VITAMIN D DEFICIENCY AND TREATMENT
Vitamin D Deficiency
Vitamin D deficiency is a growing concern and may be more frequent than you think. To make matters worse, unlike other conditions, the damage to your bones often goes unnoticed until it is too late. Studies have indicated that up to 60% of nursing home residents and 57% of patients in hospitals are deficient in Vitamin D.
But Vitamin D deficiency is also a problem among the younger and healthier populations. Studies done in Boston not long ago determined that 2 of 3 adults had insufficient vitamin D levels by the end of winter (we get a significant amount of Vitamin D from the sun).
Why is Vitamin D deficiency so serious? Here is part of the answer: we need vitamin D to help maintain a proper level of calcium in our blood. When we are low in Vitamin D, we cannot absorb enough calcium and our body begins to take calcium AWAY from our bones and into our blood. This weakens our bones over time and can lead to osteoporosis.
Not only does deficiency in Vitamin D cause bone loss, but it is also an underlying cause in many cases of otherwise unexplained muscle and bone pain. A study at a Minnesota Hospital looked at over 150 patients complaining of muscle pain and bone ache. The reviewers discovered that 90% of these patients were severely deficient in Vitamin D.
Vitamin D is essential for the function of many different cells and organs as well. It plays a role in insulin production, regulation of blood pressure, heart disease and possibly cancer prevention. It is hard to over-estimate the importance of maintaining adequate levels of Vitamin D.
The SUNSHINE Vitamin
Vitamin D has earned the nickname: "The Sunshine Vitamin" due to the fact that the radiation from the sun converts substances in our skin (specifically a precursor to cholesterol) into Vitamin D3.
The other source of Vitamin D (known as Vitamin D2) comes from food. Food sources tend to have only minimal amounts of Vitamin D, thus the "sunshine" tends to be our primary resource for Vitamin D.
WHAT CAUSES VITAMIN D DEFICIENCY?
Vitamin D deficiency may be due to several reasons.
Infants fed only breast milk may have lower levels of Vitamin D, since Vitamin D is only poorly absorbed into breast milk. Supplementation with vitamin D for breast-fed infants after 2 months of age is generally recommended.
For adults, the most common cause is limited sun exposure. The sun promotes the production of Vitamin D in our skin, which then supplies the Vitamin D to our body. Too little sun exposure, sometimes due to the use of sunscreens, can create a vitamin D deficiency in our body.
Other causes of Vitamin D deficiency include intestinal surgeries leading to poor vitamin D absorption and certain prescription medications (phenytoin, phenobarbital and rifampin are examples).
Quality Vitamin D Sources
TREATING VITAMIN D DEFICIENCY
The easiest approach to treating Vitamin D deficiency is to use a vitamin D supplement. Such supplements are available OTC (over the counter) and by prescription. Questions arise when asked about the optimal "dose" of vitamin D though. There is a broad range of "safe" doses. Overdose and toxicity are rare.
50,000IU once a week for 8-12 weeks is a fairly standard approach refilling our Vitamin D supply.
After 3 months it is recommended that Vitamin D level be checked again (this can only be done by a blood test at your physician's office). The goal is generally to reach 30-50ng/ml of active Vitamin D.
Choosing a Vitamin D Supplement:
When purchasing a vitamin D supplement from the vitamin section of the pharmacy, you will be confronted with the choice of Vitamin D2 or Vitamin D3 (or a blend of both). Which Vitamin D supplement is best? I recommend choosing Vitamin D3 (also called "cholecalciferol). Here are my reasons:
- Vitamin D3 is identical to the Vitamin D that our bodies produce through exposure to the sun.
- Vitamin D3 is more stable and will enjoy a longer shelf-life.
- Vitamin D3 is more potent, due to the unique way it binds to circulating proteins.
Important Note: Treating Vitamin D deficiency is a little different than treating other conditions. Vitamin D deficiency is sort of like having an empty (or nearly empty) Vitamin D bucket in your body. Therefore, the only difference between taking 50,000IU once a week, or 10,000IU once a day, or 5000IU daily or 2000IU daily is simply (in most cases) how "fast" you will fill up that empty bucket. There are limits. Toxicity may be a concern with doses of 50,000IU daily for extended lengths of time for some patients. Also, OTC supplements that contain much smaller doses (like 400IU or 800IU) may take far too long to "fill up" your Vitamin D bucket, or would require taking too many tablets for convenience.
Vitamin D Units: You may notice that Vitamin D products typically express their "strength" in terms of IU (International Units). In order to convert mg to IU you need to know that 1mg of Vitamin D is equal to 40,000IU.
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