Vitamin D and Me
Vitamin D is readily available through sun exposure and as a supplement yet there are new reasons to believe we are not getting as much Vitamin D as we need. Vitamin D deficiency can be discovered on a blood test done by your physician and is defined as serum 25-hydroxyvitamin D levels < 20 to 30 ng/mL. Depending on the age group and season we are looking at Vitamin D deficiency can affect 25% to 70% of people.
Why is Vitamin D important? Vitamin D affects not only bone health but deficiency of Vitamin D has been associated with increased risks for some types of cancer, cardiovascular disease, hypertension, musculoskeletal pain, and type 2 diabetes.
What has been learned from recently published Vitamin D studies?
1) A meta-analysis (analysis of a bunch of large studies already published) in the Archives of Internal Medicine 2007 [PubMed ID: 17846391] found that Vitamin D supplementation reduces mortality from all causes in adults and older individuals. These results suggest that for every 150 patients who received Vitamin D supplementation, 1 death was prevented.
2) Breast cancer has also been linked to low Vitamin D levels and pooled data from three trials found that the lower the vitamin D level the higher risk of breast cancer. This relationship was particularly true for people with Vitamin D levels < 20 ng/mL (Carcinogenesis 2008;29:93-9).
Who needs to be worry about Vitamin D deficiency? The elderly (especially those who don't spend much time outdoors), hospitalized patients, kidney patients, patients with GI illnesses or those who have had gastric bypass among others. What has surprised healthcare providers is that in healthy patients with enough sun exposure we are seeing Vitamin D deficiency. Its importance seems more apparent the more research we do.
How do we get Vitamin D? Very few foods contain Vitamin D with the exception of fatty fish and eggs. Fortified foods (foods where vitamin D is added) and the sun are the major sources. Briefly, vitamin D3 is synthesized in skin from exposure to ultraviolet rays in sunshine (cool, huh?). Vitamin D deficiency is caused by unusually low sun exposure combined with lack of vitamin D fortified foods OR malabsorption.
What's the take home message? Vitamin D supplementation is reasonable for people who have, or are at risk for, vitamin D deficiency. Current guidelines recommend 5 to 15 minutes of sun exposure at least twice weekly to the face, arms, hands, or back without sunscreen (yipes) and a daily vitamin D intake of 200 IU for persons 50 years, 400 IU for those 50 to 70 years, and 600 IU for those > 70 years. The new feeling is these recommendations may be too conservative and that daily intakes should be higher. As mentioned above, dietary sources rich in vitamin D are limited to fatty fish and some fortified foods, so the use of a vitamin D containing supplement is a good option. Many calcium supplements now contain vitamin D and I recommend these to my patients. Examples of Calcium + Vit D include: Caltrate, ColonHealth, Chew-Cal, Liqua-Cal, Os-Cal; and for Vitamin D alone, Calcitriol or Rocaltrol are popular options.
Dr O.
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16
For several years I thought I had FM but a specilist ruled that out and after several months discovered I am severly defficent oon vit. D.
The reading was 4.5 after 3 months on prescription Vit D at 1.25 mg I was still at 18.5. I am an outside person and eat a good diet..
My specialit says that my diet ot time in the sun is not the problem,
My question is are there injections for this problem.
ps I can't take over the counter Vit D supplements as I have IC and the supplemments caure a sever bladder burn.
Thanks
Diana
By dwhite352 August 11, 2008 8:51pm
15
I was told by my MS consultant here in the uk, to avoid Vitamin D as it strenthens my imune system.
I know that to be the case so is a strong imune system harnful to one who has MS...?
By jim527 July 6, 2008 11:54am
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EarswithFeet
good to hear about improvement with Vit D..
By DrOrrange June 9, 2008 5:30pm
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Hello Dr. O! I appreciate you publishing this article on Vitamin D. I’m almost 29. About a year a go I was diagnosed with Secondary Hyperparathyroidism. My doctor believes it was caused by malnutrition due to an eating disorder (bulimia). My serum vitamin D level was so low that the lab couldn’t read it. I already have osteopenia. I’m taking 1.25 MG of Vit. D capsules every other day. I never knew how exhausted and sick I was until I started taking the Vit. D and began to feel so much better. The bulimia continues to get in the way of my health (has also caused blindness); however, I’m working hard to recover. I’m glad you posted this article. It’s important for people to know how important this vitamin is!
By EarsWithFeet June 7, 2008 11:48pm
12
Hey Ladywinger: You can ask for a vitamin D level and a Vitamin B-12 level. Those can be drawn in addition to other annual/routine labs.
To wistful347: It has nothing to do with TMJ...but I was asked a vitamin D question by a member in that community..among many others.
Dr O.
By DrOrrange June 4, 2008 2:32pm
11
Interesting and informative, but what does this or any of the other articles have to do with TMJ?
By wistful1347 May 31, 2008 8:14am
10
I recently had my vit.D level checked...I am severely deficient also. I am taking 50,000 IU once a week plus Caltrate 600+D twice a day, (but unlike fruitcup who is taking it for 6 weeks), I am having to take it for 10 weeks then for the next 3 months I will take 1,000 IU daily plus the Caltrate 600+D twice daily. My body evidently has not been absorbing nutrients for maybe 20 or more year, (?because of the celiac). I guess (who knows?) all of this lead to the cancer that I have been fighting for the past two years. I am on a research drug now for the recurrence of the lymphoma. (I was only in remission for 6 months before the recurrence.)
None of my doctors ever checked my vit D level before...I just asked for it a couple of weeks ago when I read an article about vit. D.
I am currently having IVIG infusions every 4 weeks (it has been a year and a half I am doing this). My immune system has been compromised.
I am on steroids for the cancer drug and also the IVIG...I read that vit D should not be given to those on steroids...however, my doctors decided that the pros out weighed the cons at this point.
Dr. Orange are there any other vit. levels I should ask to have run?
ladywinger
By ladywinger May 19, 2008 4:14pm
9
Hi Fruitcup
Thanks for your comment and your history...we'll never know how much of your breast CA was related but its intriguing isnt it?
Dr O.
By DrOrrange May 18, 2008 10:40pm
8
There are conflicting views about vitD and auto-immune diseases. Tests in people with such diseases, show they have very low levels of vit D but high levels of the hormone form - 1,25-dihydroxyvitamin Ds, indicating a rapid conversion by the body. This homone, together with white blood cells which protect cell-wall deficient bacteria instead of destroying them, cause the bacteria to proliferate. Auto-immune diseases cannot be cured till these bacteria are destroyed. Therefore, vit D must be severely limited. see www.marshallprotocol.com/forum2/25... Willemina
By Willemina May 18, 2008 7:35pm
7
Earlier this year my psychopharmacologist suggested I have several blood tests done to learn if any of the levels tested would reveal a deficiency that might be contributing to my major depression. Among them was the Vitamin D test that you mentioned, and although I do not have the results handy, they were extremely low. After being referred to a rheumatologist (after a second D test to confirm the first reading), I have just started a regimen of 50,000 IU once weekly for 6 weeks. Thereafter, I will need to take 1,000 IU of D3 daily , and am now scheduling a bone density test (mine of two years ago was normal). I have always taken calcium with magnesium and Vitamin D, but apparently the D wasn't being absorbed or was insufficient. We did other tests, too, which I can tell you about later, but we're working on D now. (Incidentally, I also was found to have a major B12 deficiency, and took shots for that. Another subject.)
In the summer/fall of 2005 I was found to have ductal carcinoma in situ, stage 0 -- a pre-breast cancer condition. Who knows if my Vit D levels were low then, and if they were a contributing factor to my getting the cancer? My mother had invasive breast cancer, and ultimately died of its metastases to the bones and lung. I did go through genetic testing and was found not to carry the BRCA 1 or 2 mutation, but do have the familial link. Coupled with a probably low Vit D level, I believe my risk for invasive breast cancer is heightened. BTW, I am 51 years old and perimenopausal.
Comments are welcome.
By fruitcup May 18, 2008 2:04pm
6
My 20 y.o. daughter has bipolar disorder. This fall, she had a manic episode, followed by a severe depression. During both of these states, she constantly complained about feeling sick, weak and achey. She said the more the was outside during the day, the sicker she felt. Many were writing this off as hypochonria, or attention seeking whining. (She also, like many, has more trouble in fall and winter than in the summer, as far as moods) She went for a physical, and her doctor ran some tests and found she had a severe Vitamin D deficiency! She started taking 1000 i.u. Vitamin D supplements, as well as building up tolerance to being outside a few minutes a day for a walk. It did not solve all of her mood related issues, but the aches and much of the malaise greatly improved.
By KristinesMom May 16, 2008 6:41pm
5
Hi
Just to make sure that all patients taking Doxycycline are not supposed to get exposure to the sun
Im sure you know this but just in case
By ponder43 May 16, 2008 5:39pm
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Concettah: The new feeling is you should be taking about 1000 IU per day.
Dr O.
By DrOrrange May 16, 2008 1:41pm
3
i AM 50 YRS OLD. FEMALE WITH IBS, AND LACTOSE INTOLERANT HOW MUC VITAMIN D SHOULD I TAKE
By concettah May 16, 2008 1:06pm
2
I was diagnosed with low Vit. D and I discovered the problem myself by reading on the internet. I read about parathyroid and found I had all the symptoms. My dr. did a test and my PTH was low. I was put on Vit D prescription and the pharmacy messed up the prescript. but I was taking 150,000 ius per day instead of 50,000 three times a week!!!! Yes this is true. I had taken it for almost three months with all kinds of weird reactions. One was my desire or craving for milk - I could drink about threequarters of a gallon a day! Anyway I was taken off the Vit.D and now two years later my Vit. D is low again and this time I am taking 50,000 ius three times a week. My Doctor asked me if it was o.k. if I could give my details to researchers and I told her it was fine if it could help research. I presume she gave it to them with my permission. Anyway would just like to let you know some info. about my overdose!!!
By anxiousdaughter May 15, 2008 6:41pm
1
Several studies are now talking about a possible (unproven) connection between low levels of vitamin D and autism (http://autism.healingthresholds.com/research/autism-and-vitamin-d)
- PWSMom (Founder of Healing Autism group)
By PWSMom May 15, 2008 3:42pm