How to treat Vitamin D deficiency with Chinese medicine?

Tiejun Tang 

Many of my patients report of being clinically diagnosed with vitamin D deficiency. Many of which have dismissed this as a “minor” condition, due to symptoms being mild or non-life threatening. However, I believe we should pay due attention to the early onset of signs and symptoms because if left untreated it can lead to chronic health issues.

Below are some questions I have been asked by my clients and my answers as follows:

 Q: Do I have vitamin D deficiency?      

 A: If you often feel lethargic, tired, experience non specific aches and pains, with a general sense of being unwell, this could be a sign of vitamin D deficiency. 

In addition, if you are in a job, i.e. office worker, with minimal exposure to natural sunlight; or that your current health condition / constitution (i.e. women of menopause age or above) you maybe at increased risk of developing VD. It is advised that you book an appointment with your General practitioner to have your blood VD level checked.

Statistic shows that 90% of the obese population, in the UK, has VD deficiency ^[1]. The South Asian community in the UK have a higher prevalence of VD deficiency compared to the White English population, due to different lifestyle^[2].

Q: Do I need any treatment?

A: The early stage of VD deficiency can present with non to mild symptoms, which can be easily overlooked as a “minor” problem.

The main function of VD is regulating the calcium and phosphorus metabolism and  plays a key role in osteoporosis in adults and rickets in children. A recent study from Cambridge, found that VD is a custodian of cell signaling stability in health and disease. It contributes to many human diseases, such as Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), hypertension and cardiovascular diseases ^[3].  If you have VD deficiency, this can increase your risk of developing serious illness (listed above).If you are experiencing mild signs and symptoms, it is advised that you check your VD level and if necessary to start early treatment, in order to re-balance your calcium and phosphate levels.

Q: How to treat VD insufficiency？

A: Vitamin D deficiency in Western medicine is usually treated in the form of artificially manufactured oral supplements (solutions or capsules), which are available for purchase over the counter. Unfortunately, the general public often self administer vitamin D, without knowing the recommended intake and this can result in high to toxic 25-hydroxyvitamin D levels ^[4]. A randomised, placebo controlled clinical trial report showed calcium supplementation in healthy postmenopausal women is associated with upward trends in cardiovascular event rates. This is potentially detrimental to health and should be carefully weighed against the likely benefits of calcium on bone health^[5]. It is in my opinion, based upon my extensive clinical experience, the safest treatment for VD deficiency, should be naturally derived e.g. regulate diet, lifestyle and the use of natural herbal medicine and acupuncture.

 Q: What is Chinese medicine’s opinion on VD deficiency?

 A: According to Traditional Chinese Medicine theory, the Kidneys dominate bone, growth and regeneration. Bone health (strength and density) depends on the quality of Kidney Essence. Vitamin D is first absorbed via the skin (from sunlight) and transported and metabolized in the Liver. However, hyrdroxylation (the first step of degradation of organic compounds) in the liver is only capable of producing 25 hydro vitamin D3, which is almost inactive. Compared with the kidneys ability to activate 25-hydroxycholecalcifero into 1,25-dihydroxycholecalciferol, it is endogenous vitamin D3 (1000x higher than its almost inactive form in the liver).The aetiology behind vitamin D deficiency is due to Kidney deficiency, from a TCM perspective.

For further reading on “Kidney dominate bone theory,” please reference my previous publication..   

 Q: How to treat VD deficiency in Chinese medicine?

 A: Any kidney tonification method can benefit VD. These include the use of acupuncture treatment, focusing on the following key kidney meridian points, eg. KI 3, KI 6, BL23, DU4, applying reinforce manipulation. Kidney tonifying herbs can be selected according to the principle of syndrome differentiation diagnosis. For example, for Kidney Yin deficiency, use modified Liuwei Dihuang Wan. For Kidney Yang disharmony, use modified Jingui Shenqi Wan.

To conclude, Chinese medicine has a ‘two way regulation effect.’ The use of Chinese herbal medicine and acupuncture can effectively balance the kidney yin/yang, which governs and stimulates the body's natural production of vitamin D and calcium. The use of artificially manufactured Vitamin D and calcium supplements can, therefore, be avoided, preventing VD toxicity.

Kidney tonifying herbs contain active ingredients and compounds used for maintaining health and preventing premature aging for millennia. In ancient China, from Emperors to ordinary civilians, regardless of social rank, everybody enjoyed reaping the benefits of consuming kidney tonifying pills and decoctions.

Reference:

1. Grace C. High prevalence of vitamin D insufficiency in a United Kingdom urban morbidly obese population: implications for testing and treatment.  SurgObesRelat Dis. 2014;10(2):355-60.

2. Kift R. Lifestyle factors including less cutaneous sun exposure contribute to starkly lower vitamin D levels in U.K. South Asians compared with the white population. Br J Dermatol. 2013;169(6):1272-8.

3. Berridge MJ^. Vitamin D: a custodian of cell signalling stability in health and disease. BiochemSoc Trans. 201; 43(3):349-58.

4.   Shea R. ANNALS EXPRESS: Self-administration of Vitamin D supplements in the general public can result in high to toxic 25-hydroxyvitamin D levels. Ann ClinBiochem. 2016; 15.

5. Mark J Bolland. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial.BMJ. 2008; 336(7638): 262–266.