Why Do People Need Vitamin D

Is Cystic Fibrosis A Terminal Illness

In the past, cystic fibrosis was considered to be a fatal illness. People who had it died in childhood. This is no longer true. Today, most children who have CF grow up to be adults with CF.

A note from Cleveland Clinic

If you have cystic fibrosis or your child has CF, you know that this genetic disorder requires lifelong management. As with many illnesses, being diagnosed early and getting treatment early usually results in the best outcomes. Work with your healthcare team, or your childs healthcare team, to find ways to stay healthy. You may have access to more resources than you realize. Research is ongoing and scientists are working toward even better outcomes.

How To Get Vitamin D

You can make your vitamin D the old-fashioned way, by exposing your skin to UVB radiation in sunlight. It doesn’t take much, but people living north of the 37-degree-latitude line roughly the imaginary line between Philadelphia and San Francisco can’t get enough UVB in winter to do the trick. And many others will find it all too easy to overdose on UVB, increasing their risk of malignant melanomas and other skin cancers, as well as wrinkles and premature skin aging. All in all, most doctors recommend avoiding sunlight and getting vitamin D by mouth.

Diet can help, but it’s very hard to approach the new goals with food alone. Fish and shellfish provide natural vitamin D , but you’ll have to eat about 5 ounces of salmon, 7 ounces of halibut, 30 ounces of cod, or nearly two 8-ounce cans of tuna to get just 400 IU. An egg yolk will provide about 20 IU, but since it also contains nearly a day’s quota of cholesterol, you can’t very well use eggs to fill your tank with D. Other foods have even less D, which is why manufacturers fortify milk, some yogurt, some orange juice, and many cereals with vitamin D. In general, a serving will provide about 100 IU that means drinking a quart of fortified milk to get 400 IU.

Should Everyone Get Their Vitamin D Levels Checked Generally No

Karl Insogna, MD, director of Yale Medicines Bone Center

Most people should be fine. Testing is important only for certain populations: for people who are institutionalized for patients with a gastrointestinal disorder or osteoporosis those who have had weight loss surgery those on anti-convulsant medications and children who are immobilized and not outside and active. If youre over 70, I recommend getting your levels checked at least one time.

People whose cultural or religious beliefs require them to be fully clothed, especially if theyre living in northern climates, and whose dietary habits include little or no dairy , may also be vitamin D-deficient and should be tested.

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How Much Vitamin D Should You Be Getting

The amount of vitamin D someone needs depends on their age, as highlighted below.

Infants 0-6 months:

• 400 IU/day for adequate intake
• Upper level intake of 1,000 IU/day

Infants 6-12 months

• 400 IU/day for adequate intake
• Upper level intake of 1,500 IU/day

Children 1-3 years old

• Recommended dietary allowance of 600 IU/day
• Upper level intake of 2,500 IU/day

Children 4-8 years old

• Recommended dietary allowance of 600 IU/day
• Upper level intake of 3,000 IU/day

People 9-70 years old

• Recommended dietary allowance of 600 IU/day
• Upper level intake of 4,000 IU/day

People over 70 years old

• Recommended dietary allowance of 800 IU/day
• Upper level intake of 4,000 IU/day

Women 14-50 years old who are pregnant or lactating

• Recommended dietary allowance of 600 IU/day
• Upper level intake of 4,000 IU/day

That being said, other factors can affect how much vitamin D you may needâso itâs best to ask your healthcare provider what they advise for you.

What Should I Tell My Health Care Provider Before I Take This Medicine

They need to know if you have any of these conditions:

• an eating disorder, such as anorexia or bulimia
• diabetes
• take medicines that treat or prevent blood clots
• an unusual or allergic reaction to orlistat, other medicines, foods, dyes, supplements or preservatives
• pregnant or trying to get pregnant
• breast-feeding

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Vitamin D Tests: When You Need Them And When You Dont

Many people dont have enough vitamin D in their bodies. Low vitamin D increases the risk of broken bones. It may also contribute to other health problems. Thats why health care providers often order a blood test to measure vitamin D.

But many people do not need the test. Heres why:

A test usually does not improve treatment.

Many people have low levels of vitamin D, but few have seriously low levels. Most of us dont need a vitamin D test. We just need to make simple changes so we get enough vitamin D. We need to get a little more sun and follow the other advice found below.

Even if you are at risk for other diseases, like diabetes and heart disease, a vitamin D test isnt usually helpful. The test results are unlikely to change the advice from your health care provider. It is much more important for you to make lifestyle changes firstto stop smoking, aim for a healthy weight and be physically active. And, like most other Canadians, you should try to get enough vitamin D from sun and foods. And talk to your health care provider about supplements.

Extra tests lead to extra treatments.

Getting tests that you dont need often leads to treatments you dont need, or treatments that can even be harmful. For example, if you take too much vitamin D, it can damage your kidneys and other organs.

When should you have a vitamin D test?

Talk to your health care provider about your risks. Here are some conditions where you might need a Vitamin D test:

How can you get enough vitamin D?

Getting Vitamin D From Sunlight

To make vitamin D, you need sunlight on your skin. From April until the end of September its possible to get enough vitamin D by spending time outside.

For most people, you only need to be outside for short periods of time, for example around 20-30 minutes. Although the exact time isnt known because its different for different people. If you have dark skin, for example if youre of south Asian, African or African Caribbean origin, you will need longer in the sun.

You need to have some skin exposed, for example, your forearms, hands and lower legs. But you can still make vitamin D even if you sit in the shade.

Sitting inside by a sunny window doesnt count because glass filters out the UVB rays the type of light that is needed to make vitamin D.

In the UK, we dont get enough vitamin D from sunlight between October and March, because the light doesnt contain enough UVB rays. During this time, we need to rely on getting enough vitamin D from food, and possibly supplements.

The guidelines in the UK are that everyone should consider taking a vitamin D supplement in the winter, especially if youre more like to have a deficiency.

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What Causes Vitamin D Deficiency

Vitamin D deficiency can be caused by specific medical conditions, such as:

• Cystic fibrosis, Crohn’s disease, and celiac disease: These diseases do not allow the intestines to absorb enough vitamin D through supplements.
• Weight loss surgeries. Weight loss surgeries that reduce the size of the stomach and/or bypasses part of the small intestines make it very difficult to consume sufficient quantities of certain nutrients, vitamins, and minerals. These individuals need to be carefully monitored by their doctors and need to continue to take vitamin D and other supplements throughout their lives.
• Obesity: A body mass index greater than 30 is associated with lower vitamin D levels. Fat cells keep vitamin D isolated so that it is not released. Vitamin D deficiency is more likely in obese people. Obesity often makes it necessary to take larger doses of vitamin D supplements in order to reach and maintain normal D levels.
• Kidney and liver diseases: These diseases reduce the amount of an enzyme needed to change vitamin D to a form that is used in the body. Lack of this enzyme leads to an inadequate level of active vitamin D in the body.

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:

• breastfed
• 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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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.

Vitamin D Boosts Weight Loss

Consider adding vitamin D supplements to your diet if youre trying to lose weight or prevent heart disease. You can find a great selection of vitamin D supplements on .

In one study, people taking a daily calcium and vitamin D supplement were able to lose more weight than subjects taking a placebo supplement. The scientists said the extra calcium and vitamin D had an appetite-suppressing effect.

In another study, overweight people who took a daily vitamin D supplement improved their heart disease risk markers.

Many factors can affect your ability to get sufficient amounts of vitamin D through the sun alone. These factors include:

• Being in an area with high pollution
• Using sunscreen
• Spending more time indoors
• Living in big cities where buildings block sunlight
• Having darker skin.

These factors contribute to vitamin D deficiency in an increasing number of people. Thats why its important to get some of your vitamin D from sources besides sunlight.

The symptoms of a vitamin D deficiency in adults include:

• severe bone or muscle pain or weakness that may cause difficulty climbing stairs or getting up from the floor or a low chair, or cause you to walk with a waddling gait
• stress fractures, especially in your legs, pelvis, and hips

Doctors can diagnose a vitamin D deficiency by performing a simple blood test. If you have a deficiency, your doctor may order X-rays to check the strength of your bones.

• salmon

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Sun Exposure And Vitamin D

The amount of time you need in the sun depends on several things, including where you live, the season, time of day, your skin colour and the amount of skin exposed.

In summer, most people get adequate vitamin D from spending a few minutes outside. Its important to avoid high-UV times, so try to go outside mid-morning or mid-afternoon.

In late autumn and winter in southern Australia, when the UV index is typically below 3, aim to go outside in the middle of the day for some vitamin D. If you can, leave some skin uncovered.

You may be able to boost your vitamin D levels by being physically active while outside, for example by walking or gardening.

Always follow sun-safe guidelines. Too much sun can increase your risk of skin cancer and may even cause the vitamin D in your skin to break down.

You can find more information about safe sun exposure and vitamin D on our sunburn prevention page and from organisations such as the Cancer Council Australia and Healthy Bones Australia.

Never use a solarium to boost vitamin D levels because they emit dangerous levels of ultraviolet radiation that increase your risk of skin cancer.

How Much Vitamin D Do The Elderly Need

The need for vitamin D increases with age. Adults age 70 years and younger need 600 IU of vitamin D per day. Adults older than age 70 need 800 IU of vitamin D per day .

More specific recommendations on how much vitamin D an individual needs is based on blood work. A vitamin D blood serum concentration tells us how much vitamin D in present in the blood at the time it is tested.

The Endocrine Society recommends a blood serum concentration of vitamin D > 30 ng/ml. Those with a low serum vitamin D may need a dose of at least 1,200-1,500 IU of vitamin D supplements daily to increase serum vitamin D to optimal levels .

The amount vitamin D someone needs may be affected by many different factors. Talk to your doctor to determine what your individual vitamin D needs are based on your labs and medical conditions. Some deficiencies require higher vitamin D doses .

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What May Interact With This Medicine

• amiodarone
• other medicines or products for weight loss
• supplements like vitamins A, D, E and K
• thyroid hormones

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

How Much Vitamin D Do You Need

In healthy people, the amount of vitamin D needed per day varies by age. The chart below shows the often-cited recommendations of the Institute of Medicine, now the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine. It is important to know that these are general recommendations. If your doctor is checking your blood levels, he or she might recommend higher or lower doses based on your individual needs.

If you have osteoporosis, your doctor might suggest a blood test of your vitamin D levels. The amount of vitamin D supplement can be customized for each person, based on the results. For many older patients, a vitamin D supplement containing anywhere between 800 to 2000 IUs daily, which can be obtained without a prescription, can be both safe and beneficial. It is important to speak with your doctor about your individual needs.

*refers to adequate intake vs recommended dietary allowance of the other age groups.

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What Problems Does Vitamin D Deficiency Cause

Vitamin D deficiency can lead to a loss of bone density, which can contribute to osteoporosis and fractures .

Severe vitamin D deficiency can also lead to other diseases. In children, it can cause rickets. Rickets is a rare disease that causes the bones to become soft and bend. African American infants and children are at higher risk of getting rickets. In adults, severe vitamin D deficiency leads to osteomalacia. Osteomalacia causes weak bones, bone pain, and muscle weakness.

Researchers are studying vitamin D for its possible connections to several medical conditions, including diabetes, high blood pressure, cancer, and autoimmune conditions such as multiple sclerosis. They need to do more research before they can understand the effects of vitamin D on these conditions.

Who Needs Screening

Physicians use a blood test called 25D to check vitamin D levels, but theres no general consensus about what constitutes a normal level, according to the U.S. Preventive Services Task Force, which establishes recommendations about preventive health interventions and screenings.

A low from one lab could be an adequate from a different one.

Experts often rely on the National Academy of Medicine guidelines: Below 12 nanograms per milliliter is considered deficient between 12 and 20 ng/mL is low. In the NEJM study, among those who had their vitamin D tested, just 13 percent fell below 20 ng/mL.

We dont recommend across-the-board vitamin D screening for older adults, Chun says. People who are frail or in nursing homes should be checked. Its also reasonable to get screened if youre a postmenopausal woman who might have osteopenia or osteoporosis. And men 75 or older should consider getting screened as well since theyre at risk of osteoporosis, too.

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What Is Vitamin D

Vitamin D, or the sunshine vitamin, is a cholesterol-like, fat-soluble vitamin. Vitamin D is manufactured in our bodies when the suns ultraviolet light hits our skin and interacts with a form of cholesterol in our skin. From the skin, it makes its way to the liver and then the kidneys where it is converted to its most active form, vitamin D3 . We store vitamin D in our brain, bones, liver, skin, and spleen.

Besides sun exposure, we get some vitamin D through our diets.

Sun Sardines And Supplements: How Your Body Gets Vitamin D

The sun emits two types of ultraviolet rays that reach the earth: UVA and UVB . UVA rays penetrate your skin more deeply. UVB rays, on the other hand, help your body make vitamin D. But getting the vitamin D you need isnt quite as simple as stepping outside.

That means that from about September to June, you cant rely on the sun to give you the vitamin D you need, she says. Plus, if you wear sunscreen in the summer, as you should, you can kiss your vitamin D production goodbye.

Sunny days aside, you can also get vitamin D from food, but the options are limited. Fatty fish like salmon, swordfish, tuna, mackerel and sardines are all sources of vitamin D, as are egg yolks. Some cereals, orange juice, milk, cheese and yogurt are fortified with vitamin D, too, meaning its added in during production to make it easier for people to sneak in vitamin D.

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