VITAMIN D


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or years, we've all been told to take proper precautions when we go on holiday to take care of


our health. Excessive exposure to Uv rays from the sun have been linked with skin cancer, so covering your skin with adequate SPf any time we get out into the sun, is great advice.


the problem is, avoiding or blocking the sun limits the synthesis of a powerful and vital vitamin in the body; vitamin d. this problem can be solved with vitamin d supplements, which is why we're all asked to consider taking them.


vitamin d has been hitting the headlines lately, and for great reasons. though why is it being hailed as one of the most important supplements everybody should be taking?


Well, vitamin d is a fat-soluble nutrient and one that's essential for many facets of human health. While many know it for its ability to help strengthen bone structure, research is showing that it does much, much more. the average dietary intake from foods (in the UK) is around 126iu per day, which for most people is entirely inadequate to optimise good health.


as mentioned, the body produces vitamin d provided there is an adequate amount of Uvb light from sun exposure (and this serves as our main non-supplemental source). there's a wide range of factors which limit this exposure and production however, including:


• age (our ability to convert vitamin d from sun exposure declines as we get older)


• Season and latitude (those living in darker places (northern Ireland included) experience less sunlight, particularly throughout autumn and winter)


14 - PharmacY In focUS vItamIn d


• Skin pigmentation (those with darker skin need more sun exposure than those with lighter skin to produce the same amount of vitamin d)


• regular use of sunscreen (Uv rays can be blocked, reducing d synthesis)


• Sun avoidance (some medications can cause photo-sensitivity).


• covering the skin for religious reasons


a clinical review published in the Journal of the american osteopathic association (may 2017) found that almost 1 billion individuals worldwide may have insufficient or deficient levels of vitamin d. most individuals are not truly deficient in vitamin d, but are insufficient. Insufficiency is much more subtle, meaning many us need more vitamin d without realising it. Without optimum vitamin d levels, the full health benefits cannot be fully attained.


vitamin d supplementation is associated with a wide range of benefits, including an improved immune system, respiratory health, muscle function and bone health, cardiovascular protection, mental function and much more.


hoW doES It WorK? vitamin d is transported to the liver after absorption where, in the form of calcidiol, it is stored for future use. calcidiol (25-hydroxy d) is sent all over the body, where different tissues (including the kidneys) convert it to activated vitamin d (calcitriol).


activated vitamin d is better described as a hormone rather than a vitamin. When activated, vitamin d works in two main ways: calcium homoeostasis (the management of calcium levels in the blood, bones and digestive system) and regulating cell communication (which also impacts


genetic expression and cell growth). the recent recognition of vitamin d receptors in most body tissues indicates a role for vitamin d in many other facets of health, some of which are only newly being discovered, including multiple sclerosis, autoimmune disorders, infections and cancers.


ImmUnItY EnhancEmEnt vitamin d is vital to a normal, healthy immune system. a meta-analysis published in the british medical Journal concluded that not only is vitamin d supplementation safe, but it also helps protect against respiratory tract infections (this covers everything from colds, flu and pneumonia). a proposed mechanism for this is that vitamin d supplementation significantly stimulated the production of power anti-microbial peptides in the body.


rEdUctIon In cardIovaScULar rISK vitamin d has been linked to the reduction of cardiovascular events, including death. It does this via reducing the prevalence of co-morbid diseases such as diabetes and blood pressure, reducing inflammation of the cardiovascular system and reducing the risk of arterial calcification (a hardening of the arteries).


a 2008, a meta-analysis, sought to explore the relationship between vitamin d status and cardiovascular risk. What was found is that those with adequate serum levels of vitamin d were associated with lower bodily inflammation biomarkers, better recovery after a cardiovascular event, fewer cardiovascular events in total and decreased likelihood of mortality.


a separate meta-analysis two years later showed similar results, adding that adequate vitamin d (especially in the middle-ages and elderly) was


associated with a substantial reduction in the risk of type 2 diabetes and metabolic syndrome (2)


.


rEdUctIon faLL rISK and bonE fractUrES as we age, accidental falls are much more likely to lead to bone fractures, so limiting these events is important for bone health. vitamin d supports muscle function, consequently reducing the risk of falls in individuals, particularly the elderly.


a meta-analysis from the bmJ shows that in a range of studies, subjects experienced a reduction in falling and fracture risk by 29 per cent. doses of at least 700iu -1000iu showed these results, lower doses were considered ineffective (3)


. vitamin d also plays a


well-established role in the maintenance of bone structure, producing the protein osteocalcin which is vital for bone remodelling.


rEdUctIon of dEPrESSIvE SYmPtomS vitamin d demonstrates neurone protection and assisting their maintenance. this has shown to have a positive effect on mental health. In a randomised, double-blind control trial, vitamin d supplementation was shown to reduce depressive symptoms associated with major depressive disorder (mdd). (4)


vItamIn d, caLcIUm and EarLY mEnoPaUSE Early menopause (ie, before the age of 45) effects approximately ten per cent of women and is associated with elevated cardiovascular disease risk and osteoporosis. new research published in the american Journal of clinical nutrition has identified a link with early menopause and insufficient vitamin d.


the study - involving over 2000+ women - demonstrated that those


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