As the days get shorter it becomes more difficult to get your recommended daily dose of vitamin D, or “The Sunshine Vitamin.”
Vitamin D is important for many functions in the body, but it can also help you in the winter months when you start to feel blue.
Dr. Curtis Mann discusses Vitamin D deficiency, signs, symptoms, and recommended dosages to help you avoid the symptoms of SAD (seasonal affective disorder).
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Vitamin D: The Heart Healthy Sunshine Vitamin
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Learn more about Dr. Curtis Mann
Dr. Curtis Mann
Dr. Curtis Mann is a Family Medicine/Primary Care Physician.Learn more about Dr. Curtis Mann
Transcription:
Vitamin D: The Heart Healthy Sunshine Vitamin
Melanie Cole (Host): As the days get shorter, it becomes more difficult to get your recommended daily dose of vitamin D, or the sunshine vitamin. Just how much do you really need as the winter months approach? My guest is Dr. Curtis Mann. He’s a family medicine and primary care physician with NorthShore University Health System. Welcome to the show, Dr. Mann. So, vitamin D. Tell us what it does for us and how much of it we’re going to need as these winter months approach.
Dr. Curtis Mann (Guest): Sure. It's interesting, because we actually call it vitamin D, but it's not truly a vitamin D. It’s actually a steroid hormone. A vitamin by definition is something that we need to intake from an outside source. But we do actually manufacture some vitamin D. The problem is that oftentimes, we’re not out in the sun enough or there are precautions with not being in the sun that much because of risk of skin cancer and this kind of thing, or people live in the northern climates. So, we don't get enough and then, so we have to look at supplementing. And there’s different recommendations on how much you should be taking I guess depending on what you’re presenting as a patient.
Melanie: Okay, so it is something that we might have to supplement as we’re not getting so much. And talking even about sunscreens and then blocking the vitamin D, that’s a whole another show in itself.
Dr. Mann: Sure. Sure.
Melanie: So, what foods contain vitamin D if we’re not only getting it from the sun? And then, let’s talk about supplementation.
Dr. Mann: Yeah. So there’s not that many foods that have vitamin D. Fortified dairy products have it. If you look on the back of a breakfast cereal box, you will see it’s been fortified with vitamin D. There is other foods like fatty fish, beef liver, egg yolks, they do have some. They don't have that much. If you look on a multivitamin, if you’re taking that every day, traditionally that's had about 400 units of vitamin D. Lately they have been pumping that up a little bit more, so you might notice it might have a little bit more vitamin D in it. So really, for the most part, nutritionally, our day-to-day nutritional intake, we’re just not going to get enough vitamin D. So it’s interesting within the past years, one of our big organizations called the Institute of Medicine said that we should probably, if we’re up to the age of 70, have 600 units of vitamin D a day. If we’re above 70, then we should have more, 800 units. But those are just kind of bare minimum guidelines, and it’s worth talking more about if that’s right for a particular individual.
Melanie: And Dr. Mann, what are some of the signs and symptoms that we might experience if we are in vitamin D deficiency, and how do we even know if we are?
Dr. Mann: So the truth is, most of the time, when you have a low vitamin D, you're not going to have symptoms. If it’s really low, with vitamin D, one of the main things it does is it takes calcium and it's kind of a transporter for calcium and helps with bone. It prevents bone loss. So, a really severely restricted vitamin D in a patient, we might have somebody presenting with bone pain or muscle pain, fatigue. But then, there’s a myriad of other symptoms that we’re finding that people might have with a fairly low vitamin D but not that severe. So there might be mild depressive symptoms. It might be fatigue, it might be some body aches. We’re finding that lower vitamin D levels but not necessarily to the severity of having bone pain is causing a lot of these symptoms that are affecting our system in some ways. So we’re just beginning to learn a lot more about some of the symptoms that are presenting with a lower vitamin D level.
Melanie: Dr. Mann, do we ask for vitamin D to be checked when we get our blood checked? Is this automatic, no?
Dr. Mann: No. It's not automatic. If you’re a patient that has certain illnesses or certain underlying diseases—and this might be autoimmune diseases or neurologic diseases, or it might be certain gastrointestinal issues like Celiac, or even certain psychiatric diagnoses like depression—and if you’ve never had a vitamin D level, you absolutely want to get it done. Because we’re finding that vitamin D can actually be that X factor if we’re able to get that up to a sufficient level that it can actually help with your symptoms. I don't think everybody needs it. I think if you’re a young, otherwise healthy male or female in your 20s or 30s, I don't know if there is a lot of benefit to just doing that across the board. But certainly, if you are having certain underlying diseases that you’re bringing to the table, it’s certainly worth asking if it has never been done.
Melanie: So what is the recommended dose, and how much should we take supplementing? Because some people are taking thousands, and you’re like, “Okay, really do need that much?” But also, if you’re recommending a dose for us, how can that affect seasonal affective disorder? Can that help ward off some of the symptoms that we might be experiencing?
Dr. Mann: Sure. So, kind of the bare minimum recommendation is taking between 600 units and 800 units a day, and that really is not that much. For my patients, I am recommending 1,000 to 2,000 units a day as I’ve read up a lot more in vitamin D deficiency and what it can cause. So again, I don't think there’s an absolute recommendation on what the exact level should be until you actually have your vitamin D drawn. If your vitamin D level is drawn and it’s coming back low, yeah, you might be put on 5,000 units a day for a month or so. And then generally, the maintenance dose, once you get your vitamin D level up to speed, is about a thousand units. We know we can kind of maintain a vitamin D level at a certain level if we can keep that you know at a thousand units. The flip side is that people that are obese or overweight, they don't absorb vitamin D as well. So they might have to have more so. I think there’s a general guideline. We’re reading that base level’s at least 800 to 1,000, and it might be significantly more than that. And then, certainly related to seasonal affective disorder, we’re finding that vitamin D stimulates a lot of genes, and a lot of these genes reside in the brain. So we know that some of these genes might express themselves for depression and seasonal affective disorder is one of the subcategories of depression. And we’re finding that adequate supplementation with people with depression, and thereby with seasonal affective disorder, can make significant differences. Certainly, there is light therapy with seasonal affective disorder, but potentially even supplementing with vitamin D and making sure that you’re getting levels that probably are higher than what the current recommendation is. The current recommendation is to have it at least about 30, but for people with SAD, we might want to get up to a level of around 70.
Melanie: So Dr. Mann, in just the last couple of minutes, give us your best advice about vitamin D deficiency, getting proper amounts of vitamin D, whether supplements or from the sun, and why should people come to NorthShore University Health System for their primary care.
Dr. Mann: Sure. I think the big thing is that if you have some underlying diseases—and these are, again, autoimmune, depression, neurologic diseases, GI issues, vitamin D is definitely worth doing. And based on that level, then we can figure out how much vitamin D supplementation you ought to be taking. And I guess the biggest point I can make is everybody is different, and if you're out there and you’re trading war stories with people, that they’re taking X amount of unit of vitamin D and you’re only taking this amount, everybody physiologically is different. So, just because somebody else takes a different dose than what you’re taking, that’s okay. We all absorb it differently; we get different amounts of sunlight. Not all of us wear sun protection all the time, so some of us are getting different amounts of vitamin D in the environment. So, certainly, I have no objection if I have a patient coming in just asking for a vitamin D with getting that level and then figuring out from there what their ultimate dose is. And then lastly, just about NorthShore, we are an ever enlarging organization, and it’s very exciting. We’ve just actually merged with another organization called Advocate, and now we’re the largest healthcare provider in Chicago and area and the 11th largest in the country. And we have a tremendous number of resources and terrific electronic medical records that we’re doing, a lot of research and thereby just providing better patient care. So we’re always excited to have people come and see us here.
Melanie: Thank you so much, Dr. Curtis Mann. You're listening to NorthShore Health and Wellness. And for more information, you can go to NorthShore.org. That is NorthShore.org. This is Melanie Cole. Thanks so much for listening.
Vitamin D: The Heart Healthy Sunshine Vitamin
Melanie Cole (Host): As the days get shorter, it becomes more difficult to get your recommended daily dose of vitamin D, or the sunshine vitamin. Just how much do you really need as the winter months approach? My guest is Dr. Curtis Mann. He’s a family medicine and primary care physician with NorthShore University Health System. Welcome to the show, Dr. Mann. So, vitamin D. Tell us what it does for us and how much of it we’re going to need as these winter months approach.
Dr. Curtis Mann (Guest): Sure. It's interesting, because we actually call it vitamin D, but it's not truly a vitamin D. It’s actually a steroid hormone. A vitamin by definition is something that we need to intake from an outside source. But we do actually manufacture some vitamin D. The problem is that oftentimes, we’re not out in the sun enough or there are precautions with not being in the sun that much because of risk of skin cancer and this kind of thing, or people live in the northern climates. So, we don't get enough and then, so we have to look at supplementing. And there’s different recommendations on how much you should be taking I guess depending on what you’re presenting as a patient.
Melanie: Okay, so it is something that we might have to supplement as we’re not getting so much. And talking even about sunscreens and then blocking the vitamin D, that’s a whole another show in itself.
Dr. Mann: Sure. Sure.
Melanie: So, what foods contain vitamin D if we’re not only getting it from the sun? And then, let’s talk about supplementation.
Dr. Mann: Yeah. So there’s not that many foods that have vitamin D. Fortified dairy products have it. If you look on the back of a breakfast cereal box, you will see it’s been fortified with vitamin D. There is other foods like fatty fish, beef liver, egg yolks, they do have some. They don't have that much. If you look on a multivitamin, if you’re taking that every day, traditionally that's had about 400 units of vitamin D. Lately they have been pumping that up a little bit more, so you might notice it might have a little bit more vitamin D in it. So really, for the most part, nutritionally, our day-to-day nutritional intake, we’re just not going to get enough vitamin D. So it’s interesting within the past years, one of our big organizations called the Institute of Medicine said that we should probably, if we’re up to the age of 70, have 600 units of vitamin D a day. If we’re above 70, then we should have more, 800 units. But those are just kind of bare minimum guidelines, and it’s worth talking more about if that’s right for a particular individual.
Melanie: And Dr. Mann, what are some of the signs and symptoms that we might experience if we are in vitamin D deficiency, and how do we even know if we are?
Dr. Mann: So the truth is, most of the time, when you have a low vitamin D, you're not going to have symptoms. If it’s really low, with vitamin D, one of the main things it does is it takes calcium and it's kind of a transporter for calcium and helps with bone. It prevents bone loss. So, a really severely restricted vitamin D in a patient, we might have somebody presenting with bone pain or muscle pain, fatigue. But then, there’s a myriad of other symptoms that we’re finding that people might have with a fairly low vitamin D but not that severe. So there might be mild depressive symptoms. It might be fatigue, it might be some body aches. We’re finding that lower vitamin D levels but not necessarily to the severity of having bone pain is causing a lot of these symptoms that are affecting our system in some ways. So we’re just beginning to learn a lot more about some of the symptoms that are presenting with a lower vitamin D level.
Melanie: Dr. Mann, do we ask for vitamin D to be checked when we get our blood checked? Is this automatic, no?
Dr. Mann: No. It's not automatic. If you’re a patient that has certain illnesses or certain underlying diseases—and this might be autoimmune diseases or neurologic diseases, or it might be certain gastrointestinal issues like Celiac, or even certain psychiatric diagnoses like depression—and if you’ve never had a vitamin D level, you absolutely want to get it done. Because we’re finding that vitamin D can actually be that X factor if we’re able to get that up to a sufficient level that it can actually help with your symptoms. I don't think everybody needs it. I think if you’re a young, otherwise healthy male or female in your 20s or 30s, I don't know if there is a lot of benefit to just doing that across the board. But certainly, if you are having certain underlying diseases that you’re bringing to the table, it’s certainly worth asking if it has never been done.
Melanie: So what is the recommended dose, and how much should we take supplementing? Because some people are taking thousands, and you’re like, “Okay, really do need that much?” But also, if you’re recommending a dose for us, how can that affect seasonal affective disorder? Can that help ward off some of the symptoms that we might be experiencing?
Dr. Mann: Sure. So, kind of the bare minimum recommendation is taking between 600 units and 800 units a day, and that really is not that much. For my patients, I am recommending 1,000 to 2,000 units a day as I’ve read up a lot more in vitamin D deficiency and what it can cause. So again, I don't think there’s an absolute recommendation on what the exact level should be until you actually have your vitamin D drawn. If your vitamin D level is drawn and it’s coming back low, yeah, you might be put on 5,000 units a day for a month or so. And then generally, the maintenance dose, once you get your vitamin D level up to speed, is about a thousand units. We know we can kind of maintain a vitamin D level at a certain level if we can keep that you know at a thousand units. The flip side is that people that are obese or overweight, they don't absorb vitamin D as well. So they might have to have more so. I think there’s a general guideline. We’re reading that base level’s at least 800 to 1,000, and it might be significantly more than that. And then, certainly related to seasonal affective disorder, we’re finding that vitamin D stimulates a lot of genes, and a lot of these genes reside in the brain. So we know that some of these genes might express themselves for depression and seasonal affective disorder is one of the subcategories of depression. And we’re finding that adequate supplementation with people with depression, and thereby with seasonal affective disorder, can make significant differences. Certainly, there is light therapy with seasonal affective disorder, but potentially even supplementing with vitamin D and making sure that you’re getting levels that probably are higher than what the current recommendation is. The current recommendation is to have it at least about 30, but for people with SAD, we might want to get up to a level of around 70.
Melanie: So Dr. Mann, in just the last couple of minutes, give us your best advice about vitamin D deficiency, getting proper amounts of vitamin D, whether supplements or from the sun, and why should people come to NorthShore University Health System for their primary care.
Dr. Mann: Sure. I think the big thing is that if you have some underlying diseases—and these are, again, autoimmune, depression, neurologic diseases, GI issues, vitamin D is definitely worth doing. And based on that level, then we can figure out how much vitamin D supplementation you ought to be taking. And I guess the biggest point I can make is everybody is different, and if you're out there and you’re trading war stories with people, that they’re taking X amount of unit of vitamin D and you’re only taking this amount, everybody physiologically is different. So, just because somebody else takes a different dose than what you’re taking, that’s okay. We all absorb it differently; we get different amounts of sunlight. Not all of us wear sun protection all the time, so some of us are getting different amounts of vitamin D in the environment. So, certainly, I have no objection if I have a patient coming in just asking for a vitamin D with getting that level and then figuring out from there what their ultimate dose is. And then lastly, just about NorthShore, we are an ever enlarging organization, and it’s very exciting. We’ve just actually merged with another organization called Advocate, and now we’re the largest healthcare provider in Chicago and area and the 11th largest in the country. And we have a tremendous number of resources and terrific electronic medical records that we’re doing, a lot of research and thereby just providing better patient care. So we’re always excited to have people come and see us here.
Melanie: Thank you so much, Dr. Curtis Mann. You're listening to NorthShore Health and Wellness. And for more information, you can go to NorthShore.org. That is NorthShore.org. This is Melanie Cole. Thanks so much for listening.