Vitamin D: Finding a balance
Vitamin D: Finding a balance
Over the July 4th weekend, my non-physician husband with a history of skin cancer tried to justify not wearing sunscreen in order to get some vitamin D. My husband, of course, has no idea how much vitamin D he needs or why, and I suspect he is not alone.
Why do we need vitamin D?
The easy answer is for bones. Vitamin D facilitates absorption of calcium and phosphate, which are needed for bone growth. Without sufficient vitamin D, bones become brittle (in children this is called rickets and in adults it is called osteomalacia) and break more easily. Vitamin D is likely beneficial for other parts of the body as well; studies suggest an overall decrease in death in addition to reductions in blood pressure, respiratory illnesses, cancer, heart disease, and depression. Adequate vitamin D during pregnancy also appears to reduce the chances of having a low-birth weight baby. However, most of the effects of vitamin D have not been studied in controlled settings. Studies looking at the benefits of vitamin D on various conditions are ongoing. A small study published earlier this month suggested that high-dose vitamin D could reduce redness and inflammation following sunburns, but the dose tested far exceeded the recommended daily dose of vitamin D.
How do I get the vitamin D I need?
Don’t run out to the drug store to buy vitamin D pills just yet. Your body produces vitamin D when the skin is exposed to sun, and it is estimated that most people need 1,000 to 1,500 hours of sun exposure throughout the spring, summer, and fall to obtain the necessary amount of vitamin D. Vitamin D deficiency is very common and on the rise. This is mostly due to vigilant sun protection, since sunscreen with SPF 30 reduces vitamin D production by 95%. Of course, as a dermatologist I am not advocating for prolonged sun exposure, but small amounts can go a long way, as the skin produces vitamin D that can last at least twice as long the vitamin D you take in through foods or supplements. Vitamin D can also be obtained through other sources, including fatty fish (such as tuna, mackerel, and salmon), foods fortified with vitamin D (such as dairy products, soy milk, and cereals), beef liver, cheese, and egg yolks. Of course, vitamin D supplements are needed for people most at risk for deficiency, including breastfed infants, older adults, people with limited sun exposure, darker skinned individuals, and overweight individuals.
Why shouldn’t everyone just take vitamin D supplements?
Too much vitamin D can be harmful, including (ironically) increasing fractures, falls, and kidney stones, and can be toxic by causing excessive levels of calcium. Although not proven, high vitamin D levels have been associated with prostate cancer, pancreatic cancer, and mortality. A recent study found that use of high-dose vitamin D supplements increased over a 15-year period.
So how much is too much? For adults, toxic effects increase above 4,000 IU per day. The recommended dietary dose of vitamin D is 600 IU each day for adults 70 and younger and 800 IU each day for adults over 70. To put this into perspective, 4 ounces of cooked salmon contains approximately 600 IU of vitamin D. more
Over the July 4th weekend, my non-physician husband with a history of skin cancer tried to justify not wearing sunscreen in order to get some vitamin D. My husband, of course, has no idea how much vitamin D he needs or why, and I suspect he is not alone.
Why do we need vitamin D?
The easy answer is for bones. Vitamin D facilitates absorption of calcium and phosphate, which are needed for bone growth. Without sufficient vitamin D, bones become brittle (in children this is called rickets and in adults it is called osteomalacia) and break more easily. Vitamin D is likely beneficial for other parts of the body as well; studies suggest an overall decrease in death in addition to reductions in blood pressure, respiratory illnesses, cancer, heart disease, and depression. Adequate vitamin D during pregnancy also appears to reduce the chances of having a low-birth weight baby. However, most of the effects of vitamin D have not been studied in controlled settings. Studies looking at the benefits of vitamin D on various conditions are ongoing. A small study published earlier this month suggested that high-dose vitamin D could reduce redness and inflammation following sunburns, but the dose tested far exceeded the recommended daily dose of vitamin D.
How do I get the vitamin D I need?
Don’t run out to the drug store to buy vitamin D pills just yet. Your body produces vitamin D when the skin is exposed to sun, and it is estimated that most people need 1,000 to 1,500 hours of sun exposure throughout the spring, summer, and fall to obtain the necessary amount of vitamin D. Vitamin D deficiency is very common and on the rise. This is mostly due to vigilant sun protection, since sunscreen with SPF 30 reduces vitamin D production by 95%. Of course, as a dermatologist I am not advocating for prolonged sun exposure, but small amounts can go a long way, as the skin produces vitamin D that can last at least twice as long the vitamin D you take in through foods or supplements. Vitamin D can also be obtained through other sources, including fatty fish (such as tuna, mackerel, and salmon), foods fortified with vitamin D (such as dairy products, soy milk, and cereals), beef liver, cheese, and egg yolks. Of course, vitamin D supplements are needed for people most at risk for deficiency, including breastfed infants, older adults, people with limited sun exposure, darker skinned individuals, and overweight individuals.
Why shouldn’t everyone just take vitamin D supplements?
Too much vitamin D can be harmful, including (ironically) increasing fractures, falls, and kidney stones, and can be toxic by causing excessive levels of calcium. Although not proven, high vitamin D levels have been associated with prostate cancer, pancreatic cancer, and mortality. A recent study found that use of high-dose vitamin D supplements increased over a 15-year period.
So how much is too much? For adults, toxic effects increase above 4,000 IU per day. The recommended dietary dose of vitamin D is 600 IU each day for adults 70 and younger and 800 IU each day for adults over 70. To put this into perspective, 4 ounces of cooked salmon contains approximately 600 IU of vitamin D. more
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I would like to mention about my test wherein my Vitamin D level found to be 51.75. This level is not sufficient. Hence Doctor prescribed some powder to be taken after mixing in the milk. Should any one suggest whether this level of Vitamin D is sufficient or any other steps needs to be taken. Ram Yadav more
Jul 25
Since the recent declaration by the community of allopathic doctors, that all those food items like egg-yoke, butter, coffee, ghee, cholesterol, carbs, red meat, seafood except fish etc etc. which were taboo for a heart-patient for over fifty years, suddenly turned "angelic", I personally take views of allopathic doctors with a pinch of salt. Today, they have declared "sugar" as the greatest health hazard. I wouldn't be surprised if after a few decades even sugar would suddenly be canonised as "saint" and be replaced by another "devil". Suddenly Vitamin D levels have become important, also the B-11 values. Doctors today prescribe these tests at the drop of the hat. Soon B-17 is expected to enter the arena in connection with cancer. Let's make a comparison. People in cold climate countries viz. Scandinavia, Iceland, Greenland, the Soviet group, Canada, Mangolia etc. who hardly get much sunshine during the whole year, and hence should have very very low Vitamin D values, end up by living up to 90 years or more. People from African countries with stinging sunshine throughout the year (and hence expected to have an overdose of Vitamin D, are the best athletes in the world with their unchallenged physical stamina. So, where do we stand or where do we go from here? If only we could believe that God has created our body, as also that of every creature that lives, as the most perfect machinery for it to function, we wouldn't need to worry about which food items would become cause for which physical problem. Folks, your body sends you signals, listen to those.........and obey! more
Jul 24
It's true. Money is more important to a doctor as compared to humanity's. Thanks more
Jul 27
I too go with your analysis Ratti Saheb. India would have lost the entire aggricultural community or a majority of its population due to skin cancer or overgrown or brittle bones by now as almost all of rural India works in sun, hot sun and hottest sun too! Para meters for BP levels and sugar levels are adjusted from time to time at the behest os pharma industry on their profit ratios as a piolet makes course correction mid flight! For these pharma industry and modern day medical fraternity it is not the human welfare that matters, but their own bank balances and growth trajrctory that matters! more
Jul 25
Vinod ji, Thanks for the Good information. I believed that exposure to sun is the best if one can afford it in normal life style. 3-4 hours on average per day direct/indirect sun light helps. Perhaps this is the reason that the people who work in open area under sun are not Vit D deficient. more
Jul 24
Doctors are prescribing doses on 60 K-1.5 millions IU. Please read about this vitamin before taking the dose as directed by doctor. Fat soluble vitamin D is stored in body,specially in liver. 600 IU for a healthy adult are enough. This vitamin is produced within our bodies by liver,helped by Sunlight exposure. Store enough of it during winter when exposure to Sun is not a punishment. Fortified foods having fat soluble Vitamin D are popular in west where Exposure to Sun is Luxury. In our country, recently milk fortified with fat soluble vitamins A & D has been launched by Kwality & actor Akshay Kumar is promoting this milk through advertisements. Another fat soluble vitamin K enhances the absorbtion of Vitamin D. Go for a combo of Vitamin D & Vitamin K in healthy dose more
Jul 24
