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Vitamin D - The Untold Story

The importance of vitamin D and its role in health is underappreciated by most of us - clinicians and patients alike. More importantly, by following recommendations to avoid sunlight and wear sunscreen, we block the way our body gets 95% of its vitamin D - from the midday sun. While we may be aware of vitamin D's role in absorbing calcium and keeping bones strong, many of us are not aware that chronic deficiency over time may also be related to hypertension, diabetes, immune disorders, chronic pain, winter depression, and cancer.

The only natural source of vitamin D is in oily fish, such as salmon or mackerel, or in cod liver oil. Milk, bread and cereal may be "fortified" with vitamin D but in low amounts. But even if you take a multivitamin, the recommended daily amount (RDA) for vitamin D is way too low: 200IU/d for children and young adults and 400 IU/d for men and women over age 50. It is now felt that a minimum of 1000 IU/d is needed.

Most Americans are significantly deficient in vitamin D, especially those of us who live at northern latitudes (less ultraviolet B radiation) or who are darkly pigmented as is the case with Hispanics and African-Americans. In a large study of over 15,000 adults, deficiency was highest among women and minority populations; but even 34% of white males were deficient. Furthermore, gluten sensitivity, or wheat allergy that causes Celiac Disease (which may be asymptomatic) is very common and can lead to malabsorption of vitamin D.

People with vitamin D deficiency have been found to have:

• Higher incidence of cancer, especially colon, breast, ovarian and prostate
• Hypertension
• Diabetes
• Cardiovascular disease - including congestive heart failure
• Fibromyalgia
• Osteoporosis & osteomalacia
• Tuberculosis
• Autoimmune disorders, especially multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease

Giving vitamin D supplements has been found to decrease risk of:

• Type I diabetes in children
• Falls in the elderly
• Multiple Sclerosis and Rheumatoid Arthritis
• Seasonal affective disorder (winter depression)
• High blood sugar
• Hypertension

The goal is to maintain blood levels of 25-hydroxyvitamin D, the precursor of the active form of the vitamin, in the range of 32 to 50 ng/mL. If getting midday sun for 15 minutes three times per week (longer if dark skinned) is not for you, it is best to take a supplement. Check your level and then let's talk about what kind of supplement is right for you.

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