If you shun the sun, suffer from milk allergies, or adhere to a strict vegan diet, you may be at risk for vitamin D deficiency. Known as the sunshine vitamin, vitamin D is produced by the body in response to skin being exposed to sunlight. It is also occurs naturally in a few foods — including some fish, fish liver oils, and egg yolks — and in fortified dairy and grain products.
What sort of symptoms does a low vitamin D level cause?
Vitamin D is essential for strong bones, because it helps the body use calcium from the diet. Traditionally, vitamin D deficiency has been associated with rickets, a disease in which the bone tissue doesn’t properly mineralize, leading to soft bones and skeletal deformities. But increasingly, research is revealing the importance of vitamin D in protecting against a host of health problems.
Therefore, symptoms of bone pain and muscle weakness can mean you have a vitamin D deficiency. However, for many people, the symptoms are subtle – other than generalised aches and pains, you might even feel that you have low mood. Yet, even without symptoms, too little vitamin D can pose health risks.
Why have I got a low vitamin D level?
Vitamin D deficiency can occur for a number of reasons:
- You don’t consume the recommended levels of the vitamin over time. This is likely if you follow a strict vegan diet, because most of the natural sources are animal-based, including fish and fish oils, egg yolks, cheese, fortified milk, and beef liver.
- Your exposure to sunlight is limited. Because the body makes vitamin D when your skin is exposed to sunlight, you may be at risk of deficiency if you are homebound, live in northern latitudes, wear long robes or head coverings for religious reasons, or have an occupation that prevents sun exposure.
- You have dark skin. The pigment melanin reduces the skin’s ability to make vitamin D in response to sunlight exposure. Some studies show that older adults with darker skin are at high risk of vitamin D deficiency.
- Your kidneys cannot convert vitamin D to its active form. As people age, their kidneys are less able to convert vitamin D to its active form, thus increasing their risk of vitamin D deficiency.
- Your digestive tract cannot adequately absorb vitamin D. Certain medical problems, including Crohn’s disease, cystic fibrosis, and celiac disease, can affect your intestine’s ability to absorb vitamin D from the food you eat.
You are obese. Vitamin D is extracted from the blood by fat cells, altering its release into the circulation. People with a body mass index of 30 or greater often have low blood levels of vitamin D.
What can I do about getting my Vitamin D levels up?
- VITAMIN D CAPSULES: If your vitamin D level is very low, your GP will start you on an 8 week course of some high dose Vitamin D capsules to get your body loaded up with vitamin D again. After that you will then need to take a much smaller dose of vitamin D – which you will buy from your local chemist Don’t worry, they are not expensive; a year’s supply of vitamin D costs around £20.
- SUNLIGHT: The amount of sun exposure that people need in order to make sufficient vitamin D varies according to a number of environmental, physiological and social factors. Generally, our advice for those of you living in the UK would be to go outside most days without sunscreen between 11 AM and 3 PM in the summer (April till September) for about 15 minutes for people with fair skin and longer (about 30 minutes) for those with darker skin. The important point is to make sure your skin does not turn red or burn (because this can result in skin cancers developing in the future). We advise less time in the sun for people with fair skin because more care needs to be taken to prevent burning and for people with darker skin it will take longer for the skin to manufacture vitamin D. If you want to stay out longer then put some sun protection cream onto exposed areas (use a sun protection cream with a high SPF factor – minimum 30 – to prevent burns; reapply every 2 hours). Click here to read more about how to get your vitamin D levels up with Sunlight.
- DIET: Vitamin D is only found in a few foods, and not in sufficient quantities for a balanced diet to meet vitamin D requirements. Foods include herring, tuna, sardines, mackerel, salmon, egg yolks, evaporated milk, and some powdered milks. In the UK, margarine and some breakfast cereals fortified with vitamins D (check product labels).In the UK, cows’ milk is generally not a good source of vitamin D because it isn’t fortified, as it is in other countries.
Food Sources of Vitamin D
|Food||IUs per serving*||Percent DV**|
|Cod liver oil, 1 tablespoon||1,360||340|
|Swordfish, cooked, 3 ounces||566||142|
|Salmon (sockeye), cooked, 3 ounces||447||112|
|Tuna fish, canned in water, drained, 3 ounces||154||39|
|Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies)||137||34|
|Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup||115-124||29-31|
|Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV)||80||20|
|Margarine, fortified, 1 tablespoon||60||15|
|Sardines, canned in oil, drained, 2 sardines||46||12|
|Liver, beef, cooked, 3 ounces||42||11|
|Egg, 1 large (vitamin D is found in yolk)||41||10|
|Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV)||40||10|
|Cheese, Swiss, 1 ounce||6||2|
* IUs = International Units.
** DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents among products within the context of a total daily diet. The DV for vitamin D is currently set at 400 IU for adults and children age 4 and older. Food labels, however, are not required to list vitamin D content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet.
Here are 10 vitamin D foods to incorporate into your diet
- Salmon – This is the best if you like Salmon (and wild salmon has more than farmed salmon). Just half a fillet of salmon is the daily amount for one person.
- Yoghurts/Milk – You can also buy yoghurts and other dairy products that have been fortified (usually whole milk not semi-skimmed) – but you need to read the labels and check. Some types of milk are fortified with vitamin D too BUT you need to check because in the UK cow’s milk usually isn’t fortified with vitamin D unlike other countries.
- Eggs – Two large free-range eggs can hold about one-eighth of your recommended dose of vitamin D.
- Mushrooms – If you include a large handful of mushrooms to your meal you are looking at a significant amount of vitamin D.
- Tuna – Tinned fish, such as tuna or sardines, contain over a quarter of the recommended amount of vitamin D.
- Pork – Pork ribs, in particular, are rich in vitamin D. Be careful though, ribs are often fatty too!
- Cereals – cereals are often fortified with Vitamin D, but it does vary so check the label.
- Tofu – One fifth of a block of raw tofu has lots of lovely Vitamin D in it. But tofu isn’t to everyone’s liking.
- Orange juice – One cup of fortified fresh orange juice has more Vitamin D than a cup of fortified milk.
- Ricotta cheese – Ricotta has more than five times the amount of Vitamin D than other cheeses. (It’s often used in canelloni)
Is there such a thing as having too much vitamin D?
Consuming too much vitamin D is very rare and usually only affects people who have been taking vitamin D supplements well above the recommended dosage for several months. It usually happens if you take 40,000 IU per day for a couple of months or longer, or take a very large one-time dose. Vitamin D is fat-soluble, which means your body has a hard time getting rid of it if you take too much. When your vitamin D levels are too high, this can cause high levels of calcium to develop in your blood. High blood calcium is a condition called hypercalcemia. Therefore if you have symptoms of high calcium levels (hypercalcaemia), that could mean you are taking too much vitamin D. The symptoms of hypercalcemia are often described as “bones, stones, groans and psychiatric moans’.
- BONES – bone pain or muscle weakness.
- STONES – often gallbladder or kidney stones can result in causing tummy pains
- GROANS – tummy pain, nausea or vomiting. You might notice constipation or diarrhoea.
- PSYCHIATRIC MOANS- depression (feeling low), feeling anxious, not being able to sleep, feeling drowsy, confused or tired.