MPA | Pharmacy News

By Linda Branoff, C.Ph.T.

 

Have you been feeling depressed, tired and achy lately? Do you have bone pain and muscle weakness? Are you getting a lot of infections? These signs may indicate you should get your vitamin D level checked. Recent research has shown that a low level of vitamin D has been associated with several health issues. Even without symptoms, you could be at risk.

 

Vitamin D deficiency has been linked to cancer, depression, cardiovascular disease, chronic kidney disease, diabetes and severe asthma in children. It is essential for strong bones, and it helps the body use calcium from your diet. vitamin D production is also helpful in protecting older adults from osteoporosis. Cell growth, neuromuscular and immune function and reduction of inflammation are affected as well.

 

Here are just a few things that can contribute to a vitamin D deficiency:

1.       Limited exposure to sunlight - vitamin D is known as “the sunshine vitamin” because it is produced in the body from exposure to sunlight. If you don't spend much time in the sun or are always careful to cover your skin (sunscreen inhibits vitamin D production), you may be experiencing a deficiency.

2.       Not consuming recommended levels of vitamin D – It occurs naturally in a few food sources such as certain fish, fish liver oil and egg yolks. It is contained in fortified dairy and grain products, such as milk, cereal, yogurt and orange juice. Cheese also contains smaller amounts of Vitamin D.

3.       Chronic kidney disease- kidneys cannot convert vitamin D to its active form

4.       Obesity or gastric bypass surgery - Being obese does not affect skin's ability to synthesize vitamin D, but greater amounts of subcutaneous fat seize more of the vitamin and alter its release into circulation. Obese individuals who have undergone gastric bypass surgery may become vitamin D deficient over time without a sufficient intake from food or supplements, since part of the upper small intestine where vitamin D is absorbed is bypassed and vitamin D released into the serum from fat stores may not compensate over time

 

The most accurate way to measure how much vitamin D is in your body is the 25-hydroxy vitamin D blood test. A level of 20 nanograms/milliliter to 50 ng/mL is considered adequate for healthy people. A level less than 12 ng/mL indicates vitamin D deficiency.

 

Treatment for vitamin D deficiency involves getting more vitamin D through diet and supplements. Although there is no consensus on vitamin D levels required for optimal health, and it likely differs depending on age and health conditions, a concentration of less than 20 nanograms per milliliter is generally considered inadequate and requires treatment.

 

Guidelines from the Institute of Medicine increased the recommended dietary allowance (RDA) of vitamin D to 600 international units (IU) for everyone ages 1-70, and raised it to 800 IU for adults older than age 70 to optimize bone health. The safe upper limit was also raised to 4,000 IU. Doctors may prescribe more than 4,000 IU to correct a vitamin D deficiency.

 

Vitamin D toxicity can cause anorexia, weight loss, polyuria and heart arrhythmias. More seriously, it can also raise blood levels of calcium which leads to vascular and tissue calcification, with subsequent damage to the heart, blood vessels and kidneys.

 

References:

  1. WebMD. Vitamin D Deficiency. Webmd.com. http://www.webmd.com/diet/guide/vitamin-d-deficiency#2. Updated May 2016. Accessed December 2016.
  2. U.S. Department of Health and Human Services. Vitamin D: A Fact Sheet for Professionals. National Institutes of Health website. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Updated February 2016. Accessed December 2016. 

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