Vitamin D deficiencies are a very modern problem. Since most of us don't spend a whole lot of time outside, we don't get exposed to the UVB rays that our body needs to generate this important vitamin. It is believed that vitamin D deficiencies may cause many serious health problems - but how are such deficiencies treated? The answer isn't simple, and can vary considerably from situation to situation.
The Trouble With Sunlight -
One seemingly logical approach to treating a vitamin D deficiency would be exposing the patient to additional sunlight. In other words, a doctor could encourage a patient to get outdoors more often - or even to bask in the sun on a local beach. The trouble with this advice, of course, is that too much sun exposure presents its own serious roster of problems, including skin cancer. By applying sunscreen, we prevent our bodies from absorbing the rays that generate vitamin D - where's the compromise?
The Supplementation Of Vitamin D -
Ideal levels of vitamin D in a healthy adult are approximately 40 to 70 ng/mL. Very few people achieve or maintain such levels, though, and when that deficiency becomes chronic several health issues can crop up. These days, the modern compounding pharmacy is often charged with customising various forms of prescription medication that revolve around vitamin D supplementation. Why does the compounding pharmacy have to get involved? Because the amount of vitamin D, or cholecalciferol, that is required can vary a great deal from one person to the next.
Factors Affecting Vitamin D Supplementation -
Many different things can play a role in how many IUs of cholecalciferol a person will need on a per-day basis. Dosages can depend on a number of factors some of which include weight, age and the individual's specific environment. For example, a person who spends their entire day either indoors will generally require a higher dosage in comparison to one who walks to work. Likewise, a child will need a much lower dose than a full grown adult. Those who live in less sunny locales will more than likely require higher doses than people who live in sun-kissed areas of the world will. Age matters, too: Older people generally need higher amounts of vitamin D supplementation than younger people.
Managing A Vitamin D Deficiency Efficiently -
Although toxicity can occur with vitamin D supplementation, it is exceedingly rare and is not something that most people have to worry about. The first step to managing any vitamin D deficiency effectively, however, is consulting with a physician. From there, they will determine how severe your deficiency is and will figure out how many IUs of vitamin D you will require each day to bring yourself up to optimal vitamin D levels once more.
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D is for don't.
ReplyDeletemost people in northern latitudes have a deficiency that needs to be corrected, true?.
RECOMMENDED Summer Sunlight Exposure Levels Can Produce Sufficient (20 ng ml−1) but Not the Proposed Optimal (32 ng ml−1) 25(OH)D Levels at UK Latitudes
Note that "only 2.9 % have proposed optimal levels of 32 ng/ ml"
Now why is it that 97% of people have lower concentrations of vitamin D in their blood than the putative 'optimum' ? Could it have something to do with this
IN the Framingham study the lowest cardiovascular disease risks were found in participants with with baseline 25(OD)D levels of 20 to 25 ng/ml, but increased with both higher and lower values suggesting that increased cardiovascular risk occurred at levels below 30 ng/ml."
The heart attack risk is increased at lower levels than are now being considered optimum levels, that's just one disease so maybe there is a trade off and on balance the attaining the higher levels and reducing risks of all the other diseases will lead to a longer heathier life?
IN NHANES III higher mortality was observed in participants with 25 OH)D above 49ng/ml".
That English UVB exposure does not put vitamin D levels up to 32 nm/ml in 97 % of people is obviously because either :-
A - Natural selection hasn't got round to it yet, 97% of the English are still adapted to running around with no clothes on.
or
B - It wouldn't be good for them to have levels that high.
Mad dogs and ....
ReplyDeleteCONTRARY to what is expected, many studies have come to the conclusion that vitamin D concentrations are generally higher among people in northern Europe than among people in southern Europe [30], [31]. Our average serum 25-hydroxyvitamin D levels are in line with the earlier Swedish values estimated in the MORE study [30]. These values were, independent of season, approximately 30% higher than the average among people from central and southern Europe. The results have been explained by a diet containing more vitamin D-fortified foods, lighter skin and wearing lighter clothing when being outdoors during the summer [30], [31]. Our results indicate that our genes, as well as environmental factors, contribute to our vitamin D status. Higher vitamin D concentrations in northern countries may have a genetic basis."
Why are Europeans white?
For a given amount of sun whites will have higher levels of vitamin D than blacks for genetic reasons, in fact they have higher levels for the same exposure than even southern Europeans. There are dangers in humans of tropical ancestry trying to raise their vitamin d levels to Northern Europeans' natural levels, let alone trying to attain the very high putative 'optimums' that are now close to being officially recommended for everbody and which only 3% of English people reach with normal sun exposure.
UNFORTUNATELY our norms for adequate vitamin intake are based on subjects or populations of European origin. We are thus diagnosing vitamin-D deficiency in non-European individuals who are, in fact, perfectly normal. This is particularly true for African Americans, nearly half of whom are classified as vitamin-D deficient, even though few show signs of calcium deficiency—which would be a logical outcome. Indeed, this population has less osteoporosis, fewer fractures, and a higher bone mineral density than do Euro-Americans, who generally produce and ingest more vitamin D .
[...]
By pathologizing non-Europeans as being vitamin-D deficient, modern medicine is paving the way for programs that are well intentioned but ultimately tragic in their consequences: mass vitamin-D supplementation to be dispensed through the school system and awareness campaigns. Such public health programs have already been proposed for African Americans and northern indigenous peoples.
What will be the outcome of raising vitamin-D levels in these populations? Keep in mind that we are really talking about a hormone, not a vitamin. This hormone interacts with the chromosomes and gradually shortens their telomeres if concentrations are either too low or too high. Tuohimaa (2009) argues that optimal levels may lie in the range of 40-60 nmol/L. In non-European populations the range is probably lower. It may also be narrower in those of tropical origin, since their bodies have not adapted to the wide seasonal variation of non-tropical humans.
If this optimal range is continually exceeded, the long-term effects may look like those of aging."