The Vitamin D Advantage

Wherever one looks these days, vitamin D is labeled as practically the Holy Grail of good health. But the natural source of vitamin D is from the sun, which causes a dilemma for us all. Too much sun can mean courting skin cancer, but not enough may cause a vitamin D deficiency.

Vitamin D deficiency is widespread in dark-skinned African Americans and anyone with similar skin tones. The reason is that melanin limits the amount of sunlight exposure penetrating the skin.

And not having enough vitamin D could raise your risk of developing several conditions including cardiovascular disease or osteoporosis, says Asha Thomas, M.D, the director of the Sinai Hospital Division of Endocrinology.

Think swallowing a daily multi-vitamin means you are covered? Think again.

“Multi-vitamins typically have 400 units of vitamin D,” Dr. Thomas says. “That might be appropriate if you already have normal levels of vitamin D. But we are finding most people are deficient. So many people are way too low.”

Only relatively recently did people even know what their vitamin D level was. “Physicians just recently started checking people’s,” says Dr. Thomas.

According to the National Center for Health Statistics, 36 percent of Americans are vitamin D deficient. Researchers believe that number could be double for African Americans. In fact, vitamin D deficiency has been called “the hidden epidemic” for darker-skinned people.

“There is a higher incidence of vitamin D deficiency in African Americans starting in puberty and older,” Dr. Thomas says. Reasons could be because it is the time young people stop playing outdoors or other lifestyle reasons, she says.

Getting your vitamin D from the sun or supplements is a personal choice and both will work. But check with your doctor to find out where you stand with vitamin D and how much sun to get or supplements to take.
-Sandra Crockett

Vitamin D: Should you soak up the sun to get this vital nutrient?

Yesterday we discussed UVA sun rays and the aging effects they cause. Though UVA can also be responsible for skin cancer, UVB is the part of sunlight primarily responsible. (Think UVA, “A” for “aging”; UVB, “B” for “bad.”)

However, UVB light, which is the more dangerous of the two, is also the part of sunlight that causes the body to produce vitamin D – a necessary nutrient. Recent medical news has stressed that up to half of the U.S. population could be vitamin D deficient, and the FDA is considering increasing its daily recommendation of 400 International Units (IUs) of vitamin D to 800 IUs. Healthy levels of vitamin D have been linked to a decreased risk for osteoporosis, high blood pressure, cancer and certain autoimmune diseases.

While vitamin D occurs in foods such as fish and fortified dairy products, your body produces vitamin D naturally when you skin is exposed to sunlight. In fact, just 20 minutes of full body exposure will produce 10,000 International Units of vitamin D. (After about 20 minutes, your body creates a chemical response so you can’t produce too much vitamin D.) If you wear sunscreen (recommended to reduce your risk for skin cancer), the UVB rays will be blocked and your body will NOT produce vitamin D. So should you forego sunscreen so that you can get your vitamin D?

In a May 19th lunch and learn at the Alvin and Lois Lapidus Cancer Institute, Sean T. Gunning, M.D., said that he believes that the jury is still out on the health benefits of vitamin D. While there is a correlation of people who have higher levels of vitamin D in their systems and a lower risk for certain diseases, it doesn’t mean that their health is due to the vitamin D.

Healthy people tend to exercise outside, make better dietary choices and take vitamin supplements – all of which can lead to higher levels of vitamin D. Therefore these people may test higher for vitamin D simply because of their choices that make them healthy also give them more vitamin D; their health is a byproduct of their lifestyle, not necessarily because of their high levels of vitamin D.

As for getting the recommended daily amount of vitamin D, so far there’s no evidence that the vitamin D produced from being out in the sun is superior to the vitamin D we can get from vitamin supplements. The 400 (and even 800) IUs recommended by the FDA is an amount that can be easily obtained through a multi-vitamin, making it unnecessary to expose your skin to the sun.
-Holly Hosler

Vitamin D: Are You Getting Enough?

By Holly Hosler

Ever since I went to Sinai Hospital Grand Rounds last week, which featured a talk on vitamin D by John Hopkins Bayview Hospital endocrinologist Suzanne M. Jan de Beur, M.D., I’ve been tempted to spend a little time outdoors during my lunch break. That’s because I learned a mere 15 minutes outside (without sunscreen) between 10 a.m. and 2 p.m. can cause the body to produce 3,000 IUs of vitamin D. This is necessary for bone mineralization and the prevention of fractures and osteoporosis, and potentially important for staving off conditions such as breast, prostate and colon cancers; diabetes; and cardiovascular disease.

Experts recommend that we get 800 to 2,000 IUs of vitamin D per day. (Levels up to 10,000 IUs per day on a continued basis are even safe, suggests a study cited by Jan de Beur.)

Unfortunately, it is believed that up to half of us have too little vitamin D in our bodies. The consequences of vitamin D deficiency include osteoporosis, osteomalacia (in adults)/rickets (in children), thyroid problems, muscle pain and weakness, and an increased risk for breast, prostate and colon cancers, as evidenced by epidemiological data. Those who are elderly, obese, spend most of their time inside, have dark skin, live in northern climates or have certain health conditions are particularly susceptible to low levels of vitamin D.

Jan de Beur explained that barring supplemental vitamins, ninety percent (90%) of our vitamin D comes from sun exposure, while the remainder comes from food sources such as sun-dried shiitake mushrooms, salmon and cod liver oil, and a slight amount from fortified products such as milk. She showed a graph illustrating that young people naturally produce more vitamin D from the sun than older folks. Of course, the elderly are at higher risk for falls and fractures, so it is critical that they receive enough vitamin D to help their bones absorb calcium.

Ironically, the UVB rays necessary for vitamin D production are the very same rays that cause skin cancer, so I decided to scrap my idea to eat lunch outside. Plus, in Maryland, the sun only helps us produce vitamin D between March and November. Therefore, Jan de Beur recommends that vitamin D be obtained through dietary supplements, as there is no evidence that this supplementary vitamin D is inferior to the vitamin D our bodies produce from the sun. She says that most people require vitamin D supplements to get the amount that they need for good health.

Do you suffer from insufficient vitamin D? Symptoms include bone pain and muscle weakness, but sometimes the signs aren’t very pronounced. Talk with your doctor if you have concerns, especially if you are not already taking a supplement with at least 800 IUs of vitamin D.