It’s no secret that Vitamin D is critical to balancing many areas of health, but physicians and scientists at The University of Texas Health Science Center are still learning just how powerful the so-called “sunshine vitamin” is. Vitamin D deficiency is extremely common, affecting approximately 42% of the U.S. population, according to research published in the National Institutes of Health database. Because of this, some researchers across the globe have referred to this vitamin deficiency as an “invisible epidemic.”
Doctors are seeing an uptick in patients with a deficiency. “The reason why we’re seeing an upward trend is because we’re checking for it,” said family physician Deepa Iyengar, MD, professor of Global Health with McGovern Medical School at UTHealth Houston. “Identifying vitamin D deficiency is such an important part of the family medicine genre because deficiency is seen across all ages.”
How vitamin D affects the body
It is best known for promoting healthy bones and teeth. The human body can only absorb calcium, the primary component of bone, when vitamin D is present.
There is a well-documented relationship between vitamin D and orthopedic health, said pediatric orthopedic surgeon Alfred Mansour III, MD, clinical associate professor of orthopedic surgery with McGovern Medical School. His team at UT Physicians recently conducted a quality improvement project examining the link between low vitamin D levels and broken bones among pediatric patients sent to the emergency room at Children’s Memorial Hermann Hospital.
Of the pediatric patients studied by Mansour’s group who needed surgical treatment for their fracture or broken bone, 85% were found to be vitamin D deficient. The discovery has led his team to implement new protocols, including partnering with the pediatric emergency room at Children’s Memorial Hermann Hospital to test for the condition in admitted patients. A person can experience a deficiency at any age, from birth to later in life. However, some factors put certain individuals at greater risk than others.
Infants who are being breastfed are among the high-risk groups, according to UT Physicians pediatrician Kenya Parks, MD, clinical associate professor of pediatrics with McGovern Medical School. Parks said other patients who are vitamin D deficient include children and teens who are obese. This is a phenomenon at least partially attributed to the distribution of a greater amount of body tissue.
In children, extreme cases of vitamin D deficiency are manifested as rickets – a disease which results in soft bones and skeletal deformities. Rickets can also cause developmental delays, seizures, muscle spasms, and other abnormalities, Parks said. “Vitamin D is both a vitamin and a hormone,” Parks said. “Kids have growing bones, so if they don’t get enough of it, their bones aren’t fortified.”
The deficiency is highest among people who are elderly, institutionalized, or hospitalized. In the U.S., according to a study published in Pharmacotherapy, 60% of nursing home residents were low in vitamin D, while according to research published in The New England Journal of Medicine, 57% of hospitalized patients were found to be vitamin D deficient.
“As you get older, bone resorption increases and bone formation decreases, so if you don’t substitute that loss with enough calcium, it causes a bone mass deficiency,” said Iyengar, who sees geriatric patients at UT Physicians. “Your body thinks you’re short of vitamin D, so it takes that vitamin from the bone and gives it to the blood, which puts people at major risk for osteoporosis.”
Additionally, because vitamin D deficiency is also linked to parathyroid metabolism, women become especially prone as they go through menopause and lose estrogen, Iyengar said. A woman’s ability to build bone peaks in her mid to late 20s, according to Pamela Berens, MD, the Dr. John T. Armstrong, Professor of Obstetrics and Gynecology at McGovern Medical School and an OB/GYN with UT Physicians. Therefore, as women enter their 30s, Berens advises her patients to simply work on maintaining their bone health.
“For post-menopausal women, it’s important to know your bone density and vitamin D level. Having that knowledge gives you the power to fix it,” Berens said. “Younger women just need to think about what they can do to build healthy bones.”
Vitamin D also regulates many other cellular functions, with its anti-inflammatory, antioxidant and neuroprotective properties supporting immune health, muscle function and brain cell activity.
How to get enough of it
A person can get vitamin D in three ways: through the skin, from their diet, and from medically prescribed supplements.
Spending some time in the sun is recommended but given that too much sun exposure can lead to skin cancer, food may be a better source. Fatty fish, beef liver, cheese, mushrooms, and egg yolks all naturally carry the nutrient. It can also be found in fortified foods and beverages, such as milk, breakfast cereals, orange juice, yogurt, and soy drinks.
People also get vitamin D from multivitamins and supplements, which come in both pill and liquid form. The standard treatment for vitamin D deficiency involves supplements. Depending on an individual’s condition, their health care provider will recommend how much they need to take, how often they need to take it, and how long they need to take it.
According to the National Institutes of Health, the daily recommended amount of vitamin D is 400 IU for infants up to 12 months old, 600 IU for children and adults up to 70 years old as well as breastfeeding women, and 800 IU for adults who are at least 71 years old.
References:
University of Texas Health Science Center at Houston
Prevalence and correlates of vitamin D deficiency in US adults – PubMed (nih.gov)
Leave a Reply