Is Your D on the Decline?

Is Your D on the Decline?

By Stephanie Mellor, DNP, ARNP, ANP-C, GNP-C, CCCN

An increased desire and awareness of vitamin D’s benefits has been on the rise. Why? A variety of unwanted conditions have been linked with low levels of vitamin D, including: heart disease, diabetes, cancer, mental illnesses such as depression, chronic pain, falls and fractures, osteoporosis and osteoarthritis, fatigue, influenza, and autoimmune diseases. Large epidemiology studies have shown chronic disease prevention by keeping vitamin D levels > 50. It is no coincidence that flu season and seasonal affective disorder occur during the same season we are exposed to less sunlight and suffer lower levels of vitamin D.

Unfortunately, there are very few natural sources of vitamin D available. Many patients, as well as medical providers, have unrealistic expectations they can obtain the doses they need through foods. The best food sources include fortified milk and fatty fish. Living in the Midwest, we don’t have access to a coastal diet, yet even if we did, the amount of fish we would need to consume to meet the satisfactory level of vitamin D would be unrealistic. Fatty fish contains approximately 250-350 International Units (IUs)/3.5 ounce serving, and fortified milk has roughly 100 units/cup.  An individual would need to consume seven servings of fish per day, or roughly 20 cups milk per day, to obtain the recommended 2000 IU daily. Even 2000 units per day may not be enough to keep one’s vitamin D level in the optimal range.

Another major source of this important vitamin is natural sunlight. Only 10-15 minutes in the sun will generate 10,000-20,000 IU vitamin D 3. However, unless you wear a bikini without sunscreen every day around noon, in a location near the equator, like Hawaii, you likely are not getting the vitamin D exposure you need from the sun. Sunscreen inhibits your vitamin D absorption, as does darker skin pigmentation and body fat. Latitude and the different seasons will also affect the amount of radiation that will reach you.

Due to the challenges of obtaining enough vitamin D naturally, supplementation is critical in Iowa, especially during the fall and winter months. How much should you take? Many factors play a role in determining your dose level, including your age, absorption, skin color, and most importantly your current vitamin D level. Typical doses range from 400 IU-50,000 IU daily-weekly.

Concerned about toxicity? You are much more likely to be deficient than toxic. Vitamin D researchers estimate over 50% of Americans are deficient. The Institute of Medicine’s Food and Nutrition Board has never produced any evidence that 10,000 IU/day or higher of vitamin D has ever caused toxicity, and The Endocrine Society’s 2011 Vitamin D Clinical Guidelines reference dose-specific studies of men receiving 10,000 IU/daily D3 for five months and who never experienced toxicity in vitamin D or calcium levels. The study concluded that vitamin D toxicity is very rare.

Optimal levels are 50-80,with the average “normal reference range” clocking in at a dismal 32. It is recommended that your provider monitor your 25-hydroxyvitamin D (25-OHD) and calcium levels if you are concerned with toxicity.

Supplementing vitamin D to optimal ranges may be the best intervention you could give yourself to promote health and longevity.

Schedule an appointment at Integrative Health and Hormone Clinic with Dr. Stephanie Mellor, a specialist in integrative therapies such as optimizing one’s vitamin D level. Call 319-363-0033 or visit