very low vitamin d despite lifestyle and diet

[hellosally]

I have just had a routine blood test and my vitamin D levels are 12(normal above 70) this is despite daily sun exposure for 30 minutes before suncream, eating full fat dairy and oily fish 3 times a week-the nurse said to take the prescription and recheck but I am doing everything that should help. all the other bloods were normal. can anybody give me any further advice or tips?

[hellosally]

@Bettertobehealthy

Hi *@hellosally* ,

Here are a few details about Vit D , which might interest you , especially since your level was so low ( 12 ) I am assuming you are in the UK , and your blood measurement was 12nmol/L (and not different units i.e. 12 ng/ml , as used in many other countries , including USA )

Natural cows milk does not contain Vitamin D, here in the UK it is not fortified. Processed dairy products might be artificially fortified with Vitamin D, it will say on the label. The amount of addition is usually quite small and not liable to make much difference to your level.

To affect your blood levels, then a dose of 1000 IU Vit D ( that is 25 mcg or microgram ) per day, taken as a daily supplement over the long term, will increase your level by 25 nmol/L above your natural level. That figure of 25 is an average , for an averagely responding adult , weighing about 75 kg. So if you are just such a person , then 3000 IU supplementation per day , long term , will increase your blood level by 75 nmol/L . Taking you to 87 nmol/L . Roughly.

One of most reliable Vit D postal tests can be obtained here:
www.vitamindtest.org.uk/ It is an NHS lab, they charge £29 for a private test ,( if they are not doctor ordered). It consists of a blood spot, posted to them, they analyse and email the result back in about week.

In the UK , your body is unable to make vitamin D from sunshine on skin between mid-Oct and mid-April. This is because high energy UVB is absorbed by the atmosphere when the sun is low in the sky. Only when the sun is above 45 degrees , does the UVB get through to your skin. This means that even in summer, when the sun is low, i.e. before 11 am and after 3pm , you still cannot make Vitamin D from sunshine. That is why many are Vitamin D deficient, especially during the winter. Our modern lifestyle in the UK does not give us sufficient opportunity to get what we need. Western food preferences are low in Vitamin D. So it is almost impossible to get enough from our food. Oily fish is a source, but to get just 1000 IU per day , you would need to consume 120g of wild salmon , every day. Farmed salmon has only 1/4 the amount compared to wild. So even their food is depleted! The natural source for 80% of human VitD , has historically been sunlight on skin. Other food sources are limited. None in vegetables of any kind. None in oil, none in nuts, seeds etc. In fact a vegetarian/vegan diet has tiny amounts. Eggs have about 40 IU per egg. Again, that is a tiny amount. Sufficient for a one ounce chick. Lets say you consume one egg per day , then that will raise an average 75 kg persons vitamin D level by 1 nmol/L. Vitamin D requirements depend upon your weight. Meat does have some Vit D , but not much, very much dependent upon how the animal was kept and or supplemented.
A person with a higher BMI can have higher requirements for vitamin D to achieve the same increase in blood level. That is because Vit D is soluble in fat. The response variation to supplementation can be as much as 6 to 1 difference depending upon the person. That is why , if you seem to have a low response, as you do, it would be very advisable to check your blood vitamin D level, after several months of supplementation to see if your response is as expected. It may not be.

The reasons for lower levels than expected can be , high BMI , genetic variability, conditions such as hyperparathyroidism that suppress your Vit D blood level, etc. Inability to absorb due to gut conditions IBS, coeliac crohns, gall bladder/bile problems etc.

The most likely is that you simply have not been able to get enough sun or foods containing vitamin D.

IF I was you, I would supplement with the recommended dose , check what is has done to your Vit D blood level. Then check again a few months later. IF your level is going down , you might need more supplement , i.e. daily maintenence doses. Or you might consider getting checked out for high calcium in the blood ( poss hyperparathyroidism ) which could suppress your vitamin D blood level. You would need a PTH and serum calcium test to do that.

Here is a thread , with lots of information about this subject , I posted quite a bit there. It may be helpful.Quite a few people there with similar problems. www.mumsnet.com/Talk/general_health/2841497-If-you-are-vitamin-D-deficient-what-have-you-been-prescribed

If you need any more information , just get back to me.

Best of luck,
BTBH

thanks for this-amazingly detailed info BTBH!

[Taprobane]

Bettertobehealthy has posted a lot of great information, as have other posters. To add further, I see an Eco-Medicine doctor - fully qualified as a doctor but specialises in environmental stresses and nutrition. My Vit D was under 10 when my first test result came back. My doctor was surprised I was able to get out of bed with a result that low. She has told me it has to be Vitamin D3 supplements to be effective in the body, and - as many others have already said - we don't get enough sun here to make enough Vitamin D naturally. Apart from the amount of sunshine, factors such as sun cream, length of time outside, and racial ancestry come into play (people with darker skins don't make as much Vitamin D because nature thinks these people are exposed to lots of sunshine). Researching recently, I saw that pregnant women may need as much as 4,000iu a day. Extrapolating (my own opinion, not medical science), I wonder whether people who are stressed might also need this amount or even more to begin with to get their levels up. I was taking 8,000iu daily for over a year and have dropped to 4,000iu recently although I need to get my Vit D levels checked again to see what effect the supplementation has had. Amazon UK sells Solgar Vitamin D3 in 4,000iu and 2,200iu capsules.

[Bettertobehealthy]

Hi @hellosally ,

Here are a few details about Vit D , which might interest you , especially since your level was so low ( 12 ) I am assuming you are in the UK , and your blood measurement was 12nmol/L (and not different units i.e. 12 ng/ml , as used in many other countries , including USA )

Natural cows milk does not contain Vitamin D, here in the UK it is not fortified. Processed dairy products might be artificially fortified with Vitamin D, it will say on the label. The amount of addition is usually quite small and not liable to make much difference to your level.

To affect your blood levels, then a dose of 1000 IU Vit D ( that is 25 mcg or microgram ) per day, taken as a daily supplement over the long term, will increase your level by 25 nmol/L above your natural level. That figure of 25 is an average , for an averagely responding adult , weighing about 75 kg. So if you are just such a person , then 3000 IU supplementation per day , long term , will increase your blood level by 75 nmol/L . Taking you to 87 nmol/L . Roughly.

One of most reliable Vit D postal tests can be obtained here:
www.vitamindtest.org.uk/ It is an NHS lab, they charge £29 for a private test ,( if they are not doctor ordered). It consists of a blood spot, posted to them, they analyse and email the result back in about week.

In the UK , your body is unable to make vitamin D from sunshine on skin between mid-Oct and mid-April. This is because high energy UVB is absorbed by the atmosphere when the sun is low in the sky. Only when the sun is above 45 degrees , does the UVB get through to your skin. This means that even in summer, when the sun is low, i.e. before 11 am and after 3pm , you still cannot make Vitamin D from sunshine. That is why many are Vitamin D deficient, especially during the winter. Our modern lifestyle in the UK does not give us sufficient opportunity to get what we need. Western food preferences are low in Vitamin D. So it is almost impossible to get enough from our food. Oily fish is a source, but to get just 1000 IU per day , you would need to consume 120g of wild salmon , every day. Farmed salmon has only 1/4 the amount compared to wild. So even their food is depleted! The natural source for 80% of human VitD , has historically been sunlight on skin. Other food sources are limited. None in vegetables of any kind. None in oil, none in nuts, seeds etc. In fact a vegetarian/vegan diet has tiny amounts. Eggs have about 40 IU per egg. Again, that is a tiny amount. Sufficient for a one ounce chick. Lets say you consume one egg per day , then that will raise an average 75 kg persons vitamin D level by 1 nmol/L. Vitamin D requirements depend upon your weight. Meat does have some Vit D , but not much, very much dependent upon how the animal was kept and or supplemented.
A person with a higher BMI can have higher requirements for vitamin D to achieve the same increase in blood level. That is because Vit D is soluble in fat. The response variation to supplementation can be as much as 6 to 1 difference depending upon the person. That is why , if you seem to have a low response, as you do, it would be very advisable to check your blood vitamin D level, after several months of supplementation to see if your response is as expected. It may not be.

The reasons for lower levels than expected can be , high BMI , genetic variability, conditions such as hyperparathyroidism that suppress your Vit D blood level, etc. Inability to absorb due to gut conditions IBS, coeliac crohns, gall bladder/bile problems etc.

The most likely is that you simply have not been able to get enough sun or foods containing vitamin D.

IF I was you, I would supplement with the recommended dose , check what is has done to your Vit D blood level. Then check again a few months later. IF your level is going down , you might need more supplement , i.e. daily maintenence doses. Or you might consider getting checked out for high calcium in the blood ( poss hyperparathyroidism ) which could suppress your vitamin D blood level. You would need a PTH and serum calcium test to do that.

Here is a thread , with lots of information about this subject , I posted quite a bit there. It may be helpful.Quite a few people there with similar problems. www.mumsnet.com/Talk/general_health/2841497-If-you-are-vitamin-D-deficient-what-have-you-been-prescribed

If you need any more information , just get back to me.

Best of luck,
BTBH

[Mycatismadeofstringcheese]

That’s good. I might have to get it done privately

[hellosally]

Mycatismadeofstringcheese -Iwas lucky and the nurse did an NHS test , she was doing cholesterol etc and asked if I wanted anything else including vitamin D-I said I was sure it would be fine as I took a supplement over winter and have been out in the sun-it was her who said almost intuitively that she still wanted to test.

[TalbotAMan]

Low vitamin D can be a symptom of coeliac disease.

[Mycatismadeofstringcheese]

Did you do private test or nhs. My doctor says my PCT won’t authorise vitamin D test even though I have symptoms of deficiency

[endofthelinefinally]

Everybody in the UK needs supplements according to my rheumatologist. Our levels deplete so much during the winter months we just never make it up. Sunscreen is another factor. Taking good quality supplements really helps. I buy mine online because the ones my GP prescribes are very low dose and are mostly sugar.

[GuyFawkesDay]

Oh absolutely! Mine were 17 and I felt dreadful. Achy limbs, brain fog, tired 24/7.

Had high dose supplements for 10 weeks and definitely felt better but it did take weeks not days. Probably about 8 weeks to feel better.

[hellosally]

do people notice a difference when its corrected? I dont have aches and pains but put my lethargy down to lockdown blues

[Serpenta]

@Bear2014

]]

You need this - the tablets are never strong enough. It's so hard to get your levels up with sun and diet, in this country at least. Your levels are very low, you must feel really run down. My level was 20 ish last spring, I was getting chest pains and all sorts. A year of this spray and it's gone up to around 60 now and still climbing.

I use this one too. It's best to use a supplement that also has Vit K in it rather than just Vit D alone. Something to do with preventing blood vessel calcification.

[Iceniii]

I find it strange we need to supplement with vitamin d, even if we live a healthy life style. Seems like bad design.

DD levels were dreadful and DH is now also low. Eat all the right things, outside, supplement. Is there a genetic element?

[Peacelillyhippy]

In the UK you can't get vitamin d from sun from about October to April, for reasons of basic science that are beyond most on Mumsnet who think sun strength is connected to air temperature.

Sorry to derail the thread but there is no need to be so snotty. Most people understand: hotter day = more chance of getting sunburn. Which is true.

I am prepared to be corrected but uv intensity and air temperature are connected. Amount of uv radiation is due to the angle between the sun and earth, which is smallest during the summer as the northern hemisphere (uk) is tilted towards the sun and at around midday.

Also due to this tilt IR radiation from the sun (causing air molecules to gain more kinetic energy) is more concentrated leading to higher temperatures during the summer.

So both the intensities of IR and UV radiation are due the position of the sun. The presence of clouds and other geographical factors affects the exact intensity of each, which is why there is no direct correlation. But even a child correctly can understand a strong relationship between chance of getting sunburnt and temperature.

[Peacelillyhippy]

It takes months to build up vitamin d. I had about 25. I lived in Australia and decided to use the sun and high strength supplements. I used a vitamin d app. I needed to be out in the sun for about half an hour (up to uv 12) obviously without suncream. I felt really uncomfortable about that so relied more on the supplements. It took months to get my levels over 70.

After my experience in Australia I'm sure most people in the uk must be deficient in vitamin d.

[Ipanemama]

My vitamin d was low on a recent blood test and I’ve been taking a supplement all winter. I’m outside every day now so that helps.

[Bear2014]

www.amazon.co.uk/gp/product/B007DIJJ0O/ref=ppx_yo_dt_b_asin_title_o03_s00?psc=1&ie=UTF8&tag=mumsnet&ascsubtag=mnforum-21

You need this - the tablets are never strong enough. It's so hard to get your levels up with sun and diet, in this country at least. Your levels are very low, you must feel really run down. My level was 20 ish last spring, I was getting chest pains and all sorts. A year of this spray and it's gone up to around 60 now and still climbing.

[JosephineDeBeauharnais]

I take a daily multivitamin which includes VitD at 100% of the RDA and a daily high strength VitD capsule. My VitD level is optimal according to my latest blood test. That’s an awful lot of supplementation to get to “optimal”. Take the pills or the spray OP.

[hellosally]

thanks, I took an OTC supplement when I remembered over winter but it was once every few days. my hair is thin and I am hoping it might improve with the vitamin D

[murbblurb]

In the UK you can't get vitamin d from sun from about October to April, for reasons of basic science that are beyond most on Mumsnet who think sun strength is connected to air temperature. Hence the recommendation that everyone takes a supplement in the winter months. Sounds like you need those supplements.

[MyVisionsComeFromSoup]

I take a vit d spray which I find is absorbed better. I should really get my levels tested again - they weren't as low as yours, but at the end of a summer, should really have been higher than 54.

I also bought a SAD lamp last year and used it for 20 minutes every morning over the winter, which really helped with energy levels.

[stackhead]

Its super hard to get vitamin D from sunlight during the non-summer months, and it takes a few months to build up levels that can be shown in blood work.

Take the pills.