As we continue our review of the fat-soluble vitamins, let’s discuss Vitamin-D, the one fat soluble vitamin most of us should be taking. Living in Central Pennsylvania, especially this time of year we don’t get much sunlight on our bare skin.
Sources: very few foods contain natural Vitamin-D: fish liver oils, egg yolk, fortified milk, synthesized in skin exposed to UV light.
Function: acts as a hormone and plays a role in calcium balance.
Deficiency: More adults are deficient in vitamin D for the following reasons:
- increased use of sunscreens
- spending more time indoors
- and less efficient vitamin D absorption as people age
- Darker skin and living at higher latitudes also increase risk.
- Kidney failure and some drugs cause Vitamin-D deficiency.
- Consider testing for patients who are likely to be deficient such as house bound elderly, especially in a nursing home.
Rickets: still common in tropical countries even though adequate skin exposure. Soft bones in children become easily deformed. These patients see low calcium and phosphate levels in the blood.
DOSE: adults recommend 800-2000iu per day. Your Thompson Pharmacist can recommend up to 2000iu of Vitamin-D without doing a blood test. Most evidence from studies suggests that to prevent falls, a dose of at least 800 IU per day is required for our elderly patients.
Do I have to swallow a capsule, what about drinking milk, or exposure to sunshine?
Dairy Products: It takes about 5 quarts of milk, to equal 2000iu in a capsule…. not to mention over 2750 calories!
Sun Exposure: Sun Exposure (Ultraviolet-B) 2 to 3 times a week during mid-day. Bare arms & legs for10-15 minutes per session is usually adequate. The effect of sunlight exposure and vitamin D synthesis is reduced in individuals with darker skin pigment. Effective use of a sunscreen does block Vitamin-D formation in the skin. Middle aged and elderly persons who use sunscreens daily have significantly lower Vitamin-D levels. However, the benefits of using a sunscreen, far outweigh the disadvantages of a decrease in Vitamin-D. A local dermatologist told me “it is easier to treat Vitamin-D deficiency than it is to treat skin cancer…so use a sunscreen.”
What about Infants & children?
- Recommended daily intake of vitamin D is 400 IU per day in all infants (beginning in the first few days of life), children, and adolescents.
- Breastfed and partially breastfed infants should begin vitamin D supplementation beginning in the first few days of life.
Excessive dose: Side effects with excessive use may include nausea, anorexia, weight loss, constipation, polyuria, polydipsia, hypertension, weakness, and muscle aches or stiffness.
New Vitamin-D labeling:
To convert Vitamin D: From IU to mcg: IU/40 = mcg
|50,000iu Rx only||1250mcg= 1.25mg|
With 41% of the population being vitamin D deficient, especially in these latitudes, we need to be recommending this Vitamin a whole lot more. Drinking milk and sun exposure is not the answer to correcting this wide scale deficiency. People low in vitamin D who take a supplement may be less likely to fall. That makes sense, given that vitamin D plays a key role in keeping bones and muscles strong. Ask your Thompson Pharmacist for a Vitamin-D recommendation. At Thompson Pharmacy it’s all for YOU.