Vitamin D: Making Sure You Get Enough

Not too long ago, vitamin D was all the rage. Claims about the benefits of this vitamin abounded, with declarations about its ability to help fight conditions ranging from cancer to depression to multiple sclerosis. While some of these claims have been shown to be unfounded, it is still a necessary — and essential — nutrient that all of us need, and many of us fall short. Here’s how to make sure you’re getting enough of this important vitamin.

What does vitamin D do for us?
Vitamin D is a fat-soluble vitamin.

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Bone health: We need this vitamin to absorb calcium and to build strong bones (this is especially important to keep in mind, as people who have diabetes are at higher risk for bone fractures). A lack of calcium raises the risk of osteomalacia (bone softening) and osteoporosis (porous, fragile bones). Besides helping the body to absorb calcium, vitamin D regulates levels of calcium and phosphorous, which is necessary for bone health and to prevent hypocalcemic tetany, a condition involving spasms related to not enough calcium in the blood.

Immune function: A strong, healthy immune system is vital for helping us to ward off diseases and infections such as the flu and the common cold. In particular, vitamin D allows T cells, the “killer cells” of our immune system, to react and fight off infection.

Inflammation: Inflammation is the body’s immune response to a negative stimulus, such as bacteria or viruses. While acute inflammation is helpful — fighting an infection, for example — chronic inflammation can occur due to the immune system attacking the body, and can trigger serious conditions such as rheumatoid arthritis, inflammatory bowel disease, cancer, and heart disease. Vitamin D has been shown to reduce this chronic inflammation.

Dementia: Low levels of vitamin D may increase the risk for dementia, including Alzheimer’s disease, which is a type of dementia.

What’s the role of vitamin D in diabetes?
Research indicates that low levels of vitamin D is linked with a higher risk of developing both Type 1 and Type 2 diabetes. And other research indicates that low levels of this vitamin might negatively affect blood sugar control (but not all research has shown this). In addition, the risk of diabetes complications, such as eye disease, kidney disease, nerve damage, and heart disease, may increase with low vitamin D levels.

How much vitamin D do you need?
According to the Food and Nutrition Board, adults between the ages of 18 and 70 need 600 International Units (IU) each day. Adults over the age of 70 should aim for 800 IU per day. On the other hand, the Vitamin D Council, which is a nonprofit organization based in California, recommends that adults aim for 5,000 IU per day. And the Endocrine Society recommends an amount somewhere in-between: at least 1,500–2,000 IU per day. Why the differences? Recommendations come from research. Some researchers believe that the available evidence doesn’t support taking higher amounts, while others think that research will eventually support these higher levels. The best course of action for you is to talk with your doctor or dietitian about the right amount of vitamin D for you.

Is too much vitamin D harmful?
As vitamins go, vitamin D is pretty safe. However, too much vitamin D can be harmful. Keep in mind that vitamin D is fat soluble, which means that your body stores it. It’s best not to take more than 10,000 IU per day, according to the Vitamin D Council. Toxicity can occur if you take 40,000 IU daily for a couple of months or longer. If you’re deficient in vitamin D and are taking large doses of vitamin D to correct the deficiency, you should be working closely with your doctor to have your blood levels checked regularly.

Signs that you’re dealing with vitamin D overload include nausea, vomiting, weakness, poor appetite, and dehydration. Excess vitamin D can also lead to kidney problems and calcification of internal organs.

How do you get vitamin D?
There are three ways to meet your vitamin D needs: sunlight, food sources, and supplements.

Sunlight: Amazingly enough, your body can make between 10,000 and 25,000 IU of vitamin D from the ultraviolet B rays of sunshine. If you have light-colored skin, getting 15 to 20 minutes of sun exposure each day is enough for the body to make vitamin D. If you have dark-colored skin, up to a couple hours may be needed. Of course, the amount and “quality” of sunshine is dependent upon where you live, the time of year, and the time of day. If you have or are at risk for skin cancer, or if you take certain medications, you should talk with your doctor before increasing the amount of “sunshine time.”

Food: Relatively few foods naturally contain vitamin D, and because of this, it’s very difficult to meet your vitamin D needs from foods alone. Salmon, canned tuna, mackerel, and fish liver oils are the best sources. Beef liver, egg yolks, and cheese have small amounts. Some foods may be fortified with vitamin D, including milk, yogurt, orange juice, and cereal.

Supplements: Your doctor or dietitian may advise you to take a vitamin D supplement to help meet your daily needs and/or if your blood level of vitamin D is too low. If you do decide to take a supplement, it’s best to take it in the form of vitamin D3 rather than D2. D3 is the form of vitamin D made by sunshine. Supplements are available as tablets, capsules, gummies, and liquid drops. Avoid the gummies, as they contain carbohydrate. You can take supplements with or without food, but it’s not a bad idea to take your supplement with a healthy fat source, such as peanut butter, avocado, egg, or olive oil. In general, avoid taking fish liver oil as a supplement, as it contains very high amounts of vitamin A, which could be harmful.

How do you know if you’re getting enough vitamin D?
Your doctor can (and should) check your blood level of vitamin D. A blood level below 30 ng/ml (nanograms per milliliter) is too low for both bone and overall health. A level of about 50 ng/ml is recommended for most people.

For more information on vitamin D, visit the Vitamin D Council’s website.

Amy Mercer recently spoke with teen Hannah McCrary about her life with Type 1 diabetes and her experience at a Riding On Insulin camp. Bookmark DiabetesSelfManagement.com and tune in tomorrow to read more.

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