A crisis of vitamin D deficiency shadows America. Low levels of the sunshine vitamin are now linked by recent studies to rheumatoid arthritis (RA), osteoarthritis, lupus and a host of degenerative diseases.
Can a ten cent vitamin D supplement really be the answer?
Seventy-seven per cent of U.S. teens and adults are deficient in vitamin D, the so-called "sunshine vitamin" whose deficits are increasingly blamed for everything from cancer and heart disease to diabetes, according to research published in the Archives of Internal Medicine in March, 2009. While the accuracy of this statistical extreme has been questioned in some quarters, why are many Americans deficient in vitamin D?
Drawing on decades of research, Dr. Michael F. Holick, PhD, M.D. theorizes in his 2011 book, The Vitamin D Solution: "Many Americans have succumbed to the scare tactics of the dermatological community, and avoid sunlight for fear of skin cancer and premature aging. Therefore, most of us suffer from vitamin D deficiency, which causes daily aches, pains, and fatigue, worsens serious illnesses, and diminishes the quality of everyday life."
Holick, a recognized researcher and professor at Boston University School of Medicine, Section of Endocrinology, Vitamin D Laboratory, in Boston, MA, recommends that we need a sensible amount of unprotected sun exposure, as well as vitamin-D supplementation.
He says: "From my perspective there is no downside to increasing your vitamin D intake to levels I have recommended in The Vitamin D Solution which is 1000 IU of vitamin D a day for children and 2000-3000 IU of vitamin D for adults.”
A 2017 controlled study links vitamin-D deficiency to rheumatoid arthritis patients. Entitled Vitamin D Status, Disease Activity, and Endothelial Dysfunction in Early RA Patients, researchers evaluated the effect of vitamin D status on disease activity and endothelial cell function in individuals with early RA.
The study author A. Caraba concluded: “In early RA patients with moderate and high disease activity, low serum levels of vitamin D were associated with disease activity, increased insulin resistance, and endothelial dysfunction.” The study was published in the journal Disease Markers.
“Vitamin D deficiency is now recognized as an epidemic in the United States,” Holick wrote in The Vitamin D Epidemic and its Health Consequences,, an earlier article published in the November, 2005 issue of The Journal of Nutrition.
Holick also authored, Medical Progress Vitamin D Deficiency, published July 19, 2007 in the New England Journal of Medicine, in which he wrote: “Women who ingested more than 400 IU of vitamin D per day had a 42% reduced risk of developing” rheumatoid arthritis, osteoarthritis and multiple sclerosis. Holick concluded, “Sensible sun exposure and the use of supplements are needed to fulfill the body’s vitamin D requirement.”
Low vitamin D has long been associated with the bone deformity rickets in young children and osteoporosis in adults, but it also “has other serious consequence on overall health and well being,” Holick observed. “There is mounting scientific evidence that implicates vitamin D deficiency with an increased risk of type I diabetes, multiple sclerosis, rheumatoid arthritis, hypertension, cardiovascular heart disease, and many common deadly cancers.”
“The major source of vitamin D for both children and adults is from sensible sun exposure,” Holick said. He recommends in the absence of sun exposure, 1000 IU of a cholecalciferol Vitamin D3 supplement be taken daily for both children and adults.
Holick also advises everyone to be vigilant of their vitamin D status by getting a blood test. “Measurement of vitamin d 25 hydroxy level should be part of an annual physical examination,” he suggests.
A Feb. 2006 study Vitamin D deficiency in systemic lupus erythematosus (SLE) concluded that vitamin D deficiency is a possible risk factor for SLE and provides guidance for future studies looking at a potential role of vitamin D in the prevention and/or treatment of SLE.
According to the Vitamin D Council, current research has implicated vitamin D deficiency as a major factor in the pathology of osteoarthritis, chronic pain, autoimmune diseases (e.g., rheumatoid arthritis, lupus, multiple sclerosis), heart disease, stroke, hypertension, diabetes, depression, osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal disease, at least 17 varieties of cancer, and more.
Quoting from the Council’s webpage entitled, What Is Vitamin D?: “Vitamin D's influence on key biological functions vital to one's health and well-being mandates that vitamin D no longer be ignored by the health care industry nor by individuals striving to achieve and maintain a greater state of health.”
The report concludes, “If well adults and adolescents regularly avoid sunlight exposure, research indicates a necessity to supplement with at least 5,000 units (IU) of vitamin D daily. To obtain this amount from milk one would need to consume 50 glasses. With a multivitamin more than 10 tablets would be necessary. Neither is advisable.”
In the abstract of the study Vitamin D in health and disease: current perspectives published Dec. 2010 in Nutrition Journal, the authors warn: “Despite the numerous reports of the association of vitamin D with a spectrum of development disease treatment and health maintenance, vitamin D deficiency is common.”
“A great deal of the population suffers from vitamin D deficiency, especially during winter months. This widespread deficiency of vitamin D merits consideration of widespread policies including increasing awareness among the public and healthcare professionals,” the authors conclude.
The study links vitamin D deficiency to origin, progression and treatment of rheumatoid arthritis and several other disorders including osteoporosis, multiple sclerosis, cancer, hypertension, muscle weakness and diabetes.
A clinical study, Vitamin D in preventive medicine: are we ignoring the evidence? published May, 2003 in the British Journal of Nutrition summarizes that vitamin D is used in most parts of the body and it can be detected by running tests on the blood. According to the authors, “Studies suggest that most children and older adults are often deficient in vitamin D, especially during the winter months. There has also been increasing evidence as to the relation of vitamin D deficiency to the development of rheumatoid arthritis, osteoporosis, multiple sclerosis, tuberculosis, as well as different forms of cancer.”
Study researchers linked vitamin D supplementation to reduction of blood pressure for hypertension, and to modulating glucose levels for diabetes, and aiding in symptom control of rheumatoid arthritis and multiple sclerosis.
“This suggests that a daily supplement of vitamin D can help to benefit most people, and can especially help to improve symptoms of many chronic disorders,” the authors conclude.
Rickets and osteomalacia are the classical vitamin D deficiency diseases. In children, vitamin D deficiency causes rickets, a disease resulting in soft bones and skeletal deformities. The fortification of milk with vitamin D beginning in the 1930s has made rickets a rare disease in the United States. In adults, inadequate vitamin D can lead to osteomalacia, resulting in weak bones.
Although rickets and osteomalacia are extreme examples of the effects of vitamin D deficiency, osteoporosis is an example of a long-term effect of calcium and vitamin D insufficiency. According to the Dietary Supplement Fact Sheet on Vitamin D produced by the National Institutes of Health (NIH), “more than 40 million adults in the United States have or are at risk of developing osteoporosis.”
The NIH Fact Sheet continues: "A growing body of research suggests that vitamin D might play some role in the prevention and treatment of rheumatoid arthritis, congestive heart failure, type 1 and type 2 diabetes, hypertension, glucose intolerance, multiple sclerosis, and other degenerative medical conditions. However, most evidence for these roles comes from in vitro, animal, and epidemiological studies, not the randomized clinical trials considered to be more definitive."
It's difficult to obtain sufficient vitamin D from natural food sources alone. For many people, consuming vitamin D-fortified foods and, arguably, being exposed to some sunlight are essential for maintaining a healthy vitamin D status. The NIH identifies the following groups at risk of vitamin D insufficiency, and suggests that dietary supplements might be required to meet the daily need for vitamin D:
For a long while, most scientists and most educators assumed that Americans were getting plenty of vitamin D—some even thought we were getting too much—and that we shouldn’t be taking high levels of supplemental D because it’s a fat-soluble vitamin that’s stored in body tissues with potential to reach toxic levels. In the last fifteen years, with extensive new research to back it up, there’s been practically a complete reversal in that thinking. That Americans are vitamin D deficient is now a fact.
Taking a ten cent vitamin D supplement daily may be the logical answer.
“The truth is that today we’re faced with what appears to be a sub-clinical epidemic here in the US and in many parts of the world,” said Janie McManus, MD, Chairman, Medical Affairs and Health Sciences, Shaklee Corporation, Pleasanton, CA. “The latest studies show that up to 80% of Americans may have insufficient levels of vitamin D in their blood.”
“Today most experts believe that we need far more vitamin D than we’re getting,” McManus continued. “It has become clear that we’re not getting enough sun exposure to generate the internal production of vitamin D to reach adequate levels as well as to prevent the many health conditions that are associated with deficiency,” McManus added.
Lack of sun exposure is a major contributor to low vitamin D levels in the body. There are a number of factors to consider because not everybody gets the same sun exposure. For example, dark pigmented skin is less efficient at using the sun’s rays to make the active form of vitamin D, requiring more sun than those with lighter skins.
If you live in northern latitudes (north of a line drawn from San Francisco, CA to Richmond, VA) the angle of the sun from late fall to early spring is often inadequate to support the internal production of vitamin D.
While diet is a source of vitamin D, it is difficult to obtain sufficient vitamin D from fortified dairy and cereal, and few foods are good sources alone (salmon and cod liver oil the exceptions).
Here are a few quotations related to vitamin D deficiency, found at vitamindcouncil.org:
Once known only for its bone-building properties, medical journals are now overflowing with the research findings that suggest the many vitamin D benefits to one's health
There is considerable controversy concerning vitamin D intake daily. The government increased its recommendation for the second time on Nov. 30, 2010. However, the new guidelines are “too conservative,” according to vitamin D researchers/experts.
In view of two decades of extensive research that links vitamin D deficiency to a litany of degenerative diseases, many in the medical community expressed disappointment the RDA increases for vitamin D were not greater.
Perhaps a majority of the world’s most prominent vitamin D scientists debate the guidelines. Here’s a consensus of what these experts recommend:
So, what's a sufficient level of vitamin D supplementation if you have arthritis, RA or lupus? Perhaps an evidence-based study says it best:
On November 30, 2010 the Institute of Medicine’s (IOM) Food and Nutrition Board (FNB) reported that vitamin D toxicity might occur at an intake of 10,000 IU/day. This stance was harshly rebutted by the Vitamin D Council's article, Today the Nutrition Board has failed millions.
On Jan. 13, 2011 the Dietary Supplement Fact Sheet on Vitamin D by the NIH says most reports suggest a toxicity threshold for vitamin D of 10,000IU to 40,000IU/day.
Excessive sun exposure does not result in vitamin D toxicity. Vitamin D toxicity from supplement intake can cause non-specific symptoms such as anorexia, weight loss, polyuria, and heart arrhythmias. More seriously, it can also raise blood levels of calcium which leads to vascular and tissue calcification, with subsequent damage to the heart, blood vessels, and kidneys, according to the NIH.
Concerns about vitamin D toxicity are largely unfounded, according to The Vitamin D Council, which takes issue with the IOM’s ceiling of 10,000 IU/day. It is possible to take an amount of vitamin D that would eventually be toxic, the Council said, however there has been no evidence of adverse effects unless in excess of 40,000 IU/day is taken for a prolonged period.
There is little question concerning which form of vitamin D is best in a dietary supplement.
When looking for a vitamin D supplement, the preferred form of D is cholecalciferol, or vitamin D3. Cholecalciferol is the naturally occurring form of vitamin D. It is the substance made in large quantities in your skin when sunlight strikes your bare skin. It i can also be taken in a supplement. Cholecalciferol is vitamin D; all other compounds are either metabolic products or chemical modifications.
Ergocalciferol (also referred to as vitamin D2 or calciferol) is another form of D, derived by radiating fungus. It is not the naturally occurring vitamin D for humans and is not the preferred form in a vitamin D supplement. Ergocalciferol is available to U.S. doctors in prescription strength and is sometimes used in multivitamin preparations—usually at 400IU per pill. Your doctor can write a prescription for 50,000 units of ergocalciferol (brand names Drisdol and Calciferol).
As you may know from other pages on this website, my husband and I have osteoarthritis. We’ve controlled our pain symptoms since 2003 with three natural products. We’re no longer on pharmaceutical drugs of any kind. Recently we’ve become aware that most Americans are vitamin D deficient and taking vitamin D supplements may play a considerable treatment role in joint health. This one minute video on my health website, illustrates the vitamin D problem and offers a ten cents a day solution. I think you’ll enjoy seeing it.
To increase our vitamin D blood levels, we’ve added 2000IU daily by taking a new Vitamin D3 supplement with surprising results of diminished pain and knee stiffness.
There are two primary questions to consider when deciding upon a vitamin D3 cholecalciferol supplement :
In response to the alarming scientific evidence on vitamin D deficiency in the general population, the featured vitamin D supplement is new from this 60+-year-old company and is the culmination of recent cutting-edge scientific research, including two of their own industry-leading vitamin D studies.
If you have low vitamin D blood levels, or think you might, we recommend this vitamin D supplement because it’s clinically supported and proven to significantly raise blood levels of vitamin D. We highly endorse it. The company’s 100% product guarantee is ironclad.
Always check with your doctor before beginning any method of self treatment. Obtain his/her recommendation regarding getting a blood test and how many IU’s to supplement daily.
Vitamin D Deficiency Disclaimer: Health statements on this Vitamin D Deficiency 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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