Should I have my vitamin D level checked?
Should I have my vitamin D level checked?
DEAR DOCTOR:
I’ve read several articles about the negative effects of a low blood level of vitamin D, but my doctor said I didn’t need to have my level checked. Why not?
DEAR READER:
Many of my patients are asking me the same question. Vitamin D has been in the news a lot in recent years, but we still don’t have solid answers to many questions, including yours.
There is strong evidence that people with a low blood level of vitamin D have higher rates of osteoporosis (thin bones). There is less strong, but still worrisome, evidence that they have higher rates of various autoimmune diseases (including Type 1 diabetes and multiple sclerosis), atherosclerosis and associated heart attacks and strokes.
The linking of a low blood level of vitamin D to these and other diseases has led many doctors to routinely test the vitamin D levels in their healthy patients.
But an authoritative group, the U.S. Preventive Services Task Force (USPSTF), points out that even if you have a low vitamin D level, there’s little evidence that taking a vitamin D supplement will do you any good.
There are exceptions. People who might need testing include those who:
• have osteoporosis or other bone-health problems;
• have circumstances that affect fat absorption, including celiac disease or weight-loss surgery. Such conditions lower the amount of vitamin D your gut can digest;
• routinely take medications that interfere with vitamin D activity, including anticonvulsants and glucocorticoids.
Another approach many experts recommend is not to get a blood test: Just take a vitamin D pill daily. If your blood level is low, it may help. And if it’s not low, it won’t hurt. The recommended daily intake of vitamin D is 600 international units (IU) for everyone aged 14 to 70 and 800 IU for those age 71 and above. Some experts recommend 1,000 to 2,000 IU a day.
There are large studies underway here at Harvard and elsewhere to test whether there are health benefits from taking daily vitamin D supplements. Results are likely to be published in four to six years. Until then, what’s the right thing to do? I think it’s reasonable for people to take regular vitamin D supplements.
For people who are at risk for diseases linked to a low vitamin D level, I get their blood tested. If their level is low (below 30 ng/dL), I recommend taking a daily vitamin D supplement. And I retest their blood level, because in my experience the supplements don’t raise the level very much in some people. Some of my colleagues disagree with me on this.
What if the studies that are underway show that I’m wrong — that the blood tests and the daily pills achieve nothing and are just a waste of money? I’d be sorry. But what if I did no blood testing and did not recommend pills until the studies were completed — and the studies showed that, by waiting, I had put my patients at higher risk for various diseases? I’d be even sorrier. more
DEAR DOCTOR:
I’ve read several articles about the negative effects of a low blood level of vitamin D, but my doctor said I didn’t need to have my level checked. Why not?
DEAR READER:
Many of my patients are asking me the same question. Vitamin D has been in the news a lot in recent years, but we still don’t have solid answers to many questions, including yours.
There is strong evidence that people with a low blood level of vitamin D have higher rates of osteoporosis (thin bones). There is less strong, but still worrisome, evidence that they have higher rates of various autoimmune diseases (including Type 1 diabetes and multiple sclerosis), atherosclerosis and associated heart attacks and strokes.
The linking of a low blood level of vitamin D to these and other diseases has led many doctors to routinely test the vitamin D levels in their healthy patients.
But an authoritative group, the U.S. Preventive Services Task Force (USPSTF), points out that even if you have a low vitamin D level, there’s little evidence that taking a vitamin D supplement will do you any good.
There are exceptions. People who might need testing include those who:
• have osteoporosis or other bone-health problems;
• have circumstances that affect fat absorption, including celiac disease or weight-loss surgery. Such conditions lower the amount of vitamin D your gut can digest;
• routinely take medications that interfere with vitamin D activity, including anticonvulsants and glucocorticoids.
Another approach many experts recommend is not to get a blood test: Just take a vitamin D pill daily. If your blood level is low, it may help. And if it’s not low, it won’t hurt. The recommended daily intake of vitamin D is 600 international units (IU) for everyone aged 14 to 70 and 800 IU for those age 71 and above. Some experts recommend 1,000 to 2,000 IU a day.
There are large studies underway here at Harvard and elsewhere to test whether there are health benefits from taking daily vitamin D supplements. Results are likely to be published in four to six years. Until then, what’s the right thing to do? I think it’s reasonable for people to take regular vitamin D supplements.
For people who are at risk for diseases linked to a low vitamin D level, I get their blood tested. If their level is low (below 30 ng/dL), I recommend taking a daily vitamin D supplement. And I retest their blood level, because in my experience the supplements don’t raise the level very much in some people. Some of my colleagues disagree with me on this.
What if the studies that are underway show that I’m wrong — that the blood tests and the daily pills achieve nothing and are just a waste of money? I’d be sorry. But what if I did no blood testing and did not recommend pills until the studies were completed — and the studies showed that, by waiting, I had put my patients at higher risk for various diseases? I’d be even sorrier. more
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Yes you must get Vitamin D tested, as Vitamin D is used for preventing & treating- rickets, weak bones (osteoporosis), bone pain (osteomalacia), bone loss in people with a condition called hyperparathyroidism, an inherited disease-osteogenesis imperfecta in which bones are especially brittle & easily broken, falls & fractures in people at risk for osteoporosis, low calcium & bone loss in people with kidney failure. Vitamin D is also used for conditions of heart and blood vessels, including high blood pressure, high cholesterol, diabetes, obesity, muscle weakness, multiple sclerosis, rheumatoid arthritis, chronic obstructive pulmonary disease, asthma, bronchitis, premenstrual syndrome, tooth and gum disease, skin conditions including vitiligo, scleroderma, psoriasis etc. It is also used for boosting the immune system, preventing autoimmune diseases, and preventing cancer. Higher Vitamin D level is called Vitamin D toxicity, which is harmful & usually happens if you take 40,000 IU per day for a couple of months or longer, or take a very large one-time dose. Vitamin D is fat-soluble and its higher level means your body has a hard time getting rid of it & your liver producing too much of a chemical called 25(OH)D. When your 25(OH)D level is more than 150 ng/ml, this can cause high levels of calcium to develop in your blood. High blood calcium is a condition called hypercalcemia & symptoms are Feeling sick or being sick, poor appetite or loss of appetite, feeling very thirsty, passing urine often, constipation or diarrhea, abdominal pain, muscle weakness or pain, feeling confused, feeling tired. How do you know if you have taken too much Vitamin D? A blood test of 25(OH)D levels above 150 ng/ml is considered potentially toxic & potentially harmful to your health. Vitamin D is also involved in regulating the levels of minerals e.g. phosphorous and calcium. more
Mar 03
