You may have seen news items on the Institute of Medicine's (IOM) new Vitamin D recommendations, which were released on November 30th. So to keep you up to date, I'd like to share my thoughts on it with you.
First, let's look briefly at IOM's recommendations. They have increased all the doses and are recommending that everyone except those over 70 take 600 IUs of Vitamin D, and that those over age 70 take 800 IUs. The “Upper Intake Level” recommended by IOM is 4,000 IU, effectively doubling the previous levels for all ages with the exception of children under nine.
The study also reaffirms the role of adequate Vitamin D levels in preventing falls and fractures, as well as in muscle development.
So, is that the final word? Case closed? Not exactly.
Reports like this and the research that goes into them are helpful, but they often don't tell the whole story.
My Take on Vitamin D Requirements
While it might be nice to be able to rely on a report that tells you how much Vitamin D you need, it's not quite that simple. Because we get Vitamin D from the sun, and because we each live in different environments with varying degrees of access to sunlight, it's impossible to take a one size fits all approach to Vitamin D.
For example, I live in Florida and spend a good portion of each day out in the sun. Because of the sunny climate, I'm able to do that on a year-round basis (although as I write this, we're experiencing a very unusual cold spell, and I've just turned on my heater for the first time in years).
So my supplemental Vitamin D needs are quite different from those of someone who lives in Finland, where there are several months of the year during which the sun rarely makes an appearance.
So What Should I Do?
On this issue, as with many others, you ultimately need to use common sense and decide for yourself. But don't worry – I'll give you some helpful guidelines.
OK. We know that we need vitamin D, and we also know that it's ideal to get as much of it as possible from the sun. And what we can't get from the sun, we must get from supplements. Start by looking at the amount of sun exposure you get. If you live in a sunny climate and spend a lot of time outdoors, you may need only a baseline level. The bare minimum is 400 IU per day and you should increase the amount as you feel necessary depending on your sun exposure, which may vary according to the seasons.
But I've Had Skin Cancer!
While it's ideal to spend 20 to 30 minutes a day in the sun without sunscreen, of course you must take extra precautions if you've had melanomas or are dealing with another condition that requires you to limit sun exposure.
If you fall into this category, you may need to rely more heavily on supplemental Vitamin D3.
But for the general public, the minimal sun exposure required to get a dose of Vitamin D3 should not present much of a risk. Obviously, repeatedly burning the skin is a cause for concern, but a small yet healthy dose of sun is fine. Think about this… if the sun were as dangerous as we’re currently led to believe, wouldn’t we (as humans) be an extinct species by now?
Can I Use a Sun Lamp?
The UV rays of the sun react with our skin to produce Vitamin D3. Most sun lamps emit UV rays, and there are some that are sold specifically for Vitamin D supplementation. Just be very careful at first until you can gage how your skin reacts and avoid burns. Also, make sure you follow manufacturer’s directions.
And one more note of caution about sunlamps and tanning beds. Make sure the bulbs are made with electric resistance ballasts instead of the more commonly used magnetic ballasts. The latter emit potentially dangerous electromagnetic waves, because this type of radiation – especially from such proximity to the source, which is the light bulb in the equipment – can be harmful to your health.
All Vitamin D is NOT the Same
Vitamin D3 (cholecalciferol) is the most absorbable form of Vitamin D because it’s the one we synthesize from the sun. The large dosage pills some doctors recommend are made of plant-derived D2, and the vitamin D added to milk is also D2.
Because Vitamin D3 is derived from animal sources, vegetarians often resort to taking the less-effective D2. But there are vegetarian D3 supplements, most of which use the lanolin from sheep's wool, which does not cause any harm to the animal, to produce the vitamin. If this is a concern for you, just make sure you check the supplement ingredients to determine the source of your D3.
My Doctor Prescribed 50,000 IU a Week
Many doctors are prescribing “megadose” amounts in this range. Because Vitamin D is a fat soluble vitamin, which means it accumulates in the body, I do not recommend what I consider excessive doses of Vitamin D. In addition, these supplements are made with Vitamin D2, which, as stated above, is a much less-absorbable form of the vitamin. And if you are following the guidelines in the Osteoporosis Reversal Program, you shouldn't need megadoses of any nutrient.
The Bottom Line
The bottom line is that, in my opinion, this latest report does not really change much. Vitamin D supplementation has always been very much a matter for individual adjustment, and it continues to be. But there are some basic guidelines you can follow:
- Use the minimum baseline of 400 IU of D3 and build from there depending on your sun exposure and skin tone.
- If you can spend time in the sun year-round, then try to have some sun exposure every day. Twenty minutes a day in the summer, and at least 30 minutes in the spring, fall and winter (add at least 10 minutes if you are dark skinned) is sufficient. It's best if you can sunbathe your legs, arms, and the abdomen if possible.
- In cold climates with little sun, you can supplement in winter on a daily basis. Then you can reduce the dose during the summer, assuming you spend the minimum time in the sun.
- Should you need extra Vitamin D3 because your blood levels are demonstrably low, stick to D3 instead of the massive D2 doses typically prescribed by doctors. You can then start by taking larger daily doses, up to the Upper Intake Level of 4000 IU for two or three months, at which time you should repeat the blood test. The daily dose of D3 varies depending on the test results, so you can consult with your health practitioner about this.
Take a look at this great information graphic courtesy of Information Is Beautiful.