What Causes Low Vitamin D
Anything that interferes with the bodys ability to make vitamin D through the skin, including liver or kidney disease, can cause deficiency. Malabsorption syndromes or a diet low in foods containing vitamin D can also lower vitamin D levels.
The following factors may interfere with our body’s ability to make vitamin D:
- Chronic illness or disability that prevents regular sun exposure
- Living at latitudes above 37 degrees north or below 37 degrees south of the equator over winter, although this is controversial, and studies have shown only Caucasians show a correlation with low vitamin D levels and latitude.
- Skin color: Individuals with a darker skin produce less vitamin D with the same amount of sunlight exposure than individuals with lighter skin color.
- Age: Older people are less efficient at making D3 and less likely to go outside in the sun.
- Religion or culture: People whose beliefs require them to cover most of their skin and/or face usually do not receive adequate sunlight for their skin to make vitamin d.
- Avoidance of the sun and use of sunscreen: Fears of skin cancer and skin aging mean people spend less time in the sun than in the past, although only 10 minutes of direct summer sun is necessary to make an adequate daily dose of vitamin D.
In addition, a poor intake of vitamin D through the diet may also contribute however, studies have shown less than 10% of the vitamin D in our body is obtained through diet, so it is not considered a major contributing factor.
How Much Vitamin D Does My Child Need
Vitamin D is measured in international units .
- Babies younger than 1 year old need 400 IU of vitamin D a day. Baby formula has 400 IU per liter, so babies who drink at least 32 ounces of formula each day get enough. If your baby drinks only breast milk or gets less than 32 ounces of formula each day, ask your health care provider about giving your baby a vitamin D supplement.
- Kids older than 1 year need 600 IU or more of vitamin D a day. Health care providers often want healthy kids to take 600 to 1,000 IU daily.
Some kids might need more vitamin D, such as those who:
- have certain medical problems
Prevalence Of Vitamin D Deficiency In Amyotrophic Lateral Sclerosis And Control Individuals
Four observational studies reported levels of vitamin D in ALS patients and in control subjects . Overall, only Cortese et al. reported a significant difference in vitamin D levels between ALS patients and controls. The data available from these four studies were pooled to estimate the mean vitamin D difference between ALS and controls .
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Can Vegans Take A Vitamin D Supplement
Vegans can be more susceptible to a vitamin D deficiency. The double whammy of not getting enough sunlight during the winter months and not being able to eat most of the food sources of vitamin D can make it a little more difficult.
However, even with meat, dairy and eggs off the menu, there are still natural vegan sources of vitamin D like mushrooms for vitamin D2 and lichen for vitamin D3.
As these are limited, a vitamin D supplement is recommended. Especially for vitamin D3 as we dont think many vegans will be chowing down on some lichen!
Coverage And Cost Comparison Of Vitamin D Vs D3
Vitamin D2 in prescription form is commonly covered by most commercial and Medicare insurance plans. The over-the-counter formulations are typically not covered by commercial or Medicare insurance plans. The price can vary greatly depending on dosage. The average cost of the 50,000 IU dose for 12 weeks of therapy is $47.99. With a coupon from SingleCare, this price drops to as low as $11.
Vitamin D3 is over-the-counter, and therefore is typically not covered by insurance plans. The price varies depending on dose. D3 can cost as $40 but if your doctor prescribes the medication you can get it for as low as $20 with a SingleCare discount coupon.
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Fact: Age Affects Your Skins Ability To Make Vitamin D
Speaking of some women needing different amounts of vitamin D, older women will likely require more vitamin D. As mentioned, the recommended amount, according to the NIH, is 800 IU per day for men and women over 70.
The reason they need more: According to Johns Hopkins, older people dont absorb vitamin D as well, and create less of it, than younger individuals. A review of research published in Endocrinology and Metabolism Clinics of North America noted that aging reduces vitamin D production in skin, and treatment of elderly people with 800 IU of vitamin D per day can increase levels to an adequate range and reduce fractures.
Still, scientists don’t suggest that the elderly megadose. Not only is it important to talk to your doctor before starting any supplement, but a study published in January 2019 in the American Journal of Clinical Nutrition showed that large doses of vitamin D were not any more effective at increasing bone mineral density than smaller doses.
No matter what you do, despite its overall low risk, it’s best to talk with your doctor or informed healthcare practitioner before you start taking a vitamin D supplement not only might he or she have further recommendations about how much vitamin D is right for you, but you also may be able to get brand recommendations. Because the U.S. Food and Drug Administration doesnt regulate supplements as rigorously as traditional medications, getting a brand recommendation from your doctor can be helpful.
Common Side Effects Of Vitamin D Vs D3
There are no common side effects to therapy with either vitamin D2 or D3. Side effects related to vitamin D are the result of hypervitaminosis D, an extremely rare condition that occurs when you intake too much vitamin D. This is sometimes seen in patients who take megadoses of vitamin D, leading to vitamin D toxicity. The result is a build up of dangerously high levels of calcium in the blood which can lead to nausea, vomiting, constipation, and frequent urination. If left untreated, irreversible renal failure can occur along with calcification of organs and soft tissues.
The following table lists side effects related to hypervitaminosis D, not normal vitamin D supplementation. More information on vitamin D toxicity may be obtained from your doctor or pharmacist, as this may not be a complete list.
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Vitamin D Can Help Strengthen Oral Health
Because vitamin D helps our body absorb calcium, it plays a crucial role in supporting oral health, lowering the risk of tooth decay and gum disease. A 2011 review in The Journal of the Tennessee Dental Association notes that while the research is scant, there’s an “emerging hypothesis” that the vitamin is beneficial for oral health, due to its effect on bone metabolism and “its ability to function as an anti-inflammatory agent and stimulate the production of anti-microbial peptides.”
Risks And Side Effects
What happens if you take too much vitamin D? Can you overdose on vitamin D?
Taking high doses of vitamin D causes your liver to produce a chemical called 25D, which makes calcium accumulate in your bloodstream. Youre most likely to experience symptoms of too much vitamin D when taking supplements in high doses for a long period of time. This can potentially cause side effects if levels of 25 in the blood become elevated.
Potential side effects can include high blood calcium levels exhaustion abdominal pain and digestive issues like nausea, constipation, diarrhea or loss of appetite increased thirst and dry mouth and possibly kidney stones. The best way to avoid experiencing vitamin D toxicity is to not take very high doses of vitamin D in supplement form, such as 10,000 IU per day for more than several days in a row. Instead, get the vitamin D you need from sunlight, a healthy diet and supplements in the recommended dosage range.
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Who Should Be Screened For Vitamin D Deficiency
Most experts are against routine screening for vitamin D deficiency. This is because:
- Vitamin D testing is considerably more expensive than supplements
- No clear cut-off point for deficiency has been agreed upon
- Routine screening can lead to overtreatment of perceived vitamin D deficiency.
Most experts recommend that babies, children, and adults who are at high risk of vitamin D deficiency should be prescribed supplements without testing for deficiency, even if they dont have any symptoms.
Testing may be appropriate in people who are suspected of having severe vitamin D deficiency. In these cases, blood levels of calcium, phosphate, and alkaline phosphatase kidney function and other tests should be investigated as well.
Vitamin D testing is appropriate for people with:
- low calcium or phosphate levels or an unexplained increase in serum alkaline phosphatase
- atypical osteoporosis
- unexplained limb pain near a joint in older people
- unusual fractures, unexplained bone pain, or other symptoms suggesting metabolic bone disease.
Some people may need a referral to a specialist if it is discovered that they have a metabolic bone disease rather than a simple vitamin D deficiency.
What Are The Main Differences Between Vitamin D And D3
The term vitamin D is kind of a misnomer because you will not find anything labeled simply as vitamin D in a pharmacy vitamin aisle. Rather, your choices will be vitamin D2 or vitamin D3 . Generally, when one mentions vitamin D, the implied selection is vitamin D2. For the purpose of this article, when vitamin D is mentioned, it will refer to vitamin D2. The names can be confusing, because many times, patients go into the pharmacy looking for vitamin D and are surprised that there is a D2 and a D3.
Vitamin D comes from plant sources, such as wild mushrooms, as well as fortified foods, such as milk or cereal products. Its strength is typically measured in international units, which is abbreviated as IU on labeling. The 50,000 IU capsules are prescription only, while lower strengths are available over-the-counter. Vitamin D is less expensive to produce and therefore is the form most commonly found in fortified food products.
Vitamin D3 mainly comes from animal sources such as fish oil, fatty fish, liver, and egg yolks. When your skin is exposed to sunlight, it produces vitamin D3. For this reason, it is sometimes referred to as the sunshine vitamin. Its strength is also measured in international units. All forms of vitamin D3 are available over-the-counter.
|Main differences between vitamin D and D3|
|Who typically uses the medication?||Infants, children, adolescents, and adults||Infants, children, adolescents, and adults|
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Where Does Vitamin D Come From
Our bodies make vitamin D when our skin is exposed to the sun. It’s hard to get enough vitamin D from the sun, though. Most kids and adults spend lots of time indoors at school and work. When outdoors, it’s important to protect skin to prevent skin cancer and skin damage from too much sun exposure.
Very few foods have vitamin D naturally. The foods with the most are fatty fish , liver, eggs and fish oils. Kids don’t eat these foods a lot. That’s why food companies add vitamin D to milk, yogurt, baby formula, juice, cereal, and other foods.
Adding vitamin D to foods is called “fortifying.” It’s helpful, but it still may not be enough.
To get enough vitamin D, children often need to take a multivitamin with vitamin D or a vitamin D supplement. Vitamin D is sometimes labeled as vitamin D3.
You can buy vitamin D pills, gummies, chewables, liquids, and sprays in stores without a prescription. Ask your child’s health care provider for advice on choosing the right one.
Taking It Late In The Day May Affect Sleep
Research links vitamin D levels to sleep quality.
In fact, several studies associate low levels of vitamin D in your blood to a higher risk of sleep disturbances, poorer sleep quality and reduced sleep duration .
Conversely, one small study suggested that higher blood levels of vitamin D may be linked to lower levels of melatonin the hormone responsible for regulating your sleep cycle in people with multiple sclerosis .
Some anecdotal reports claim that taking vitamin D at night can negatively influence sleep quality by interfering with melatonin production.
However, scientific research to determine how supplementing with vitamin D at night may affect sleep is currently unavailable.
Until studies exist, it may be best to simply experiment and find what works best for you.
Vitamin D deficiency may negatively impact sleep quality. Some anecdotal reports assert that supplementing with vitamin D at nighttime may interfere with sleep, but scientific data to that effect is unavailable.
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Fact: Having Low Vitamin D Is Linked To A Bad Mood
If youre feeling low, you may want to get your vitamin D levels checked.
According to a study using rat brain cells published in July 2018 in Genes and Nutrition, vitamin D seems to play a role in the production of serotonin. Serotonin is a hormone that helps regulate mood and sleep per Stanford University. There are correlations between low vitamin D levels and mood disorders, research shows. Whats more, a study published in September 2017 in the Journal of Diabetes Research found that a vitamin D supplement improved the mood of women with type 2 diabetes , yet overall the data is mixed on whether vitamin D supplements for people with lower levels will prevent or help treat mood and psychiatric disorders.
There are many causes of depression, but Cleveland Clinic notes that depression and fatigue may be a sign you have low levels of vitamin D, and getting your vitamin D in the normal range may help. Still, there are challenges with the connection. Sunlight improves both vitamin D and mood, so we wouldnt know if its really the vitamin D improving the mood versus the sunlight improving mood, says McTiernan.
Fact: Adequate Vitamin D Is Linked With A Lower Risk Of Certain Cancers
Individuals with very low vitamin D levels are thought to be at increased risk for breast, colon, kidney, lung, and pancreatic cancers, says Carol Fabian, MD, an oncologist at the University of Kansas Cancer Medical Center in Kansas City and the chair of its cancer prevention research program. The Cleveland Clinic notes, too, that vitamin D may help lower the risk for prostate cancer.
The most at-risk groups are individuals who are obese or have darker pigmented skin and have lower levels of vitamin D but are not supplementing, notes Dr. Fabian. Other factors can also drive up the risk. Most people who are obese do not exercise much, and obesity and a sedentary lifestyle are also risk factors for breast, colon, kidney, lung, and pancreatic cancers, says Fabian. While vitamin D deficiency may not be directly upping cancer risk, an association between the two exists in some cases.
That said, a review published in May 2020 in Seminars in Cancer Biology suggests that there is strong data supporting a protective effect of vitamin D against several types of cancer.
Right now, there are challenges to vitamin D and cancer studies, a review published in October 2018 in Trends in Cancer Research noted. For example, the amounts of vitamin D provided to study participants varies greatly from study to study, and men and women respond to vitamin D supplementation in different ways.
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Are Vitamin D And D3 The Same Thing
Vitamin D3, or cholecalciferol, is one of the forms of vitamin D. Both D2 and D3 need to be converted by the liver and then by the kidneys into the main form of vitamin D that circulates in your body. But D3 appears to more effectively raise our levels of active vitamin D than D2 which is why you may have heard it suggested by everyone from healthcare providers to wellness blogs. And, because its worth repeating, its one of two forms of vitamin D that are essential for humans. D3 is fat-soluble, which means your body absorbs it along with fats in your diet.
You might have also heard it referred to as the sunshine vitamin. Thats because your body can make vitamin D3 in the skin when exposed to direct sunlight. Your body converts a type of cholesterol called 7-dehydrocholesterol into vitamin D3 through a reaction thats kicked off by ultraviolet B rays.
And there are some key differences between these two critical forms, vitamin D2 and D3. Although many foods are now fortified with vitamin D2such as orange juice, whole wheat bread, cereals, and milkit is naturally only found in plant sources, such as mushrooms and yeast. Vitamin D3, on the other hand, is found in animal sources, including egg yolks, some fatty fish such as salmon, and liver.
Advice For Infants And Young Children
The Department of Health and Social Care recommends that babies from birth to 1 year of age should have a daily supplement containing 8.5 to 10 micrograms of vitamin D throughout the year if they are:
- formula-fed and are having less than 500ml of infant formula a day, as infant formula is already fortified with vitamin D
Children aged 1 to 4 years old should be given a daily supplement containing 10 micrograms of vitamin D throughout the year.
You can buy vitamin D supplements or vitamin drops containing vitamin D at most pharmacies and supermarkets.
Women and children who qualify for the Healthy Start scheme can get free supplements containing vitamin D.
See the Healthy Start website for more information.
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