Sunshine Vitamin D Supplement May
|<12||Associated with vitamin D deficiency, leading to rickets in infants and children and osteomalacia in adults|
|12-20||Generally considered inadequate for bone and overall health in healthy individuals|
|21-50||Generally considered adequate for bone and overall health in healthy individuals|
|>50||Emerging evidence links potential adverse effects to such high levels, particularly >60 ng/mL|
The new RDA immediately brought outcries that they’re too low. Numerous experts, researchers and doctors believe vitamin D blood levels should be set higher for optimal health. Critics are disturbed the FNB committee focused on bone health, ignoring thousands of studies over the last ten years that suggest lower levels of vitamin D linked to a host of health conditions.
The following table reflects a consensus among vitamin D researchers. Note that its cut points concerning adequacy and inadequacy are considerably higher than the RDA:
RESEARCHERS CONSENSUS Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health
|<10||Associated with vitamin D deficiency, leading to rickets in infants and children and osteomalacia in adults|
|10-29||Generally considered inadequate for bone and overall health in healthy individuals|
|30-49||Generally considered adequate for bone and overall health in healthy individuals|
|50-80||Generally considered optimal for bone and overall health|
|>100||Evidence suggests possible toxicity at this level|
The FNB committee cited research which found that intakes from a vitamin D supplement of 5,000IU/day achieved serum 25(OH)D concentrations between 40–60ng/mL, but no greater.
As we learn more about vitamin D, Dr. Haque anticipates that the optimal level will be pushed considerably higher, with an ideal range between 50 and 70ng/mL.
For additional information, please see this June 1, 2012 article Shining Light on Vitamin D Testing by Connie Mardis, MEd, CLPMAG.
John Cannel, Executive Director of the Vitamin D Council, wrote on Nov. 30, 2010, “Today the FNB has failed millions of pregnant women whose as yet unborn babies will pay the price. They recommended that a three-pound premature infant take virtually the same amount of vitamin D as a 300 pound pregnant woman”
“My advice, especially for pregnant women: continue taking 5,000 IU/day until your 25(OH)D is between 50-80 ng/mL (the vitamin D blood levels obtained by humans who live and work in the sun and the mid-point of the current reference ranges at all American laboratories).”
He also said, “The FNB committee consulted with 14 vitamin D experts and - after reading these 14 different reports - the FNB decided to suppress their reports.”
Walter Willett at Harvard, who may be the single best-known nutritionist in the world, commenting on the IOM’s Nov. 30, 2010 vitamin D adequacy recommendations, wrote, “a threshold of 20 ng/m/L for its 25(OH)D blood level is not supported by the available data from double-blind randomized controlled trials (RCTs) of fracture risk.”
Willett pointed out that “in two 2009 meta-analyses of double-blind RCTs, a threshold of 20 ng/ml was insufficient for fracture or fall reduction” based on achieved blood levels in the treatment groups. He also cited that in the very large NHANES analysis, “bone density increased with higher 25(OH)D levels far beyond 20 ng/mL in younger and older adults suggesting that the IOM threshold recommendation is too low for optimal bone health in adults.”
Robert P. Heaney MD, Professor of Medicine, Creighton University, in response to the new vitamin D RDA, in his online blog Feb. 2, 2013, based on his and other studies, said that the requirement to ensure that 97.5% of the population would have a value of at least 20 ng/mL, was 8,895 IU per day. Recall that the IOM figure was less than 1/10 that, i.e. 600 IU per day up to age 70 (and 800 IU per day thereafter). My colleagues and I calculated a value closer to 7,000 IU per day, still a full order of magnitude higher than the estimate of the IOM." Previously, Dr. Heaney has said, “It is important to stress that there is no disagreement in the scientific community about the importance of vitamin D for total body health. Where there is disagreement it is about how much is needed to insure that the bulk of the American population achieves vitamin D’s full benefits. There is an impressive body of scientific evidence supporting levels higher than the IOM panel is currently recommending. “
Heaney added, “Even if the evidence for a higher intake were uncertain (and I don’t believe it is), intakes two to five times the IOM recommendations would carry a good chance for benefit at essentially no cost and no risk.” Dr. Heaney also said that serum 25(OH)D values for “adequacy” needed to be 40-60 ng/mL.
For additional information, click on GrassrootsHealth an online public health organization that assembled a science panel of 41 expert vitamin D researchers and medical practitioners.
Vitamin D toxicity does not occur from too much sun—the body regulates D produced from sun exposure. Food and fortified food do not contain large enough amounts of vitamin D. Toxicity is rare and usually results from taking an excessive amount of vitamin D supplement. Few people take anywhere near the upper limit of vitamin D.
A buildup of calcium in the blood (hypercalcemia) is the main consequence of vitamin D toxicity. It causes symptoms such as nausea, lack of appetite, constipation, weakness, confusion, heart rhythm abnormalities and kidney stones. Treatment may include stopping any vitamin D supplement. Hospital intervention rarely occurs.
“Toxicity is simply not a concern in doses below 10,000 units a day. Restoring physiological serum levels of 25(OH)D will help many more patients than it will hurt,” said John Jacob Cannell, MD, Executive Director, VitaminDCouncil.org.
Quoting the NIH Vitamin D Fact Sheet for all adults: “Symptoms of toxicity are unlikely at daily intakes below 10,000 IU/day. Most reports suggest a toxicity threshold for vitamin D of 10,000 to 40,000 IU per day and serum 25(OH)D levels of 200-240 ng/mL”.
The Fact Sheet applies the following toxicity thresholds for children: Infant to six months, 1000 IU/day, age 7 to 12 months 1500 IU/day, 1 to 3 years 2500 IU/day, 4 to 8 years 3000 IU/day, and 9 years to adulthood 4000 IU/day.
Americans are vitamin D deficient, period. According to author Jordan Lite in a March 23, 2009 article in Scientific American, titled "Three-quarters of U.S. teens and adults are deficient in vitamin D -- study says New research suggests that most Americans are lacking a crucial vitamin", the so-called "sunshine vitamin" whose deficits are increasingly blamed for everything from cancer and heart disease to diabetes.
Most experts now agree that the optimal level should be 30 ng/mL or higher.
Using a cutoff of 32 ng/ml, up to 80% by some estimates, have suboptimal blood levels of vitamin D. In part, that's because we spend less time outdoors and absorb less vitamin D from sunlight. However, it also may be because we don't get enough vitamin D from our diet.
Whatever the cutoff or whatever the percentage, no less a recognized authority than Dr. Michael F. Holick, MD, PhD, one of the world's most prominent vitamin D scientists, said “Vitamin D deficiency is now recognized as an epidemic in the United States” (The vitamin D epidemic and its health consequences, Journal of Nutrition, 2005, Nov; 135(11):2739S-48S). “We estimate that vitamin D deficiency is the most common medical condition in the world,” he cautioned.
Vitamin D is actually available in two forms, cholecalciferol and ergocalciferol, better known as vitamin D3 and vitamin D2.
When taking a vitamin D supplement, the recommendation of the Harvard School of Public Health and many other public health organizations is to supplement with vitamin D3 (cholecalciferol) rather than D2 (ergocalciferol).
In October, 2006, the American Journal of Clinical Nutrition published a study by Houghton, L and Vieth, R The case against ergocalciferol (vitamin D2) as a vitamin supplement in which the authors conclude “vitamin D2 should no longer be regarded as a nutrient appropriate for supplementation or fortification of foods.”
An online article on vitamin D dated Feb. 10, 2011 by Dr. Joseph Mercola, D.O., an osteopathic physician, online health activist, and entrepreneur, advised: “Make sure, if you supplement, that you are using vitamin D3 and not the far inferior vitamin D2. As the latest research shows, D3 is approximately 87% more potent in raising and maintaining vitamin D concentrations and produces two to threefold greater storage of vitamin D than does D2.”
Once you’ve decided to supplement using vitamin D3, there are two primary questions to consider when deciding upon a vitamin D3 cholecalciferol supplement :
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It comes in a 90-tablet size, each tablet contains 1,000 IU of Vitamin D3 (as cholecalciferol). At one tablet daily this is a three-month supply for a total cost of about $10.00 and can be purchased online.
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Bottom line: always check with your doctor before beginning any method of self treatment and obtain his/her recommendation regarding adding a vitamin D supplement to your daily regiman.
Vitamin D Supplement Disclaimer: Health statements on this Vitamin D Supplement page have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
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