Although medical professionals and nutritionists have long known about the link between vitamin D and healthy bones, it was not considered very important until a few years ago.
Now we know that vitamin D deficiency can not only lead to weaker bones, but it can also increase the risk of cancer and heart disease.
There is further evidence, that has come out during the COVID-19 pandemic, that deficiency may also make people more prone to infection and increase the risks in those with an illness. This is now featured on the NHS website, you can view the information here – https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/get-vitamin-d-supplements/
What is Vitamin D?
It is thought to be one of the oldest hormones and has been present for about 750 million years, helping animals evolve and develop ever more complex bones and skeletons. It is required for healthy bones throughout the lives of humans and animals.
It might also be why when the big asteroid hit our planet millions of years ago and its debris cut off sunlight for years, smaller burrowing animals that didn’t rely on getting their vitamin D from the sun survived. Whereas because of no sunlight, the bigger animals, like the dinosaurs, whose bones made vitamin D from sunlight couldn’t survive.
How do we get our Vitamin D?
- 10% of our vitamin D comes from our diet
- 90% comes from a chemical found in the skin that is changed into vitamin D by the action of sunlight
- 10 – 20 minutes of sunlight on the face and arms at the sunniest time of the day may be equivalent to 2,000 units of vitamin D
- However, in people with pigmented skin and older people they need more sunlight to get the same amount of vitamin D. In the UK winter, there is not enough sunlight to make vitamin D from the skin and we need to get it from our food.
How common is low Vitamin D?
Low levels of vitamin D are very common. In the UK up to 50% of individuals have low levels of vitamin D. This is more likely if you have darker skin, are pregnant, overweight, vegetarian or drink too much alcohol.
One of the reasons there has been historically little interest in vitamin D, is that for most people with low rates, there are no symptoms or signs of this deficiency. If the level is very low, you can sometimes get weakness and pain, and in severe cases deformity of the bones and teeth (rickets).
How is it diagnosed?
A blood test for vitamin D can identify if a patient has low levels:
- The normal result is 50 nmol/L, if the result is under 25 nmol/L, this is called ‘vitamin D deficiency’
- If the result is between 25 and 50 nmol/L it is called ‘vitamin D insufficiency’ and is less dangerous
- If the tests are abnormal, your GP may wish to do further tests which can vary depending on how abnormal the level is and your symptoms.
How do you treat low Vitamin D?
There are lots of different treatments for low vitamin D including:
- SAFE, exposure to sunlight. We now all know that too much sunlight can cause skin cancer. Now we know that too little causes low vitamin D. 10-20 minutes of sun exposure, to the face, arms and legs, twice a week will give you enough vitamin D if you have lighter skin. If you have darker skin you may need to double this amount of exposure. Sunscreen does not stop the body making vitamin D, but it does reduce how much the body makes. Some people are advised to have their vitamin D sun exposure without sunscreen. Others say the risk of skin cancer means that you should always wear sunscreen, though you then may need more sun exposure to make enough vitamin D. In general, the longer you expose yourself to sunlight, the greater the risk of skin cancer. It would be therefore be sensible to always use sunscreen when in the sun, BUT get your vitamin D levels checked by your GP to make sure your body is making enough of it.
- Improving vitamin D in your diet. The best source of vitamin D is from oily fish and cod liver oil. It can also be found in egg yolks, liver and fortified processed foods (margarine, breakfast cereal and baby food).
- Vitamin D supplements. Many multivitamins contain a small amount of vitamin D, but not usually enough to treat vitamin D deficiency. This is where you need to see your GP. The amount of vitamin D replacement therapy will depend on your vitamin D blood test result and your GP will ensure that you are prescribed the correct amount. Your doctor will also arrange for monitoring of your vitamin D level to ensure it is improving and staying in the normal level.
How to prevent low Vitamin D?
- Safe sun exposure
- Regular monitoring and testing – ensure that if you are at risk of low vitamin D your GP monitors you and you have regular blood tests. This group includes; pregnant and breastfeeding females, children, people over 65 years of age and those who do not get much sun exposure.
Can Vitamin D therapy help prevent Coronavirus?
There is increasing evidence that vitamin D supplements can help reduce the risk of Coronavirus. Whilst it may not prevent you catching it, it may help to reduce the more serious side effects i.e. needing to be in intensive care and even the risk of dying from the disease. Currently the studies that have been undertaken looking at the link between vitamin D and Coronavirus are small, and making decisions based on the low numbers in each study is difficult.
Even though the National Institute of Health and Care Excellence (NICE) and Public Health England still maintain that there is little evidence for using vitamin D supplements to prevent or treat Coronavirus (https://www.nice.org.uk/guidance/ng187/chapter/Rationale) many doctors and even some UK hospitals are recommending vitamin D supplements to patients to help prevent coronavirus, or help reduce the risk of serious complications.
If you would like to speak to one of our GPs about your vitamin D levels, you can book an appointment here – https://www.privategpextra.com/appointments/ or call us on 0161 428 4464.