Some People Are Overdoing It In Search Of Better Health
Vitamin D is having its day in the sun. In recent years, research has associated low blood levels of the vitamin with higher risks of everything from heart disease, diabetes, and cancer to mood disorders and . The findings have not gone unnoticed. and screening tests have surged in popularity.
“Vitamin D testing is one of the top Medicare lab tests performed in the United States in recent years,” says Dr. JoAnn E. Manson, the Michael and Lee Bell Professor of Women’s Health at Harvard Medical School. “This is really surprising for a test that is recommended for only a small subset of the population.”
Unfortunately, this vitamin D trend isn’t all blue skies. Some people are overdoing it with supplements. Researchers looking at national survey data gathered between 1999 and 2014 found a 2.8% uptick in the number of people taking potentially unsafe amounts of vitamin D that is, more than 4,000 international units per day, according to a research letter published in the June 20 issue of The Journal of the American Medical Association . And during the same time period there was nearly an 18% increase in the number of people taking 1,000 IU or more of vitamin D daily, which is also beyond the dose of 600 to 800 IU recommended for most people.
Why Wearing Sunscreen Can Affect Vitamin D Absorption
While wearing sunscreen daily is key to help prevent sunburns, premature aging, and skin cancer, this healthy habit can also affect how much vitamin D your skin synthesizes from the sun.
To get your fix, aim to spend 10 to 15 minutes outdoors without sunscreen, Foroutan says. It can help get your levels where they need to be, she says, echoing information from Harvard Health Publishing.
Your Value Is Between 50
Congratulations, your values are in the optimum range to take advantage of the numerous health benefits of vitamin D. There is currently no sufficient scientific evidence to suggest that values above 60 ng/ml offer increased health benefits. Consequently, there is no need to attempt to reach higher levels.
Take the recommended dose of vitamin D daily to maintain your vitamin D levels, as described in point 1 above. Or continue to spend the same amount of time in the sun to maintain your value.
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So You Really Can’t Get Enough Vitamin D From Diet And Sun
We know, we know, this can be pretty hard to wrap your brain aroundbut you really can’t depend on food and time spent outside to keep your vitamin D status in a healthy place .
While there are a few dietary sources of vitamin D , we still can’t typically get enough of it from our diets. “Unless you are eating sardines, salmon, or mackerel daily, there is a good chance your food is vitamin D insufficient,” explains Henderson.
And when it comes to the sun? There are some concerns here, too. Crouch points out that UV exposure and subsequent vitamin D production changes with the seasons, the latitude you’re located at, your skin color, the amount of skin you have exposed, and the amount of time you spend in the sun. Your ability to produce vitamin D from sun exposure is also largely dependent on your age and decreases dramatically after the age of 50, adds Henderson.
Of course, there’s also the issue of sun overexposure. If you spend too much time outside unprotected or end up with a sunburn, it can ultimately do more harm than good. So, what’s the solution? A high-quality vitamin D supplement.*
Understanding Vitamin D Toxicity
Also called hypervitaminosis D, vitamin D toxicity is uncommon and occurs when your bodyâs vitamin D levels are too high. Vitamin D toxicity typically develops from over-supplementation, as opposed to diet or sun exposure. With the sun, your body can regulate the amount of natural vitamin D thatâs produced. And when it comes to food, naturally-occurring vitamin D isnât commonâand fortified foods donât usually contain enough vitamin D to lead to toxicity.
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Other Ways To Get Enough Vitamin D
There are other ways to get vitamin D beyond just taking a supplement. Sunshine is an excellent source of vitamin D, and so are many foods.
Spending 10 to 20 minutes in the sun provides 1,000-10,000 IUs of vitamin D. The amount of time you should spend in the sun and the number of IUs youll get will vary on the season, where you live in the world, and how dark your skin is. No matter where you are, the short time in the sun that you spend daily should be unexposed so that your body can adequately absorb the light.
Try incorporating vitamin D-rich foods into your diet, too. Here are some options:
- Fatty fish are high in vitamin D.
- Some mushrooms, like portobello and maitake, have proper levels of vitamin D, especially if theyre grown using UV light.
- The United States fortifies milk with vitamin D. Still, raw milk is known to have naturally occurring vitamin D as well. It may even have a higher concentration of nutrients.
Q: Why Is Vitamin D Important
A: Research I have done in this area has found that people with low blood levels of vitamin D have a greater risk of a heart attack, heart failure, stroke, diabetes or high blood pressure later in life. In pregnant women, low vitamin D levels are linked to pre-eclampsia, gestational diabetes and adverse pregnancy outcomes. No matter your age or stage of life, having adequate vitamin D levels is important.
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Will Vitamin D Really Prevent Falls Or Fractures
Good question. Some studies have suggested that vitamin D reduces the chance of these serious health events, but these results have been questioned by later studies.
The US Preventive Services Task Force used to recommend Vitamin D to help reduce fall risk. But in 2018, they changed their recommendation.
My current take is that vitamin D might help with falls and fracture risk, especially for certain older adults. Since it has a low chance of harm and possible helps some people a least a little, I recommend it.
However, I usually tell people to not have overly optimistic expectations of vitamin Ds effects. In most older adults, problems such as pain, fatigue, and/or falls are due to multiple underlying causes, so theres often no easy fix available.
Who May Not Get Enough Calcium And Vitamin D
Many foods are fortified with calcium and vitamin D, and your body uses sunshine to make its own vitamin D. From age 9 through 18, girls need more calcium from foods to meet the daily recommended intake. If they cannot get enough calcium from foods, a calcium supplement may be needed.
Many Canadians don’t get enough vitamin D from food and sunshine only. If you are diagnosed with osteoporosis, it’s more important to get enough calcium and vitamin D. Talk to your doctor about how you can get the right amount through supplements and what you eat.
Things that reduce how much vitamin D your body makes include:
- Limited sun exposure. This can be due to sunscreen use or living at a high latitude .
- Dark skin, such as many people of African descent have.
- Age, especially if you are older than 65.
- Digestive problems, such as Crohn’s or celiac disease.
- Liver and kidney disease.
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Vitamin D Dose Depending On Your 25d Value:
Here you’ll find dosage recommendations for the intake of vitamin D in form of a dietary supplement, depending on the respective 25D value. The recommendations are based on the findings of Dr. John J. Cannell, a vitamin D expert and founder of the Vitamin D Council organization.
The given vitamin D dose may be slightly rounded up or down in order to take the recommended amount using the available vitamin D preparations.
Can You Take Too Much Vitamin D
Too much vitamin D can be harmful. It is not possible for the body to make too much vitamin D from sun exposure.
Having too much in the body usually results from taking supplements. However, it is very rare and usually only occurs when people take a very high dose for an extended period, such as more than a year.
The maximum quantity of vitamin D that a person can take before it causes health problems is . Symptoms of having too much vitamin D in the blood include:
- vomiting
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How Ethnicity May Affect Your Need For Vitamin D
People who live in colder climates generally need more vitamin D than those who live closer to the equator, but among all geographic locations, people with darker skin tones often need more of the vitamin than those with lighter skin. Indeed, people with highly pigmented skin who live in cold climates are considered to be at a particularly high risk of vitamin D deficiency, according to a study published in June 2017 in the Journal of the American Academy of Dermatology. 31404-4/fulltext” rel=”nofollow”> 13)
Observationally, weve seen that people of African descent and people of Middle Eastern descent also need more vitamin D to achieve optimum levels, Foroutan says.
What Does Sunlight Have To Do With Getting Enough Vitamin D
There are health benefits of sunlight. Vitamin D is produced when your skin is exposed to sunshine, or rather, the ultraviolet B radiation that the sun emits. The amount of vitamin D that your skin makes depends on such factors as:
- The season: This factor depends a bit on where you live. In areas such as Cleveland, OH, the UV-B light does not reach the earth for six months out of the year due to the ozone layer and the zenith of the sun.
- The time of day: The sun’s rays are most powerful between 10 a.m. and 3 p.m.
- The amount of cloud cover and air pollution.
- Where you live: Cities near the equator have higher ultraviolet light levels. It is the UV-B light in sunlight that causes your skin to make vitamin D.
- The melanin content of your skin: Melanin is a brown-black pigment in the eyes, hair and skin. Melanin causes skin to tan. The darker your skin, the more sun exposure is needed in order to get sufficient vitamin D from the sun.
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So What Are The Ideal Levels Of Vitamin D
Here’s where things get a little tricky. While a serum level of 30 ng/ml is often considered the minimum cutoff for “normal” vitamin D status, that number really describes the bare minimum for not being at direct risk of true deficiency, which is defined as 20 ng/ml or less. In other words, 30 ng/ml is a cutoff for vitamin D insufficiency that you don’t want to teeter around.
In fact, many experts and an ever-growing body of research agree that you need to keep your levels significantly higher than this to keep your body healthy and feel your best.
“This is the bare minimum level to avoid issues known to occur with vitamin D deficiency, including suboptimal bone and thyroid health,” explains board-certified endocrinologist Brittany Henderson, M.D., who specializes in hormones in her clinical practice. “Higher levels of serum 25D have consistently been associated with healthy mood, optimal immune function, and more.”*
For that reason, Henderson typically targets blood levels of at least 50 ng/mland she’s far from alone in that.
But, as Crouch points out, “every human has different genes, biochemistry, and skin color. One person’s optimal level is not another person’s, to a degree.” Working with your health care practitioner to understand and monitor your individual vitamin D needs is always a good idea.
How Is Vitamin D Deficiency Treated
The goals of treatment and prevention are the sameto reach, and then maintain, an adequate level of vitamin D in the body. While you might consider eating more foods that contain vitamin D and getting a little bit of sunlight, you will likely be told to take vitamin D supplements.
Vitamin D comes in two forms: D2 and D3. D2, also called ergocalciferol, comes from plants. D3, also called cholecalciferol, comes from animals. You need a prescription to get D2. D3, however, is available over the counter. It is more easily absorbed than D2 and lasts longer in the body dose-for-dose. Work with your doctor to find out if you need to take a vitamin supplement and how much to take if it is needed.
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What Are The Signs And Symptoms Of Vitamin D Deficiency
Severe lack of vitamin D causes rickets, which shows up in children as incorrect growth patterns, weakness in muscles, pain in bones and deformities in joints. This is very rare. However, children who are deficient in vitamin D can also have muscle weakness or sore and painful muscles.
Lack of vitamin D is not quite as obvious in adults. Signs and symptoms might include:
- Fatigue.
Ways To Get Vitamin D
You can get vitamin D from sunlight exposure, dietary sources, and supplements.
Getting ample vitamin D through sun exposure can be straightforward, but you do need to make sure you donât get sunburned .
In food, vitamin D can be found in beef liver, egg yolks, and fatty fish like salmon and tuna. There are also many fortified foods, like milk and dairy products, that provide your body with vitamin D.
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How Can You Get More Calcium And Vitamin D
Calcium is in foods such as milk, cheese, and yogurt. Vegetables like broccoli, kale, and Chinese cabbage have calcium. You can get calcium if you eat the soft edible bones in canned sardines and canned salmon. Foods with added calcium include some juices, soy drinks, and tofu. The food label will show how much calcium was added.
Calcium supplements are available as citrate or carbonate. Calcium carbonate is best absorbed when it is taken with food. Calcium citrate can be absorbed well with or without food. Spreading calcium out over the course of the day can reduce stomach upset and helps your body absorb the calcium better. Try not to take more than 500 milligrams of calcium supplement at a time.
Vitamin D is in foods such as salmon, tuna, and mackerel. These are some of the best foods to eat when you are trying to get more vitamin D. Other foods that have vitamin D, but in small amounts, include cheese, egg yolks, and beef liver. You can also get vitamin D from fortified foods such as milk, orange juices, yogurts, margarines, and soy beverages.
The most common kind of vitamin D found in supplements in Canada is cholecalciferol .
Your Value Is Between 10
Vitamin D deficiency is still present, along with increased risk of developing osteoporosis. Parathyroid hormone levels are likely to be elevated. This hormone regulates calcium and phosphorus levels in the body.
If your vitamin D blood level is e.g. 25 ng/ml or higher and you want to increase them, you can take the following amount of vitamin D :
To reach the mentioned value.. take this vitamin D Dose per day:
20 ng/ml ..500 IU 30 ng/ml ..1700 IU 40 ng/ml ..3200 IU 50 ng/ml ..4900 IU 60 ng/ml ..7000 IU 70 ng/ml ..9700 IU
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British Columbia Specific Information
Calcium is important to building strong, healthy bones and your body needs vitamin D to absorb calcium. The amount of calcium and Vitamin D you need each day depends on your age and if you are male or female. Fortified food is the best source of vitamin D and calcium.
For more information about vitamin D, including a list of what foods contain vitamin D, see HealthLinkBC File #68e Food Sources of Calcium and Vitamin D. You may also call 8-1-1 to speak to a registered dietitian, Monday to Friday 9:00 a.m. to 5:00 p.m., or you can Email a HealthLinkBC Dietitian.
What Are The Optimal Blood Levels Of Vitamin D
To find out if you are deficient in vitamin D your doctor can order a blood test, called a 25-hydroxy vitamin D test.
- Vitamin D levels should be above 20 nanograms per milliliter of blood, which indicates that you arent suffering from severe vitamin D deficiency.
- A level of 50+ ng/mL indicates a good level of vitamin D, while 3050 ng/mL means you want to supplement with vitamin D, work on spending more time in the sun and adding vitamin D foods into your diet.
- Subclinical vitamin D deficiency is thought to be very common. It is defined as a lower than normal vitamin D level that has no visible signs or symptoms. Levels below 30 ng/mL indicate vitamin D insufficiency.
- A level less than 20 to 30 ng/mL means you are very deficient and definitely want to take immediate action to bring those levels up.
- On the other hand, vitamin D toxicity is considered anything above 200240 ng/mL of blood.
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Can You Ever Have Too Much Vitamin D
Yes. You can get too much vitamin D if you overdo the supplements. Interestingly, you cannot get too much vitamin D from the sun. Vitamin D toxicity is, thankfully, quite rare but can lead to hypercalcemia and together the symptoms can include:
- Confusion.
- Ataxia .
Do not take higher-than-recommended doses of vitamin D without first discussing it with your doctor. However, your doctor might recommend higher doses of vitamin D if he or she is checking your blood levels and adjusting your dose accordingly. Also, be cautious about getting large doses of vitamin A along with the D in some fish oils. Vitamin A can also reach toxic levels and can cause serious problems.
