As my nutrition practice turns ten years old, it is a good time for me to reflect on lessons I have learned about the effects of nutritional therapy on the mind. Though nutrition is a second career for me, and one to which I came relatively late in life, it is the realization of my lifelong interest in psychology and the mind in general.

While at an earlier point in my life I might have chosen to study psychology or psychotherapy, by the time I was finally able to embrace this field I had learned enough about the interaction between the mind and chemistry or nutrition to know that nutritional medicine held far more powerful answers than any type of talk therapy.

This interest led me to chiropractic school in a roundabout way, basically because I felt I needed some medical training and a license that would enable me to practice.  In any case, while in school and in my first years of practice I took every seminar and advanced training I could find on clinical nutrition.  However, seminars on nutrition for the mind are rare, when available at all, and consequently the field is replete with preconceived ideas and unsubstantiated theories.

My first significant learning experience came when a patient asked me to read the book "Seven Weeks to Sobriety" by Joan Larson, PhD, so I could help her with her own alcohol problem. Dr. Larson is a mother whose son committed suicide - as is only too common - when he was supposedly succeeding in his recovery from alcoholism.

Because of this experience, Dr. Larson knew that commonly available treatment programs for alcoholism were not the answer. These programs are based on regular meetings and talk therapy. Patients following them often replace one addiction with another and, if they achieve any success at all, it is through heavy use of antidepressant medications. Instead, Dr. Larson believed that a drug-free program that used diet and nutritional supplements to balance brain chemistry would yield much better results.

This led her to years of study culminating in a PhD in biochemistry, and then to opening a clinic in Minnesota you can read about at

http://www.healthrecovery.com/HRC_2006/OpeningPage.htm

At her clinic Dr. Larson, aided by a team of like-minded physicians, has been successfully treating alcoholism and other addictions with nutritional therapy since 1980, and reporting a success rate as high as 80%.

Over time people sought Dr. Larson’s help not only for addictions but also for depression, anxiety, compulsive thoughts and so on, and she found that the same principles she had been applying to the treatment of alcoholism worked equally well in these other areas. She then wrote the book "Depression-Free Naturally," which I read carefully while taking extensive notes I then used as practice guidelines for years, and which I still consult on occasion.

Her approach is based on a diet aimed at avoiding food allergens and balancing blood sugar, and on an individually targeted and intensive supplement programs aimed at replenishing nutrients and balancing brain chemistry and hormones. The program tends to be complex and not always easy to follow, but in my experience it works very well when properly implemented.

Later on I ran across the interesting work of psychotherapist-turned-nutritionist Julia Ross and read her books "The Mood Cure" and "The Diet Cure."  In her psychotherapy practice, Julia had found that people could often see her for years while continuing to suffer from the same problems.  So, long before treating mood issues with nutrients was in vogue, Julia started to experiment with amino acids such as l-tryptophan, l-tyrosine, GABA, and others. She found that once she identified the correct mix of nutrients an individual needed, moods improved rapidly and problems that might have been ongoing for years could be resolved in a matter of days or weeks.

Julia’s approach is not all that different from Dr. Larson’s, though it is more flexible.  She also developed a comprehensive checklist to analyze symptoms and determine an individual’s amino acid needs. I have found this checklist to work better than any of the new fancy and overpriced lab tests that are often promoted these days.

Although some psychotherapists feel threatened at the thought of their clients recovering in days or weeks, Julia proved their worries to be misplaced by building a hugely successful practice you can read about here: http://www.moodcure.com/.

Compared to Julia Ross and Dr. Larson, Marty Hinz, MD, is a relative newcomer to the field of nutrition for the mind, though he may have made the most significant contribution to our understanding of what it can achieve.  He is a conventionally trained physician who at one time ran a weight-loss clinic where he wrote thousands of prescriptions for the drug combination commonly known as Fen-Phen.  This combination, as you may remember, looked promising at first but was later found to be deadly and was eventually removed from the market.

In time he started to experiment with nutritional therapy and found that by combining certain amino acids with a few other associated nutrients at high doses he could achieve even better results in weight loss than with Fen-Phen, of course with the added bonus of no side effects or adverse long-term consequences.

Similar to how Dr. Larson had discovered that her alcoholism programs worked for depression, Dr. Hinz found that his weight-loss nutrient combinations aimed at balancing neurotransmitters could be used to successfully treat many other conditions as well. These included depression, anxiety, and some other obvious ones, but also conditions like fibromyalgia, migraine headaches, and Parkinson’s. I am including a partial list of conditions that respond to amino acid therapy at the end of this article.

Many of us used to be more or less secretly impressed with medical scientists’ ability to develop a class of drugs called "reuptake inhibitors" that increased the availability of serotonin and other neurotransmitters where they were needed. Dr. Hinz dispelled this myth by showing evidence that, aside from medicines, many street drugs - including cocaine - also work by inhibiting reuptake of neurotransmitters. Often researchers only duplicated the actions of street drugs to make patented prescription medicines.

Dr. Hinz then unearthed research showing that antidepressant drugs - like street drugs - deplete neurotransmitter stores, leading over time to a need for ever-higher doses or stronger drugs, and eventually a loss of effectiveness of the drugs. Though these studies were obviously easily accessible in the medical literature, no one I know had ever heard of them, and few if any patients being prescribed these medications were ever told about them.

Dr. Hinz also recommended amino acids at higher doses than had been common practice. He proved that these higher doses are not only safe but effective - and not just for mild or moderate depression as was thought previously, but equally for severe long-term depression even when it is no longer responsive to medications.

Not only that, but Dr. Hinz was also the first doctor I know of in the US to combine amino acids with prescription antidepressants. You will find warnings all over the Internet and on supplement bottles against doing this but it is misguided information; once again, Dr. Hinz found valid studies, mostly from Europe, showing that the combination is safe and also that the addition of amino acids increases the effectiveness of antidepressants. This is a great tool to have at our disposal, especially for people wanting to wean off antidepressant medications. Nevertheless, I do not recommend that you try it without expert supervision.

Finally, Dr. Hinz can be credited with pioneering urine tests to measure neurotransmitter levels. He also proved that people with depression do not have lower than normal neurotransmitter levels, so these tests are of no help in making a diagnosis or initiating treatment. Testing does have value in monitoring progress, but only for a minority of difficult cases with atypical responses to amino acid supplements.

You can read about Dr. Hinz and his work at http://neuroassist.com/. While his work is groundbreaking in many ways, it has its shortcomings.  Maybe because of his mainstream medical background, Dr. Hinz never saw the connection between the mind and diet or overall health that is so obvious to more holistic practitioners, including both Dr. Larson and Julia Ross.

His system also tends to be rigid, and is based too much on a "one size fits all" approach. When people do not respond well, this system can be difficult to adapt to individual needs, leading to people losing faith and discontinuing the program. In my experience working with a more flexible approach such as the one developed by Julia Ross yields better results and is more enjoyable for everyone involved.

Today I combine the best of what I have learned from the practitioners I described here and a few others, plus my own years of experience.

In summary, my current approach is based on the following five points:

• Determine an individual’s amino acid needs based on detailed history and exam. I have not found neurotransmitter tests to be of added benefit in this area, though sometimes they can be helpful at a follow-up evaluation. Once the correct formula and dosage are identified, it can rapidly relieve symptoms, though it may not solve the root cause of the problem.
• Identify food sensitivities through a laboratory test or by other means, such as an elimination diet. Recommend an overall healthy eating program, taking into consideration possible blood sugar imbalances or the presence of intestinal yeast. Diet change can lead to long-term resolution of symptoms and limit the need for amino acid supplements, eventually enabling people to stop taking them altogether.
• Identify possible hormonal issues through history or lab tests as needed. Depletion of hormones, especially stress hormones, can be a clear cause of depression, anxiety and other similar conditions. This often becomes obvious in the course of the initial appointment. In these cases it is still possible to relieve symptoms through amino acid supplements, but the problem can never be fully solved until hormonal imbalances are identified and corrected.
• Consider the possibility of yeast overgrowth, a toxic gut, or other digestive issues that could be contributing to symptoms. When necessary, this can be assessed through a digestive stool test.
• Evaluate toxin buildup in the body - including a possible buildup of lead, mercury or other environmental poisons - and employ a targeted detoxification program when called for.  More often than not, detoxification is essential to long-term relief of symptoms.

In addition to depression, conditions that respond partially or fully to neurotransmitter therapy using amino acids include, but are not limited to: Parkinson’s disease, obesity, bulimia, anorexia, anxiety, panic attacks, migraine headaches, PMS, OCD, insomnia, aggressive behaviors, fibromyalgia, ADD, ADHD, Alzheimer’s disease, traumatic brain injury, chronic pain, phobias, irritable bowel syndrome, and alcoholism. 

I grew up by the sea and often tell people that the ocean is in my blood.  Recently I came across some fascinating old research that made me think that this is true in a far more literal sense than I had ever thought possible.

The research dates back to the early 1900’s and was conducted by French biologist and self-taught physician Rene Quinton. In analyzing the composition of human plasma and that of ocean water, and superimposing the two, Quinton observed that they are virtually identical - the only real difference between the two being that ocean water is three times more concentrated than plasma.

Quinton attributed this difference to the fact that, since life originated in the ocean millions of years ago, seawater has become more concentrated.  His conclusion was that we all still carry original ocean water in our blood. Human (and animal) plasma, in his view, is a “marine environment.”

To prove his point Quinton carried out a series of experiments that later came to be known as the “dog studies.”  Though we are no longer accustomed to studies being performed on dogs, in his day dogs and cats were often used for medical research.

In a series of experiments he drained progressively more blood from dogs, replacing it with seawater diluted to have the same concentration as plasma. In the final experiment all the blood was drained from a dog and, when the poor animal was on the verge of death, an equal amount of seawater was introduced through a vein.

Although the dog experienced a rough couple of months, he recovered fully on his own with no medical treatment of any kind. He was then renamed Sodium, spared further experimentation, and he continued to live at the Quinton clinic until he died of natural causes years later.

If you think this story defies our basic understanding of physiology and that it must have been made up, you are not alone. I thought the same thing when I first read it. After all, even if plasma and seawater are alike, blood is much more than plasma alone and also contains cells and all-important hemoglobin that is key to carrying oxygen to the brain and other organs of the body that keep us alive.

However, aside from the thorough documentation kept at the time and the numerous witness reports, the experiment was also repeated by a team of French physicians in 1969 under modern-day controlled hospital conditions and the outcome was the same. The only explanation I can think of is that some yet-to-be-identified component of seawater must have compensated, at least partially, for the lack of blood components until the body was able to reconstitute them.

Quinton then observed that many illnesses plaguing humanity in his day were associated with a disturbance in the composition of plasma. His view was that this change in the inner “marine environment” of the body was far more likely to be the cause of illness than any bacteria attacking the body from the outside.

Modern medicine has clearly embraced the opposite view that it is bacteria (or viruses, or other pathogens) that cause illness, and that a person who becomes ill just happened to be exposed to a bug by being in the wrong place at the wrong time. In Quinton’s day, however, the cause of illness was a topic of heated debate.

Today, a few of us - including myself - still basically agree with Quinton, and hold that illness takes place because an individual’s internal chemistry has become disturbed, whether this happens because of poor diet, toxins or other reasons. Though bacteria and other pathogens clearly play a role, in most cases they only seriously affect people who present an inner environment already favorable for disease.

Given Quinton’s belief that seawater had the right balance of elements to support optimal health, he theorized that by administering it to patients he could help reestablish a balanced internal chemistry that would enable them to regain health.

The rest, as they say, is history. Quinton developed a protocol for harvesting and purifying seawater, and administered it in pure or diluted form to patients either by mouth, injection or enema, and carefully recorded changes in their health keeping detailed progress reports including before and after photographs. Much of this data, including accounts of the dog studies, can be found on this Canadian website: http://www.oceanplasma.org/. 

One of Quinton’s biggest claims to fame was to have cured thousands of children with cholera - in that era almost always fatal - with seawater intravenous drips. This is not the same as saline drips that were common at the time (and still are today) that were helpful, but seawater brought about much higher recovery rates.

Aside from cholera, looking at the case histories on the website, it is clear that Quinton treated a broad range of health conditions. Many of the patients he saw were small children with what would be called today failure to thrive, or an inability to gain weight. Other cases include children and adults with eczema, psoriasis, and a variety of digestive disorders from colitis to what is now known as Irritable Bowel Syndrome.

You may wonder why, if this treatment was so helpful, no one talks about it today. The reality is that medicine increasingly lost interest in natural treatments and opted instead for synthetic drugs that could be patented. This started slowly, but gained momentum after World War I with the development of the chemical industry. At that time Quinton and many other innovative doctors fell out of favor and were labeled as quacks. However, there still are doctors in France carrying out this work, apparently with continued success, as a brief internet search will reveal.

Here at home there are a few companies that still harvest and prepare seawater according to Quinton’s guidelines but with greater concern for purity. One of these is the Canadian company Ocean Plasma (website link above).

I have personally been taking and recommending their products and I am finding them to be helpful for many, including children. These products have been extensively purified, tested for possible contaminants, and found to be pure. They are high in sodium, which can be a concern in some cases, for instance those with high blood pressure. However, the sodium in this water has a different effect from table salt because it is balanced with a complete range of minerals and trace elements.

Because of their unique mineral balance, these products have significant benefits for the nervous system and electrical functioning of the body, and are key to effective detoxification, aside from more esoteric benefits that may result from the fact that life originated in the ocean.

If ocean water is so healing, concentrating certain components in it could even be better in some cases. As it turns out, there is a concentrated ocean water product that had been used in medicine over the ages, then was forgotten, and just recently was rediscovered.

This product forms spontaneously in the process of making sea salt. As seawater evaporates, sodium - or table salt - dries up, turning into the white grainy substance we all know. At the same time magnesium and other minerals remain wet, forming a type of brine that never evaporates completely and that gets separated out so the salt can fully dry.

Once separated, this brine forms a clear liquid that is much denser than water and feels oily to the touch though it contains no oil. It also contains no sodium, but contains close to 35% magnesium - an extremely high concentration - as well as a full range of trace minerals. This liquid can be seen as a true essence of seawater in that it takes a gallon of water to make just six ounces of the liquid. Because of its consistency and composition it is known as magnesium oil.

Since it is such a highly concentrated product, some have expressed a valid concern that it could be contaminated with mercury or other toxins. It is interesting to note, however, that mercury builds up through the ocean food chain but is not really found in clean seawater. Certificates of analysis I have seen for this product reported a mercury content of less than 0.01 parts per million, the lab’s detection limit. In fact, research has shown that mined magnesium used to make most magnesium supplements sold in stores is far more likely to be contaminated with heavy metals than this ocean-derived product (find a more detailed discussion of this in the book Transdermal Magnesium Therapy by Mark Sircus).

Pain management specialist and medical maverick Norman Shealy, MD, PhD is usually credited with rediscovering magnesium oil and making it available as a supplement. However, according to Dr. Shealy’s own account he first heard of it in the late 90’s from a free-spirited man named Jim Carter.  Dr. Shealy calls him a modern-day Ponce de Leon, in homage to the Spanish explorer who searched for the secret of life.

Apparently Jim Carter never completed high school, though he acquired a great deal of uncommon knowledge through his personal reading and research. Among other things, when he came across an 1875 edition of the Encyclopedia Britannica he read the entire set of volumes from cover to cover.

In doing so he rediscovered all sorts of forgotten knowledge including the information about magnesium oil and its medical uses. When he told Dr. Shealy about the oil, the health claims he made for it seemed outrageous. Nevertheless Dr. Shealy decided to put it to the test.

Given that this product is used topically and not usually ingested, Dr. Shealy decided to find out first whether the magnesium it contained could even be absorbed through the skin. He recruited a group of volunteers and tested their intracellular magnesium levels (the only reliable measurement of magnesium status).

He then had them mix the oil 50/50 with water, because occasionally it can sting or irritate the skin if used at full strength. He instructed them to spray the mix on their bodies once a day and have a 20-minute footbath in it once a week.

After four weeks he retested their levels and found that 75% of the participants had experienced a significant rise in intracellular magnesium. This is a dramatic result, considering that with the best-absorbed oral form of magnesium it can take one year to finally see a change in intracellular levels - and for some people this never happens.

You may ask what is so special about raising intracellular magnesium. In fact, magnesium is known to be essential to life, meaning that if we had none in our bodies we would die, while lesser deficiencies cause some type of health problem. Compared to other essential nutrients, magnesium has the double distinction of being needed for the greatest number of health functions, and of being the most commonly deficient mineral.

Unfortunately magnesium is very often overlooked, even among experts. No one in America seems to pay much attention to it while everybody wants to make sure they get enough calcium. The reason for this, according to author Mark Sircus, is that there has been no powerful lobby, like the dairy lobby, to promote the need for magnesium.

As hard as this may seem to believe, magnesium is more important than calcium even for bone health. While many of us obsess about getting 1,000 mg or more of calcium per day, only to find out year after year that our bone density levels have dropped, there are countries where osteoporosis is rare or doesn’t exist. In those countries, some of which are in Asia, adults only get 200 to 300 mg of calcium per day, whereas their magnesium intake is much higher than it is in the US (see Transdermal Magnesium Therapy by Mark Sircus).

To get an idea of how common magnesium deficiency is, consider that a recent study by the respected National Academy of Sciences found that roughly 70% of Americans obtain less than the recommended daily allowance (RDA) of magnesium from their diet. Among children I would bet that number is much closer to 100% given that magnesium is found mostly in whole grains and green vegetables. However, magnesium deficiency is not about intake alone. Stress, alcohol consumption, caffeine, sugar, excessive sweating, and fluoride all cause the body to excrete increased amounts of magnesium and can lead to deficiency even in people who have enough magnesium in their diets.

Conditions that can be helped by restoring normal magnesium levels in the body read like a who’s who of modern-day American ills, including irritability, hyperactivity, depression, anxiety, tics, seizures, migraine headaches, asthma, osteoporosis, diabetes, fatigue, high blood pressure, muscle and joint pain, and more. To get a thorough and organized review of conditions that can be helped by magnesium, read the informative book Transdermal Magnesium Therapy by Mark Sircus.  Below I will touch on a few topics of particular interest to me.

Magnesium is essential for integrity and stability of cell membranes and the blood-brain barrier. These are critical factors for function of the brain and nervous system. Thought we think of fish oil, B vitamins and other nutrients in this context, no one seems to remember the most essential of all, and the most likely to be deficient: magnesium.

Magnesium is a regulator of the NMDA receptor. This is a receptor for excitatory neurotransmitters. When everything is in harmony it plays an essential role for healthy function of the brain. However, with exposure to mercury and certain pesticides, this receptor can become over-sensitized leading to disastrous consequences, including destruction of brain circuits. According to biochemist and researcher Martin Pall, PhD malfunction of this receptor is to blame for the development of many modern epidemics, including Chronic Fatigue Syndrome, Multiple Chemical Sensitivity, Fibromyalgia, as well as Autism and ADHD.

Magnesium oil, when absorbed through the skin, raises DHEA levels in aging individuals. This finding led Dr. Shealy to call magnesium oil the “fountain of youth.”  DHEA has been described as the master hormone in the body, and dropping levels of this hormone are tantamount to aging. Because DHEA is used in the body to make sex hormones, magnesium oil alone has been reported to control menopausal symptoms.

Magnesium is a key for the body to make glutathione.  Glutathione is a protein made in the body that is essential for detoxification. Although glutathione injections can help in autism and many neurological conditions, they do not induce the body to make its own glutathione and must be repeated regularly, whereas magnesium has been shown to trigger natural glutathione production.

Dr. Shealy also wrote a book on this topic entitled Holy Water, Sacred Oil but it is now out of print. I managed to find and read a copy and it is informative, but it’s actually not the easiest book and can be confusing at times.

Magnesium oil also has a more esoteric aspect. When we use a dipstick designed to test urine and dip it in magnesium oil it always tests positive for blood. Could it be that we are finding the mystery element that kept Sodium - the bloodless dog - alive?  No one knows, but it’s a thought. Another thought is that the ocean, where life originated millions of years ago, could be the place where we finally find some answers to our 21^st century health crises.

If you have fibromyalgia - a condition characterized by persistent muscle pain - or if a friend or loved one of yours is afflicted, you'd do anything for some relief, and if it can come in the form of a natural supplement that is good for you, all the better.

This study (J Rheumatol. 1992 Jan; 19 (1): 90-4) is a bit old, but it deserves a second look. Reviewing the blood levels of different nutrients, investigators found that people with fibromyalgia had consistently lower levels of tryoptophan, a protein-derived amino acid that the brain uses to make serotonin, the "happy" neurotransmitter.

Tryptophan is also known for an infamous episode in the 1980's when the FDA removed it from the market after a single contaminated batch made it into the U.S., probably as a result of poor FDA supervision. Fortunately, tryptophan is slowly making its way back and 5HTP - a related compound - is readily available at health food stores.

It is not known whether fibromyalgia is in some way associated with low levels of serotonin in the brain, or whether it is some other function of tryptophan that is lacking. Nevertheless it has been a steady observation of mine that, although not a cure, either tryptophan or 5HTP can help. This is also a case where if a little doesn't do the job, more might.

Although I have written about the importance of vitamin D before, new information on this vitamin continues to surface. The more we learn about vitamin D, the more we find how many critical roles it plays in the body.

A "Vitamin D Council" was set up as a cooperative effort by a group of research scientists and recently launched a new website that can be found at www.cholecalciferol-council.com

Members of this council include Robert Heaney, MD, Professor of Medicine at John A. Creighton University. Dr. Heaney is considered the world's leading expert on vitamin D, having published over three hundred original papers on this topic.

According to Dr. Heaney, the current government vitamin D recommendations are so low they ensure deficiency for anyone who adheres to them and also avoids the sun. Oddly enough, Dr. Heaney participated in setting up those very recommendations, but later discovered that humans need 4,000 IU of vitamin D per day, not the recommended 400.

The council's purpose is stated on the front page of their website and reads "To end the needless death and disability from vitamin D deficiency." Can this be true? Are we dying and becoming disabled from vitamin D deficiency? It would seem so.

The list of possible disorders resulting from vitamin D deficiency is astounding. It includes osteoporosis, heart disease, high blood pressure, autoimmune diseases, Type 2 diabetes, multiple sclerosis, chronic muscle and bone pain, numerous cancers, chronic fatigue and even depression.

According to experts at the Vitamin D Council, the problem is one of enormous proportions with as many as 70% of American deficient in this vitamin, mainly because of widespread avoidance of the sun. While most of us know that our bodies make vitamin D from the sun, few realize that we cannot synthesize vitamin D if the sun's rays are filtered by glass or if sunblock is used. In addition, pollutants in the atmosphere and even chlorine in swimming pools may hinder the body's ability to make vitamin D from the sun.

This situation is particularly severe among older individuals. Studies of nursing homes have found all residents to be deficient in vitamin D. Many of these people suffer from osteoporosis and unremitting pain of osteomalacia, both of which are caused by vitamin D deficiency and can be treated successfully by replenishing this vitamin at a cost of pennies per day. Instead, these patients receive expensive patented drugs that further compromise their health. (J Clin Endocrinol Metab 2003 Nov; 88 (11): 5109-15).

A recently published review article indicates that vitamin D has been proven to 1) reduce blood pressure in hypertensive patients who are deficient; 2) improve blood glucose in diabetics; and 3) improve symptoms of rheumatoid arthritis and multiple sclerosis (Br J Nutr 2003 May; 89 (5): 552-72).

Vitamin D has also been found to play a role in mental function, and deficiency may be associated with conditions ranging from mild depression or ADD to true mental illness including bipolar disorder, schizophrenia and possibly autism. Although the exact role of vitamin D in the brain is not fully understood, it appears to play a role in the synthesis of dopamine and other neurotransmitters.

As pointed out in the Vitamin D Council's website, studies reveal that mental illness is less common with adequate sun exposure and that vitamin D deficiency occ urs more frequently among individuals with mental illness than in others. Finally, several small studies show that vitamin D supplementation can alleviate mental illness. The absence of larger and more conclusive studies is unquestionably due to lack of interest in an inexpensive vitamin (see the Vitamin D Council's website for references).

The first step towards identifying and correcting a possible deficiency is to have your blood levels of this vitamin tested. Unfortunately most doctors are unaware of the importance of vitamin D and don't even know how to test it or how to interpret the results.

In most cases of suspected Vitamin D deficiency, doctors will order a test called 1,25-dihydroxy vitamin D (calcitriol). However, this test is unreliable because it does not accurately portray levels of vitamin D in the body. The only test that truly tells us the actual level of vitamin D is called 25-hydroxy-vitamin D (calcidiol). The names of the two tests are similar but the tests are very different.

This can lead to confusion, since laboratories then report "normal" ranges of vitamin D that are incorrect, reflecting a state of widespread deficiency in which deficient levels have come to be considered normal. According to research performed by Dr. Healey and others, levels above 35 ng/ml are truly normal and a level of 32 or below is indicative of clear deficiency. By contrast, many labs indicate 10 as "normal."

The dose needed to correct a deficiency ranges from 5,000 to 10,000 IU per day. This should not be seen as a maintenance dose and should be taken only under supervision because blood levels must be monitored to avoid possible toxicity.

Alternatively, deficiencies can be corrected with daily or almost daily exposure to the sun. The entire body should be exposed without sunblock and the front and back of the body should receive equal exposure. Required time in the sun depends on a number of variables, but is equal to 1/3 of the time it takes the skin to begin turning pink. This might only be a few minutes for very fair-skinned individuals, but increases 5 to 10 times in those with darker complexions. In these individuals, vitamin D supplements may be the only realistic way to correct a deficiency.