Vitamin D Supplementation On The Rise
Between 2006 and 2014, the number of people taking over 4,000 IUs daily rose from less than 0.5% to over 3%. That was according to a 2017 study in the Journal of American Medicine, which pulled data from 39,000 participants in the National Health and Nutrition Examination Survey.
The study also found that over the same period, those taking more than 1,000 IUs per day jumped from less than 1% to over 18%. This amount is not known to cause immediate health problems, but the findings indicate that more people than ever are seeking out extra vitamin D and may be at risk of overdoing it.
This doesn’t mean that no one should take a vitamin D supplement. Other than infants and those over 70 who likely require supplements, people should get their blood levels checked routinely to determine if supplements are advised.
Advice For Adults And Children Over 4 Years Old
During the autumn and winter, you need to get vitamin D from your diet because the sun is not strong enough for the body to make vitamin D.
But since it’s difficult for people to get enough vitamin D from food alone, everyone should consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter.
Between late March/early April to the end of September, most people can make all the vitamin D they need through sunlight on their skin and from a balanced diet.
You may choose not to take a vitamin D supplement during these months.
Q: Whats The Link Between Vitamin D And Heart Health
A: That isnt entirely clear. We know that low vitamin D levels are a risk factor for heart disease, but at this time, we do not know whether treating low vitamin D with supplements can prevent a heart attack. There are a number of large clinical trials studying this now. Part of the problem with finding the answer is accounting for the many factors involved in heart disease. For example, maybe people who develop heart disease are also getting less physical activity outdoors. It may not be low vitamin D levels causing the heart disease.
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What Is The Difference Between Vitamin D2 And D3
Vitamin D2 and D3 are two important forms of vitamin D. D2 comes from plants and D3 comes from mainly animal sources or it is made by our bodies when our skin is exposed to sunlight. D3 is better absorbed and more potent than D2. Fortified milk or juice is more likely to contain D2 because it is cheaper to produce.
Its Very Individual How Much Sun Exposure A Person Needs Roberta Bivins
Its very individual how much sun exposure a person needs during summer, depending on the pigment in the skin to the amount of fat in the body and how quickly your body makes new bone. Its incredibly complicated, she says.
Thats why the best way to determine if you have low vitamin D is not by symptoms alone, but with a blood test arranged through your medic.
Supplement levels
Then there is the question of exactly what level of supplementation people need. Reid says theres no danger in taking over-the-counter vitamin D of less than 25 nanomols per day.
US and Canada guidelines suggest taking 15 micrograms of vitamin D supplements each day, but some believe its not enough
But with supplements offering doses as high as 62.5 micrograms available over the counter, there are concerns around the risk of excessive vitamin D levels, which can, in rare cases, cause side effects, including nausea and vomiting. In the long term, some studies suggest too much vitamin D can increase risk of cardiovascular disease, although the research isnt conclusive.
But others argue that even more vitamin D is needed.
With such conflicting results, its unsurprising that medical experts themselves are deeply divided over the benefits of widespread supplementation. Some even argue that vested interests are propping up the billion-dollar vitamin industry, with Spector calling vitamin D supplements a pseudo-vitamin for a pseudo-disease.
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How Do I Get Vitamin D
Our skin makes vitamin D when it is exposed to the sun. It can also be obtained from foods containing vitamin D, and D2/D3 supplements.
- Mushrooms
- Vitamin D2 supplements
- Fortified foods containing D2
- Exposing our skin to sunlight
- Butter
- Oily fish and fish oil
- Vitamin D3 supplements made using lanolin from sheeps wool
- Vitamin D3 supplements made using lichen
- Fortified foods containing D3
Since D2 is cheaper to produce, its the most common form in fortified foods.
Help Prevent Bone Diseases Such As Osteoporosis
Its clear that vitamin D aids in the absorption of calcium. Without enough vitamin D in the body, there will not be enough of calcium’s active form, the hormone calcitriol, according to the National Institutes of Health . Calcium absorption allows the body to maintain a sufficient level of that element as well as phosphate, both of which promote the growth and maintenance of healthy, strong bones.
Thats why getting enough vitamin D is critical for warding off bone diseases, such as rickets in children, osteomalacia in adults, and osteoporosis in the elderly.
Rickets is a rare disease in the United States. It is marked by soft and weak bones in children and is typically associated with developing countries, but an inadequate vitamin D level from lack of sun exposure or diet can affect children anywhere in the world, research shows. According to the Mayo Clinic, signs and symptoms of rickets include pain in the spine, pelvis, and legs, as well as delayed growth and muscle weakness.
Meanwhile, osteomalacia refers to softening of the bones due to vitamin D deficiency. Its signs include dull, aching pain in the legs, hips, pelvis, ribs, and back, though the condition often doesnt present symptoms in its early stages, the Mayo Clinic notes.
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Vitamin D Benefits Bones Immunity Skin & More
More and more research shows just how important it is for overall health to get enough sun exposure one reason being because the sun provides us with vitamin D. This is important because vitamin D benefits the body in so many ways.
What does vitamin D do exactly? Research indicates that this so-called sunshine vitamin impacts not only your bones and skeletal structure, but also immune function, blood pressure, mood, brain function and your bodys overall ability to protect against a range of illnesses.
According to a 2019 review, benefits of vitamin D are thought to include support for bone health and immunity, as well as resistance against chronic conditions, including heart disease, cancer, diabetes and depression along with infections and viruses.
Given all of these vitamin D benefits, its unfortunate that so many people are lacking in this essential vitamin.
Its estimated that up to 95 percent of most peoples vitamin D comes from casual sunlight exposure. However, because many people today dont spend time in the sun each day, or regularly consume foods that provide enough vitamin D , most adults and children too, even infants and breastfed babies are now encouraged to supplement with vitamin D.
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
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Lacking Vitamin D In Ones Diet
Vitamin D deficiency can be caused by failing to gain sufficient amounts of vitamin D from one’s diet, leading to insufficient levels in the body overall.
The recommended daily intake of vitamin D is:
- 400 IU for children under one year
- 600 IU for children, teens and adults up to age 70
- 800 IU for pregnant people and adults over the age of 71
To increase a personâs chances of meeting the vitamin D target for their age group, healthcare professionals advise everybody to ensure that their diet contains sources of vitamin D â which can be found in certain foods, especially in fatty fish, such as salmon or tuna, and certain dairy products, like milk and cheese.
However, most foods that contain vitamin D do not contain sufficient quantities to meet a personâs daily required intake. For this reason, many traditionally consumed sources of vitamin D are fortified with vitamin D.
Failing to eat regular or sufficient quantities of vitamin-D-containing food increases the likelihood of developing vitamin D deficiency. Even with a vitamin-D-rich diet, it is not usually possible for a person to maintain sufficient levels of vitamin D in their body from food alone. For this reason, vitamin D deficiency is a very common problem worldwide.
Failing to source additional vitamin D from sunlight
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.”
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What Are The Vitamin D Requirements
Only 20% of our vitamin D is meant to come from our diet with the remaining 80% provided by our skin from UV-B exposure to the sun. There are currently two sets of guidelines for vitamin D intake. Typically, vitamin guidelines are established by the Institute of Medicine in the form of Recommended Dietary Allowances or adequate intakes . The RDA is the average daily intake sufficient to meet the nutrient requirements of nearly all healthy individuals. These guidelines were set on a population model to prevent vitamin D deficiency based on bone health for the general population. The Endocrine Society put together a task force to review the research and came up with a set of guidelines based on a medical model for those at risk for a deficiency. The two recommendations are as follows:
| Infants | |
|---|---|
| 1,500-2,000 IU/day | 1,500-2,000 IU/day |
These amounts are based on what is needed to maintain the blood levels that each guideline committee has established as ideal. The higher the blood level that you need to maintain, the more vitamin D you will need to maintain that level. If your blood level is deficient, these are not the guidelines for you to follow. You will first need to get your levels up by taking vitamin D above these amounts and then you will follow these levels once you have reached your adequate level. Your health care provider can provide recommendations for a safe way to do this.
If You Take Any Group Of Patients With Almost Any Disease Their Vitamin D Levels Will Be Lower Than In A Healthy Individual Ian Reid
Ian Reid, professor in medicine at the University of Auckland, believes that diseases cause low vitamin D levels, as being unwell often leads to spending less time outdoors exposed to sunlight, rather than vice versa. If you take any group of patients with almost any disease, their vitamin D levels will be lower than in a healthy individual. This has led some to hypothesise its low vitamin D developing the disease, but theres no evidence to prove it, he says.
Some experts believe people who are unwell have low vitamin D levels because they spend less time outdoors, not that their low levels cause health problems
Researchers have found that higher vitamin D levels are associated with a lower risk of colorectal cancer it plays a role in stemming the formation of new blood vessels and stimulating better communication between cells. Vitamin D also has been found to help maintain normal levels of calcium in the colon, which slows growth of non-cancerous but high-risk cells.
Other studies, including of the link between vitamin D and liver cancer,breast cancer and prostate cancer, suggest there is good reason to think that low vitamin D plays a part in the spread of cancer cells. But taking supplements would then, surely, help stave off cancer and a recent meta-analysis failed to find that supplementation reduced cancer risk.
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What Do We Know About Vitamin D
Vitamin D plays an important role in the body: It helps the body absorb calcium. Getting enough calcium is essential for your bone health â not getting enough can put you at risk of problems like osteoporosis or rickets. Vitamin D can come from several sources, including supplements, diet, or exposure to ultraviolet-B radiation from sunlight. But the reasons why people take vitamin D often have nothing to do with its relationship to calcium.
Vitamin D came to prominence in the publicâs mind on the back of several small studies that showed it could benefit health beyond your bones. Taking the supplement could reduce the risk of a number of illnesses and conditions, including type 2 diabetes, chronic kidney disease, and high blood pressure, they claimed.
For years, it seemed the supplement was âriding high,â Dr. Myles Wolf, professor at Duke University School of Medicine, argued in a recent JAMAeditorial. But randomized clinical trials â designed to validate these small studiesâ claims â changed all that. The trials just didnât bear out the studiesâ findings.
Based on the results of those clinical trials, we shouldnât expect that vitamin D supplementation will have any benefits beyond supporting skeletal health because âthe body of clinical trial data do not support these broader claims,â Wolf tells Inverse.
How Do I Know If I Have Vitamin D Deficiency
Vitamin D deficiency is measured with a blood test that measures 25D. This is the form of D3 that has undergone conversion by the liver although it is still inactive and requires further conversion by the kidneys to active vitamin D3, 1,25D.
The reason 25D is measured is because it is the most stable form of D3. It is also the most abundant form and lasts several weeks in the body. It is a good representation of how much vitamin D has been obtained from both diet and sun exposure.
Conversely, 1,25D only lasts for a few hours in the body and levels are a thousand-fold less than those of 25D. Our body also has a way of increasing the production of active D3 by the kidneys during times of deficiency and insufficiency, so a blood test for 1,25D may appear normal or elevated even when your actual levels of vitamin D are low. However, in some disorders of calcium metabolism, the 1,25D test may be used.
25D levels will tell your doctor if you are deficient in vitamin D, borderline, sufficient, or vitamin D toxic.
See the flow chart above for an overview of the different forms of vitamin d.
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How Vitamin D Works
Vitamin D helps control how much calcium and phosphate you absorb from food.
Calcium is essential for bone health. Phosphate is needed for healthy bones, teeth, muscles, nerves, and basic bodily functions.
Vitamin D comes in two forms:
- Vitamin D2 is naturally found in some plants.
- Vitamin D3 is naturally found in animals and is produced by the skin when its exposed to sunlight.
You can meet your vitamin D needs with either form. But healthcare providers generally suggest D3 supplements. That’s because it:
- Raises your overall vitamin D level more than D2
- Lasts longer in the body than D2
Vitamin D And Safe Sun Exposure
UV levels vary depending on the time of year, and the amount of sun exposure you need varies accordingly.
The ‘daily sun protection times’ indicate when the UV level is forecast to be three or above. During these times, people are recommended to use a combination of sun protection measures .Check the free SunSmart app or the Bureau of Meteorology website for daily sun protection times for your location.
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