Q:Should I be taking a Vitamin D supplement?
Yes, if you live in the northern part of the United States, you probably need one. I did, and didn’t realize it until my doctor did a blood test and discovered how deficient I was.
Vitamin D plays an important role in maintaining the strength of your muscles and bones. It’s also called the “Sunshine Vitamin” because your body generates it when your skin is exposed to UVB rays in direct sunlight. Unfortunately, sun exposure also increases risk of skin cancer, so medical professionals recommend you cover up or use sunscreen when going out into the sun.
You are more likely to be deficient in vitamin D If you are elderly, have dark skin, or, like me, take medicine that causes sun sensitivity and have to avoid exposure to sunlight or wear sunscreen.
Vitamin D deficiency from not being able to absorb fat-soluble vitamins like vitamin A, D, and E is common after gastric bypass surgery, in inflammatory bowel disease, or when taking prescription medicines like prednisone or anticonvulsants or the weight loss drug Alli®.
Over 50% of elderly Americans are thought to be deficient in vitamin D, and there is evidence that vitamin D deficiency is associated with muscle weakness and falls. Replenishing body stores of vitamin D with supplementation has been shown to improve muscle strength and balance and decrease falls in some groups of elderly Americans and may be particularly helpful for elders who are homebound or live in nursing homes.
Unfortunately, it’s hard to get enough vitamin D from just your diet. The best source is fatty fish such as salmon, canned tuna and sardines, which have about 300 units of vitamin D per 3.5 ounce serving. The next best source is fortified milk, which has up to 100 units per cup of added vitamin D. Milk was fortified in the United States beginning in the 1930s to combat rickets, a deficiency of vitamin D in children that caused soft bones and deformed legs.
How can you find out if you need vitamin D supplementation? A simple blood test measuring the level of 25-hydroxyvitamin D can determine how much vitamin D is present in your body. A normal level is 20ng or above; my blood test came back at only 12ng, which is considered vitamin D deficient.
If you are deficient, your doctor will prescribe an 8-week course of prescription vitamin D supplementation at 50,000 units once a week, after which you’ll be retested, which is what happened to me. If your vitamin D level rises to 20ng or above, you’ll be switched to a maintenance dose of 1000 to 2000 units daily, but if you’re not there yet you’ll continue on 50,000 units of prescription vitamin D for another 4-8 weeks. I was able to switch to a maintenance dose of 2,000 units of vitamin D after taking the once weekly prescription tablets for 12 weeks.
How much vitamin D should you take? Those of us who live in Washington State don’t get a lot of vitamin D in the winter, and you are even more at risk if, like me, you avoid being out in the sun in the summer months. Most adults can maintain a good level of vitamin D with a supplement of 1000 to 2000 units per day, but if you have any concerns that you may be deficient please tell your doctor so you can get tested.
Here Are 5 Tips on Getting Enough Vitamin D:
- Include foods rich in vitamin D in your diet.
Egg yolks, tuna, salmon, and fortified foods like milk, yogurt and fortified orange juice are also good food sources of vitamin D. Unfortunately, most other foods have very little vitamin D in them.
- Take a vitamin D supplement.
The National Osteoporosis Foundation and the North American Menopause Society both recommend 800 to 1000 IU daily of D3 for people age 50 and older, but if you are overweight you will need 2-3 times that amount.
- Supplement with 1000-2000 units of D3 (cholecalciferol) daily.
With 1300 units per tablespoon, cod liver oil is the most concentrated vitamin D supplement, but thankfully, there are less fishy tasting alternatives available.
- Avoid taking the weight loss medicine Alli®.
As a fat blocker, Alli® will interfere with your body’s ability to absorb vitamin D.
- Get some sunlight every day.
UVB radiation from sunlight on bare skin produces vitamin D in your body, but due to an increased risk of skin cancer, diet and supplements are preferred over sun exposure.
