THE DOCTOR IS IN
OP / ED BY DR. ADIL MANZOOR
Ever heard the advice to bask in the midday sun for a few minutes to get a super dose of vitamin D? That’s certainly good advice, as vitamin D is associated with a wide range of health benefits, from strengthening your bones to improving heart health and elevating mood. And, yes, you can indeed get vitamin D from sunshine.
Trust me, I wouldn’t want to bore you with the deep chemistry of the biochemical process. Still, it is important to know that the ultraviolet (UV) B rays from the sun break a cholesterol ring in the skin, which then rearranges to produce vitamin D. It is, therefore, only fitting that vitamin D is dubbed the sunshine vitamin.
However, it’s not just sunshine and blue skies with vitamin D, as researchers have identified a few risks that exist with its supplementation. What are these risks? How significant are they? Do they outweigh the benefits of the vitamin? Let’s find out together. Before that, though, a brief introduction of our guest of honor for today – vitamin D.
There is a total of 13 vitamins and they serve different functions and contribute to several bodily processes. When many people hear about vitamins, they think of them as a luxury in diet and the body, but that could not be further from the truth. Vitamins are crucial to good health, and some vitamin deficiencies can be potentially fatal.
Of the 13 vitamins we have, vitamin D is the one most associated with strong bones and the prevention of osteoporosis. This is because the vitamin helps the body absorb calcium, which is one of the primary building blocks of bones. Beyond the role of vitamin D in our skeletal system, the vitamin is also important in fostering good mental, muscular, cardiovascular, and immune health.
I really cannot overemphasize how essential it is in the body. In fact, when there is a deficiency of the vitamin, several unpalatable experiences like peripheral neuropathy (pins and needles), bone pain, muscle pain, fatigue, muscle weakness, hair loss, frequent illness, and, of course, brittle bones and increased risks of fractures. Although we all need vitamin D, this message is even more consequential in adults.
It is no secret that the bones of the elderly are weaker than younger adults, especially in older women, because of the depletion in estrogen levels after menopause. So, the logical conclusion, then, is that adults should take more vitamin D to combat the effects of depleting estrogen and weakening bones, right? Eh, not so fast. This is the same answer to whether it is feasible to increase supplementation to younger adults and children, too – not so fast.
As good as vitamin D is, there is a major risk associated with its supplementation – vitamin D is a fat-soluble vitamin. I didn’t tell you this earlier, but vitamins can be divided into two broad groups: water-soluble and fat-soluble. As the name very much implies, the water-soluble vitamins dissolve in the body’s water content, while the fat-soluble vitamins are absorbed by fat. The four fat-soluble vitamins are vitamins A, D, E, and K, while vitamins B and C are water-soluble. How is this a problem?
When you take more fat-soluble vitamins than your body needs, the vitamins simply accumulate in your body’s tissues. If you keep loading up on these vitamins, they may reach toxic levels and cause several adverse effects. In the case of vitamin D, the symptoms you may experience include nausea and vomiting, kidney stones, appetite loss, excessive urination and thirst, confusion, and pain. If vitamin D supplementation increases still, it approaches dangerous levels in the body and can affect regular heartbeat and even lead to death.
This holds even more weight with adults, as they tend to have higher fat content as they age. So, it may very well be a case of moving from frying pan into fire if vitamin D supplementation is wrong. There’s a pretty easy fix, though.
The skin regulates the amount of vitamin D you get from the sun, so you can never overdose on naturally produced vitamin D. That is your cue to work out more outdoors in the midday sun. Plus, if you eat a well-balanced diet (typically fortified with vitamin D) consisting of any of these – soy milk, fatty fish, fish liver oil, beef liver, egg yolk, and some mushrooms – you will have little need for supplementation.
However, for people living in northern states with long winter months, older adults, people with darker skin, obese people, and people with liver conditions, you may need extra vitamin D supplementation. It has to be done very carefully, though. Do not hesitate to contact your healthcare provider for guidance before using vitamin D supplements. Better safe than sorry.
This article was written by Dr. Adil Manzoor, DO, a Board-Certified Internist; Board certified Pediatrician who works as a Hospitalist and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice, Mobile Medicine NJ; House Call Doctors. He is also currently pursuing an Executive MBA and a Master’s of Science in Healthcare Leadership at Samuel Curtis Johnson Graduate School of Management and the Weill Cornell Graduate School of Medical Sciences.
References
- https://ods.od.nih.gov/factsheets/VitaminD-Consumer/
- https://www.health.harvard.edu/staying-healthy/taking-too-much-vitamin-d-can-cloud-its-benefits-and-create-health-risks
