we can get it from our diets but not a great amount and you know, if we look at how much vitamin D we get, you know wild salmon is is a high source you know get some from eggs but it's it's really you know, you have to be eating a huge huge amount like an unreasonable amount of those things to achieve a good level to be realistic it's it's pretty impossible to do isn't it? Yeah, so no theory you can but as you say I can talk about in clinic it definitely seems an impossibility.

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Yeah. So it does it's not for no reason that we know vitamin D is the sunshine vitamin because it is produced when we are exposed to the sunshine and we produce it in the layers of our skin and that's how we get the highest amount of vitamin D is through sun exposure. But you know these days everybody's a little bit afraid of skin cancer and so we use a lot of sunscreens we cover up we just don't get the exposure I don't know about up but I'm in Manchester and it's you know, it's even on the days when technically I should be able to get good sunshine because the sun is overhead, it's strong, it's the summertime, then quite often it's cloudy and raining. So it's quite difficult for me to achieve a full exposure of vitamin D, even if the sun's out. So I can struggle sometimes. So there are other factors as well. So there's lots of reasons why people may be deficient. It can be things like, as I said, limited time outside limited exposure to actual sunshine, even when you're outside of rhinoplasty or outside, and then a certain category of the population who actually have a higher risk of being deficient. 

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Can we go on to this? I think this is quite an important bit. Because again, not only are we talking different races, but we're also talking the difference between people who are lean, as opposed to people who are overweight or obese.

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Yeah, absolutely. So basically, it's a fat soluble vitamin, meaning that it's absorbed into our fat cells, if you're underweight and don't have carry a lot of fat, then it can be difficul t to get enough vitamin D, or to hold enough Vitamin D. But likewise, if you have a large amount of fat cells, then it will be stored in those fat cells as well. So it sort of acts as a sponge for the vitamin D. So people who are overweight or obese actually need two or three times the normal daily amount of vitamin D to actually achieve the same blood levels.

I mean, the word that they seem to use in literature is sequestered. And I suppose what they're almost saying is that it sort of gets stuck, doesn't it? I think that is that the way to describe it. 

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And also, if you think about the, we know, we need it in every single cell, including those fat cells. So if you just have a larger amount of those cells, then you're gonna have a higher requirement for vitamin D as well. So on the whole, that's, that's another reason why somebody may have a deficiency or have a higher requirement, I don't know about you Pete. When I look at people's nutritional status, when we considering supplementation, there's two different ways that you can use a supplement. And I always find this quite fascinating. One of them is that you give a supplement to get a direct effect. And this tends to be more like your herbs and things like that, if somebody has a particular condition. So you got a cold right now and you wanted to take some vitamin C, that would have a higher amount, and you'd get a direct effect. The other way that you can take supplements is to correct nutritional deficiencies. And I think this is something I mean, it's probably we'll get into this a bit more later. But it's just raising the levels back to normal function. So it's all about just achieving normal function within the cells. And vitamin D deficiency is so widespread, that people's cells just aren't functioning properly. And that affects again, so you know, I keep saying it, but it's so many different areas of health are affected, including bones, but it could be immune system, it could be inflammation, it could you know, there's just lots and lots of different things that it actually impacts.

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So I think this is what we've learned, isn't it. And I think this is almost like conventional thinking, move into systems thinking, because I think what the evidence has shown us is that vitamin D is not just about bones were actually found the seems to be a receptor in every single cell of our body for vitamin D. And I think that, for me is the Wow, point. It's like holy cow. So that means is that every single cell in our body, if we're deficient in vitamin D, maybe isn't going to be performed as optimally as it should do

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Yeah, so it's basically we make it in the skin, then we use a protein to transport it around to all the different cells. And then it's actually attached in the cell to the vitamin D receptor. We need things like magnesium, we need vitamin A, we need things ensure that that absolutely works 100%. And these are all things that we may not be getting enough of in our diets and you know, getting enough exposure to sun exposure to have adequate vitamin D levels. And then that can unlock them potential within the cell, and actually have then good quality. And I think what the research has shown is that the associated issues that people are having from vitamin D deficiency, it's not necessarily that vitamin D is is this sort of snake oil kind of cure all. It's more that the Vitamin D deficiency is affecting us negatively. So we just need to restore our levels and get them to a really good level.

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So I also think what you bring in is a really key question here or because we'll have many people or many of our patients go,  I took I took that vitamin, I mean, it didn't it didn't solve it. I don't feel any better from it. And I think you're absolutely answering the question, though, is that for many people, unless they are highly, highly deficient, it's unusual for them to see. So I mean, I can think about I'm going slightly off subject here, but I can think about being deficient in B 12. I think being deficient in iron, and to some degree being highly deficient in vitamin D. You do see the change you do see the reduction in symptos over time. But it's unusual that you're going to give someone a supplement. And suddenly they're going to, you know, all the diseases have been sorted and all their symptoms are going down. I think that's a key understanding, I think, for patients to understand is that has that vitamin worked? Well, here's where your level was when we started. And here's where your level is now, what we've been given you as absolutely hit the mark, it may not, you know, fundamentally solve what you think it's going to solve, but it's done its job.

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Absolutely. And I think that nutrition is one of those fields of study, were actually what we're doing is we want to level the playing field, we want to give everyone a fair start. So if you're raising people's vitamin D to a normal level, then we need to be looking at the other things that they might be missing as well. So it's just about ticking off right, vitamin D, we've got that a good level, that's not going to cause you an issue, let's look at what else we might be needing to find that raise you to that good starting point. So there may be multiple deficiencies, or not necessarily deficiencies, sometimes it's inadequacies or higher requirements. And then we weren't looking to just try and balance those out. But vitamin D is usually one of the first ones that we go for, because it is so widespread, you know, you get people going to the doctor and having tests done and showing the bed levels are just through the floor. And again, that can be some of the groups that we highlighted, but particularly in black, Asian minority and ethnic groups where the skin acts at the melanin pigment in the skin  is actually acting as a barrier to the sun's rays. So people who are in the BAME community need to spend longer getting a sun exposure to achieve the same vitamin D levels as white counterparts. So they'll just that's just just one thing to bear in mind as well.

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And I think to be clear on that is that if we still, you know, the the evidence suggests evolutionary that we've we've all come from South Africa. So what has happened over time isn't is white skin, and particularly ginger, hair and white skin are genetic mutations, as civilizations and peoples have moved to more northern climate because you're not going to get as much sun. So you need a skin that is going to capture more sun. And it's really relevant isn't it is the BAME group is really relevant from a point of view of going into the winter, and particularly with COVID. Because obviously, the most at risk group is the BAME group. And when we're when we're talking about COVID. And Vitamin D plays a huge part of that. Can you can you just talk briefly with regards to disease risk and latitude because we know and vitamin D, we know has a big component with that, particularly with autoimmunity, which is sort of discovered about 30 years ago.

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Yeah, so it's really interesting, I'm a bit of a geek about maps that represent sort of like health across the world, and autoimmunity and vitamin D exposure, our latitude, you know, so the strength of the sunlight that we're getting. And as we move further away from the equator, then we get a less strong sunlight. And I suppose this time of year, we're starting to see our shadows drawing out. So a good measure is, if you're standing in the midday sun, and your shadow is longer than your, then you are tall, so it's longer than the height of you, then you're not going to be getting good exposure. You know, the sun at that latitude is just, you know, the sun's angle and things like that. I'm not a physicist. So I'm not great at describing that. But it generally means that the sun's not strong enough if your shadow is longer than you are at tall. And that's as we move away from the equator. And you know, as the seasons change in the position of the earth to the sun changes, the sun is less strong, we just get less exposure, you need to be out in, you know, sunlight, you need to be exposed in about a quarter of your body. So like arms and legs, if you're, you know, shorts and a T shirt type thing would give you good exposure, you know, between the hours of 11 in the morning and one o'clock is usually when the sun's strongest. Obviously, we need to be careful of overexposure and sunburn. But you know, you can sort of tell I've got very pale skin and I do you know, if I'm not careful, I do burn very easily, but I can feel the pinkness in my skin after about five minutes of sun exposure, and that's my vitamin D and then I put my sunscreen on. So, so I catch it very easily, which is great for my vitamin D, but other people need to sort like you can often find your own level of of that kind of exposure. But yeah, definitely if you plot the lines, those who are closest to the equator have by far less autoimmune conditions. And as you move away to say, like Northern Europe, where the sun exposure is much, much less than we start to see increases in autoimmunity and other illnesses associated with low vitamin D.

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Interesting. I mean, what is the science telling you? I mean, I think well, it's I'd sort of, I sort of know what the science does great to get a deeper understanding is that we do seem to see that vitamin D pretty much has some degree of, and I'll be careful what we do. Because I think there's a, there's always this argument about Association isn't causality or isn't direct mechanism. And what we're saying on that is that subject, let me give you an example, vitamin D isn't going to mean that you're not going to get COVID as an example, but what we're saying is that vitamin D, and we're going to talk is highly associated with less risk.

Yeah, and there's so much research at the moment, particularly like you say, so we could take COVID, there is good research, looking at the blood levels of vitamin D in those who have had COVID. And looking at how strong the case of COVID was, how you know how many symptoms they had, and it matches what they've done in the past with things like pneumonia, colds, and flu, all of these things, the lower your vitamin D level, the worse the symptoms generally, so you can plot this time and time again, showing that your duration of your illness is generally longer. And the severity is generally worse, if your vitamin D levels are low, it's not the case that just by magically taking vitamin D, it's going to prevent you from getting it like you say, it's not something that's going to be a cure all, and I'm just going to take vitamin D, and I don't need to worry about COVID. But it will certainly help you, you know, like the research would be on your side, then you'd be setting yourself.

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And, and so that's leading us into moving into the winter in the conversation around. And I'm not gonna just say COVID because, of course, what we're looking at is flu viruses and, and colds in general, you know, the upper respiratory tract infections that I'm going to, I'm going to get you to pull out on some of the research. So I sort of wanted to move into the reason probably why we're on this podcast today. And that really is because I've just watched, you know, obviously, I'm keeping up with the COVID research, and I've just watched the Institute for Functional Medicine who are doing have consistently done an incredible job of and I had Pat Hanaway on a couple of weeks ago who was talking about COVID. And they've done a brilliant job keeping up with the data. And I think they do a brilliant job of lack of bias, you know, should you or shouldn't you they're just presenting the facts, as we know. And Dr. Joe Pizzorno, had a brilliant line right at the beginning of the recent updates. And he said vaccinated or not, you have to increasingly look after yourself better than you were before. Because no one's talking about and I think this is the I think this is the annoying thing I think about where we're at, I suppose from a government in the UK. It's it's all about the vaccination. And I get that and I get it. And again, whether you're vaccinated or not, that's not what we're going to talk about. But there's nothing about actually looking after yourself. There was lots of these messages last year about think about your weight. I think about the you know, certainly the more at risk groups like the BAME groups, of course, you know, more overweight, darker skin, we're nearly not getting any help here. And what I think what I want to do from this is that the reason I wanted to talk about vitamin D and get your expertise is because it's pennies a week, as far as an intervention. And it's just got such significant science behind it. You know, it's a win win on every single thing that is so incredibly easy to do, and easy to implement. So let's move on to as you say, what we've learned with Vitamin D, and not just we've COVID, but with upper respiratory tract infections and with the flu, because obviously, what we're hoping is not going to happen is we're going to have a double whammy effect is that we're going to have a big flu issue, and we're going to have COVID And even having flu and you've got COVID at the same time. That's going to be pretty nasty on anyone's sort of day to day basis. So just what are we with that?

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Yeah, I mean, absolutely. I mean, I've got small children as well who are school age we've just been through and a cold that's been picked up, I think people haven't been mingling. So it's like you say it's not just about the vaccine and whether you've had it or not, and getting COVID It's about all the other things that are around at the moment as well. So vitamin D count has been shown to help with colds and flu and other infections by just it forms a big part of our immune system, how we actually mount an immune response, essentially, a lot of our immune system is causing inflammation so then get rid of the virus or the infection or the bacteria. So the Vitamin D can help us with that as well. So it's it's really about ensuring that the best you know, it's certainly something I've given my kids vitamin D top ups we've not seen a lot of sun like I say we're in Manchester so when we actually managed to have some time off to go and spend outside you know 90% of the time, it's terrible weather. So so, you know, I top my children up ahead of, you know, the return to school and ahead of the mingling that they've been doing just to try and give them a fighting chance of Fending off some of these colds and just give their immune system a bit of a boost. The research out there particularly in children is, you know, like, it's a very well studied area, but in adults too, very large surveys that have been done looking at, like I said, reducing that duration of a cold or a flu, and also reducing the severity. And I think everybody who's ever had any kind of cold or flu or upper respiratory tract infection, would appreciate a reduction in duration and severity. And that's really what the research is showing us.

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And so I suppose this leads us into thinking about what Okay, so we know, again, I think we're both clear that the evidence is is pretty clear that there's a very strong association with vitamin D levels, and risk of colds of infections and flus and COVID. And in fact, again, I mean, this is just a hotbed, isn't it? At the moment of research of actually looking at vitamin D, there's been so much done around COVID. And I'm looking at a paper now that came out, really about a month ago, I just want to read out the title, because what we start getting into next and we can get your opinion is well, how much do I need daily? And is it proven that I should maybe think about testing and I think the answer to that, for me is absolutely in in a lot of people if you want us to certainly go higher dose. But this paper is called COVID mortality risk correlates inversely with vitamin D status. And the mortality rate close to zero could theoretically be achieved at 50. NGS per millilitre. This paper is a sort of conclusion of what we call a systematic review and meta analysis. So for people who don't understand that, really what these researchers have done is they've got lots and lots of review papers on COVID and vitamin D, and looked at all of them and come up with come up with some conclusions of what they're saying. And they've actually suggested that there is a level that we want to try to achieve as we go through the winter. Now 50 MG is is is an international unit. And that's not what we use in the UK. So we use nanomoles. So it's usually a conversion of 2.4. So it works out round about a level of the minimum that we're trying to achieve. And this sir, is what we're using with our patients and in clinic is that we want them to try and achieve a minimum level of 125 nanomoles per litre on testing. So I think that's a conversation. And I know, again, I can be a little bit more pushy on this. And I know you guys can, but can we talk about the levels that the government are suggesting? And what we see in in the literature? And what would be some sort of real, I suppose, moderate conclusions that we can give to people on their on a sort of day to day supplemental need.

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Yeah, so Public Health England have act for a long time, they've said that anyone age for an over should consider supplementation through the winter months, and they recommend 400 international units per day. So that's their their record, that was their recommendation, through COVID, they've actually increased that to say that it's not just at risk groups that should consider all year round supplementation, everybody should consider 400 international units daily. So that's their level that they recommend. Now, it's not a high amount. It's certainly not what I would take or give my children.

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And it's not really what the literature suggests, as well. Yeah, and

I think, again, working with supplements, there's two ways to approach it. So we need a maintenance, we need a daily amount, and we need to correct a deficiency sometimes. So if you've had your levels tested, now, the chart that you're talking about, so using the nanomoles basis, you know, looking at getting into 125, doctors would consider that if you were over 50, that you were sufficient. I've heard of people being tested at like, you know, below 10. And that is really, really shocking. And to the point that, you know, they need very high amounts quite quickly, only for a short period, so that it would be a limited period. So I don't think people should take that into their own hands without testing and without repeat testing to see that they've achieved a good level in the blood. But some people will struggle. Some people have a genetic variation on their receptors. And that means that you need higher amounts and it can means they can struggle, even with supplementation at high levels to get their levels up if I can test it in. Yeah, absolutely.

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So one of the things that we've done and I'm going to use me myself Personally, because I'll give you an example, when we had a lockdown, we had a really great summer, didn't we? Yeah, first lockdown, it was great. And I've got quite dark skin. So I was bronzer button. Because I was basically overtraining exercise wise in the garden for most of the summer, so I couldn't have been more sunshine. And so obviously, one of the key things that we do is we test people at certain times of the year, because we want to always optimise vitamin D. And even through that summer, I came off the end of the summer with a vitamin D level of 80 nanomoles, which in many people will still there's many organisations and many vitamin D researchers suggesting that that is not an optimal level. And what we've gone on to find with me is not only do I have genetic polymorphisms on the on the VDR receptor, ie that you know, the receptor on every cell that receives the the active Vitamin D, I also have polymorphisms on the transporters and the way vitamin D is metabolised through the liver. So I've almost got a triple whammy is that I might be an individual who never ever has the capacity to get to the optimal levels without supplementation. And so these are some of the things that we're finding in certain individuals is I think this is the beauty of having that genomic data is that it gives you how is this individual getting to that point. So that's just an example of me, probably never being able to, or will always struggle to get to 125 Minimum unless I'm probably quite well supplemented throughout the year. So can we just continue to talk about the levels? Because we will talk about I mean, I think we can talk about the risk of overdosing, and I suppose the risk of taking it into your own hands, but also how you can take charge here? Because I think this is the key thing is that it number one, it's it's an easy thing to manufacture high quality. So it's cheap as chips to do with such huge returns. And it's cheapest chips to test as well.

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Yeah, so testing is excellent. And it's easy. And it's convenient. If you do the blood for finger prick ones that you can do through the post, they're really nice and easy and quick to do. If I hate them, I have to get my husband to prick my finger. But it's it's so worth it because it's quick and easy. And you've got the info then. So then you can go on a supplementation. So the government recommendation is 400 international units per day. Now, what we would consider more of an appropriate maintenance is more like 2000 to 4000, depending on your individual circumstance. And this is worth testing, I wouldn't use really high doses if people weren't testing. If you've got deficiency.

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I mean, many people would say that nutri are being very conservativesaying 2000- 4000. Because if I've got an overweight chap, who is of Nigerian descent living in a northern climate, you know, there are double without even knowing the genetic polymorphisms there may be double or triple or quadruple risk factors, that this chap is going to need at least 10,000 international units pretty consistently. So I know you guys have been conservative with some of your dose urging, but you're also looking at the literature. And I think again, we're always trying to be let me let me check change this, is there a significant risk of overdosing on vitamin D? it can happen that people get very high levels of vitamin D, toxic levels, you have to really be taking quite a lot for a long time. For that to happen. And without testing. So you need to test if you're taking high doses, I do think it's important to remember that you you generate so, you know, a light coloured skin would probably generate about 10,000 international units of vitamin D in strong sunlight in 20 minutes, you know, easily. So a natural production would be at a much higher level than we're actually talking about supplementing. So what I would say is, you know, when we when we go to the supplements, we supplement with vitamin d3, we use the cholecalciferol, which is the vitamin d3, which is the form that we make in our skin in response to sunlight. So I wouldn't recommend going over 10,000 international units a day unless you're doing testing and you know, you know my family's from Norway. So in the winter, you get three hours of slight Twilight. And just to be clear, you don't get the sun

or the sun just isn't strong enough in the winter to give you any vitamin D.

No, it's not strong enough. Even if even if you had a very sunny day in the middle of winter you would not get enough sun. 

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I can't remember which researcher told me but he said come November. You have to go to below Lisbon to be able to get any vitamin D from the sun from November onwards and I think it's literally till about well probably till about April because it's not so much about how hot it is, is about how high the sun is in the sky. And so the really human you know, humans in northern climates really don't get any vitamin D,

you don't get any. So it's really good. We recommend a test twice a year for maintenance, generally around September, October, and then again in see how you how you did over the winter. So when you're coming into spring, round that sort of April time, like you mentioned, it's a good time to test again, and just see how you survived that winter with with your low vitamin D exposure.

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So this is exactly what we do with every single patient when we come to October, October is vitamin D test testing time for us. We want to know how were their levels of being free the summer. And then we want to continue to because it's such an important because it's not really it's not really a vitamin is it? It's a it's a pro hormone, if you like it's

structurally it's very similar to hormones, and it acts very similar to hormones in the body.

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Yeah, and and again, speaking to people, it's like, imagine that you're always going to be imagine you're always deficient as a man in testosterone. And that's sort of going to give you an example is there's going to be I think, I think we should think about vitamin D in that way. But going back, we have all our patients test in October, because we want to optimise or at least put them on a structural programme. As we go through the winter. And particularly for us, we always see the upper respiratory tract infections, the immune suppression, the colds and flus as we go past into the new year, particularly January and February. And I firmly believe that a lot of that is related to a not all but it's related to how vitamin D is utilised and dropped out the body because we're using it all the time, aren't we, because vitamin D is is helping the immune system protect us from the outside world. And of course it runs out, it's important to stock up.

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I mean, I know we've all become virologists, recently, but I did read something that said that at any one time your body is responding to, you know, eight or nine different viruses, it's just that they don't, you know, our immune system does its job most of the time, so we don't feel it, we don't notice. So we're constantly using that vitamin D for our immune system. So it's important to get it back up, I would say definitely, with the levels, you know, we have resources on our website that can take people through, you know, different levels of what we went to that, yeah, that we recommend. And we go up to about 50,000, using the Michael Holick research about 50,000 international units a week for about eight weeks or repeats, again to 16 weeks and for people who are very deficient to just try and get a real boost of their levels. So that it's quite high amounts when you when you're talking 400 international units from public health. And then we're talking about 50,000 international units a week, then it's it's quite a dramatic increase. I don't think people should be afraid of those high numbers. But I thought, well, if I can do the test, then I can quote. 

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So I was actually just watching some literature with regards to warts. And one of the ways you can treat warts is you can inject them with very high levels of vitamin D. And the level is we're looking at on that. And on those which resolved the warts is I think it was 2.4 million international units of vitamin D on injection. So I think what we're looking at in the right time, you know, Vitamin D is going to be relatively safe. Now. Let me just confirm on this. I think once we're starting to I mean, I would be happy on anyone been between again and again, depending on the, you know, an adult 2000 to 4000 international units. I think a day would be something that, you know, if people didn't want to test, you would still think okay, that's probably going to be an okay level as you go through the winter. I think anything probably over that you might want to think about probably testing. But what I would say on that is that it's so cheap to test. I mean, the testing is what 30/35 pounds. I mean, it's such an incredible investment into really helping you to try and protect yourself over over the winter.

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Yeah, and it's worth if anyone's got a comorbidity that it's worth, you know, if you have an illness already, that you're getting blood, blood tests at the GP, show them some research about your diabetes, show them some research about your hypertension been linked with vitamin D, and they'll test it for you. Ah they sort of gave up testing, because everybody came out deficient. And I have heard of doctors giving injections of up to like 100,000 international units in one go because with it being fat soluble, you can take a mega dose and just you know you will hold on to that you'll absorb all of it. 

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So just confirm that. I know there are some mega dosing out there. And there was I think there was a recent paper that came out of Brazil that looked at Mega dosing COVID patients in the ITU and it didn't work very well but As far as I understand the research, mega dosing in one bolus doesn't tend to work as well as just on a daily dose, that's correct, isn't it on the research.

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Daily dose would be better, we do recommend that you can take a weekly dose of the 50,000 international units. And you can do that. And we have seen really good results with people taking that to then correct a deficiency in a sort of relatively quick timeframe. So we would recommend that but I think consistency is key with nutrition, you want to do something consistently to achieve the best results and to make it part of your habits, you know, so it's about remembering to take it as well. 

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So if you're, if you're somebody who's identified as needing a vitamin D, throughout the winter or throughout the year, then you need to make sure that you're going to take it when you remember. And so it's built it into your part of your your daily habit and your daily routine.

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So what we can do is that, of course, with me having such a long relationship with you guys, I've actually tapped you up to make sure that anyone who's listening to the podcast, you guys are actually going to give them additional reduction in cost, aren't you, you're going to give him an additional 10% reduction to anyone who I think we've Sam one of your sales reps is going to create a link for us. So anyone can link into this and use some of your products. So thanks very much for doing that. I know I sort of pushed you into that, but

that's okay, that's okay. And anyone who signs up you get, I think it's 10% off your first order. Like it's over 45 pounds or something. So and then you'll get you know, if you sign up, you get our newsletter, where we send out loads of great information on things like a Vitamin D you know, just just on that on a on a on a flip, because I know, we're fundamentally we're gonna wrap up in a minute, when we obviously will make some sort of, you know, here's the things that you can start implementing on a day to day basis. 

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But you know, what we're thinking about the winter because also, there's been pretty strong evidence that some of the minerals and sort of the Friends of vitamin D, like zinc are also really quite important for immune protection. So vitamin C, zinc, etc. And can you just very briefly, just give us a minute or so on that because that I think would be helpful, because I know a lot of supplement companies are actually sort of doing a sort of a one a day immune as well, which is a bit vitamin D, probably vitamin A and a bit of vitamin C, and of course, zinc, because I think the evidence is suggesting that may be an additional particularly Zinc, of 15 micrograms a day are going to be probably, again, another prudent thing to do through the winter.

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And zinc, Zinc is absolutely another one of those nutrients that is we don't get it from the sun. But we do get a good amount from from certain foods, but we just don't eat those foods in high enough quantities and our soils are a bit over depleted. So even those foods that used to have high levels are starting to wane a little. So they it's almost like the plants that we're eating are also a little bit deficient. So think yet again, another one that we just have low levels of and if you look at the research, again, having a lower level of something like Zinc is going to increase your duration, your severity of certain illnesses, it impedes your immune systems ability to actually fight that infection. 

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So very often we have vitamin D in association with think vitamin C, I find is one of those ones that when you take it, especially if you take it a good quantity whilst you've got an infection, it works very well to sort of give your immune system a little injection or fighting spirit so so the research on vitamin C does tend to be more about in the moment, you know, take taking it for the duration of a cold or in or an illness. Although Vitamin C is still very important to take, well to have enough daily.Again, Vitamin C is is needed much higher amounts than you you would look at from a point of view of a Zincyes, yeah, so we're normally talking about gram amounts of vitamin C or to bowel tolerance, which is where people if you're not used to taking vitamin C and you take it at high amounts it can have a very slight laxative effect. So we normally talk about tolerance level for people taking vitamin C. So if you're taking too much, that's the worst that will happen. So just bring it back a bit.

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So can we then now just maybe just summarise some pertinent points imagine that we're we're in the consultation room with nutritionist SARAH SHARPE, and we're coming in there because we want that advice about vitamin D as we go through the winter. What are going to be your sort of clinical pearls for us to take away from from today. What would you say to us? 

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Well, certainly look at your risk factors. You know, let's look at where your vitamin D comes from normally. Are you getting enough? And the answer is usually no. So let's look at testing. Let's see where your levels are. Let's make sure you get in enough it's really is one of the easiest things within our control. Yeah, that we can make a difference on.

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And I think this is why we're having this conversation, aren't we? Because, as you say, vaccinated or not, you know, you're going to need additional help. And this is such a simple intervention, where, you know, the overwhelming scientific evidence to suggest this is the key for me. I mean, vitamin D as a supplement is cheap as chips. So it's literally pennies a day if that, yeah, you don't need any special delivery. And we've got different forms with the tablets, liquids, that kind of thing to it. That's personal preference. So it's not, it's not because it's better absorbed than any other, it's literally just down to personal preference. They all work in the same way.

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And you would again, oh, you know, this is your bread and butter, and has been for nearly 30 years now. But you would agree that looking at the scientific evidence that trying to achieve sort of a level of 125 would be a good place to be?

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Yeah, so I think the studies show between 75 and 150 is a good level to have, but I would say above 100, between 100 and 150. Aim for about 120. Yeah, plus is a good level. I think toxicity happens at about 375. So if you were up at that level, you must be like really taking an extreme amount. But yeah, don't panic if you go over 120 by a bit I mean that's incredibly rare, isn't it? I mean, yeah, and of course, that toxicity is dependent on whether you're seeing changes in blood levels of calcium and that side, and I can actually remember seeing a CrossFitter, who was up at 390. And he'd been completely overdosing on vitamin D. But again, we weren't seeing any rises in blood levels of calcium, although, you know, we immediately said no more vitamin D. And let's just see those levels drop over time. 

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So Sarah, I really appreciate your time this morning. I really appreciate nutri advanced coming on and giving me your time. I'm going to interview your boss at some stage in the future because me and Ken go back a very long way and I just want to get his sort of journey really about, you know why Nutri was started, where  everything is going and where he thinks the future is going. Thanks so much for giving us additional discount, which we'll link in and if you can find some for organising all of that.

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Sarah: Thanks for inviting me. It's been great chatting.

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Pete: Thanks for your time, kid. And no doubt I will see you soon. 

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