Top 10 Tips

VITAMIN D
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1. Bone up on vitamin D.
Vitamin D – which comprises D2 (ergocalciferol) and Vitamin D3
(cholecalciferol) – is important to help maintain bone health.  The body cannot optimally absorb calcium from food or supplements with adequate intake of Vitamin D.  Vitamin D3 helps increase the body's ability to absorb calcium by as much as 30-80%, while low Vitamin D levels can impair calcium absorption.

2. Osteoporosis treatment
Osteoporosis affects one in four women over the age of 50 and one in eight men over the age of 50. 1,3  Several studies have found that more than fifty percent of people with osteoporosis have inadequate levels of Vitamin D.2  In the treatment of osteoporosis, it is essential to get Vitamin D and calcium through all possible sources.2  According to the Osteoporosis Canada 2002 Guidelines, Vitamin D, along with calcium, are important adjuncts to osteoporosis therapy. 3

3. How much is enough?
Many studies worldwide point to a high prevalence of inadequate Vitamin D in humans – especially in older adults who are also likely to have osteoporosis.2 The Osteoporosis Canada 2002 Guidelines recommend an intake from all sources (diet and supplements) of 400 international units (IUs) of Vitamin D3 per day for adults up to 50 years of age or 800 IUs of Vitamin D3 per day for adults over 50 years of age.2

4. Age makes a difference
The body's ability to manufacture Vitamin D declines with age – as Vitamin D is produced less efficiently through the skin in older people.4  Older adults, in particular, need to monitor their diets to ensure they are getting enough Vitamin D.

5. Only a limited supply
Unlike calcium, the sources of Vitamin D are limited.  The body produces Vitamin D in the skin when exposed to ultraviolet B (UVB) light.  It can also be obtained through diet (such as from fortified milk and fatty fish) and supplements.2 

6. Here comes the sun
Canadians are likely to suffer low Vitamin D levels during the late fall and winter (October to March) when Vitamin D production in the skin virtually stops.  During this time, sunlight must pass a much longer distance through the atmosphere and most of the UV light is absorbed.4 As you know, it is important to protect the skin from damage by applying sunscreen.  However, sunscreen interferes with the cutaneous production of Vitamin D3.4 Other factors such as clothing and darkly pigmented skin may also hinder the body's ability to produce adequate amounts of Vitamin D3 in the skin from sunshine.2

7. Keep Pouring
Milk fortified with Vitamin D3 is our main dietary source of Vitamin D.  Milk contains 100 IUs of Vitamin D per 250 ml glass.1 However, for person over the age of 50 to achieve Osteoporosis Canada recommended daily allowance of Vitamin D3 from milk alone, a person would need to drink eight 250 ml glasses of fortified milk every day. 

8. Bring on the fish
Fish oils and fatty fish such as salmon, sardines, and mackerel are among the only significant natural dietary sources of Vitamin D that can help provide the daily allowance of Vitamin D recommended by the Osteoporosis Canada 2002 Guidelines.5

9. Look at the options
Since it may be difficult to get enough Vitamin D from natural sources such as sunlight and diet, you may with to consider other options.  Remember that a daily dose of 400 IUs or 800 IUs of Vitamin D3 (depending on age of the adult) is essential for optimal calcium absorption and overall bone health.2, 3

10. Can there be too much?
Vitamin D toxicity has not been documented during chronic therapy in generally healthy adults at a dose less than 10,000 IU/day.  In a clinical study of healthy adults, a 4000 IU daily dose of Vitamin D3 for up to five months was not associated with hypercalciuria or hypercalcemia.2, 6

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References
1. Osteoporosis Canada website.  http://www.osteoporosis.ca/index.php/ci_id/7001/la_id/1.htm. Accessed Feb 2009
2. Reginster JY et al.  The high prevalence of inadequate serum Vitamin D levels and implications for bone health.  CurrMed Res Opin, 2005;21(4):579-85
3. Brown JP, Rosse Rg. 2002 clinical practice guidelines for the diagnosis and the management of osteoporosis in Canada.  CMAJ 2002; 167 (10 suppl):S1-S34
4. Lips P et al. Vitamin D Deficiency and Secondary Hyperparathyroidism in the Elderly:  Consequences for Bone Loss and Fractures and Therapeutic Implications, Endor Rev.  2001 Aug;22(4):477-5014.
5. Meyer C.  Scientists probe role of vitamin D, JAMA, 2004;292:1416-8.
6. PrFosavance®  Product Monograph.  Merck Frosst Canada Ltd, 2009.