That Sunny Vitamin

We might actually be getting more sunshine during Stay at Home than we did before the COVID-19 outbreak. More people are out walking, jogging, or biking as their exercise classes and gyms are closed and their normally busy lives aren’t so busy. Those who are working from home can even arrange a little break to sit outside, exercise, have a picnic, or do some gardening. 

About Vitamin D

We know that dairy products are fortified with vitamin D and this is good for our bones. Yet, you may be surprised at all the other important health benefits of this fat-soluble vitamin. It also enhances the function of your immune, digestive, circulatory, and nervous systems.  

The Sunshine Vitamin

It’s called the sunshine vitamin because when the cholesterol that lives in your skin is exposed to UltraViolet, UV-B radiation from the sun, a complex path of conversions leads to a healthy result: voila–vitamin D! And the sun is the best source, as vitamin D from the sun stays in our systems twice as long as that derived from food or supplements. You know that I’m a food first person, and we know that the food matrix also enhances the absorption of the nutrients.

Several factors can affect the absorption of the UV-B rays: 

• As we age less is absorbed. Over age 60 we need a little more time in the sun. This is an extra challenge for elders who cannot easily get outside.
• Where you live. Northern climates provide less sunshine than places closer to the equator. 
• Skin color. Those with darker skin tones will need more sun to get the same vitamin D benefit because the pigment (melanin) acts like a shade. 
• Sunscreen. Try to go in the sun for 15 minutes a few times a week without sunscreen. Wear it the rest of the time to protect your skin from damage and cancers. 
• Or, wear sunscreen on your face, arms and hands and skip it on your legs.

What Are Vitamin D Deficiency Symptoms?

I have seen children in Tanzania with rickets, a severe bone disease brought on by malnutrition and vitamin D deficiency. Rickets was much more common in the United States prior to WW2, when milk was not fortified with Vitamin D.

These symptoms can be subtle and caused by many other factors. Some possible signs of Vitamin D deficiency:

• Fatigue or tiredness
• Bone pain
• Joint pain
• Muscle pain
• Irritability
• Low energy
• More frequent illness
• Anxiety
• Weight gain
• Hair loss

D and Disease Prevention

Research suggests that a good vitamin D level can help in the prevention and prognosis of colon and blood cancers, reduce cancer cell growth, help control infections, and reduce inflammation. Our kidneys, muscles, parathyroid glands, have receptors for vitamin D, and scientists are exploring how vitamin D affects their function as well.

Vitamin D and COVID-19

A new study of 20 European countries has found a link between lower levels of vitamin D and higher numbers of COVID-19 cases and mortality rates. Led by Dr. Lee Smith of Anglia Ruskin University and Mr. Petre Cristian Ilie, lead urologist of Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust, the research is published in the journal Aging Clinical and Experimental Research.

Vitamin D regulates the white blood cell response and the flood of inflammatory cytokines. So, it is thought to influence susceptibility to acute respiratory tract infections. The COVID-19 virus is known to cause a dangerous onset and storm of cytokines. Two of the European countries with worse coronavirus outcomes are Italy and Spain, with high populations of the elderly who tend to avoid the hot sun, and have darker skin. The Scandinavian countries, on the other hand, have populations with the lowest numbers of COVID-19 cases and highest consumption of fish oils and vitamin supplements. 

Dr. Lee Smith, said: “We found a significant crude relationship between average vitamin D levels and the number COVID-19 cases, and particularly COVID-19 mortality rates, per head of population across the 20 European countries. Vitamin D has been shown to protect against acute respiratory infections, and older adults, the group most deficient in vitamin D, are also the ones most seriously affected by COVID-19.” This obviously has implications for those in hospitals and nursing homes.

Getting Vitamin D in Your Diet

Along with sunshine, food is the best way to up your vitamin D. Good food sources include:

• Fatty fish, such as salmon, tuna, and sardines. In fact, a 3.5-ounce serving of canned salmon can provide up to 386 IU of vitamin D — about 50% of the RDI
• Fortified dairy products, including milk, cheese, and yogurt
• Mushrooms. Attention vegans! Mushrooms are the only completely plant-based source of vitamin D
• Egg yolks 
• Fortified cereals and juices

Recommended Supplement Amounts – if Needed

Like me, most healthcare providers are testing our patients Vitamin D levels regularly now. We like to see the value above 32 ng/ml. If it’s low, we advise people to add more dairy and also take a supplement.

The Recommended Dietary Allowance for vitamin D provides the daily amount needed to maintain healthy bones and normal calcium metabolism in healthy people. It assumes minimal sun exposure. The RDA: The Recommended Dietary Allowance for adults 19 years and older is 600 IU daily for men and women, and for adults >70 years it is 800 IU daily.

The Tolerable Upper Intake Level (UL) is the maximum daily intake unlikely to cause harmful effects on health. The UL for vitamin D for adults and children ages 9+ is 4,000 IU. 

For pregnant women who need vitamin D supplementation, it’s also recommended that they take between 2,000 and 4,000 IU/per day and not exceed 4,000. Some people do need higher amounts, those with Crohn’s disease or ulcerative colitis and those who have had gastric bypass surgery. But for most people, high doses are unnecessary, and can be harmful.

Before I write you a prescription for a trip to Hawaii or Mexico to soak up the UV-B and start converting it to Vitamin D, please consider doing what you can where you are. As with all things, a healthy, well-balanced diet with dairy or supplementing and getting exercise out in the sunshine is the best way to keep yourself healthy.