What to do with the two vitamin D guidelines?

Nutritional Health
As we've discussed in a number of past blogs, many adults are deficient in vitamin D, placing them at elevated risk for fracture, frequent falls, and a slew of other medical problems including several types of cancer. But what is the ideal way to prevent this deficiency? And does the method used matter in terms of health outcomes? As I've mentioned in the past Osteoporosis Canada recently reviewed these issues and offers bold new recommendations for vitamin D supplementation. But their recommendations are quite different from those offered by the Institute of Medicine. (more…)
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Institute of Medicine says megadoses of vitamin D, calcium unnecessary

General Health, Nutritional Health
In a front-page article, the New York Times says, "The very high levels of vitamin D and calcium that are often recommended by doctors and testing laboratories – and can be achieved only by taking supplements – are unnecessary and could be harmful, an expert committee says" in a low-awaited report. The "group said most people have adequate amounts of vitamin D in their blood supplied by their diets and natural sources like sunshine." Dr. Clifford J. Rosen, "a member of the panel and an osteoporosis expert at the Maine Medical Center Research Institute," said, "For most people, taking extra calcium and vitamin D supplements is not indicated." The AP reports, "Long-awaited new dietary guidelines say there's no proof that megadoses prevent cancer or other ailments – sure to frustrate…
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How Much Sunlight Is Equivalent to Vitamin D Supplementation?

Cancer, Mental Health
Readers of this blog are well aware than many (if not most) Americans have insufficient to deficient levels of vitamin D. Other than prescribing oral vitamin D or vitamin D-containing foods, we doctors were left with prescribing a little sunshine. But, we know that exposing your skin to unprotected UVA or UVB light can increase your risk of skin cancer. And, there has been controversy about exactly how much sunlight one might need to avoid vitamin D supplements. Now, I may have an answer for you. But, first a few basics. Vitamin D is essential for bone mineralization and may have a wide variety of other health benefits. Here are just a few I've blogged about: Vitamin D Supplementation and Cancer Prevention Vitamin D helps fend off flu and asthma…
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How much vitamin D is too much?

Children's Health, Men's Health, Nutritional Health, Parenting, Woman's Health
Now that so many more people are taking vitamin D, some are asking how much vitamin D is too much. And, it’s important to note that vitamin D doses vary widely and toxicity is rare. Here are some guidelines recommended to healthcare professionals from the evidence-based experts at The Prescriber’s Letter: To prevent deficiency, recommend 1000 to 2000 IU/day of vitamin D for adults and 400 IU/day for infants and children. Most people will need supplements. We don't get much vitamin D from the sun these days due to sunscreens, staying indoors, etc. Diet usually isn't enough, either. Very few foods contain vitamin D ... and milk only contains only 100 IU per cup. Higher doses are needed to maintain adequate levels in some patients ... or to treat a…
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Adults may need up to twice the amount of vitamin D than is typically recommended

Men's Health, Nutritional Health, Woman's Health
Here’s news about a new guideline that will change something I do in practice. The Los Angeles Times "Booster Shots" blog reported, "Older adults need up to twice the amount of vitamin D than is typically recommended, according to guidelines released Monday by the International Osteoporosis Foundation." The guidelines "urged adults, defined by this group as 65 and older, to aim for a 25-OHD blood level – the primary marker for vitamin D in the blood – of 75 nanomoles per liter. In our community, physicians have been aiming for a vitamin D level of 50. So, the new guideline will be a new practice for me. To reach that level, one would need an intake of 20 to 25 micrograms per day (or 800 to 1,000 international units) of…
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Take Vitamin D With Largest Meal

Nutritional Health
Taking your vitamin D supplement with the largest meal of the day may boost its absorption substantially, according to a new study from researchers at the Cleveland Clinic. Here are details from WebMD: The researchers  instructed 17 men and women, average age 64, whose blood levels of vitamin D were borderline insufficient despite taking supplements, to take their supplements with the largest meal of the day. After two or three months, the study participants had about a 50% increase in blood levels of the vitamin, regardless of the dose they took. Researchers Guy B. Mulligan, MD, and Angelo Licata, MD, had noticed that patients typically report taking the supplement either on an empty stomach or with a light meal. Because the vitamin is fat-soluble, the researchers speculated that taking it…
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Is OJ as good a source of vitamin D as supplements?

Nutritional Health
A glass of orange juice may not only help the vitamin pill go down. A new study suggests that fortified varieties can also help the body's vitamin D levels go up - just as effectively as the supplement itself. The finding could bring a welcome addition to a very short list of sources for vitamin D, which is thought to help fend off an array of health problems including brittle bones, diabetes, and cancer. Here are details from Reuters Health: "A lot of people don't drink milk," which has been fortified with vitamin D since the 1930s, "but they do drink OJ in the morning," the study's study author, Dr. Michael Holick, of the Boston University School of Medicine, told Reuters Health. Simply adding a vitamin to a food does not guarantee its…
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Vitamin D Supplementation and Cancer Prevention

Cancer, Men's Health, Nutritional Health, Woman's Health
Readers of this blog know that, in general, I'm in favor of healthcare professionals checking vitamin D levels as part of routine exams. I do this on all adolescents and adults. And, I've blogged more on the topic of vitamin D this year than any other topic. So, I'm trying to post less on the topic, but this and the next too blogs were too important not to mention to you. The subject of this blog is based upon an abstract of an amazing study titled “Vitamin D Supplementation and Cancer Prevention.” It is authored by Thomas L. Lenz, PharmD, and published in the American Journal of Lifestyle Medicine (2009;3[5]:365-368): It is estimated that approximately 1 billion people worldwide have blood concentrations of vitamin D that are considered suboptimal. Much…
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Increasing vitamin D levels may cut heart disease risk

Heart Health, Men's Health, Nutritional Health, Woman's Health
I may have blogged more on vitamin D this year than any other topic. And, now, the Los Angeles Times is reporting, "Raising the amount of vitamin D in the blood appears to help some people -- at least those deficient in the vitamin -- reduce their risk of heart disease by about 30%." This is according to research presented at the American College of Cardiology annual meeting. In the past, "researchers have been uncomfortable randomizing people with low vitamin D into a group that ... does not" receive treatment, because deficiency "can contribute to weaker bones and" has "been associated with increased risks of several diseases, including several types of cancer." The Salt Lake Tribune reports that the researchers reported that "patients who increased their vitamin D levels to 43 nanograms…
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Babies should take vitamin D supplement

Children's Health, Parenting
Frequent readers to this blog are aware of the growing incidence of vitamin D insufficiency and deficiency in all age groups in the US. Now, according to a new study published online in the journal Pediatrics, "most babies should take a daily vitamin D supplement." USA Today reports that the researchers say, "only 1% to 13% of infants under one year now get a vitamin D supplement, available in inexpensive drops." The study said "those drops are needed ... because only 5% to 37% of American infants met the standard for vitamin D set by the American Academy of Pediatrics (AAP) in 2008: 400 international units (IU) a day. This matches what I am recommending for my pediatric patients (from infancy, through childhood, and into adolescence): give a supplement of 400…
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Vitamin D Supplementation Helps Prevent Falls in Older Adults

Nutritional Health
Each year, one third of adults 65 years and older have at least one fall. And, 9% of those falls require an emergency department visit and up to 6%result in a fracture. Consequently, strategies to prevent falls have become an important public health goal for the elderly. A recent review of multiple published studies concluded that vitamin D supplementation taken in dosages of 700 to 1,000 IU per day (achieving a serum 25-hydroxyvitamin D level of at least 24) reduces falls in older persons by 26%. And, for good news for the cost conscious, the more expensive active forms of vitamin D (which also had double the rate of a significant side effect) were no more effective than the very inexpensive and safer over-the-counter supplemental vitamin D. A vitamin D level…
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Vitamin D Linked to Lower Heart Risk

Heart Health, Nutritional Health
According to new research, vitamin D supplements may not only help your bones, they may help protect your heart. A new review of research on vitamin D and calcium supplements shows that people who take moderate to high doses of vitamin D have a lower risk of heart disease -- while calcium supplements seemed to have little effect on heart disease risk. Here's the full report from WebMD: Vitamin D is produced by the body in response to exposure to sunlight but is also commonly found in fortified dairy products and supplements. It is already known to play a critical role in calcium absorption and bone health, but a growing number of studies suggest that vitamin D supplementation may also lower the risk of heart disease. Researchers say vitamin D and…
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Can Vitamin D Ease Fibromyalgia Pain?

Men's Health, Nutritional Health, Woman's Health
Vitamin D is known as the sunshine vitamin because when sunlight hits skin, the body produces this vitamin, essential for strong, healthy bones. However, a mountain of new evidence suggests that the vitamin may have a more versatile role than previously thought, particularly when it comes to maintaining a healthy immune system and boosting mood. Low levels of vitamin D have been associated with more severe asthma, colds, seasonal affective disorder, depression, a number of types of cancer, and even chronic pain or fibromyalgia. So does that mean that taking more vitamin D (or spending a bit more time in the sun) can combat fibromyalgia? Not just yet. But, here's a hopeful report from Health.com on the topic that may be of help to those wrestling with fibromyalgia: Studies have found that…
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In Lab Tests Vitamin D Shrinks Breast Cancer Cells

Cancer, Nutritional Health
I've posted a number of blogs about the fact that vitamin D deficiency or insufficiency (low levels of serum vitamin D) is associated with a number of types of cancer, as well as diabetes and asthma, but now new research also shows that vitamin D can kill human cancer cells. The results of this new research fall far short of an immediate cancer cure, but they are encouraging, medical professionals say in a report from ABC News. JoEllen Welsh, a researcher with the State University of New York at Albany, has studied the effects of vitamin D for 25 years. Part of her research involves taking human breast cancer cells and treating them with a potent form of vitamin D. She reports that within a few days, half the cancer cells shriveled up…
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Low levels of vitamin D may be linked to greater asthma severity

Nutritional Health
Study suggests 70 percent of children, young adults do not get enough vitamin D More reasons to consider having your vitamin D level checked – you may think better and have less arthritis Specific vitamins and a supplement (B vitamins, vitamin D, and calcium) may lower risk of stroke, blindness, and cancer Vitamin D tests soar as deficiency, diseases linked Lack of vitamin D raises death risk Vitamin D Recommendations for Teens May Be Too Low Vitamin D may protect against heart attack Low Vitamin D Levels Associated with Artery Disease The Los Angeles Times "Booster Shots" blog reported that researchers at the National Jewish Health in Denver found that "adult asthma patients with the highest levels of vitamin D in their blood had better lung function compared with people with…
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Vitamin D deficiency in kids is getting more attention

Children's Health, Nutritional Health
A recent cross country study sample suggests that MOST children in the U.S. have suboptimal vitamin D levels. Healthy blood levels of vitamin D are at least 30 ng/mL; but 2 out of 3 kids have levels below this, and about 1 in 5 kids ages 1 to 11 are deficient with a vitamin D level below 20 ng/mL. The problem is especially severe in Black and Hispanic children. HALF are deficient, with levels below 20 ng/mL. This is likely because their darker skin blocks out more of the sun's UV-B rays needed for making natural vitamin D. The American Academy of Pediatrics recommends 400 IU/day of vitamin D, starting days after birth all the way through adolescence. A cup of cow's milk or baby formula contains only about 100…
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More reasons to consider having your vitamin D level checked – you may think better and have less arthritis

Alternative Medicine, General Health, Men's Health, Mental Health, Nutritional Health, Woman's Health
Low vitamin D levels may impair thinking and adequate vitamin D levels may help prevent knee osteoarthritis, according to two studies released this last week. Both of these studies, added to the others I’ve discussed in this blog in the past, may lead you to get your doctor to check your vitamin D level at your next physical exam. More Information: (more…)
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Most Children are Vitamin D Deficient Also

Children's Health, Nutritional Health, Parenting
Vitamin D deficiency is a growing problem in the United States. A 2004 study reported that 42 percent of otherwise healthy adolescents in a primary care setting were vitamin D deficient. Among infants, dark skin pigmentation and breastfeeding without supplementation have been cited as risk factors. Most studies have examined infants, but there are fewer data as to whether this problem persists as children are weaned to fortified milk and solid foods. A new study should raise a red flag for parents. More Information: (more…)
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Vitamin D tests soar as deficiency, diseases linked

Cancer, Children's Health, Health Headlines, Heart Health, Men's Health, Nutritional Health, Woman's Health
USA Today is reporting that testing for vitamin D levels, once uncommon, has skyrocketed as medical studies raise awareness about vitamin D deficiencies. Physicians agree that they're increasingly using the blood test to find out whether their patients are low on the vital vitamin. My Take? (more…)
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