Insights by Goldie: Vitamin D: a nutritional super-hero (may be) missing in action

Severe vitamin D deficiency has been reported in pediatric journals for a decade, noting the re-emergence of childhood rickets. This painful and disabling condition essentially had disappeared for more than half a century, probably due to mandatory vitamin D fortification of milk.

If vitamin D is deficient, adequate calcium absorption is not possible and young growing bones fail to mineralize properly. Osteomalacia, or soft bones, in many older people sometimes is called adult rickets.

In 2003, due to heightened concern, the American Academy of Pediatrics added guidelines on vitamin D for children. Starting with all infants by two months, including those who are exclusively breastfed, they called for a minimum intake of 200 IU (international units) of vitamin D per day.

The Office of Dietary Supplements at the National Institutes of Health also recommends 200 IU per day, from infancy to 51 years, as an “adequate” level of vitamin D. From 51 to 70 years, they recommend 400 IU, and for people over 71, 600 IU is recommended.

Many scientists in the public health sector have become increasingly outspoken that the vitamin D recommendations do not serve the public interest. They want them increased dramatically. Walter Willett, PhD, nutritionist at Harvard School of Public Health, favors at least 1,000 IU as a base for adults and supports much higher levels in certain circumstances.

The sharpest critics of the current recommendations are scientists with decades of experience researching the safety and the potential of this underrated nutrient for relieving pain and suffering.

Their perspective is that “adequate” levels of a nutrient should not be confused with “optimal” levels. They acknowledge that much higher levels may be essential to prevent, maintain or — dare we say it — cure a diseased condition resulting from a deficiency. In other words, for healing, extraordinary concentrations of a specific nutrient may be required. Vitamin D seems to be the most important candidate for “thinking out of the pillbox.”

Consider this: The “tolerable upper intake levels” of vitamin D established by the National Institutes of Health are 1,000 IU for infants to 12 months and 2,000 IU for all other ages throughout life. So, we have to ask, “If an infant safely can “tolerate” 1,000 IU, why is only 200 IU the standard for everyone, birth to mid-life?” The logic is not evident.

Food sources of vitamin D are not common. A serving of salmon has about 400 IU (much less if fried). An egg has only 20 IU. Eight ounces of fortified milk — nonfat, whole, organic or not — has 100 IU, as does soy or other fortified non-dairy beverage. Other dairy usually is not fortified. One teaspoon of cod liver oil has 400 IU (Don’t turn up your nose! Natural flavored types aren’t bad.)

Tablets or capsules vary. Most supplement advice does not distinguish between choosing the D2 (plant form) or D3 (animal form), and some labels don’t list the form. Some researchers feel D3 is preferable.

Summer sun, from May to October, can provide all the vitamin D we need in 15 minutes of exposure if light skinned, about three times a week, or 45 minutes if dark skinned. With each exposure, the skin produces 10,000 to 20,000 IU, with no possible overdose. That’s without sunscreen. Sunscreen with an SPF#8 or more prevents vitamin D formation. For best results, expose the face, arms and legs. Add the back if you can or the full body (for shorter times).

Our body can store D for a couple months after summer. But during the other six months, no matter how bright the sun, the UVB rays used to make D are not available. The same is true on cloudy or smoggy summer days.

Vitamin D deficiency is a probable factor in cancers, including breast and prostate cancers, chronic obesity, depression, type I and II diabetes, hypertension, Celiac (gluten intolerance), Crohns and other intestinal diseases, and muscular sclerosis. That’s in addition to osteoporosis and all diseases associated with D deficiency and insufficient calcium absorption.

So, however you do it, try to avoid D deficiency. It can be stealthy because it’s invisible and silent, and its relation to disease or symptoms not readily apparent. That’s why some physicians advise high-risk patients to have occasional blood tests.