Each year, as the days grow shorter and darker, we are frequently asked for recommendations about vitamin D supplements. Here in the Pacific Northwest, given our latitude and the short supply of sunshine in the winter months, that’s a reasonable question. Here are a few things to consider to determine if vitamin D supplements may be right for you.
Why do we need vitamin D?
Vitamin D is a fat-soluble vitamin that promotes health in many ways. Sometimes called “the sunshine vitamin” because our bodies can make vitamin D when exposed to sunlight, it helps the body absorb calcium and promotes strong teeth and bones. Research also points to the role of vitamin D in maintaining a strong immune system and even in regulating mood and reducing depression. It helps prevent osteoporosis and bone fractures as we grow older as well.
Many of us don’t get enough vitamin D. An estimated four of every 10 toddlers and children are vitamin D deficient. A 2011 study estimated that approximately 40 percent of adults are deficient. Kids tend to spend more time indoors than they once did. With our busy lives, adults often find it difficult to find the time for outdoor activities as well.
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What are sources of vitamin D?
Exposure to sunshine is one source of vitamin D. However, recommendations on sun exposure vary. While some suggest that waiting 10 to 15 minutes before you apply sunscreen when you’re out in the midday sun is safe, others caution that any unprotected exposure to the sun’s strong UV rays can cause damage and increase the risk of skin cancer. Some dermatologists suggest that you can still get some vitamin D, even when you apply sunscreen right away. The American Academy of Pediatrics recommends that infants younger than six months old avoid direct sunlight.
If you prefer to limit your sun exposure, there are dietary sources of vitamin D you can consider. Foods high in vitamin D include salmon, tuna, sardines and eggs. Foods that are often fortified with vitamin D include milk, cereal, infant formula, yogurt and orange juice.
How much vitamin D do I need?
The American Academy of Pediatrics and the Institute of Medicine recommend that infants have 400 IU per day. For those over the age of one year through age 70, including pregnant and lactating moms, the Institute of Medicine and Health Canada recommends a daily intake of 600 IU. Adults over the age of 70 need 800 IU daily. Those at high risk of bone fractures or with certain chronic conditions may need as much as 1000 IU or more.
Is vitamin D screening recommended?
The U.S. Preventive Services Task Force is the body that makes recommendations for health care providers about preventive medicine. The position of the task force is that the evidence is insufficient to recommend broad-based screening. However, if you or your child are experiencing symptoms of deficiency or if you have concerns about your risk factors, such as having dark skin, having a history of kidney disease and digestive disorders, or if you’re pregnant, talk to your health care provider. Symptoms of deficiency can include bone and back pain, frequent bone fractures, muscle pain or weakness, fatigue, and depression. Many of these symptoms can be associated with other causes though, so discuss your symptoms with your health care provider to determine whether vitamin D screening may be needed.
Is it possible to get too much vitamin D?
Yes. But it takes a significant amount of vitamin D to reach a level of toxicity. The Institute of Medicine defines the “tolerable upper intake limit” for vitamin D as 4,000 IU daily for children over the age of 9 and adults.
So what about those vitamin D supplements?
The American Academy of Pediatrics recommends that infants who are breastfed or consume less than one liter of infant formula each day receive vitamin D supplements. This is because the vitamin D content of human breastmilk is low. You can usually find infant oral vitamin D drops at a local drug or grocery store.
For everyone else, it’s not unreasonable to take the recommended dosage of vitamin D supplements in our dark winter months if you feel unable to obtain adequate vitamin D from your diet. Both vitamin D2 and D3 are effective at raising vitamin D levels. Vitamin D is available in multiple forms, including capsules, tablets, liquid drops and gummies. It’s a fairly inexpensive way to make sure you get enough vitamin D to keep your body healthy.
JoAnne Balsiger holds a doctor of pharmacy degree and is the Unity Care NW pharmacist.