Vitamin D

[spaceneedle]

I've recently been diagnosed as being seriously vitamin D deficient.

There is a blood test now that can measure vit. D and mine was at 1/3 the level it should be.

I am now on 50k units of RX vit. D once a week for six weeks until it can be rechecked.

Apparently this is a big problem in this region.

Anyone else have this problem?

[Deleted]

I am always amazed when this sort of thing happens, because I automatically assume that people in developed countries eating a relatively balanced diet and engaging in a few healthy activities (like walking around) could not possibly have any vitamin deficiencies. Vitamin gobblers like my brother fascinate me, as does the whole culture of '1-a-day' multi vitamins, as though we were all on a 17th century sailing ship and suffering from scurvy.

However, I have never really bothered to read anything about this, which leaves two possibilities:

1. I am hopelessly misinformed/underinformed about health issues.

or

2. The manufacturers of these products are taking us for a ride.

Are you a native of 'Rain Country' SN, or did you move there? I would think that the natives of the area would have completely adapted to local conditions, with their bodies automatically finding alternate ways to get vitamin D, while transplants might more easily suffer from deficiencies such as you describe.

[spaceneedle]

K2,

I am a transplant from sunnier climes, so I fully subscribe to your theory.

My doctor explained that we have been so conditioned to protect against sun exposure, that although we are greatly reducing our skin cancer rates, we are also depriving ourselves of much needed vitamin D in the process.

This is also true for me. I spent my entire childhood and part of my young adult years on beaches with a surfboard and no sunscreen. I have been a fanatic about sunscreen since my late 20s and a skin cancer scare a couple years ago has reinforced that.

I also drink a lot of milk, so this is all very odd. I have been very tired recently and apparently this is also a symptom of this problem. And to think, I thought it was old age.

Feb 19, 2010 10:01:58 GMT kerouac2 said:

I am always amazed when this sort of thing happens, because I automatically assume that people in developed countries eating a relatively balanced diet and engaging in a few healthy activities (like walking around) could not possibly have any vitamin deficiencies. Vitamin gobblers like my brother fascinate me, as does the whole culture of '1-a-day' multi vitamins, as though we were all on a 17th century sailing ship and suffering from scurvy.

However, I have never really bothered to read anything about this, which leaves two possibilities:

1. I am hopelessly misinformed/underinformed about health issues.

or

2. The manufacturers of these products are taking us for a ride.

Are you a native of 'Rain Country' SN, or did you move there? I would think that the natives of the area would have completely adapted to local conditions, with their bodies automatically finding alternate ways to get vitamin D, while transplants might more easily suffer from deficiencies such as you describe.

[spaceneedle]

Forgot to mention above, my doctor has been my doc for almost two decades and we are the same age. We found each other when she was fresh out of medical school. When I saw her about the fatigue problem, she told me the vitamin D test was "trendy". Apparently it's new and is being used more frequently. She also said that research is indicating there is a real link between vitamin D deficiencies and mood disorders. I hope that is explored more, because I think the pharma industry and their psychopharmaceuticals in this country are just OUT OF CONTROL.

As for the RX vitamin D, it was very cheap, so I don't think that drug companies are making huge profits on the stuff?

ETA: Here is a good article on the vitamin D thing:

www.womentowomen.com/healthynutrition/vitamind.aspx

[Deleted]

It is very common to have false/positive results on these tests. Lab f- ups occur quite frequently. You may want to have a repeat test if you are really concerned about it.
Yes,mood disorders are very common with vitamin D deficiency,therefore,SAD suffered by many in winter months.

[Deleted]

I am counting on the glow of my computer screen to produce vitamin D.

[bjd]

Didn't Vitamin D deficiency cause rickets? I was born in northern England and as a little kid I remember being given cod liver oil in the winter.

I haven't worried about lack of sun for years now though -- I assume just going outside will be enough. But I don't use sunscreen either.

Kerouac -- this morning I was in a Picard store and they were advertising frozen dietary supplements! I didn't actually stop to read the ad.

[Deleted]

Yes, I noticed that also the other day and hurried by.

[bixaorellana]

An interesting note about vitamin D and sun exposure ~~ if you've been out in the sun, do not bathe for at least a half hour after you come back inside. Apparently you need that time to absorb the vitamin D into your skin.

[spindrift]

Bixa - now that's very interesting. I had no idea this was the case.

[spindrift]

bjd - what sort of frozen nutrients?

[Deleted]

Vitamin D is an interesting one. I have more trouble getting it naturally then some. As it comes from the sun, and I have a tone to my skin, it doesn't get 'through' as easily as with people with white skin. So I take a multi-vitamin every day, just to be sure.

I do get other benefits for having my skin color though, one being that I have a natural resistance to harmful rays of the sun. (A natural sunblock). So the trade off is good.

[bjd]

No idea, Spindrift. I don't take any nutrients that I don't find in food, so didn't bother reading the ad. Next time I go there, I'll try to remember to have a look.

[spindrift]

I would love to have your skin colour Deyana... ;D

[Deleted]

aww..thank Spinny. I must admit I feel lucky to have my color, I've always liked it.

But you have that classic English Rose colouring and all that beautiful blond hair. Just lovely.

[spindrift]

Deyana how kind of you....but I've always felt I'm Asian under the skin....

[lagatta]

bjd, there are some nutrients I have to supplement with pills - especially calcium and magnesium. This is common among women especially, and I'm rather intolerant of cow's milk, though I have freinds who do drink milk and have to take this - there is usually also some vitamin d in the mix, to help absorb the minerals. I'm certainly not a person to take a wide range of supplements, or to take them instead of striving to eat my fruits and veg.

I hitchhiked from France down to Italy years ago with a friend who had milky-white skin and she was miserable indeed.

[existentialcrisis]

I thought it was common knowledge that people who live up north are not able to absorb the vitamin D they need from the sun in the winter months. So I've supplimented with halibut liver oil gels and now just vitamin D pills. I do this to help my mood in these months, and also just in case all these "health benefits" from taking lots of vitamin D are for real.

[bjd]

I don't think taking "lots' of any kind of supplement is a good idea. Either your body will eliminate what it doesn't need, or else it will cause problems because you will have too much of whatever you are taking.

I just found this in an anthropology paper:
"Humans have spent most of their history moving around. To do that, they've had to adapt their tools, clothes, housing, and eating habits to each new climate and landscape. But Jablonski's work indicates that our adaptations go much further. People in the tropics have developed dark skin to block out the sun and protect their body's folate reserves. People far from the equator have developed fair skin to drink in the sun and produce adequate amounts of vitamin D during the long winter months."

[bixaorellana]

I can't really argue the point since I don't have the background, but consider this as a talking point:

Even though it's true that humans have physically adapted over time to their environments, they haven't really had time to completely adapt. Also, many modern humans are not "pure" creatures from that environment. In the US or Canada, especially, you only need to go as far back as your great-grandparents -- or even your parents -- to discover heritage from the Mediterranean, say, on one side and northern Europe on the other, not to mention mixed heritage from non-European areas. A while back there was a diet book written on eating like your ancestors, and the immediate question is "which ancestors?", not to mention "what do I feed my kids?", whose ancestor I am.

Even if you are a completely undiluted product of a particular geographic environment, do you live in that environment or in a completely different continent and/or hemisphere? If you live in the ancestral environment, do you spend all day in an office?

There's also the question of how global environment has been altered -- holes in the ozone layer, sun-refracting pollution particles, air and water carrying ingredients that didn't exist when humans came into being.

If we were truly adapted, you'd never see a wrinkled African or a morose Norwegian.

[traveler63]

Spaceneedle, I had the same thing, virtually no vitamin D in my body. I also had the 50K units but I had to take one a day for a month. AND I live in Arizona!
So, now I am taking 100MG a day of D3. So, I think it may be a problem here too.

[gertie]

That whole thing of the use of sunscreen causing people to not get enough vitamin D was indeed reported heavily in various health mags and several studies were recently done on it, according to some of the medical rags...seems like it was within the last 2 years they were all touting this as a big issue. Probably explains why the doc said it was trendy. I can sort of see how sunscreen would block it, and most adults don't drink enough milk to get their calcium and D from it, or so I've always read. Lot of women are on calcium these days to prevent the lack of calcium in their diet from causing them to have "Dowager's Hump", that big bump old ladies of past generations commonly had on their backs from osteoporosis. I take calcium myself, even though I am not much on taking vitamins.

[bixaorellana]

Here's more on vitamin D deficiency in developed countries:

What Do You Lack? Probably Vitamin D        July 26, 2010, by Jane E. Brody

Vitamin D promises to be the most talked-about and written-about supplement of the decade. While studies continue to refine optimal blood levels and recommended dietary amounts, the fact remains that a huge part of the population — from robust newborns to the frail elderly, and many others in between — are deficient in this essential nutrient.

If the findings of existing clinical trials hold up in future research, the potential consequences of this deficiency are likely to go far beyond inadequate bone development and excessive bone loss that can result in falls and fractures. Every tissue in the body, including the brain, heart, muscles and immune system, has receptors for vitamin D, meaning that this nutrient is needed at proper levels for these tissues to function well.

Studies indicate that the effects of a vitamin D deficiency include an elevated risk of developing (and dying from) cancers of the colon, breast and prostate; high blood pressure and cardiovascular disease; osteoarthritis; and immune-system abnormalities that can result in infections and autoimmune disorders like multiple sclerosis, Type 1 diabetes and rheumatoid arthritis.

Most people in the modern world have lifestyles that prevent them from acquiring the levels of vitamin D that evolution intended us to have. The sun’s ultraviolet-B rays absorbed through the skin are the body’s main source of this nutrient. Early humans evolved near the equator, where sun exposure is intense year round, and minimally clothed people spent most of the day outdoors.

“As a species, we do not get as much sun exposure as we used to, and dietary sources of vitamin D are minimal,” Dr. Edward Giovannucci, nutrition researcher at the Harvard School of Public Health, wrote in The Archives of Internal Medicine. Previtamin D forms in sun-exposed skin, and 10 to 15 percent of the previtamin is immediately converted to vitamin D, the form found in supplements. Vitamin D, in turn, is changed in the liver to 25-hydroxyvitamin D, the main circulating form. Finally, the kidneys convert 25-hydroxyvitamin D into the nutrient’s biologically active form, 1,25-dihydroxyvitamin D, also known as vitamin D hormone.

A person’s vitamin D level is measured in the blood as 25-hydroxyvitamin D, considered the best indicator of sufficiency. A recent study showed that maximum bone density is achieved when the blood serum level of 25-hydroxyvitamin D reaches 40 nanograms per milliliter or more.

“Throughout most of human evolution,” Dr. Giovannucci wrote, “when the vitamin D system was developing, the ‘natural’ level of 25-hydroxyvitamin D was probably around 50 nanograms per milliliter or higher. In modern societies, few people attain such high levels.”

A Common Deficiency

Although more foods today are supplemented with vitamin D, experts say it is rarely possible to consume adequate amounts through foods. The main dietary sources are wild-caught oily fish (salmon, mackerel, bluefish, and canned tuna) and fortified milk and baby formula, cereal and orange juice.

People in colder regions form their year’s supply of natural vitamin D in summer, when ultraviolet-B rays are most direct. But the less sun exposure, the darker a person’s skin and the more sunscreen used, the less previtamin D is formed and the lower the serum levels of the vitamin. People who are sun-phobic, babies who are exclusively breast-fed, the elderly and those living in nursing homes are particularly at risk of a serious vitamin D deficiency.

Dr. Michael Holick of Boston University, a leading expert on vitamin D and author of “The Vitamin D Solution” (Hudson Street Press, 2010), said in an interview, “We want everyone to be above 30 nanograms per milliliter, but currently in the United States, Caucasians average 18 to 22 nanograms and African-Americans average 13 to 15 nanograms.” African-American women are 10 times as likely to have levels at or below 15 nanograms as white women, the third National Health and Nutrition Examination Survey found.

Such low levels could account for the high incidence of several chronic diseases in this country, Dr. Holick maintains. For example, he said, in the Northeast, where sun exposure is reduced and vitamin D levels consequently are lower, cancer rates are higher than in the South. Likewise, rates of high blood pressure, heart disease, and prostate cancer are higher among dark-skinned Americans than among whites.

The rising incidence of Type 1 diabetes may be due, in part, to the current practice of protecting the young from sun exposure. When newborn infants in Finland were given 2,000 international units a day, Type 1 diabetes fell by 88 percent, Dr. Holick said.

The current recommended intake of vitamin D, established by the Institute of Medicine, is 200 I.U. a day from birth to age 50 (including pregnant women); 400 for adults aged 50 to 70; and 600 for those older than 70. While a revision upward of these amounts is in the works, most experts expect it will err on the low side. Dr. Holick, among others, recommends a daily supplement of 1,000 to 2,000 units for all sun-deprived individuals, pregnant and lactating women, and adults older than 50. The American Academy of Pediatrics recommends that breast-fed infants receive a daily supplement of 400 units until they are weaned and consuming a quart or more each day of fortified milk or formula.

Given appropriate sun exposure in summer, it is possible to meet the body’s yearlong need for vitamin D. But so many factors influence the rate of vitamin D formation in skin that it is difficult to establish a universal public health recommendation. Asked for a general recommendation, Dr. Holick suggests going outside in summer unprotected by sunscreen (except for the face, which should always be protected) wearing minimal clothing from 10 a.m. to 3 p.m. two or three times a week for 5 to 10 minutes.

Slathering skin with sunscreen with an SPF of 30 will reduce exposure to ultraviolet-B rays by 95 to 98 percent. But if you make enough vitamin D in your skin in summer, it can meet the body’s needs for the rest of the year, Dr. Holick said.

Can You Get Too Much?

If acquired naturally through skin, the body’s supply of vitamin D has a built-in cutoff. When enough is made, further exposure to sunlight will destroy any excess. Not so when the source is an ingested supplement, which goes directly to the liver.

Symptoms of vitamin D toxicity include nausea, vomiting, poor appetite, constipation, weakness and weight loss, as well as dangerous amounts of calcium that can result in kidney stones, confusion and abnormal heart rhythms.

But both Dr. Giovannucci and Dr. Holick say it is very hard to reach such toxic levels. Healthy adults have taken 10,000 I.U. a day for six months or longer with no adverse effects. People with a serious vitamin D deficiency are often prescribed weekly doses of 50,000 units until the problem is corrected. To minimize the risk of any long-term toxicity, these experts recommend that adults take a daily supplement of 1,000 to 2,000 units.

Link to article above: www.nytimes.com/2010/07/27/health/27brod.html?src=me&ref=general

[bjd]

I heard a report on French radio today about the lack of Vitamin D. The doctor being interviewed said that small children in particular are not getting enough sun and said 5-10 minutes a day of sunshine was necessary. He also said that sunblock should be used on the face, but not everywhere so that sunlight will provide the needed benefits.

I see he said the same thing as in the article Bixa posted.

[bixaorellana]

A beauty-related note here -- you hear so much about protecting your face from the sun, but little mention of how the back of the neck and the V of chest exposed by most women's clothing will suffer wrinkling from sun exposure.

[tod2]

Today on a medical TV talk show we learned that the bone disease called rickets is being found more and more in the children of affluent families - sitting indoors at the computer and TV too much and never going outside to get some sunlight. The poorer children run around in the streets and parks soaking up the very necessary sunlight that helps bones absorb Vt D.

[bjd]

I must be spending too much time in front of the computer! Last week I had a bone density test and learned I have osteoporosis in my back. Had Vitamin D and calcium blood tests done too and am at the lower limits. I have to go see the doctor to see what she says.

[Deleted]

Sounds like some of us could become rich by marketing "vitamins for computer addicts". ("Stay healthy online up to 20 hours a day." "Play games nonstop for up to 72 hours without collapsing.")

We can be rich.

[mich64]

It has already happened here. They actually have a commercial for Vitamin D drops and show that parents should apply a drop on their soothers! Not a parent so not sure about this... but I hope for their sakes that this is not misleading the hype of Vitamin D and their infants risk!

I am sitting in front of my 8 ft. wide patio doors absorbing as much sunshine as I can!

[Deleted]

For all other deficiencies, there is always Red Bull.