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Know Your Vit D Levels

KIM KOZLOWSKI The Detroit News

Posted Aug 11, 2010

By Kim Kozlowski

The Detroit News

Susan Waun remembers her doctor was skeptical when she asked for a vitamin D test.

That changed when the test showed she was deficient. Since then, Waun's doctor has given her a prescription dosage that increased her vitamin D level.

A growing body of research suggests the vitamin -- long known to ward off rickets in children and osteoporosis in adults -- also shows promise in fighting scores of ailments, including heart attacks, cancer, autism, arthritis, migraine headaches and even depression.

More doctors are testing patients' levels as a federal committee prepares a vitamin D report scheduled for release this year.

"I feel better that I've discovered something that could have a long-term effect" on preventing serious disease, said Waun, a Lathrup Village resident.

Vitamin D, found only in a limited number of foods such as salmon and tuna, is produced naturally in the body through sunlight.

But officials say the number of people deficient in vitamin D is reaching epidemic proportions, as more forgo the sun over fears of skin cancer and other skin damage.

Many also live in regions far away from the equator, making it more difficult to get adequate sun exposure to produce vitamin D naturally. The maximum amount of possible sunshine from sunrise to sunset with clear skies in Detroit is 53 percent annually, compared to 70 percent in Miami and 73 percent in Los Angeles, according to Comparative Climatic Data, a report by three federal agencies.

Federal officials issued guidelines for recommended daily vitamin D intake in 1997. The suggested amounts range from 200 to 600 units, depending on age.

But new recommendations could be on the horizon: The Institute of Medicine's Food and Nutrition Board has just completed its final meetings of a year long examination of vitamin D, and a report on recommended levels is expected later this summer or early fall, said Matthew Spear, senior program assistant.

Vitamin D technically is not a vitamin but a steroid hormone system in the skin. It is critical because it regulates more than 1,000 genes, said Dr. John Cannell, executive director and founder of the Vitamin D Council in San Luis Obispo, Calif.

"Treating vitamin D deficiencies has a good chance to profoundly change the practice of medicine," Cannell said.

More doctors are starting to test their patients' vitamin D levels with a blood test. Although data is not available for Michigan, Quest Diagnostics, one of the world's largest medical testing labs, which is based in Madison, N.J., reported a 50 percent growth in vitamin D tests during the last quarter of 2009 over the previous year, said spokeswoman Wendy Bost.

Vitamin D eases symptoms

Among the doctors who screen patients' vitamin D levels is Dr.

James Dowd, a Brighton-based rheumatologist. He personally discovered an optimum level of vitamin D can make a difference when he was struggling with insomnia, muscle cramps and aching joints at age 40. Many of his patients were complaining of the same thing.

He started taking supplements and his symptoms vanished. He has since been testing all of his patients' vitamin D levels and prescribes supplements when necessary.

"It amazing how such a simple change made a difference in how they felt," said Dowd, who wrote the book "The Vitamin D Cure."

Dr. Paul Erhmann, a Royal Oak general practitioner, also tests patients for vitamin D deficiency.

He said it's important to monitor levels since too much of the fat-soluble vitamin can lead to neurological or kidney problems.

"We've been surprised by people who are vitamin D deficient," Erhmann said. "It's an important risk factor for a lot of preventable problems."

Tied to disease prevention

Research began decades ago when epidemiologists noticed fewer people suffered from chronic diseases who lived in regions with more sun exposure. Hundreds of studies have since shown links between optimum level of vitamin D and prevention of disease.

"It's one issue but it's a very, very important issue because it can be so easily addressed and so inexpensively addressed," Cannell said.

New federal research released last month is dashing hopes about the potential that vitamin D could have in reducing the risk of some cancers. Though some studies have shown a risk reduction in colorectal cancer with higher levels of vitamin D, a large study by researchers at the National Cancer Institute found adequate levels of vitamin D offered no protection against cancers such as non-Hodgkin's lymphoma or cancers of the esophagus, stomach, kidney, ovary or pancreas.

"We did not see lower cancer risk in persons with high vitamin D blood concentrations compared to normal concentrations for any of these cancers," said Demetrius Albanes, an investigator in the study that appeared online in the American Journal of Epidemiology.

Even so, many Metro Detroiters are turning to supplements or extra sunshine, just in case.

Leigh Anne Cutcher thought it was funny when she saw her cousin sprawled out in the sun, hoping to boost her vitamin D levels.

But not long after, Cutcher, 47, went to her doctor and found out she needed more of the "sunshine vitamin."

Cutcher, of Farmington Hills, has since been taking vitamin D regularly to give her body what it needs. "When you have something low or out of balance," she said, "it's important to know it so you can proactively address it and avoid some of those health issues."

Who should take vitamin D?

Breast-fed infants: The American Academy of Pediatrics recommends breast-fed infants receive a daily supplement of 400 international units, since there is not enough vitamin D in breast milk.

People 50 and older: As people age, their skin is less efficient in synthesizing the vitamin and kidneys are less able to convert it to its active hormone form, so people in this group are at risk for deficiency.

People with limited sun exposure: Those who are homebound, living in northern latitudes or wear head coverings and long robes.

People with dark skin: High amounts of pigment melanin reduces the skin's ability to produce vitamin D from sunshine.

People who are obese: Individuals with a body mass index equal to or greater than 30 typically have a low concentration of the vitamin in the blood.

Source: National Institutes of Health Office of Dietary Supplements

 
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