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How Much Is Enough of the Sunshine Vitamin? PDF Print E-mail
Written by Valerie Smith   

The popularity of Vitamin D, sometimes called the sunshine vitamin, exploded over the past decade, with sales going from $40 million in 2001 to $430 million in 2009, according to the Nutrition Business Journal.

The surge in supplementation is due to a slew of recent epidemiological studies showing patients with higher Vitamin D levels in their blood experience better health outcomes in a wide range of maladies, from colorectal and breast cancer to stroke.

Vitamin D is produced by the body with exposure to sunlight and is also found in fortified milk, eggs, fish and cod liver oil. It helps the body absorb the calcium needed to form strong bones. Exposure to sunlight without sunscreen is the best way to manufacture Vitamin D in the body; maintaining good Vitamin D levels in the blood is harder from diet alone.

Patients with a Vitamin D deficiency may suffer from a variety of ailments including rickets and adult rickets, soft or weak bones, skeletal abnormalities, muscle weakness or pain, hyperparathyroidism and Fanconi syndromerelated hypophosphatemia.

Supplementing these patients’ diets with Vitamin D can relieve the symptoms associated with these problems.

Research has also shown Vitamin D supplementation can help slow bone loss for patients with osteoporosis, help prevent bone problems for patients with chronic kidney failure and relieve the symptoms of psoriasis, according to National Standard® Patient Monograph.

Lorraine Gravante, D.C., of Snellville recently attended the Eighth Annual Roizen’s Complementary and Alternative Medicine Conference, where Vitamin D supplementation was a hot topic.

“Vitamin D is very important for skeletal health – the research is definitely there,” she said. “Normal levels are 30 – 74 ng/ ml.”

Recent research studies have gone far beyond the proven positive impact Vitamin D has on bone health, claiming that Vitamin D can also prevent breast and colorectal cancer, diabetes, high blood pressure, heart disease and stroke. As a result, use of the supplement in both regular and mega doses of up to 10,000 international units (IU) has skyrocketed.

JoAnn Manson, M.D., is leading a five-year study of 20,000 Americans to research the effectiveness of Vitamin D and omega-3 fish oil supplementation.

“I think it is important that we not leap ahead of the evidence in recommending high doses of Vitamin D. We will soon have a better understanding of the optimal doses of Vitamin D and the optimal blood levels associated with the best balance of benefits and risk. Right now there are many unanswered questions,” she said last August.

Dr. Raul J. Seballos, M.D., F.A.C.P., vice chair of preventive medicine at the Cleveland Clinic, agreed. “The health benefits (of Vitamin D) beyond bone health are predominantly observational studies with conflicting results,” he said.

Thus far, research into Vitamin D’s benefits has focused on surveys and epidemiological studies that have found patients with higher levels of Vitamin D in their blood tend to have better health outcomes. Manson’s study, called the VITAL Study, will test the effectiveness of taking a 2,000 IU dose of Vitamin D daily, either alone or in conjunction with 1 gm of fish oil.

And too much Vitamin D has been linked to pancreatic cancer. Other side effects of Vitamin D toxicity may include nausea and vomiting, constipation, kidney stones and damage, weakness and confusion, lack of appetite and heart arrhythmia due to a build up of calcium in the blood.

The National Academy of Sciences’ Institute of Medicine weighed in on Vitamin D in November 2010 with a new report that found while evidence supported the impact of Vitamin D on bone health, current evidence does not prove Vitamin D’s effectiveness in impacting other health conditions.

According to the report, people under the age of 70 need 600 IUs of Vitamin D a day to maintain bone health. That number increases to 800 IUs a day after age 70. And the institute said patients should not exceed 4,000 IUs per day, far below the mega dose level of 10,000 IUs that some scientists and doctors have been recommending. The Institute of Medicine maintains 20 ng/ml of Vitamin D is adequate for bone health.

Seballos, in a presentation at the Roizen’s Complementary and Alternative Medicine Conference outlined his recommendations for when to test patients’ Vitamin D levels with the 25-hydroxyvitamin D test.

“There is insufficient evidence to recommend routine screening of asymptomatic individuals for Vitamin D deficiency,” he said.

However, patients with the following characteristics may be at high risk of Vitamin D deficiency and may need to be screened:

• Over 65 years of age

• Obese

• Dark-skinned

• Limited sun exposure

• Osteoporosis

• Malabsorption

• Taking medication that alter Vitamin D (anticonvulsants or glucocorticoids)

• Breastfed exclusively without Vitamin D supplementation

Patients with the following symptoms may also need to be screened:

• Bone discomfort or pain

• Muscle aches

• Proximal muscle weakness

• Increased falls and impaired physical function

Vitamin D supplementation is recommended for patients who are below 30 ng/ml, but Gravante urges doctors of chiropractic to be conservative.

“Just be cautious and follow the table from the Institute of Medicine. It shows how much patients should take at what age and provides the corresponding amount of calcium they should be taking,” she said.