As reported by the Danbury News-Times, October 27, 2008.
New Evidence Points to Importance of Vitamin D
By Robert Miller
In New England summers, when the sun gets up early, goes down late, and sits high and bright in the sky, getting some serious rays is easy.
But now, the sun is lower, slow to rise and early to set. From November through January, it will be a wan presence. And by and large, without the sun, our bodies may not be making enough vitamin D.
That may be more serious than we think. Increasingly, researchers are finding that vitamin D is one of the essential substances we need for good health.
There are now studies seeing whether, and how, it plays a part in fighting infection, in slowing cancer growth, in preventing periodontal disease, in preventing autoimmune diseases, in slowing bone and muscle loss and in preventing osteoarthritis.
"I'm testing all my patients,'' said Dr. Joseph Belsky, an endocrinologist at Danbury Hospital who's been busy trying to educate his colleagues about the vitamin.
There's also some interest in seeing whether there's a link between vitamin D deficiencies and mental issue problems, such as depression and seasonal affective disorder or SAD.
"I'm trying to get our psychiatry people to look at this,'' Belsky said.
And if most people in the United States are vitamin D deficient for a good part of the year, should they routinely be taking supplements? Many doctors are now saying yes.
"Absolutely,'' said Dr. Pamela Taxel, an associate professor of medicine in the department of endocrinology at the University of Connecticut School of Medicine in Farmington. "I call it the Hot Vitamin right now. We're really finding out a lot about it.''
"Of course,'' Reinhold Veith, an assistant professor of laboratory medicine and pathobiology at the University of Toronto, said when asked whether people should be getting more vitamin D. "Epidemiologists are finding this out now.''
The American Academy of Pediatrics is saying the same thing. This month, it doubled its recommendations for vitamin D for infants, small children and adolescents from 200 International Units to 400 IUs.
Researchers are also finding that Americans with darker skins -- African-Americans, darker-complexioned Hispanics -- may be even more Vitamin D deficient than their lighter-skinned compatriots, whose skin absorbs more sunlight.
"I think this is one of the biggest health disparity issues I know,'' said Dr. Bruce Hollis, a professor of pediatrics and director of pediatric nutritional science at the University of South Carolina.
One of the oddest things about these discoveries is that vitamin D isn't like a vitamin at all. It isn't found much in any food, other than the oils of fatty fish, such as salmon.
When it is in food, like orange juice, milk or other dairy products, it's been added as a supplement.
That makes it almost impossible to eat your way back to healthy vitamin D levels.
Belsky points out that the standard amount of vitamin D prescribed for adults is 400 IUs -- a level most researchers now think is far too low.
"One cup of milk has 100 IUs of vitamin D,'' Belsky said. "So you'd have to drink four cups -- a quart of milk -- a day to get the minimum, which isn't enough.''
Vitamin D actually is more like a hormone, Belsky said.
"It's similar to cholesterol, to estrogen, to testosterone,'' he said. "It's made in our bodies, and distributed through our bodies.''
But for our bodies to make vitamin D, we need sunlight hitting our skin. We need at least 15 to 20 minutes a day of exposure to the sun for this to happen. Which is why many Americans, lacking serious sunlight in winter, develop vitamin D deficiencies.
Doctors have known for many years that severe vitamin D deficiencies can cause the bones to weaken -- that's called rickets in children and osteomalacia in adults.
They now think there's many more health issues involved.
"Bone disease is just the tip of the iceberg,'' Vieth of the University of Toronto said.
Researchers are now finding two things. People have less vitamin D in their system than once thought -- especially in any state north of the deep South -- and higher levels may be a key to good health.
"We know that vitamin D is important for immune functions,'' said Adrian Gombart of the Linus PaulingInstitute at Oregon State University. "We know that people with vitamin D deficiencies are less healthy and more prone to infection.''
"If you broke this into quarters, with all the people with good levels of vitamin D in one quarter, and all the people with vitamin D deficiencies in the lowest quarter, and then looked at all the health aspects involved, I know I'd prefer to be in the quarter with a lot of vitamin D,'' Vieth said.
What vitamin D does, in simple terms, is help cells communicate with one another, Vieth said, as well as helping different parts of a single cell to carry on a conversation.
"It's like paper in an office,'' he said. "You need it.''
That's why vitamin D has been linked to so many different functions in the body.
"Different offices use paper differently,'' he said. "They still need paper. Vitamin D is required for a lot of stuff. It does all these things, and is involved in so many health issues, because all the cells use it.''
Vieth has participated in one study to see whether higher doses of vitamin D could cure "the winter blues'' -- not a full scale depression or even SAD, but just the general physical and mental malaise that can set in around February.
One group in the test got 600 IUs of vitamin D a day; the other got 4,000 IUs. The people with the higher doses felt better and had more energy, he said.
But there are problems getting the vitamin D message out.
One reason, Vieth said, is that people are skeptical of the grandiose claims made about the healing powers of some vitamins.
"Remember vitamin C? Remember vitamin E?'' he said. "Where are they now?''
Another problem grows out of a fear that too much vitamin D will force the body to absorb too much calcium, which, in turn, can cause kidney disease. At very high levels, that's true.
But doctors studying vitamin D said the old standards -- 200 IUs a day for children, 400 for adults, 600 for seniors -- are too low. Those doctors say a base level should be at least 1,000 IUs a day for adults; Belsky and Hollis both said they are now taking 2,000 IUs a day.
With more people spending time in an office today out of the sun, there may soon come a time when doctors will be prescribing vitamin D supplements for a great number of people.
"It will happen,'' said Vieth of the University of Toronto. "But we're maybe two years away.''
"If you have high cholesterol, you get a statin,'' Hollis of South Carolina said. "If you have high blood pressure, you take medication for it. If you have a vitamin D deficiency, why not take a supplement?''
"I tell my patients they should all take a Caribbean vacation,'' said Taxel of the University of Connecticut. "Or they can take vitamin D. That's a lot cheaper.''