Vitamin D is the ‘Sunshine Vitamin’

Over 50% of elderly Americans may be deficient in vitamin D. You are more likely to be low in vitamin D if you are older, are obese, have dark skin, are homebound, or live in an institution like a nursing home.

We call vitamin D the “Sunshine Vitamin” because our skin generates vitamin D from the ultraviolet energy of UVB rays found in direct sunlight. Unfortunately, sun exposure also increases your risk of getting skin cancer. Medical professionals recommend you cover up or use sunscreen when going out into the sun, limiting your ability to get enough daily vitamin D.

Years ago, I took a prescription medicine that caused my skin to turn bright red and itchy whenever I was outside in the sun for more than 15 minutes. After avoiding being outside in bright sunlight and wearing sunscreen faithfully for several years, my vitamin D level dropped so low that I needed supplementation.

You can develop a deficiency in vitamin D from not being able to absorb fat-soluble vitamins like vitamins A, D, and E. This can happen after gastric bypass surgery or in people with inflammatory bowel disease. Prescription medicines like prednisone, anticonvulsants, or the weight loss drug Alli® can also cause vitamin D deficiency by interfering with your ability to absorb vitamin D from your food.

Vitamin D plays an essential role in maintaining the strength of your muscles and bones, with deficiency contributing to thinning bones and muscle weakness, and falls in the elderly.

According to Dr. JoAnn Manson, professor of medicine at Harvard Medical School and Brigham & Women’s Hospital, there is evidence that vitamin D boosts your immune response to viral infections and has a calming effect on inflammation. People testing positive for COVID-19 who end up hospitalized with severe lung symptoms are more likely to be significantly deficient in vitamin D than those with only mild symptoms.

The National Osteoporosis Foundation and the North American Menopause Society recommend 800 to 1000 IU daily of vitamin D for people aged 50 and older. People who are obese may need 2-3 times that amount. Some researchers suggest that 1000-2000 IU per day of vitamin D is a more reasonable target.

It’s challenging to get enough vitamin D just from your diet. The best source is fatty fish such as salmon, canned tuna, and sardines, with 300 units of vitamin D per 3.5 ounces serving. Another good source of vitamin D is fortified milk, with up to 100 units per cup of added vitamin D. The United States began adding vitamin D to milk in the 1930s to combat rickets, a vitamin D deficiency in children that causes deformed legs.

Do you need a vitamin D supplement? A simple blood test can help determine how much vitamin D is present in your body. A healthy level is considered 20ng or above; I was deficient because my vitamin D blood test was 12ng.

One intriguing source of vitamin D is Prevagen, a non-prescription supplement marketed for memory loss that contains 2000 IU of vitamin D in every dose. One of my patients had a vitamin D level that was too high. Despite stopping her vitamin D supplement, her level didn’t drop back into the normal range. Eventually, we discovered that she was taking Prevagen, so she switched to a version that did not include vitamin D.

With emerging evidence of vitamin D deficiency increasing the risk of breathing problems from the coronavirus, I restarted vitamin D supplementation with 2000 IU every day. Should you?

Here Are 4 Tips for Getting Enough Vitamin D:

1. Eat vitamin D-rich foods.

Egg yolks, tuna, and salmon, along with fortified foods like milk, yogurt, and fortified orange juice, are good sources of vitamin D. Unfortunately, most foods contain minimal vitamin D unless they have been fortified.

2. Take 1000-2000 IU of vitamin D3 (cholecalciferol) daily.

With 1300 IU in each tablespoon, cod liver oil is the most concentrated vitamin D supplement. Thankfully, there are other alternatives available today. If you are obese, take 2000 IU daily.

3. Avoid taking the weight loss medicine Alli®.

The fat-blocking action of the non-prescription weight loss medicine Alli® interferes with your body’s ability to absorb vitamin D from your intestine.

4. Get outside.

UVB radiation from sunlight on bare skin produces vitamin D in your body. Getting your entire daily vitamin D from direct sun exposure is not recommended due to the increased risk of skin cancer from UVB rays. Taking a vitamin D supplement is safer.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and the author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog,©2022 Louise Achey


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