”Why do I feel this bad every morning?” worried Sylvia Owusu-Ansah, M.D., as soon as she opened her eyes. “Lately, my body seemed so drained and stiff — even after a full night of sleep — that climbing out of bed required a multistep process. First, I’d sit up, then swing my feet to the side. And finally, I’d slide off the mattress and onto my feet. Something is really wrong, I thought. I’m like the Tin Man from ‘The Wizard of Oz,’ desperately in need of an oil can!
Foggy and Moody
“For months, I hadn’t felt like myself. I suffered from zero energy, cloudy thinking, achy joints, and cramping muscles. As an emergency room pediatrician, my patients kept me on my toes, but fatigue made me feel like I was 100 years old. I was also at the mercy of my moods, which were up and down, but mostly down. That was unusual for me because I knew I wasn’t depressed.
“I wanted to be proactive, so I started troubleshooting diagnoses. I had a history of anemia, but my iron levels were fine. I also wondered whether hormones could be behind my fatigue: I’d been diagnosed with a thyroid condition, but I was managing it well, so that seemed like another dead end. Maybe it’s just stress from juggling work and motherhood, I reasoned. Emergency room docs don’t get enough sleep anyway.
“As my symptoms continued, I grew more concerned. I knew I couldn’t suffer like this forever. In my job, I got exposed to more germs than a kindergarten teacher, and I didn’t want my health to unravel even more by developing extra sinus infections, colds, or the flu while I was already running on empty.
“One day, I was hobbling through the hospital hallway like the robot C-3PO from Star Wars, when I was hit by my usual wall of afternoon fatigue. I had no choice but to put my head down on a desk and rest for a bit. That’s when an older nurse looked at me and said, ‘You better get your vitamin D checked.’
“Caught off guard, I responded, ‘What are you talking about?’ This wise nurse — who hailed from the Caribbean — explained, ‘It happened to me. It’s common for people like us with dark skin.’
“Sure enough, when I visited my endocrinologist, I had my levels checked and the results were shocking: I was extremely deficient in vitamin D. The normal range is between 30 and 50, and I was only at nine! No wonder I feel like a sloth! I thought.
The Natural Fix
“Finally aware of what needed to be addressed, I started making changes. I knew there were different forms of vitamin D, which you can get from the sun and from nutrition. I also learned that African Americans are at a greater risk for this type of insufficiency because the higher levels of melanin, the dark pigment in our skin, reduce our body’s ability to produce vitamin D. I guess I took it for granted that I was getting enough sun, but clearly I wasn’t. To start healing, I made sure to spend a couple of hours each day in sunlight, while protecting myself from UV rays.
“I also added more vitamin D–rich foods into my diet, such as oily fish, egg yolks, portobello mushrooms, orange juice, and fortified cereals. Knowing many African Americans are lactose intolerant, I was glad to see lots of fortified dairy alternatives too, like soy milk and yogurt. And since my levels were so low, I also supplemented with a high dose of D — 10,000 IU daily.
“Within two weeks of making these changes, I noticed a huge improvement in my health. My joints didn’t hurt, and my body felt spry. My thinking was clear — I could multitask again. Plus, my naps and mood swings were history! When I told the nurse she was right, she quipped, ‘See, I told ya.’ After a few months, I was able to drop down to a lower dosage of 2,000 IU, taken before my largest meal of the day for ideal absorption. My efforts were working because I was able to raise my vitamin D levels from nine to 40 in just six months!
“This eye-opening diagnosis impacted the way I practice medicine. For healthcare professionals, vitamin deficiencies are often not at the top of our list when screening patients. But now it’s always on my radar, especially for people of color.
“Thankfully, it’s easy to overcome a vitamin D deficiency. Now, I feel an overwhelming sense of wellness. I have energy to care for my patients and my own children, plus walk 10 miles a week for exercise. I feel amazing. I’m exactly where I should be!”
How Low Vitamin D Causes Fatigue
“I can count on one hand how many of my patients had adequate vitamin D levels when I tested them,” says Susan Blum, M.D., assistant clinical professor at Mount Sinai’s Icahn School of Medicine. Indeed, research shows 91 percent of women have suboptimal D levels — and women over 50 are at the greatest risk. “They’re more likely to stay out of the sun or wear a hat and sunscreen,” says Dr. Blum, so they don’t absorb enough UV rays to make D. The result: exhaustion, mood swings and frequent illness.
Having dark skin has been shown to double the risk of low vitamin D. “Melanin, the pigment responsible for darker skin, is a natural sunscreen,” explains rheumatologist James Dowd, M.D. “But when they’re not outside as much and not near the equator, darker-skinned people can have egregiously low D levels.” Being overweight is another deficiency risk factor, he says. “D is a fat-soluble vitamin, so it’s sequestered in stored fat and not available to be used.”
How to Stop It
Testing levels of 25-hydroxy vitamin D can ID a deficiency. “My goal is to get levels to 50 to 70 ng/ml,” says Dr. Blum. But if you’re experiencing red flags like fatigue and frequent illness, consider the steps below to boost levels.
Supplementing with vitamin D3 is the best way to correct a shortfall. “My rule is to take 20 IU per pound of body weight per day,” says Dr. Dowd (that’s 4,000 IU for a 200-pound woman). “And for women with darker skin, 25 IU per pound per day.”
Snack on almonds. They’re a top source of magnesium, a nutrient Harvard researchers say is required for the body to break down and utilize vitamin D. Adding 200 mg. of magnesium (1⁄2 cup of almonds) daily can boost vitamin D levels eightfold.
This article originally appeared in our print magazine.