Is vitamin D a miracle vitamin? Find out

What are the consequences of “national and global” Vitamin D deficiency?

Bones

• In Pregnancy: fetal growth problems for the fetus
• Childhood: Lack of calcium in the skeleton (if very low, rickets; if insufficient, future low bone mass and osteoporosis).
• Adults: Osteomalacia (soft bone and bone pain) Note: This may cause chest pain and bone pain in individuals diagnosed with fibromyalgia, chronic fatigue and even depression.
• Osteoporosis:  47% of women and 22% of men over the age of 50 will have an osteoporotic fracture in their lifetime. Adding 800 units of D3 daily for 3 years together with 1200 milligrams of calcium decreases fracture rates by as much as 26% (but if calcium is given with less D, there is little or no improvement).

Cancer

Hodgkin’s Lymphoma: People living at higher latitudes (with less UVB radiation from the sun) are at increased risk for this type of cancer as well as prostate, ovarian and breast cancer. Blood levels of 25-hydroxy vitamin D below 20ng/ml are associated with a 30-50% increased risk of these cancers and higher mortality. (The Nurses’ Study of 32,826 women showed that increasing Vitamin D to 39.9 ng/ml decreased the risk of developing colon/rectal cancer by 50% and conversely, if they had very low D (less than 12ng/ml), their risk for this cancer increased 253% during 8 years of follow-up. Studies have also suggested similar decreased risk of breast cancer in women with high D levels.

Diabetes: Living at higher latitudes increases the risk of Type 1 diabetes. In a study from Finland of over 10,000 children, adding Vitamin D during pregnancy together with 2000 units daily during the first year of life decreased the risk of Type 1 diabetes by 80% over 31-years of follow-up. Another study has shown that combining daily doses of 1200 milligrams of calcium and 800 units of D decreased the risk of Type 2 diabetes by 33%.

Cardio-vascular disease: Again, living at higher latitudes has been linked to an increased risk of hypertension and diabetes. Is this also due to D deficiency? ...Perhaps to some extent; one study showed that when hypertensive individuals were exposed to ultraviolet B radiation three times a week for 3 months, their blood pressure went down. (If you are hypertensive don’t go off your medication and try this on your own!)

Schizophrenia and depression: An association of low D has been shown. Perhaps D in the womb is important for brain development and functions later in life.

Muscle weakness: Skeletal muscles require D for maximum function. Increased D levels have been shown to improve performance, speed and strength of certain muscles. Supplementing 800 units daily also helps the elderly maintain their balance. (Nursing home residents decrease their falls on 800 units of D and 1200 mg of calcium, but not when they receive only 400 units of D with the calcium).

Immune reaction: When blood levels of Vitamin D are under 20ng/ml certain immune reactions just don’t happen. (This gives credence to a theory that Vitamin D deficiency increases risk of tuberculosis in black Americans who are more likely to have D deficiencies because of the pigmentation of their skin and their diminished absorption of UVB rays.)

How Do We Get Our D?

Natural sources                               Vitamin D Content

Salmon, fresh/wild 3.5 ounces           600-1000 units of D

Fresh farmed salmon 3.5 ounces       100-250 IUs of D

Canned salmon (3.5 ounces)              300-600 IUs of D

Sardines, canned (3.5 ounces)           About 300 IUs of

Tuna, canned (3.6 ounces)                230 IUs of Vitamin D

Cod liver oil (1 teaspoon)                  400-1000 of Vitamin D

Egg yolk                                    About 200 IU’s of Vitamin D

Fortified foods

Fortified milk                               About 100 units/8 ounces Vitamin D

Fortified orange juice                    About 100 units/8 ounces Vitamin D

Fortified breakfast cereals              About 100 IUs/serving, Vitamin D

Supplements

Prescription                                   Vitamin D2, 50,000 units/capsule

Over the counter multi-vitamin          400 IUs (usually D3)

Vitamin D3                                     400, 800, 1000 and 2000 units

How Much Should We Get?

Although the RDA (recommended daily amount) is only 400 IUs for adults and 600 for those over seventy, this may not suffice to prevent a Vitamin D deficiency.

Prevention of Vitamin D Deficiency

Group                                                Prevention Measures         

Breastfeeding infants                            400 units of D3 daily

                                                       1000-4000 units of D/day is safe

Children with inadequate sun
exposure or dark skin                        400-1000 units of Vitamin D, Sensible sun exposure

Adults with inadequate sun exposure/over 50   Supplementation with 800-1000 units of D3/day or

Or over 50                              50,000 units of D2 every 2 to 2 weeks, Sensible sun exposure

Pregnant or lactating women             1000-2000 units of Vitamin D3/day, 50,000 units of D2 every 2 or weeks

Obesity                                      1000-2000 units of D3 a day or 50,000 units of D2 every 1, 2 or 4  Weeks

(Condensed from the New England Journal of Medicine - 353:3)

What is Sensible Sun Exposure?

5 to 10 minutes of direct sunlight between 10AM and 3PM (depending on the season, latitude and skin sensitivity) on the arms and legs without sunblock. This gives the equivalent of up to  3000 Units D which is stored in body fat and released over time.

Should We All Get Our Vitamin D Level’s Checked?

It’s expensive; and the current recommendation is simply to assume that your level will be okay if you consume proper amounts of D or get it through sun exposure. I have, however started to check some of my patients who have low bone density or whom I feel are “at risk”. I council them on the need for supplemental doses of D and/or limited sun exposure.  I did check my own Vitamin D level and was relieved to see that it was an adequate 32 ng/ml. (I have taken D with calcium for years). 

After considering all the evidence, I also go outside on weekends (easy, I live in Southern California) for 10 minutes without smearing sunscreen on my arms and legs. This should keep me in good “D stead”.

Your Health with Judith Reichman  | More Worried about post-baby weight gain? Don’t be If you eat well and stay active, avoiding the extra pounds is pretty simple. Dr. Judith Reichman shares some helpful hints on how to stay slim. Can a DNA home test help predict your health? Beyond contraception: 6 benefits of the pill What women can do to stop hair loss Dealing with labor pain: 4 ‘natural’ options

Dr. Judith Reichman, the TODAY show’s medical contributor on women’s health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, “Slow Your Clock Down: The Complete Guide to a Healthy, Younger You,” which is now available in paperback. It is published by William Morrow, a division of HarperCollins.

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.

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