The Low Down on vitamin D

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Doctors and researchers are finding more vitamin D deficiency in adults and elderly. Many questions arise about the importance of this vitamin and signs of deficiency.

Doctors and researchers are finding more vitamin D deficiency in adults and elderly.  Many questions arise about the importance of this vitamin and signs of deficiency.    Vitamin D plays an essential role in overall bone health and calcium levels. Bone needs calcium and phosphorus to maintain its strength.  The body uses vitamin D to keep the levels of both calcium and phosphorus normal, both of which are necessary for the normal function of almost every cell in the body.   Sunlight and ultraviolet light forms vitamin D in the skin, and from there it can reach other organs by traveling through the bloodstream.  But vitamin D is also absorbed in the digestive tract from food.  However, it is found in only a few foods, like fortified milk, fatty fish, cod-liver oil, and (to a lesser extent) eggs.   Vitamin D deficiency is high in the elderly due to decreased dietary intake, reduced vitamin D processing in the digestive tract, and limited exposure to sunlight. However, the prevalence of vitamin D deficiency in younger adults is as high as 57%, depending on the study.   If vitamin D level is too low, it can result in low calcium and phosphorus, and in turn, decreased bone strength.  Two examples of this are osteoporosis in adults and elderly, and rickets in children (rare). Vitamin D insufficiency and deficiency is common in elderly where osteoporosis can lead to easy bone fractures after falls. Vitamin D is now also thought to play other important roles in immune and neurologic function as well as cardiovascular health. Low levels of vitamin D are associated with increased risk of cardiovascular conditions, including hypertension, and diabetes. However, it is not entirely clear if vitamin D supplementation actually lowers cardiovascular risk.  Vitamin D deficiency may also play a role in colon cancer. In some studies, relatively high vitamin D levels have been associated with a decreased cancer risk. ***Estimates of vitamin D requirements depend on sun exposure. If there is ample sun exposure, your vitamin D requirement from food sources is lower.  However, this is difficult to quantify and often your blood test is the best way to know for sure. Consumption of a minimum of 200 IU (International Units) daily of vitamin D is recommended by the National Research Council. In diets high in fruits and vegetables (i.e., 5-9 servings total per day), supplementation is rarely necessary.  In elderly and in younger adults at risk for vitamin D deficiency, 800 IU daily is often recommended for the prevention and treatment of osteoporosis. This is most often achieve with vitamin supplements. ***Be careful: excessive doses of vitamin D can result in intoxication, with symptoms including confusion, loss of appetite, vomiting, muscle weakness, and bone weakness—believe or not. In children, too much vitamin D can lead to brain injury. The Institute of Medicine has defined the "tolerable upper intake level" for vitamin D as 2000 IU daily for healthy adults and children 1 to 18 years.   Talk to your doctor about your vitamin D level and if you require supplementation. Copyright 2010 Chicago Defender Dave Montgomery, MD, PhD is Senior Fellow in Cardiology at Northwestern University and a sought after Speaker and Health Coach.   http://davemontgomerymd.com

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