Vitamin D- The ‘Sunshine Vitamin’
What is it? Why do we need it?
And, how do we get it….?
Awareness for vitamin D is much higher now thanks to Public Health England announcing in 2016, that it is advised people in the UK consider taking a vitamin D supplement of 10mcg (micro grams, often written as μm) throughout autumn and winter (roughly September - March).
I hear people speaking about vitamin D more often now, but how many people are actually taking the supplement in these colder, darker months?? And possibly should some people continue supplementing all year? I feel that knowing a little more about what vitamin D is and why we need it can be an empowering persuader to help insure more of the population consider adding this vitamin to their daily routine!
So first of all, what is Vitamin D?!?..
A vitamin is something that we cannot make within our body but something we must consume to help our bodies function properly. We call Vitamins D a vitamin...but it is a little misleading, as it is in actual fact a hormone!! A hormone which we can make under the skin. We can make this hormone under the skin only when our skin is exposed to daylight. This is why you may of heard it being called the 'sunshine-vitamin'.
Why do we need it?
What does this vital vitamin actually do in the body? Well it is essential for our bone health. Which many of us (myself included) may not think about all too often...it's so easy, especially while we are young or because we have never had any problems with our bones to date, to not think about bone health. Keeping good bone health is so important especially when thinking about our future selves and the lives we hope to lead as we grow older.
Vitamin D works with calcium and phosphorous to help maintain healthy bones, teeth and muscles. Vitamin D is essential for the absorption of calcium. This means that even if you are eating a diet rich in calcium (very good sources being dairy and dark leafy greens!!) you will not actually be reaping the benefits for you bones, as without sufficient Vitamin D your body will not be able to use the calcium.
Some vitamins love to team up in this way! That's why variety in the diet is a good thing to aim for.
What does a vitamin D deficiency look like..
"According to national surveys in the UK, across the population approximately 1 in 5 people have low vitamin D levels (defined as serum levels below 25 nmol/L"[1].
In children a lack of vitamin D can cause Rickets and in adults can lead to Bone pain, muscle weakness and diseases like, Ostemalicia. [2]. Someone with low levels may also experience fatigue, or changes in mood. If you are concerned about any of these symptoms, they may not always be a symptom of Vitamin D deficiency so it is important to see your GP and request a blood test. This is why some people claim that taking vitamin D can help alleviate low mood, as when deficient it can be effected, however, it has not been proven to always improve low moods.
If you are concerned about your mental health, please reach out to your Doctor, and family and friends.
Who is at risk of Vitamin D deficiency??
As we have learned Vitamin D is more about sunshine than food...a little tricky in a country like England..!
From September to late March/early April anyone living in the UK or northern hemisphere may be at risk of deficiency as how the planet is tilted towards the sun, we just do not get enough of it! This is why the recommendation that everyone takes a supplement is essential.
However, you may need to continue taking the supplement through out the year for various other reasons, such as..
People living in a care home, or institution.
Anyone not mobile and unable to get outside often.
Also, anyone with darker skin, for example of African, Afro-Caribbean, Asian, Middle Eastern decent living in the UK or northern hemisphere.
This is due to the levels of melanin in the skin. Melanin which causes skin pigmentation lowers the skins ability to produce vitamin D under the skin.
If you don't go outside often during summer as working indoors, travelling and then home. Or night shift workers for example.
If you often wear clothing which covers most of your skin.
Pregnant and breastfeeding women.
Babies and children. Plus any teenagers who may not be outside enough.
So how do we get this ‘sunshine vitamin’ and how do we know when we’re getting enough??!? Why supplementation route?
It is firstly important to note, despite everything I have explained about getting this vitamin from sunlight, Vitamin D can also be found in a small amount of foods. Such as,
Egg Yolks
Liver
Red Meat
Oily fish - such as, salmon, herring, mackerel and salmon
Fortified foods, such as breakfast cereals and margarine spreads.
However, it is often only in small amounts and majority of these foods should not be eaten in large quantities for other health reasons.
Therefore, supplementation is the best route for most, especially during the Autumn/Winter Months or for the reasons stated above.
How much??
The recommended amount for children from the age of 1 and adults is 10micrograms (μm) per day. This is the equivalent of 400IU. Which stand for International Units and many supplement companies use this as a quantity on their packaging.
For babies and children under the age of 1 it is 8.5-10microgams (μm) [3]
If the baby is being breast-fed, the dose should be as above. However if they are formula fed, they should not supplement if they are still having at least 500ml of formula a day, as it is fortified already with Vitamin D.
Is there Toxicity Potential? What happens if you take too much of the vitamin?
It is possible to have too much vitamin D. In very high doses the vitamin can be toxic. Taking too much, over a long period of time can lead to the body producing too much calcium, and there being a build up within the tissues causing Hypercalcaemia. This can cause damage to the kidneys and heart, plus cause weakened bones.
Be aware, a lot of supplement companies on the market now have offerings of very high doses (I have seen some of 4000IU!). This is not needed for normal supplementation and would only ever be prescribed by a doctor, and monitored under supervision if a patient was particularly deficient. For general supplementation please stick to the guidelines of 10micrograms per day = 400IU. If you feel you need the higher dose, please consult your doctor before hand for tests.
Where can we find them/cost?
You will normally find the supplements on the shelves in either D3 or D2 form. Both are suitable, D3 is suitable for vegetarians and vegans (always check packaging).
They vary in price, but should only pay around £2.50 - £5.00 for 90-150pills. This is for the recommended dose of 10 micro grams, (400IU)
Here is the recommended dose at Boots, UK, for £2.30.
https://www.boots.com/health-pharmacy/menshealth/menshealth-supplements/boots-vitamin-d-90-tablets-10145801
KEY TAKE HOME POINTS..
Vitamin D is essential for the absorption of calcium, therefor adequate amounts are needed to ensure healthy, strong bones. A deficiency can lead to osteomalacia in adults or rickets in children.
Vitamin D can be found in some foods in small doses, but we make the majority of our vitamin D under the skin, after exposure to sunlight.
Between September/October and late March/April it is advised that anyone living in the northern hemisphere should supplement Vitamin D, with 10 micrograms a day (for children over 1 years of age and adults)
You may also be at risk of deficiency during the rest of the year, if you do not get enough sunlight, from working in doors, wearing clothing which covers most of your skin or being unable to go outside. You may also have increased rick if you are of African, Afro-Caribbean, Asian, Middle Eastern decent living in the UK or northern hemisphere.
Please be wary of high dose supplements and stick to the guidance given of 10micrograms per day. Always consult with your doctor or healthcare practitioner if you think you are suffering from a deficiency.
References
[1] https://www.nutrition.org.uk/nutritioninthenews/new-reports/983-newvitamind.html#:~:text=According to national surveys in,below 25 nmol%2FL).
[2]https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
[3]https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
Calame, Wim et al. “Vitamin D Serum Levels in the UK Population, including a Mathematical Approach to Evaluate the Impact of Vitamin D Fortified Ready-to-Eat Breakfast Cereals: Application of the NDNS Database.” Nutrients vol. 12,6 1868. 23 Jun. 2020, doi:10.3390/nu12061868 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353432/
Jim Mann & A. Stewart Truswell, 2012, ‘Essentials of Human Nutrition, Fourth Edition”