The Move Away From International Units
Starting in 2021, the International Unit will no longer be the only strength listed on vitamin D supplements. In fact, it may not be listed at all.
New dietary supplement labeling requirements from the FDA will go into full effect by January 2021. Among other things, they will require the strength of vitamin A, D and E to be listed as a metric measure .
Per the Food Labeling: Revision of the Nutrition and Supplement Facts Labels:
“In addition to changing some DVs , the proposed rule would change the units used to declare vitamins A, E, and D frominternational units, or I.U. to a metric measure, milligrams or micrograms, and also would include the absolute amounts in milligrams or micrograms of vitamins and minerals, in addition to the % DV, on the label.” Federal Register / Vol. 81, No. 103 / Friday, May 27, 2016
Many manufacturers have already started following these new requirements, by listing both the IU strength and the metric strength on their labels. Here is one example:
Hopefully, manufacturers will list both the International Units and the metric strength to assist individuals in finding the appropriate product. However, there certainly may be situations where you need to convert between one or the other.
Fortunately, the conversion is easy:
- 1 mcg equals 40 IU
Similarly, going from IU to mcg:
- 1 IU equals 0.025 mcg
The most common strengths you will see are:
Can Vitamin D Prevent Or Help Manage Type 2 Diabetes
Cardiovascular Disease Taking vitamin D supplements does not reduce the risk ofheart attack, stroke, or death from heart disease, according to the findings of a randomized, controlled clinical trial involving more than 25,000 participants that was published in the aforementioned January 2019 in The New England Journal of Medicine.
Cancer In the same study, researchers found that vitamin D supplementation was not found to reduce the risk of cancer in participants overall. However, those who had developed cancer and were taking vitamin D were less likely to die early than those who took a placebo. Researchers also found a possible reduction in cancer risk for African Americans, and they called for further study to confirm those results.
Rheumatoid arthritis A small observational study of 44 people with RA and 25 controls found that vitamin D deficiency appeared to be more prevalent among people with RA, suggesting these people may benefit from taking a supplement. But a separate small randomized, controlled trial found that while a vitamin D supplement helped people with RA build stronger bones than the control group, the supplements didnt result in other expected health improvements.
Vitamin D Supplements: How To Take Them Safely
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Please read this document in full before you decide whether to opt in and before you start taking the vitamin D supplements that have been provided to you.
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Vitamin D And Sunlight
Fair-skinned people are recommended to go outside without sunscreen, for 15-20 minutes per day, in spring and summer, to avoid vitamin D deficiency all year. In the winter there is very little UVB, and most vitamin D will be coming from the diet.
For dark-skinned people, sun exposure should be 20-40 minutes per day, but this will be beneficial in the summer only.
Dr Deborah Lee Of Dr Fox Online Pharmacy Highlights The Importance Of Taking A Daily Vitamin D Supplement Following The Nhs Latest Recommendation
Did you know we should all be taking a daily supplement of vitamin D?
In April 2020, the NHS issued a statement, based on recommendations from Public Health England , that we should all consider taking 10 mcg/day vitamin D as a supplement, to keep our bones and muscles healthy.
This advice has been issued now, largely because of the restrictions imposed by quarantine and lockdown. However, many people remain unaware.
The guidance is for everyone including pre-school children, and the elderly. It applies to us all, and not just to those in specific high-risk or vulnerable groups.
It also states there is no evidence taking extra vitamin D will reduce the risk of the coronavirus.
Why is vitamin D so important for our health? and why and how, should we follow this recommendation?
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Study 1 Biochemical Responses
Results of biochemical tests are presented in Figure . For those patients in whom biochemistry data were tested within 26 months after starting vitamin D, both doses increased 25D significantly, with higher levels in the higher vitamin D dose group than in the lower dose group. In both groups, statistically significant suppression of PTH was detected only after 6 months of supplementation. While mean PTH was slightly lower for the 100 mcg/day group, PTH was not significantly different between dose groups. There were no significant differences in serum total or plasma ionized calcium concentrations, either over time, or between groups. There were no significant differences or changes in 1,252D concentrations between groups, or over time. Information relevant to determining nutrient intake requirements for adults is indicated by the bottom whiskers for 25D concentration measured beyond 6 months: 15 mcg /day resulted in average 25D concentrations of 79 nmol/L with a minimum non-outlier value of 44 nmol/L 100 mcg /day resulted in average 25D concentrations of 112 nmol/L with a minimum non-outlier value of 69 nmol/L D levels should be lower than the summer/fall values presented for data > 6 mo beyond the start of treatment).
Importance Of Vitamin D Supplements For Those That Are Cev
In the UK everyone is advised to take a daily vitamin D supplement in autumn and winter to protect their general health, in particular bone and muscle health. This is because during the autumn and winter we cannot make vitamin D from sunlight. CEV people are likely to have been indoors more than usual this spring and summer, so might not have been able to obtain enough vitamin D from sunlight.
The government has prioritised groups that were asked to stay indoors more than usual over the spring and summer due to national restrictions, such as those who are considered to be CEV and those living in care homes, to receive vitamin D supplements for this reason.
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Unlike Most Vitamins That Can Only Be Obtained From The Diet Our Bodies Produce Vitamin D When The Skin Is Exposed To Sunlight When Evaluating If Sun Exposure Is Enough To Meet Your Daily Vitamin D Needs Consider The Following Factors
As we age, the skin produces vitamin D less efficiently. Vitamin D absorption may also decrease with age, making vitamin D supplementation especially beneficial for older individuals.
When used as directed, a sunscreen graded SPF-10 will block 90% of UVB radiation reaching the skin.10 UVB radiation is needed to stimulate production of vitamin D.
Residents of northern climates may have inadequate exposure to sunlight in order to produce sufficient vitamin D, especially during the winter months.
Immune memories allow for fast recognition and elimination of repeat offenders
Current Advice On Vitamin D
In the UK during autumn and winter everyone is advised to take a supplement containing 10 micrograms of vitamin D a day to support general health and in particular bone and muscle health. This is because we cannot make vitamin D from sunlight at this time of year.
This advice is particularly important for those who have limited exposure to sunlight during the spring and summer, such as those in residential and nursing care homes and those in prisons and those who usually wear clothes that cover up most of their skin when outdoors. These groups are more at risk of not having enough vitamin D. Those with dark skin may also not get enough vitamin D from sunlight. All of these groups are advised to take a vitamin D supplement all year round in line with usual government dietary advice.
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Normal Vitamin D Levels
According to the , the following are the minimum amounts of vitamin D a person needs per day:
|10 micrograms or 400 international units|
|170 years||15 mcg or 600 IU|
|71+ years||20 mcg or 800 IU|
People who are pregnant or breastfeeding also need 15 mcg or 600 IU of vitamin D per day.
Doctors use blood tests to determine if someone has adequate levels of vitamin D. They measure vitamin D using one of two measurements: nanomoles per liter or nanograms per milliliter .
The following table provides for low, normal, and high vitamin D levels for the average adult in nmol/ml and ng/ml.
|30 nmol/l or 12 ng/ml or below|
|Adequate||50 nmol/l or 20 ng/ml or above|
|High||125 nmol/l or 50 ng/ml or above|
A person can talk to their doctor to get a better understanding of what their blood test results mean.
According to the U.S. Department of Agriculture, vitamin D helps the body absorb calcium and phosphorus, both vital minerals for building strong bones.
Without adequate vitamin D, a person may develop soft, weak, or brittle bones. This conditions such as rickets in children, or osteomalacia and osteoporosis in adults.
Vitamin D also contributes to the health of muscles, nerves, the brain, and the immune system.
Evidence suggests vitamin D may help to prevent some medical conditions, including some types of cancer.
The symptoms of a vitamin D deficiency can be subtle , but the classic symptoms are bone aches and muscle weakness.
Vitamin D For Immune Health
Vitamin D is a fat-soluble vitamin that can be obtained through the diet or synthesized in the skin upon exposure to sunlight. Vitamin D3, the form of vitamin D formed in the skin, is a potent and active form of the vitamin. Vitamin D2 is a vitamin D analog formed in plants, mushrooms and yeasts during photosynthesis. While vitamin D2 is sometimes used in food fortification, Puritans Pride supplements provide the active form.
Vitamin D plays a regulatory role in the growth, differentiation, and proliferation of different types of white blood cells.8** It is important to regulate these processes to maintain immune balance. Think of a thermostat set to 70 degrees.
When the temperature falls below 70 degrees the heat comes on but once the temperature is reached, the heat needs to turn off or else the temperature will continue to rise indefinitely. The same delicate balance is needed for our immune systems to maintain optimal health.
The T and B cells of the adaptive immune system are both regulated by vitamin D.** Many cells of the innate immune response also require vitamin D such as monocytes which need it to mature properly.** Adequate concentrations of vitamin D are also necessary for the synthesis of important proteins with immune-fighting properties.8**
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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.
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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If You Opted In To Receive Vitamin D Supplements
If you applied for free supplements before the service closed on 21 February 2021, the service will check whether youre on the shielded patients list of people at high risk from coronavirus.
If youre on the list, the partner provider will send out supplements directly to your home. If you gave an email address, you will also get an email to let you know your application was successful. The email will include contact details for any questions.
If you have applied, but are not on the shielded patients list, you will not receive the supplements. If you gave an email address, you will get an email to let you know that your application was not successful.
CEV people are advised to read the guidance on how to take vitamin D supplements safely in full before they start taking the vitamin D supplements that have been provided.
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Vitamin D Is Associated With Levels Of Both Serotonin Important For Mood Regulation And Melatonin Which Regulates Our Sleep
Evidence suggests there may be a relationship since vitamin D is associated with levels of both serotonin, important for mood regulation, and melatonin, which regulates our sleep. Low levels of either hormone could contribute to SAD symptoms. Researchers have yet to carry out a definitive randomised control trial, however, and the exact mechanism by which vitamin D bolsters the hormones is unknown. One theory is that vitamin D receptors which are found in many parts of the brain and concentrated in the hypothalamus, a region involved in our circadian timing play a part in controlling the bodys hormone levels.
Research has found that vitamin D plays a wider role in our mental health, from depression to schizophrenia, as well as in brain development, but how it plays a role also remains unclear. A meta-analysis published earlier this year found that while there is a correlation between lower vitamin D levels and depression, that didnt necessarily mean D caused depression.
Again, perhaps depressed people just went out less and got less sunlight.
If studies are inconclusive, though, perhaps that doesnt reflect on the importance of vitamin D. Perhaps its the fact that most of them are based on supplements, not sunshine.
Some experts believe that vitamin D is most effective when its from the sun, not supplements
Do You Need A Vitamin D Supplement
Because there are so many factors that can affect your vitamin D level, its important to talk to your doctor if you suspect youre deficient. They can perform a blood test to see if you may benefit from upping your intake of vitamin Drich foods like salmon, fortified milk, and eggs, or taking a vitamin D supplement, according to MedlinePlus. Again, if you live in a place where winters are cool and dark, you may benefit from a supplement.
Talking with your doctor before supplementing is even more important if youre managing a chronic condition. Not only are the benefits of vitamin D supplements unclear for certain health conditions but theres a chance the supplement may do more harm than good if youre taking a medication that interacts poorly with it.
Another thing to keep in mind is that the Food and Drug Administration doesnt regulate supplements like it does over-the-counter medication and prescription medication. Have a conversation with your doctor about their recommended brand and dose to maintain or improve your health.
Additional reporting by Melinda Carstensen and Jamie Ludwig.
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What Happens If I Take Too Much Vitamin D
Taking too many vitamin D supplements over a long period of time can cause too much calcium to build up in the body . This can weaken the bones and damage the kidneys and the heart.
If you choose to take vitamin D supplements, 10 micrograms a day will be enough for most people.
Do not take more than 100 micrograms of vitamin D a day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11 to 17 years.
Children aged 1 to 10 years should not have more than 50 micrograms a day. Infants under 12 months should not have more than 25 micrograms a day.
Some people have medical conditions that mean they may not be able to safely take as much. If in doubt, you should consult your doctor.
If your doctor has recommended you take a different amount of vitamin D, you should follow their advice.
You cannot overdose on vitamin D through exposure to sunlight. But always remember to cover up or protect your skin if you’re out in the sun for long periods to reduce the risk of skin damage and skin cancer.
Page last reviewed: 03 August 2020 Next review due: 03 August 2023
Reducing The Risk Of Covid
The 10 mcg vitamin D supplement recommended by Public Health England is verging on the homoeopathic it would raise blood 25D levels over 2-3 months by only around 4 nmol/L, leaving someone who is vitamin D deficient still deficient!
Most adults will require much bigger doses to achieve optimal 25D levels – 5,000 IU /day is not unusual. will raise blood 25D levels by around 10 nmol/L.) The potential for toxicity from taking vitamin D supplements is low – according to the US National Institutes of Health / Office of Dietary Supplements, most reports suggest a toxicity threshold for vitamin D of 10,000-40,000 IU/day and serum 25D levels of 500600 nmol/L whereas the potential benefits are huge.
The planned randomised controlled trial of vitamin supplementation to reduce the risk of covid-19 over winter will be a waste of time if inadequate doses are used lets hope that the different vitamin D supplementation strategies includes some sensible doses such as suggested above
Competing interests: No competing interests
23 June 2020
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