Vitamin D Intake And Status
Until recently, it was generally assumed that enough vitamin D was synthesized from sun exposure to meet requirements and no recommendations for dietary intakes for adults aged 18-65 yrs were set. However, research highlighting the effects of low vitamin D status has indicated the importance of vitamin D in the diet. Within Ireland, the Food Safety Authority for Ireland has set a wide range of 0-10 g/d for adults while in the UK there is no reference nutrient intake for adults , only for those over 65 yrs and pregnant and lactating women . In the US, adequate intakes are set at 5 g/d and 10 g/d which also correspond with the WHO/FAO Expert Group recommended intakes .
As mentioned earlier, the dietary intake of vitamin D required to prevent vitamin D deficiency and ensure optimal vitamin D status will vary depending on sun exposure preferences. A recent study concluded that to maintain 25D > 25 nmol/L in 97.5% of the population during wintertime the recommended dietary allowances should be set at 8.7ug/d. However, the authors also calculated that a dietary intake of 12.1ug/d would be required to prevent deficiency among sun avoiders . Such intakes are considerably higher than estimated vitamin D intakes in Ireland , the UK , the US and other European countries .
What Other Factors Can Lead To Vitamin D Deficiency
- Age: The skin’s ability to make vitamin D lessens with age.
- Mobility: People who are homebound or are rarely outside are not able to use sun exposure as a source of vitamin D.
- Skin color: Dark-colored skin is less able to make vitamin D than fair-colored skin.
- Human breast milk: A woman’s breast milk only contains a small amount of vitamin D. Often infant formulas also only include a small amount of D also. Therefore infants are at risk of not receiving enough vitamin D. This is especially true for infants who are only fed breast milk.
Getting Enough Calcium And Vitamin D
You can get enough calcium and vitamin D from foods and supplements. Food should be your primary source when possible.
When calcium or vitamin D is available in food, a food label will read percent daily value. The percent daily value is the percentage amount of a nutrient contained in that food. That percentage does not necessarily reflect the amount of that nutrient you should be getting.
It is much easier to look at the number of milligrams of calcium in food. For example, a glass of milk has around 300 mg of calcium. Most adults and children need around 1,000 mg per day so, that glass of milk means you need at least 700 more milligrams of calcium for the day to meet the daily recommended amount.
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How Much Vitamin D And Calcium Do You Need
The Endocrine Society and The Institute of Medicine have suggested recommended daily allowances for vitamin D and calcium, as well as maximum daily consumption amounts that you should not exceed for your safety:
The recommendations come with two precautions:
Some people may need more than the RDA if they are:
Taking anticonvulsant medications, glucocorticoids, antifungals such as ketoconazole or medications for AIDS
Taking too much of either nutrient appears to be harmful, with:
Kidney stones associated with too much calcium from supplements
Very high levels of vitamin D potentially causing kidney and tissue damage
Talking To Your Doctor
While your bones need calcium and vitamin D, it is never a good idea to start taking any type of supplement without first talking to your doctor. They can advise you how much calcium and vitamin D you should be taking daily and what to do if you experience side effects. Your doctor can also advise on the types of supplements available and the ones they recommend for improving your bone health.
It can hard to achieve daily recommendations for calcium and vitamin D if certain circumstances apply to you, such as if you are a vegetarian who avoids dairy, are lactose intolerant, or if you have a health condition that keeps your body from absorbing vitamin D effectively. Your doctor can also help you to determine how you can meet recommended daily levels through both diet and supplementation.
Supplements might be sold without a prescription, but your doctor is always the best source of information on your bone health. These medications can interfere with other medications you are taking to treat other conditions.
It is important to be especially careful with supplements if you are pregnant or nursing, about to have a medical procedure, or have a serious medical condition. You should also be careful when giving supplements to children.
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Calcium 1100 Mg By Amy Myers Md
This calcium supplement by Amy Myers provides high-quality bovine bone extract that comes from grass grazing New Zealand cows. It also includes IGF-I & IGF-II growth factors which provide optimal bone metabolism. This is a great supplement for someone that needs to strengthen their bones.
What Is Vitamin D And What Does It Do
Vitamin D plays an important role in protecting your bones, both by helping your body absorb calcium and by supporting muscles needed to avoid falls. Children need vitamin D to build strong bones, and adults need it to keep their bones strong and healthy. If you dont get enough vitamin D, youre more likely to break bones as you age.
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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:
- 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.
If You Live Far From The Equator
People living in areas farther away from the equator make less vitamin D in their skin.
In these areas, more of the suns rays, especially UVB rays, are absorbed by the earths ozone layer. So people who live farther away from the equator usually need to spend more time in the sun to produce enough .
Whats more, people who live farther from the equator may not produce any vitamin D from the sun for up to six months a year during the winter months.
For example, people who live Boston, USA and Edmonton, Canada struggle to make any vitamin D from sunlight between the months of November and February (
During this time of year, its important that they get their vitamin D from foods and supplements instead.
People who live farther away from the equator need more time in the sun, as more UVB rays are absorbed by the ozone layer in these areas. During winter months, they cannot make vitamin D from sunlight, so they need to get it from foods or supplements.
Vitamin D is made from cholesterol in the skin. That means you need to expose lots of skin to the sunlight to make enough.
Some scientists recommend exposing around a third of the area of your skin to the sun .
According to this recommendation, wearing a tank top and shorts for 1030 minutes three times per week during the summer should be sufficient for most people with lighter skin. People with darker skin may need a bit longer than this.
Below are some consequences of too much sunlight:
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Can You Get Too Much Vitamin D Or Calcium
Calcium and vitamin D supplements can be good for health but taking too much can pose negative effects. For example, research shows that too much calcium can lead to a heart attack or stroke in both men and women.
Without enough vitamin D to offset calcium and absorb it, that extra calcium will make its way into the arteries instead of the bones. Once in the arteries, it can cause blocks that threaten the heart and brain. Excess calcium has also been linked to muscle pain, abdominal pain, mood disorders, and kidney stones.
Vitamin D toxicity can occur when vitamin D levels in blood exceed 150 ng/mL. When this happens, the extra vitamin D will trigger extra calcium absorption, which leads to negative effects from the calcium.
Vitamin D Affects Your Bones Muscles Joints And Tissues
We have known for a long time that vitamin D is important for bone health. One of the jobs of vitamin D is to help your gut absorb the calcium and phosphorus from your diet. These minerals in turn help build and maintain the strength of your bones. Low levels of vitamin D have been linked to stress fractures and other problems with the bones.
But vitamin D has many other functions as well. I describe it to my patients as a delicate symphony of everything that goes on in your body. If one of the instruments in this case, your vitamin D is off, it can throw off the whole symphony.
In recent years, we have learned more about how vitamin D affects the entire musculoskeletal system. We recently conducted research that looked at vitamin D levels in young women between the ages of 16 and 40 who were treated in the for a variety of problems with their lower extremities. These included injuries to the ligaments, tendons, cartilage and muscles, as well as the bones.
We found that nearly 66% of them had low levels of vitamin D in the blood about three-fifths were insufficient and the rest were actually deficient. Low blood levels were found in patients with acute injuries as well as overuse injuries. Because these rates of low vitamin D are higher than what’s seen in the general population, they suggest a link between low vitamin D and musculoskeletal injuries. More research is needed to confirm this connection.
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How Much Vitamin D Do Your Bones & Muscles Need
Similar to our Disease Incidence Prevention chart, the table below, adapted from a paper Sports Health Benefits of Vitamin D by Shuler et al., illustrates the impact of different levels of vitamin D on multiple aspects of the musculoskeletal system. As mentioned above, up to 99% of rickets cases can be prevented at levels of 20 ng/ml , however, additional benefits for bone and muscle health can be seen with higher vitamin D levels. Studies have also shown that maintaining a vitamin D level of at least 40 ng/ml resulted in a decreased risk of bone fracture and stress fracture. Fast-twitch muscle fibers have been shown to be especially sensitive to vitamin D levels, which are important for burst activities and fall avoidance. Overall, cumulative research has shown that peak musculoskeletal performance may occur with a vitamin D level of at least 50 ng/ml.
Alternatives To Vitamins For Bones
Improving your bone health is an important task and something that many people in America struggle with. If you are looking to improve your bone health, but you do not want to take vitamins, there are a few other options for you.
The first thing you can do is make sure to eat calcium-rich foods. You can find calcium in some surprising foods like almonds, navy beans, tofu, sesame, or even soybeans. The second thing you can do is rather easy and rather inexpensive, eat lots of green, leafy veggies. Some veggies include broccoli, curly kale, Chinese cabbage, and okra.
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Vitamin D And Bone Health
Peak bone mass is attained by the third decade of life with genetics, physical activity, nutrition and lifestyle factors playing key roles in the accumulation and maintenance of bone. Age related bone loss occurs around the fourth decade , resulting in a gradual decline of BMD though this process is accelerated in females during and up to 10 years post-menopause owing to possible oestrogen deficiency derived bone loss . The development of bone disease in later life is related to the attainment of maximum peak bone mass and the maintenance of bone mass in adulthood . In relation to vitamin D, research has shown that inadequate vitamin D intakes over long periods of time can lead to bone demineralization . Vitamin D deficiency leads to decreased calcium absorption and ultimately the release of calcium from the bones in order to maintain circulating calcium concentrations . Continuous bone turnover and resorption weakens the architecture of bones and increases fracture risk via secondary hyperparathyroidism ultimately leading to the development of osteomalacia and osteoporosis. Osteoporosis is clinically defined as a BMD 2.5 standard deviations below the mean of healthy young individuals .
More Information Coming On The Potential Effects Of Vitamin D Supplementation
Beginning in 2000, research into vitamin D’s role in conditions beyond bone health began to expand rapidly, and people started taking vitamin D supplements in hopes of warding off everything from heart disease to cancer. The science is finally catching up.
Harvard Medical School professor Dr. JoAnn E. Manson is the principal investigator of the ongoing Vitamin D and Omega-3 Trial , a large study investigating whether vitamin D and omega-3 supplements can lower risks for cancer, cardiovascular disease, and other conditions. She says while there is strong support for vitamin D’s role in bone health and growing evidence that it may reduce cancer-related deaths, the evidence that it prevents conditions unrelated to bone health is not yet conclusive. “Research on vitamin D supplementation has been mixed, and especially when it comes to randomized clinical trials, it has not shown clear benefits,” she says. Longer-term follow-up of VITAL and results from other ongoing trials may provide additional information about any links between vitamin D and disease prevention.
However, when it came to heart disease, vitamin D supplementation seems to fall short. A meta-analysis that Dr. Manson and her team published in June in JAMA Cardiology showed no benefit from vitamin D supplements in preventing heart attack or stroke.
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Vitamin D Comes From Sunlight And Food But Sometimes Supplements Are Needed
When your skin is exposed to sunlight, UV radiation helps your cells convert a molecule called 7-dehydrocholesterol into vitamin D. For some people, getting 10 to 30 minutes of midday sunlight on the face and arms several times a week may allow their body to produce enough of the vitamin. But for people living in a colder climate, this can be hard to achieve in the wintertime. And for others, especially those with darker skin, sunlight alone may not produce healthy levels.
Vitamin D is naturally found in some foods, primarily oily fish like salmon and sardines, egg yolks, mushrooms and liver. It’s also added to some fortified foods, including milk and cereal. For many people, taking a supplement may be the best way to get the vitamin D they need. If your doctor tells you your vitamin D levels are low, speak with them about the right dose for you. This is important, because it’s possible to get too much vitamin D if you’re taking supplements.
Vitamin D Affects How Your Body Responds To Inflammation And Pain
Our study also found that patients who had pain, including a type of knee pain known as patellofemoral-related pain frequently called runner’s knee often had low levels of vitamin D. We believe that vitamin D acts on hormones called prostaglandins, which control how the body responds to injury. Prostaglandins are connected to both inflammation and pain receptors.
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Are You Getting Enough Vitamin D
Vitamin D is best known as a bone-health hero, helping the body absorb calcium and phosphate to keep bones strong.
If you dont have enough, your bones can become soft and weak. In children, this can lead to rickets, and in adults it can lead to osteoporosis or osteomalica and a higher risk of breaking bones more easily. Ask your GP for a blood test if you think you might have a vitamin D deficiency.
What Are The Risks Of Taking Vitamin D
At normal doses, vitamin D seems to have few side effects. But if you take any medications, be careful — it can interact with many medicines, such as drugs for high blood pressure and heart problems. Ask your doctor if it’s safe for you to take vitamin D supplements.
Too much vitamin D can cause loss of appetite, the need to pee a lot, nausea, and weight loss. High doses of vitamin D can also make you disoriented and lead to bone pain and kidney stones.
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Vitamin D Deficiency: Are You At Risk
Vitamin D deficiency occurs when you are not getting the recommended level of vitamin D over time. Certain people are at higher risk for vitamin D deficiency, including:
- People who spend little time in the sun or those who regularly cover up when outdoors
- People living in nursing homes or other institutions or who are homebound
- People with certain medical conditions such as Celiac disease and inflammatory bowel disease
- People taking medicines that affect vitamin D levels such as certain anti-seizure medicines
- People with very dark skin
- Obese or very overweight people and
- Older adults with certain risk factors.
Talk to your healthcare provider if you have any of these risk factors. If you have osteoporosis and also have a vitamin D deficiency, your healthcare provider may temporarily prescribe a high dose of vitamin D to bring you up to a healthy level.