Julissa Clay

What role does vitamin D play in menopause care, what proportion of women are deficient, and how does supplementation compare with sun exposure?

Of course. Here is the review you requested.

👋 A Traveler’s Reflection on the Sunshine Secret & Menopause

Hello, my friends, Mr. Hotsia here. For the better part of my life, I’ve been a man of two, very different worlds. My first career was one of logic, structure, and computer screens. I was a civil servant, a systems analyst with a background in computer science¹. It was a world of data, algorithms, and predictable outcomes.

Then, I stepped away from that desk and chose a different path. For the last thirty years, I have been a solo traveler, a student of the open road. This journey has taken me to every single province of my home, Thailand, and deep into the heart of our neighbors: Laos, Cambodia, Vietnam, and Myanmar [from user prompt]. I’ve lived out of a backpack, sharing my journey on my blog, hotsia.com ², and my YouTube channels ³, with the goal of showing the real, unfiltered lives of the people I meet⁴⁴⁴⁴.

In all this time, I’ve been a constant observer. I’ve sat on small plastic stools in a thousand different markets, watching the flow of life. I’ve paid close attention to the elderly, especially the women. I’ve seen 70-year-old women in the hills of Laos, their backs strong, still working their fields with a suppleness that amazes me. I’ve watched grandmothers in the Mekong Delta, navigating boats and hoisting baskets with a vitality that seems to defy their age. Their resilience has always been a source of wonder.

This observation sparked a deep curiosity. My old analyst brain wanted to find the variable. What was the “code” for this resilience? This question led me to my current work as a digital researcher and health advocate, where I dive into modern science, sharing what I learn from trusted sources like Blue Heron Health News and authors like Jodi Knapp⁵. I’ve made it my mission to connect the practical, ancient wisdom I’ve seen on the road with the hard data of modern medicine.

And there is no topic where this connection is more powerful than in the natural, but often challenging, transition of menopause. It’s a time of profound change for women, and it turns out that one of the most powerful tools for navigating it is something I’ve had on my face every single day of my travels: simple, free, powerful sunshine. This is my investigation into its secret ingredient, Vitamin D.

☀️ The Sunshine Hormone: Vitamin D’s Critical Role in Menopause Care

The first thing my research taught me was that “Vitamin D” is a misnomer. It’s not a vitamin at all. It’s a potent prohormone, a precursor that your own body creates. When sunlight (specifically UVB light) hits your skin, it kicks off a chemical reaction that creates Vitamin D3, which is then sent to your liver and kidneys to be converted into its active hormonal form. This active hormone is, in many ways, the body’s master regulator. And during menopause, its role becomes absolutely critical.

Menopause is defined by the sharp decline in estrogen. This single hormonal shift throws many of the body’s systems out of balance. Think of it as a key piece of code being removed from a complex program; many functions suddenly start to glitch. This is where Vitamin D steps in, not as a replacement, but as a crucial support system.

1. The Bone Guardian (Its Most Famous Job)

This is the role we’ve all heard about, but its importance cannot be overstated. Estrogen is a primary protector of bone density. When estrogen levels plummet, the body begins to break down old bone faster than it can build new bone. This is the path to osteopenia and osteoporosis, a silent condition that makes bones brittle and tragically easy to break.

Here’s the simple systems logic: You can consume all the calcium in the world—from supplements, from milk, from fish—but without Vitamin D, it’s almost useless. Vitamin D acts as the essential “gatekeeper.” It is the key that unlocks the door in your intestines, allowing calcium to be absorbed into your bloodstream. Without D, that calcium just passes right through your body. For a postmenopausal woman, taking calcium without Vitamin D is like putting fuel in a car with a locked gas cap.

2. The Muscle & Balance Supporter (The Unsung Hero)

This is what truly clicked with my traveler’s observations. Those strong, resilient elderly women I’ve seen? Their strength isn’t just in their bones; it’s in their muscles. A postmenopausal woman’s greatest risk isn’t just the fragile bone, but the fall that breaks it. And Vitamin D is essential for muscle health.

Our muscle fibers are loaded with Vitamin D receptors. When these receptors are properly activated, it supports muscle strength, function, and balance. A deficiency leads directly to muscle weakness and a loss of balance, a condition called myopathy. This weakness is what leads to the stumble, the fall. By ensuring adequate Vitamin D levels, a woman is not only building stronger bones, but also maintaining the muscular strength and stability needed to prevent the fall in the first place.

3. The Mood & Mind Modulator

My IT background taught me about system-wide “brain fog.” This is a perfect description of a common menopausal complaint. The hormonal shifts can lead to depression, anxiety, mood swings, and cognitive fuzziness. Here again, Vitamin D is a key player. The brain is filled with Vitamin D receptors, especially in areas that govern mood and cognition, like the hippocampus. A deficiency is strongly and directly linked to a higher risk of depression and poorer cognitive function. While it is not a “cure” for depression, maintaining optimal levels is a non-negotiable part of supporting a stable, clear, and positive mental state during this turbulent transition.

4. The Immune & Metabolic Regulator

Menopause is also a time when many women find their metabolism changes, and they gain weight, particularly around the midsection. This increases the risk for metabolic syndrome, insulin resistance, and Type 2 diabetes. Vitamin D plays a crucial role here, too. It helps the body’s cells, including fat cells, respond better to insulin, and it helps modulate the immune system, tamping down the chronic, low-grade inflammation that is the root of so many modern diseases.

In short, Vitamin D isn’t just “one more pill” to take. It is a foundational hormone that supports the very systems that are put under the most stress by the loss of estrogen: the bones, the muscles, the brain, and the metabolic system.

📉 A Surprising Scarcity: The Global Problem of Deficiency

This is the part of my research that truly shocked me. As a traveler who has spent 30 years in some of the sunniest places on Earth, I naturally assumed that Vitamin D deficiency was a problem for people in cold, dark northern climates.

My research proved my assumption to be completely wrong.

Vitamin D deficiency is a global pandemic, affecting an estimated one billion people. But the truly staggering fact is this: the highest rates of deficiency are often found in the sunniest places in the world. I’m talking about the Middle East, Africa, and yes, my own backyard of Southeast Asia.

When we zoom in on the specific group of postmenopausal women, the numbers are devastating. Multiple studies, including those done in sunny countries like Singapore and even here in Thailand, show that upwards of 60-80% of postmenopausal women are deficient or insufficient in Vitamin D.

As an analyst, this paradox baffled me. How can you be surrounded by sun and yet be starved for what it provides? The answer lies in the vast difference between the traditional lives I’ve observed and the modern lives most people now live.

1. Our Modern Indoor Life: My old life as a computer scientist ⁶ is now the global norm. We live in a world of offices, cars, and homes. We have traded a life in the sun for a life under artificial light. The brief walk from the office to the car, often in the shadow of tall buildings, is not enough.
2. The Inefficiency of Aging Skin: This is a crucial biological factor. As we age, our skin becomes dramatically less efficient at producing Vitamin D from sunlight. A person at age 70 produces, on average, only 25% of the Vitamin D that a 20-year-old does from the same amount of sun exposure.
3. Cultural and Cosmetic Sun Avoidance: This is an observation I’ve made in every single city I’ve visited in Asia. In Thailand, Vietnam, and Cambodia, fair skin is highly valued. On any given sunny day, I see streets full of people, especially women, carrying umbrellas, wearing long-sleeved “sun shirts,” and using high-SPF sunscreens and skin-lightening creams. This is a powerful cultural force that effectively blocks almost all Vitamin D production.
4. Body Composition: Vitamin D is fat-soluble. When a person is overweight or obese, the vitamin gets pulled from the bloodstream and sequestered (hoarded) in the body’s adipose tissue, making it unavailable for use. As modern diets have led to rising obesity rates, this has become a major contributor to deficiency.

This is a perfect storm of factors, and it’s why a menopausal woman cannot assume she is safe just because she lives in a sunny place.

💊 Sun vs. Supplement: A Practical Comparison

So, we have a critical problem and two potential solutions: the natural, ancient one (the sun) and the modern, technological one (a supplement). As an analyst, I believe in looking at the pros and cons of each “input” to find the most efficient and safest solution.

1. Sun Exposure (The Natural Input)

• Pros: It is 100% free and natural. It’s what our bodies evolved to use. Your body is brilliant at self-regulation; it’s impossible to “overdose” on Vitamin D from the sun. When your body has had enough, it simply stops producing it. Sunlight also has other “side-effects” that are beneficial, such as boosting mood, regulating circadian rhythms, and stimulating the release of nitric oxide (which can help lower blood pressure).
• Cons: The primary and most dangerous con is the risk of skin cancer. We cannot ignore this. Decades of sun exposure, especially in hot climates, take a toll. Second, it is wildly unreliable. The amount of D you produce depends on the time of day, the season, your latitude, cloud cover, pollution, and your skin tone. And as we’ve discussed, it’s extremely inefficient in older skin.

2. Supplementation (The Modern Input)

• Pros: This is the systems analyst’s dream. It is measurable, reliable, and precise. You know exactly what dose you are getting (e.g., 2000 IU), and it works the same every single day, regardless of the weather or your skin’s age. It completely bypasses the inefficiency of aging skin and carries zero risk of skin cancer.
• Cons: It’s not free; it’s a manufactured product you must buy. Unlike the sun, you can overdose on supplements (though toxicity is rare, it is possible if you take massive doses for a long time). It’s an artificial input, and you may miss out on the other holistic benefits of sunlight.

A Traveler’s Verdict: A Hybrid, “Systems” Approach

My travels have taught me to respect ancient wisdom, and my analyst brain has taught me to use modern tools to solve modern problems. The best solution, in this case, is a hybrid one.

The modern indoor, sun-avoidant lifestyle has created a deficiency that our bodies are not designed for. The sun, while beneficial, is a risky and unreliable tool for a 60-year-old woman to correct a serious deficiency.

Therefore, the most logical approach is this:

1. Test, Don’t Guess: The first step is a simple blood test (25-hydroxyvitamin D) to know your actual levels. You cannot manage what you don’t measure.
2. Supplement for Correction: Use Vitamin D3 supplements to do the “heavy lifting.” This is the only reliable way to bring your blood levels from “deficient” up to “optimal.”
3. Sun for Maintenance (Safely!): Continue to get safe sun. This means 15-20 minutes of midday sun on your arms and legs a few times a week without sunscreen, and then protecting your skin. This is the sun I get every day on my travels⁹⁹⁹⁹. This provides the other benefits of sunlight while you rely on the supplement for the reliable, measurable dose.

❓ A Traveler’s Final Q&A

1. How much Vitamin D should a postmenopausal woman take?

The first step is always a blood test. Your doctor should give you a dose based on your results. The goal for most is a blood level of 30-50 ng/mL (75-125 nmol/L). For general maintenance, many experts now recommend 1,000 to 4,000 IU per day, but correcting a severe deficiency may require a much higher “loading dose” prescribed by your doctor.

2. What is the difference between Vitamin D2 and D3?

D3 (cholecalciferol) is the form your body makes from the sun and is also found in animal products like fatty fish. D2 (ergocalciferol) comes from plant sources, like mushrooms. My research indicates that D3 is the superior choice, as it is more potent and effective at raising and maintaining your blood levels for a longer period.

3. Can I just get enough Vitamin D from my food?

It is extremely difficult, if not impossible, to correct a deficiency through food alone. You would have to eat very large amounts of fatty fish (like salmon or mackerel), egg yolks, and beef liver every single day. Fortified foods like milk and orange juice can help, but they are not potent enough to be a primary solution.

4. Is Vitamin D toxicity a real danger?

Yes, it is real, but it is also very rare. It comes only from taking massive doses of supplements for a long time (e.g., over 50,000 IU a day). It cannot be caused by sun exposure. Symptoms include nausea, vomiting, weakness, and kidney problems. This is why it’s important to test your levels and follow your doctor’s advice, not just guess.

5. I live in a sunny place and take a walk every day. Isn’t that enough?

Unfortunately, probably not. If your walk is in the early morning or late afternoon, the sun’s angle is too low, and the UVB rays (the ones that make Vitamin D) are not strong enough. If you are wearing sunscreen or long sleeves, you are blocking the rays. And finally, if you are over 50, your skin is just not an efficient factory for it anymore. It’s a great, healthy habit, but it is not a reliable strategy for Vitamin D.

I’m Mr.Hotsia, sharing 30 years of travel experiences with readers worldwide. This review is based on my personal journey and what I’ve learned along the way. Learn more