VITAMIN D DEFICIENCY

As the fall season turns into winter, our sun exposure diminishes significantly, especially in the Chicago area. This also affects how much vitamin D we obtain from the sun.

Vitamin D deficiency is a very common finding on patients’ labs. Almost 80 percent of my patients are vitamin D deficient. So why is treating and obtaining normal vitamin D levels important? We know the deficiency can adversely affect our bones, insulin production, immune function, and even worsen our memory according to some studies. In recent years, more primary care physicians are checking patients’ vitamin D levels, especially in those older than 65. Dark-skinned or higher pigmented individuals have a higher risk of vitamin D deficiency.

The lab tests for 25-[(OH)D] or 25-hydroxyvitamin D, and there are two types of vitamin D. Ergocalciferol is obtained from dietary vegetable sources and oral supplements. Cholecalciferol is obtained primarily from skin exposure to ultraviolet B (UVB) radiation in sunlight or the ingestion of food sources. The Recommended Dietary Allowance (RDA) for adults is 600 international units (IU) per day or 800 IU daily for those older than 70. However, in my experience, many patients require a much higher dose of 1,000 to 5,000 IU per day. Foods that are rich in vitamin D include fish like salmon, trout, tuna, and halibut, and dairy products like milk and yogurt.

You are considered vitamin D deficient when your blood level is below 20 ng/ml, insufficient between 20 and 30, and normal between 30 and 80 ng/ml. When your levels are 30 or less, it’s almost impossible to correct from just sun exposure and food. Supplementing vitamin D comes in various strengths, forms, and dosing considerations.

Your dosing may require adjustments based on factors like prior gastrointestinal surgeries, kidney conditions, osteoporosis, malabsorption syndromes, taking steroids, or eating disorders. Most supplements come in tablet or gel-cap forms, are over the counter, and are typically well tolerated. Occasionally I prescribe a higher weekly dose when levels are extremely low. Most patients also require the supplement to maintain a normal vitamin D level.

Most reading this article probably have a low vitamin D level. The good part is that it’s easy to diagnose via blood test levels, treat with an over-the-counter supplement, and has a low side effect profile. Before starting any treatment, always consult with your trusted health care professional. So, as you head south for the winter, remember to supplement your vitamin D and protect yourselves with sunscreen.

Hansa Medical Groupe has offices at 5250 Old Orchard Road, Suite 300, in Skokie, and in Chicago, 847-920-0902, hansamedicalgroupe.com.