Vitamin D Deficiency

Every day we see patients in the clinic who are vitamin D deficient. It is a multifaceted issue but aside from a medical condition (usually liver or kidney problems) that would cause the vitamin D deficiency, there are plenty of environmental issues that could be culprits. People with dark skin complexions (Africans, Islanders) are more protected from the sun then someone with a light skin complexion and thus the darker skin individuals do not reap the same benefits of short stints in the sun (as far as vitamin D absorption and synthesis is concerned) as their Irish counterparts might. If you are diligent with your sunscreen, you also will not get any vitamin D from the sun, as the sunscreen repels the UV light that is necessary for synthesis. If you live in the northern latitudes, and we're not talking about Siberia here people - we are talking about pretty much any place above the Florida-Georgia line (break into song if you like), the angle of the sun is only strong enough to help us between Memorial Day and Labor Day. If you are lucky enough to have an indoor job though - here comes the trifecta - you don't see the sun anyway! Soooooo how do we work on improving a vitamin D deficiency? Supplements are always helpful as there is very limited vitamin D in foods (see below).

3.5oz cooked salmon = 360 IU Vitamin D
3.5oz tuna in oil = 235 IU
8oz milk = 100 IU
1 whole egg = 40 IU
3.5oz cooked beef liver = 15 IU
3.5oz raw portabello mushrooms = 10 IU
3.5oz raw portabello mushrooms exposed to UV light = 446 IU

It is recommended that adults get approx 2000 IU of vitamin D each day, and with very few foods containing vitamin D, it is definitely beneficial to take at least 1000 IU/day as a supplement, with 2000 IU supplemented being better, then you could eat some foods with vitamin D in them, but that would be more like the icing on the cake! And while you're at it, and there are still 4 weeks left of prime rays, get outside and check out the sun (all you need is 10 minutes of exposure without sunscreen on to reap the benefits - then lather up!)

New Vitamin Flavors

For anyone who is using Bariatric Fusion Vitamins they have two new flavors available: Wild Cherry and Tropical (not exactly sure what 'tropical' means but they have a picture of a Kiwi with the new bottle so somehow there is probably that flavor in it :) )

If you want to order Bariatric Fusion Vitamins - click on the link above left and shop to your heart's desire!

A friend asked me the other day for directions down the vitamin isle of her local pharmacy, while I gladly put in my two cents, I couldn't help but think about the factors driving a thriving supplementation industry in this country.

Theoretically, there is no real need for supplementation of any kind if (BIG IF) you are doing the right things and you do not have a inborn condition which requires more or less of a certain substance. Every diet based on religious or cultural beliefs still allows for a diet completely balanced in all vitamins and minerals. Even vegetarianism, if practiced correctly, provides all the nutrition the body needs. Only the vegan followers need supplementation and that is with B12. So why the need, or the craze with all these vitamins?

The majority of Americans perceive an ideal life as a great job which they either love or it pays very well, or both; they have a nice house; a nice car; maybe they have 'perfect' children; pets; thriving social life; 'good health' etc etc. Not many people put 'ability to consume a balanced diet' or 'sound mind, healthy body' in their list of things which would make life more idealistic. The media is all over the release of scientific studies on disease prevention and nutrient interactions and is constantly 'enlightening' citizens as to how they can prevent disease with certain nutrients or lifestyle activities. The relentless "go-go-go" lifestyle of working American takes in all this information by relies on the convenience (of a pill, packaged diet foods etc) to the actual thought process over purchasing, production and consumption choices surrounding nutrients in the food itself.

The body is a pretty cool machine. Take for instance Vitamin D. The body needs it, we can't really find it in our food supply, so humans went through this great evolutionary process to produce it ourselves from something we get everyday - sunlight! Now, there are a few kinks in this system that still need a few thousands to work out but for the most part the system has good intentions. While we don't know how much vitamin D the body actually produces on a daily basis, how the mechanism differs from person to person, or how much vitamin D is to much, we do know that the production system is effected by how much sunlight is able to penetrate the skin, and this depends on the angle of sun throughout the day and the year as to 'how strong' the sun's rays are. The sun's rays are also deferred if you wear sunblock. Since many Americans 'enjoy' the luxury of an indoor desk job and when they do venture outdoors have been trained to lather on the sunscreen to prevent skin cancer, we can be pretty darn certain that most Americans are vitamin D deficient. The favorite saying to parents in the pediatric clinic when I worked in WI was, "you can put your kids outside starting October 1st in nothing but there underwear and leave them outside 24 hours a day until June 1st and they still will be vit D deficient, there just isn't enough sunlight here, and if you cover them with sunscreen all summer they will never get enough sunlight to produce adequate amounts of vitamin D." So for those of us blessed enough to live north of Florida and Texas, a little vitamin D supplementation is probably not a bad idea. For all my ladies out there, some calcium wouldn't hurt you either. Women are much less likely to take in calcium in their diet to the same degree as men, and the only time we (women) retain calcium in our body & bones is during our period, so it is very important that we keep calcium levels in the black (as opposed to red :)). Otherwise, if you are nervous that your food choices might stink, a multivitamin could ease your anxiety. Here are some suggestions below:

Vitamin D3 - 400 I.U. tablets; take 1 tab/day (if you think you are vampire take 1 tab, 2x/day)

Calcium - 1200 mg/day, use 600mg Calcium CITRATE tablets (a few people can not tolerate the Citrate form, for these people use the carbonate form but realize that it is not as well absorbed so you will need to take more); take 2 tablets/day, 1 tab in am and 1 tab in pm

Multivitamin - ie Centrum, One a Day, CVS Multi etc - BOYS!!! be sure that your multivitamin is FOR MEN - unless you bleed profusely on a regular basis I don't want you getting iron poisoning from the added iron to regular multivitamins