We asked an endocrinologist at the Rassvet expert clinic for evidence-based medicine, Candidate of Medical Sciences Marina Sviridonova to tell the most important thing about vitamin D: how it works, why it is needed, to whom and how to get it correctly, and what its excess can turn out to be (yes- yes, it happens too).
Marina Sviridonova
What is vitamin D and where does it come from
Vitamin D is a fat-soluble compound that is found in a fairly limited number of foods. It is abundant in seafood and fish oil and significantly less in dairy products. Vitamin D can be synthesized on its own in the skin, but this requires exposure to ultraviolet radiation.
At the same time, vitamin D coming from food and formed in the skin is inactive. In order for it to activate and begin to show its properties, certain reactions must occur in the liver and kidneys. (So the condition of these organs is also important for the full functioning of vitamin D.)
Why vitamin D is needed and how does it work
Vitamin D promotes intestinal absorption of calcium and maintains adequate levels of calcium and phosphorus in the blood (to ensure adequate bone density). It is also involved in the process of bone growth (lack of vitamin D in childhood leads to the development of rickets). In addition, research in recent years has demonstrated the participation of this vitamin in a variety of body processes. Vitamin plays a significant role in the prevention of cancer, autoimmune, infectious diseases, as well as some diseases nervous system... Vitamin D is involved in most metabolic processes, contributes to the normal functioning of the reproductive system.
There is evidence that, against the background of vitamin D deficiency, the risk of developing cancer of the breast, gastrointestinal tract, prostate, uterus, ovaries increases, Bladder and kidneys. However, it is too early to draw conclusions - the effect of vitamin D on human health will be studied for a long time.
Who needs vitamin D
results recent research showed that in Russia a huge number of people suffer from both a lack of vitamin D and its deficiency. This is primarily due to climatic conditions and our geographic location. From November to March in our country, the angle of incidence of sunlight is such that vitamin D in the blood is simply not produced under their influence. And in the spring-summer period, we also do not have many sunny and warm days. Thus, the only source of vitamin D remains foodstuffs, in which its content is also, alas, small.
So everyone needs vitamin D: in prophylactic doses, it is really recommended to everyone. According to epidemiological data, almost 90% of older women suffer from a lack of vitamin D. Moreover, this problem is also widespread among young people.
Who needs to get their vitamin D levels checked?
Most often, the basis for studying the level of vitamin D in the body is already established risk factors: bone diseases, osteoporosis, fractures, obesity, chronic diseases of the liver, kidneys, gastrointestinal tract, pregnancy, dark skin tone. Not everyone gets symptoms of vitamin D deficiency, but attention should be paid to bone pain, muscle weakness, and a tendency to fall. In the laboratory, it is enough to say that you want to get tested for the level of vitamin D, and you will be prescribed the right one.
What preparations contain vitamin D
In Russia, only solutions of vitamin D are registered as medicines. The most common are “Aquadetrim” and “Vigantol”, water and oil solutions of vitamin D, respectively. These drugs are taken in drops with the addition of a small amount of liquid. Vitamin D capsules and tablets, which can be found in our pharmacies, are usually dietary supplements. There was no significant difference in the effectiveness of solutions and BA-supplements of vitamin D, so everyone can choose the most convenient option for themselves.
How to take vitamin D correctly
As mentioned above, it is enough to add a drop of vitamin D to a small amount of liquid and drink. For babies, you can add vitamin D to formula milk. Vitamin capsules are often recommended to be taken with meals. However, it's okay if you accept them at any other time - it's better than nothing.
A prophylactic dose of vitamin D is on average about 800 IU (1-2 drops of solution per day). During pregnancy and in old age, the dose is increased to 1,000-1,500 IU (2-3 drops of solution per day).
Body weight must be taken into account - overweight and obese people sometimes need higher doses to maintain normal blood levels of the vitamin (6,000-10,000 IU or 12-20 drops per day). The category of people who may require a higher dose include patients with digestive disorders, diabetes mellitus, and many other chronic diseases.
In case of vitamin D deficiency, the required dose of the drug increases significantly. Therefore, if during the examination you had a lack of vitamin, then the doctor should choose and prescribe the dose. For the first two months, as a rule, “saturating” doses of vitamin D are recommended, after which its level in the blood is measured and, if normal values are reached, they switch to prophylactic dosages.
What combinations are most often prescribed for vitamin D
Since vitamin D is directly related to calcium metabolism, adequate intake of this trace element is necessary to realize its potential. If for one reason or another (this is often observed in old age) calcium intake or absorption suffers, then it is advisable to take vitamin D and calcium at the same time.
In recent years, there has been an increasing focus on omega-3 fatty acids. Due to the fact that vitamin D is fat-soluble, it works well with them. There are also special complexes that contain both vitamin D and omega-3 fatty acids.
Vitamin D is needed by every person, since there is no such age group that would not need it. With its help, the body is provided with calcium, magnesium and phosphorus, which are necessary for the formation of the musculoskeletal system.
This vitamin is formed under the influence of sunlight, for this it is imperative to be outdoors in daylight for at least 15 minutes with open areas of the body.
It is also found in small amounts in some foods. This substance was isolated by McCollum in 1921, when he conducted experiments with cod oil.
What is vitamin D for?
Vitamin D is needed for:
- formation of the musculoskeletal system
- maintaining the required level of phosphorus and calcium
- acceleration of regeneration after fractures and bruises
- improving the condition of nails, hair and teeth
- strengthening the heart muscle
- stabilization of blood pressure
- improving immunity
- improving the functioning of the thyroid gland
Vitamin D for children
The child's body often has an acute need for vitamin D during the rapid growth and formation of the musculoskeletal system. Vitamin deficiency leads to rickets, a rather serious disease that affects not only the formation of musculoskeletal mass, but also significantly depletes the body.
Vitamin D for adults
Previously, it was believed that vitamin D is necessary only for children, but today doctors are talking about the benefits of this vitamin for adults. When the body gets enough of it, it is possible to prevent diseases of the kidneys, liver, nervous and skeletal systems. Even cancer can be prevented, as normal vitamin D levels inhibit the appearance and growth of cancer cells.
Why do women need vitamin D
Women need this especially during puberty, breastfeeding and pregnancy. At such moments, the body experiences increased stress. The lack of vitamin has a bad effect on the work of the whole organism, since phosphorus and calcium are washed out.
During menopause, vitamin D is essential, as bone tissue becomes thinner and more fragile. As a result, osteoporosis can develop and the risk of fractures increases, the condition of the skin, nails and teeth worsens.
Lack of vitamin D in pregnant women can complicate the course of pregnancy, as well as negatively affect the development of the fetus.
Symptoms of Vitamin D Deficiency in Adults
The initial stage of vitamin D deficiency can go unnoticed, since a person can attribute general weakness and pain in the joints to something else (overwork, lack of sleep, increased physical exercise). Rarely causes anxiety and increased sweating in the head area, which is also a sign of vitamin deficiency. But when vitamin D is already starting to be significantly lacking, the following symptoms may occur:
- muscle spasms and cramps
- joint and muscle pain
- headache
- disorder of the digestive tract
- increased blood pressure
- general weakness and increased fatigue
- decreased visual acuity
- memory impairment and decreased concentration
- the development of caries, fragility and loss of teeth
In the future, this can lead to serious health problems. Cardiovascular diseases, osteoporosis and pathologies of the musculoskeletal system, endocrine disorders, diseases of the genital area, metabolic disorders may occur.
How to take vitamin D correctly
The daily requirement for vitamin D is 400 to 800 IU.
The drugs are available in various forms, including drops, tablets, gummies, and suspensions. I used to drink Aquadetrim from time to time, especially in winter, but since I didn't want to take any synthetic drugs, I chose the perfect natural drug by trial and error. We are talking about fish oil with a high content of vitamins A and D from the Solgar company. I drank both Avkadetrim and fish oil (or rather, even more often "fish oil"), which is sold in our pharmacies, but when I started taking Solgar lozenges, I felt the result in the form of good health and normalization of blood pressure.
In addition, the pains in the joints are gone, and the mood just got better. At the heart of Vitamin D from Solgar contains pure cod liver oil. You can view all information or purchase these lozenges HERE , in a pharmacy of eco-goods Ayherb. I have been ordering all the drugs there for a long time and nutritional supplements, and still not disappointed. If you want to buy something through Ayherb for the first time, then when ordering, enter the code QPN133, then you will receive a discount from 5 to 10 dollars.
Unlike other nutrients, it is almost not found in food, but in maximum doses it is produced when our skin is exposed to heat and light. But given the typically Russian summer, out of three months of which thirty days are hot and sunny (at best), there is no need to talk about a sufficient amount of vitamin in the body of an average person. Who is to blame and what to do? We are sorting it out right now.
Who is at risk
In an interview with Healthista, nutritionist Kim Pearson notes that there are several factors that put a person at risk. Firstly, it is dark skin, which synthesizes vitamin D in the body much more slowly than light skin. The second is when vitamin D must be taken from supplements to avoid any potential risks. Also at risk are:
- Elderly people who are rarely on the street;
- Office workers who spend most of the day indoors;
- People who work night shifts and therefore sleep during the day.
“I regularly test my clients' vitamin D levels. And people at optimal levels are usually those who take supplements or spend a significant amount of time in sunny countries, ”says Peer.
Signs of Vitamin D Deficiency
Vitamin D deficiency poses a serious health problem, as long-term lack of it in the body, according to research, increases the risk of developing and can potentially increase the risk of cancer. Below are five signs that should alert you.
Frequent infections
Vitamin D is vital for the proper functioning of the immune system. “Without adequate amounts of the vitamin, our immune cells will not be able to respond appropriately to threats, making the body as a whole more susceptible to infections,” notes Kim Peer. At the same time, vitamin D affects the quality of both innate and adaptive immunity.
Lack of mood
In addition, vitamin D plays a key role in maintaining healthy serotonin levels in the brain, adds Peer. Recall that we are talking about the neurotransmitters that we need for a great mood and thirst for life. Interestingly, a 2014 compilation study published in Medical Hypotheses found a link between vitamin D deficiency and (seasonal depression).
Constant fatigue
“Vitamin D is also needed by our bodies to convert food into energy,” continues Kim Peer. - If you are, it may mean that the body does not absorb nutrients from food, which, in turn, can be triggered just by a deficiency of vitamin D. " The good news is that you can deal with the problem quickly (as shown in a study published in 2016 in the journal Medicine, a vitamin D supplement can fix it in 7-8 days).
Weak bones
In addition to all of the above, vitamin D is needed to regulate the level of calcium and phosphate in the body, which - and everyone knows this - are important for bone health and. Adequate vitamin D levels have been shown to help prevent osteomalacia (softening of the bones) and osteoporosis (loss of bone density) in adulthood. A 2014 study found that people over 50 with vitamin D deficiency were more likely to have pain in hip joint and knee joints.
Muscle aches
Vitamin D also supports muscle function as receptors for it are located throughout the body. “If your muscles are for no particular reason, you should consider a possible vitamin D deficiency in your body,” warns Kim Pearson. The fact is that when it gets into the cells of muscle tissue, vitamin D increases the frequency of muscle contractions, helping the muscles to remain strong and elastic. This protects them from tears and minor injuries, including during training.
How to get vitamin D
Most people can get enough vitamin D by being in the sun for 15-20 minutes daily. The optimal time for this is from 11:00 to 15:00. Moreover, in order to provide your body with vitamin D, you need to stay in the sun without a cream with SPF, which is all dermatological recommendations.
And here's a more rational option - food. While they will never provide you with the same amount of vitamin D as sunlight, they will work quite well in a supplement company. So in the fall and winter, make sure you have fatty fish (salmon, mackerel, tuna), liver, and vitamin D-fortified dairy products and cereals in your diet.
I am already beginning to feel a little spring in the air. Tell me early? Maybe, but for me it happens already on an unconscious level)) However, it is really a long time to wait for sunny days, so I fulfill my promise, tell about the benefits and how to choose vitamin D (more information about self-calculation of dosage).
Can I get vitamin D from food?
I am always in favor of getting nutrients from food with both hands, but this is a special case. Some foods certainly contain vitamin D (oily fish and fish oil, egg yolks, cheese, some mushrooms, etc.), but an adequate amount of food from our body do not get.
What is vitamin D for?
The purpose of vitamin D is to maintain proper calcium and phosphate levels. This is why calcium supplements are highly recommended to be paired with. Vitamin D deficiency is observed in many diseases, so the causal relationship is constantly being studied.
Vitamin D is considered as an auxiliary helper:
✔ to increase bone mass and strength
✔ reduce the risk of falls and fractures in older people
✔ during pregnancy and early infancy (rickets-like diseases)
✔ diabetes mellitus Type 2 (improving tissue sensitivity to insulin)
✔ increase testosterone levels
✔ multiple sclerosis
✔ severe asthma attacks
✔ obesity
✔ depression
How do you get vitamin D?
Vitamin D can be obtained in the following ways:
↪ sun
↪ vitamin supplement
↪ food
↪ solarium and special lamps
Due to the fact that we do not get the required amount of vitamin D with food, and I myself do not consider the solarium as a source, we will focus on the most effective recommendations.
Sunbathing is a natural and completely free source of vitamin D. Vitamin D is formed under the influence of UVB rays, but not everything is so simple and effective due to dependence on:
time of year and day - solar activity in our living conditions in winter is not enough. On a sunny day, the closer to noon, the more vitamin D is produced. A simple rule of thumb: if your shadow is longer than your height, you are already getting less vitamin.
place of residence - the closer to the equator, the more vitamin D you can get from sunlight all year round. In the summertime, when the angle has changed with the rotation of the Earth, more UVB rays reach places farther from the equator.
Most of the Russian Federation is located in the northern latitude above the 35th parallel, which means that in the period from November to March, the skin produces practically no vitamin D, regardless of the time we spend in the sun
skin color- the amount of melanin affects vitamin D. Light skin receives vitamin D much faster than dark skin. For example, if very light skin may need 15 minutes of exposure to the sun, while completely dark skin may need up to 6 times longer.
body area- the more you bare in front of the sun, the correspondingly more and faster vitamin D you will receive.
age- when we get older, we gradually lose the ability to synthesize vitamin D.
other reasons- kidney disease, liver failure, certain medications, cloudiness, short daylight hours, air pollution also affect vitamin D.
Even being in the sunlight, we don't get vitamin D behind glass, through clothes and sunblock
Does it matter which vitamin D to take?
There is. Despite the fact that many domestic experts do not see the difference in effectiveness between taking vitamin D2 or D3, Western doctors are more categorical - they prescribe vitamin D3.
(ergocalciferol / ergocalciferol) can be ingested with food, most commonly found in plants.
(cholecalciferol / cholecalciferol) can be ingested with food and also synthesized by ultraviolet rays. It is a component of fish oil (along with vitamin A and).
Vegetarians, be careful!
Most vitamin D3 supplements are of animal origin (lanolin) as opposed to vitamin D2
How and when to take vitamin D?
Vitamin D is usually easily absorbed, but many recommend taking it with food or a source of fat (such as fish oil, coconut oil, etc.). In this case, the form (capsules, tablets or drops) will not matter for absorption.
How to determine the lack of vitamin D in yourself?
You can determine the level of vitamin D by donating blood for the content of 25 (OH) D. It is carried out at least three days after the last dose of the drug.
Unfortunately, in our healthcare institutions, the analysis is not included in the standard general scheme of doctors, therefore, you will have to take the analysis at your own request or appointment at your own expense. The service is offered by many medical centers and clinics in cities, but the price may vary.
Decoding the result obtained:
❖ Deficiency - less than 20 ng / ml (50 nmol / l)
❖ Insufficiency - from 20 to 30 ng / ml (from 50 to 75 nmol / l)
❖ Adequate amount - more than 30 ng / ml (75 nmol / L)
The scale of vitamin D deficiency in postmenopausal women (level less than 30 ng / ml) can be represented by the following data:
↪ 50% in Thailand and Malaysia
↪ 75% in the USA
↪ 74-83.2% in Russia
↪ 90% in Japan and South Korea
↪ In the Middle East and South Asia, the average level ranges from only 4 to 12 ng / ml.
How much vitamin D should you take?
I want to note right away that many people here do not experience critically acute deficiency of vitamin D, but at the same time most do not receive adequate amount.
You should not be afraid of an overdose of vitamin D from the sun, our body ceases to produce it when enough rays are received. But when taking supplements, you should pay attention to the dose, which does not differ for men and women.
The Russian Association of Endocrinologists issued clinical guidelines * for the prevention of vitamin D deficiency in adults in 2015, indicating the minimum daily allowance:
❖ 18-50 years old = 800 IU
❖ Over 50 years old = 800-1000 IU
❖ Pregnant and lactating women = 800-1200 IU
❖ May be needed to maintain 25 (OH) D levels above 30 ng / ml = 1500-2000 IU
❖ In case of diseases (impaired absorption of vitamin D, obesity, taking long-term drugs against epilepsy, AIDS, glucocorticosteroids, antifungal agents), you may need to take vitamin D in doses 2-3 times higher daily requirement age group.
❖ 0-12 months = 400 IU
❖ Over one year = 600 IU
The dosage of 1000-2000 IU meets the prophylactic needs of the majority of the population
For information and recalculation, the activity of vitamin D preparations is expressed in international units IU (IU):
1 IU = 0.025 μg cholecalciferol
40 IU = 1 mcg cholecalciferol
Which vitamin D should you choose?
Beneficial options with optimal dosages and low cost, nevertheless, worthy of the composition, from the Healthy Origins brand. They have the widest selection of dosages and capsules, on the product page in the drop-down windows, you can select the necessary parameters:
Vitamin D for children
Vitamin D is very often prescribed to children, there is also an alternative to Aquadetrim and Vigantol on iHerb (all pictures are clickable).
1 oil (coconut) drop contains 400 IU of vitamin D3. At this dosage, it lasts for a whole year.
Oily (olive oil) drops with berry flavor. One drop also contains 400 IU of vitamin D3.
Liquid oil (coconut) vitamin D3 for babies and children. A dosage of 400 IU is contained in 4 drops.
Popular oil drops (olive oil, flaxseed oil and natural vitamin E) for children. One drop contains 400 IU of vitamin D3. The favorable volume is sufficient for 500 applications.
Vitamin D3 in oil (coconut) drops for babies. With one drop, you can get 400 IU of vitamin D3.
One drop provides a child with 400 IU of vitamin D3. Droplets based on olive oil.
1 drop (sunflower oil) contains 400 IU of vitamin D3. Designed for newborns from 0 months.
Liquid drops with natural orange flavor based on a special complex for absorption from phospholipids, safflower and orange oils. With each drop, you can get 200 IU of vitamin D3.
Gummies for children 4 years of age and older. The manufacturer recommends giving children only 1 piece of candy a day.
Vitamin D (dosage 1000 IU)
The gelatin capsules contain olive oil. Favorable ratio of price, quality and quantity.
There are an incredible number of constant fans of this brand. The jar contains a solid number of capsules that contain safflower oil.
Chewable tablets with strawberry, banana and lollipop flavor.
Liquid Vitamin D3 drops with natural citrus flavor. The bottle is designed, just imagine, for 900 servings.
Gelatin sweets with strawberry, peach and mango flavor.
It's hard for me to resist vitamins in the form of sweets)) These gelatinous sweets with peach, blackberry and strawberry flavors.
Vegan plant-based vitamin D3 without lanolin. Spray with vanilla flavor. Also contains an omega complex in the form of pumpkin seed and cranberry oils.
Vitamin D (dosage 2000 IU)
Fat soluble. We get it through sunlight or food. Ultraviolet rays interact with fatty substances on the skin, promoting the formation of this vitamin, which is then absorbed internally through the skin. When taken orally, vitamin D is absorbed with fats through the intestinal wall. Measured in International Units (IU). Air pollution (smog) reduces the amount of sunlight that contributes to the production of vitamin D. Natural sources: fish oil, sardines, herring, salmon, tuna, milk and dairy products.
Description
Another name for vitamin D:
Calciferols.
Forms
Vitamin D exists in the following forms: ergocalciferol (vitamin D2), cholecalciferol (vitamin D3).
Action
The biological effect of vitamin D: regulating the exchange of calcium and phosphorus, promoting the absorption of vitamin A, immunomodulatory, cancer-protective, reducing lead intoxication, etc.
Application
Vitamin D is required for the following conditions and diseases:
Vitamin D is also needed in the following situations: rickets, dysfunction of the parathyroid glands, osteomalacia, arthritis, multiple sclerosis, preeclampsia, prevention of breast, ovarian, prostate and other tumors; lead intoxication, etc.
Dosage
Dosages are determined based on the nature of the disease and the type of therapy.
special instructions
Special instructions, side effects and contraindications: do not use for hypercalcemia, active form of pulmonary tuberculosis, gastric ulcer and duodenal ulcer, acute and chronic liver and kidney diseases, organic heart disease.