How to Interpret Your Vitamin D Test Results

Dr. Robert Rountree:

This is The Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet, supplements, and lifestyle approaches to good health. I'm Dr. Robert Rountree, Chief Medical Advisor at Thorne and functional medicine doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease.

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Hi, everyone, and welcome back to The Thorne Podcast. This week we're going to be taking a look at Thorne's Vitamin D at-home test kit. As always, when we do one of these test kit deep dives, in addition to the audio part of the episode, we're releasing a video version as well. So be sure to check that out on Thorne.com or on our YouTube page so you can follow along as we go over our results and see all of the graphics and visuals that come along with the recommendations. Joining me to talk about this test, as always is my good friend, colleague, and returning guest of the pod, Thorne's VP of Medical Affairs, Dr. Amanda Frick. Welcome, Amanda. How you doing?

Dr. Amanda Frick:

I'm great, Bob. How are you?

Dr. Robert Rountree:

I'm good. I'm good. Life just keeps on chugging along.

Dr. Amanda Frick:

That's a good sign.

Dr. Robert Rountree:

Right. Very interesting thing. So, Amanda, you and I have both taken Thorne's Vitamin D at-home test kit. We're going to walk our listeners through our results, but first we always like to establish why the heck would anybody want to know their vitamin D levels? Who should be concerned about their vitamin D levels? Why is this an issue?

Dr. Amanda Frick:

I have a technical answer and I have a smart aleck answer. [Laughs]

Dr. Robert Rountree:

Let's hear both of them.

Dr. Amanda Frick:

My smart aleck answer is everyone should be concerned about their vitamin D levels.

Dr. Robert Rountree:

Everyone. Yeah, who shouldn't be concerned?

Dr. Amanda Frick:

Exactly. Everyone should be concerned. So in my opinion, it should be a regular part of your health-care programming or working with your practitioner. Figure out what your vitamin D level is. It's just important to too many things to be ignored. But some things that may make you pay special attention or particularly want to seek it out could be persistent immune challenges. Maybe you're getting sick a lot during a season, some more serious things like bone pain, but I mean vitamin D is related to so many things. It could just be like your mood is struggling, or you're having low mood. It could be because seasonally you're not getting a lot of sun or you've moved to a new location. But if you're not doing it just because you're curious, then those might be some things that would trigger you to look.

Dr. Robert Rountree:

I think, I wouldn't say outdated, but it's kind of old to think that vitamin D is only related to bones.

Dr. Amanda Frick:

There you go.

Dr. Robert Rountree:

I think that's a concept that a lot of people have is that vitamin D is the bone vitamin, and “Hey, you're 58 years old, you just got diagnosed with osteoporosis, you went through menopause, and you got a bone scan and you got low bone density.” So “Wow, suddenly, suddenly I should start worrying about my vitamin D. And hey, maybe if I take vitamin D, it will cure my osteoporosis.” Well, vitamin D is not a quick fix or a quick cure for anything. It's more of a preventive vitamin, I think. And I got to say, it's not really a vitamin, it's a hormone, right? Even though we get it in our food, and we get it after our skin is exposed to sunlight, it really is a hormone, and it's a hormone that regulates a lot of things. I think there's thousands of vitamin D receptors throughout the body, and that's a new thing.

So I'm saying this because a lot of times I'll read medical articles that say, "Oh, vitamin D is overrated." When I read that I think, “You must not be aware of the literature, right? Have you heard of a library?” Well, maybe libraries don't exist anymore. I don't know. There's still libraries out there, but have you heard of Dr. Google? Maybe you should just do a little research. Because a lot of these articles I'll see, they say things like, "Hey, we gave 400 units of vitamin D to people for three months, and they didn't feel any different." And I go, how ridiculous is that? Did they measure vitamin D levels? And that's a huge flaw in a lot of medical studies that use vitamin D as an intervention because they give a dose that's too low. And even if they gave a higher dose without measuring the levels, you don't know what's going to happen because everybody responds to supplementation in a different way.

People even respond to sunlight exposure in a different way. And part of it has to do with body weight. People with a higher body weight seems like they need more vitamin D to get their levels up. The odd thing is here in Colorado where there's a lot of sun exposure, you would think vitamin D deficiency is not a common thing, but it's very common. I measure vitamin D levels routinely on people, not just for patients with osteoporosis, but for immune disorders, for cardiovascular disease, for dementia, really just about any chronic illness you can think of, I think measuring vitamin D levels are very helpful. 

Why do we offer an at-home test? Because surprisingly, a lot of doctors won't order it for their patients. I would meet people at a conference and I would say, "Hey, you should get your doctor to order vitamin D." "Oh, my doctor won't do it because my doctor says it's not important to know that." And I'd say, "OK, well tell your doctor there is this thing called Google where you can look it up and look at the research and not just look at what the recommendations are." I mean, I hate to say that, but if some guideline gets published that says, “You don't even need to look at vitamin D, it's better not to know” then just because the guidelines out there doesn't mean it can't be flawed.

Dr. Amanda Frick:

Well, unfortunately too, even if you talk to your doctor and they order your vitamin D level for you and it runs through insurance, you end up with a cost to run the vitamin D if they don't cover it. Because of the way it was coded or whatever type of visit that you got your vitamin D ordered through, the cost can be higher than what it would cost for you to just do an at-home test. So I think it's worth considering either knowing how much it will cost through your doctor or getting that idea if your doctor won't order it, then you have other options out there.

Dr. Robert Rountree:

But sometimes the doctor will order it, but they'll only do it once a year. And so doing an at-home test gives you better chance for feedback throughout the year. You can do it as often as you would like. Probably doesn't need to be done more often than every couple of months, but still can be helpful.

Dr. Amanda Frick:

Well, that's what I was going to say. I don't know how you feel, but depending on someone's baseline level and the amount of vitamin D I would have them take, I would want them to retest in every three months until we got to [a] sort of sweet spot and then decrease to maintain. But sometimes it takes a bit of re-measuring and adjusting of how much vitamin D you're taking to make sure that you can stay in that zone that you want to be in.

Dr. Robert Rountree:

So yeah, again, everyone's different. And the more information we have about how those levels are going up and down, the better. And I will say on the other end of it, I've seen a few patients that were overdosing, that were taking too much, because they heard vitamin D is good, so the more the merrier. And I've had people that were taking say 20,000 units a day, which I think is too much for most people. And I would get a level and I would say, "Yeah..." Even then the level would be above the normal range, but I don't see any sign of toxicity, so I don't put them in the emergency room. “Oh my God, your vitamin D level's high. We're putting you in the ICU.” I've never seen that actually. It's been reported. It does happen that people can get really toxic from it, but you have to take a lot to get super toxic. So mostly when I find a high vitamin D level, I just say stop taking it for generally a few months and then we need to retest you to make sure it's coming down.

Dr. Amanda Frick:

Yeah.

Dr. Robert Rountree:

So we are looking for deficiency. Deficiency is much more common than most people realize, including the doctors. A lot of doctors just don't realize how common deficiency is. It's not just for bone disease, it's for immune health, it's for brain health, metabolic health. So there are lots of different reasons for doing it. And then if you want to rule out toxicity from excessive doses, it can be helpful in that area as well. So let's take a short break and when we come back, we're going to show you our test results, talk a little bit about how the test went, what the experience was, etc., and what does all of that mean.

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And we're back. It's time to see what Thorne's Vitamin D at-home test has to say about our samples. So we've taken our test. Just to comment about that, it really helps to prepare for the test ahead of time, and by that I mean making sure your fingertips are nice and warm. I've done these tests a lot in the past, and I find that I often don't get enough blood, and I'm very appreciative of what diabetics go through that are pricking their fingers all the time. So I've actually learned some tips from my diabetic patients about how to warm up your fingertips. You can, for example, put your hands under warm water, pretty warm, almost hot water on the spigot, run your hands under that. It helps to rub your fingertips a little bit to get them nice and red, and you want to do that in advance. I think you get more accurate results when you get your fingertips nice and warm ahead of time, then you do if you prick your finger and you're not getting enough blood and then you squeeze the heck out of it. I've certainly been there, done that. But again, preparing ahead of time. And then it's really important that you fill up all the circles on the blotter card. I mean, they don't have to be overlapping, spilling outside of the circle, but the blots of blood should be reaching the edges of the circle at least. So fill them up as much as you can. The more you do that, the more accurate the test is going to be. So, Amanda, I'm wondering if you have any other tips to add about a good collection.

Dr. Amanda Frick:

At least for me and for some other people I've spoken to, if you're sitting and sort of crunched up and trying to do it sitting at a desk or a table, maybe it'll be a little slower. So if you're having difficulty, I have people stand up and sort of put their arms at their sides. It's just getting blood flow to your hand and then if you're standing, it's not crunched up so much and sometimes you can get a better flow by standing up and sort of standing over top of the table to collect your sample.

Dr. Robert Rountree:

That's actually a great idea that I wouldn't have thought about it. So letting your hands kind of hang to your side for a little bit. Really good idea. All right, so that's the collection part of it. It's really pretty simple. You order the test, the kit shows up in the mail, you do the finger prick, you let the water dry out, pop it back in the mail, and the results came back very quickly for me. This time, I think I had them in maybe two weeks. So it was a really good fast turnaround. 

And so now we're going to show you what our results look like. We're going to go with mine first. So here's the vitamin D panel analysis and really let's cut to the chase. Your test results indicate that your level is in the normal range. And what was that range? 59 ng/ml, which is, I'm happy with that.

I've measured my vitamin D level a lot over the years and I found that if I do not supplement, I plummet pretty quickly, which probably no surprise to you. Again, living in Colorado at high altitude, I do a lot of hiking, especially in the summer, and I cover up, so I don't get a ton of sun exposure. I'm either wearing sunscreen or I'm wearing a big floppy hat, long sleeves, etc. So I don't have a way to get a lot of vitamin D in my system from the skin. And I found that I have to take 5,000 units a day. So this 59 is on 5,000 IUs of the Thorne Vitamin D every day. And again, if I stop taking that or every now and then I forget, I've tried to be consistent over the years, but if I forget, then my levels can plummet, and I've been down in the 20s pretty easily. Do I feel anything different? No, I wouldn't have any way of knowing that without actually measuring my level. So again, this is something I like to do frequently. I like to do it several times a year because it can go up and down so much, even over the course of a couple of months. 

So I'm getting a “congratulations.” I'm being told that for people who are really active, this is kind of an ideal level. Now, I've occasionally seen people who come back with blood levels over 100. That's not an urgent situation, right? Check their calcium levels. If you're a doctor or if you're a patient, get your calcium and phosphate levels checked. Most of the time they're going to be normal. So it's not something you need to panic about if the levels are high, but it does mean you need to back off. And I've never seen that in people taking 5,000 a day. Is that something that would fit with your experience as well? We hear 5,000, “Oh, that's a huge amount of D, right?” I hear that from my mainstream colleagues that aren't familiar with the literature and they go, "5,000 a day? That's a lot." Well, no, it isn't.

Dr. Amanda Frick:

I agree, it isn't. I haven't seen anyone go over 100 unless they're taking at least 10,000, at least in my experience. I was going to ask you too, do you take a multi-vitamin? So are you getting vitamin D in more than one source?

Dr. Robert Rountree:

No. Yeah, only take it as a separate thing.

Dr. Amanda Frick:

Yeah. And you're having to take it to just keep it here. So imagine if you did want it to be a bit higher, you'd have to take more than 5,000. So only rarely did I have patients that didn't need to take something near that amount to keep a vitamin D level in what I thought was an optimal range.

Dr. Robert Rountree:

Yeah. And even kids now, it's not unusual for me to be recommending at least 1,000 a day, even though in the literature, say you got a toddler who's 3 years old, “They don't need 1,000 units a D a day.” Well, yes they do. If you're measuring their levels, then you find that they're often really low, especially depending on where they live. 

So I got a “congratulations” on that. And then this caveat, which I think is reasonable, even though your levels are optimal, you should still keep an eye on them. So just because you do it once and it's good, doesn't mean you're done. It's something that has to be maintained a lot. It varies a lot seasonally. I definitely find that in the winter my levels go down a lot. And I think that's more than just the sunlight issue. I think there's other things going on with metabolism as well.

So here we have lots of relevant literature here, especially the work from Michael Holick, who's really the guy that spearheaded a lot of this research. 

So recommendations. What's a surprise? Eat a lot of vitamin D rich foods, fatty fish, which I try to do. Beef liver? Sorry, I'm not going to do it. Just don't go there. Cod liver oil, well, I take Super EPA, so probably getting adequate. Lately I've been reading that full-fat dairy products are back in. They seem to go in and out of fashion. “Oh, full-fat dairy used to be eating skim,” etc. But I've just seen a couple of studies recently that says actually maybe full-fat dairy is good for you, provided you're not allergic to dairy, et cetera. But that the fat in the dairy products may be a beneficial kind of fat.

Dr. Amanda Frick:

I've always been on full-fat dairy team, so I'm loving this.

Dr. Robert Rountree:

Yeah, I love the flavor. I love my cheeses. I love my eggs, which I eat several times a week. I love my shiitake mushrooms, which make vitamin D in the D2 form, which isn't quite as effective as D3, but especially for vegans, it's a pretty good source. And then fortified foods, and especially for kids, this is true. Milk, OJ, soy milk, cereals, etc. So here we get a list of foods that are rich in vitamin D3. Can't say I eat a lot of sardines or herring.

Dr. Amanda Frick:

No pickled herring for breakfast? [Laughs]

Dr. Robert Rountree:

No pickled herring for breakfast.

Dr. Amanda Frick:

I would like to point out though, if you just look even on your screen now, everything is an animal protein, everything is animal-based.

Dr. Robert Rountree:

Yeah, So it's much more of a challenge for vegans. And I do have a lot of clients that are vegans. So in that case, supplements are really necessary de rigueur. So again, we can look at this list, make sure you've got a lot of vitamin D rich foods there. Mushrooms grown in the dark, don't have any vitamin D2, right? So needs to be in a well-lit greenhouse with a lot of UV light, and then the vitamin D2 levels go way up. Again, love my shiitakes. Vigorous exercise is a good thing. And so different ways to get the vitamin D1 is Basic Nutrients 2/Day, that'll give you 2,000 units of vitamin D. And again, I just take straight vitamin D by itself because I also take Methyl-Guard®, so I'm more likely to kind of parse out all the different supplements. With that, I'm going to stop sharing my screen and switch over to yours and see what you've got.

Dr. Amanda Frick:

Yeah, here's where my show, so like yours, mine saying good news, maybe I'll get a “congratulations” later, we'll see. But mine is at 41, so the range here is pretty large. Bob, what was yours? 59.

Dr. Robert Rountree:

59.

Dr. Amanda Frick:

So 41, also normal. But you'll see this range is pretty wide, 32 to 80. So according to this test, and according to many test ranges, 32 is considered normal. But in my personal opinion, it is not optimal. And I would rather see my level over 50 at least, or to the higher end of this range. So for me, I'm learning that my vitamin D pulsing that I thought I had dialed in is not quite dialed in. I tend to take breaks from supplements for various reasons. And so then when I get back on, or I was on vitamin D, I tend to take a higher dose for a period of time and then go back to the multi-vitamin or whatever products that I'm taking that contain vitamin D to maintain.

So what I'm seeing is what I'm doing now is not enough. So I will probably go and add some extra vitamin D in various sources. Like you, I take Methyl-Guard Plus®, and so I don't want to overload, but I'll go in here and sort of do a little tweak to my program to make sure I can get to that higher level.

Dr. Robert Rountree:

I have to throw in a little anecdote here, which is I have a patient with multiple sclerosis and she's working with a neurologist. She's on a medication for it. And I've also put her on supplements including vitamin D. And there's some pretty good research showing that adequate vitamin D levels are really helpful for keeping the immune system under control and autoimmune diseases like MS. Well, this particular patient, I had on 5,000 units of vitamin D, and she had been doing great for I think well over a year. And we got a vitamin D level on her and it came back at 80 and her family doctor said, "Oh, that's too high. You need to either stop it or cut back."

And first of all, there is zero evidence that 80 ng is too high. There's just no evidence that that's toxic or harmful in any way. So I don't know where the doctor got that from, but told her to cut back on the D. A month later, she had the first flare that she had had in ages. I cannot prove that that's why. But nothing else changed. So what can I say? I think the literature says 32 to 80 is a good range, but for people with immune disorders, they want to keep the level higher. That's what I can say.

Dr. Amanda Frick:

How much did she cut back, do you know?

Dr. Robert Rountree:

She was on 5,000 and she cut back to like 1,000. And I immediately said, "No, go back on 5,000. You had your level of 80. That's where I want your level. That's not too high. It's ideal. It's optimal."

Dr. Amanda Frick:

You'll have to duke it out with the other doctors.

Dr. Robert Rountree:

I'm going to duke it out with them. Yeah, I'm going to say, "I wish you hadn't done that."

Dr. Amanda Frick:

I mean, shameless plug here too, that's one good thing about liquid. So capsule options are 1,000, 5,000, 10,000. But maybe because of practitioner differences or your individual goals, you want to take something in the middle. Liquid options give you the opportunity to sort of drop by drop or two drop by two drop customized. So she could have switched to a liquid and done 4,000 instead of going all the way from 5,000 to 1,000, which gives a great option for people. 

So mine's 41, which is coming back normal. So I think we're going to see similar recommendations as what you had, which is eat vitamin D rich foods, similar lists here. Again, mine will also show the mushroom information and what difference that makes. And then activity is more about keeping your vitamin D levels normal. And so that's what those recommendations are here. And then similarly, I got Basic Nutrients 2/Day which the intention of the recommendation is to maintain what's already existing. So for me, because I want it to be a little higher, I'm going to personally recommend for myself something in addition to Basic Nutrients.

Dr. Robert Rountree:

So again, Basic Nutrients is what, 2,000 IU if you take two a day.

Dr. Amanda Frick:

2,000.

Dr. Robert Rountree:

So it's a great supplement for general use in the public. But then if you want to crank, then I would be much more inclined to individualize and say, let's go with 5,000 if you want to crank up the dose.

Dr. Amanda Frick:

Yep. And for me, I'll probably do liquid and somewhere a little more than 5,000.

Dr. Robert Rountree:

Yeah, I'm a little more than that even. Great. So all right folks, that's all the time we have for this week. Amanda, thanks again for coming on the podcast. Always ask, if people want to follow what you're doing, want to keep in touch with the latest at Thorne, where should they go?

Dr. Amanda Frick:

I think you should follow Thorne on LinkedIn and other whatever social media aspect you like or platform that you use. And then any updates that I have or other pieces that get included on will be posted on my LinkedIn as well.

Dr. Robert Rountree:

Terrific. Excellent. Well, that was Thorne's vice president of medical affairs Dr. Amanda Frick on Thorne's Vitamin D At-Home Test Kit. As always, thank you everyone for listening. Please tune in next time. 

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Thanks for listening to The Thorne Podcast. Make sure to never miss an episode by subscribing to the show on your podcast app of choice. If you've got a health or wellness question you'd like answered, simply follow our Instagram and shoot a message to @thornehealth. You can also learn more about the topics we discussed by visiting thorne.com and checking out the latest news, videos, and stories on Thorne's Take 5 Daily blog. Once again, thanks for tuning in, and don't forget to join us next time for another episode of The Thorne Podcast.