What you need to know about Vitamin D

A Doctor's Note: Kevin J. Kelleher, M.D.

The American Academy of Pediatrics (AAP) released new guidelines (see Prevention of Rickets and Vitamin D Deficiency in Infants, Children and Adolescents) to increase the recommended daily dose of vitamin D for all children to 400 IU. This decision was founded on the concerns of vitamin D deficiency-related rickets in children along with new evidence that supports a potential role for vitamin D in maintaining immune system function and preventing diseases such as diabetes and cancer. The AAP and other organizations also advocate that all breast feeding babies should receive supplemental vitamin D in drops, unless they are also receiving formula or milk with vitamin D (see FAQ sheet).

At EHS, we routinely screen adults for vitamin D deficiency for the past year or two. The incidence of vitamin D deficiency seems very under-reported and, in addition to contributing to osteoporosis in adults, it is associated with problems absorbing and retaining calcium and phosphorus. Studies also suggest that vitamin D keeps certain cancer cells from growing and dividing. Low vitamin D levels may predispose to diabetes and other autoimmune problems, play a role in high blood pressure for some, and contribute to fatigue, depression and chronic muscle aches. Click here for a good review of vitamin D.

Optimal intakes for adults should be 400 - 1000 IU (10-25 mcg). In addition to brief sun (15-20 minutes, as more than 20 minutes does not contribute to further creation of vitamin D), cod liver oil, certain fish and other forms of omega-3 fatty acids are great sources. Fortified cereals are another good source (see Vitamin D rich foods). Even with adequate efforts to include vitamin D rich foods in your diet, we encourage some vitamin D supplementation daily. We suggest the cholecalciferol (D3) form of vitamin D, targeting a daily intake close to 1000 IU.

For osteoporosis prevention, in addition to the vitamin D supplementation, one needs to take 1200-1500 mg of calcium daily. The calcium does need to be in at least two divided doses during the day. More information can be found at NOF Osteoporosis Prevention - Risk Factors for Osteoporosis.

If you have not yet had your vitamin D level checked, we encourage you to do so. Of course, this is best done as part of a complete physical exam, as it is just one aspect of a comprehensive health maintenance program.

Yours in health,