Low Vitamin D & Deficiency Blood Testing

Did you know that vitamin D impacts wound healing and implant failure? If you are deficient in vitamin D, it may prevent you from recovering properly following a surgical dental procedure. If that procedure involved the placement of a dental implant, your vitamin deficiency could have a negative effect on the results of your treatment.

Vitamin D is a key player in bone growth and metabolism, promoting intestinal absorption of calcium and phosphorus. It is vital for the health of your brain, cardiovascular system, respiratory tract, skin, and your immune and endocrine systems. In the dental field, vitamin D plays an important role in the development of teeth and the promotion of your natural immune response to infection, as well as improving your healing following oral surgery, including surgical periodontal and implant treatments.

Most cases of vitamin D3 deficiency can be traced to three main causes:

  • Diet — We get D3 from the sun not food.
  • Sun Exposure — The human body synthesizes approximately 20,000 International Units (IU) of vitamin D from natural sunlight on skin without suntan lotion during months when the sun emits UVB exposure which in Virginia is mostly June, July and August. We get a little in May and September. Often patients mistake sunburn for vitamin D3 exposure. You can burn outside in Virginia from October through April and not get any vitamin D exposure, because that is UVA exposure not UVB. People who have darker skin are more at risk for inadequate vitamin D exposure; and individuals wearing sunscreen and have dark pigmented skin may require a higher vitamin D supplement. But most of all, it does not matter how long you are in the sun. If you do not have the right microbiome you will not be able to absorb vitamin D from the sun or a capsule. So the key is to make sure you get the correct microbiome in your gut to absorb any vitamin D. Dr. Roca at Arlington Smile Center helps each patient get their microbiome and D working for optimal health. We also look at your medical history — if you have had COVID-19 there is a good chance you are D deficient. If you have a sleep disorder of any kind, high blood pressure, runny nose, constipation, diarrhea or have the need to urinate often at night or during the day, there is a good chance you are deficient. Vitamin D is converted to an active form in the kidneys. Individuals with kidney disease may be at a greater risk for a vitamin D deficiency. Additionally, intestinal diseases such as celiac disease, cystic fibrosis and Crohn’s disease may limit the amount of vitamin D absorption. Vitamin D deficiencies are also common in obese individuals with a body mass index greater than 30 but many skinny people have low levels of vitamin D as well.
  • Medical History — Vitamin D is converted to an active form in the kidneys. Individuals with kidney disease may be at greater risk for a vitamin D deficiency. Additionally, intestinal diseases such as celiac disease, cystic fibrosis and Crohn’s disease may limit the amount of vitamin D absorption. Vitamin D deficiencies are also common in obese individuals with a body mass index greater than 30.
Sleep Health
D Hormone
Airway Health

Vitamin D is important to our immunity, especially during this time when we all need to protect our bodies from COVID-19.

I spent a great deal of time reading, watching webinars and podcasts and attending a weekend class with Dr. Stasha Gominak, a neurologist from Texas who has done years of research and treated over 7,000 patients with Vitamin D and B. I quickly got started on testing the vitamin D3 and B12 levels on our adults and children. I was not surprised to see that our all the blood test results showed my patients were deficient in vitamin D3 with a level under 30 and had a B12 level under 500. Dr. Gominak’s  research shows that our ideal levels should be between 60-80 ng/ml, we each have our Vitamin D “sweet spot” so we need to find what level is right for us. On her website Dr. Gominak has a workbook that you can purchase to learn more. Or let me know and I can be your help you raise your vitamin D3 levels.

In the past, most physicians were not in a preventative mindset and they usually wanted to give us medicine instead of preventing the problems in the first place.  In the last two years of my practice, I no longer want to provide band aids for my patients. My mission is to get to the root of the problem and look at a patient’s whole body health. since we have found that much of our body’s inflammation, sleep and heart issues are discovered in the mouth.  Most physicians are still treating the fire instead of becoming proactive when they see the smoke. Usually they do not check the amount of vitamin D  in your blood and if they do decide to check your D levels they order a total D blood test and not the D3 level tested with liquid chromatography/tandem mass spectrometry (LC-MS/MS). This is a much more reliable and predictable test. In medical and dental school we were not taught the serious role Vitamin D plays in or health.  Vitamin D is actually considered a hormone and low levels or excessive high levels of a hormone can cause serious problems.

My personal story has increased my passion about Vitamin D, because every time I had a blood test in the past 25 years, I would ask for them to check my Vitamin D and every time they told me I had low levels. But they never really worried about it, but just told me to take some Vitamin D.  No one ever checked to see if the level was normal again. I would just wait till a future blood test was needed and ask for it to be tested. Again, the doctor would say my vitamin D level was low. A few years ago, a physician gave me a RX for a green capsule of Vitamin D2. I thought, “Finally someone is going to track my vitamin D and I am going to get it where it needs to be.” At the time, I did not know that there was a difference between Vitamin D3 (small gold capsules) and vitamin D2 (green capsules 1:50,000). The standard of care for low vitamin D in medicine still recommends one D2 capsule a week. Research has proven this to be insufficient but not all physicians are aware of this. The one piece that was missing was adding B50 to the mix and testing my Vitamin B12, as well.

My children and I have had a life time of stomach problems starting with my son’s colic as a baby.  Sadly, I passed my low levels of vitamin D to my kids through childbirth, since I was pregnant with low D levels and their levels have also been low for years. Dr. Gominak and many other researchers have proven that only D3 matters and only D3 should be taken as a supplement, not D2.  After Dr. Gominak’s class, I had my vitamin D3 levels tested with the correct lab testing protocol. My total D was 60 ng/ml, so according to the standard of care, my vitamin D levels would have been considered normal. I ignored the word “normal” and followed the protocol in Dr. Gominak’s workbook.  The results of my blood test showed a total D of 60 ng/ml.  Although my total D was 60 ng/ml it was factoring in my D2 level which was 45 ng/ml ( since I was taking a Rx D2 green capsule, once a week) and the test revealed that my D3 was ONLY 15 ng/ml

After the first month of following her workbook protocol, I am happy to report for the first time my D3 went from 15 ng/ml to 37 ng/ml in a month. I have personally noticed many changes. The one that I can  actually prove is that after a week into Dr. Gominak’s protocol I cut my hypothyroid medicine in half because I was feeling dizzy after taking my medication. That lasted through the day and a month later, even with my medicine cut in half my TSH blood test had never been so low. It went from an average of 2.5 to 1.3.  My son’s D3 was 24 ng/ml and in a month, his D3 was 47 ng/ml and his TSH also went from an average of 2.5 to .44.  We are looking at taking him off his thyroid medicine completely. The bottom line is when your D3 is working, your body has what it needs to get healthy and does what it knows how to do. We need to have the right amount of Vitamin D in our bodies to get our thyroid working correctly.

If you have EVEN ONE of the following diagnosis or symptoms; sleep apnea, sleep disordered breathing, fatigue, needing coffee, daily headaches (especially on waking), sleep problems, body aches, diabetes, autism, restless legs, ADHD, teeth grinding, memory issues, brain fog,  colitis, celiac, hypothyroid, insomnia, depression, autoimmune illness or cardiovascular diseases, including high blood pressure you are MOST LIKELY deficient in Vitamin D and possibly B12 as well.

Our bodies were designed to be paralyzed during deep sleep so that we can’t cry out while sleeping or act out our dreams. But we need to be able to still swallow and keep our airway open. This is where the vitamin D plays a large role because without the correct vitamin D level, the neurotransmitters that affect our sleep switches are not working correctly. Because of that some of people are not paralyzed enough and others are too paralyzed. During deep sleep your mouth should be closed, your body should not be moving and your breathing should be silent.  If your vitamin D is low your body are not able rest correctly during deep sleep.

There are certain cells that are assigned to paralyzing the oral airway, including the throat and the tongue. Imagine a set of switches that makes our throat and tongue weak and paralyzed during sleeping, another set of cells responsible or paralyzing the diaphragm and the chest wall, and another set of cells responsible for paralyzing our limbs.

We are not able to get “perfectly paralyzed’ if our switches are misfiring instead of firing at the correct rate for normal sleep.  Several missed nights of normal sleep can cause multiple health issues that can  take a long time to correct, depending on how many bad nights of sleep you have had in your life. The bottom line is that our bodies will not begin to “repair” our sleep if our vitamin D level is not at the correct level.

These switches need to fire at a perfect rate, so that you are perfectly paralyzed. For example, if you have obstructive apnea most likely the tongue or throat get too paralyzed.  It is true that many of us have very small airways that can cause sleep disordered breathing and eventually obstructive sleep apnea. But that is just one piece of the puzzle.  A large airway is also just one piece of the puzzle. It does not mean we will have great sleep and health. We need our vitamin D to be at an ideal level for us to get to the “perfect paralysis” our bodies need. If a child is vitamin D/B deficient, they may get a runny nose, an increased number of allergies and they are not able to breathe through their nose. This will most definitely cause an unfavorable formation of their lower face over time and their teeth will be crooked.

Vitamin D is NOT the cure for all sleep problems but it is a large piece of the puzzle. It is important to understand that once you have an illness the body needs to repair itself for a long time and it is not a quick fix. You need to be patient and keep track of your symptoms along with your D3 levels. Over time your body will repair itself if you are able to get into deep sleep”. My hope is that each one of us will spread the word to help reduce this epidemic of low level Vitamin D3 that we see in most adults and children. During the 21st  century, this problem has greatly affected many of our friends and family. We are feeling old before our time.

Why are we worried about our level of Vitamin D now? 

Dr. Gominak graduated from medical school in the 1980’s before problems such sleep apnea, fibromyalgia, chronic fatigue were recognized as part of an epidemic.  She has never been a vitamin pusher but after noticing changes in her patients and listening to her patients with sleep apnea describe their whole body symptoms, she started to make the connection. She knew we get our Vitamin D from the sun and realized that in the 1800s, an entire population moved indoors for their entire lives to work in factories. They developed heart failure, non-healing ulcers, rickets, diabetes and renal failure. Now these diseases are also epidemics. Until the 20th century, Americans dealt with the hot weather as many still do around the world: they sweated and fanned themselves. But in the United States, things began to change in the early 1900s when the first electric fans appeared in homes. Shortly after, most people preferred the inside due to air-conditioning.  At about same time people began spending more time inside watching television. The addition of video games and computers has not helped the lack of sun exposure. Also, due to the rise in skin cancer few parents send their kids outside without lathering them up in sunblock. We know daily exercise is an important component for good sleep and that certain diets around the globe are extremely narrow. But people can thrive on them when they live outdoors which is why our country has so many people with low vitamin D and so many existing health problems.

When our vitamin D is very low, (<40 ng/ml) over time, our brain actually forgets how to sleep. We repair our bodies during deep sleep. When our D is low, instead of having both “light sleep” and “deep sleep” we spend the night in light sleep. We sleep but we don’t get any work done. We wake up tired and we age faster.

Chronic illness is related to lack of repair in sleep:

  • When we can’t repair our bodies every night we get sick.
  • Our pancreas fails and we could be at risk for diabetes.
  • Our blood pressure system fails and our risk for high blood pressure increases.
  • Our immune system fails leaving us vulnerable to autoimmune diseases, asthma, allergies, MS, and rheumatoid arthritis.
  • Our heart and blood vessels don’t repair and we are at a higher risk for heart disease and stroke.
  • Our brain does not repair, increasing our chances for dementia.
Much of this content and information was taken from my class notes with Dr. Stasha Gominak and found on her website, https://drgominak.com/

Below, I have attached a few podcasts with her speaking to an ENT physician Dr. Stephen Park, if you want to listen instead of read, I have found them to be very helpful.




Dr. Gominak advises people to get 4 vitamin D3 25OH levels checked in the first year.

You will need to keep a weekly or daily record about how you feel.  Over time, you will be able to tell that your sleep is improving.

Eventually you will know when your vitamin D3 blood level is in range (60-80 ng/ml) and when it is not. Your sleep will not change much until the vitamin D level is 60-80 ng/ml. Please note that D3 levels above 80 ng/ml can cause terrible sleep, too.

When your chemistry gets better your body will want to sleep more. Do not get discouraged if you are sleepy during the day. Listen to what your body is asking for and go take a nap.

You are making up the sleep you have lost.  If your body will only sleep from 3:00 am to 12:00 noon then that is when you will need to sleep. Over time, your sleep will get better and your internal clock will make you drowsy earlier. Just be patient. Sleeping at the ‘’wrong’’ time is better than no sleep at all.  Eventually, you will start to feel drowsy at 10:00pm. Once that happens do not fight it. If sleeping pills are helping you, continue using them. During a normal body sleep cycle you should get tired around 10 pm and wake around 6:00-7:00 am.

With vitamins D and B – remember MORE IS NOT BETTER.  JUST RIGHT IS BETTER and TOO MUCH Vitamin B and D, CAN HURT YOUR SLEEP.

citaminsGrade your sleep every morning and your pain level on awakening. Take a one-minute inventory every morning when you first wake up. Assess the things you are following: fatigue, tremors, headaches, burning in the feet, pain in the joints, back pain etc.  If the pain is gone in the early morning but comes back later in the day, pay attention to what time it comes back and watch if that time becomes later and later in the day as you sleep better.)  If you have pain, grade it on a scale of 0-10.

Dr. Gominak strongly believes that sleep is not something we have any control over. You cannot “do it wrong”, so it cannot be “your fault”. If you have normal brain function you will fall asleep despite the television, telephone or your partner’s snoring. People with insomnia get bored lying in the bed and get up. Watching television will not prevent you from getting better. When your brain is better you will fall asleep despite the television. A sleep study is not the only way to get information about your sleep. Your observations about your bedclothes and what happened during the night are very valuable. For example, is your hair a mess? Does your bed look like you slept in in with covers all over the place or does it look barely touched? Did you get hot and push off the covers? Did you wake and have trouble falling back to sleep? did you get up to use the bathroom? Did you have good dreams?  Each person is unique. Any treatment that allows you to fall asleep, stay asleep and feel better when you wake up is valid for you at that time.  Notice how messy the bedclothes are. “I was always a restless sleeper” is still not normal. Many people with sleep disorders have not slept normally since childhood. Actigraphic sleep measurement (actigraph measures movement) with a FitBit®  or phone application is a good measure of the amount of deep sleep. We are normally completely paralyzed in deep sleep and if you are moving a lot between 3 am and 6 am you’re not getting normal REM sleep. Other things besides vitamin D,  such as food, exercise, alcohol and life stress all have an effect on your sleep. Try to record things that you think have significantly affected your sleep for that week.

If you have a sleep problem you most likely have both vitamin D deficiency and the wrong belly bacteria!

The B vitamins are crucial for normal sleep. When we lost our connection to the sun, we lost vitamin D and the B vitamins and we stopped sleeping normally. B12 deficiency and D deficiency are linked. B12 deficiency makes us tired because B12 is needed for normal sleep. If you are B12-deficient (B12 < 500 pgm/L) it usually means that you have had D deficiency for a long time.

Believe it or not the belly bacteria run our sleep!

Our belly bacteria have a direct effect on our sleep:

We have a symbiotic relationship’ with our belly bacteria. In other words, we share and rely on each other. We give that bacteria our vitamin D and, in return they give us eight chemicals called the B vitamins.


Research on Vitamin D

Remember Vitamin D is not the cure the sleep is the cure ….. we just want to make sure you are getting the most refreshed restorative sleep possible so you can repair and wake up pain free and rested.

As far as research on Vitamin D levels being ideal between 60-80, not much to be found since no money to be made in vitamin D. Sadly, the research is being funded by major pharmaceutical companies because they want to back research that funds their bottom line. They only want to research where money can be made on drugs whereas vitamin D is cheap and we are not seeing any large studies. Research is expensive. Hopefully, due to COVID -19 we will finally start to see more D research since we know it was very connected.

I started this program with a thought of what do I have to lose. Nothing else has worked. I was shocked the difference it made for me personally, my kids my husband, my staff and their families my patients of all ages. I have been low in D my entire life same with my family and staff and we finally have been able to keep it in normal range and feel great. My patients have shared how come you know more about this than my primary care doctor? Most doctors don’t even ask for a D test and know about the more accurate D test that Dr. Gominak taught me about… she only learned all of this from trial and error with herself and her patients she is not selling Vitamins she has nothing to gain but happiness that she is helping so many get the right sleep!

Perhaps Instead of research one should listen to lots of the videos Dr Gominak has done with lots of respected doctors like Dr Stephen Park and Dr Mercola. My favorite photo about research I attached. At this point you either trust anecdotal eveidence she has with 7,000 patients treated this way by her or you don’t. In medical school we are taught zero about D in 5 minutes. No instruction or no help. She has done all the research and is the D guru. It is impossible for you medical doctors to know as much about D as she does they don’t have time to learn and take classes nor desire. Dr. Joel Gould is also an excellent source on Vitamin D and how it changed his life.

Vitamin D soars to new heights in United States

New JAMA article below Still digesting it…..definitely appears a connection with deficiency (<20ng/ml). Still, not many people evaluating INSUFFICIENCY (<60ng/ml).

Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results

Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention ideally want it between 60-80

Self-reported sleep bruxism is associated with vitamin D deficiency and low dietary calcium intake: a case-control study

Massive Review of papers on Vitamin D and COVID-19 – July 3, 2020

A search on pubmed for 60 ideal this is what I found


Dr. Gominak’s website

Click on the links to download pdf.

  1. ”The world epidemic of sleep disorders is linked to vitamin D deficiency.” Authors: S.Gominak, W.Stumpf. Med Hypotheses. 2012 Aug;79(2):132-5.
  2. “Vitamin D deficiency changes the intestinal microbiome reducing B vitamin production in the gut.” Med Hypotheses. 2016 Sep;94:103-7
  3. “The Commensal Relationship of the Normal Human Colonic Microbiome: We supply them with vitamin D they supply us with B vitamins.”
  4. “Vitamin D Supplementation results in Secondary Pantothenic acid Deficiency producing Sleep Disruption, Pain and Neuropathy.”
  5. Oral Health: The Next Step in Sleep Dentistry: Is There Anything We Can Do For The Ones Who Don’t Have Apnea?
  6. Sleep D microbiome and Brain Health

Massive Review of papers on Vitamin D and COVID-19 – July 3, 2020

Grass roots website research section

Vitamin D deficiency and depression in adults: systematic review and meta-analysis

Our dentist at Arlington Smile Center offers testing for vitamin D levels and deficiency to determine if you need supplemental vitamin D to improve your health prior to treatment. For more information about vitamin D testing in Arlington, Virginia, and to make an appointment with Dr. Lupita M. Roca, contact us today at 703-237-7622.