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Are you topping up your vitamin D levels?

Vitamin D

Over the last few days, people up and down the country have been sunning themselves and so vitamin D levels are the least of our worries. But, vitamin D is essential for healthy bones and joints, so how are you keeping your levels topped up?

Throughout the year, most of us don’t get enough vitamin D – so much so that last year, the government issued advice for everyone over the age of one to consider taking a daily supplement of 10 micrograms.

Most of the vitamin D we get is made when we’re in the sunlight, so it’s no surprise that we UK residents just aren’t getting enough.

Putting the D in food

There are a few foods that are naturally high in vitamin D, such as oily fish, red meat, liver and egg yolks.

But in the last few years, it seems like lots of foods that contain added vitamin D have cropped up in our supermarkets.

I’ve seen vitamin D added to milk in Asda, mushrooms in Tesco, and bread in M&S. Not to forget the margarines, breakfast cereals and yoghurts that are fortified with vitamin D.

I spoke to some nutrition experts who said that new food sources of vitamin D were a welcome addition, but that you’d have to eat them every day to make sure you were getting enough. And often, a supplement can be cheaper.

Personally, I’d prefer to rely on a supplement that will give me the amount I need, rather than try to calculate the levels in lots of different fortified foods every day.

But I can see how buying vitamin-infused staples like milk and bread might be an easy way to get what you need without making any changes.

Getting vitamin D

If you do choose to buy food with added vitamins, you’d be forgiven for thinking it’ll give you everything you need in one portion.

The government advice is for adults and children over the age of one to get 10 micrograms of vitamin D every day. But you won’t see this on any food labels, as these are bound by labelling rules which quote an old figure of 5 micrograms.

So while a yoghurt drink might say it’ll give you 15% of your daily recommended intake, it could actually be delivering just 7.5%.

Do you buy food that’s been fortified with vitamin D? And do you check the label to see how much you’re getting? Or do you stick to supplements?

John Beardmore says:
20 June 2017

Good point, but would’t it be most sensible to highlight this issue going into autumn ?

I am actually prescribed vitamin D supplements by my GP as I have a condition that creates a deficiency. However my GP stresses that you cannot take vitamin D supplements continuously as that in itself can be harmful.

It is nice to be reminded that the UK is catching up with other countries in this matter of Vitamin D insufficiency.

I suspect that there is a qualifier Mike, and that would be at the levels you currently take them however that is a guess. I have never seen that advice written before though I have been following the Vitamin D saga for some years. The closest to that is NHS England advice:

“What happens if I take too much vitamin D?
Taking too many vitamin D supplements over a long period of time can cause too much calcium to build up in the body (hypercalcaemia). This can weaken the bones and damage the kidneys and the heart.
If you choose to take vitamin D supplements, 10mcg a day will be enough for most people.
Don’t take more than 100mcg of vitamin D a day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11-17 years.
Children aged 1-10 years shouldn’t have more than 50mcg a day. Infants under 12 months shouldn’t have more than 25mcg a day.
Some people have medical conditions that mean they may not be able to safely take as much. If in doubt, you should consult your doctor.”

This is the Scottish Government’s advice:

I take a vitamin D supplement every day between October and March.

John H Atkinson says:
21 June 2017

There are some bits of information about Vitamin D missing. Is it fat soluble and stored in the liver, and is it possible to indicate how much exposure to the sun creates?

I prefer to get my vitamins from food and though I don’t worry about what I eat every meal or every day, I buy foods that are likely to provide me with sufficient vitamin D and also omega-3 fatty acids. For about the last year I have taken a single multivitamin tablet daily, providing 5mg vitamin D.

Vitamins are essential but the danger is to assume that more is better. That’s what the supplement sellers would like us to believe.

Introduction of HbA1c testing has helped to identify in the early stages of developing diabetes before severe damage has been done, not only helping individuals but saving the NHS a fortune. I wonder if there is a case for routine testing of vitamin D levels, carrying out a test during the winter when there is no sun and stores may have been depleted. Our NHS is very good at treating illness but as many have said, it’s better to prevent problems.

I try to keep out of sun when it is most intense, so may have not made a great deal of vitamin D during the recent hot spell.

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I think it will get worse before it gets better, Duncan. Look at the vast range of supplements on sale in many supermarkets. Vitamins present a difficult case compared with other supplements because we need a small amount, suggesting to many that more is better.

Hazel Roberts says:
24 June 2017

In UK we are above 40 degrees of latitude so only between April
and September and between 10am and 2pm is the wavelength of UV light present that is required to manufacture Vitamin D in the skin

It is important that anyone considering taking a vitamin supplement seeks medical advice first. While vitamin supplements can be very beneficial, they are not without risk. There are known drug interactions with Vitamin D supplements (e.g. steroids) and anyone taking regular medication should check for these before self-medicating. People who are prone to heart arrhythmias or who take digoxin are advised not to take vitamin D except under medical supervision.


Peggy says:
24 June 2017

I think it’s also useful to know that you can’t absorb Vit D if you don’t have enough magnesium. I read that it’s estimated up to 60% of the population could be lacking magnesium so it seems wise to combine suppliments (and taking extra Vit D depletes magnesium levels still further if you are already low this could be bad news).

I also read magnesium is 5 x better absorbed through the skin and many friends are now spraying it on once a day as ‘magnesium oil’. Just wanted to share as this information seems to be rarely known.

Is vitamin D the same as vitamin D3? I take 2000 IU of vitamin D3 each day. I am also confused about the different systems of measurement!

The one you want is vitamin D3 (cholecalciferol), Pat. The 10 microgram daily dose mentioned in the introduction is often written as 10 mcg. I’m not sure what the it in IU (international units) but there is a simple conversion.

10 mcg is 400 IU. It might be worth adding that to the introduction.

Pat, the British National Formulary (BNF) is the book used by the medical profession for information on drugs”. To quote the BNF, the term vitamin D is used for a range of compounds which possess the property of preventing or curing rickets. They include ergocalciferol (calciferol ,vitamin D2 ), cholecalciferol ( vitamin D3) ) , dihydrotachysterol, alphacalcidol and calcitriol.” Thus, the description “Vitamin D”refers to a range of different compounds. These are chemically similar but do differ to some degree in their biological activity in relation to bone.
There are 2 systems of measurement: international units (iu) and micro grams (mcg). 10mcg are equivalent to 400 iu, so your dose of 2000iu is 50mcg. Your doctor will have decided on this higher dose for some special reason. If you are not clear on this reason, ask him.
Hope this helps.
PS The BNF is now available online to the public

As Dave says, BNF is available to the public and now there is no need to register as a user: https://bnf.nice.org.uk

I cannot resist cod liver and malt. I am 80 years old!

I will stick to sunshine, oily fish and the occasional (single) malt. 🙂

I suppose johncfberg means malt extract rather than the malt you desire, wavechange. Not quite the same :-). I still like spoonfulls of the extract and, when young, used to be given that and calves foot jelly if I was poorly. I used to like that! Is it still around?

That could be it, Malcolm. I have not tried making home-brewed beer but apparently it was quite common to use malt extract with cod liver oil instead of plain malt extract because both were on the same shelf.

Anyway, I know what I prefer.

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Apparently in the US it requires a prescription to obtain, and yet can be bought over the counter here. It’s marketed as Imitrex, Imigran, Sumatran, Sumatriptanum, Sumax and Treximet but I’ve never seen it in Boots.

There seems to be a widespread shortage of sumatriptan despite the fact that it’s out of patent and manufactured under various brand names, as Ian has pointed out. There are alternative drugs in the same class as sumatriptan: https://www.evidence.nhs.uk/formulary/bnf/current/4-central-nervous-system/47-analgesics/474-antimigraine-drugs/4741-treatment-of-acute-migraine/5ht1-receptor-agonists

I had a dexa scan on the advice of my GP 5 years ago at the age of 57 and was found to have osteopenia. The GP started me on Accrete D3 (calcium and Vitamin D) I then had a further scan 2 years later and my bone density had increased by 7%, a further scan last year showed my bone density had increased even further and I no longer have osteopenia, so would definitely recommend a dexa scan for patients over 55, especially if suffering from an auto immune disease ( I have Rheumatoid Arthritis) as this can also contribute to a lack of Vitamin D.