New Government Guidelines

‘Vitamin D supplements advised for everyone’, ran the BBC headline back in July, citing the government backed research now recommending that everyone should be getting at least 10 micrograms of the nutrient every single day.

What is Vitamin D?

Vitamin D is known as ‘The Sunshine Vitamin’. This is because sunlight is necessary for the synthesis of vitamin D in the skin and those lacking in sunlight are at high risk of deficiency.

We can’t stress this point enough as vitamin D is not found in abundance naturally in foods. So simply put, not enough sunshine means not enough vitamin D, and hence issues with widespread deficiency in the UK particularly in areas such as parts of Scotland that get even less sunshine. The amount of sunlight (UV) in our winter months is insufficient and over the winter we need to draw on our bodily reserves.

There are some foods rich in vitamin D, primarily oily fish and eggs however fish consumption is poor in this country and as the Vitamin D Mission note:

“Salmon and other oily fish are big in vitamin D, along with liver, eggs and fortified cereals. But because of the quantities needed it’s hard to get enough from diet alone.”

Why is Vitamin D so important?

As noted on the Vitamin D Council website, “Vitamin D is important for good overall health and strong and healthy bones. It’s also an important factor in making sure your muscles, heart, lungs and brain work well and that your body can fight infection.”

Vitamin D has the following permitted health claims.

Vitamin D contributes to the:

• normal absorption/utilisation of calcium and phosphorus
• normal blood calcium levels
• maintenance of normal bones and teeth
• maintenance of normal muscle function
• normal function of the immune system
• process of cell division and
• vitamin D is needed for normal growth and development of bone in children

The new government guidelines

In July this year, Public Health England released new guidelines that for everyone in the general population age 4 years and older they should consume 10 micrograms per day.

According to the report, these recommendations are to ensure a minimum serum level of 25 nmol/litre is maintained all year round. 

As we move into the winter months where sunshine is scarce in this country, the vast majority of us will be well below the updated recommended daily intake of vitamin D which is why supplementation can be so important.

An Improvement, but is 10mcg enough?

“The Grassroots Health Scientists Panel of 48 expert vitamin D researchers and medical practitioners hold the position that the serum level should be between 100 to 150 nmol/litre (or 40-60 ng/ml)”

Sources of Vitamin D

Vitamin D dietary sources include butter, eggs, oily fish and fortified foods – these sources provide only low levels of vitamin D – most is produced in the skin following sun exposure. In the UK, vitamin D can be synthesised in the skin between April and September, 10.00 am to 2.00 pm, on sunny days (i.e. without cloud cover). Production also depends on genetics, age, sunscreen, clothing, and skin colour. Although vitamin D cannot be synthesised during the winter at our latitude, it can be stored in the body. Levels are likely to be lowest around March.

Cardiovascular disease

Research suggests that Vitamin D deficiency plays a role in the onset of cardiovascular conditions:

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851242/)

Diabetes

Research suggests that there is a link between vitamin D and diabetes, with the Vitamin D Council suggesting that “people with high vitamin D intake during their first year of life are less likely to develop type 1 diabetes later in life.”

Inflammatory Bowel Disease

Vitamin D helps to reduce levels of inflammatory proteins that are overproduced in the immune system. One of these proteins is called tumour-necrosis factor (TNF). Much research has suggested that vitamin D may be the natural alternative to medication when it comes to reducing inflammation in the digestive tract. This is because medications that are frequently used to manage IBD are involved in blocking the production of this particular protein.

Musculoskeletal Health

Research into osteomalacia and rickets provided early evidence of the important role of vitamin D. These diseases represent vitamin D deficiency and present symptoms of hypocalcaemia (low serum calcium levels) and skeletal deformity due to poor mineralisation of the bones. Patients with these diseases usually have serum vitamin D levels below 20 nmol/L.

Rickets, a condition that affects bone development in children, has seen a dramatic rise in cases in recent years. Indeed, the number of children suffering from this condition has reportedly doubled in the last decade. 

According to an article in theDaily Telegraph from last year, this is partly down to an increase in children staying indoors and playing video games as opposed to going outside and being exposed to sunlight (therefore not getting enough vitamin D!).

The NHS Website states that “any child whose diet doesn’t contain enough vitamin D or calcium can develop rickets, but the condition is more common in children with dark skin, as this means they need more sunlight to get enough vitamin D, as well as children born prematurely or taking medication that interferes with vitamin D.”

Are you deficient in Vitamin D?

Vitamin D deficiency is very common in the United Kingdom. Indeed, Public Health England stated that 1 in 5 people in the United Kingdom are low in vitamin D and are not even aware of it. According to the Vitamin D Council, the following criteria leaves you more susceptible to deficiency of this particular vitamin:

• People who spend a lot of time indoors during the day. For example, if you’re housebound, work nights or are in hospital for a long time.
• People who cover their skin all of the time. For example, if you wear sunscreen or if your skin is covered with clothes.
• Older people have thinner skin than younger people and this may mean that they can’t produce as much vitamin D.
• Infants that are breastfed and aren’t given a vitamin D supplement. If you’re feeding your baby on breast milk alone, and you don’t give your baby a vitamin D supplement or take a supplement yourself, your baby is more likely to be deficient in vitamin D.
• Pregnant women.
• People who are very overweight (obese).

Symptoms

These are some of the main bodily symptoms associated with vitamin D deficiency:

• difficulty thinking clearly
• bone pain
• frequent bone fractures
• muscle weakness
• soft bones that may result in deformities
• unexplained fatigue

It is important to note that symptoms do not always arise with vitamin D deficiency until levels get extremely low, which makes it particularly difficult to diagnose.

A vitamin D blood test is the only way to categorically determine if you are deficient in vitamin D. You can either get a blood test at your doctors or you can purchase a home fingerprick test.

Choosing the right supplement – vitamin D3 vs vitamin D2

Choosing the correct form of vitamin D to supplement with is just as important as supplementation itself, and although the new government guidelines now advise that everyone takes a vitamin D supplement, actual advice in this area has been scarce.

Vitamin D3 vs Vitamin D2

Vitamin D3 is the most bioavailable form of this nutrient and far preferable to Vitamin D2 to supplement with.

Vitamin D3 (also known as cholecalciferol) is the most bio effective and biologically active form of this nutrient and is found in humans and animals. When sunlight hits the skin it then converts cholesterol into the bioactive form of vitamin D3 hence why sunlight is so important – without it, vitamin D3 cannot be utilised by the body.

Look out for D3 oral spray in your local chemist.