Vitamin D has historically been linked to bone health – deficiencies implicated in the diagnosis of rickets and osteomalacia in children and frail adults. Besides cases of rickets have diminished over the years, the important role that Vitamin D continues to play in not only musculoskeletal but also overall health has captured the medical community’s attention.
In fact, Vitamin D deficiency, which has reached an epidemic proportion in the world, is now linked to an increased risk of fragility fractures in younger adults and many chronic diseases. Its impact on health is now believed to be so significant that the National Institute for Health (NIH) in 2010 increased the daily recommended amount that individuals take. Though many within the healthcare industry believe that this new NIH recommendation is too conservative and advocate higher amounts for those with chronically low levels of the vitamin and those at greater risk for a deficiency.
Research suggests that “healthy” levels have strong disease fighting benefits. But, the definition of “healthy levels” broadly ranges in recommendation from 40 ng/mL to 100 ng/mL. Some scientific data suggests maintaining levels at the higher end of the range (80 ng/mL – 100 ng/mL) for the strongest benefit in the prevention and treatment of conditions such as Type 1 and Type 2 Diabetes, hypertension, cardiovascular disease, glucose intolerance, multiple sclerosis and cancer.
While additional studies may help better define “healthy levels” in individuals, it is clear most within the scientific community recognize a multitude of problems that can come with a “deficiency.”
Individuals are urged to request that their physician check Vitamin D3 levels (a simple blood test) during regular checkups or physical examinations – discussing with their physician ways to address low levels if found.
According to Mark Sanders, MD, FACS science and technology have finally caught up with one another – closing the gap between refined Vitamin D tests for patients and scientific data showing that deficiencies can result in problems with the nervous system, degenerative diseases, heart disease, osteoporosis, osteomalacia, cancer and more.
“Today it is a safe assumption that a patient is deficient in this very important vitamin – particularly if they present with a fracture – which is why checking their D3 levels is a standard part of our lab work up,” said Dr. Sanders.
“A Vitamin D deficiency is the major contributor to poor bone health and non healing fractures, as well as one’s general state of health – preventing a more successful recovery. The vast majority of patients I test show a deficiency in this important nutrient,” he added.
“Unless related to high energy trauma, rarely is a musculoskeletal injury or condition isolated. It is increasingly today tied to a larger problem affecting the body. This can include chronic diseases such as diabetes, poor nutrition, obesity, smoking and lifestyle. Orthopedic surgeons today have to look at the whole person to accurately treat that limb or area of the body,” said Dr. Sanders.
The benefits of a healthy Vitamin D level is now believed to go beyond an individual’s health to that of a mother’s unborn child. A recent study reveals higher levels of muscle strength in those infants conceived and developing while mothers had optimal Vitamin D levels (sunnier months of the year), compared to those during the same stages of development in women with insufficient levels (conception and development during fall/winter months).
What is Vitamin D?
Vitamin D has been historically associated with what is synthesized in the skin after exposure to direct sunlight (not inhibited by sunscreen blocks).
In today’s society it has become more complex than that. Descriptions for Vitamin D include:
- Vital nutrient
- Hormone made in our own bodies
- Medical treatment/supplements
The term Vitamin D refers to either vitamin D2 or vitamin D3. Vitamin D3, also known as cholecalciferol, is either made in the skin or obtained in the diet from fatty fish. Vitamin D2, also known as ergocalciferol, is obtained from irradiated fungi, such as yeast. Vitamin D2 and Vitamin D3 are used to supplement food products or are contained in multivitamins.
Studies suggest that vitamin D3 may be more effective than vitamin D2 in establishing normal vitamin D stores.
The active form of Vitamin D3 has three important functions. Combined with calcium, it is an essential component in the bone matrix – important in preventing osteoporosis, osteomalacia and bone fractures, as well as other diseases described above. It also aides in cell differentiation and prevention of cell overgrowth – often a precursor to cancer as cell overgrowth leads to mutation. And thirdly, it is an important immune system modulator – enhancing immune system health, which is key to maintaining overall health.
The primary source of the active form of Vitamin D is sunlight. As little as 20 minutes of unprotected sun exposure a day is enough for most lighter skinned, otherwise healthy individuals, to maintain sufficient levels. Darker skinned individuals require a bit more, and the elderly may require supplements despite this exposure as a result of deficits in aging skin.
Certain foods also contain a small amount of Vitamin D. These include such things as fish and fish liver oils (cod liver, salmon, tuna, mackerel, Sardines), egg yolk, liver, and Vitamin D fortified milk and orange juice. Though, it is very difficult to obtain sufficient levels through food alone and studies are showing much lower levels of the vitamin in “fortified” products than previously believed.
Vitamin D3 supplements are proving effective in helping those of all ages reach healthier levels – daily recommended values depending on level of deficiency.
Those Most at Risk for Vitamin D Deficiency
While there are sometimes physical reasons for a Vitamin D deficiency, an underlying kidney or liver problem inhibiting conversion or aging skin’s inability to absorb/convert the vitamin, most deficiencies are environmentally related and can be corrected with lifestyle and diet change.
Vegetarians and those consuming foods which lack omega three fatty oils (diet foods, processed foods, minimally “fortified” foods, etc.)
- Obese individuals – as excess body fat inhibits Vitamin D conversion
- Those on medications inhibiting Vitamin D conversion
- Elderly with aging skin – as there is a decreased capacity of human skin to produce vitamin D3 as it ages
- Those living in extreme latitudes combined with lengthy winter months
- Individuals unexposed to natural, unrestricted sunlight for at least 20 minutes per day
Symptoms of Vitamin D Deficiency
The symptoms of a Vitamin D deficiency are subtle and can be easily misdiagnosed. They include muscle fatigue and weakness, which may or may not be accompanied with bone and joint pain.
Other symptoms associated with low blood levels of the vitamin include
- Severe asthma in children
- Cardiovascular disease
- Cognitive impairment in older adults
Too often medications prescribed to treat a symptom further complicate the problem, as medications may further hinder Vitamin D absorption – and combined with adverse side effects, further distance the patient from optimal health.