Vitamin D - widespread deficiencies and evidence of serious consequences

[Druzhok]

As featured on The Food Programme this afternoon (R4: www.bbc.co.uk/programmes/b00t66nr#synopsis )

The UK guidelines are far lower than those in most other northern (i.e. fewer hours of daylight and sun) countries. Apparently, it's a particular problem for women (esp. in pregnancy) and babies/small children, and ethnic minorities with darker skintones. The melatonin in the latter's skin offers protection against UV light that, whilst beneficial in sunnier locations, can lead to a deficiency in a northerly country like the UK.

My Dutch friend has given her children vit D drops since they were tiny: I have asked a GP, HV and pharmacist and told there was no need at all. The UK has apparently been very slow to react to the issue.

The best sources are oily fish, meat and egg yolk. If you have a darker skin tone and/or are vegetarian (or eat low quantities of the above sources), you should consider supplements.

Conditions triggered / exacerbated by Vit D deficiency include multiple sclerosis, muscle wastage, type A diabetes and loss of bone density (I assume that's Ricketts).

Who knew???

Apologies for any errors: working mainly from memory.

RubberDuck - I found this page which outlines a trial given to those who are affected by SAD and treatment was Vit D plus a light box. (scroll halfway down).

We use a lightbox all year round as we have a very dark house plus are all affected by SAD in winter.

Interesting. I have a light box (which is generally awesome) - may look at getting vit D supplements then. Thanks for that Swans

Rubberduck: recommend you listen to the programme, if you can. All the medical practitioners who were willing to say either way DID take Vit D supplements. The female respondent said she was largely anti-supplement, but made an exception for vit D.

I think the MS/Vitamin D issue is a bit more complicated than that but it's worth watching the research that's being done.

There is good evidence that Vitamin D deficiency in the UK is very common.
But the evidence is not as good that it is harmful (outside of severe deficiency such as Rickets).

The NHS currently advises that Vitamin D supplementation may be needed from 6mths to 5yrs, those who are covered up for cultural reasons and in older adults.

Also, I'm personally a fan of this BBC4 radio show.

I can't view the BBC at work, dbennet: is the R4 show 'Casenotes'?

Iwould be very wary of giving Vit D supplements to children. It is stored in the liver and over dose can be harmful.

The people who would most benefit are adults, adults who are older, and women with low bone density.

Children should get enough from milk, eggs and fish, and of course, sunlight if they play outside.

My father had mild rickets as a child as his family was very poor and they didn't get enough milk. You have to have a very poor diet as a child to be deficient.

[[Food IUs per serving Percent DV*
Cod liver oil, 1 tablespoon 1,360 340
Salmon (sockeye), cooked, 3 ounces 794 199
Mushrooms that have been exposed to ultraviolet light to increase vitamin D, 3 ounces (not yet commonly available) 400 100
Mackerel, cooked, 3 ounces 388 97
Tuna fish, canned in water, drained, 3 ounces 154 39
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup 115-124 29-31
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies) 100 25
Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV) 80 20
Margarine, fortified, 1 tablespoon 60 15
Sardines, canned in oil, drained, 2 sardines 46 12
Liver, beef, cooked, 3.5 ounces 46 12
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV) 40 10
Egg, 1 whole (vitamin D is found in yolk) 25 6
Cheese, Swiss, 1 ounce 6 2
*IUs = International Units.

**DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents of products within the context of a total diet. The DV for vitamin D is 400 IU for adults and children age 4 and older. Food labels, however, are not required to list vitamin D content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient.

I have been given a VitD supplement by my Obs (I'm pregnant). Apparently they are dishing them out as there is a "possibility" that Vit D deficiency may be linked to autism although she did caution that this is a big "might".

I actually live in Asia so you'd think we'd be getting enough sunlight but apparently widespread/ routine use of sunscreens means we don't.

Fair skin vs dark - the fairest skinned people make Vitamin D at 6x the rate of the darkest skinned people. This maximises their chances of making sufficient vitamin D with minimal sun. Even so, at the latitude the UK is, winter sun will produce insufficient UVB rays to allow much Vitamin D production to happen.

Vitamin D is an antioxidant and a prohormone; it's best known use in the body is in bone formation. Lack of Vitamin D while the bones are forming/growing can lead to rickets, which is having a resurgence. In adults, lack of vitamin D can result in osteomalacia ("bad bones").

Vitamin D deficiency has been linked to many conditions, not least of which is Alzheimer's disease - numbers of elderly people with Alzheimer's has increased hugely in Australia (again, possibly thanks to the message to stay out of the sun or use sunscreen whenever possible).

UVB is necessary for Vit D production and melanin production (Not melatonin, that is produced by the pineal gland to help you sleep). Anything that stops you going brown will stop you making Vitamin D as well.

The radio show about the Vitamin D segment was The Food Program

does wish had double checked melanin/melatonin before posting as had vague sense was talking bollocks, but was too lazy to Google

purple peony: I think there is a key difference between a severe deficiency resulting in Rickets disease, and having levels that are far below the optimum for health. Like vitamin C, surely: you don't have to exhibit all the symptoms of scurvy to be deficient.

Anyway, I'm not selling supplements or anything ... I was just interested in the programme and thought would share.

Druzhok, tis a very easy mistake to make - have done it myself several times - now I have to remind myself by saying "melanoma", which puts me straight

I knew because my booking midwife told me. Apparently they are trialing supplements in Bradford and Cardiff as they are both areas would bwhere more childten are born with or develop rickets. I was told I would be given supplements but at my second midwife appointment it wasn't even mentioned.

Where I live there are a lot of women who wear a full veil, so all bfing women are told to dose their babies with vitamin D. I declined on the basis of being very fair skinned and getting half an hour's daylight every day. Plus, the drops seemed to give DS a funny tummy. This is obviously just anecdotal but it was spectacular at the time.

I can't emphasise how important Vit D is for everyone especially a baby. 3 months ago I almost lost my son because he was vit D deficient. He was well within his weight, looked very healthy and was developing at a reasonable pace. Then he had a seizure one evening that lasted for 10mins and he stopped breathing and had to be resuscitated he had another later in hospital which lasted 15mins. Vit D is responsible for the absorption of calcium. Important for brain dev, muscle dev, heart fnc, bone dev, WALKING, being able to sleep well etc. My son was exclusively breastfeed up until 6mths and then once on solids ate well. I used the Pregnacare range from before conception and I ate very well. Its important to remember that vit D can not be obtained sufficiently from food it has to be from the sun or supplements. The UK has a large percentage of adults who are vit D deficient or borderline deficient. Women who are deficient may never know they are unless they do a test. If you are deficient you will be unable to pass on enough during pregnancy to your baby. I thought we were a healthy family with a very balanced diet but that made no difference what we needed was sunlight or vit D supplements. I urge parents please if you want to choose to not give your child any vit D please either move to a temperate country or have them tested of vit D and calcium. It could save their life! 1 in 3 babies are Vit D deficient and the problem seems to be getting worse here in the UK. This is the info coming from the DOH. Kids have developed Rickkets some babies have died because of this please please Don't take this lightly! It really hurt me that my son almost died because of something so simple.

There was something on radio 4 yesterday or the day before about vitamin D deficiency being a factor/the cause in some cases of apparent shaken baby syndrome and sudden infant death syndrome.

Purplepeony, are you sure there's a problem with supplements for children? It's not like Vitamin A, is it?

Yes, it is possible to have too much vitamin D (which can cause you to absorb too much calcium and cause kidney failure), but not from sun exposure, as the body makes its own vitamin D from the sun, so wouldn't deliberately overdose itself. The body does store vitamin D - that's how you can stock up on vitamin D in the summer when there is enough sun in this country to get your vitamin D that way. As for getting too much from your diet - that would be incredibly difficult, unless you have a weird diet (and are probably overdosing on mercury at the same time, as the best source is from oily fish...), since most foods contain little or no vitamin D, unless they are fortified with the stuff, which is a very rare instance in the UK (in other countries, they deliberately fortify their milk and cereals with it, but they don't fortify cows milk with vitamin D in the UK, nor do they seem to add vitamin D to many cereals, just tonnes of the B vitamins...). I don't think milk has much vitamin D in it at all... I think purplepeony was getting confused between vitamin D and calcium, since you need vitamin D in order to be able to absorb calcium, but that doesn't mean anything with lots of calcium in, like milk, actually has much vitamin D...

You could overdose on supplements, though - but since children's supplements in the UK only appear to contain a max of 5 micrograms, which is still technically the daily requirement in the UK but half the required daily amount now advised by many other countries and many, many times less than the amounts considered to be toxic (which it is thought would be in well in excess of 10,000 micrograms a day, possibly up to 40,000 micrograms before you get any symptoms of overdose), it would be exceptionally difficult to take too much of the stuff unless you ordered your supplements from overseas where they may be in far higher doses and never bothered to read the labels on vitamin bottles.

ps baby formula milk has vitamin D added. Human breast milk is naturally low in vitamin D and cows milk is naturally low in vitamin D (but a bit better than human milk). Hence the poorly communicated advice that breastfeeding mothers ought to be taking vitamin D supplements themselves and giving them to their babies.

oops, sorry, make that 250 micrograms could be an overdose of vitamin D, not 10,000...

Hi everyone

I was Vitamin D deficient in pregnancy even though I was taking supplements. Luckily I found out because my knowledgeable chiropractor advised me to be tested. My widwife agreed - even though there were no clinical signs of deficiency - so I was doubly lucky (friends of mine have been told no they can't be tested).

I've signed a 10 Downing Street e-petition to call for vit d testing as routine in pregnancy. Please would you sign it too and pass it on?

Enough signatures and it can be debated in the House of Commons.

Thank you.

hiho.... xx

epetitions.direct.gov.uk/petitions/28536

Details:
Check Vitamin d levels as part of routine blood testing during pregnancy

Responsible department: Department of Health

Vitamin D has been shown as a major player in maternal & foetal health. Linked to numerous vital health issues, vitamin d deficiency is now known to be prevalent. In the last three years an increasing amount of research suggests that some of the damage done by vitamin d deficiency is done in-utero while the foetus is developing. Much of that damage may be permanent, that is it cannot be fully reversed by taking vitamin d after birth. This research indicates vitamin d deficiency during pregnancy endangers the mother's life & health & is the origin for a host of future perils for the child, especially for the child's brain & immune system. Pregnant women undergo a number of routine blood checks. It would be prudent to check vitamin d levels at the same time. This preventative care would empower women with knowledge so they can supplement for their health and that of their unborn baby. We call for ante natal screening to include the simple check of vitamin d levels known as 25 (OH)D.

(sorry...i didn't get the link converted automatically....not sure what i did wrong but am trying again..here goes!)

Hi everyone

I was Vitamin D deficient in pregnancy even though I was taking supplements. Luckily I found out because my knowledgeable chiropractor advised me to be tested. My widwife agreed - even though there were no clinical signs of deficiency - so I was doubly lucky (friends of mine have been told no they can't be tested).

I've signed a 10 Downing Street e-petition to call for vit d testing as routine in pregnancy. Please would you sign it too and pass it on?

Enough signatures and it can be debated in the House of Commons.

Thank you.

hiho.... xx

epetitions.direct.gov.uk/petitions/28536

Details:
Check Vitamin d levels as part of routine blood testing during pregnancy

Responsible department: Department of Health

Vitamin D has been shown as a major player in maternal & foetal health. Linked to numerous vital health issues, vitamin d deficiency is now known to be prevalent. In the last three years an increasing amount of research suggests that some of the damage done by vitamin d deficiency is done in-utero while the foetus is developing. Much of that damage may be permanent, that is it cannot be fully reversed by taking vitamin d after birth. This research indicates vitamin d deficiency during pregnancy endangers the mother's life & health & is the origin for a host of future perils for the child, especially for the child's brain & immune system. Pregnant women undergo a number of routine blood checks. It would be prudent to check vitamin d levels at the same time. This preventative care would empower women with knowledge so they can supplement for their health and that of their unborn baby. We call for ante natal screening to include the simple check of vitamin d levels known as 25 (OH)D.

I feel my problem is that, despite going outside, very little of my skin is exposed to sun. I take Vit D between Oct & Apr because I feel I have no chance of getting enough sunlight. I leave for work in the dark, come home in the dark and wear many layers, hat, scarf & gloves. Only the strip of skin at my nose and eyes is exposed. I live in northern Scot btw.

Im pale and walk outdoors loads so apparently shouldnt be vit D deficient. But got tested last year and I was. Coincidentally (or not..) I have suffered from SAD for years, also only diagnosed last year. So, I have been taking a high dose vit D supplement and now have a light box and this winter I feel fab! Worth getting tested even if you think you should be fine I reckon.

Have to say tho, I always used a factor 15 sunscreen face cream, so in retrospect...