Are you Vitamin D Deficient

From an Yahoo article titled "8 Ways to Tell if You Are Vitamin D Deficient". Vitamin D is one of the easiest nutrients to supplement with and one of the most important, although everyone needs robust levels of all nutrients in order to work synergistically within the body to support the immune system.

 

Vitamin D is an extremely important vitamin that has powerful effects on several systems throughout the body. Unlike most vitamins, vitamin D actually functions like a hormone and every single cell in your body has a receptor for it.

Your body makes it from cholesterol when your skin is exposed to sunlight. It's also found in certain foods such as fatty fish and fortified dairy products, although it's very difficult to get enough from diet alone.

The recommended daily intake is usually around 400-800 IU, but many experts say you should get even more than that.

My Aching Knees comment: Most nutritionists and researchers today are recommending daily intake of 4,000 to 6,000 IU. My base line daily supplement gives me 2,500 IU and I routinely take 2,000 to 4,000 more IU of Vitamin D each day.

Vitamin D deficiency is very common. It's estimated that about 1 billion people worldwide have low levels of the vitamin in their blood.

According to a 2011 study, 41.6 percent of adults in the U.S. are deficient. This number goes up to 69.2 percent in Hispanics and 82.1 percent in African-Americans.

These are common risk factors for vitamin D deficiency:

• Having dark skin.

• Being elderly.

• Being overweight or obese.

• Not eating much fish or milk.

• Living far from the equator where there is little sun year-round.

• Always using sunscreen when going out.

• Staying indoors.

People who live near the equator and get frequent sun exposure are less likely to be deficient, because their skin produces enough vitamin D to satisfy the body's needs.

Most people don't realize that they are deficient, because the symptoms are generally subtle. You may not notice them easily, even if they are having a significant negative effect on your quality of life.

Here are eight signs and symptoms of vitamin D deficiency.

1. Getting Sick or Infected Often

One of vitamin D's most important roles is keeping your immune system strong so you're able to fight off the viruses and bacteria that cause illness.

It directly interacts with the cells that are responsible for fighting infection. If you become sick often, especially with colds or the flu, low vitamin D levels may be a contributing factor.

Several large observational studies have shown a link between a deficiency and respiratory tract infections like colds, bronchitis and pneumonia.

A number of studies have found that taking vitamin D supplements at dosages of up to 4,000 IU daily may reduce the risk of respiratory tract infections.

In one study of people with the chronic lung disorder COPD, only those who were severely deficient in vitamin D experienced a significant benefit after taking a high-dose supplement for one year.

Bottom Line: Vitamin D plays important roles in immune function. One of the most common symptoms of deficiency is an increased risk of illness or infections.

2. Fatigue and Tiredness

Feeling tired can have many causes and vitamin D deficiency may be one of them. Unfortunately, it's often overlooked as a potential cause.

Case studies have shown that very low blood levels can cause fatigue that has a severe negative effect on quality of life.

In one case, a woman who complained of chronic daytime fatigue and headaches was found to have a blood level of only 5.9 ng/ml. This is extremely low, as anything under 20 ng/ml is considered to be deficient. When the woman took a vitamin D supplement, her level increased to 39 ng/ml and her symptoms resolved.

However, even blood levels that aren't extremely low may have a negative impact on energy levels. A large observational study looked at the relationship between vitamin D and fatigue in young women.

The study found that women with blood levels under 20 ng/ml or 21–29 ng/ml were more likely to complain of fatigue than those with blood levels over 30 ng/ml.

Another observational study of female nurses found a strong connection between low vitamin D levels and self-reported fatigue. What's more, the researchers found that 89 percent of the nurses were deficient.

Bottom Line: Excessive fatigue and tiredness may be a sign of vitamin D deficiency. Taking supplements may help improve energy levels.

3. Bone and Back Pain

Vitamin D is involved in maintaining bone health through a number of mechanisms. For one, it improves your body's absorption of calcium. Bone pain and lower back pain may be signs of inadequate vitamin D levels in the blood.

Large observational studies have found a relationship between a deficiency and chronic lower back pain. One study examined the association between vitamin D levels and back pain in more than 9,000 older women.

The researchers found that those with a deficiency were more likely to have back pain, including severe back pain that limited their daily activities. In one controlled study, people with vitamin D deficiency were nearly twice as likely to experience bone pain in their legs, ribs or joints compared to those with blood levels in the normal range.

Bottom Line: Low blood levels of the vitamin may be a cause or contributing factor to bone pain and lower back pain.

4. Depression

A depressed mood may also be a sign of deficiency. In review studies, researchers have linked vitamin D deficiency to depression, particularly in older adults.

In one analysis, 65 percent of the observational studies found a relationship between low blood levels and depression. On the other hand, most of the controlled trials, which carry more scientific weight than observational studies, didn't show a link between the two.

However, the researchers who analyzed the studies noted that the dosages of vitamin D in controlled studies were often very low. In addition, they noted that some of the studies may not have lasted long enough to see the effect of taking supplements on mood.

Some controlled studies have shown that giving vitamin D to people who are deficient helps improve depression, including seasonal depression that occurs during the colder months.

Bottom Line: Depression is associated with low vitamin D levels and some studies have found that supplementing improves mood.

5. Impaired Wound Healing

Slow healing of wounds after surgery or injury may be a sign that vitamin D levels are too low.

Results from a test-tube study suggest that the vitamin increases production of compounds that are crucial for forming new skin as part of the wound-healing process.

One study on patients who had dental surgery found that certain aspects of healing were compromised by vitamin D deficiency.

It's also been suggested that vitamin D's role in controlling inflammation and fighting infection is important for proper healing.

One analysis looked at patients with diabetic foot infections. It found that those with severe vitamin D deficiency were more likely to have higher levels of inflammatory markers that can jeopardize healing.

Unfortunately, at this point there is very little research about the effects of vitamin D supplements on wound healing in people with deficiency. However, one study found that when vitamin D deficient patients with leg ulcers were treated with the vitamin, ulcer size reduced by 28 percent, on average.

Bottom Line: Inadequate vitamin D levels may lead to poor wound healing following surgery, injury or infection.

6. Bone Loss

Vitamin D plays a crucial role in calcium absorption and bone metabolism. Many older women who are diagnosed with bone loss believe they need to take more calcium. However, they may be deficient in vitamin D as well.

Low bone mineral density is an indication that calcium and other minerals have been lost from bone. This places older people, especially women, at an increased risk of fractures. In a large observational study of more than 1,100 middle-aged women in menopause or postmenopause, researchers found a strong link between low vitamin D levels and low bone mineral density.

However, a controlled study found that women who were vitamin D deficient experienced no improvement in bone mineral density when they took high-dose supplements, even if their blood levels improved.

Regardless of these findings, adequate vitamin D intake and maintaining blood levels within the optimal range may be a good strategy for protecting bone mass and reducing fracture risk.

Bottom Line: A diagnosis of low bone mineral density may be a sign of vitamin D deficiency. Getting enough of this vitamin is important for preserving bone mass as you get older.

7. Hair Loss

Hair loss is often attributed to stress, which is certainly a common cause. However, when hair loss is severe, it may be the result of a disease or nutrient deficiency. Hair loss in women has been linked to low vitamin D levels, although there is very little research on this so far.

Alopecia areata is an autoimmune disease characterized by severe hair loss from the head and other parts of the body. It's associated with rickets, which is a disease that causes soft bones in children due to vitamin D deficiency.

Low vitamin D levels are linked to alopecia areata and may be a risk factor for developing the disease.

One study in people with alopecia areata showed that lower blood levels tended to be associated with a more severe hair loss.

In a case study, topical application of a synthetic form of the vitamin was found to successfully treat hair loss in a young boy with a defect in the vitamin D receptor.

Bottom Line: Hair loss may be a sign of vitamin D deficiency in female-pattern hair loss or the autoimmune condition alopecia areata.

8. Muscle Pain

The causes of muscle pain are often difficult to pinpoint. There is some evidence that vitamin D deficiency may be a potential cause of muscle pain in children and adults.

In one study, 71 percent of people with chronic pain were found to be deficient. The vitamin D receptor is present in nerve cells called nociceptors, which sense pain.

One study in rats showed that a deficiency led to pain and sensitivity due to stimulation of nociceptors in muscles.

A few studies have found that taking high-dose vitamin D supplements may reduce various types of pain in people who are deficient.

One study in 120 children with vitamin D deficiency who had growing pains found that a single dose of the vitamin reduced pain scores by an average of 57 percent.

Bottom Line: There is a link between chronic pain and low blood levels of the vitamin, which may be due to the interaction between the vitamin and pain-sensing nerve cells.

Correcting a Vitamin D Deficiency is Simple and again it is incredibly common and most people are unaware of it.

That's because the symptoms are often subtle and non-specific, meaning that it's hard to know if they're caused by low vitamin D levels or something else. If you think you may have a deficiency, then it's important that you speak to your doctor and get your blood levels measured.

Fortunately, a vitamin D deficiency is usually easy to fix. You can either increase your sun exposure, eat more vitamin D rich foods or simply take a supplement......and it will have have big benefits for your health.

MyAchingKnees Comment: You really can't obtain adequate Vitamin D from Sun exposure. You can get the Vitamin D you need by eating foods rich in Vitamin D, but it is hard, very hard, in today's world to get wholesome foods. The best way to get the Vitamin D you need is through supplementation - just make sure you get it from quality supplements.

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Vitamin D deficiency rampant in neuromuscular diseases, study shows

This report was posted in the Chicago Tribune. A study by two Pennsylvania doctors shows that people suffering from neuromuscular diseases have a high prevalence of vitamin D deficiency, the Newswise news service reported Friday. The results were presented at the annual meeting of the American Association of Neuromuscular & Electrodiagnostic Medicine in Savannah, Ga.

"Previous work has shown vitamin D deficiency to be quite common in other neurological disorders such as multiple sclerosis, myasthenia gravis and Parkinson's disease. This study suggests this concern may be more prevalent in other neuromuscular conditions as well," said Dr. Ileana Howard, a member of the association's editorial board.

"While the connection between vitamin D deficiency and neurologic disease is likely complex and not yet fully understood, this study may prompt physicians to consider checking vitamin D levels in their patients with neurologic conditions and supplementing when necessary," Howard added.

The use of vitamin D supplements has been suggested previously to improve function in frail elderly patients at risk for falls and also for people with myasthenia gravis and Parkinson's. Whether vitamin D deficiency and supplementation play a role in other neurologic conditions requires more research, Newswise reported.

The study was conducted in Hershey, Pa., by Drs. Sankar Bandyopadhyay and Sol Dejesus.

Beyond vitamin supplements, sunshine is one of the best sources of vitamin D, but sun exposure plummets for most of the country during the winter. Good food sources include fatty fish like wild salmon, cod liver oil, beef liver, orange juice or milk fortified with vitamin D, and eggs.

MyAchingKnees comment: I would have liked to see this study talk about blood levels of Vitamin D and in relation to how much Vitamin D the patients are consuming each day. My wife was taking 900 IU of Vitamin D each day, which is more than twice the FDA recommended daily allowance (RDA) and yet he blood tests showed that she was Vitamin D deficient. We added 2,000 more IU and now her blood levels of Vitamin D are above normal. I take 4,900 IU of Vitamin D. 900 IU with my daily supplements plus two 2,000 IU tablets.

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7 Signs You May Have A Vitamin D Deficiency

Posted on the Huffington Post, by Sarah Klein. Not where you expect to find good nutritional information, but this is a good article none the less. Especially when the article states that we need much higher doses of Vitamin D that the 800 IU's recommended by the FDA.

With the Polar Vortex now firmly in our past, we're ready to shed some layers and soak up some springtime sun.

About time, too, considering it's our greatest source of vitamin D, a nutrient crucial to bone, skin and mental health. In fact, about 80 to 90 percent of our vitamin D comes from sun exposure, says Dr. Michael F. Holick, M.D., Ph.D., a professor of medicine, physiology and biophysics at the Boston University Medical Center who has studied and published on vitamin D for decades. "The problem is [many of us] assume if you have a healthy diet that you're getting enough of every nutrient," he says. Even the best dietary sources of vitamin D aren't loaded with the nutrient: a serving of salmon is a good bet, with around 450 International Units (IU) of vitamin D per three ounces, according to the National Institutes of Health Office of Dietary Supplements. But there are just 137 IUs per serving of fortified OJ and around 120 in fortified milk.

The Institutes of Medicine recommend most children and adults under age 70 get 600 IUs of vitamin D daily, and those over 70 should aim for 800. But Holick, working with an Endocrine Society committee, found that up to 1,000 IUs a day for children and 1,500 to 2,000 IUs a day for adults was safe and effective, he says. (These recommendations are also well within the safe upper limits set by the IOM).

Without enough sunlight and dietary D, children may be at greater risk for rickets, a softening of the bones, and adults may be at greater risk for osteoporosis. Vitamin D deficiency may also up risk of high blood pressure and type 2 diabetes, says Holick.

So what should you watch for if you're concerned you might not get enough? Here are a few signs you might need more vitamin D.

Your bones ache.

"Especially in winter, [vitamin D deficient] adults feel more achiness in bones and muscles," says Holick, "and joints are a little more stiff when they get up in the morning."

MyAchingKnees comment:  Vitamin D is a key component to my bone and joint health.  It has other applications, such a heart health as well, but Vitamin D supplementation is so cheap it doesn't make sense not to take advantage of it. 

You've got the blues.

Vitamin D seems to improve levels of the neurotransmitter serotonin, says Holick, which in turn could lift your spirits. In a small 1998 study, healthy people given vitamin D supplements during the winter reported greater positive feelings than people given no D. However, a larger study in women over 70 found no significant mental health benefit.

You're 50 or older.

The skin simply doesn't make as much vitamin D as you get older, and the kidneys start to grow a little less productive when it comes to converting that D into the form the body puts to good use, according to the American Cancer Society. Older adults may also spend more time indoors, according to the NIH.

You're overweight or obese.

There's no change in vitamin D production in people carrying excess weight, but the higher concentration of body fat affects the levels of vitamin D in the blood. That's because vitamin D is fat soluble, says Holick, meaning the more body fat you have, the more it gets "diluted," he says. People who are overweight or obese may require more daily vitamin D to make up for this effect.

You have darker skin.

Studies have shown distinct demographic differences in rates of vitamin D insufficiency and deficiency. "Your skin pigment is natural sunscreen," says Holick. A sunscreen with 30 SPF reduces the skin's ability to make vitamin D by a whopping 97 percent, he says. Someone with very dark skin needs up to 10 times the amount of sun exposure than someone with a very pale complexion to make the same amount of vitamin D, he says.

You're a big-time head sweater.

Travel back in time a century or so and you'd find visiting doctors asking new mothers about how sweaty they found their heads. No joke, says Holick. "It's one of the first, classic signs of vitamin D deficiency."

You have gut trouble.

People with Crohn's, celiac or inflammatory bowel disease may be a greater risk for vitamin D deficiency because of the way these gastrointestinal conditions affect fat absorption. With these and other stomach issues, fat absorption can be lower, but that in turn lowers absorption of fat-soluble vitamins like D, according to the NIH.

So how can you get your D safely?

Holick says "sensible sun exposure" is key, since D production only occurs on unprotected skin. If you know you're likely to get a mild sunburn after 30 minutes outside without sunscreen, venture out for about 10 to 15 minutes and then put your sun protection on, he says. Expose arms, legs, abdomen and back if you can, for max vitamin D production. And keep in mind depending on where you live, you may only make vitamin D for part of the year due to the angle of the sun, he says, and likely only from about 10 a.m. to 3 p.m. for the same reasons.

If that all sounds a little confusing -- and it certainly can be -- check out Holick's handy app, D Minder, which can help you pinpoint how long you need to be outside depending on your location and your skin type to get your optimal vitamin D.

MyAchingKnees comment:  They can say it all they want, recommending exposure to the Sun for Vitamin D, but you are not going to get adequate Vitamin D from Sun exposure.  You have to supplement, ...eat right, but supplement. 



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Vitamin D Deficiency Increases Risks

MyAchingKnees.com has written before about the necessity for Vitamin D at much higher levels than previously thought to support a healthy immune system. In fact, one of our auto responders when you sign up for more information from this site, is on the effects of Vitamin D to combat oxidative stress which often manifest itself in joint pain as well as many other symptoms of degenerative disease. I take 3,800 IU's of pharmaceutical grade Vitamin D daily.

Published study, although it gets a little technical, showed that adults with low vitamin D levels had more than double the risk of pre-hypertension and pre-diabetes than adults with higher vitamin D levels.

Pre-diabetes and pre-hypertension have been associated with low vitamin D levels. In a recent issue of the journal Diabetes Care, scientists report a correlation between reduced vitamin D levels and pre-diabetes and pre-hypertension in adults. Both pre-diabetes and pre-hypertension are estimated to exist in at least one-fourth of disease-free adults.

Researchers analyzed data from 898 men and 813 women who participated in the National Health and Nutrition Examination Survey (NHANES), 2001-2006. Blood pressure measurements were obtained during examinations conducted upon enrollment, and blood samples were evaluated for glucose, serum 25-hydroxyvitamin D and other factors.

Pre-diabetes was defined as having a fasting serum glucose of between 100 and 125 milligrams per deciliter, and pre-hypertension was defined as systolic blood pressure of 120 to 139 mmHg and/or diastolic blood pressure between 80 and 89 mmHg. Pre-diabetes was 33 percent higher among those with vitamin D levels of 76.3 nmol/l (30.5 ng/ml) or less compared to those with higher levels. Pre-hypertension was evident in 61 percent of those with the lower vitamin D levels. Participants with undiagnosed diabetes and untreated hypertension had even lower vitamin D levels on average. Serum vitamin D levels tended to decline with increasing age and body mass.

When the risk of having both conditions was considered, those with low vitamin D levels had 2.4 times the risk of that experienced by subjects with higher vitamin D levels.

It is reasonable that among those with pre-diabetes or pre-hypertension, vitamin D supplementation resulting in increased serum vitamin D levels may help reverse subtle changes in fasting serum glucose and resting blood pressure that may lead to more advanced disease states.

Source: Pre-diabetes and Pre-hypertension in Healthy Adults Are Associated With Low Vitamin D Levels. Diabetes Care March 2011 vol. 34 no. 3 658-660, Alok K. Gupta, MD, Meghan M. Brashear, MPH and William D. Johnson, PHD.

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