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Vitamins & Supplements for Seniors

Large Study Claims to Pinpoint Lower and Upper Safe Limits of Vitamin D

Supplement widely used by senior citizens but safety limits have been unclear until this study on when risk of death increases. Second new study says low vitamin D leads to pneumonia in seniors

April 30, 2013 – Vitamin D is widely used by senior citizens - older women in particular - to maintain bone density and prevent fractures but the recommendations on how much to take has been confusing. A report today says the safe range of vitamin D levels with respect to coronary morbidity lies between 20 to 36 ng/mL.

Vitamin D levels below and above this range increased risk of mortality and morbidity significantly, according to the research that focused on defining the safe limit for vitamin D.

The current recommendation by the Office of Dietary Supplements of the National Institutes of Health states: "In general, levels below 30 nmol/L (12 ng/mL) are too low for bone or overall health, and levels above 125 nmol/L (50 ng/mL) are probably too high. Levels of 50 nmol/L or above (20 ng/mL or above) are sufficient for most people." (See more below)

 

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There is increasing evidence that vitamin D plays a pivotal role in human physiology. Vitamin D deficiency has been linked to cardiovascular events and mortality, but previous studies have found supplementation fails to decrease mortality or cardiovascular events, while other studies found only minor positive effects, according to background on the study to be published in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

Low Vitamin D Levels a Risk Factor for Pneumonia in Older People

April 30, 2013 - A University of Eastern Finland study showed that low serum vitamin D levels are a risk factor for pneumonia. The risk of contracting pneumonia was more than 2.5 times greater in subjects with the lowest vitamin D levels than in subjects with high vitamin D levels. The results were published in Journal of Epidemiology and Community Health.

The follow-up study carried out by the UEF Institute of Public Health investigated the link between serum vitamin D3 and the risk of contracting pneumonia. The study involved 1,421 subjects living in the Kuopio region in Eastern Finland.

The results showed that during the follow-up, subjects with vitamin D3 levels representing the lowest third were more than 2.5 times more likely to contract pneumonia than subjects with high vitamin D3 levels.

The risk of contracting pneumonia also grew by age, and was greater in men than women. At baseline, the mean serum D3 concentration of the study population was 43.5 nmol/l, and the mean age of the study population was 62.5 years.

Earlier research has shown that vitamin D deficiency weakens the immune system and increases the risk of mild respiratory infections. This University of Eastern Finland study was the first one to establish that vitamin D deficiency also increases the risk of contracting pneumonia in the ageing general population.

The recommended daily intake of vitamin D in Finland is 20 micrograms for those over 60 years of age.

“The unpredictable results from previous studies may be due to the misconception that ‘the higher the better,’” said Yosef Dror, PhD, of Hebrew University in Rehovot, Israel, and lead author of the study.

“Although our study did not directly test the impact of vitamin D supplementation, we believe our results suggest it may be possible that only moderate supplementation within a narrow range of serum calcidiol (the main vitamin D fraction in the blood) will be associated with the most positive results.”

Researchers conducted a study of 422,000 people aged 45 years or older, who underwent vitamin D blood assays.

More than 60 percent of the tested population had insufficient blood levels of vitamin D. Half of these subjects had severely low vitamin D levels which was associated with a 1.5 times increased risk of acute coronary morbidity or mortality.

Three percent of those tested had elevated vitamin D levels above 36 ng/mL, which was associated with a 1.13 times elevated risk of coronary morbidity or death.

“Supplementing the entire population may jeopardize those found within the upper-normal range, shifting them to levels that are beyond the range associated with the lowest morbidity rates,” said Dror.

“Although we could not assess the impact of Vitamin D supplementation, our results may suggest that such supplementation to increase vitamin D blood levels, with strict monitoring to avoid overload, may have a significant influence on public health. This hypothesis still needs to be assessed in intervention trials”

Other researchers working on the study include: Shmuel Meir Giveon of Tel-Aviv University in Israel; and Moshe Hoshen, Ilan Feldhamer, Ran Balicer and Becca Feldman of the Clalit Research Institute, Clalit Health Services in Israel.

The article, “Vitamin D Levels for Preventing Acute Coronary Syndrome and Mortality: Evidence of a Non-Linear Association,” appears in the May 2013 issue of JCEM.

About Endocrine Society

Founded in 1916, The Endocrine Society reports it is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 16,000 scientists, physicians, educators, nurses and students in more than 100 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Md. To learn more about the Society, and the field of endocrinology, see the web site at www.endo-society.org or Twitter at https://twitter.com/#!/EndoMedia.


Information Below on Vitamin D is from the Office of Dietary Supplements, National Institutes of Health

Vitamin D helps your body absorb calcium, which your bones need to grow. A lack of vitamin D can lead to bone diseases such as osteoporosis or rickets. Vitamin D also has a role in your nerve, muscle, and immune systems” according to the National Institutes of Health Office of Dietary Supplements.

You can get vitamin D in three ways: through your skin, from your diet, and from supplements. Your body forms Vitamin D naturally after exposure to sunlight. However, too much sun exposure can lead to skin aging and skin cancer. So many people try to get their vitamin D from other sources.

Vitamin D-rich foods include egg yolks, saltwater fish, and liver. Some other foods, like milk and cereal, often have added vitamin D.

You can also take vitamin D supplements. Check with your health care provider to see how much you should take. People who might need extra vitamin D include

   ●  Seniors

   ●  Breastfed infants

   ●  People with dark skin

   ●  People with certain conditions, such as liver diseases, cystic fibrosis and Crohn's disease

   ●  People who are obese or have had gastric bypass surgery

How much vitamin D do I need?

The amount of vitamin D you need each day depends on your age. Average daily recommended amounts from the Food and Nutrition Board (a national group of experts) for different ages are listed below in International Units (IU):

Life Stage

Recommended
Amount

Birth to 12 months

400 IU

Children 1–13 years

600 IU

Teens 14–18 years

600 IU

Adults 19–70 years

600 IU

Adults 71 years and older

800 IU

Pregnant and breastfeeding women

600 IU

Am I getting enough vitamin D?

Because vitamin D can come from sun, food, and supplements, the best measure of one's vitamin D status is blood levels of a form known as 25-hydroxyvitamin D. Levels are described in either nanomoles per liter (nmol/L) or nanograms per milliliter (ng/mL), where 1 nmol/L = 0.4 ng/mL.

In general, levels below 30 nmol/L (12 ng/mL) are too low for bone or overall health, and levels above 125 nmol/L (50 ng/mL) are probably too high. Levels of 50 nmol/L or above (20 ng/mL or above) are sufficient for most people.

By these measures, some Americans are vitamin D deficient and almost no one has levels that are too high. In general, young people have higher blood levels of 25-hydroxyvitamin D than older people and males have higher levels than females. By race, non-Hispanic blacks tend to have the lowest levels and non-Hispanic whites the highest. The majority of Americans have blood levels lower than 75 nmol/L (30 ng/mL).

Certain other groups may not get enough vitamin D:

   ● Breastfed infants, since human milk is a poor source of the nutrient. Breastfed infants should be given a supplement of 400 IU of vitamin D each day.

   ● Older adults, since their skin doesn't make vitamin D when exposed to sunlight as efficiently as when they were young, and their kidneys are less able to convert vitamin D to its active form.

   ● People with dark skin, because their skin has less ability to produce vitamin D from the sun.

   ● People with disorders such as Crohn's disease or celiac disease who don't handle fat properly, because vitamin D needs fat to be absorbed.

   ● Obese people, because their body fat binds to some vitamin D and prevents it from getting into the blood.

Can vitamin D be harmful?

Yes, when amounts in the blood become too high. Signs of toxicity include nausea, vomiting, poor appetite, constipation, weakness, and weight loss. And by raising blood levels of calcium, too much vitamin D can cause confusion, disorientation, and problems with heart rhythm. Excess vitamin D can also damage the kidneys.

The safe upper limit for vitamin D is 1,000 to 1,500 IU/day for infants, 2,500 to 3,000 IU/day for children 1-8 years, and 4,000 IU/day for children 9 years and older, adults, and pregnant and lactating teens and women. Vitamin D toxicity almost always occurs from overuse of supplements.

NIH: National Institutes of Health Office of Dietary Supplements

Where to find out more about vitamin D?

For general information on vitamin D:

   > Office of Dietary Supplements Health Professional Fact Sheet on Vitamin D

   > Vitamins, MedLinePlus

For more information on food sources of vitamin D:

   > U.S. Department of Agriculture (USDA) National Nutrient Database Web site

   > Vitamin D Content of Selected Foods, USDA

For more advice on buying dietary supplements:

   > Office of Dietary Supplements Frequently Asked Questions: Which brand(s) of dietary supplements should I purchase?

For information on the government's food guidance system:

   > MyPlate

   > Dietary Guidelines for Americans

 

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