Who is at risk for Vitamin D deficiency? Exclusively breast-fed infants, dark skin, aging, northern climate dwellers, city-dwellers, those who cover their heads when outside, sunscreen users, lactose intolerance, s/p gastric bypass, cystic fibrosis patients, gallbladder disease, IBS, obesity, women.
Diseases associated with vitamin D deficiency: osteoporosis, breast, colon and ovarian cancer; autoimmune disorders such as multiple sclerosis, rheumatoid arthritis and diabetes; Seasonal Affective Disorder (depression during winter months), cardiovascular disease and hypertension, Alzheimer’s Disease.
Osteoporosis progression slows at 32 ng/mL ; goal of therapy should be 50 – 80 ng/mL to decrease cancer risks
Sources of Vitamin D: sun, food, supplements
Sun block SPF 8 or greater reduces conversion of Vitamin D in the skin by 95% If using sunscreen, apply after sun exposure for twenty minutes
Adequate sun exposure: Bikini-wearing, 10:00 a.m. – 3:00 p.m., 2-3 x per week Everybody living North of 37 degrees latitude (basically, North of line extending across the U.S. from Atlanta, GA to Los Angeles, CA) should take supplements (2000 IU daily) from October through March
Dietary sources of vitamin D include: wild-caught, fatty fish, dairy products, fortified cereals, fortified orange juice, egg yolks and cod liver oil
Take Vitamin D supplements during meals with fatty foods
Vitamin D3 is better than Vitamin D2 for supplementation (except prescription strength only comes in D2)
Children should receive 400 IU Vitamin D3 daily
Lab to order: 25-hydroxy-Vitamin D [AKA: 25(OH)D]
Definitions: “deficiency” <> 32 ng/mL
Too much vitamin D in the system: > 200 ng/mL
Treating vitamin D deficiency when measuring 25(OH)D : <>: Vitamin D2 50,000 IU weekly x 1 year 21-31 ng/mL: Vitamin D2 50,000 IU weekly x 12 weeks then Vitamin D3 2000 IU daily; recheck in 1 year 32 ng/mL: Vitamin D3 2000 IU daily
Who should not take Vitamin D without supervision? Individuals with impaired kidney function
Food sources Vitamin D (IU) Pink salmon, wild caught, 3 oz 530 Sardines, 3 oz 231 Tuna, canned, 3 oz 200 Cow’s milk, 8 oz 100 Fortified O.J., 8 oz 100 Fortified cereal, 1 cup 40-50 Eggs (Yolk), 1 oz 30 Cod Liver Oil, 1 oz 1, 360
Highlights of Dr. Paykel's Presentation 
