Vitamin D: What’s All the Fuss?

A large and growing amount of evidence on the benefits of vitamin D and the risks of its deficiency has been predominantly ignored until recent years. Vitamin D deficiency has very few obvious outward signs which may account for the lack of attention previously paid. Several years ago a nutrition expert I often consult with told me that, based on her study and observations over the years, she recommends extra vitamin D3 for her clients in the winter time, especially those who struggle with winter-worsening depression. The patients often reported good results. It seems more of the medical community is now paying attention to this simple, safe and inexpensive supplement. Dr. Ellie Campbell, a frequent lecturer on the topic of menopause, vitamin D and osteoporosis stated that in her practice in Atlanta, Georgia, as many as seventy percent of her patients are vitamin D deficient. In one study of Hawaiians, fifty-one percent of them were deficient. It seems quite fair to say that almost everybody deserves an evaluation of their vitamin D blood levels.

Vitamin D has been called "life's most fundamental hormone" and the "cheapest medicine on the planet." It is made in the cells of most organisms and can act on as many as 200 genes. There are 2 forms, D2 and D3, both of which can be ingested in the diet. The major source of vitamin D is the vitamin D3 synthesized in the skin from exposure to ultraviolet-B (UVB) rays. Low levels can cause depression and brain fog, soft and brittle fingernails and muscle weakness and postural instability. Higher blood levels of Vitamin D have been associated with "higher bone mineral density, lower fracture risk, lower incidence of periodontal disease and tooth loss and a lower risk of colorectal cancer." (Bischoff-Ferrari, et al. Raising the RDA of vitamin D is warranted and will Have Multiple Health Benefits, American Journal of Clinical Nutrition. 84: 18-28, 2006). According to a report by the North American Menopause Society (NAMS), deficiency of this vitamin has also been associated with an increase in the risk of other cancers, as well, including prostate, breast and esophagus. A very recent report from Aurora Sinai Medical Center in Milwaukee states that more and more studies are also linking insufficient levels of vitamin D to increased risk of heart disease. An article in the current Journal of the American College of Cardiology (January 2009) reports the same conclusion. In a study involving German heart patients, those in the group with the lowest vitamin D levels had twice the risk of dying, especially from heart disease, when compared to those in the group with the highest levels.

Many primary doctors have begun to include a blood test for vitamin D3 levels (25-hydroxyvitamin D) as part of the annual exam. The National Institutes of Health have set the normal range at 16-74ng/ml, but many experts are urging that the lower end of the range be elevated. Muir and Birge writing about Vitamin D deficiency in pre- and postmenopausal women estimate the requirement in healthy adults to be 3000-5000 IU of vitamin D daily. This estimate is currently higher than generally seen in the literature, but the tide is definitely turning. The amount necessary will depend on your age, lifestyle, underlying risk factors and health history. Because of the vitamin receptor's dependency on estrogen, postmenopausal women are more likely to be deficient. However, premenopausal women are also at risk because of limited sun exposure and use of sunscreen products.