Why Getting Enough Vitamin D In Wintertime Is So Important
Winter is upon us and so is the risk of vitamin D deficiency and infections. Vitamin D which is made in our skin following sunlight exposure and also found in oily fish , mushrooms and fortified dairy and nondairy substitutes is essential for good health. Humans need vitamin D to keep healthy and to fight infections. The irony is that in winter, when people need vitamin D the most, most of us are not getting enough. So how much should we take? Should we take supplements? How do we get more? And, who needs it most?
I am a medical microbiologist and immunologist who studies the functions of vitamin D in immune cells. My laboratory has been interested in figuring out why the immune system has vitamin D receptors that determine which cells can use vitamin D. In the immune system, vitamin D acts to improve your ability to fight infections and to reduce inflammation.
Cme Questions About Vitamin D Deficiency In Adults
Which one of the following patients is at greatest risk for vitamin D deficiency?
A formula-fed infant
A teenaged girl eating an unrestricted diet and taking a multivitamin
A 30-year-old male nursing home resident treated with phenytoin for epilepsy
A 70-year-old woman with osteopenia taking a calcium carbonate with vitamin D supplement
A 43-year-old male farmer
Which one of the following biochemical tests provides the best initial assessment of a person’s vitamin D status?
Serum parathyroid hormone
What To Know If You Take A Supplement
Its a good idea to talk with your doctor before starting any new supplement regimen.
For optimal bone health, you should also be sure to pair it with at least 1,000 milligrams of calcium per day, either through diet or a combination of diet and supplements, she says.
Keep in mind that if youre taking a daily multivitamin, any vitamin D in that supplement should be included in your daily dose.
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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.
What To Know About The Risk Of Low Levels And Who Should Be Tested
Vitamin D has been promoted as a cure-all. You may have seen headlines claiming that taking vitamin D can help prevent or even treat COVID-19, but theres no solid science to support that yet. A paper recently published in BMJ Nutrition, Prevention & Health indicated that while everyone should strive to get enough of the vitamin, theres still a dearth of research showing a beneficial effect on COVID-19.
But there’s a connection between vitamin D levels and the risk of respiratory infections in general. The vitamin plays many roles throughout the body. It supports a range of antiviral responses, says Adrian Martineau, Ph.D., a clinical professor of respiratory infection and immunity at Queen Mary University of London. It boosts the ability of lung cells to fight bacteria and viruses, among other things, he says.
Martineau was the lead author of a 2017 analysis of 25 studies looking at the vitamin and respiratory illness. Published in BMJ, it involved almost 11,000 people of all ages, and concluded that taking a D supplement reduced the risk of having at least one respiratory tract infection. Those who were very deficient in the vitamin saw the most benefit.
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How Prevalent Is Vitamin D Deficiency And Who Is At Risk
Worldwide, naturally occurring dietary sources of vitamin D are limited, and food fortification is optional, inconsistent, inadequate, or nonexistent. Therefore, for most people, vitamin D is primarily obtained by cutaneous production from sun exposure. However, many variables influence the amount of UVB from sunlight that reaches the skin and its effectiveness. These include time of day, season, latitude, altitude, clothing, sunscreen use, pigmentation, and age. In Minnesota in 2008, less than half of days provided enough solar UVB radiation at noon to effect cutaneous vitamin D production. Even those who normally reside in sunny climates are commonly found to be deficient in vitamin D, probably due to cultural habits and/or dress. Even if regularly exposed to sunlight, elderly people produce 75% less cutaneous D3 than young adults. Further barriers to cutaneous vitamin D production are ongoing public health campaigns promoting sunscreen use, as advocated by the American Academy of Dermatology . Unfortunately, commonly recommended daily intakes of vitamin D are known to be insufficient if sunlight exposure is limited.
Follow Your Diet Carefully
You will need to make sure you are getting enough protein, vitamins, and minerals while you are losing weight quickly. Eating mostly protein, fruits, vegetables, and whole grains will help your body get the nutrients it needs.
Protein may be the most important of these foods early after surgery. Your body needs protein to build muscles and other body tissues, and to heal well after surgery. Low-fat protein choices include:
- Skinless chicken.
- Whole eggs or egg whites.
- Dairy products, which includes low-fat or nonfat hard cheeses, cottage cheese, milk, and yogurt.
After gastric bypass surgery, your body will not absorb some important vitamins and minerals. You will need to take these vitamins and minerals for the rest of your life:
- Multivitamin with iron.
- Vitamin B12.
- Calcium and vitamin D. Your body can absorb only about 500 mg of calcium at a time. Divide your calcium into 2 or 3 doses during the day. Calcium must be taken in the citrate form.
You may need to take other supplements also.
You will need to have regular checkups with your provider to keep track of your weight and to make sure you are eating well. These visits are a good time to talk with your provider about any problems you are having with your diet, or about other issues related to your surgery and recovery.
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How Do You Get Vitamin D And Calcium
Your body makes Vitamin D when your skin is exposed to sun, but several factors limit its creation:
Living anywhere in the country above latitude 33 degrees
Wearing sunscreen to protect against melanoma
Having naturally dark skin
Aging, which changes absorption ability
The amount of sun you would need to achieve normal blood vitamin D levels is probably more than is safe for your skin, so most people may need supplements to achieve a normal vitamin D level.
Either form of vitamin D benefits the body, but very few foods naturally contain the nutrient or are fortified with it. Thats why doctors recommend supplements to make up the difference. Foods containing vitamin D include:
Cod liver oil: 400-1,000 IU per teaspoon
Wild caught salmon: 600-1,000 IU per 3.5 oz
Farmed salmon: 100-250 IU per 3.5 oz
Canned salmon: 300-600 IU per 3.5 oz
Canned sardines: 300 IU per 3.5 oz
Canned mackerel: 250 IU per 3.5 oz
Canned tuna: 236 IU per 3.5 oz
Fresh shitake mushrooms: 100 IU per 3.5 oz
Sundried shitake mushrooms: 1,600 IU per 3.5 oz
Egg yolk: 20 IU per yolk
Milk, orange juice, infant formula, yogurt, margarine, butter, cheese and breakfast cereals are often fortified with vitamin D.
Calcium is found in:
How To Store Your Vitamin D Supplements
Store the supplements out of the reach of young children.
The supplements should be kept away from pets. Consult with a vet if you are concerned that your pet has consumed any of the vitamin D supplements provided.
Check the product seal is still in place on delivery and do not take the supplements if the seal has been broken.
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Which Foods Contain Vitamin D
When it comes to vitamin D from food sources, its naturally present in very few foods. It is mainly found in fatty fishes, such as salmon and tuna, as well as cod liver oil and egg yolks. For people who dont eat animal products, its more difficult to rely on food sources for vitamin D. Non-animal sources of vitamin D include mushrooms, spinach and soybeans.
For followers of The Blood Type Diet, its important to check that any particular vitamin D-containing food is right for your type. For instance, cod liver oil is an Avoid for Type O non-secretors. Using our Official Blood Type Diet App is an easy way to find out.
Fortunately, our bodies can store vitamin D in the liver and fat tissues, so vitamin D levels dont plummet immediately when the weather gets cold. However, they can drop significantly during the winter months, which puts us at a greater risk of seasonal viruses.
Phyto D 2000 can be purchased by itself or as a part of Dr. D’Adamo’s Resistance Pack, which combines elderberry, quercetin, Andrographis paniculata, Chinese Skullcap Root Extract and vitamin D to provide a cornerstone of immune modifying support during the winter months, especially during these uncertain times.
How Much Vitamin D Do You Need
Despite widespread assertions in the popular and scientific press that many Americans have a vitamin D deficiency, the term “deficiency” isn’t strictly accurate. The official definition of a vitamin deficiency means that specific health problems stem solely from the lack of a specific nutrient. An actual vitamin D deficiency results in bone disease, such as rickets, which is rare in the United States.
On the other hand, lower-than-optimal levels of specific vitamins, including vitamin D, may increase your risk of numerous health problems, even though they are not solely responsible for these problems. “Insufficiency” may be a better term for these lower levels than “vitamin D deficiency”.
So far, the most clearly established benefit of vitamin D is that it helps the body absorb calcium and therefore promotes healthy bones. However, a steady drumbeat of studies beginning in the 1980s started to build a case that low blood levels of D were connected with a variety of chronic health problems, leading to claims by a number of researchers that the RDA for D was way too low. The confusion and controversy surrounding optimal vitamin D intake and blood values prompted the U.S. and Canadian governments to request that the Institute of Medicine review the evidence on vitamin D and calcium and update the DRIs.
To learn more about the vitamins and minerals you need to stay healthy, read , a Special Health Report from Harvard Medical School.
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Benefits Of Fish Oils
Omega-3 fatty acids strengthen the hearts electrical system, preventing heart rhythm abnormalities. Within the artery walls, omega-3 fatty acids inhibit inflammation, which is a factor in plaque build-up. Therapeutic doses of fish oils are therefore used to prevent the re-blockage of arteries that commonly occurs after angioplasty, a procedure in which a small balloon is used to open blocked blood vessels.
Omega-3 fatty acids are also effective general anti-inflammatories. Other preliminary evidence suggests that fish oils have many additional benefits, including prevention of graft failure after heart bypass surgery.
What Are The Best Sources Of Vitamin D
Its hard to get enough vitamin D from sunshine, but its even harder to get it from foodat least the way most people eat. The best source of dietary D is from fish livers, such as cod liver oil, but now ask yourself when was the last time you ate cod liver oil?
Mackerel, salmon, sardines, swordfish, trout, and tuna all offer D, as do mushrooms and eggs. If you eat them regularly, youll meet the government-recommended requirement, but if youre in the camp that thinks 600 IU is too low, youll need to be more aggressive to hit your D goals. Dairy products and cereals are fortified with vitamin D, which helps, but one review, and Harvard University, determined that supplementation with a multivitamin or concentrated vitamin D capsule provides a better insurance policy.
Of course, you shouldnt completely avoid the sun. According to a report in Alternative Medicine Review, the health benefits accruing from moderate UV irradiation, without erythema or excess tanning, greatly outweigh the health risks, with skin pigmentation providing much of the protection.
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Is There A Benefit To Taking Vitamin D At Night
Thereâs been some buzz suggesting a link between supplementing with vitamin D before bedtime and the ability to drift off to dreamland. Some studies have shown that vitamin D is connected to the production of melatonin, which regulates circadian rhythm and drives sleep. There is also research linking vitamin D deficiency to some sleep disorders. But, while being vitamin D deficient may contribute to poor sleep, thereâs no direct link between taking a vitamin D supplement at night and better sleep quality.
Can You Get Enough Vitamin D From The Sun Alone
Some people will be able to get enough vitamin D just from sunlight. However, it depends on where in the world they live, the time of year, the time of day, and their skin color.
People who live nearer the equator get more sun exposure. In the Northern Hemisphere, a person may not get sufficient vitamin D from sunlight during the winter.
The sun is usually strongest between 11:00 a.m. and 3:00 p.m. In the summer, a person does not need to be out in the sun for very long during this period to make enough vitamin D.
The amount of melanin a persons skin contains affects how much vitamin D they can make. Less melanin results in lighter skin, which does not protect as well against harmful ultraviolet rays.
People with more melanin in their skin have better protection from the sun, but take longer to make vitamin D. In the United States, the Centers for Disease Control and Prevention found that Mexican-Americans and non-Hispanic black people are more likely to have vitamin D deficiency.
These varied factors make it difficult to recommend how much sunlight a person should get to make the vitamin D that their body needs.
The Vitamin D Council gives some examples:
- At noon during summer in Miami, someone with a medium skin tone would need to expose one-quarter of their skin to sunlight for 6 minutes.
- At noon during summer in Boston, someone with a darker skin tone would need to expose one-quarter of their skin to sunlight for 2 hours.
- egg yolk
- beef liver
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What Protects From Fractures
For older patients at risk of vitamin D deficiency, supplements can have a major impact. They can prevent osteomalacia, a softening of the bone that makes fractures more likely.
A University of Auckland meta-study reported that vitamin D supplements had little effect on bone density.
We would not expect vitamin D supplements to have a large impact on bone density unless the deficiency was severe, he says. Then their impact could be significant.
Improving bone density is not the only way to prevent fractures especially in older patients. Vitamin D can also have huge benefits for muscle function, cognition and falling.
One study found no evidence that vitamin D supplements reduced mortality, or prevented falls or fractures. A different study found no evidence that vitamin D supplements reduced overall mortality. Drilling down into the type of supplement taken, however, vitamin D3 significantly reduced mortality while vitamin D2 slightly increased mortality.
How Much Is Too Much Vitamin D
Overdosing on vitamin D is hard to doin 2010, the IOM defined the safe upper limit for vitamin D consumption as 4,000 IU per day.
If you are very deficient in vitamin D, your doctor may suggest a supplement with more than 4,000 IU per day for a short period of time to boost your level quickly. This should be monitored closely with follow-up blood tests to ensure the level of vitamin D circulating in your blood doesnt reach toxic levels, says Marchand.
Signs of vitamin D toxicity, which is rare, include nausea, vomiting, a metallic taste in your mouth, headaches and body aches. It can also lead to pancreatitis and calcification in the kidneys and blood vessels.
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The Best Vitamin D Supplements
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Most people can get enough vitamin D from sunlight and food. However, some people may need to take a vitamin D supplement to help them get enough of this nutrient.
This article looks at who may need a vitamin D supplement, how much people need by age, and some vitamin D products to consider. It also discusses how to get more vitamin D naturally.
Vitamin D is a fat-soluble vitamin that is essential for healthy bones, immune function, and cell growth.
Some people are more at risk of developing a vitamin D deficiency. According to the National Institutes for Health , these groups include:
If a person is concerned that they might not be getting enough vitamin D, a doctor can provide a blood test to confirm whether or not they have a deficiency.
Vitamin D deficiencies can cause conditions that affect the bones, such as osteomalacia and osteoporosis. This is because vitamin D deficiencies reduce calcium absorption.
Deficiencies in vitamin D can also lead to rickets. However, in the U.S., most companies fortify milk with vitamin D. This has lead to rickets becoming rarer.
A persons daily requirement for vitamin D depends on their age, whether or not they are pregnant, and whether or not they have any underlying medical conditions.
The provides a general guideline as follows:
The following brands or products: