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Interestingly, an “overdose” of vitamin D3 is not possible during prolonged periods of sun exposure, as its excess is degraded by sunlight in inactive photographic products. And what about taking vitamin D supplements? Are they all necessary in our latitudes and in what dose? When is it best to test for vitamin D? The questions are answered by BENU pharmacist Gintaras Verbus and Kristina Lebedevaitė, a family doctor at the Endemik medical clinic of the Affidea group of companies.
The main source of vitamin D for up to 90% of humans is its synthesis in the skin, where ultraviolet B spectral rays (the optimal wavelength for synthesis is 295-300 nm) of cholesterol form previtamin D3, which it slowly converts to vitamin D3 when exposed to temperature. Vitamin D3 has been found to be 60-80%. more active than D2.
“The amount of the so-called” solar “vitamin that will be synthesized in the skin depends on several factors: the time of year – in winter in our latitude due to the naturally reduced intensity of solar radiation, the synthesis of vitamin D3 in the la skin is almost non-existent; time of day: in the warm season, the UV rays required are between 10 am and 4 pm, but most people are forced to work indoors during this time and cannot naturally replenish reserves of vitamin D; skin color – as you move away from the equator, the intensity of the sun decreases, so it seems that the ability to produce vitamin D3 also decreases, but in nature there are compensatory mechanisms and lower levels of melanin in the skin of people far from the equator, more efficient synthesis of vitamin D ”, explains G. Verbus.
With food, a person receives only a small portion of the necessary vitamin D. Vitamin D2 is of plant origin, so it is found in mushrooms, cereals such as oats. Vitamin D3 is of animal origin and is found in fatty fish (salmon, mackerel, sardines, herring, tuna), egg yolk, beef liver, cheese.
Unfortunately, there is very little vitamin D in natural products, and the average Western diet provides less than 10 percent. Levels of vitamin D in the body. In some countries, foods such as milk, yogurts, margarine, orange juice, and flakes are industrially fortified with vitamin D2 or D3.
Science reveals an increase in vitamino D svarbto
Traditionally, vitamin D, the active form of which is called calcitriol, is believed to be responsible for the absorption of calcium and phosphorus by the body: it regulates the absorption of these substances in the intestine, helping them to remain in bones and teeth, thus preventing rickets, arthritis and osteoporosis.
“However, research in recent decades has greatly expanded the focus of the effects of vitamin D. It is understood that it is important throughout the life of the body, and not just during certain periods, for example, during the development of the bones. Vitamin D participates in growth and maturation processes, removes toxic lead from the body more quickly, is essential for a healthy nervous system and immunity, participates in many vital cellular processes, and even regulates around 3%. the human genome ”, says the pharmacist.
Kuo grmesia vitamin D deficiency?
Common symptoms such as bone or muscle pain, muscle weakness, increased sweating, hair loss, irritability or inattention, poor sleep, increased drowsiness, and frequent infections may indicate a vitamin D deficiency.
Family doctor K. Lebedevaitė says that vitamin D deficiency in different age groups can manifest itself somewhat differently: breastfed, since infant formulas are often already supplemented with vitamin D.
In adults with long-term vitamin D deficiency, osteomalacia can occur as a skeletal disease in which bone mineralization is impaired, resulting in altered bone structure and impaired function. It also weakens muscles and reduces resistance to infectious diseases. In the elderly, vitamin D deficiency causes osteoporosis – thinning of the bones, causing the bones to become more brittle and break faster. It is also important that men get enough vitamin D to avoid low testosterone levels, ”says the doctor.
Studies in the United States and Europe show that between 40 and 100 percent of the elderly are deficient in vitamin D, as the skin’s ability to synthesize vitamin D3 decreases with age, and the elderly move less and They go outside to receive direct sunlight. Obese people also absorb vitamin D inefficiently, because much of the vitamin is “trapped” in excess fat and does not enter the bloodstream.
Vitamin D is insoluble in water, making it difficult for the body to eliminate it. Is an overdose dangerous?
The problem of vitamin D deficiency is even called a global epidemic, exacerbated by changes in people’s lifestyle and environment in recent decades – we get less sunlight because we spend a lot of time indoors, both at work as in our free time; for fear of skin tumors, we use creams with UV protective filters and we wear clothing that covers almost the entire body; Vitamin D in food has decreased due to the technological peculiarities of production, in addition, the consumption of foods as necessary as fish has not been enough, so the recommended daily amount of vitamin D has changed significantly in recent decades , has increased.
However, before buying vitamin D supplements, according to the pharmacist, it is important to understand what the quantity markings on the packaging mean: TV is an international unit commonly used to measure fat-soluble vitamins, including vitamins A, E, and D. UI is often abbreviated on packaging (International Units). Vitamin D content can also be expressed in micrograms using the Greek letters μ and g.
“In cases of minimal vitamin D deficiency, prophylactic doses of vitamin D supplements are recommended: 400 IU (10 μg) for babies under 1 year, 600 IU (15 μg) for children and adults, and 800 IU for people over the age of 70 years of age (20 μg). In case of vitamin D deficiency, it is better to choose doses of 800-1000 IU (20-25 μg) or more. In especially complex cases, therapeutic doses of vitamin D and prescription vitamin D preparations can reach 40,000 IU or more, ”says BENU G. Verbus pharmacist.
Vitamin D is fat soluble, so it has the ability to accumulate in the body and is eliminated slowly; vitamin D3 is cleared faster than D2. It is true that overdose of vitamin D is extremely rare: the risk arises from the daily use of extremely high doses of vitamin D supplements. In adults, vitamin D toxicity occurs at blood levels above 100 ng / ml.
However, according to family doctor K. Lebedevaitė, excess vitamin D can lead to unwanted weight loss, appetite disorders, anorexia, frequent and heavy urination, heart rhythm disorders. Excess vitamin D increases the level of calcium in the blood, which leads to calcification of the walls and tissues of the blood vessels, which damages the heart, blood vessels and kidneys. There is also an increased risk of developing kidney stones.
The best time to check your vitamin D levels is in the spring.
There is no single opinion and final recommendation as to whether vitamin D testing should be performed on everyone who lives in areas with little sunshine. It is only clear that the studies are recommended for risk groups: obese, pregnant and lactating, with rickets or osteoporosis, inflammatory bowel disease, cystic fibrosis.
However, according to the doctor, it is likely that a person who has spent a lot of time outdoors after a sunny summer has accumulated enough vitamin D in the fall; the highest concentration of vitamin D in the population of European latitudes is 30-60 days later. the sunniest summer period. However, in the spring, after a slightly sunny winter, there is a critical moment for the Lithuanian population, when a special lack of vitamin D can occur.
“In early spring, I would definitely recommend testing your blood levels for vitamin D, especially if you have symptoms of vitamin D deficiency. Often times, patients take vitamin D supplements in their own discretionary doses. However, you must first know the initial amount of vitamin D and, in consultation with your family doctor or pharmacist, choose individual tactics and appropriate doses of vitamin D “, says K. Lebedevaitė. This indicator is stable and shows the amount of vitamin D obtained from food, supplements, and the sun.
Although both forms of vitamin D3 and D2 are important for the human body, according to the doctor, a general study of vitamin D is carried out in clinical practice. According to the international recommendations of endocrinologists, it is sufficient to assess the absence of vitamin D deficiency. And only in exceptional cases, such as in the case of rare diseases in which the processes related to vitamin D are interrupted, tests can be performed of vitamin D2 or D3 separately.
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