Vitamin D is an essential fat-soluble vitamin that is produced by our bodies when ultraviolet (UV) rays from sunlight exposure trigger vitamin D synthesis. Fat soluble means that it can be absorbed in the lymph system and transported in our blood.
Vitamin D is naturally present in a few foods including some fish, fish liver oils, and egg yolks. But, it is also added to other foods – fortified dairy and grain products; and, is available as a dietary supplement.
With Vitamin D sourced from so many different directions, it is ironic that it is one of our most common deficiencies. 1) Why? Because our bodies cannot make this vitamin in sufficient amounts from our diet.
Vitamin D has multiple roles in the body. It assists in:
- promoting healthy bones and teeth
- supporting immune, brain, and nervous system health
- regulating insulin levels and supporting diabetes management
- helps to regulate sex hormones
- helps bones to absorb calcium
- supporting lung function and cardiovascular health
- reduces the risk for certain cancers
Why are so many people deficient in Vitamin D?
One of the primary causes of Vitamin D deficiency is the growing concerns about skin cancer. Everyone bathes themselves in UV protection before going outside. But, In the United States, people who live north of a line drawn from Los Angeles to Columbia, South Carolina have difficulty getting enough sun exposure, because of the angle of the earth’s tilt away from Sun.
Our changing work patterns have an impact on Vitamin levels. Fewer people work outside. Instead, work from home patterns and the increasing role of the internet means fewer people are getting outside and getting exposed to the Sun’s rays. 2)
Deficiencies can arise if a person does not take in enough Vitamin D or their skin has an impaired ability to synthesize it from the sun. A person can also become deficient if the body is not able to absorb the vitamin or convert it to its active form in the liver and kidneys.
Symptoms of Vitamin D Deficiency
Some of the health issues caused by a vitamin D deficiency include rickets, infections, cognitive and psychological disorders, obesity, heart disease, and some skeletal diseases such as osteoporosis.
Lack of vitamin D is not quite as obvious in adults. Signs and symptoms might include:
- Fatigue.
- Bone pain.
- Muscle weakness, muscle aches, or muscle cramps.
- Mood changes, like depression.
- Positional vertigo 3)
- Increased incidences of falling. 4)
Vitamin D levels can be decreased by certain medications. These include:
- Laxatives.
- Steroids (such as prednisone).
- Cholesterol-lowering drugs (such as cholestyramine and colestipol).
- Seizure-control drugs (such as phenobarbital and phenytoin).
- A tuberculosis drug (rifampin).
- A weight-loss drug (orlistat). 5)
Because of the above, it is highly recommended that you discuss your dosage of Vitamin D with your physician if you are taking any prescription medicines.
How is vitamin D deficiency treated?
The goals of treatment and prevention are the same—to reach, and then maintain, an adequate level of vitamin D in the body. Even though you might consider eating more foods that contain vitamin D and getting a little more sunlight, you will likely be told to take vitamin D supplements.
Vitamin D comes in two forms: D2 and D3. D2, also called ergocalciferol, comes from plants. D3, also called cholecalciferol, comes from animals. You need a prescription to get D2. D3, however, is available over the counter. It is more easily absorbed than D2 and lasts longer in the body. 6)
Spend time in sunlight. Vitamin D is often referred to as “the sunshine vitamin” because the sun is one of the best sources of this nutrient.
- Consume fatty fish and seafood.
- Eat more mushrooms.
- Include egg yolks in your diet.
- Eat fortified foods.
- Take a supplement.
- Try a UV lamp. 7)
Can Vitamin D Be Effective In Treating COVID 19
A new research study at the University of Chicago Medicine has found that when it comes to COVID-19, having vitamin D levels above those traditionally considered sufficient may lower the risk of infection. This is especially true for African-Americans. This is important because African-Americans in the more northern states have as much as 25 percent lower levels of the vitamin. Black individuals who had levels of 30 to 40 ng/ml had a 2.64 times higher risk of testing positive for COVID-19 than people with levels of 40 ng/ml or greater. 8)
Additional studies found the same or similar results regardless of race or age. 9) These studies found that significantly lower Vitamin D serum levels were found in COVID-19 patients.
Can You Have Too Much Vitamin D In Your System?
While Vitamin D deficiency is extremely common, with as many as one billion people world wide suffering from it, Vitamin D toxicity is possible. Confusion, apathy, frequent vomiting, abdominal pain, urinating in large quantities (2.5 L or more a day for an adult), excessive thirst (possible symptom of diabetes), and dehydration are the most often noted clinical symptoms of vitamin D toxicity (VDT). 10)
In the past, VDT arising from external causes was considered a rare adverse effect arising primarily from food supplementation. From the1930s through the 1950s, health officials in the United States and the United Kingdom recommended routine fortification of milk and other foods with vitamin D. 11) That policy was implemented initially as an effective public health strategy to prevent nutritional rickets in children and then as an intervention to improve the general health of the population. Nothing was known at the time of health risks arising from high intakes of Vitamin D. After multiple cases of VDT arose, with sometimes severe consequences, food fortification standards were tightened up substantially in both countries. 12)
In the general population, people are becoming increasingly aware of vitamin D related health benefits; however, the increased consumption of vitamin D supplements may result in an increased incidence of VDT. Therefore, without medical supervision, caution is advised for people who self-administer vitamin D at doses higher than recommended for age and body weight.
How Much Vitamin D Should We Take?
The Institute of Medicine recommends getting the following amounts of vitamin D from diet or supplements (assuming that a person gets virtually no vitamin D from sunshine — and that this person gets adequate amounts of calcium):
- Infants age 0 to 6 months: adequate intake, 400 IU/day; maximum safe upper level of intake, 1,000 IU/day
- Infants age 6 to 12 months: adequate intake, 400 IU/day; maximum safe upper level of intake, 1,500 IU/day
- Age 1-3 years: adequate intake, 600 IU/day; maximum safe upper level of intake, 2,500 IU/day
- Age 4-8 years: adequate intake, 600 IU/day; maximum safe upper level of intake, 3,000 IU/day
- Age 9-70: adequate intake, 600 IU/day; maximum safe upper level of intake, 4,000 IU/day
- Age 71+ years: adequate intake, 800 IU/day; maximum safe upper level of intake, 4,000 IU/day. 13)
While the above appears to be reasonable, there are a multitude of differing opinions to fuel the debate, some from other studies cited in this report. My personal opinion is that because of the possibility of developing VDT D, check with your doctor before going above these recommendations.
1) https://www.healthline.com/nutrition/7-common-nutrient-deficiencies
2) https://simplyhealth.io/14-common-causes-of-low-vitamin-d-levels
3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913711
4) https://www.todaysgeriatricmedicine.com/news/ex_012511_02.shtml
5) https://my.clevelandclinic.org/health/articles/15050-vitamin-d–vitamin-d-deficiency
6) https://www.healthline.com/nutrition/vitamin-d2-vs-d3
7) https://www.healthline.com/nutrition/how-to-increase-vitamin-d
8) https://www.uchicagomedicine.org/forefront/coronavirus-disease-covid-19/vitamin-d-covid-study
9) https://doi.org/10.3390/nu13030717
10) https://pubmed.ncbi.nlm.nih.gov/30294301/
11) Holick MF. Mayo Clin Proc. (2015) 90:561–4. 10.1016/j.mayocp.2015.03.015
12) Jacobus CH, Holick MF, Shao Q, Chen TC, Holm IA, Kolodny JM, et al. . Hypervitaminosis D associated with drinking milk. N Engl J Med. (1992) 326:1173–7. 10.1056/NEJM199204303261801
13) https://www.webmd.com/osteoporosis/features/the-truth-about-vitamin-d-how-much-vitamin-d-do-you-need#:
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