Vitamin D: Everything You Need To Know For Endurance Performance

Original Article: Shawn Hueglin, PhD, RD, CSSD

Update: By Robert Kunz MS

Pro Triathlete Jeanni Seymour soaking in some vitamin D.

Most athletes have a general understanding of how many grams of carbohydrate, protein, and fat they eat per day. However, few athletes are concerned with the amount of vitamin D they consume and synthesize in their bodies each day. In the past, the importance of this nutrient has often been overlooked. Researchers and sports dietitians have long recognized the important role vitamin D plays in bone health and that a serious deficiency can lead to rickets and osteomalacia.    Though athletes are frequently exposed to the sun, vitamin D insufficiency rates range between 37% – 83%. Emerging evidence shows that vitamin D deficiency can also increase the risk for cardiovascular disease, diabetes, hypertension, autoimmune diseases, compromised immune function, exercise-related inflammation and certain types of cancer. Recent data suggests vitamin D may play a role in athletic performance.

Vitamin D is a unique nutrient in that it can be synthesized in the body when the skin is exposed to UVB radiation. It is very common for people to rely on this process for vitamin D intake. However, because sunlight is required to activate the process, any factor that limits the quality of sun exposure can compromise the status of vitamin D in the body. Some of these factors include sunscreen, aging, skin pigmentation, clothing, cloud cover, time of day and latitude. Vitamin D can also be obtained from a limited number of dietary sources which include fatty fish, cod liver oil, egg yolk and fortified products such as milk, yogurt, orange juice and cereals.

Recently, Vitamin D deficiency and insufficiency (also called marginal deficiency) have received a lot of attention in the media. Some researchers have used the term epidemic due to the high prevalence reported in all age groups (14 – 94% depending on race, geographic region, presence of disease and age). Vitamin D deficiency is typically defined as a blood concentration of 25(OH)D < 20 – 25 nmol/L whereas insufficiency is defined as a concentration of < 37.5 – 50 nmol/L . Recent research indicates blood concentrations of 25(OH)D 75 – 80 nmol/L may be required to support optimal functioning. Athletes are not immune to deficiency or insufficiency, yet less is known about the levels of vitamin D in this population (~37 – 68% based on 3 published studies). An athlete’s training environment (indoor vs outdoor), use of sunscreen and season of assessment may influence these values.

Due to the important role vitamin D plays in bone health, immune function and inflammatory response, vitamin D status may impact an athlete’s ability to adapt to training and improve performance.

  • Stress fractures that prevent optimal training are a common problem in athletes. Evidence suggests an association between decreased serum concentrations of vitamin D and increased risk of stress fractures in males and females. There is also data to support that supplementation with vitamin D can decrease the incidence of stress fractures. Therefore, compromised vitamin D status may increase an athlete’s risk of incurring a stress fracture.
  • Vitamin D has a direct effect on immune cell function. Preliminary self-report data suggest that vitamin D supplementation can decrease the incidence of influenza and the common cold. Athletes who participate in prolonged intense training are typically at increased risk for upper respiratory tract infections (URTI). More data is necessary to show an effect; however, it appears vitamin D intake may influence an athlete’s susceptibility to viruses like the flu and common cold.
  • Currently there is evidence to suggest vitamin D deficiency is related to the inflammatory cycle in animals with autoimmune diseases. More research is needed to understand the impact vitamin D might have on exercise-induced inflammation in humans. An increase in the production of inflammatory factors may be involved in the development of overtraining syndrome which is associated with high volume training and inadequate rest periods. There is data to support that vitamin D increases the production of anti-inflammatory factors. Additionally, studies have found that adequate vitamin D concentrations protect against cartilage loss and progression of osteoarthritis.

Recommended Vitamin D Levels:

Most experts agree that the current recommendations of 200IU – 600IU/day are too low to support optimal health and functioning. However, there is a lack of agreement on optimal intake which varies from 1,000 – 10,000 IU/day (keeping in mind intake depends on synthesis from sun exposure and also storage of vitamin D).  It is estimated that the body requires 3,000-5,000 IU of vitamin D per day to meet the needs of essentially every tissue in the body. Athletes at risk for poor vitamin D status are those with a low intake or limited sun exposure due to use of sunscreen, indoor training, protective clothing, dark skin pigmentation, early morning or late afternoon training sessions or those with minimal or excessive body fat. Vitamin D is stored in subcutaneous (under the skin) body fat and released as needed during winter months or lower exposure times. This process, however, seems to be ineffective in individuals with high or very low amounts of body fat. Extremely high supplemental doses (> 150,000/day) of vitamin D can cause toxicity but doses of 10,000 IU/day for up to five months appears to be safe. This level of dosage may be recommended by a physician when an individual is vitamin D deficient, in order to raise the blood concentration to an optimal level. Excess sun exposure does not lead to vitamin D toxicity, but caution is needed regarding skin cancer.  Recent data suggests that levels higher than 35 nmol/L of Vitamin D are associated with improved VO2 suggesting that a favorable vitamin D status may improve aerobic performance.

Vitamin D and Athletic Performance:

Though the data is limited, Vitamin may play a role in athletic performance.  The data that does exist demonstrates poor vitamin D status is associated with decreased muscle strength, poor physical function, muscle discomfort, and aching bones. Several new studies on athletic populations have shown improved performance, improved VO2 and improved vertical jump on athletes that improved their vitamin D status. These studies showed that athletes with higher vitamin D status >20 – 25 nmol/L had better physical performance and muscle strength.

Researchers have two theories why vitamin D may play a role in improved muscle function.   First, vitamin D receptor (VDR) sites have been identified in every tissue within the body. These VDR sites regulate expression of hundreds of genes that perform dozens of body functions.   The discovery of VDR sites within the muscle suggests vitamin D plays a role as a regulator of skeletal muscle function.   These VDR sites are especially prevalent in fast twitch muscle fibers which have been shown to have better muscle performance.   Secondly, vitamin D has also been shown to modify the transportation of calcium in the sarcoplasmic reticulum which in turn increases the efficiency of calcium binding sites. Since calcium plays a significant role in muscle contraction, the improved efficiency through these binding sights is theorized to be the reason for improved muscle function. In other words, calcium plays a significant role in muscle contraction and therefore along with vitamin D, or more specifically VDR’s, may improve muscle function and strength.

Recommendations:

Vitamin D plays a critical role in bone health, chronic disease prevention, inflammation, immune function and optimal training.   As discussed above vitamin D may also play a role in athletic performance.   The best approach is for athletes to measure vitamin D status and develop a baseline level.   For optimal health a general population should target levels of 20 – 25 nmol/L or higher, whereas athletes seeking additional performance benefits should look for levels at or above 35 nmol/L.

First Endurance MultiV contains 500IU Vitamin D, which may be sufficient for those athletes consuming ample vitamin D from select foods and spending ample time in low latitude states with significant sun exposure year round.   Though the body requires 3,000-5,000 IU’s per day, higher levels do have an ability to be stored in fat for future use.   Athletes seeking an advanced level of vitamin D to ensure optimal health and performance should consider MultiV-PRO which contains 2,500IU vitamin D.

 

18 replies
  1. Barry
    Barry says:

    Great report

    Did you look at its effect on mood state ? Some good evidence to show that it improves serotonin levels.

    Also, it is possible to take a weekly dose of VitD3 in 1-2 servings. E.g. lets say dosage is 3000IU per day. this could be taken in 2 x 10,000IU servings

    Reply
  2. Shawn
    Shawn says:

    Hi Barry,
    I did not include a discussion of vitamin D and mood state in this article. However, there is some evidence to show that serotonin synthesis and sunlight exposure are related. Some individuals are more sensitive to low levels of sun exposure, particularly in the winter. When supplemented with vitamin D, some individuals experience a positive effect on mood. There is also some research to indicate that individuals with depression have low levels of vitamin D.

    With regard to dosing, when an individual is diagnosed with vitamin D deficiency or insufficiency, they often need a larger dose (as you mentioned) in order to raise their levels to a healthy range.

    Thanks for your comments!
    Shawn

    Reply
  3. marion
    marion says:

    I have often read that certain medications, antiepileptics for example inhibit the absorption of vitamin D…would that mean someone under treatment for epilepsy would need to take more than the average athlete?

    Reply
  4. marco
    marco says:

    (dairy) specifically cows milk is fortified with D2 – which you said is less effective at increasing blood concentration. not to mention the other negative health consequences of cows milk.

    Reply
  5. Shawn
    Shawn says:

    Hi Marion,
    That is a great question. Based on the research I have read I have seen two things. 1) Individuals on antiepiletptic meds have lower BMD values and lower vitamin D concentrations (25(OH)D). 2) Individuals on antiepiletptic meds have lower levels of blood calcium (hyocalcemia) and osteopenia (low BMD values) but normal concentration of vitamin D (25(OH)D). It seems that bone health is a risk factor but that is not necessarily explained by vitamin D levels. I would recommend having your vitamin D levels check by your physician regardless since there are so many factors that influence blood levels in addition to the medication.
    Thanks for the question.
    Shawn

    Reply
  6. Robert S.
    Robert S. says:

    Is there a direct test available for the quantification of Vit D3 in blood/serum? Do you think clinicians would prefer D3 tests or 25(OH)D tests? What would you consider to be more valuable?

    By D3, I mean cholecalciferol.

    Regards

    Robert

    Reply
  7. Ruth
    Ruth says:

    Do you have any recommendations for Vitamin D supplements that are D3-based and also made by brands which meet the facility manufacturing quality requirements that would allow an athlete who is USADA-tested to supplement with it?

    Reply
  8. Robert Kunz MS
    Robert Kunz MS says:

    Ruth,
    Ultragen, by First Endurance has 200IU of Vitamin D3 in addition to 500mg Calcium. IF you are looking for a product that can guarantee that it is free of banned substances, we can only speak about First Endurance. We do not know what controls or lack-there-of other companies use. With First Endurance, we own our formulas and use GMP TGA/Pharmaceutical grade manufacturing. We closely monitor all quality control measures to offer a products that are free of any banned substances. It is why so many of the Worlds best endurance athletes look to First Endurance.

    Reply
  9. Barry
    Barry says:

    Robert,

    200IU is nowhere near the required dosages required by most people. I have read reports recommending anything between 20 and 70IU/Lb body weight (depending on sun exsposure, skin type etc)…. so 2-3000IU/day is a minimum dose.

    Ruth – there are plenty of GMP/batch tested D3 products out there… Solgar being one..but do a search or ask at your local healthfood store and you will find products supplying high D3 dosages. I don’t work for any of these companies, I’m simply calling it as it is

    Reply
  10. Robert Kunz MS
    Robert Kunz MS says:

    Barry,
    When Ultragen was formulated, the purpose of vitamin D was not to deliver an ideal dose, but to help with the absorption of calcium. Ultragen is not a
    Vit D supplement, but a well designed recovery drink.
    With Dr. Dolan’s review of Vit D, we will no doubt consider how and where to incorporate an advanced dose of this nutrient in our products.

    Reply
  11. ryan @ vitamin d3
    ryan @ vitamin d3 says:

    I’ve discovered that maintaining optimal levels of Vitamin D has repeatedly been proven to be necessary to just about every aspect of proper health, from disease prevention to strong bones and mental alertness.

    Reply
  12. benefits of vitamin d3
    benefits of vitamin d3 says:

    On the topic of Vitamin D I’ve learned it plays an essential role in the body which is absolutely necessary for the absorption and maintenance of calcium. Having the right levels of calcium in the body enables the maintenance of the appropriate structure within the bones, teeth and proper functioning of the nervous system. This is the major reason why we require the appropriate levels of vitamin D in our body. Vitamin D belongs to a group of fat-soluble vitamins. This means you need to transport the fats.

    Reply
  13. Chamitus
    Chamitus says:

    Thank you, this information has been very helpful and mind settling. It explains my every day changing moods and joint pain. What about numbness and irregular menstrual cycle?

    Reply
  14. keith mason
    keith mason says:

    Sorry to see you didn’t stress the importance of taking K2 when supplementing with D. When testing your level it’s my understanding it should be fro 25D hydroxy

    Reply
    • Robert Kunz MS
      Robert Kunz MS says:

      Keith,
      You are absolutely correct in that this combo is highly effective for bioavailability, bone health and mineralization. There is so much positive data on Vitamin D and in so many different functions that it was difficult to keep this article short.
      Note: MultiV and MultiV-PRO both contain vitamin K2 for this added benefit.

      Reply

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