Vitamin D

What is it?
Vitamin D is a pro-hormone that is produced naturally by
your skin and kidneys in the presence of sunshine.
 
Why is it important to think about?
Current research indicates that Vitamin D deficiency can play a role in cancer, heart disease, diabetes, birth defects, depression, chronic pain, stroke, high blood pressure, arthritis, and osteoporosis. This does not mean that a lack of vitamin D is the cause of these diseases, or that taking vitamin D will prevent these diseases. What it does mean is that Vitamin D is an important part of achieving overall health. In growing children, Vitamin D is important for developing strong bones.
 
In Southeast Alaska, deficiencies of Vitamin D are common due to the high number
of cloudy and/or cold days. Because we cover our skin with clothing most days of the year, we do not produce enough Vitamin D, even in the summer.
 
What should I do?
We suggest taking a Vitamin D supplement throughout the year. Supplements are available in tablets and liquid form. You may also choose to increase your intake of foods which are high in Vitamin D, such as fatty fishes, eggs, and enriched foods such as dairy or soy.
 
For infants and children, supplementation is also recommended. Breast milk does not
contain adequate amounts of Vitamin D, so it is recommended to supplement breastfed infants. Children's Vitamin D is available within a multivitamin, or as a separate supplement.  The recommended dose for infants and children is 400 IU per day. As Vitamin D can be toxic in high doses, it is important not to over-supplement.

Supplementation for Adults

• The current USDA recommendations for adults are 400 international units a day.
• This is not enough for Juneau residents for a variety of reasons. Due to the high number of days of cloud cover, combined with our high latitude, plus our cold climate and the amount of clothing we wear most days of the year, we do not produce enough vitamin D through our skin, even in the summer.
• Current research indicates that 2,000 international units a day is needed to maintain healthy levels of vitamin D in adults, including pregnant and breastfeeding women, without good exposure to sunlight.

Supplementation for Infants and Children

• Breast milk does not contain adequate amounts of vitamin D, so it is necessary to supplement infants from birth.
• Infants exclusively receiving formula will obtain adequate vitamin D - it is not necessary to provide additional vitamin D supplementation.
• For older children, vitamin D received through the diet is usually NOT adequate unless they are eating foods high in vitamin D.
• The Canadian Pediatric Society recommends 800 international units a day during the winter months for infants and children living above latitude 55.
• The American Academy of Pediatrics recommends 400 international units a day for all infants and children and does not specify additional requirements for those living at high latitudes. Given the lack of sunlight that infants and children experience in Juneau, it makes sense to follow the Canadian Guidelines.

Sources of Supplementation

• For adults, Vitamin D is available in tablets and liquid emulsion and comes in two varieties, Vitamin D2 and D3.
• Vitamin D3 (cholecalciferol), derived from animal based foods, is the best form as it is better absorbed by your body. It is available over the counter.
• Vitamin D is best absorbed when taken with food, particularly foods with fat.
• For infants and children, multivitamin liquids and chewable tablets typically contain 400 international units of vitamin D per daily dose. It may be tempting to double the daily dose to get 800 iu of vitamin D a day. However this is strongly discouraged, as it will result in overdosing the other vitamins that are contained in the multivitamin. Instead use a vitamin D3 only supplement, available in liquid form at local pharmacies. Keep in mind that vitamin D can be toxic in high doses.

For questions regarding Vitamin D and your family's health, speak to your midwife or medical provider.