With warmer days and more sunshine lately, the chances of our skin making large amounts of vitamin D increase as we have more exposed skin and time in the sunlight. That's a good thing.
But too much sunshine increases our chances of skin cancer. A bad thing. So what's the right thing to do - especially since doctors say they're seeing more D deficiencies?
Fifteen to 20 minutes in sunlight a day helps your body produce the vitamin D it needs to absorb calcium and promote bone growth and keep the heart healthy. But sunscreen - important to protect against skin cancer - reduces the body's ability to manufacture the vitamin.
Doctors can be torn on recommending time in the sun when too much and too little both have consequences.
In addition to heart problems and a number of other health issues being linked to low vitamin D levels, Dr. David Lee of Southeastern Orthopedic & Sports Medicine says patients who don't have enough D in their system have softer bones.
Dr. Lee says the body needs vitamin D to help the calcium reach its full bone-building potential. Those without enough can end up at his Lexington Medical Center practice with fractures and complete breaks that require a cast or other kind of protective wrap.
For a long time, doctors focused on calcium for strong bones, but now are playing offense with vitamin D.
"And so when we started looking more at vitamin D because we know vitamin D is critical and that is actually the hormone that helps regulate your gut absorption of calcium, so that is just as important as the actual calcium level. Because, just because you have normal calcium levels does not mean that your bones are going to be healthy," Dr. Lee said.
So how much do you need? Most doctors recommend 200 to 400 units a day in your diet and through your skin - for most people. For those over 70, doctors may recommend much higher levels.
To know if you're low will require a blood test. In fact, Dr. Lee says many doctors now make it part of your normal blood workup.
"We know that anything between, like less than 20, is definitely low, but there haven't been any studies to show anything above 30 is more beneficial."
Depending on your activity, some doctors believe a blood level reading below 30 means an increased risk of having a stress fracture.
And just because taking a little extra vitamin D may be necessary doesn't mean more is better. In fact, it can be dangerous.
"There is toxicity with vitamin D. And basically what it does is causes something called hypercalcemia or too much calcium, because your body is absorbing too much," Dr. Lee said.
In addition to getting enough sun to make enough vitamin D, foods that are rich in D include fatty fish like salmon and tuna, eggs, yogurt and fortified milk. For vegans and plant-based eaters, sources are mushrooms, non-dairy milks, fortified orange juice, soy yogurt and some cereals.
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