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The truth about vitamin D in pill form (beyond just adding K2 & magnesium) - what you need to know so you can make the best decision to optimize your health |
Why low vitamin D is a symptom you can't always fix with a pill...
Sunlight is a hot topic right now in the alternative wellness space, and since 2020 more and more people are talking about the importance of vitamin D when it comes to everything from metabolism to chronic illness to longevity.
But what if it wasn't as simple as popping a pill.....and what if there was a potential downside to vitamin D supplementation (spoiler alert - there IS).
Today I am doing to do a deep dive on this topic & do my best to provide nuance so you can make the most informed decision possible for yourself.
I'm going to discuss why low vitamin D is a symptom in chronic illness, thyroid, cancer & obesity - as well as my thoughts on sunlamps & lab tests someone might want to consider (none of this is medical advice).
Keep reading for my deep dive article (a few quick announcements)
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Ok - I know this is a bold statement - but I promise to make it make sense to the best of my ability in this article.
Here's the thing: You CAN stay out in the sun too long - but as far as vitamin D goes - your body actually puts on the brakes when it’s time.
Your skin can make up to 20,000 IU of vitamin D in just 20- 30 minutes of sun exposure (depending on skin type & UV index), but your body actually stops producing more once you’ve had enough.
But with supplements? It’s a different story, and you can bypass your body’s natural safety checks (this is the story NOT being told often enough).
Long-term high doses (10,000+ IU/day) can lead to hypercalcemia, kidney stress, and tissue calcification,and most people aren’t even measuring the active form, 1,25(OH)₂D, which is what actually matters.
Supplements can push storage levels up on a lab test, but that doesn’t mean your body is using it properly.
Ok - I know your next thought (it's often what get's pushed in wellness circles online): "Just add K2 & Magnesium"..... Let's dig deeper on why that doesn't solve the problem ⬇️
While K2 and magnesium can help buffer soft tissue calcification, they don’t address the fact that oral D supplements bypass circadian and UVB signaling, disrupt the body’s natural regulation of D storage, and may interfere with vitamin A balance and thyroid hormone transport by altering calcium/potassium ratios: all of which depend on light, not just nutrients.
Citation: Wang TJ et al. Vitamin D and the Risk of Cardiovascular Disease. Circulation. 2008;117(4):503–511.
"Vitamin D" acts more like a steroid hormone than a simple nutrient (which is why people report feeling better after beginning a supplement regimen).
However - high doses can eventually alter renin-angiotensin signaling (your body’s built-in system for regulating blood pressure, fluid balance, electrolytes & inflammation) immune modulation, and thyroid hormone receptor sensitivity - effects that are independent of calcium metabolism and not addressed by K2 or magnesium.
Rosen CJ et al. Vitamin D: Moving Toward Evidence-Based Decision Making in Primary Care. Ann Intern Med. 2012;156(4):271–273.
Vitamin D plays a role in modulating the renin-angiotensin system - especially by suppressing renin.
But high-dose vitamin D can over-alter this system, leading to:
- Disrupted blood pressure control
- Fluid retention
- Increased oxidative stress
- Hormonal dysregulation (especially cortisol and thyroid)
This is why vitamin D supplementation isn’t “just a vitamin” - it’s a hormonal signal that impacts multiple regulatory systems in your body, including the one that controls your blood pressure and inflammation.
Citation: Li YC et al. (2002). 1,25-Dihydroxyvitamin D3 is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest.
Most people are already deficient in magnesium - a critical cofactor in all hydroxylation steps of vitamin D activation. High-dose vitamin D actually increases this demand, which can lead to functional magnesium depletion unless intake is carefully adjusted & monitored.
Over time - this can actually worsen fatigue, anxiety, and sleep issues - the very symptoms people often take D to improve.
Citation: Rosanoff A et al. Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutr Rev. 2012;70(3):153–164.
In people with inflammation, autoimmunity, or mitochondrial dysfunction, it’s common to see low 25(OH)D but elevated 1,25(OH)₂D - which suggests dysregulation, not deficiency.
Supplementing D in this state can eventually worsen immune stress, increase oxidative damage, and push the system further out of balance. K2 and magnesium don’t regulate this conversion - sunlight and mitochondrial health do.
Citation: Blaney GP et al. Vitamin D metabolic pathways in patients with chronic fatigue syndrome. Inflamm Res. 2009;58(5):311–317.
Simply testing 25(OH)D is not going to give you an accurate picture of what's really going on in your body in regards to vitamin D.
Simply testing 25(OH)D only tells you how much is currently circulating in the blood, but not how well it’s being converted to the active form (1,25(OH)₂D), how effectively it’s binding to receptors, or whether it’s even functionally available at the cellular level.
In cases of chronic illness, inflammation, or mitochondrial dysfunction, the body may intentionally downregulate active vitamin D conversion as a protective response.
As a basic step, testing both 25(OH)D (the storage form) and 1,25(OH)₂D (the active form) - and looking at the ratio between them - can offer valuable clues about how well your body is converting and using vitamin D.
For example, low 25(OH)D with high 1,25(OH)₂D may indicate inflammation, infection, or dysregulated immune signaling, rather than a true deficiency.
This ratio can help reveal whether the issue lies in intake, conversion, receptor function, or cellular utilization - giving you a much more accurate picture than 25(OH)D alone.
One other factor is that 1,25(OH)₂D is very unstable and must be frozen immediately after drawing. To my knowledge - labs like Quest Diagnostics in the U.S. are equipped to do this properly. Without correct handling, your results may be inaccurate.
I know I sound like a broken record with this one - but sun exposure must be done in a slow titrated manner with nuance for the individual.
If you haven't already read my article on sunscreen - click here, and I highly recommend downloading MyCircadianApp & becoming acquainted with the Vitamin D timer and all the free video guides (code SARAHK gives you a free trial).
If you want a deeper dive into this topic and things like: summer nutrition - (1 food list ebook & a 21 page summer recipe ebook) - a safe sun exposure guide & an additional 18 page ebook on figuring out your fitzpatrick skin type - nuances around sunglasses & sunscreen - traveling - northern latitudes in summer & more: get Sunwise!
Are sunlamps the answer for everyone?
Not necessarily & here's why I am cautious overall...
Much of the research on sunlight and skin cancer has actually been done with narrow band UV lamps.
There are some great lamps like the EMR TEK Krypton (click here and use code SARAHK) - and I do have one myself.....BUT it is still missing far infrared - which is needed to help build EZ water/cellular water.
Low EZ is absolutely a root cause for low vitamin D status & low mitochondrial function & must be considered.
If someone wants to use a sunlamp to help improve their health - I recommend the following (not medical advice - for informational purposes only):
- Circadian Health must be on point! Precondition eyes and skin with morning sunlight, and block artificial light at night
- Eat a low inflammatory diet & avoid seed oils. Eat in a circadian window & avoid eating too close to bed.
- Use the lamp always with red & infrared at the same time (you can also use the Sperti Vitamin D Lamp in combination with a small EMR Tek Red light panel for a more economical option)
- Start low & slow with these lamps as they can produce a "delayed burn" (ask me how I know 😖).
I actually used the Sperti + the EMR Tek Inferno during my pregnancy with my son who is now 2-1/2, and my midwife complimented my vitamin D levels the entire pregnancy (she assumed I was using supplements).
Now here's where some might disagree with me
And I don't want anyone saying "Oh - Sarah recommends taking vitamin D now" (and I think someone who took the time to read this entire article would not jump to that conclusion).
However - after working with many chronically ill people over the last few years WHILE supporting them with circadian work - sunlight exposure - nutrition - mitochondrial support & sleep in personalized protocols (as well as thoroughly assessing labs) - I have seen short term supplementation be helpful in some cases.
If someone wanted to do this - I would highly recommend working with a practitioner who can monitor your labs & symptoms - and sees the supplementation as a short term intervention.
The issue I have with scientific studies showing health benefits of vitamin D supplements is that most of them were not done over long periods of time - AND there is actually data to show that long term supplementation does not prevent chronic illness or improve health outcomes (here's a post I did about this).
One more point to discuss is GENES ⬇️
Genetic Mutations that block vitamin D
Yes - certain SNPs (single nucleotide polymorphisms) can impair how your body handles vitamin D, even if you get sun or take supplements. The most common ones include:
- VDR (Vitamin D Receptor) mutations - These affect how well your cells can respond to active vitamin D (1,25(OH)₂D). You can have normal or high blood levels, but still have poor biological effect.
- GC gene (aka DBP - Vitamin D Binding Protein) - This affects how vitamin D is transported in the blood. Some variants reduce transport efficiency, which may lower usable levels at the tissue level.
- CYP2R1 and CYP27B1 mutations - These impair the liver and kidney enzymes needed to convert vitamin D into its active form.
However, even with these mutations, environment still matters.
Healthy mitochondria, circadian rhythm, sunlight exposure, and EZ water can improve gene expression and help mitigate these mutations.
So while genetics may influence your baseline, they don’t override your biology. You can still support vitamin D function by restoring the natural light-water-charge system your body depends on.
I recently found out I do have one of these SNPs & was advised to supplement based on that information alone 😓, but my blood work actually looks fantastic, and (even more important) I have great energy & a great metabolism. So you won't find me stressed over these SNPs anytime soon.
With anything you put in your body - it's important to consider all sides, and have informed consent with any supplements or medications you decide to use.
That's always my wish for my readers & community members: Empower you with information & resources so that you feel like you can make the best decision for you.
Extra resources: This episode I did with Jim Stephenson Jr. which dives even deeper into more nuances than I really could fit into one article - including the "genetics issue" - pregnancy & supplementation in babies.
More citations: “Even exposure of sunlight to large areas of the body cannot lead to vitamin D toxicity because of the photodegradation of previtamin D3 and vitamin D3.“ - Holick MF (2004) - Am J Clin Nutr. 80(6 Suppl):1678S–1688S.
“Vitamin D toxicity is not induced by sun exposure, even in those who have high sun exposure year-round.” - Vieth R (1999)- Am J Clin Nutr. 69(5):842–856.
“All toxicity cases occurred in patients taking supplements… No case was linked to sun exposure.” - Galior K et al. (2018) - Nutr Clin Pract. 33(1):56- 65.
I hope this was helpful & informative.
If you enjoy looking at health through this lens in a non-dogmatic way - consider taking advantage of the Leptin Master Plan Early Bird Deal - ends June 30th.
Have a fantastic rest of your week,
🌞Sarah🌞
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