Vitamin D and hypovitaminosis D (low vitamin D level). (revised 3/29/08)

Robert C. Baker, M.D

Vitamin D is a vitamin that has to do with building bones. It also has many functions regarding cancer prevention and in the prevention of many other diseases. Vitamin D also greatly increases the absorption of calcium from the gastrointestinal tract. If the blood level of Vitamin D is 50 nanograms, this means the vitamin D is present in the ideal amount in every cell including the gastrointestinal tract, and the absorption of Vitamin D in the diet is greatly increased. Numerous studies from the United States and other countries have shown that normal vitamin D levels mean a much lower incidence of osteoporotic fractures.

Sunshine increases Vitamin D. At certain levels north or south of the equator,the production of vitamin D is limited and during the winter, no vitamin D production occurs.



Medical studies have shown that the incidence of low vitamin D levels is very high, regardless of age. 67% of women presenting with fracture of the hip (non-blunt trauma) had low vitamin D levels. Studies of school children of various ages, and various parts of the world, have shown low vitamin D levels in a very high percentage of individual.

Vitamin D collects in fat cells, but is unavailable to the body. So an obese individual who eats a lot of dairy food, thinking they are getting a lot of vitamin D, can be more likely to have a vitamin D deficiency than a slim individual who doesn’t eat dairy foods. (Vitamin D is not naturally present in cow’s milk – milk is fortified with vitamin D.) Vitamin D is present naturally in fruits and vegetables.

I have measured 25-hydroxy vitamin D levels in 800 patients over the past 3 years. 2/3rds of the results are below normal.

The deficiencies are found in all age groups. I have obtained levels in a dozen teenagers; ten were low; three were in single digits. I have seen the results in one eight year old; the result was less than 10 ng.

TRUE NORMAL VALUE OF 25-HYDROXY VITAMIN D

The normal value is considered 32 to 100 ng., but the ideal value is 50 to 70 ng. There are even some studies that indicate a higher value might have additional benefits.

TREATMENT:

There are very few studies in MEDLINE regarding treatment of low vitamin D levels. Rheumatologists are recommending the following and this have been proven to be completely safe. There have been no cases of excess vitamin D giving this dose:

1. One vitamin D 50,000 Unit capsule a week for 3 months (this is by prescription only. A 50,000 Unit capsule contains 125 times more vitamin D than a 400 unit capsules that is available over the counter).

2. Repeat the blood test in 3 months.

3. If the level is close to 50 ug. then a 50,000 Unit capsule once a month should be taken indefinitely. If the value is much less than 50 ug. then the once a week capsule can be continued for up to another 3 months, depending on the level. The final goal is to maintain a level of 50 ug.


CALCIUM

The idea that Americans have a lot of osteoporosis because of insufficient calcium intake has always been suspect. It is widely promoted by the dairy industry. Most countries in Africa have an extremely low rate of osteoporosis but the population drinks no milk after infancy. Eskimos eat a large amount of calcium in the form of fish bones, and have a very high rate of osteoporosis (they eat double the protein that Americans eat, and high protein diets are associated with osteoporosis. Proteins, especially animal proteins are acidic and wash calcium out of the bone) No animals in nature who have an adequate food supply develop osteoporosis, and they don’t drink milk after weaning, and of course, never drink the milk of another species. Only calcium or dairy intake studies in humans sponsored by the dairy industry have been the only ones showing any positive results, and the results are minimal. Many of these studies over the years have been proven to be fraudulent.


CONCLUSIONS

Vitamin D levels represent in my opinion the largest epidemic in America since the recognition of the epidemic of elevated cholesterol levels. The treatment is very simple and very inexpensive.

The expected results of aggressive intake of Vitamin D in keeping the level 50 ng., or higher, is the drastic reduction of osteoporosis.

Rheumatologists and some primary care doctors are getting 25-hydroxy vitamin D levels in those having osteopenia or osteoporosis. Very few if any vitamin D levels are being ordered on those who haven’t been diagnosed with these conditions.
I expect that getting routine 25-hydroxy vitamin D levels is going to take years to catch on in this country. It may never catch on.

What does paying attention to your vitamin D level mean? (WHAT EXACTLY IS AT STAKE?)

It means the difference between getting osteoporosis and a broken hip of vertebrae in the 60’s, 70’s, and 80’s, and not getting such a fracture. A fracture at this age frequently necessitates a nursing home admission, bedrest, decubitous ulcers, poor nutrition, and FREQUENTLY RESULTS IN DEATH, OR A LIFE THAT IS WORSE THAN DEATH.

An ounce of prevention is not worth a pound of cure; in the case of vitamin D, it’s worth a ton of cure.