Vitamin D

“I got sunshine on a cloudy day.”
The Temptations

Meek Life Minute Summary

Vitamin D is essential for your overall body function, especially your bones and immune system.
Vitamin D is naturally produced in the human skin via sun exposure; however, it also can be found naturally in foods like fish, eggs, and mushrooms and fortified foods like cereal and orange juice.
Non-white populations, people with obesity, older adults, pregnant or lactating individuals, and others have a higher risk for vitamin D deficiency.
People older than 19 years should receive at least 600 IU of vitamin D daily, and adults over 70 need 800 IU.
When choosing supplementation, Vitamin D3 may be the better option for increasing blood levels of vitamin D and sustaining those levels.
There is some concern that low vitamin D levels are associated with COVID-19 risk, morbidity( being hospitalized or dealing with side effects for extended periods), and mortality (death).
Overall, I encourage you to talk with your doctor about your vitamin D levels, get more sunlight (still wear sunscreen), eat vitamin D-rich foods, and at least take a daily vitamin that includes your recommended amount of Vitamin D.

What is Vitamin D?

Vitamin D is essential for proper body function, including bone, intestinal, immune, cardiovascular, pancreatic, muscular, brain, and cellular health. Therefore, a deficiency of vitamin D can lead to bone weakness, muscle weakness, skeletal deformities in children, and frequent falls and fracture risks in the elderly, to name a few. Vitamin D can be obtained through two forms. One form is D2, which comes from sun-exposed mushrooms. Humans do not make this type of Vitamin D, but it is used in vitamin D supplements. Humans also make Vitamin D in their skin (vitamin D3) via sunlight exposure. Also, oily fish like salmon contains Vitamin D3.

Vitamin D Insufficiency/Deficiency

Even with the known importance of Vitamin D, about 50% of the world’s population has vitamin D deficiency. This is due to several factors like limited outdoor daytime activities and air pollution that decreases sun exposure. Vitamin D deficiency is a Vitamin D level (25(OH)D) of less than 20 ng/mL. In comparison, vitamin D insufficiency is between 21-29 ng/mL. The risk for vitamin D deficiency or insufficiency is equal across the lifespan. As previously mentioned, the primary source of vitamin D is natural sunlight exposure. However, sunscreen reduces vitamin D synthesis, but it is needed for other protections (i.e., skin cancer prevention, hyperpigmentation treatment).

Furthermore, people with darker skin have natural sun protection, which requires three to five times longer sun exposure to gain the same out of vitamin D as someone with a white skin tone. Specifically, research supports that 42% of African American women aged 15 to 49 have vitamin D deficiency. Another common association with vitamin D deficiency is obesity or excessive fat mass (a body mass index (BMI) greater than 30 in adults or BMI percentile greater than 95 in children).

Other populations with a high risk for vitamin D deficiency include the following:

Breastfed infants- mothers who exclusively and partially breastfeed, should supplement with 400 IU of vitamin D daily.

Pregnant women- have a risk of vitamin D deficiency regardless of supplements like prenatal vitamins.

Older adults, especially those with fall and/or fracture history

People with limited sun exposure- homebound, individuals who wear clothing that limits skin or head exposure, employees at occupations with limited sun exposure, geographical locations with limited sunlight

People with darker skin/ non-white individuals- research is still needed on if these low levels are as detrimental as low levels in individuals with lighter skin tones

People with fat malabsorption – liver disease, cystic fibrosis, and Chron’s disease

People who had gastric bypass surgery, oncologic patients, hospitalized patients, people with respiratory disease or lung disease (COPD, asthma, sarcoidosis, tuberculosis), and those with thyroid issues

Vitamin D & COVID-19

With the prominence of COVID-19, there has been research on the impact of Vitamin D levels on the risk for contracting the disease and the need for hospitalization. Since vitamin D is crucial to many of the processes related to the immune system that fight viruses, this is of concern. This is especially concerning for the African American community since they generally have lower vitamin D levels. African Americans also have a 6-fold higher death or mortality rate compared to white people.

Vitamin D & Health Outcomes

Some research supports that vitamin D levels can impact the following:

Cancer risk or death

Heart disease and hypertension

Obesity

Type 2 diabetes

Depression, cognitive impairment, and Parkinson’s disease

Fractures and falls

Autoimmune disease and influenza (flu)

Bacterial vaginosis and pelvic floor disorders

Age-related macular degeneration

Symptoms, Treatment,& Prevention

If you feel tired, feeling depressed, have frequent muscle weakness, easily fracture or have any of the risk factors previously mentioned, ask your healthcare provider about assessing your Vitamin D. They can check your levels and determine if you need extensive Vitamin D supplementation. Supplements are the primary treatment for vitamin D deficiency, along with eating vitamin D-rich foods. Also, you take a daily vitamin, it usually contains vitamin D. Overall, I encourage you to get more sunlight exposure but still use sunscreen. Also, eat vitamin D-rich foods like salmon, herring, sardines, canned tuna, whole eggs (especially the egg yolk), mushrooms, and vitamin D fortified foods like orange juice, cereal, and milk.

When it comes to choosing a supplement, you will see two choices Vitamin D2 and Vitamin D3. D3 is naturally produced in the human body; research supports that D3 tends to raise blood levels of Vitamin D more than D2, and the levels remained for a longer time. It is also found in foods that naturally contain vitamin D.

The recommended dietary allowance for adults 19 years and older is 600 IU daily for men and women and 800 IU daily for adults over 70. You should find this information on the back of the nutritional label of food or vitamins. However, if you have a vitamin D insufficiency or deficiency, you may be prescribed by your doctor to take more than the dietary allowance. Unfortunately, in general, the U.S. population is only getting half of the allowance, and only half of that is coming from their food.

Disclaimer

As mentioned in the disclaimer, this information is not to be taken as medical advice. I encourage you to do your research and discuss your questions with your healthcare provider. Also, this blog’s goal is to share basic knowledge about this topic. I encourage you to check out the links below for more details. If you have any questions, please feel free to leave them in the comment section.

Peace, Love, & Light,