Vitamin D gets a lot of attention these days. It is printed in bold letters on food labels when we shop for groceries, there is an abundance of vitamin D supplements on the shelves of every store with a health section and many articles have been written in medical journals recently about getting too little or too much of it. The more vitamin D is studied, the more scientists learn that this nutrient may have a larger impact on our health than we ever realized before. There is a lot of information out there about vitamin D. The following is an attempt to summarize and simplify what we know about it.

What is Vitamin D?

Vitamin D, in the truest sense of the word, is not actually a vitamin at all. By definition, vitamins are nutrients that the body cannot make itself. The body requires vitamins from outside sources, like from the foods that we eat. When direct sunlight hits a person’s skin, the body is able to use that sunlight to produce vitamin D. This is why vitamin D is sometimes known as the “sunshine vitamin.” It is also why, vitamin D is less like a vitamin, and more like a hormone. Hormones are chemicals produced by the body, and they control most body functions by influencing many things from our organs to our moods.

Why Do I Need Vitamin D?

It has been proven that vitamin D helps the body use calcium and phosphorus. These two important minerals work together to build strong, healthy bones and teeth. Without the presence of vitamin D, these minerals would not be absorbed in the intestines or reclaimed in the kidneys before being excreted from the body. Without the proper balance of calcium and phosphorus in the blood, bone can become soft, fragile, and misshapen.

When the amount of vitamin D falls below healthy levels in the body, the condition is called vitamin D deficiency. This condition can lead to bone diseases like rickets, osteomalacia, and osteoporosis.

Rickets results from the softening of the bones in children due to the lack of calcium or phosphorus. It is rare in the United States, but it can affect children anywhere in the world when they don’t get enough vitamin D through exposure to sunlight or diet. The disease is most likely to develop in children during their high-growth years, and it commonly leads to severely bowed legs.

Osteomalacia results from the softening of bones in adults. Like rickets in children, osteomalacia is due to the lack of calcium and phosphorus in the blood. Osteomalacia can lead to low bone density and muscle weakness. Affected adults often show no symptoms in the early stages of the disease.

Osteoporosis results from the creation of less bone and the loss of existing bone because of a vitamin D deficiency. The disease causes bones to become thin and brittle. Osteoporosis is one of the leading causes of broken bones in older adults. Post-menopausal women are at a particularly high risk of developing osteoporosis. As with osteomalacia, symptoms of the disease are often unnoticeable in the early stages.

What are Other Health Benefits of Vitamin D?

The health benefits of vitamin D can be divided into two categories:

1. The benefits that have been proven, and

2. The benefits have been observed, but have not been proven beyond doubt.

The first category of benefits is the relationship between vitamin D and healthy bones and teeth. It has been firmly established and proven that vitamin D has an essential role in the body’s use of calcium and phosphorus to build strong bones and prevent bone disease.

However, vitamin D probably plays a role in our health that goes way beyond good bones and teeth. Many other health benefits are likely. Although there is plenty of observed evidence that other health benefits exist, there are not enough studies that can confirm a “cause and effect” relationship between vitamin D and those benefits. Some of the probable health benefits of vitamin D include:

1. Strengthen the immune system

It is likely that vitamin D helps the body’s immune system fight off upper respiratory infections like the common cold or flu.

2. Reduce the risk of heart disease

There is some evidence that vitamin D deficiency can be linked to an increased risk of cardiovascular disease.

3. Reduce the risk of diabetes

There are some studies showing that vitamin D can affect insulin secretion and glucose tolerance, therefore providing a possible benefit in the prevention and management of Type 2 diabetes. A lesser benefit related to Type 1 diabetes also seems to exist.

4. Prevent certain cancers

Some promising study results are pointing to a potential connection between vitamin D and the prevention of colon cancer, ovarian cancer, breast cancer, and prostate cancer. The effect which vitamin D has on regulating cell growth may slow the growth of blood vessels in cancerous tissue, helping to reduce its spread within the body.

5. Treat seasonal affective disorder

Although the possible link between vitamin D and symptoms of clinical depression is still unclear, studies seem to show a hopeful connection between the use of vitamin D supplements to treat individuals suffering from seasonal affective disorder, also known as SAD.

6. Prevent some pregnancy disorders

Vitamin D seems to be helpful in preventing preeclampsia, gestational diabetes, and other pregnancy-related disorders. Studies also point to a possible connection between vitamin D deficiency and an increased risk of delivery complications and health conditions developing in newborns.

In addition to the 6 potential health benefits listed above, promising research indicates possible relationships between vitamin D and:

1. Weight loss

2. Preventing dementia

3. Treating autoimmune conditions such as rheumatoid arthritis and multiple sclerosis

What are the Symptoms of Vitamin D Deficiency?

As mentioned previously, more studies must be completed and reviewed before any of the possible benefits of vitamin D listed in the previous section can be proven beyond doubt. With that being said, however, it is clear that the health benefits of vitamin D should not be taken lightly, and the symptoms of vitamin D deficiency should be checked out as soon as they are noticed.

The early symptoms of vitamin D deficiency may include:

1. Dull pain or ache in the bones of the legs, hips, pelvis or ribs

2. Back pain

3. Joint pain

4. Fatigue

5. Muscle cramps or weakness

6. Headaches

7. Increased occurrences of colds or infections

8. Depressed mood

9. Restless sleep

10. Hair loss

If vitamin D deficiency goes untreated and complications set in, symptoms may include:

1. Intense bone pain or back pain

2. Stress fractures in a bone

3. Stooped posture

4. Difficulty walking

5. Loss of height

6. High blood pressure

7. Obesity

Some risk factors associated with vitamin D deficiency include:

1. Old age

The older you get, the more vitamin D your body requires and the higher your risk of vitamin D deficiency grows. This is especially true for women after menopause.

2. Living too far north

When direct sunlight hits your skin, your body is able to use the sun’s ultraviolet B (UVB) rays to manufacture vitamin D. In the southern states of the United States, when the sun’s rays are the strongest between 10:00 am and 2:00 pm, you only need 10 – 15 minutes of exposure a day, for three days per week for your body to make the vitamin D you need. If you live in a northern state, you may not be able to get enough vitamin D from the sun regardless of how much exposure you have to sunlight, because the UVB rays are not strong enough at that latitude. This is especially true in the winter months.

3. Limited exposure to sunlight

Working indoors, being active at night rather than during the day, wearing long clothing or being homebound for any reason will limit your exposure to sunlight and reduce the amount of vitamin D your body can produce.

4. Dark skin

The more melanin your skin contains, the darker its color appears. Darker skin cannot convert direct sunlight into vitamin D as effectively as skin with less melanin.

5. Sunscreen use

Extended exposure to sunlight can lead to skin cancer and permanent skin damage. Therefore, the use of sunscreen is recommended by all doctors. The use of sunscreens, however, will block the rays used by your body to make vitamin D. Even so, it is preferable to depend on diet and supplements to meet your vitamin D requirements rather than run the unnecessary risk of prolonged and frequent exposure to your skin to the sun.

6. Breastfeeding

Infants who are breastfed only and are not receiving any fortified formula in their diet are at risk of not getting enough vitamin D.

7. Diet restrictions

If you have a milk allergy or lactose intolerance; or if you eat a vegan or vegetarian diet, you are at a higher risk of having a vitamin D deficiency.

8. Certain diseases and medical conditions

Certain conditions that make it difficult for your body to digest and absorb dietary fat, liver disease or kidney disease all increase your risk of vitamin D deficiency. Research is showing that obesity, having a body mass index (BMI) over 30, also increases your risk.

How Much Vitamin D Do I Need daily?

There are basically 3 ways to get vitamin D: food, sunlight, and supplements. Many people are not able to get enough vitamin D from sunlight, so it is necessary to eat a healthy diet consisting of foods that are natural sources and foods that are fortified with vitamin D.

The amount of vitamin D your body needs from your diet depends upon your age. The most recent recommended dietary allowances (RDA) are below:

RDA for ages 0 to 12 Months – 400 IU (10 micrograms or mcg)

RDA for ages 1 to 70 Years – 600 IU (15 mcg)

RDA for ages 70 and up – 800 IU (20 mcg)

There is no difference between the RDA for men or women, nor does the RDA change for women who are pregnant or breastfeeding.

What Foods Contain Vitamin D?

There are very few foods that contain vitamin D naturally; but in the United States, the nutrient is added to several fortified foods. Therefore, getting plenty of vitamin D from your diet is possible for many. Foods that are natural sources of vitamin D include:

1. Fish with high-fat content like salmon, trout, tuna, swordfish, mackerel, and sardines

2. Shrimp

3. Beef liver

4. Eggs

Foods that are often fortified with vitamin D include:

1. Milk

2. Orange juice

3. Yogurt

4. Breakfast cereal

5. Margarine

If you are not able to get all the vitamin D your body needs from sunlight or diet, your doctor can determine whether or not you have a vitamin D deficiency by a simple blood test. If your test results indicate a deficiency, your doctor might suggest further tests to determine the density of your bones.

Many people take vitamin D supplements that are readily available. One supplement that’s been around for a long time is cod liver oil. One teaspoon of cod liver oil contains 1,360 IU of vitamin D. For those who prefer their vitamin D in pill form, there are many options. Remember to always discuss a supplement with your doctor before taking it. Your doctor will want to make sure you are not getting too much vitamin D because that can cause health problems too.

How Can Centric Healthcare Help?

Medication Therapy Management

If you suffer from any number of conditions that require you to take medications that put you at risk of vitamin D deficiency, or if you have already been diagnosed with a deficiency and are currently taking vitamin D supplements, Centric Healthcare can help. We offer Medication Therapy Management (MTM) services that are coordinated with your pharmacist to help optimize the therapeutic outcome of each medication prescribed to you. MTM services help you or your caregiver to understand each medication you are taking, to know how and when to take your medication properly, to understand the possible side effects of the medication and to help you understand possible interactions with other medications or supplements you are taking.

Medical Nutrition Therapy

Eating healthy is important to ensure that you are getting enough vitamin D in your diet. Centric Healthcare offers Medical Nutrition Therapy (MNT) services that can help. A Registered Dietician can help you design a nutrition program that is tailor-made for you. When helping you make a plan, we will take into account factors such as your medical history, your current health needs, your dietary restrictions, and many others. Through the MNT services offered by Centric Healthcare, you can make better food choices, eat healthier portions and learn delicious ways to enjoy a healthier lifestyle.