Vitamin D – Are you getting enough?

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I have recently had my annual blood tests and when I got the results it showed that I have a marked Vitamin D deficiency.  Last year I was mildly deficient at 35 nmol/l, this year despite taking Vitamin D supplements my levels have gone down to 25 nmol/l.  Stands to reason that unless I make some changes my levels will be even lower next year.

It is difficult to get sufficient levels of Vitamin D from food and having had skin cancer in the past I need to make sure I stay sun safe.  The sun is brutal here in SE Queensland so I tend not to spend too much time in the sun without +50 sunscreen.  I work indoors and walk the dog after dark when it is cooler so I don’t actually get that much sun exposure.   Time to rethink what I am doing!

The effects of a severe Vitamin D deficiency can be quite horrific, soft bones that are prone to breaks, bone and muscle pain, fatigue ….. I am already suffering some of these symptoms.  I get bone and muscle pain and fatigue and put it down to my fibromyalgia.  I could be damaging my bones because I am trying to be sun smart and avoid more skin cancer – scary thought!

Here is some information on Vitamin D.

What does vitamin D do?

Vitamin D helps your body absorb the calcium it needs to keep your bones and muscles strong and healthy.

Sources of vitamin D

The main source of vitamin D for most Australians comes from exposing bare skin to ultraviolet B (UVB) light from the sun.

Food sources of vitamin D include:

  • fatty fish (such as salmon, mackerel and herring)
  • liver
  • eggs
  • margarines
  • some milk products
  • infant formula are fortified with vitamin D in Australia.

It’s difficult to get enough vitamin D from food alone because it only makes a small contribution to the body’s overall vitamin D levels.

Sun exposure and vitamin D

It depends on a few things such as where you live, the season, time of day, your skin colour and the amount of skin exposed. It’s important to always follow safe sun guidelines because too much sun can increase your risk of skin cancer and may cause the vitamin D in your skin to break down.

You can find more information about safe sun exposure and vitamin D on our Stay safe in the sun page and the Cancer Council Australia website.

Never use a solarium to boost vitamin D levels because they emit dangerous levels of ultraviolet (UV) radiation that increase your risk of skin cancer.

What happens if I don’t have enough vitamin D?

Moderate to severe vitamin D deficiency can lead to rickets (soft bones) in infants and children.

Low vitamin D levels can lead to osteoporosis and increase your risk of falls and fractures (broken bones) if you are over 50. Osteoporosis occurs when your bones lose calcium and other minerals making them fragile and easier to break. Vitamin D helps your body to absorb calcium, and not having enough can increase your risk of developing osteoporosis.

People with very low levels of vitamin D (moderate to severe deficiency) are the most at risk of developing health problems.

A number of diseases have been linked to low vitamin D levels such as diabetes, heart disease and some cancers. Doctors don’t know why this is the case, and the benefits of increasing vitamin D intake for these diseases is also unknown.

Who is at risk of vitamin D deficiency?

You may be at risk of vitamin D deficiency if you:

  • stay mostly indoors for health, work or other reasons
  • have naturally dark skin
  • cover your body for religious or cultural reasons
  • avoid the sun for skin protection or due to medical reasons
  • are obese
  • have a health condition that affects vitamin D absorption from your diet
  • take medicines that cause vitamin D to break down
  • are a baby of a vitamin D deficient mother.

Do I need a vitamin D test?

A vitamin D test is a simple blood test that measures a form of vitamin D in your blood called 25-hydroxyvitamin D (25-OHD).

Vitamin D tests are most likely to be useful for people most at risk of health problems such as brittle bones or bone fractures as a result of low vitamin D levels including:

  • older people diagnosed with osteoporosis
  • older people with an increased risk of fallsand bone fractures
  • pregnant women and breastfeeding mothers at risk of vitamin D deficiency because this deficiency could affect their baby’s bone and tooth development
  • babies, children and adolescents at risk of vitamin D deficiency because their bones are still growing.

Vitamin D tests are less likely to be useful for healthy adults under 50 years who don’t have symptoms or risk factors for vitamin D deficiency.

If you’re healthy but worried that your lifestyle is putting you at risk of vitamin D deficiency you could:

Talk to your doctor if think you need a vitamin D test.

The best time to test for vitamin D is at the end of winter or in early spring when your vitamin D levels are at their lowest.

How is vitamin D deficiency treated?

If you have a mild deficiency then your doctor may recommend a few simple things such as:

  • increasing your sun exposure
  • increasing dietary calcium
  • increasing physical activity
  • taking a vitamin D supplement.

If you have a moderate to severe deficiency then you might need to take a high-dose supplement and repeat the blood test in three months time. Your doctor will discuss this course of treatment with you.

Some children and teenagers may need to be tested every year if they are identified as having a high risk of a deficiency.

Vitamin D supplements

Vitamin D supplements are available over-the-counter as in different forms including capsules, tablets, dissolvable tablets, chewable tablets, powder and liquids. Your doctor or pharmacist can advise you on the best one for you based on the strength of the medicine, the number and type of active ingredients it contains and your reason for taking it.

You can find more information on vitamin D supplements on the NPS Medicine Wise website.

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