Holistic Adult and Child Psychiatry in Newton, MA

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Judy Tsafrir, M.D.
Tel: 617-965-3020

Monday to Friday:
6 AM to 6 PM

About Me

My practice is dedicated to healing through integration of heart, mind, body and soul.

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Adventures in Holistic Adult and Child Psychiatry

"One only sees what one looks for, one only looks for what one knows." - Goethe

Vitamin D: Fundamental to Sleep and Digestive Health


Adequate blood levels of Vitamin D in my patients are very rare. Everyone I have tested who is not supplementing with Vitamin D is deficient. According to the thoughtful and public health minded neurologist Stasha Gominak, MD, an expert in Vitamin D, we need levels of 60-80 ng/ml in order to sleep normally. There is a disagreement amongst the experts about what qualifies as adequate, with some stating that any level above 20 ng/ml is sufficient, but I agree with Dr. Gominak. She has a very accessible and useful website entitled Sleep, Chronic Pain and Headaches, which I highly recommend. It is full of clear explanations and clinical wisdom.

In 2005 Dr. Gominak serendipitously discovered that many of the patients in her neurology practice who consulted her about headaches, seizures, back pain, dizziness and balance problems had abnormal results when she performed sleep studies on them. Often they were not even aware that their sleep pattern was abnormal.  She discovered that they also were deficient in Vitamin D. When she prescribed supplementation with Vitamin D and adequate blood levels were achieved, their sleep issues resolved, eliminating the need for masks to treat sleep apnea or sleeping pills, and their other symptoms also improved.

Vitamin D is a crucial factor in a many diverse bodily functions. It should more accurately be designated a hormone rather than a vitamin. Vitamins are defined as organic compounds which are essential for health, which we must obtain from external sources, because we cannot synthesize them. Our skin produces Vitamin D in response to exposure to sun light. Vitamin D would therefore more appropriately be classified as a hormone rather than a vitamin, because it is a chemical substance produced by the body which controls and regulates the activity of a variety of cells and organs.

There are also a few dietary sources of Vitamin D; some of the best being fatty fish such as salmon, tuna, and mackerel. Small amounts of vitamin D can be found in beef liver, cheese, and egg yolks. Some foods are fortified with Vitamin D, such as milk, breakfast cereals and some brands of orange juice, but the amounts contained in these foods is negligible. For instance, a cup of milk has only 100 IU of vit­a­min D. You would have to drink 100 cups of milk a day to prevent Vitamin D deficiency.

Dr. Gominak believes that Vitamin D deficiency is correlated with a great variety of symptoms due to the fact that Vitamin D deficiency causes sleep disorders.  Much healing occurs when the body is asleep. When a person suffers from a sleep disorder, it interferes with the body’s healing process. When sleep quality is improved ”headaches, seizures, tremor, back pain, bal­ance dif­fi­cul­ties, depres­sion, mem­ory loss, etc. all get better”.

I was especially fascinated by Dr. Gominak’s perspective on Vitamin D and digestive health. This is particularly relevant to my readers, many of whom suffer with gut issues. She links it with acid reflux, IBS and diabetes.  ”D hor­mone affects the entire GI tract. There are D recep­tors in our sali­vary glands, our teeth, our esophageal sphinc­ter, and the stom­ach cells that make acid. When the stom­ach sphinc­ter is weak the acid moves up into the esoph­a­gus, where it doesn’t belong, caus­ing acid reflux. The D we make on our skin goes to the liver, then into the bile, it keeps the bile acids dis­solved, pre­vent­ing gall stones from form­ing. Because there are D recep­tors in the islet cells of the pan­creas that make insulin, not enough D may con­tribute to the devel­op­ment of dia­betes. Low vit­a­min D lev­els are related to poor stom­ach emp­ty­ing as well as bloat­ing and con­sti­pa­tion or “irri­ta­ble bowel”. The irri­ta­ble bowel may result from los­ing our “happy, help­ful” bac­te­ria in our lower GI tract. They die off when we don’t sup­ply the vit­a­min D the bac­te­ria also need to sur­vive. Because those same colonic bac­te­ria supply 7/8 of the B vit­a­mins we need on a daily basis, some of my patients have vit­a­min D defi­ciency and sec­ondary B vit­a­min defi­cien­cies. (At least 2 of the B vit­a­mins, B5 and B12, are needed to sleep nor­mally) So there are sec­ondary B vit­a­min defi­cien­cies that may also have to be cor­rected before the sleep will return to normal.”

Compromised gut health is often associated with multiple psychiatric symptoms, including depression and mood disorders, anxiety, attentional issues and learning disabilities, as well as more globally disabling conditions such as autism and psychotic disorders. This is the premise underlying the GAPS healing protocol developed by another brilliant neurologist, Dr. Natasha Campbell McBride. GAPS is an acronym for The Gut and Psychology Syndrome, and the protocol is designed to treat these disorders.

Dr. Gominak links Vitamin D deficiency with a whole host of other conditions, including anemia, autoimmune disorders and cancer, osteoporosis, pain syndromes, balance difficulties, infertility, poly cyctic ovary syndrome, and endometriosis.

A great resource about all things related to Vitamin D is the website of the Vitamin D Council.  They recommend a dosage for adults of 5000 IU a day, and for children they recommend 1000 IU a day per 25 pounds of body weight. This is a much higher dose than that recommended by most conventional medical practitioners. An at home finger prick blood testing kit is available through with a ZRT Laboratories for $75.

As I mentioned above, there is considerable disagreement about what constitutes an appropriate blood level.  The Vitamin D council suggest 50 ng/ml as an appropriate target, as compared to Dr. Gominak’s recommendation of 60-80 ng/ml. Though quite rare, it is possible to take too much Vitamin D which can result in too much calcium in your blood (hypercalcemia) resulting in symptoms of  poor appetite, nausea, vomiting, weakness, frequent urination and kidney problems. The Mayo Clinic reported that 50,000 IU per day for several months could cause toxicity, which is 10 times the daily dose recommended by The Vitamin D Council.

The highest dosage available over the counter for Vitamin D is 5000 IU. It can be purchased at Sam’s Club, Walmart and Amazon. Vitamin D is your friend. I recommend supplementation to all of my patients, since it is intimately involved in supporting so many functions crucial to health and well-being, and as it seems that none of us are getting a sufficient amount from sunlight or dietary sources.

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