In recent years, vitamin D has risen to prominence as the one most in the news, and with good reason. As many as 30 percent of adults are deficient in this important vitamin. Doctors are recommending that some patients be tested to determine their vitamin D levels, and sales of supplements have skyrocketed as reports continue to come out suggesting a link between certain diseases and a lack of adequate amounts of vitamin D.
Why is vitamin D important? How much do you need? How do you know if youre getting enough? What are the best sources for vitamin D? To get answers to these and other questions about whats sometimes called the sunshine vitamin, we spoke with Robin Page, MD, a Cortez-based board certified internal medicine specialist.
Vitamin D tells the intestine to absorb calcium, Page said. Without enough vitamin D on board, you dont get enough calcium and that can cause bone problems such as chronic pain, an increased risk for fractures, and osteoporosis. Vitamin D also helps the body absorb phosphorous, another element that is necessary for healthy bones.
Heightened public awareness about the risks of osteoporosis may be part of the reason vitamin D has become the new darling of the vitamin world.
Osteoporosis drugs dont work properly if someone is vitamin D deficient and not absorbing enough calcium, Page said.
Most people with vitamin D deficiency have no physical symptoms.
You can get bone pain, commonly in the shins, or sometimes muscle weakness, Page said. Broken bones may be what reveals that youre vitamin D deficient, but thats not the way you want to find out.
Some studies have shown a correlation between vitamin D deficiency and other medical problems, including autoimmune disorders and certain cancers. Page notes, however, that its difficult for researchers to prove a direct cause-and-effect link between vitamin D and anything other than bone problems, mainly because so many people are deficient.
Correlation is not causality, Page said. Studies have shown Vitamin D is important for bone health and fall prevention in the elderly. Currently, other claims regarding the benefits of vitamin D are speculation.
Research continues to prove or disprove other proposed benefits of vitamin D.
That said, if you suffer from a condition that studies have shown a correlation between improvement and increased levels of vitamin D, there is probably no harm in taking a daily supplement. Be careful not to take too much, however, because vitamin D is stored in fat and large doses can cause toxicity. Toxicity is unlikely if someone supplements less than 4,000 IU per day; however, more than 2,000 IU per day is generally not needed.
The Institute of Medicine determined in 2010 that individuals up to the age of 70 should get 600 IU (international units) of vitamin D daily. Over the age of 70, the recommendation is 800 IU per day. Other organizations recommend 800 to 1,200 IU daily. This assumes a person is getting little or no sun exposure. More on that in a moment.
Certain foods (although not very many) are good sources of vitamin D. A 3.5 ounce serving of canned tuna provides 235 units, and the same size serving of salmon packs 360 units. A whole egg has about 30 units, and vitamin-D fortified milk provides approximately 120 units per cup. If you can stomach it, cod liver oil provides a whopping 1,300 units of vitamin D per tablespoon.
The least expensive and most natural way to get vitamin D is to go outside for a few minutes each day, without sunscreen, when the sun is high in the sky. I tell people that 15 minutes outside, three to four days a week, with their arms exposed is usually enough, Page said. Sunlight on the skin tells the liver to produce vitamin D.
Certain groups of people are at higher risk for vitamin D deficiency, including elderly people in nursing homes or who do not get outside much. Individuals who live in areas of the country where the days are short or where its overcast a good deal of the time are also more likely to be deficient in vitamin D (not a problem here in the Four Corners area). Some medical conditions also make people more susceptible to not getting adequate vitamin D.
Individuals who have small intestinal absorption problems like Crohns disease or Celiac Sprue (wheat gluten allergy) and people with chronic kidney or liver disease are at risk, Page said.
Should you ask your doctor for a vitamin D test?
I dont recommend general screening, Page said. I do test people who have low bone density or osteoporosis or who are in one of the higher risk groups.
If you are tested, know that there is some disagreement among health professionals about what constitutes a normal result.
Most bone experts say a level above 30 is optimal. Others say 20 is the benchmark, Page said. Levels below 20 to 30 increases someones risk for bone problems.
If youre found to be deficient in vitamin D, your doctor may prescribe either prescription or over-the-counter supplements. Page usually puts her patients on 50,000 IU of prescription vitamin D once a week for two to three months, and then retests them.
Then the decision is made if someone can go on over-the-counter supplements or if they should take another round of prescription strength medication, Page said. Once you get to the optimal level, you can switch to OTC supplements.
If you are in one of the high risk groups for vitamin D deficiency or have symptoms that might indicate youre not getting enough of the sunshine vitamin, ask your health care provider for more information.
Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal health care provider.