Deficiency of vitamin D
Vitamin D is a fat-soluble vitamin that regulates the absorption of calcium and phosphorus as well as facilitates normal immune system function. This vitamin is an essential nutrient important for strong bones. Vitamin D has 2 forms: D2 (obtained from foods you eat) and D3 (obtained from sun exposure). Vitamin D is produced by the body when your skin is exposed to sunlight. You can also get vitamin D through certain foods and supplements. It’s important to get enough of this vital nutrient so you don’t end up with a vitamin D deficiency.
Benefits of Vitamin D
Vitamin D can boost your immune system, support muscle function, keep your heart healthy, and aid in brain development. Vitamin D may also reduce your risk of multiple sclerosis and depression.
Vitamin D Boosts Bone Health
Your body needs vitamin D to help absorb the calcium and phosphorus in your diet that makes for strong bones. Vitamin D deficiency can cause bone loss, low bone density, and increase your chances of breaking bones. Vitamin D deficiency can also cause rickets in children and a condition called osteomalacia in adults. Symptoms may include weakness and bone pain.
Vitamin D and Multiple Sclerosis
Higher blood levels of vitamin D seem to be associated with a lower risk of developing multiple sclerosis (MS). A recent study shows vitamin D may slow the progression of the disease, though the connection between the vitamin and MS is not clear. It is unknown if low levels of vitamin D cause MS or are a result of the disease. MS is more common in areas north of the equator, suggesting that the amount of sunshine one receives is connected to their likelihood of developing MS. People are less likely to develop MS if they have higher vitamin D levels. Supplementation with vitamin D may be beneficial for MS patients, but the dose is yet to be determined.
Vitamin D and Diabetes
Type 2 diabetes is a condition in which the body does not use insulin properly and blood sugar levels can rise above normal. Researchers are looking into whether vitamin D can help regulate blood sugar levels. In addition, vitamin D helps with the absorption of calcium, and calcium helps manage sugar in the blood. Studies have found people with vitamin D deficiency have a higher risk of developing type 2 diabetes later in life, but the link is not conclusive. More research is needed to determine if vitamin D supplementation can help people with type 2 diabetes.
Vitamin D and Weight Loss
Obesity is a risk factor for low vitamin D levels because the more weight you carry, the more vitamin D your body requires. Studies have also shown vitamin D deficiency may increase your risk of becoming obese later in life. One small study found women with low levels of vitamin D might be more prone to gain weight. Vitamin D and calcium may act as an appetite suppressant as well.
Vitamin D Deficiency and Depression
There may be an association between low levels of vitamin D and depression, but studies show mixed results and further research is needed. Vitamin D receptors in the brain have been linked to the development of depression. Vitamin D itself may not ward off depression, but patients who are taking antidepressants along with vitamin D may help reduce symptoms of depression.
Sunlight and Vitamin D
The easiest way to get vitamin D is by exposing your skin to direct sunlight, specifically, ultraviolet B (UVB) rays. The more you expose your skin, the more vitamin D your body produces. You only need to spend about half as much time as it takes to turn pink and get sunburn. This means if you are fair-skinned and normally start to turn pink in 30 minutes, you only need 15 minutes of pre-sunscreen sun exposure to produce the vitamin D3 your body needs. The darker your skin, the more time you need in the sun to produce vitamin D. The amount of vitamin D you get from sun exposure depends on the time of day, your skin tone, where you live, and how much skin you expose.
Vitamin D Foods
Generally, sun exposure is the best way to get the vitamin D your body needs. Most foods that contain vitamin D only contain small amounts and won’t give you the total amount your body needs.
Foods High in Vitamin D
- Fatty fish such as salmon or mackerel
- Beef liver
- Egg yolks
- Orange juice fortified with vitamin D
- Fortified cereals
- Infant formulas
Breakfast Foods High in Vitamin D
If you are unable to obtain enough vitamin D from sun exposure, there are foods containing this vitamin that can start kick-start your day. Many foods typically eaten for breakfast are fortified with vitamin D. Read labels to find out how much vitamin D is in the food you eat for breakfast.
Breakfast Foods Good for a Vitamin D Boost
- Milk (fortified)
- Cereal (fortified)
- Orange juice (fortified)
- Breads (fortified)
- Yogurt (fortified)
- Egg yolks
Vitamin D Supplements
If you don’t get enough sun exposure, food is unlikely to give you the amount of vitamin D your body needs. In this case, your doctor may recommend you take vitamin D supplements. There are two forms of vitamin D: D2 (ergocalciferol), found in food, and D3 (cholecalciferol), produced by your body from exposure to sunlight. Most over-the-counter vitamin D supplements contain vitamin D3, which is not usually vegetarian. If you have concerns about this, your doctor may prescribe vitamin D2 supplements.
Vitamin D Deficiency
People may be at risk for vitamin D deficiency if they dislike the sun, suffer from milk allergies, or stick to a vegan diet. People with dark skin may also be at risk for developing vitamin D deficiency. This is because the pigment melanin reduces their skin’s ability to make vitamin D after sun exposure. Other risk factors for vitamin D deficiency include:
- Covering your skin with clothing or SPF all the time
- Obesity or gastric bypass surgery
- Infants who are breastfed and not given a vitamin D supplement
- Living in northern regions where there are fewer hours of sunlight
- Being older (your skin is thinner)
Vitamin D Deficiency Symptoms
Vitamin D deficiency symptoms may be very general. You might have aches, pains and fatigue or you may have no symptoms at all. If your vitamin D deficiency is severe, you may suffer from bone pain and reduced mobility. In adults, severe vitamin D deficiency is called osteomalacia, and in children a severe deficiency can lead to rickets (softening and weakening of bones).
Testing the Body for Vitamin D
A simple blood test called the 25-hydroxy vitamin D test can measure levels of vitamin D in the blood. Levels of the vitamin are measured in nanograms per milliliter (ng/mL). 20 ng/mL to 50 ng/mL is an adequate level for bone and overall health, and a level less than 12 ng/mL indicates vitamin D deficiency. Many experts suggest that higher levels of vitamin D, 35 to 40 ng/ml, are suggested for preventive health. Levels higher than that do not appear to offer any additional benefits.
What is the Right Amount of Vitamin D?
The U.S. recommended daily allowance (USRDA) for vitamin D is 600 IU (international units) per day for those 1-70 years of age. Infants under 1 year need 400 IU, while adults 71 and older require 800 IU.
Vitamin D and Breastfeeding
The amount of vitamin D in human breast milk is minimal. Since infants should be kept from direct sunlight and use sunscreen, they generally do not get enough of this vitamin without supplementation. The American Academy of Pediatrics (AAP) recommends nursing infants should receive 400 IU of vitamin D supplementation per day. Over-the-counter products, such as multivitamin products, are available to provide vitamin D supplementation for infants.
Vitamin D for Older Children
Many children do not get the recommended amounts of vitamin D in their diet, putting them at risk for vitamin D deficiency and rickets. The American Academy of Pediatrics (AAP) recommends infants 1 year and under get 400 IU per day of vitamin D and 600 IU daily of vitamin D for children and teens. Talk to your child’s pediatrician about vitamin D supplementation and the right amount for your child.
How Much Is Too Much Vitamin D?
There is such a thing as too much vitamin D. Vitamin D in excess of 4,000 IU can cause side effects such as anorexia, excessive urine output, heart arrhythmias, and kidney stones. Excess vitamin D is usually caused by taking too much in the form of supplements. It is not possible to get too much vitamin D from sun exposure – the body regulates the amount it produces.
Vitamin D Overdose Side Effects
Hypervitaminosis D occurs when people take too many vitamin D supplements. When there is too much vitamin D in the body, calcium levels rise and can lead to hypercalcemia. Symptoms of hypercalcemia include:
- Excessive urine output
- Heart arrhythmias
- Excessive thirst
- Muscle weakness
- Vomiting, nausea, and dizziness
- High blood pressure
Organs Damaged by Long-Term Vitamin D Toxicity
- Blood vessels
Vitamin D and Drug Interactions
Vitamin D supplements can interact with several types of medications. Steroids can interfere with vitamin D metabolism and affect calcium absorption. Weight loss drugs including orlistat (Xenical, and Alli) and the cholesterol-lowering drug cholestyramine (Questran, LoCholest, Prevalite) can reduce your body’s absorption of vitamin D and other fat-soluble vitamins. Drugs to control epileptic seizures, phenobarbital and phenytoin (Dilantin), can increase the metabolism of vitamin D and reduce calcium absorption. Statins and diuretics can increase vitamin D levels. Tell your doctor if you take any vitamin D supplements.
Vitamin D and Colon Cancer
Some studies have shown that high levels of vitamin D may lower cancer risk. More research is needed to determine if low levels of vitamin D in the blood increase cancer risk, or if adequate supplementation of vitamin D can prevent cancer.
Vitamin D and Other Cancers
Research is ongoing on the possible connection between certain cancers and vitamin D. Some think it may help prevent colon, prostate, and breast cancers, but the evidence is lacking and it is unknown if vitamin D can prevent cancer, or increase risk. One study even found that low vitamin D levels might increase the risk of pancreatic cancer. Vitamin D and omega-3 fatty acids may reduce risk for developing cancer, heart disease, and stroke.
Vitamin D and Heart Disease
Low levels of dietary vitamin D are associated with a greater risk for stroke and heart disease. On the flip side, high levels of vitamin D deficiency can cause toxicity and damage the heart, blood vessels, and kidneys. Talk to your doctor about the right amount of vitamin D for your health needs.
Vitamin D: A Factor in Dementia?
One risk factor for lower levels of vitamin D is age. As we age, our skin thins, and we can’t produce as much vitamin D as we used to. Low levels of vitamin D have been associated with cognitive decline. Vitamin D may be a very important factor for preventing dementia
Mineral Health: Do You Get Enough Iron?
Why You Need Iron
Iron is a mineral that your body uses to make two proteins: hemoglobin and myoglobin. Hemoglobin helps your red blood cells move oxygen from your lungs to the rest of your body. Myoglobin brings oxygen to your muscles. Iron is also important in making hormones, as well as tendons, ligaments, and other connective tissue.
What If You Don’t Get Enough Iron?
You might not notice anything at first because your body will use what it has stored in your muscles, bones, liver, and elsewhere. But when these supplies run out, your red blood cells get smaller and so carry less hemoglobin. That means less oxygen gets delivered throughout the rest of your body, which is one kind of anemia.
What Are the Symptoms of Anemia?
You might feel tired, weak, or dizzy and have pale skin, a fast pulse, cold hands, headaches, and digestive problems. A weaker immune system could make you sick more often, and your body temperature could vary more than usual. It can even affect your ability to think clearly and remember things. Children who get anemia from lack of iron sometimes develop learning problems.
What Causes Low Iron?
It’s more likely if your diet isn’t great or if you don’t eat much meat, fish, or poultry. It also can happen if you lose blood due to injury or illness (like ulcers or colon cancer) or you have a condition that hampers digestion. Women get it more than men, especially once their monthly cycle starts or if they’re pregnant. And iron levels can go down as you get older and start to eat less.
How Much Do You Need?
If you’re a man, you should get about 8 milligrams (mg) per day. If you’re a woman 19 to 50 years old, you need more than double that: about 18 mg per day. That jumps to 27 mg if you’re pregnant and drops to 10 mg if you’re breastfeeding. After age 50, women’s needs drop to the same as men: 8 mg per day.
What If You’re Vegetarian or Vegan?
Your body doesn’t absorb iron from vegetables as easily as it does from animal protein like fish, chicken, and meat. That’s why vegetarians or vegans should almost double the daily iron amount that doctors recommend for meat eaters. That’s 14 mg for men, and 32 mg for women age 19-50. You can do it if you eat a varied diet and get plenty of vitamin C (in foods including oranges, red peppers, strawberries, and broccoli), which helps your body absorb the iron.
Which Foods Provide Iron?
Oysters, beef liver, white beans, lentils, and spinach are some of the top natural food sources. Lean meat, seafood, and poultry are great animal sources and help your body absorb iron from other foods like beans, nuts, seeds, dried fruit, whole grains, and green leafy vegetables. Iron is also in many “fortified” grain products like bread and breakfast cereal. Check the label to see how much is in a serving.
Do You Need Iron Supplements?
Women who’ve been through menopause and men probably don’t. Other people might, but most get enough iron from food. Too much iron can cause stomach cramps, constipation, nausea, diarrhea, and lightheadedness. It also could make it harder for your body to absorb enough zinc. Overdoses of iron supplements, which can provide different amounts of iron, can cause life-threatening problems in children younger than 6. And most adults shouldn’t get more than 45 mg of iron per day, so it’s best to ask your doctor first before taking any iron supplements.
If You’re Pregnant
You need more iron to keep up with the greater amount of blood that nurtures you and your growing baby. Without enough, your baby might be born too soon or with a low body weight. It could even cause problems with parts of your baby’s brain development. Your doctor will likely watch your levels and may prescribe a supplement if you need it or just to be safe.
Around 10% of infants and toddlers don’t get enough iron. If your little one was born early or underweight, they may not have much in the tank. Even a full-term baby only has enough for a few months before it runs out. If not restocked, this early lack of iron could lead to behavior and attention problems later. Talk to your doctor about how to track, and, if needed, supplement your child’s iron.
Steve Ramsey, PhD- PUBLIC HEALTH.