Benefits of Vitamin D – Why we need it? Why we don’t get enough from sun and diet? How to get enough from Vitamin D Supplements

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Benefits of Vitamin D

Vitamin D is a substance, essential for health, and we aren’t getting enough.

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While, the advantages of Vitamin D for bone health are well established, there has been growing recognition of its effects on other body systems and a myriad health conditions. Researchers have found Vitamin D receptors in an array of locations throughout the body.

While the science is not definitive, it’s thought that widespread Vitamin D deficiency may be a player in the development of heart disease, diabetes, cancer and auto immunity, all of which have been on an upswing, while Vitamin D levels have been on the downswing.

While diet plays a part in maintaining adequate Vitamin D levels, it is environmental factors, namely, adequate sunlight that plays probably the most significant role in maintaining adequate vitamin D levels. Some clinicians argue that today Vitamin D supplements are essential for most people to maintain adequate levels of this key Vitamin.

Benefits of Vitamin D – An Essential Hormone with Myriad Benefits

When Vitamin D (or lack of it) was identified as the cause of the bone softening disease rickets, scientists thought it a vitamin. Eventually researchers realized it was no vitamin but a hormone.

A hormone is a substance produced in one part of the body that travels, via the blood stream, to have effect in another part.

Some well known hormones are the sex hormones testosterone and estrogen; the adrenal hormones including cortisol, adrenaline (also called epinephrine) and noradrenaline (also called norepinephrine); and the mood enhancers serotonin and dopamine. The effect of hormones are diffuse and invariably diverse. Vitamin D, we have learned, is no different.

How the Benefits of Vitamin D Arise – The Formation of Vitamin D is a Complex Process. Why it’s the Sunshine Vitamin?

Vitamin D is made in the skin with the help of sunlight (UVB rays) and a cholesterol based substance called pro-vitamin D3; it then travels via the blood to the liver where a second conversion happens, followed by another cruise through the blood stream to the kidneys where the active form of vitamin D3 forms. Finally, Vitamin D3 is disseminated into the blood stream from where it can make its mark on various destinations in the body.

A hiccup at any stage in this process can result in Vitamin D deficiency.

Reasons for not enough Vitamin D are varied and include

1. not enough sunlight,


2. insufficient cholesterol, or


3. a shortfall or defect in other factors, including certain vitamins and minerals, needed to transport or convert the precursor forms of Vitamin D into a useable form.

People with liver or kidney disease often have low vitamin D levels, because Vitamin D production takes place in these organs.

No surprise that when something is “off” in either organ, vitamin D production may suffer.

Effects and Benefits of Vitamin D

Vitamin D has multiple effects throughout the body. It follows that the benefits of Vitamin D are numerous.

Evidence points to Vitamin D being important for the following:

• forming and maintaining strong bones and teeth
• ensuring strong muscles
• maintaining healthy immune function
• avoiding insulin resistance
• regulating blood pressure

No wonder, getting enough vitamin D is an essential step to avoid illness and maintain good health.

Effects and Benefits of Vitamin D – Strong Bones are a key benefit of Vitamin D

The most recognized benefit of Vitamin D is healthy bones. This isn’t surprising because Vitamin D was identified while scientists sought the cause of rickets, the bone softening disease in children; insufficient Vitamin D was found to be the culprit.

Rickets were widespread among children in cities who got little or no sunlight. In 1900 it was estimated that 80% of the children in Boston suffered from rickets. Fortification of dairy products and some other foods with Vitamin D largely eradicated the problem of rickets.

Vitamin D promotes intestinal absorption of the bone building minerals calcium and phosphorus. By making these minerals more readily absorbed, bone remains strong and diseases like rickets, osteomalacia (the adult form of rickets or soft bones) and osteoporosis are prevented.

While there is a Multitude of Benefits of Vitamin D - Deficiency is the Norm

Vitamin D deficiency is widespread.

Studies have concluded that 90% of adults in the UK don’t’ have enough and that 50 – 75% of Americans are low in Vitamin D. Only 7% of seniors in the US get enough from diet.

Rickets and osteomalacia are on the rise again, especially among dark skinned people in northern locales.

How to know if you are Vitamin D Deficient? Symptoms of Vitamin D Deficiency – Signs that you are missing the benefits of Vitamin D

Symptoms of Vitamin D deficiency include

1. Body ache and pain
2. back ache
3. Joint pain
4. Tooth decay
5. Muscle cramps
6. Fatigue

Vitamin D Deficiency Diseases and Conditions – When Benefits of Vitamin D are Absent

In recent decades, researchers have drawn some striking associations between Vitamin D deficiency and a variety of health conditions. Some connections, like Vitamin D and bone health, are clear; while others are more tenuous.

Diseases and Health Conditions Positively or Possibly Related to Vitamin D Deficiency. Osteoporosis, Ostopenia and Osteomalacia Cancer, especially colorectal cancer but also breast and prostate cancer Heart and Cardiovascular Disease Hypertension Type II Diabetes Glucose intolerance Multiple Sclerosis Chron’s Disease & Ulcerative Colitis Psoriasis Metabolic Syndrome Rheumatoid Arthritis Type I Diabetes among children born to Vitamin D deficient mothers Fibromyalgia Chronic Fatigue

While the connection between Vitamin D and bone health is well established and there is strong evidence it is protective in the case of colo-rectal cancer and psoriasis, the scientific jury is still out on the connection between Vitamin D deficiency and other diseases. The current evidence is persuasive but comes largely from studies done on animals and epidemiological studies – not double blind placebo controlled trials conducted among large groups of people.

Indeed, the Endocrine Society, an organization that includes both US and Canadian endocrinologists (hormone specialists) called for just this type of research in a statement issued May 2012 by its Vitamin D Task force.

"We need large randomized controlled trials and dose-response data to test the effects of vitamin D on chronic disease outcomes including autoimmunity, obesity, diabetes, hypertension and heart disease."

Despite the scientific uncertainty, it is clear that Vitamin D is an essential hormone needed in adequate amounts for good health. You should take measures to ensure you get enough. These measures will include testing and, if necessary and depending on your circumstances, lifestyle modification, dietary changes and/or supplements.

Why aren’t we getting enough Vitamin D or Benefits of Vitamin D? Lifestyle Factors that Prevent us enjoying the Benefits of Vitamin D

There are several theories for the upsurge in Vitamin D deficiency and Vitamin D deficiency conditions.

1. Sunlight Avoidance Many of us stay out of the sun or remain covered with clothing or high SPF sunscreens in order to reduce risk of skin cancer.


2. Sedentary and Indoor Lifestyle Many people work, shop and exercise indoors exclusively. They drive instead of walk. They can spend the summers indoors with the prevalence of air conditioning. The expansion of malls and mega stores means indoor shopping instead of outdoor.


3. We eat few Vitamin D rich or Vitamin D fortified foods People don’t eat on a regular basis oily fish or cod liver oil, both of which are relatively high in Vitamin D. Instead, many avoid Vitamin D fortified dairy products for allergic or dietary health reasons.

Vitamin D– Why We Don’t Get Enough? How we are prevented from Maximizing the Benefits of Vitamin D

There are several reasons why people either don’t produce enough vitamin D or can’t benefit from the Vitamin D they have.

1. Distance from the equator Those living closer to the equator get more direct and, therefore, stronger UVB rays for longer periods during the year. People in these regions routinely are found to have higher Vitamin D levels and suffer from fewer Vitamin D deficiency conditions than those in regions closer to the poles. This may explain the prevalence of Multiple Sclerosis (MS) in northern climates and its relative rareness in equatorial regions.


2. Concerns About Skin Cancer Too much UVB sunlight is a risk factor in skin cancer. People are heeding medical advice and staying out of the sun, wearing sunscreen and covering up to avoid skin cancer – all factors that reduce Vitamin D levels. The most intense sun and, therefore, best time to generate Vitamin D is between 10 am and 3 pm – the same period that doctors advise people to avoid the sun for cancer prevention.


3. Age The old don’t generate Vitamin D as effectively as the young. Studies show older people contain less of the cholesterol precursor needed to form Vitamin D – so, even with the amount and intensity of sunshine being equal, an older person generally makes only 25% of the Vitamin D that a younger person does.


4. Breastfeeding Children who are exclusively breastfed, without the addition of supplemental Vitamin D, are at risk of low levels, especially when the mother has low Vitamin D levels.


5. Skin Color People with darker skin, especially those living far from the equator, often have lower levels of vitamin D or suffer from Vitamin D deficiency disease more often than fairer people or other dark skinned people living in sunnier climes. Melanin, the substance in the skin that imbues color, blocks the absorption of UVB rays.


6. Sunscreen, Cloud Cover, Air pollution, Clothing Sunscreens with an SPF of 8 have been found to block up to 95% of the sun’s UVB rays. UVB rays do not travel through glass so sitting by a window does not help vitamin D stores. Complete cloud cover can reduce UVB rays 50%; pollution can reduce UVB by 60%; cultural and religious practices, such as in the Middle East and Northern Africa, to cover most of the body in public also reduces UVB exposure.


7. Obesity Fat stores prevent Vitamin D from circulating effectively in the body. It follows that being fat can reduce the function of the Vitamin D you’ve got. The rise in obesity in the US may explain, in part, the increase in some chronic diseases associated with low Vitamin D levels.
8. Medical Diseases Mal-absorption conditions like Chron’s disease, ulcerative colitis, celiac disease, leaky gut syndrome or stomach surgery including bariatric surgery for weight loss, can impair Vitamin D uptake. As mentioned, liver disease like cirrhoses and kidney disease can curtail Vitamin D production.


9. Medications Many medications can reduce the absorption or production of Vitamin D. Most notably steroids, used routinely for asthma, arthritis and Chron’s disease among other conditions, reduce levels of Vitamin D and conversely Vitamin D benefits. Certain epilepsy and weight loss drugs also reduce Vitamin D’s effectiveness, as well as the benefits of Vitamin D.


10. Sub-optimal Intake of Vitamin D Supplements There is growing consensus among experts that in northern regions (42 degrees North latitude – Northern California, Boston and above - an area that includes much of Northern Europe, the Northern US, Canada and Russia) it is impossible to get enough sunlight throughout the year to ensure adequate amounts of Vitamin D for good health.– the situation only gets worse the closer to the pole you get.

How much Vitamin D does the sun give you? Maximizing the Benefits of Vitamin D using nature’s Vitamin D Supplement – the Sun.

Exposure to sunlight is the main source of Vitamin D for most people. It’s called the sunshine vitamin for a reason.

How much time do you need in the sun?

There are no official guidelines, because there are so many variables that can effect UVB intensity and exposure, as well as individual variation in ability to produce or use Vitamin D. See the above for details.

The National Institute of Health (NIH) Office of Dietary Supplement explains in its Fact Sheet outlining the Benefits of Vitamin D that between 5 to 30 minutes of sun exposure, at least twice a week, without sunscreen and with substantial parts of the body (lower legs, back, arms and face and hands) exposed are sufficient – the face and hands alone won’t do it.

Some experts, including Dr Sarfraz Zaidi, an endocrinologist specializing in Vitamin D therapy and author of Power of Vitamin D thinks this inadequate and that a couple hours per day in the sun is needed to get enough Vitamin D. However, he considers this inadvisable, due to the increased risk of skin cancer.

The popular Dr. Mercola, a proponent of natural sunlight for Vitamin D and author of the free booklet Over A Million People Die Every Year From Lack of Sun Exposure, recommends between 20 minutes to 2 hours (depending on sun strength and skin color) three times a week to generate adequate Vitamin D.

Generally, lighter skinned people need less time than those with darker skin to get the same Vitamin D benefits from sunlight; some experts say up to 3 times to the get the same benefits as light skinned individuals.

All experts caution against excess sun exposure due to the increased risk of skin cancer.

To avoid this risk, limit your sun bathing and never burn – stop, when any redness appears. If you are high risk for skin cancer, follow your health care provider’s advice with respect to sun exposure. It may be that you will have to rely on diet and Vitamin D supplements for your Vitamin D intake.

As mentioned, the time of day is important for maximizing Vitamin D production from sunlight – the most intense sun is between 10 in the morning and 3 in the afternoon. Sun bathing during this time would mean that you would have to spend less time to produce the same amount of Vitamin D than at a shadier period.

There are many ways to block the sun’s UVB rays and your skin’s ability to produce Vitamin D.

Remember you won’t get the UVB rays through your car window. Sunscreens above an SPF of 8 along with cloud cover and pollution significantly reduce the sun’s intensity and the skin’s ability to produce Vitamin D. Keep these in mind when relying on the sun to replenish your Vitamin D stores.

How Much Do you Need to Reap the Benefits of Vitamin D? - Recommended Amounts versus Optimal Amounts to achieve Benefits of Vitamin D – Guide for Vitamin D Supplements

Below is the US government’s Recommended Daily Allowance (RDA) for Vitamin D:

• 400 IU (10 mcg) per day for infants up to one year old;
• 600 IU (15 mcg) per day for ages 1-70;
and
• 800 IU for those over age 70.

A significant number of experts believe these amounts are insufficient for optimal health. Dr. Sarfraz Zaidi, in his book Power of Vitamin D, quotes an editorial recommendation in the American Journal of Clinical Nutrition that the daily intake of Vitamin D should be a minimum of 1,700 IU per day for adults.

Dr. Zaidi distinguishes between the Vitamin D needed to maintain optimal health (his suggested intakes) versus preventing deficiency disease (the RDA’s).

Note that your health care provider may prescribe a much higher dose than the above figures on a temporary basis in order to correct a diagnosed Vitamin D deficiency.

Best Type of Vitamin D Supplements to Achieve The Benefits of Vitamin D – Guide to Vitamin D Supplements

There are two types of Vitamin D available as supplements - Vitamin D2 and D3.

Vitamin D2, also called ergocalciferol, is made from yeast and is, therefore, appropriate for vegans and others wanting to avoid animal products. Vitamin D3, called cholecalciferol, is of animal origin.

Vitamin D2 often is used to correct severe Vitamin D deficiency in amounts of 10,000 IU and more per pill, depending on the level of deficiency; Vitamin D3 is used generally to maintain optimal long term levels.

While some practitioners have thought there was a difference in absorption or effect between vitamin D2 and D3, the latest medical consensus is that they are equivalent, except for evidence showing high doses of Vitamin D2 being less effective than high dose D3.

You can take Vitamin D

• orally usually in a gel capsules;
or

• sublingually (under the tongue).

The advantage of sublingual vitamin D is that it absorbs more rapidly than oral tablets and bypasses the liver; a plus for people with compromised liver function.

Achieving the Benefits of Vitamin D through Testing – What Test is Best?

Knowing your Vitamin D status is a simple matter involving a blood test.

The preferred test is the 25 OH Vitamin D (25-hydroxy vitamin D) blood test. The alternate test called 1,25 (OH)2 Vitamin D (1,25 dihydroxy vitamin D) is a less sensitive indicator of the body’s Vitamin D status.

Achieving the Benefits of Vitamin D – What is the Ideal Range for blood level of Vitamin D to ensure the Benefits of Vitamin D? Important Information when taking Vitamin D Supplements

Official blood levels of Vitamin D for health have not been established.

However, many experts, including a committee of the Institute of Medicine believe that the target range for blood levels of Vitamin D for most people should be greater than 20 ng/ml (50nmol/l) but no higher than 50 ng/ml (125nmol/l), in order to avoid adverse effects of too much vitamin D but get the benefits of Vitamin D. Excess Vitamin D has been linked to a higher risk of pancreatic cancer, high calcium levels that may lead to cardiovascular problems or kidney stones, and higher mortality rate.

As with so much with Vitamin D, there is controversy and some experts dispute the above figures. They consider the above amounts too low and urge for higher blood levels of Vitamin D. Many consider 50-100 ng/ml (125-250nmol/l) a desirable range. Some research announced in May 2013 may shed some light on the upper safe limits of Vitamin D blood levels.

On the other extreme, some labs consider serum levels of 10 ng/ml (25 nmol/l) normal even though most experts consider this figure the minimum to prevent rickets.

I list the above figures, not to confuse, but to indicate there is controversy among the experts on how much Vitamin D is appropriate whether from sunlight, diet or Vitamin D supplements. You should address your Vitamin D lab results and the best target range for you with your health care provider.

How Much is Too Much - Avoiding Overdose but Maintaining the Benefits of Vitamin D – Guidelines for Vitamin D Supplements

The official upper intake levels per day(Upper Limits or ULs) for Vitamin D are as follows

• 0 to 6 months 1,000 IU


• 7-12 month 1,500 IU


• 1-3 years 2,500 IU


• 4-8 years 3,000 IU


• 9 years and older 4,000 IU

The 4,000 IU per day level for older children, teenagers and adults is thought to maintain blood levels of Vitamin D within a safe range so that you can still enjoy the benefits of Vitamin D but avoid excess.

As mentioned, your health care provider may give you a higher supplement than above, in order to correct a severe Vitamin D deficiency. As always, when taking any Vitamin D supplements make sure you monitor your levels.

Cofactors for better Absorption and Maintaining Benefits of Vitamin D

Like other vitamins and minerals, Vitamin D works better in conjunction with other nutrients or cofactors than alone. This is one reason why eating a healthy balanced diet is essential for good health; and why dosing of single nutrients should be done cautiously under the guidance of a knowledgeable practitioner.

For optimum Vitamin D absorption and function, adequate zinc, magnesium, Vitamin K, Vitamin A and boron are needed.

Maintaining Benefits of Vitamin D - Avoiding Overdose – Cautions with Vitamin D Supplements

While Vitamin D deficiency is much more common than Vitamin D overload, Vitamin D toxicity can happen.

Toxicity is possible because Vitamin D is a fat soluble vitamin and can build up in the system. This generally would happen only when taking excessive supplements, as in the case of mega dosing or if you have a compromised system, like inadequate liver function.

Toxicity has been reported with doses of more than 40,000 IU (1,000 mcg) per day. For more on toxicity see the Vitamin D Council Web page.

Rest assured that you won’t get too much Vitamin D from sunlight. The body naturally suspends Vitamin D production once sufficient levels are reached.

Maintaining Vitamin D Benefits - Symptoms of Vitamin D toxicity – Cautions with Vitamin D Supplements

Symptoms of Vitamin D toxicity include the following:

• Nausea
• Stomach Cramps
• Vomiting
• weakness
• Weight Loss
• Tingling sensation
• Confusion
• Heart arthymia

If you are taking Vitamin D supplements, especially large amounts above the government ULs, you should have your health care provider monitor your Vitamin D status regularly.

Boosting The Benefits of Vitamin D– Eat Vitamin D Rich Foods

While sunlight is probably the most important source of Vitamin D, diet and food are significant.

Click here for a list of Vitamin D Foods.

Vitamin D Absorption Problems Can Limit Benefits of Vitamin D

Certain medications can impair Vitamin D absorption and diminish the benefits of Vitamin D.

1. Steroids including Corticosteroid medications like prednisone.
2. Weight loss drug orlistat (brand name Xenical and Alli)
3. Cholesterol lowering drugs cholestyramine (brand names Questran, LoCholest and Prevalite)
4. The epilepsy and anti seizure drugs phenobarbital and phenytoin (Brand name Dilantin)

The above can reduce Vitamin D and Calcium absorption and lead to bone loss and other Vitamin D deficiency conditions.

Some Final Thoughts on Benefits of Vitamin D and Vitamin D Supplements

Remember that you need sufficient Vitamin D, not only to avoid disease, but to get the benefits of Vitamin D – strong bones, energy and optimal health.

By checking your Vitamin D levels, you can determine whether you need more ...

…. In the event you do …. with a few changes to your lifestyle including increased sun exposure, eating Vitamin D rich foods and following a sensible program of Vitamin D supplements, you can achieve the Benefits of Vitamin D.

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