The problem is preventable with an adequate diet and time outdoors. The body naturally synthesizes vitamin D when the skin is exposed to the sun, and milk and certain other foods, including many breakfast cereals, are fortified with the vitamin. But U.S. children increasingly fill up on soft drinks at the expense of milk, and spend more time in front of the TV or computer than outdoors.
Vitamin D
information regarding recommended daily dosageSources of vitamin D
Vitamin D also is found in fortified milk and oily fish, but it’s hard to get
enough just from diet. Sunlight is the biggest source of vitamin D, which is
needed for strong bones. Studies have linked high levels of vitamin D in the
blood to lower risks of a variety of
cancers.
Which form of vitamin D to
use
Vitamin D2 or vitamin D3?
Rev Med Interne. 2008 April. Mistretta VI, Delanaye P, Chapelle JP,
Souberbielle JC, Cavalier E. Service de chimie médicale, CHU de Liège,
université de Liège, domaine du Sart-Tilman, 4000 Liège, Belgique.
Nearly one billion people around the world are deficient in vitamin D and need
to be supplemented. Vitamin D is available in medicines and fortified foods. It
is available in two forms: vitamin D2 ( ergocalciferol ) and vitamin D3 (
cholecalciferol ). Several studies have showed that serum level of 25(OH)D is
increased more effectively with vitamin D3 than vitamin D2. Vitamin D2 has
shorter plasma half-life and a lower affinity for the vitamin D binding protein,
the hepatic vitamin D hydroxylase and the vitamin D receptor. Vitamin D2 should
not be regarded anymore as suitable for supplementation or fortification.
Currently though, it is still the most used in some countries such as Portugal
and Australia.
Pancreatic cancer benefit
Taking a Vitamin D supplement may reduce
the risk of fatal pancreatic
cancer. Vitamin D has shown benefit in preventing and treating
several types of cancer. Regions with greater sunlight exposure have lower
incidence and mortality for prostate, breast, and colon cancers. Harvard
University researchers reviewed data and found that people who took Vitamin D, 400 IU a day
had a lower risk of pancreatic cancer. Those who took doses of
less than 150 IU per day had a 22 percent reduced risk of cancer. Taking
more than 400 IU a day did not reduce the risk any further.
Vitamin D and telomere
length
Vitamin D is a potent inhibitor of inflammation and reduces turnover rate of
leukocytes (white blood cells). Leukocyte telomere length is a predictor of
aging-related disease and decreases with each cell cycle and increased
inflammation. Higher body vitamin D concentrations, which can be achieved
through sunlight exposure, diet, and vitamin D supplements, are associated with
longer leukocyte telomere length, which indicates vitamin D has an influence on
aging and age-related diseases.
Vitamin D deficiency
Vitamin D deficiency is widespread in many locations in the USA. Vitamin D
deficiency is particularly prevalent in the elderly and may cause osteoporosis,
increased risk of cancer, and altered glucose and lipid metabolism. Increasing
evidence strongly supports the benefits of vitamin D supplementation and also
reveals that present recommendations are inadequate, especially for older
individuals. Physicians should consider prescribing vitamin D supplements at
least 400 to 600 international units (IU) per day - to all elderly patients.
Oral vitamin D supplements at that level is inexpensive, safe, and effective,
and has great potential to improve the quality of life of the elderly.
Vitamin D and atorvastatin
statin drug
It appears that taking a vitamin D supplement reduces atorvastatin levels
but also reduces cholesterol levels, which is a good thing. The effects of long
term use of vitamin D supplements along with statin drugs is not clear.
Effects of Vitamin D Supplementation in
Atorvastatin-Treated Patients: A New Drug Interaction With an Unexpected
Consequence.
Clin Pharmacol Ther. 2008 August. Schwartz J. [1] 1The Jewish Home of
San Francisco, Department of Research, San Francisco, California, USA [2]
2Division of Clinical Pharmacology, Department of Medicine, University of
California, San Francisco, California, USA.
The objective of this study was to determine vitamin D supplementation effects
on concentrations of atorvastatin and cholesterol in patients. Sixteen patients
(8 men, 8 women; 10 Caucasians, 4 African Americans, 1 Hispanic, 1 Asian), aged
63 +/- 11 years on atorvastatin (45 +/- 33 mg/day) were studied with and without
supplemental vitamin D (800 IU/day for 6 weeks). Levels of vitamin D
(1,25-dihydroxy(OH) and 25 OH-metabolites), atorvastatin (parent, OH-acid
metabolites, lactone, and lactone metabolites), and cholesterol (total,
low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL)
cholesterol) were determined at 0.5, 3, and 10 h after dosing. Vitamin D
supplementation increased vitamin D-25-OH metabolites without increased
1,25-dihydroxy vitamin D. Atorvastatin and active metabolite concentrations as
well as LDL-cholesterol and total-cholesterol levels were lower during vitamin D
supplementation. The conclusion of the study is that vitamin D supplementation
lowers atorvastatin and active metabolite concentrations yet has synergistic
effects on cholesterol concentrations.
Vitamin D summary
During the past few decades, major advances have reported the importance of
vitamin D on the bone metabolism and other health benefits. Adequate vitamin D
reduces the risk of non vertebral fractures, improves neuromuscular function. A
possible role of vitamin D has been implicated in the reduction of mortality, of
non-skin cancers, of the risk of infections, of inflammatory diseases, of
cardiovascular diseases and maybe osteoarthritis. Serum vitamin D level is
influenced by several factors (skin vitamin D production, fat mass, dietary
sources, UV-B exposure, latitude).
Scientific Experts Call For
Increased Vitamin D UL
2007-01-22 - Council for Responsible Nutrition
Newly-Published Risk Assessment Supports Safety of Higher Intakes Needed to Reap
Additional Health Benefits—
WASHINGTON, D.C., January 22, 2007 — Four nutrition experts, including two
Council for Responsible Nutrition scientists and two of the world’s pre-eminent
vitamin D researchers, are urging the Food and Nutrition Board (FNB) to raise
the vitamin D Tolerable Upper Intake Level (UL) five-fold, based on a safety
evaluation of the latest scientific research that shows this vitamin to be safe
at intake levels much higher than its current UL. John Hathcock, Ph.D., and
Andrew Shao, Ph.D., both of CRN, and Reinhold Vieth, Ph.D., of Mount Sinai
Hospital, Toronto, and Robert Heaney, M.D., of Creighton University, have
co-authored a vitamin D risk assessment using the FNB method and published in
the American Journal of Clinical Nutrition (AJCN) this month (Jan 2007; 85:
6-18). The paper concludes the safety profile of vitamin D should safely permit
raising the UL for vitamin D to 250 µg (10,000 IU) per day from the current UL
of 50 µg (2,000 IU) per day. “The UL established by the FNB in 1997 for vitamin
D is outdated. It is not based on current evidence and is viewed by many in the
scientific community as being too restrictive—limiting research, commercial
development, and optimization of nutritional policy,” noted Dr. Vieth. “An ample
collection of human clinical trial data published since the 1997 recommendation
was made supports a significantly higher UL.” Although many experts have been
calling for a revision of the vitamin D UL in recent years, the AJCN risk
assessment review article is the first to provide a quantitative basis and
recommendation for an actual revised UL value. For the vitamin D risk
assessment, Drs. Hathcock, Shao, Vieth and Heaney considered 21 relevant,
well-designed human clinical trials using a vitamin D dose substantially above
the current range of adequate intake (AI) levels of between 5 µg (200 IU) and 15
?g (600 IU) per day for different populations. Collectively, the absence of
toxicity in these trials conducted in healthy adults that used a vitamin D dose
250 µg (10,000 IU vitamin D3) per day supports the confident selection of this
value as the UL.
Dr. Hathcock noted that the term UL does not suggest that nutrient intakes above
the level identified are unsafe, nor does it constitute a recommended intake.
The UL simply identifies a level of daily intake at which there is no known
toxicity and at which there is sufficient evidence of safety for the nutrient.
The Council for Responsible Nutrition (CRN), founded in 1973, is a
Washington, D.C.-based trade association representing dietary supplement
industry ingredient suppliers and manufacturers. CRN members voluntarily adhere
to a strong code of ethics, comply with dosage limits and manufacture dietary
supplements to high quality standards under good manufacturing practices.
Q. I heard a program that said there's a
"handshake" between vitamins A and D; I'm not clear on what was meant but I took
the meaning to be that more vitamin A should be taken if one takes more vitamin
D. Does this make any sense, and if so, can you clarify what might be meant?
A. It is not clear to us what a "handshake" between vitamins A and
D means. These two vitamins are not too closely related and it is best not to
take too high a dosage of each for prolonged periods.
Q. I've spent too much time searching the web with
no results on how long after taking a vitamin D supplement should someone wait
in order for it to be in the blood in ample supply before sunning for maximum
benefit. Is there an average time period? Say an hour... 3 hours, etc?
A. We are not aware of any need to sun after taking a vitamin D
supplement. The vitamin D supplement already provides the final molecule needed
for its effects, there is no need to expose oneself to sunlight for this
purpose. Sun exposure would help the body form more vitamin D, but we don't see
how it would influence the vitamin D supplement already ingested.
Q. I am taking an
erectile
dysfunction herbal formula, would a vitamin D supplement product interfere
with sexual herbs?
A. We don't see any reason why vitamin E supplements would
interfere with the use of herbs.
Q. I take a
yohimbe
bark supplement twice a week, will this influence a vitamin D dosage of 400
units a day, any information would be helpful.
A. We don't think there would be any interaction.
I have been tested as very low in vitamin D, but
whenever I take it I get extremely depressed, even with small doses. I wondered
if there is an explanation for this, or a way I can take it without this effect.
We have not had this side effect reported to us before on low
dosages.
There is some debate about the most constantly absorbed
form to take - powdered or gel cap and it appears that the gel caps do make a
difference according to Dr. William Davis.
We have not seen any comparison studies as of August 2009.
As a lay person, I read lots of books and articles on
nutrition. I have read three books on vitamin D, plus a bunch of articles. The
first book I read was The Vitamin D Cure by James Dowd. His big thing is getting
people to take Vitamin D and Magnesium. He had excellent luck with that for many
of his patients. Then I read The Vitamin D Revolution by Soram Khalsa, and just
recently I read The Vitamin D Solution (just released) by Michael Holick.
Michael Holick is widely regarded as the foremost researcher on Vitamin D in the
world, and his book for lay audiences is an important contribution. I also noted
that T. Colin Campbell, in his landmark tome The China Study, spoke highly of
'activated Vitamin D', and its value throughout the many systems of the human
body. In particular, one would benefit a lot by reading Holick's book. The
simple fact, as pointed out by Holick, is that very few people in the US these
days gets any vitamin D from sunshine, because they are all scared from the
media attention to the harm of the sun, i.e. possible skin cancer. Holick points
out that with modern sunscreen on, you are not going to get any vitamin D. So
now nearly everyone is deficient, even if they live in southern latitudes, and
even if they go outdoors sometimes. Most people get almost no sun exposure over
any extent of their body. Holick's estimate of safe upper limits is based partly
on how much people get from sun exposure, which I think is a legitimate basis,
even though sun-derived vitamin D is better stored and released in different
ways than that from diet. He also claims that you should try to maintain a blood
level of 30 ng/ml vitamin D or more, up to 50 ng/ml, and his basis for those
numbers can be reviewed, but it is broad. He points out that, without sun, you
will not get above 20 ng/ml with just 1000 iu vitamin D per day. Another
interesting book that sheds some light on the subject, and on another vital
supplement area, is Mildred Seelig's book The Magnesium Factor. I call her 'Ms
Magnesium', since she has devoted her professional career to studying its
effects in human physiology. She points out that the great majority of first
world people are deficient in magnesium. She discusses the importance of
maintaining proper magnesium status to control cholesterol and for proper
utilization of vitamin D and calcium. People will have less risk of vitamin D
toxicity or calcification if they are up to snuff on their magnesium, plus they
probably will not need as much vitamin D if other nutrients such as magnesium
are in the right ranges. I guess my feeling is that people need to keep ALL of
their nutrients up in some semblance of a decent range. Because their diet is
thoroughly skewed toward severe imbalances of many nutrients (too much sodium,
not enough potassium, magnesium, zinc, chromium, etc.), people need to be told
to not get too myopic about just one nutrient, but keep them all in a decent
range. One of the problems with all of the 'double blind studies' that is rarely
pointed out, is that the people in the study are all eating atrocious diets, and
their systems are very skewed from something that might be considered ideal.
Such people really need all of their nutrients to be brought into some sort of
decent range, rather than just boosting one by itself, which is still an
imbalance. Ms. Seelig points out that improving the status of one mineral when
certain others are quite low can aggravate the body condition. Balance is
important. So recommending a 'correct dose' of one thing when the individual may
be severely deficient in a number of other things, is problematic. My own
experience was positive (better energy) when I upped my vitamin D intake to
using 1000 iu D3 pills once or twice per day, plus an A & D fish oil pill that
gives another 400 iu of D. I continue to do this, plus I am now trying to get
some sun exposure. Even though I keep in pretty good health for a 60-year-old, I
must have been somewhat deficient in vitamin D, since I felt a little better
when I added in the new dosage. This stands to reason, since I get almost no sun
ordinarily, and I avoid milk. So, anyway, I appreciate what you are doing, and I
hope that you will continue to educate yourself and help people see how to
improve their health through better diet, some supplements, exercise, stress
relief, etc. Overall, my feeling is that the evidence that Vitamin D is vital to
pretty much every system in the human body is overwhelming, and that nearly
everyone is at least somewhat deficient. So they need to take more, or better
yet, get some sensible sun exposure.