Alphabet Soup

Overview of calcium regulation (See Wikipedia:...

Image via Wikipedia

So many letters, so little time. At least that’s what I thought when I read the Institute of Medicine’s (IOM) new report on dietary intake of calcium and vitamin D. For the last three years, reports and studies began to surface indicating that most Americans were deficient in vitamin D. Experts attributed this deficiency to inadequate time in direct sunlight on well-exposed skin, inadequate amounts of vitamin D in prepared foods, or just poor absorption of this prohormone through our intestines.

Many scientists felt that the Food and Drug Administration (FDA) guidelines for 400 international units (IU) a day was far too low. It wasn’t long before many studies began to describe the benefits of high vitamin D levels curing everything from helping to prevent cancer to curing depression. There seemed no limits on what adequate amounts of the ‘miracle’ vitamin could do to help us lead healthier, longer lives. Suggestions for adequate doses escalated from 1,000 IU daily to over 5,000 IU of vitamin D3 daily. Dermatologists frowned upon trying to increase our sunlight exposure to enhance our vitamin D levels, due to the risks of sun–induced skin damage. The only downside to popping this powerful pill was the association of high levels of vitamin D with increased patient falls. Whether this was from the effects of the vitamin, or from patient’s trying to reach for their vitamin pill bottle wasn’t clear.

Physicians began to order vitamin D blood levels as part of their medical screenings. We believed that levels below 30 were too low, but found little consensus on what is the adequate range. Many of us settled on a range of 40 to 60 as being adequate to prevent the harmful effects of not having enough vitamin D. As long as patients took their vitamin D3 everyday, the blood levels would typically stay consistent giving the patient and their physician a collective sigh of relief.

Then along comes the IOM and their new report. Wouldn’t you know they would do a detailed analysis of all studies involving vitamin D and subject them to the rigors of medical scrutiny. And once again, many physicians in the trenches had their assumptions turned upside down. It seems that the most, if not all, of the studies supporting miracle cures with the wonder drug didn’t stand up to reasoned analysis. The researchers found a clear need for adequate amounts of vitamin D3 to enhance calcium absorption and help prevent bone loss. Beyond that, it’s really anyone’s guess.

The IOM researchers suggest that blood levels above 30 are adequate. And no, higher levels do not necessarily mean better, as we commonly seem to think. For anyone age one and above, the IOM believes 600 IU of vitamin D3 daily is adequate. Once we get above the age of 71, the IOM recommends 800 IU of vitamin D3 daily. They make no distinction between vitamin D obtained through foods, sunlight or pills. It now seems reasonable to have our vitamin D levels checked at least once and if low, use a vitamin supplement containing the proposed amounts of vitamin D3 to bring this up.

We can be assured that the other vitamin alphabets will soon get their due as well; don’t toss out those Flintstone vitamins just yet. We may discover a whole new ‘Yabba dabba do’ way of getting what our bodies need to stay healthy and possibly, just possibly, live longer.

About Steve P. Sanders

A general internist writing and sharing ideas and art.

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