A cautionary tale about vitamin D deficiency reminded me how important it is. A reader went to her GP having felt tired and lacking in energy for more than six months. She had also suffered dizzy spells and joint pain. After testing for a range of ailments, he said she was ‘massively lacking in vitamin D’ and prescribed her a rapid-correction daily supplement (Fultium-D3, 3,200 IU capsules). After ten days, she reports: ‘I feel so much better. I have more energy and don’t feel tired when I wake up.’
But she was taken aback when her GP asked how she had let her vitamin D levels get so low. ‘How could I have known?’ she asks. Despite at least one in five people suffering from low vitamin D, the response from the Royal College of General Practitioners (RCGP) is not clear.
Dr. Imran Rafi, chair of the RCGP Clinical Innovation and Research Centre, says: ‘In some patients, signs they aren’t getting enough vitamin D can include bone aches, muscle pains or even muscle weakness.’ Somewhat surprisingly, he adds that ‘if a person is concerned they have vitamin D deficiency, they should discuss it first with their local pharmacist’.
In fact, the National Institute for Health and Care Excellence states that health professionals should not routinely test people’s vitamin D status unless they have symptoms of deficiency, are considered to be at particularly high risk because they have low exposure to sunlight, have had a fall or have osteomalacia (softening of the bones), or rickets in the case of children. Usefully, a home Vitamin D Testing Service is now available from Better You in collaboration with Sandwell and West Birmingham NHS trust (£28/betteryou.com/vitamin-d-testing-service).
Harvard School of Public Health offers a more comprehensive list of possible symptoms including fatigue and generalised weakness, depression, mood changes and irritability, blood sugar issues,low immunity, weight gain and low calcium levels in the blood, as well as bone softening (low bone density) or fractures, muscle cramps and joint pain (most noticeably in the back and knees).
US research found that the most common type of vertigo is also related to low levels of vitamin D. Symptoms include dizziness, loss of balance and nausea. Additionally, sufferers of irritable bowel syndrome tend to be low in vitamin D.
The simple solution is to take a supplement. In a U-turn from previous advice, Public Health England now recommends that we should all consider taking a daily supplement in the winter months. If you get 15 minutes of unprotected sun exposure every day in the summer months, you may not need a supplement from April to October, but if you have minimal exposure you should continue. Babies and children from one to four years should take a supplement daily.
THE VITAMIN D LOWDOWN
• Vitamin D is a fat-soluble vitamin, also categorised as a hormone. It is made by our bodies from cholesterol by the action of UVB from sunlight on our skin.
• It helps to control the amount of calcium and phosphate in our bodies, which are needed for healthy bones, teeth and muscles.
• In this country, most people should get enough UVB in the summer months if they get outside in the sun, but UVB dwindles to almost nothing from October to March.
• Vitamin D3 (the type we need) is also found in oily fish (salmon, mackerel, herring and sardines), egg yolks, red meat, fat, liver and fortified foods such as some dairy products and breakfast cereals. While it is wise to eat these, we would have to consume huge amounts to get enough – thus the need for supplements.
• So how much vitamin D do we need? The recommended supplementary amount of vitamin D3 from the age of one to 70 is 400 IU (10mcg) and 320-400 IU for babies.
• However, many experts believe 1,000 IU or higher is more appropriate for adults.
• For people with diagnosed vitamin D deficiency, the recommended maintenance therapy (after testing to ensure an optimal level has been reached) is 800 to 2,000 IU daily.