Thursday, December 2, 2010
Vitamin D: Front Page News!
This week Vitamin D (aka. the Sunshine Vitamin) made front page news this week when the Institute of Medicine tripled the recommended daily dose from 200IU (International Units) to 600 IU. Interestingly enough, there were polar opposite slants on the same story. The TIMES said that extra Vitamin D and calcium are not necessary, while the Wall Street Journal quoted experts saying that that this increase is not nearly enough.
What should we believe at this point? Well, like everything in medicine, it depends. Seriously. If you are elderly or otherwise decreased in mobility; if you have increased risk of cardiac disease or cancer; if you have dark skin or live in northern locations with limited sunlight; then I think the medical evidence is solid that you likely will need Vitamin D supplementation.
I practice medicine in Austin, Texas, which is clearly a sunny locale. Despite that, I have found in the last year or two that I have been more aggressively checking vitamin D levels that 90+% of my patients were deficient. Interestingly enough, a good chunk of these patients (I would estimate a third) have had clinical improvement in some fashion after a few months of vitamin D replacement. Often it is with mood and energy, and other times it is with very nonspecific "aches and pains" that the patient previously was attributing to "aging." Initially I gave simply over-the-counter doses, but within 6 months saw minimal improvements and switched to supplementing with prescription weekly Vitamin D (at 50,000IU per week doses.) This is the dose that has yielded results both in lab tests and far more importantly, in patient symptoms.
BOTTOM LINE: The jury may still be out on Vitamin D supplementation, but we do know that replacing Vitamin D in people who are proven to be deficient can potentially improve their health in multiple organ systems (bones, cardiac, neuro/psychological.)