Vitamin D - Are You Getting Enough

Photo by Michele Blackwell on Unsplash


No doubt you've seen the headlines cautioning us about our potential vitamin D deficiency. What does this mean for our overall general health?  Everyday we are learning more and more about vitamin D and its possible benefits ranging from building and maintaining strong bones, boosting our immune system to even fighting off cancer. As it turns out, many of us are potentially falling short.  Or are we? 


Let’s start at the beginning.  Scientists discovered vitamin D in the early 20th century while looking for a cure for rickets (soft deformed bones affecting the young during periods of skeletal growth).  Once discovered, the US began fortifying milk with vitamin D and rickets became almost nonexistent. Fast forward to the early 2000s. The medical community started seeing an increased number of infants with rickets.  Two reasons were believed to be the culprit. Increased use of sunscreens and increased prevalence of breastfeeding. While breastfeeding is nutritionally sound, if mom is vitamin D deficient she produces milk low in vitamin D.  With rickets on the rise, physicians stepped up their testing of individual vitamin D levels.  


Vitamin D testing became the norm, yet healthcare providers did not have clear guidelines indicating what normal levels should be.  Increased testing resulted in increased disagreement and confusion among healthcare providers as well as the public. Furthermore, testing procedures were not standardized resulting in highly variable results.  Fortunately, the National Institutes of Health stepped in to help define what constituted a normal level of the vitamin. Levels below 30 nmol/mL, they said, were too low to maintain bone health and even maintain overall health.  At these decreased levels researchers found increased chances of bone fractures, immune system insufficiency and perhaps even certain cancers. Growing scientific evidence has implicated vitamin D deficiency in a multitude of chronic conditions including type 1 diabetes, rheumatoid arthritis, hypertension, cardiovascular disease and several common deadly cancers (colon, breast, ovarian and prostate).  The good news is, according to an article published in The American Journal of Clinical Nutrition (Vitamin D Status in the United States, 2011-2014), nearly three-quarters of the population has sufficient levels of vitamin D.


Unfortunately, Vitamin D is not found naturally in many foods.  The flesh of fatty fish and fish liver oil are among the best sources.  Small amounts are found in beef liver, cheese, and egg yolks. Fortified foods provide most of the Vitamin D in the American diet.  For example, almost all of the U.S. milk supply is voluntarily fortified as well as many ready-to-eat breakfast cereals. Plant milk alternatives (beverages made from soy, almond or oats) are often fortified with vitamin D as well.  Be sure to read labels to be sure though. The second source of vitamin D is sunlight. You may have heard vitamin D referred to as the “sunshine” vitamin. Most Americans obtain part of their vitamin D needs from sun exposure. However, season, sunscreen use, geographic latitude, time of day, cloud cover, skin color all affect vitamin D synthesis in the skin.  This leaves sunlight a highly variable and unreliable source. And as we all know, we should be avoiding sun exposure to reduce the risk of skin cancer. Last but not least, vitamin D is available through dietary supplements. If you plan a well-balanced diet, supplementation should not be needed, however, discussing this option with your healthcare provider may prove beneficial.  


Vitamin D has been touted to prevent everything from cancer to hypertension to improving overall general health.  While it may not be a cure-all vitamin it may perhaps play a role in lowering the chances of disease. If you spend a “sensible” amount of time in the sun and plan a diet wisely you should be able to obtain adequate amounts of vitamin D and prevent deficiency.   If you are concerned about your vitamin D levels, ask your healthcare provider for testing.


Erika Niedernhofer, RD