Getting Vitamin D From Food
Most foods dont contain much vitamin D so its hard to get enough vitamin D from food alone.
Foods which contain vitamin D include:
- oily fish such as salmon, sardines, mackerel, trout
- red meat
- liver and fish liver oil
- foods with vitamin D added such as most fat spreads, some breakfast cereals and some plant-based alternatives to milk. Check the labels.
- infant formula which has vitamin D added to make sure babies get enough.
As most of these foods are animal products, its harder to get vitamin D from food if you are vegan or vegetarian. Plant-based sources of vitamin D include sun-exposed mushrooms and fortified foods such as vegetable spreads, breakfast cereals and plant based dairy alternatives.
In the UK, cows’ milk is generally not a good source of vitamin D because it isn’t fortified, as it is in some other countries. There are some yoghurts which have been fortified, but check the label as they can also be high in saturated fat and so should be avoided.
Is It Possible To Prevent Vitamin D Deficiency
A few foods naturally contain vitamin D, and other foods are fortified with it. With only 20% of our vitamin D intake expected from food, exposure to the sun and taking supplements remain the primary sources. Follow your health care provider’s recommendations for supplementing on a regular basis, get some sun exposure, consume foods that contain vitamin D, have regular blood work to monitor your level, and make adjustments to your intake based on your medical needs and seasonal changes.
- 1 tsp cod liver oil has 400 to 1,000 IU/vitamin D
- 3.5 oz salmon, fresh has 600 to 1,000 IU/vitamin D
- 3.5 oz salmon, fresh has 100 to 250 IU/vitamin D
- 3.5 oz salmon, canned has 300 to 600 IU/vitamin D
- 3.5 oz sardines, canned has about 300 IU/vitamin D
- 3.5 oz mackerel, canned has about 250 IU/vitamin D
- 3.5 oz tuna, canned has 236 IU/vitamin D
- 3.5 oz shiitake mushrooms has about 100 IU/vitamin D
- 3.5 oz shiitake mushrooms has about 1,600 IU/vitamin D
- 1 egg yolk has about 20 IU/vitamin D
- 8 oz fortified milk or yogurt has 100 IU/vitamin D
- 8 oz fortified orange juice has about 100 IU/vitamin D
- 3 oz fortified cheese has about 100 IU/vitamin D
What About Sun Exposure
The DRIs for vitamin D are set based on the assumption of minimal sun exposure. This was necessary because of public health concerns about skin cancer due to ultraviolet radiation from the sun. Currently, there is a lack of information about whether sun exposure may be experienced without increasing risk of cancer.
Many people meet at least some of their vitamin D needs through exposure to sunlight. However, season, time of day, cloud cover, smog, skin pigmentation, and sunscreen use are all factors that can affect the amount of ultraviolet radiation received and thus vitamin D synthesis.
The DRI values have been set at levels that ensure that sun exposure is not necessary in order to obtain enough vitamin D.
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Some Perspective On What Is And Isnt Vitamin D Deficiency
I spoke with osteoporosis expert Dr. Joel Finkelstein, associate director of the Bone Density Center at Massachusetts General Hospital, whose research in this field spans over three decades. He agreed with the authors of the NEJM article that we are currently over-screening for vitamin D deficiency, and overtreating people who are getting enough vitamin D through diet and sun exposure. “Vitamin D has been hyped massively,” he states. “We do not need to be checking the vitamin D levels of most healthy individuals.”
He points out that from an evolutionary standpoint, it doesnt make sense that higher vitamin D levels would be beneficial to humans. “Vitamin D is actually quite hard to find in naturally occurring food sources,” he points out. “Yes, we can get vitamin D from the sun, but our bodies evolved to create darker skin in the parts of the world that get the most sun. If vitamin D is so critical to humans, why would we evolve in this way, to require something that is hard to come by, and then evolve in such a way as to make it harder to absorb?”
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What Is The Difference Between Vitamin D
There are two forms of vitamin D. Vitamin D-2 or ergocalciferol and vitamin D-3, cholecalciferol. Both forms are biologically inert and must undergo two hydroxylations in the body for activation. The first occurs in the liver which converts vitamin D to 25-hydroxyvitamin D , also known as calcidiol. The second occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D , also known as calcitriol.
There are a limited number of foods that are sources of these compounds. Vitamin D-2 is found mostly in mushrooms and fortified foods such as cereal. Vitamin D-3 is found primarily in animal-based foods such as fish, liver, eggs and Americas old favorite, cod-liver oil.
While both versions are effective in increasing vitamin D concentration in the body, vitamin D-3 is thought by many to be more effective in raising vitamin D levels. It is widely available as an inexpensive over-the-counter supplement in a variety of dosage forms and dosages.
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Vitamin D Deficiency Overdose And How Much To Take Safely
Vitamin D offers numerous benefits to the body. You will be making yourself vulnerable to health problems if you do not make effort to ensure optimal levels. Vitamin D deficiency is a more common issue than many people realize. It doesnt usually cross the mind of many people when they notice unpleasant signs of their health. They fail to think that the low level of this vitamin may be the reason. You need to read on to learn about how to tell the presence of this condition. You will also learn what you can do treat or reverse it.
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Understanding Vitamin D Deficiency
Vitamin D is more or less an umbrella term for a number of fat-soluble hormones. This helps with absorption of calcium, phosphate and magnesium in the body in the intestine. There is going to be a problem absorbing these minerals if its levels are low. The result of this will be a drop in the levels of calcium, magnesium and phosphate. The vitamin is crucial to bone formation and cell growth. It helps to control inflammation. Vitamin D is also said to have effects on the immune, muscle and nervous systems.
This vitamin is often called the sunshine vitamin. This is because your body produces it naturally when exposed to sunlight. Apparently, vitamin D deficiency means having too low levels of the substance. But what is the definition of a deficiency really? Or more appropriately, how low is too low to be described as deficiency?
The amount of vitamin D in the body is commonly measured as nanograms per milliliter , or nanomoles per liter . Using this metric, the usual, healthy levels of these organic compounds fall within the range 20 ng/mL to 50 ng/mL. You are at risk of a deficiency when levels drop below this. Potential deficiency is having between 12 ng/mL and 20 ng/mL. Any amount below 12 ng/mL means you are vitamin D deficient.
The kinds of lifestyle many people maintain today make them highly likely to have low levels. One billion people have this problem, as estimated by Harvard University. Yet, many of those affected do not even know they have the problem.
How Much Vitamin D3 Should A Person Take
Only a few foods contain vitamin D3, making it impossible to meet your bodys needs through diet alone. Supplementation and sun exposure serve as the primary ways to get enough of this vital nutrient. Supplementation is suitable for those at risk for deficiency, in which case its necessary to see your health care provider to determine whether supplementation is appropriate for you and how much you need to take. In the meantime, gathering more information about vitamin D and its role in keeping you healthy will help you prepare to discuss supplementation.
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Do I Need To Take Vitamin D And Vitamin K Together
Some supplements contain both vitamins D and K together. This is because both are needed for calcium metabolism: vitamin D promotes calcium absorption and vitamin K promotes the calcification of bones and reduces the calcification of soft tissues such as blood vessels .
However the current evidence doesn’t suggest you need to take supplements that combine vitamin D and vitamin K for optimal absorption, especially as it’s easy to get enough vitamin K from your diet.
Vitamin K is found in leafy, green vegetables such as spinach, kale and broccoli. It’s also in vegetable oils, dairy products, meat and eggs.
What Tests Can Reveal
The most common way to measure vitamin D levels is with a blood test for 25D , but its not perfect. There are many different versions of the test, and the results can vary, says Mark Moyad, M.D., director of complementary and alternative medicine at the University of Michigan Medical Center, who specializes in studying vitamins, minerals, and supplements. You can get different results from different labs and even after multiple tests at the same lab.
Many of us in geriatrics, for better or worse, do screen and do treat vitamin D deficiencies, says Veronica Rivera, M.D., an assistant professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai. She admits that the evidence about testing and treatment is unclear. If Im doing yearly labs on someone, I may add it in. If theyre having falls, I may check it. If someone has osteoporosis or osteopenia, I would definitely screen, she says. The evidence is still conflicting, but I think the safe approach is to keep everyone at sufficient levels and to make it easy.
Another confounding factor is that normal D levels may differ depending on skin color. We make vitamin D when our skin is exposed to sunlight. Darker skin makes it harder to synthesize the vitamin, leading to lower levels, but researchers are still trying to understand the health implications of that and the need for supplements.
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How Much Vitamin D Is Too Much
Since relatively little is known about how vitamin D toxicity works, its hard to define an exact threshold for safe or toxic vitamin D intake .
According to the National Academy of Medicine, formerly known as the Institute of Medicine, 4,000 IU is the safe upper level of daily vitamin D intake. However, doses up to 10,000 IU have not been shown to cause toxicity in healthy individuals (
Hypercalcemia caused by regularly taking high amounts of vitamin D supplements may take a few months to resolve. This is because vitamin D accumulates in body fat and is released into the blood slowly .
Treating vitamin D intoxication includes avoiding sun exposure and eliminating all dietary and supplemental vitamin D.
A doctor may also correct your calcium levels with increased salt and fluids, often by intravenous saline.
The main consequence of vitamin D toxicity is hypercalcemia, with symptoms including nausea, vomiting, weakness, and kidney failure. Treatment involves limiting all vitamin D intake and sun exposure.
What Is Vitamin D
Vitamin D is a fat-soluble vitamin that acts as a steroid hormone in the body.
There are two types of vitamin D in the diet:
Vitamin D2 : is found in some mushrooms.
Vitamin D3 : is found in oily fish, fish liver oil, and egg yolks.
D3 is more potent in these two types and raises blood levels of vitamin D by almost twice as much as D2.
A large amount of vitamin D can also be produced on your skin when exposed to UV rays from the sun. Any excess vitamin D is stored in your body fat for later use.
Every cell in your body can absorb vitamin D. This vitamin is involved in many processes, including bone health, immune function, and cancer prevention.
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How Much Vitamin D Do You Really Need
How much vitamin D do you need to ensure strong, healthy bones? Unfortunately, there isnt an easy answer.
Its incredibly controversial, says Neil Binkley, MD, a UW Health geriatrician and internationally recognized researcher who leads the UW Osteoporosis Clinical Research Program. The experts in the field are quite polarized. I try to be somewhere in the middle because I really believe that we simply dont know.
Why all the controversy about the sunshine vitamin? Doctors determine whether an individuals vitamin D level is normal, insufficient or deficient by measuring serum 25-hydroxyvitamin D in the blood. But the measurement has historically been problematic and difficult to standardize, and experts dont agree on the optimal level.
Another problem: Randomized trials of vitamin D supplementation havent required that participants start with low levels, so its difficult to draw clear conclusions from such research. Additionally, there is substantial variation in 25-hydroxyvitamin D increase after individuals begin vitamin D supplementation.
Heres what we do know about this controversial vitamin:
How Much Vitamin D Should I Take For Specific Conditions
How much vitamin D should I take if Im deficient?
If a blood test has revealed that youre low in vitamin D, you can either take smaller doses for a long period of time to bring your level up, such as 5,000 to 10,000 IU per day, or a high dose administered over the course of several weeks. For adults with low vitamin D levels, the Endocrine Society recommends taking at least 1,5002,000 IU per day.
If youre taking a very high dose all at once, such as more than 40,000 IU, then its possible that side effects may occur due to vitamin D toxicity. The best thing to do is talk with your doctor about supplementing with higher doses of vitamin D if you are severely deficient or have a very low level according to a blood test.
How much vitamin D should I take for depression?
Theres some evidence that low vitamin D levels are linked with depression, although this doesnt mean that vitamin D deficiency causes depression. Rather, its speculated that people who dont spend much time outside or eat vitamin D foods may also be more likely to develop depression. The dosages of vitamin D used in studies that have focused on depression have varied, typically between 600 IU/day to 4,000 IU/day.
How much vitamin D should I take to lose weight?
What Process Did The Iom Use To Conduct Its Review
The Food and Nutrition Board of the Institute of Medicine put together a committee of scientific experts for this review of vitamin D and calcium in January 2009. As in previous DRI reviews conducted by the Food and Nutrition Board of the IOM, the expert panel reviewing the latest science related to vitamin D and calcium was made up of experts from both Canada and the U.S.
The IOM’s process for the review of data on vitamin D and calcium was rigorous. The 14-member expert committee gathered background information on the metabolism of vitamin D and calcium throughout the life cycle. Then, using a risk assessment approach, they identified potential health-outcome indicators for establishing DRIs. Important documents for this phase were the two evidence-based systematic reviews conducted by the U.S. Agency for Healthcare Research and Quality on the effectiveness and safety of vitamin D in relation to bone health and the relationships of vitamin D and calcium intakes to nutrient status indicators and health outcomes, conducted at the request of the U.S. and Canadian governments. The committee also performed their own systematic review of scientific literature and identified other relevant studies.
Canadian data from the Canadian Community Health Survey Cycle 2.2, Nutrition, and the Canadian Health Measures Survey were used in the IOM review.
Calcium And Vitamin D: A Partnership
Calcium and vitamin D is the dynamic duo that works together to strengthen and protect your bones. For years, healthcare providers have recommended that postmenopausal women take calcium and vitamin D supplements to prevent osteoporosis, a bone-thinning disease that is a major cause of devastating fractures in old age.
Research linking calcium supplements to heart attack and stroke caused many to take vitamin D supplements alone for prevention.
Calcium supplements can increase calcification in the arteries and predispose people, especially women, to heart disease, he says. Thats why we always prefer dietary calcium. However, some people get adequate dietary calcium but are low in vitamin D.
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