Vitamin D Help on Disease Prevention

Can vitamin D help with the symptoms of multiple sclerosis (MS)? Will vitamin D supplementation delay the progression of MS in someone who has MS?

Patients with multiple sclerosis are often vitamin D deficient. Since vitamin D deficiency causes muscle weakness, correcting their vitamin D deficiency significantly improves overall muscle function. If you have multiple sclerosis, there is no reason not to have your vitamin D status checked, be treated for your vitamin D deficiency, and prevent the recurrence of vitamin D deficiency.

In milk to moderate cases of osteopenia (the prelude to osteoporosis), would taking adequate vitamin D and calcium be enough to prevent osteoporosis, thus eliminating need for osteoporosis medications?

May men and women who present with milk or moderate osteopenia are vitamin D deficient and calcium deficient. It is recommended that the calcium be taken in two or three divided doses, rather than all at once, because it will be more bioavailable. The vitamin D can be taken any time.

Does vitamin D have any association with scoliosis in adolescent girls? Can vitamin D supplementation help correct spinal curvature?

It’s not aware of any association between scoliosis and vitamin D deficiency in adolescent girls. However, many adolescent girls are vitamin D deficient, and to maximize their bone health, they should be receiving an adequate amount of vitamin D and calcium. But vitamin D supplementation will not correct spinal curvature. Unfortunately, this is a permanent deformity. But if the vitamin D deficiency is exacerbating the spinal curvature, correcting vitamin D deficiency may help prevent further curvature from occurring. Keep in mind that vitamin D will also improve muscle strength; a study out of Lebanon showed that 2,000 IU a day to girls ten to seventeen years old did just that. Another recent study, which examined the influence of vitamin D levels on bone mass, bone turnover, and muscle strength in 301 healthy Chinese adolescent girls, also confirmed the importance of adequate vitamin D in reaching peak bone mass and muscle strength.

Would the recommendation be the same for Down’s syndrome and intellectual disability patients?

It is recommended that children over one year and adults receive at least 1,400 to 2,000 IU of vitamin D a day if they are not getting adequate exposure to sunlight. This also applies to patients with Down’s syndrome and with intellectual disabilities.

I have primary hyperparathyroidism and my calcium is elevated and I am vitamin D deficient. My doctor says taking vitamin D will increase my calcium level and therefore I should avoid vitamin D. True?

This is not true. Two studies have proved that, if anything, your parathyroid hormone and calcium levels will be improved by correcting the vitamin D deficiency.

I have sarcoidosis and my doctor says I should not take vitamin D because it could cause my calcium to elevate above normal. True?

It is true that excessive exposure to sunlight or taking too much vitamin D can cause the macrophages in the sarcoid tissue to make too much activated vitamin D. however, patients should not remain vitamin D deficient, because that can cause muscle weakness and symptoms of osteomalacia (aches and pains in bones and muscles).

I have kidney disease and am on dialysis. My doctor said that since my kidneys cannot make activated vitamin D from 25-vitamin D, there is no need for me to take vitamin D to maintain my blood levels of 25-vitamin D above 30 nanograms per milliliter. Is this correct?

No. the National Kidney Foundation recommend that all patients with kidney failure – even patients with no kidneys – should maintain 25-vitamin D levels of 30 to 100 nanograms per milliliter.

What about people who have a vitamin D receptor (VDR) defect and need more vitamin D?

Patients who have a VDR defect can sometimes benefit by increasing their vitamin D intake. It depends upon the severity of the alteration in the VDR gene. Patients with the VDR gene mutation known as vitamin D-resistant rickets or vitamin D-dependent rickets type II will sometimes benefit from being treated not only with vitamin D but also with the active form of vitamin D.

I take medications that make me extra sensitive to the sun. What should I do?

If you cannot expose yourself to the sun for any amount of time, then supplementation is key. Ami to take 2,000 IU of vitamin D a day year-round. This can be in addition to any multivitamins containing vitamin D, vitamin D-fortified foods and beverages, and vitamin D-rich fish you consume.

A lot of women are being given gabapentin for hot flashes instead of estrogen. Can it lower 25-vitamin D levels?

It is not known that whether gabapentin (brand name Neurontin or Gabarone) used for treating hot flashes will lower 25-vitamin D levels. However, we do know that many drugs will enhance the destruction of vitamin D in the body. Thus, at a minimum taking at least 2,000 IU of vitamin D a day and having your blood level of 25-vitamin D monitored.

The current recommendation of 400IU of vitamins D per day may not be enough to prevent vitamin D deficiency during the winter months. USANA’S supplement has 2000 IU of vitamin D per tablet.

The Role of Calcium in Their Everyday Function

Calcium is required for skeletal and cardiac muscle contraction, blood-vessel expansion and contraction, secretion of hormones and enzymes, and transmission of impulses through the nervous system. The body strives to maintain constant concentrations of calcium in blood, muscle, tissues, and intercellular fluids, though less than 1 percent of total body calcium is needed to support these functions. The rest of your calcium – 99 percent – is stored in your bones and teeth, where it supports their structure. And bone itself undergoes continuous remodeling, with constant resorption (breakdown of old bone) and deposition of calcium into a newly formed bone collagen matrix. The balance between bone resorption and deposition changes with age. Bone formation exceeds resorption in growing children, whereas in early and middle adulthood the two processes are relatively equal. In aging adults, particularly among postmenopausal women and men over sixty years old, bone breakdown exceeds formation, resulting in bone loss that increases the risk of osteoporosis over time.

We all need calcium to survive, just as we need water. But there is a certain balance to be struck, a so-called homeostasis. In fact, you can think of the homeostasis of calcium ions in the body as a center of gravity for a number of physiological processes. If there is too little calcium in your blood (a condition called hypocalcemia), soft-tissue cells – especially nerves and muscle, which rely on calcium to operate – become dysfunctional. Your entire neuromuscular system will become abnormally excitable, and impulses may be triggered spontaneously. This, in fact, sends your body into convulsions as muscles, including those of the respiratory system, contract uncontrollably. In this situation, a person can die from failure to breathe. The heart, which also depends on calcium to beat properly, can lose its rhythm, with fatal consequences. Conversely, if there is too much calcium in the blood (a condition called hypercalcemia), organs calcify and eventually cease to work. This is especially true for the kidneys. Blood vessels will calcify, rendering them less plant and thus increasing the risk of stroke and myocardial infarction. Those excess calcium ions have an opposite effect on the nervous system, abnormally depressing it and causing depression, constipation, and confusion. Having too much calcium can be just as hazardous as having too little.

So you can see how important it is to maintain steady and healthy levels of calcium in the body. You can also see how vitamin D promotes healthy bones by indirectly maintaining adequate serum calcium and phosphorus for bone mineralization to occur. Vitamin D controls the level of calcium in the blood. If there is not enough calcium in the diet, then it will be drawn from the bone. High levels of vitamin D (from the diet or from sunlight) will actually demineralize bone if sufficient calcium is not present.

We know that if you are vitamin D deficient, as most Americans are, your body will steal the calcium out of your bones. That is what would cause you to have osteopenia or osteoporosis, severe low bone density with increased risk of fracture. But being vitamin D deficient also prevents calcium from coming into the bones. And as a result, there’s nothing more than a Jell-O-like collagen matrix left behind, and it will get hydrated just like Jell-O and water.

Women who complain of throbbing, aching bone pain are sometimes met with doctors who can’t understand it. When the doctor presses on a patient’s bones almost anywhere, she will often wince in pain, and that’s because the doctor is pressing down where there’s no mineralized bone on the surface. It’s simply a Jell-O-like substance, triggering significant discomfort. The covering on the bone is full of nerve endings, and if there is no mineralized bone underneath it but instead a rubbery “Jell-O”, then when the doctor presses on it, that compresses the covering and excites those nerve endings, resulting in pain. Like Jell-O, the collagen matrix expands under the periosteal bone covering, causing throbbing, aching bone pain. When people are sitting with aches in their hips or lying in bed with throbbing aches in their bones, it can be very hard for physicians to immediately think of vitamin D deficiency. But often that’s exactly what’s causing the problem.

Making sense of this remarkable relationship between calcium regulation and vitamin D has opened many new doors in science and medicine. In addition to shifting the course of treatment for people suffering from bone disease, it has paved a new path for people suffering from calcium-regulation disorders due to underlying medical conditions. It suddenly became possible, for example, to treat patients who had lost their parathyroid glands or their kidneys and, as a result, could no longer regulate the level of calcium in their blood. Now that we had the ability to synthesize activated vitamin D hormone commercially, we could treat these patients with activated vitamin D and calcium. The effects were dramatic, putting an end to their painful muscle spasms, convulsions, and chronic bone disease.

Vitamin D – Dosage

How long does it take to increase 25-vitamin D levels after starting supplementation?

Healthy adults taking 1,000 IU of vitamin D a day reach their peak blood level within five to six weeks. When the patients are treated with 50,000 IU of vitamin D2 once a week for eight weeks to treat a deficiency, their blood level begins to increase by the first week and levels off by the eighth week of treatment.

Is there any advantage to taking smaller doses more frequently rather than one large dose per day?

There is no advantage to taking smaller doses more frequently rather than a large dose of 1,000 or 2,000 IU of vitamin D a day. Indeed, you can take 2,000 IU of vitamin D a day or 14,000 IU of vitamin D once a week or 60,000 IU of vitamin D once a month; they all work the same way.

Do you need to take a supplement even during the summer?

If you’re good about getting plenty of sensible sun exposure throughout the summer months, or you live in a sunny place like Florida, then you may not necessarily need to supplement. However, it’s much easier to get into the routine of taking a supplement year-round. And even Floridians have been shown to be largely deficient, because they avoid the sun or wear sun protection. You cannot overdose on sunlight exposure and become vitamin D intoxicated, so no matter how much sun you get during the summer, taking an additional 1,000 to 2,000 IU supplement cannot hurt you. It is recommended that everyone taking 1,000 to 2,000 IU of vitamin D a day along with a multivitamin containing 400 IU of vitamin D. This will not cause any buildup of vitamin D in the body, and by using this routine, you are less likely to forget it in the winter.

How many units of vitamin D would a person have to take to become toxic?

Vitamin D intoxication will not occur until a person is taking more than 10,000 IU of vitamin D a day for more than six months. Adults who received 10,000 IU of vitamin D a day for five months showed no signs of toxicity. You cannot overdose on vitamin D from exposure to sunlight or a tanning bed or a UVB-producing lamp, no matter how much UVB you get.

What is the best supplement for children who cannot swallow pills?

Infants can be administered vitamin D through pediatric vitamin drops. If you have children who cannot or will not swallow pills, you can crush a vitamin D tablet or squeeze the contents of a gel capsule into a glass of milk or juice. A good product that has emerged on the market and is a liquid form of vitamin D. Made by Wellesse, it contains 500 IU of vitamin D per teaspoon.

Does the recommended dose of vitamin D supplement need to be taken with fat (not in a tablet form)?

The recommended dose of vitamin D supplement does not need to be taken with fat. Vitamin D is equally bioavailable in corn oil, milk, and orange juice.

How should a vegan or vegetarian make sure he or she gets enough vitamin D?

Vegans should supplements with at least 1,000 IU of vitamin D a day, and preferably 2,000 IU. This would be in addition to a multivitamin. Vegans concerned about animal sources of supplemental vitamin D3 can opt for supplements containing vitamin D2, which comes from yeast.

What is the advice for vegan or vegetarian children?

It is recommended that all children, including vegan children, ingest at least 400 IU of vitamin D a day, and preferably 1,000 IU of vitamin D a day, along with a multivitamin, especially if they are not getting adequate exposure to sunlight.

If a person is not vitamin D deficient, what is the best over-the-counter form and dose to take? What if the person is vitamin D deficient?

If a person is not vitamin D deficient, to maintain a vitamin D sufficiency the person should take at least 1,000 IU of vitamin D2 or 1,000 IU of vitamin D3 a day in addition to multivitamin with 400 IU of vitamin D. if a person is vitamin D deficient, then double or triple the dose and he or she should take 2,000 to 3,000 IU of vitamin D a day along with a multivitamin. A person who is severely vitamin D deficient should consult a doctor to inquire about prescription-level treatment.

What form of supplementation do you recommend – D2 or D3?

1,000 IU of vitamin D2 is as effective as 1,000 IU of vitamin D3 in raising blood levels of 25-vitamin D. Either form can be used. But note: to raise blood levels of 25-vitamin D to above 30 nanograms per milliliter, you need to take more than 1,000 IU.

Is the prescription form of vitamin D different from what’s available over the counter?

In the United States, the only vitamin D form available by prescription is vitamin D2, also known as ergocalciferol. It comes either in a capsule with 50,000 IU of vitamin D2 or in a liquid form (for pediatric patients) with 8,000 IU of vitamin D2 per 1 milliliter. Vitamin D2 can also be found in some over-the-counter supplements, and it’s just as effective as vitamin D3.