Vitamin D Supplements

According to the Institute of Medicine (IOM) the majority of US citizens have an acceptable level of vitamin D within their blood levels. This was rated at 20 nanograms per milliliter. Even so, there is evidence that levels on closer to 30 nanograms per milliliter or even higher would be more beneficial. At this level, the body would be better able to protect vital systems such as bones and might even be able to lower colon cancer risks as well as other disease. This higher level of vitamin D is also considered safe and can be achieved by taking supplements that contain between 800 and 1000 IU in vitamin D. For those who may have lower levels of vitamin D, 2000 IU of daily supplement may be necessary.

IOM Findings Debate on Vitamin D Supplements

The findings of the IOM, however, are no without some debate. Their recommendation that 600 IU of vitamin D a day is considered by some to be somewhat misleading and some go so far as to suggest that those findings do not make sense. Case in point:

The IOM report contained suggestions that certain people (infants who are breastfeeding and especially those of dark skin) are at a higher risk of vitamin D deficiency. The report also suggested that older individuals who may reside in institutions may be at risk as well and should be monitored for any signs of vitamin D deficiency. It went on to say that those who do not eat animal products or forms of diary should consider adding a vitamin supplement to their daily diet to prevent problems with a lack of this important vitamin. It did not, however, go on to suggest or recommend that the population, as a whole, include vitamin D supplements as a daily part of their diet. It also left out certain other groups of people who may be at risk such as those who are obese; those who are dark skinned, or those who simply do not get enough direct sunlight.

The main point of the debate concerning the IOM report is that it did include data that was based on research conducted by the National Health and Nutrition Examination Survey that found that nearly 11 percent of white and 54 percent of African-Americans do have levels of vitamin D that are below the minimal 20 nanograms per milliliter. What this means, is that millions of US citizens currently have vitamin D levels that are too low. Ironically, these numbers would be much higher if 30 percent of Americans who are currently using vitamin D supplements were not doing so. The numbers would have been higher as well if the survey has reported on those who live in the Northern part of the US who often have low vitamin D levels during the winter months.

The IOM committee did acknowledge that getting a daily dose of 600 IU of vitamin D through consumption of food alone was rare for most people. Their conclusion, even after this acknowledgment, that US citizens are getting what they call the average requirements of this vitamin is yet another reason some debate the report as being somewhat misleading or confusing. One issue pointed out by those who disagree with the findings is that if half the population is just getting the minimal amount of vitamin D, the other half of the population is below that level, which should be a cause of concern.

This brings up the question of how people truly do get their vitamin D. The committee suggested that most people get at least some of their D vitamin via direct sunlight exposure. While this may be true, unprotected exposure to the Sun can increase the risk of skin cancer and most medical experts do not recommend this as the best way to get the vitamin. This leads to the problem with the IOM report: If people are not getting vitamin D via diet and should not spend excessive amounts of time in direct sunlight, how should they get the vitamin and why the suggestions that people not use vitamin D supplements?

Are High Blood Levels of Vitamin D an Issue?

Some of those who are debating the report suggest that the committee overstated its concerns regarding high levels of vitamin D while diminishing the health benefits of the vitamin when taken as a supplement.

An example of this was illustrated with the IOM report findings that there is a relationship between high levels of vitamin D and early death. The report focused on cases where the blood levels were above 70 nanograms per milliliter, but the death rates for those cases was reported as being only slight. The committee spent little time on the reverse where studies show that death rates steadily decrease as vitamin D levels increase toward the 40 nanogram per milliliter level. Few people have blood levels of the D vitamin above 40 nanograms per milliliter and as such there is not much data on the death rates of these individuals. Overall, the majority of studies suggest that mortality rates decrease when the blood level is between 40 and 70 nanograms per milliliter. Only a few studies suggest the opposite.

In a press release put out by the IOM, they also suggested that other types of vitamin supplements such as beta carotene antioxidants as well as vitamin E were thought to be beneficial to health when they first came out, but were later found to be ineffective in terms of improved health. The basis of their conclusion was thought by many to be flawed in that the studies cited used extremely high dosages of these substances (10 to 20 times more than provided by a regular diet).

Vitamin D, on the other hand, is different. Even a small amount of time in direct sunlight can produce as much as the equivalent of 10,000 IU’s. Our ancestors, who spent much more time outdoors and in less clothing than we do, surely had to have high levels of vitamin D in their blood. If one thinks about it, a vitamin D supplement of 1,000 to 2,000 IU a day can be considered a modest dose, and for some people, may be lower than what they truly need.

Vitamin D Supplements: People Need Them

It should come as no surprise that modernday men and women need more vitamin D in order to remain healthy. Consider the International Osteoporosis Federation’s vitamin D recommendations in which they recommend taking a vitamin D supplement in the range of 800 to 1,000 IU’s each day. They report that this level will help most individuals to reach what they consider to be adequate blood levels of vitamin D. They recommend 30 nanograms per milliliter. This is a safe level to take on a daily basis and is much lower than the upper limit of 4,000 IU’s. Most good-quality supplements and multivitamins already contain between 800 and 1,000 IU’s of this important vitamin.

Individuals should check their supplements to see that they are getting at least 800 IU’s a day. Those who are “at risk” of deficiency should consider taking 2,000 IU’s of vitamin D. Some individuals may need even more than that. At risk individuals include dark skinned men and women, those who are obese and elderly individuals. Before doing so, discuss the dose and use of supplements with your health care provider.

For those who want more information on their blood levels of vitamin D, consider getting a vitamin D blood test. This could be a good idea for those who may be at risk of getting too much vitamin D from the sun.

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