Sep 17, 2019Home Health Comments

Do You Have Enough Vitamin D?

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Prevent Vitamin D Deficiency

An estimated 1 billion people are vitamin D deficient. Just how much vitamin D is required? It seems like a simple question but few among the population know the answer. This is largely because professional guidelines for nutrition vary. Hence, doctors practicing at different facilities have inconsistent recommendations.

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How To Measure Vitamin D

There is a difference between the recommended daily allowance (RDA) and the optimum level found within our blood stream. Vitamin D RDA is 400–800 IU/day, or 10–20 micrograms. However, some studies suggest that a higher daily intake of 1000–4000 IU (25–100 micrograms) maintains optimal blood levels.

Labs use one of two measuring standards so 40–80 ng/mL is equivalent to 100–200 nmol/L. Some say normal range within the blood stream is 40–80 nanograms per milliliter (ng\mL). Other experts say 20 ng/mL (50 nmol/L) is sufficient. In the New England Journal of Medicine, several of the leading epidemiologists and endocrinologists who were on the original Institute of Medicine (IOM) committee now say deficiency is evident below 12.5 ng/mL (31 nmol/L), affecting about 6% of Americans. Still others debate the significance of vitamin D in overall health. In this article sifts through the debate to extract useful information from several notable sources.

There are two forms of vitamin D: D2 and D3. Vitamin D2 (ergocalciferol) comes from fortified foods, plant foods, and supplements. Vitamin D3 (cholecalciferol) is derived from fortified foods, animal foods, supplements, and can be internally generated when exposing skin to ultraviolet (UV) radiation from the sun. Because malabsorption can hinder supplementation, it is wise to establish gut health while having vitamin D levels tested.

Vitamin D Sources

Fatty fish and sunlight are the two most abundant sources of natural vitamin D. Going beyond these, there is a sharp decline. In North America, milk (dairy), some milk substitutes, breakfast cereals and some orange juices are fortified with vitamin D. The larger population of the earth are more reliant upon non-fortified nutrition and sunlight.

High Sources of Vitamin D

Salmon
Sardines
Cod liver oil
Mackerel
Canned tuna
Oysters
Shrimp
Egg yolks
Liver
Mushrooms
Tofu
Cheese

Nutritional amount varies according to quality of food, portion size, and preparation method.

Who Is At Risk?

Given, the number of animal sources, vegans and people who are lactose intolerant are likely to have low levels of vitamin D within their blood. Since melanin blocks UV rays, dark-skin people, those who cover themselves with sunscreen, or those housebound do not absorb much vitamin D from the sun. Lupus patients are photosensitive so are at risk for deficiency. Children with type 1 diabetes have a higher incidence of vitamin D deficiency compared than the general population.

There are so many imposed food restrictions that many people are malnourished.

Vitamin D deficiency is common in patients with Alzheimer’s disease, Parkinson’s disease, schizophrenia, depression, anxiety disorders and dementia. Also included are people with anorexia nervosa, people who have had gastric bypass surgeries, or who suffer from other malabsorption syndromes like celiac sprue. Perimenopausal women, people diagnosed with osteopenia (reduced bone density, but not osteoporosis) and osteoporosis, or other skeletal disorders, as well as pregnant and lactating women should have vitamin D blood levels screened.

September 3, 2020 – A cohort study of 489 patients by David O. Meltzer, MD, et al. suggests that having a vitamin D deficiency may increase your likelihood of testing positive for the COVID-19. —JAMA

Symptoms of Low or High Vitamin D

How do you know if your vitamin D is too low? When deficient, the following symptoms may be evident:

Vitamin D Deficiency Symptoms

Chronic bone pain
Depression
Frequent sickness
Fatigue
Fragile Bones
Gut issues
Hair loss
Head sweating
Slow healing wounds
Weakness

Rickets is a bone disorder caused by a deficiency of vitamin D, calcium, or phosphate. Going to the other extreme for a moment, vitamin D toxicity is possible, rare though it may be. It can occur when levels in blood rise above 150 ng/mL (375 nmol/L). This could lead to kidney malfunction, gastrointestinal problems, fatigue, and confusion. So patients are not advised to take high doses for longer than prescribed.

Treatment for Low Vitamin D

While we know vitamin D levels can be too low or high, consensus on these two thresholds is subject to interpretation by the treating physician. It is generally safe to say that 12 ng/mL (30 nmol/L) and below requires intervention. With some latitude, most doctors are satisfied with a patient’s range between 20–40 ng/mL (50–100 nmol/L), though the higher range is probably better.

Do You Have Enough Vitamin D?
To correct extremely low levels of vitamin D, doctors prescribe high doses of the vitamin.

The clothing we wear, local weather, pollution, sunscreen use, weight and genetics may affect our body’s ability to absorb and produce vitamin D. Assuming there are no malabsorption issues, you can restore proper nutrition with prescription-strength supplements.

It is generally safe to say that 12 ng/mL (30 nmol/L) and below requires intervention.

The American agricultural society declined about a century ago. Today, most people are not farmers. Healthy eating was first replaced by the convenience of canned food. Today, fast junk food abounds. In an attempt to remain healthy, people impose many consequential food restrictions and dining habits. Among the self-imposed dietary restrictions are ketone diets, carbohydrates-free diets, veganism, and medically prescribed gluten-free or egg-deficient diets. So malnutrition in varying degrees is more common.

If your vitamin D level concerns you, speak to your doctor. A blood test called the 25(OH)D can determine if it is an issue. A treatment plan to help you be A Bit More Healthy follows. Then strive to improve nutrition with non-processed foods.