By Andrea Hartley
Tired? Muscles aching? Have you had trouble sleeping and just not felt like yourself? You might be deficient in vitamin D. Recent studies indicate that up to 75 percent of the American population may be deficient in vitamin D; a deficiency which has been linked to a plethera of illnesses including the three top killers, heart disease, cancer and diabetes. Darker-skinned individuals, older adults, obese individuals and post menopausal women are at greater risk for vitamin D deficiency. There are vitamin D receptors all over the human body, therefore, it is involved in many biological processes including cell growth, and immune function.
Michael Monte Carlo, M.D., who practices family medicine in West Deptford, New Jersey, says that he routinely checks vitamin D levels in most of his patients on a yearly basis and finds that about 50 percent of them are deficient.
“I believe that the higher incidence is due to multiple factors, but the main factor being related to poor nutrition. A poor diet that is a diet high in processed foods is low in vitamin D. People do not consume enough fresh vegetables and fish, both sources high in vitamin D, therefore there dietary intake is low.,” Dr. Monte Carlo said. “In addition, we are seeing a higher incidence because the largest group of the worlds population is aging. vitamin D production in the skin declines with advancing age, making elderly populations more dependent on dietary vitamin D, which goes back to my first point. For the average older person, higher dietary intake of vitamin D may be required to achieve normal serum levels.” He added that the increased use of sun block is another factor.
“SPF blocks about 99% of the production of vtitamin D. Also, when you start to tan, the tanning process itself begins to block vitamin D,” Dr. Monte Carlo said.
So what’s a guy to do? Sun block or not? The British may have the answer! “Some of the messages about sun exposure have been too negative,” explained Professor Rona Mackie, from the British Association of Dermatologists, to BBC News. “We’re now saying that exposure of ten to fifteen minutes … without suncream, several times a week is probably a safe balance between adequate vitamin D levels and any risk of skin cancer.” The best time of day for this is between 11:00 A.M and 2:00 P.M
If you are over the age of 50, it may be more difficult for you to synthesize vitamin D in the skin with sun exposure. You may want to opt for a change in diet or supplementation
The Institute of Medicine recommended daily dose allowance is 600 IU and 800 IU for adults over age 70. Many physicians find this threshold too low and advise 2,999 IU. The daily intake should not exceed 4,000 IU per day unless prescribed by a physician. Dr. Monte Carlo prescribes 1200IU of vitamin D2 with calcium for post menopausal woman and for those patients with moderate to severe deficiencies he prescribes 4,000 to 8,000 IU. Depending on the patient, it might be taken daily, 3 times a week, or weekly.
Now, you have a good reason to take that fishing trip you have been wanting to take without guilt; since vitamin D is found naturally in very few foods. Salmon, Mackerel, Blue fish, are some of the best sources.
“A serving of salmon (3.5oz) contains approximately 1400 IU of vitamin D3; this amount remains unchanged after baking, but is decreased by 50% if the fish is fried,” Dr. Monte Carlo said. Cod Liver oil is also a good source of vitamin D
Another tip, read the labels on your milk and cereal to be sure they are fortified with vitamin D.
Dr. Monte Carlo had more great things to say about the sunshine vitamin. “Vitamin D is very beneficial in preventing osteoporosis, heart disease, cervical cancer, infections. It is also useful in treating rhuematoid arthritis, lupus, diabetes and multiple sclerosis,” he said. “There is really no difference in the effect of vitamin D deficiency between men and women. In children, (both boys and girls), vitamin D deficiency can manifest itself as Rickets, which presents itself as bowing of the legs. In adults (both men and women), it can lead to osteomalacia, which presents as a poorly mineralized bone. Osteomalacia can lead to osteopenia, followed by Osteoporosis. Adults with a vitamin D deficiency may experience fatigue, headaches, poor sleep quality, chronic muscle aches and pains.”
There are actually a couple of forms of the vitamin, D2 and D3. Vitamin D3 is the naturally occurring form of the vitamin and is essential for life. Its molecular structure is similar the body’s steroid hormones, e.g. cortisol, estradiol, progesterone, aldosterone, and testosterone. Cholesterol is the precursor substance for these hormones and for vitamin D3 ,which, though it is called a “vitamin”, is actually a hormone as well . The manufacturing process of the supplement is complex. It typically starts by extracting cholesterol from the lanolin of sheep wool and through a patented purification process, is converted to active D3. This is the form of vitamin D that most physicians recommend . Vitamin D testing is expensive and is not covered by many insurance companies.
“Most people pay for it themselves, “ said Dr. Monte Carlo. He suggests that the price may come down in the future.
People from all over the world have been fascinated with vitamin D’s healing potential. One woman in London gave vitamin D capsules to her husband who had prostate cancer; and to the amazement of the doctors, he got better! This incident prompted a study which is about to be published in the journal BJU International. Professor Jonathan Waxman, from Imperial College, London . They found that using vitamin D alone, once a day reduced PSA levels (an indicator in the severity of Prostate Cancer) by as much as half in 20% of the patients.
Other studies have also shown that vitamin D holds promise in treating Prostate Cancer. One study conducted at Stanford School of Medicine by David Feldman, M.D., showed that Cancer cell growth in a laboratory dish could by reduced by up to 70 percent when a form of vitamin D called Calcitriol, (available only by prescription), is combined with low doses of over-the-counter-pain killers. Researchers have discovered that hormones called prostaglandins cause inflammation, and inflammation is associated with cancer growth, as well as other health problems. Calcitriol and NSAIDs (nonsteroidal, anti-inflammatory) drugs both block prostaglandins.
Feldman says there is great enhancement when the drugs are given together but it is difficult to make an exact comparison since they are using cells in a petri dish and not a human.
Dr. Adam Perzin,M.D., a urologist with the Delaware Valley Urology, says that these studies provide great hope for the treatment of Prostate Cancer; but that it will be years before doctors will be able to conclusively prescribe vitamin D and anti-inflammatories as a treatment.
“I don’t want to squash the enthusiasm here, but first, there will need to be animal studies and then clinical trials on humans,” Perzin said. “This study definitely suggests that there may be some benefit and if it is proven that there is a link between vitamin D deficiency and prostate cancer, it would be incredible.”
The department of Preventative Cardiology at Hartford Hospital (Connecticut) is examining the effects of vitamin D supplementation (400IU vs 4,000IU) on blood pressure. The study is seeking men and women ages 18-50 years old with slightly elevated blood pressure (over 120/80), vitamin D deficient (under 20ng/ml), and who are not currently being treated with blood pressure lowering medications. Research participants will receive $150 for their time if they qualify and complete the study. For more information call 860-545-3454.
The following is a list of vitamin D quantities of certain foods reported by the US Department of Agriculture’s Nutrient Data Lab:Courtesy of Dr. Monte Carlo.
Fortified Milk (8oz)–100IU
Fortified Orange Juice(8oz)–100IU
Fortified Cereal(1 serving)–40 to 80IU
Canned salmon (100grams)–624IU Mackerel (100grams)–360IU
Cod liver oil(1 Tbsp)–1360IU
Shiitake mushrooms dried (4)–249IU
Egg, 1 large (vitamin D found in yolk)–26IU
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