Vitamin D plays an important  role in maintaining the several aspects of our health. It is actually more like a hormone than a vitamin. It is important for the absorption and the use of calcium and phosphorus, which build and maintain strong bones. As sunshine is a natural source of vitamin D, getting sunlight on our skin can help our body produce it.  Vitamin D deficiency is a common problem worldwide impacting approximately 1 billion people globally. Additionally, about half of the population experiences insufficient levels of vitamin D. Approximately 35% of adults in the United States experience a lack of vitamin D.

When sunlight’s ultraviolet B rays interact with our skin, a chemical reaction takes place, transforming 7- dehydrocholestrol into vitamin D3, also known as chlolecalciferol. This form of vitamin D is then further processed by the liver and kidneys to become an active form that the body can use.

There are two main forms of vitamin D: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D3 is produced in the skin in response to sunlight, while vitamin D2 is derived from plant sources or supplements.

 

 

Preventing Vitamin D Deficiency: Sources, Supplements, and Sunlight Exposure

Vitamin deficiency can be prevented. Diets that include fatty fish, fish liver oils, egg yolks, cheese and beef liver are natural food sources that are rich in vitamin D3.  Some mushrooms contain small amounts of vitamin D2 and certain commercially sold mushrooms may have higher levels of vitamin D2 due to exposure to ultraviolet. Many foods and supplements, including dairy products, plant–based milks, fortified dairy products, orange juice and cereals are enriched with vitamin to increase its levels. Salmon, Mackerel and tuna are rich sources of vitamin D, promoting bone health, immune function and inflammation regulation. Some breakfast cereals are also fortified with vitamin D, which improves its intake. Also, a regular sun exposure can help prevent vitamin D deficiency. However, it’s important to strike a balance between sunlight exposure and protecting your skin from harmful UV rays.

Vitamin D deficiency can also affect infants and the American Academy of Pediatrics (AAP) advises giving breastfed infants a vitamin D supplement of 400 IU per day. This is important because infants have limited sun exposure and can’t produce enough vitamin D from sunlight. Vitamin D drops are available and should be given according to dosage instructions or as directed by a healthcare professional. It’s crucial for infants’ growth and development to ensure they receive sufficient vitamin D.

 

 

Health Benefits Of Vitamin D

  • Bone health: Vitamin D plays a crucial role in helping our bodies absorb calcium and maintain optimal blood calcium levels and phosphorus in our bones. This is essential for keeping our bones and spines strong and healthy, reducing the chances of fractures, increasing bone density and preventing conditions like osteoporosis which weakens the bones. It helps to reduce risks of bone fractures in older adults and those with conditions like osteoporosis. It is essential for bone mineralization, which is the process of incorporating minerals such as calcium into the bone structure.
  • Immune system: It helps to boost the immune function in the body. It helps regulate immune cells and promotes the production of proteins that fight against infections, making body better equipped to defend against illnesses.
  • Chronic diseases, such as cancer and heart disease: Maintaining sufficient vitamin D levels may help reduce the risk of chronic diseases, including certain types of cancer and heart disease. Having enough vitamin D in the body may help decrease risk of stroke.
  • Weight loss: Vitamin D might have an indirect impact on weight management, as preliminary studies indicate a potential link between low vitamin D levels and obesity. It also reduces appetite. However, further research is necessary to establish a conclusive relationship. Gastric bypass surgery can impact nutrient absorption including vitamin D absorption, leading to an increased risk of deficiency and the need for vitamin D supplementation.
  • Mental health: It may have a positive impact on mood and mental health. Some studies suggest that low vitamin D levels are associated with an increased risk of depression and other mental health conditions.
  • Skin conditions: Vitamin D can benefit skin conditions such as psoriasis. It helps regulate the immune system and reduces inflammation, which is important in managing psoriasis symptoms. While it may not cure the condition, vitamin D treatments such as creams or light therapy can help improve skin health.
  • Multiple sclerosis: Research indicates a beneficial link between low vitamin D levels and extended risk of multiple sclerosis (MS). Sufficient vitamin D intake may have a positive impact on MS risk and progression, but more research is needed for a complete understanding.
  • Pregnancy: Vitamin D is important during pregnancy for fetal development, bone health and immune system.
  • Cancer: Adequate vitamin D levels may play a role in reducing the risk of certain cancer like prostate cancer, although more studies are needed to fully understand the relationship.

 

The Importance of Blood Tests for Accurate Measurement

A healthcare professional can measure vitamin D levels through a blood test. Vitamin D levels in the blood are measured through a simple blood test called the 25-hydroxyvitamin D test, also known as the 25 (OH) D tests. This test is the most accurate way to determine vitamin D status.

During the test, a healthcare professional will draw a small amount of blood from a vein, usually from arm. The blood sample is then sent to a laboratory for analysis. In the lab, the sample is tested to measure the concentration of 25-hydroxyvitamin D, which is the form of vitamin D that circulates in the blood.

The results of the test will indicate vitamin D levels in nanograms per milliliter (ng/mL) or nanomoles per liter (nmol/L). The desired range may vary depending on the reference values used by the specific laboratory conducting the test. Generally, vitamin D levels below 20 ng/mL (50 nmol/L) are considered deficient, while levels between 20-30 ng/mL (50-75 nmol/L) are considered insufficient. Levels above 30 ng/mL (75 nmol/L) are usually considered sufficient or optimal.

 

Examples Of Diseases With Vitamin D Deficiency 

  • Rickets: Rickets is a condition where the bones become weak and soft due to severe vitamin D deficiency. It can cause growth delays, skeletal deformities, and muscle weakness.
  • Osteomalacia:  Severe and long–lasting vitamin aspartic acid deficiency in adults can cause a condition called osteomalacia. This condition weakens bones, causing pain, muscle weakness and greater chance of breaking bones.
  • Hypertension: Researchers suggest that vitamin D deficiency may contribute to high blood pressure, while maintaining adequate vitamin D levels can help regulate blood pressure and lower the risk of hypertension.
  • Crohn’s disease: Vitamin D deficiency is common in individuals with crohn’s disease, a type of irritable bowel disease (IBD) and supplementation may help reduce disease activity and improve symptoms.
  • Hypophosphatemia: It occurs due to impaired phosphorus absorption and vitamin aspartic acid deficiency.
  • Hyperparathyroidism: Adequate vitamin D levels are important for regulating calcium and parathyroid hormone levels. Its deficiency can lead to secondary hyperparathyroidism, where parathyroid glands become overactive.

 

The Recommended Dietary Guidelines For Vitamin D

The recommended dietary allowances (RDAs) for vitamin D differ based on age and life stage.

  • Infants (0-12 months): 400-1,000 international units (IU) per day
  • Children (1-18 years): 600-1,000 IU per day
  • Adults (19-70 years): 600-800 IU per day
  • Adults (71 years and older): 800-1,000 IU per day
  • Pregnant and lactating women: 600-800 IU per day

It is challenging to get enough vitamin D through sunlight alone, especially in regions with limited sunlight or during winter months. Therefore, vitamin D supplements can be an effective way to ensure adequate intake.

While vitamin D is essential for good health, it is possible to have too much of it, which can lead to toxicity. Vitamin D toxicity is rare but can occur from taking extremely high doses of supplements over a long period of time.

 

 

Vitamin D as Supplements

There are different types of vitamin D supplements available. The most common ones include vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol). Vitamin D3 is the preferred form as it is more easily absorbed and utilized by the body. These supplements are available over the counter and typically come in the form of capsules, tablets, or liquid drops.

 

 

Interactions With Other Medications

Yes, as vitamin D can possibly interact with certain medications, it is important to talk to a healthcare professional who can advise on the potential interactions and provide guidance on proper supplementation.

Possible interactions with vitamin D include:

  • Aluminum-containing phosphate binders: Long-term use with vitamin D in people with kidney failure may lead to harmful levels of aluminum.
  • Anticonvulsants (phenobarbital and phenytoin): These medications can increase the breakdown of vitamin D and reduce calcium absorption.
  • Atorvastatin (Lipitor): Vitamin D may affect the way the body processes this cholesterol drug.
  • Calcipotriene (Dovonex, Sorilux): Taking vitamin D with this psoriasis drug may increase the risk of hypercalcemia (high calcium levels in the blood).
  • Cholestyramine (Prevalite): This cholesterol-lowering drug can reduce the absorption of vitamin D.
  • Cytochrome P-450 3A4 (CYP3A4) substrates: Vitamin D should be used cautiously with drugs processed by these enzymes.
  • Digoxin (Lanoxin): Taking high doses of vitamin aspartic acid can lead to hyperglycemia, which is an excessive level of calcium in the blood. It can also increase the risk of heart problems when combined with certain heart medications.
  • Diltiazem (Cardizem, Tiazac): High doses of vitamin D can cause hypercalcemia and reduce the effectiveness of this blood pressure drug.
  • Orlistat (Xenical, Alli): This weight-loss drug can reduce the absorption of vitamin D.
  • Thiazide diuretics: Taking these blood pressure drugs with vitamin D increases the risk of hypercalcemia.
  • Steroids (prednisone): These medications can reduce calcium absorption and impair the body’s processing of vitamin D.
  • Verapamil (Verelan, Calan SR): High doses of vitamin D with this blood pressure drug can cause hypercalcemia and may reduce its effectiveness.

 

Vitamin D Deficiency And Its Impact On Fertility, Hormones, And Thyroid Function

Vitamin D deficiency may have an impact on fertility, hormone regulation and thyroid function, although the precise mechanisms are still under investigation. Low vitamin D levels have been associated with decreased fertility and may play a role in the production and maturation of sperm and eggs. Vitamin D also influences hormone production and function, including reproductive hormones like estrogen and testosterone. In terms of thyroid function, vitamin D deficiency has been linked to certain thyroid conditions, but more research is needed to understand the relationship fully.

 

Fortified Foods: Boosting Vitamin D Intake For Health

Fortified foods are products that have been enriched with additional nutrients, including vitamin D. These foods are intentionally supplemented with vitamin D to help individuals meet their recommended daily intake and combat deficiencies. Examples of fortified foods include milk, cereal, and orange juice, which can provide a convenient dietary source of vitamin D.

 

Vitamin D Deficiency And Type 2 Diabetes: Impact And Potential Benefits

Vitamin D deficiency can have a negative impact on the biochemical processes related to the development of type 2 diabetes (T2DM). It can impair the function of beta cells in the pancreas, contribute to insulin resistance, and promote inflammation. On the other hand, research has shown that higher levels of vitamin D in the blood are associated with lower rates of T2DM.

 

The Role Of Vitamin D In Arthritis, Asthma, And Alzheimer’s Disease

Vitamin D plays a role in several health conditions, including arthritis, asthma, and Alzheimer’s disease:

  • Arthritis: Adequate vitamin D levels are essential for bone health, and low levels of vitamin D are associated with an increase in risk of certain types of arthritis. Vitamin D may help to regulate the immune system and reduce inflammation.
  • Asthma: Vitamin D has been linked to lung health, and studies have showed that low vitamin D levels may be associated with an increased risk of asthma and poorer asthma control. Some research has indicated that vitamin D supplementation may improve lung function and reduce the frequency and severity of asthma symptoms in certain individuals.
  • Alzheimer’s disease: There is emerging evidence suggesting a possible link between low vitamin D levels and an increased risk of developing Alzheimer’s disease. Vitamin D plays a role in brain health, and it may help protect against the cognitive decline associated with Alzheimer’s disease.

 

Some Common Questions On Vitamin D

Can I Get Enough Vitamin D From Sunlight Alone?

The amount of vitamin D obtained from sunlight alone depends on factors such as location, season, skin colour, age and the extent of exposed skin. Spending a few minutes in the sun a few times a week with exposed skin can help our body to produce enough vitamin D. However, it’s important to balance sunlight exposure to avoid sunburn and skin cancer risk. Higher melanin levels in darker skin can reduce the skin’s ability to produce vitamin aspartic acid from sunlight, increasing the risk of vitamin D deficiency.

 

How Long It Takes To See The Result Of Vitamin D Supplements?

The time it takes to see the results of vitamin D supplementation or increased exposure to sunlight can vary depending on various factors; including the individual’s initial vitamin D levels, dosage or sunlight exposure, and overall health. In general, it may take several weeks to months to observe significant changes in vitamin D levels and associated health outcomes.

For individuals with severe vitamin D deficiency, it may take a longer time to restore optimal levels as the body needs to replenish its stores. Regular monitoring of vitamin D levels through blood tests is recommended to assess progress and determine the effectiveness of supplementation or increased sun exposure.

 

Are There Any Side Effects Of Vitamin D Supplements?

Vitamin D when taken within the recommended dosage are generally considered safe. However, taking excessive amounts of vitamin D can lead to toxicity, known as vitamin D toxicity. This can occur with very high doses of supplementation, not through sunlight or dietary intake alone. Symptoms of vitamin D toxicity may include nausea, vomiting, weakness, confusion, and in severe cases, organ damage. It’s crucial to follow the recommended dosage and consult with a healthcare professional if you have any concerns.

 

Who Is At Risk Of Vitamin D Deficiency?

People at risk of vitamin D deficiency include those who have limited sun exposure, such as individuals who spend most of their time indoors or live in regions with little sunlight. People with darker skin tones, older adults and individuals who regularly wear clothing that covers most of their skin are at a higher risk of experiencing vitamin D deficiency. Additionally, individuals with certain medical conditions or who have undergone certain surgical procedures may be at higher risk.

 

What Are The Symptoms Of Vitamin D Deficiency?

Vitamin D deficiency can lead to various symptoms including fatigue, muscle weakness, bone pain or fractures, frequent infections, depression, hair loss and impaired wound healing. However, some individuals may not exhibit noticeable symptoms, underscoring the importance of getting tested if deficiency is suspected.

 

How Does Vitamin D Affect Calcium Absorption?

Vitamin D helps body to absorb calcium from the foods. It does this by promoting the production of a protein called calbindin, which helps transport calcium from intestines into bloodstream. Without enough vitamin D, body may have trouble absorbing calcium properly, which can negatively impact bone health.

 

Can Vitamin D Improve Athletic Performance?

Vitamin D may have a positive impact on athletic performance. It is involved in muscle function, strength, and bone health, which are all important for physical activity. Adequate vitamin D levels may help improve muscle strength and endurance, balance, and overall athletic performance.

  

Can Vitamin D Prevent Or Treat Seasonal Affective Disorder (SAD)?

Vitamin D may play a role in preventing or treating Seasonal Affective Disorder (SAD), a type of depression that occurs during certain seasons, typically in the winter. While the exact relationship is not fully understood, low vitamin D levels have been linked to SAD. Taking vitamin D supplements may help improve symptoms, but it’s best to consult with a healthcare professional for personalized advice.