What You Need to Know about Vitamin D

1. What YouNeed to KnowaboutVitamin D Kelly Forrest, R.N.

2. The “Sunshine Hormone” • There are two ways ourbodies receive Vitamin D: • We can synthesize it from the sun • We can eat foods that contain Vitamin D • It is classified as a hormone, fat-soluble vitamin and an antioxidant.

3. What Does Vitamin D Do? • Regulates cell growth • Limits abnormal cell (possibly cancerous) proliferation • Improves muscular strength • Reduces the effects of autoimmune disorders • Promotes healthy BP • Assists in the promotion of bone health • Works in conjunction with hormones to stabilize blood calcium, phosphorus and insulin levels

4. What do the studies show? Therapeutic Vitamin D Levels have been linked to Chronic Deficiencies have been linked to Autism Post-Partum Depression Bone disorders (osteoporosis in adults and rickets in children) Heart attacks High blood pressure Multiple Sclerosis Type I Diabetes • Reduced colon cancer risk by up to 60% • Even better blood pressures in people without blood pressure problems • Reduced heart attack risk by up to 50% • Reduced risk of Influenza A by up to 40%

5. Vitamin D Pathways Source: http://www.well.ox.ac.uk/aug-10-vitamin-d-influences-over-200-genes

6. Daily Recommended Intake (DRI) 6 months-50 years of age 5 mcg (200 IU) 51-70 years of age 10 mcg (400 IU) Over 71 years of age 15 mcg (600 IU) It is very difficult to get the DRI from food alone. There is no DRI for breast-fed infants at this time.

7. Dietary Considerations Food Sources Limitations We are encouraged to reduce our intake of fish due to mercury levels. We are also encouraged to reduce our egg yolk intakes due to their high fat and cholesterol content. Any liver or kidney disease will reduce the amount of bioavailable Vitamin D. • Oily fish 3 oz. = 5.7 mcg Vit D • Fortified Cereal ¾ cup = 1 mcg Vit D • Egg yolks 1 yolk = 0.5 mcg Vit D • Fortified cow or soy milk 1 cup = 2.5-2.9 mcg Vit D

8. Sunshine Recommendations Limitations Use of sun screen severely limits vitamin D absorption. Receiving sunlight through a window or tanning bed do not produce the same effect. Ethnicity and skin pigmentation affect Vitamin D production greatly. • No definitive recommendations for daily time exposure have been set, but many doctors recommend 15 minutes of sunlight daily.

9. Any precautions with Vitamin D? • Vitamin D is a fat soluble vitamin, so it is possible to reach toxicity • Some effects of toxicity include: nausea, vomiting, decreased appetite, constipation, weakness, abnormal heart rhythm, weight loss, confusion and kidney damage • Due to multiple factors, toxicities are very rare.

10. Questions for Your Doctor Can I benefit from taking a supplement? What about medication interactions? Check with your doctor or pharmacist for possible interactions with your current medications and supplements. • Ask your doctor which dose is recommended for you. • Dosing recommendations vary from 400 – 2000 units daily (or even up to 50,000 units once a week), so it is very important to take the right dose for you. • Also ask your doctor about a plan to recheck your Vitamin D level in the future.

11. Sources Corwin, E., Ellsworth-Bowers, E. (2012). Nutrition and the Psychoneuroimmunology of Postpartum Depression. Nutrition Research Reviews. 25(1): 189-92. Retrieved from pubmed.gov Harvard School of Public Health. (2014). Vitamin D and Health. Retrieved from http://www.hsph.harvard.edu/nutritionsource/vitamin-d/ Medline Plus. (2012). Vitamin D. Retrieved from http://www.nlm.nih.gov/medlineplus/druginfo/natural/929.html Office of Dietary Supplements, National Institutes of Health. (2011). Dietary Supplement Fact Sheet: Vitamin D. Retrieved from ods.od.nih.gov Schlenker, E., Roth, S. (2011). Williams’ Essentials of Nutrition and Diet Therapy, 10th Ed. St Louis, MO: Elsevier. The Wellcome Trust Centre for Human Genetics. (2014). Retrieved fromhttp://www.well.ox.ac.uk/aug-10-vitamin-d-influences-over-200-genes