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January 2009
Deeper than Bone: The Strength of Vitamin D
Most of us know that Vitamin D is vital for strong bones. Yet it goes beyond that, says Carol Wagner, MD, professor in pediatrics.
Vitamin D has also been linked to the innate immune system, says Dr. Wagner, and associated with diverse diseases including lupus, multiple sclerosis, cancers, juvenile and adult diabetes, preeclampsia, obesity and even cardiovascular disease.
"These are long-latency diseases that can take years to develop and are multi-factorial: Vitamin D deficiency increases the risk of developing these conditions."
Dr. Wagner's extensive research on Vitamin D - and its widespread deficiency in children and adults - recently resulted in a rewrite of an important American Academy of Pediatrics recommendation. The Academy now recommends that all children, including breastfeeding infants, receive 400 IU of Vitamin D per day.
Published in the November 2008 issue of Pediatrics, the recommendation is expected to also eventually affect the Institute of Medicine's recommendations - and therefore FDA guidelines - over the next few years. These recommendations are just the beginning of changes that will result from important research being conducted at MUSC by Dr. Bruce Hollis, professor of pediatrics and cellular & molecular biology, Dr. Wagner and others.
"We're seeing a widespread deficiency of Vitamin D in all ages because of lifestyle changes," explains Dr. Wagner. "We don't go outside as much as we used to, and when we do, we put on sunscreen."
Sunscreen is important and necessary, she explains, but a side effect is that it blocks the synthesis of Vitamin D, making supplements essential.
Along with Dr. Hollis, one of the world's foremost Vitamin D researchers, Dr. Wagner is co-principal investigator of two important studies underway in more than 700 pregnant women.
Vitamin D deficiency has a profound effect on a developing fetus: if the mother is deficient, the baby is deficient, says Dr. Wagner. If a breastfeeding mother is deficient, her baby will likewise be deficient. Typically babies on formula do not need to receive a supplement.
A third, ongoing study - taking place at MUSC and the University of Rochester - is looking at how Vitamin D supplements given to women during lactation can meet the needs of both the mother and her breastfeeding infant.
Two preliminary studies have indicated great results. "We're finding that the subjects taking Vitamin D supplements are replete and their milk has good levels, so their babies do not need to be supplemented," notes Dr. Wagner.
A majority of both dark- and light-pigmented women are deficient in Vitamin D, she adds.
The solution is to take an oral vitamin D supplement if you're not able to get adequate sun exposure.
The well-publicized "rule" of 15 minutes of unprotected sun exposure doesn't ensure enough Vitamin D during winter months because of the angles of the sun's rays, warns Dr. Wagner.
"You do run off the 'stores' of Vitamin D that you've built up over the summer, but that's usually a marginal status for most of us so, by mid-winter, your levels are likely deficient."
She recommends a simple blood test to check your levels. "The amount of Vitamin D that's in a typical multi-vitamin - 400 IU - is not enough. Most adults need about 2,000 IU per day or more to get levels up. And yes, while it is rare, you can overdose. Check with your physician."
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Inderjit Singh, PhD
Scientific Director
Darby Children's Research Inst. |
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Bernard L. Maria, MD, MBA
Executive Director
Darby Children's Research Inst. |
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