What vitamin D deficiency means for a woman

What vitamin D deficiency means for a woman

Vitamin D is an important vitamin with powerful effects on several systems throughout the body.  Obtaining sufficient vitamin D whether from food sources, the sun or supplements, is important for everyone.  But women especially will want to take note making sure their vitamin D status is adequate. 

What is vitamin D?

Vitamin D is a fat-soluble vitamin that acts as a hormone.  It is nicknamed the sunshine vitamin as it can be made in the skin with exposure to ultraviolet light.  Because vitamin D can be made in the body, it is essential in the diet only when exposure to sunlight is limited or the body’s ability to synthesize it is reduced.  Whether vitamin D is obtained from food sources or the sun, it is inactive until it is modified by biochemical reactions in the both the liver and the kidneys.

Vitamin D has many important functions in the body including:

·      Mineralization of bones and teeth

·      Absorption of calcium and phosphorus

·      Cell differentiation

·      Immunity

·      Blood pressure regulation

Causes of vitamin D deficiency in women

Women appear to have lower vitamin D levels than men for several reasons:

·      Women tend to have more body fat than men.  Being obese or having more body fat is an important factor in lowering vitamin D levels because fat cells absorb vitamin D and keep it from circulating throughout the bloodstream.

·      Women tend to spend less time outdoors than men with adequate exposure to the sun.  Women may also be more likely to use sunscreen blocking UV light for making vitamin D in addition to wearing hats or clothing with long sleeves or pants. 

·      As we age, whether a woman or man, less vitamin D is absorbed from dietary sources and our bodies produce less vitamin D in our skin from the sun. 

·      If a woman lives above the 42nd parallel – from Chicago or Boston north – the months of November through February do not produce sufficient vitamin D even on a sunny day. 

Testing for vitamin D status

Vitamin D status is checked with a blood test called a 25(OH)D blood test.  This can be done at a doctor’s office and it will show whether a person is getting enough vitamin D or not and if they need to take a supplement or not. 

Depending on what organization you trust more on the results of this test and what your physician recommends, the ranges of vitamin D status vary as to whether a person is considered deficient, insufficient or sufficient in their vitamin D status:

If you go by the Vitamin D Council, they recommend the following:

Deficient – 0-30 ng/ml

Insufficient – 31-39 ng/ml

Sufficient – 40-80 ng/ml

Toxic - >150 ng/ml

The Endocrine Society follows and recommends these ranges:

Deficient – 0-20 ng/ml

Insufficient – 21-29 ng/ml

Sufficient – 30-100 ng/ml

What does a vitamin D deficiency mean for a woman?

If a woman is deficient in vitamin D, it can affect her health in many ways:

·      Breast cancer – Studies have shown women with sufficient vitamin D levels had a 45% decreased risk of breast cancer.  Other studies have found that women diagnosed with breast cancer had, on average, lower blood levels of 25(OH)D.

·      Ovarian cancer – The impact of vitamin D on ovarian cancer has not been as well studies but it is reported to have a protective effect.  A recent study found that sufficient vitamin D status appears to delay progression of ovarian cancer.

·      Cardiovascular disease – A growing number of studies point to vitamin D deficiency as a risk factor for heart attacks, congestive heart failure, peripheral arterial disease, and strokes.  Even though more large scale studies are required, a recent 2016 study suggest that daily vitamin D supplementation may reduce cardiovascular risk factors.  

·      Depression – There have been studies suggesting that supplements of vitamin D may improve mild depression.  At this point, treatment with high dose supplements of vitamin D for depressive symptoms is considered experimental and should only be used with medical supervision.

 ·      Lupus – Lupus is a chronic autoimmune disease that can affect almost any organ system in the body with multiple symptoms. About 9 out of 10 adults with lupus are women ages 15 to 45.  Vitamin D has been found to have effects on immune function and inflammation with studies suggesting a relationship of vitamin D to autoimmune conditions. This may suggest a possible connection of low vitamin D status and lupus. 

·      Osteoporosis – Postmenopausal women are at a higher risk of the brittle bone disease of osteoporosis.  In order for calcium to be absorbed and deposited into bone, there must be sufficient vitamin D for this to happen.  Women who have had a low calcium intake over the years along with insufficient vitamin D, are more likely to develop osteoporosis as they age.  Women obtaining adequate vitamin D along with calcium throughout their lifetime appear to have a reduced risk of osteoporosis.

·      Fatigue and tiredness – An often overlooked potential cause of chronic tiredness is vitamin D deficiency.  Several studies have shown a relationship between vitamin D and fatigue in women with blood levels under 20 ng/ml or 21-29 ng/ml compared to women with blood levels over 30 ng/cl. 

 Recommendations and sources of vitamin D 

The current Institute of Medicine Guidelines for vitamin D are as follows:

·      Infants 0-12 months – 400 IU (International Units)

·      Children 1-13 years  - 600 IU

·      Adolescents 14-18    - 600 IU

·      Adults 19-70 years   - 600 IU

·      Adults 71 or older    - 800 IU

·      Pregnancy                - 600 IU

·      Breastfeeding          -  600 IU

Best sources of vitamin D include the following:

·      Sunlight – Between 10-20 minutes of sun exposure on arms and legs or face 3 times weekly between 10 am to 3 pm.

·      Food sources:

·      Cod liver oil, 1 tablespoon – 1360 IU

·      Cooked salmon, 3.5 ounces – 400 IU

·      Sardines in oil, 1.75 ounces – 250 IU

·      Tuna in oil, 3 ounces            -200 IU

·      Vitamin D fortified orange juice, 1 cup – 142 IU

·      Vitamin D fortified milk, 1 cup – 98 IU

·      Vitamin D fortified yogurt, 6 ounces – 80 IU

·      Egg yolk, 1 -20 IU 

·      Vitamin D3 supplements – Best to consult with your physician on the amount to take.  Most adults can safely take up to 2000 IU of vitamin D3 a day for maintenance.