Vitamin D in the diet or supplements is measured in micrograms or International Units. Micrograms are a measurement of weight whereas IUs are a

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Amberly Porter
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Vitamin D in the diet or supplements is measured in micrograms or International Units. Micrograms are a measurement of weight whereas IUs are a measurement of activity.

2 Vitamin D in the diet or supplements is measured in micrograms or International Units. Micrograms are a measurement of weight whereas IUs are a measurement of activity. IUs were preferred in the past but currently micrograms are the most frequently used measurement. Levels of vitamin D in the blood are measured in nanomoles per litre with experts currently suggesting 100nmol/l to be optimal. 2

3 The major source of vitamin D in the UK is from unprotected exposure of the skin to the sun Sufficient exposure in the middle of the day during the summer months could potentially make around 10,000 IUs of Vitamin D 3

This is a diagrammatic representation of the levels of sunshine received in countries around the world - so if you look at the key at the bottom of the page you can see the sunshine categories.

4 This is a diagrammatic representation of the levels of sunshine received in countries around the world - so if you look at the key at the bottom of the page you can see the sunshine categories. The latitude for Great Britain is highlighted and show us in the moderate sunshine category during June July and August, low sunshine levels in late spring and early autumn and not enough sun to produce any vitamin D from Nov to Feb Look back at the key- we see that during those summer months we need between 20 and 60 minutes of sunshine every day, depending on how fair or dark skinned we are. But we have sunny winter days - Why can t we produce vitamin D then too? 4

5 Vitamin D is made by UVB rays, not UVA. The amount of UVB radiation available for vitamin D production depends on the angle at which the sun s rays strike the earth, the presence of clouds and pollution, buildings and altitude. In the UK we only receive UVB rays in the Spring and Summer so just being sunny doesn t mean you can make vitamin D. If your shadow is longer than you are tall then it is not possible to make any vitamin D. Because vitamin D is fat soluble the body is able to store up any excess production during the summer months but without a constant supply it will gradually decrease as the body uses it up. We will review summer sun exposure later in the presentation. 5

6 Vitamin D deficiency is a worldwide problem with a group of the worlds leading vitamin D scientists suggesting that between 40 and 75% of the world s population is deficient in vitamin D pdf 6

Not surprising then that we learn Vitamin D deficiency in Great Britain is common. Vitamin D experts recommend optimum levels for health to be 100-150nmol/L.

7 Not surprising then that we learn Vitamin D deficiency in Great Britain is common. Vitamin D experts recommend optimum levels for health to be nmol/L. Others have recommended a lower level of 75nmol/L but this study chart shows just how much vitamin D levels fluctuate during the winter and spring. Even if you take the 75nmol/L as being the blood level for optimal status, 90% of the UK population are affected by low D status throughout the year with January & February showing vitamin D at it s lowest. 7

8 For many years scientists have speculated why people are more susceptible to colds and flu in the winter time. We noted in the last graph that Vitamin D levels drop to their lowest level in February when the stores which the body built up from exposure to the sun in the previous summer, have declined. As vitamin D plays a vital role in immune cell function, it has been suggested that it is the low levels of vitamin D in winter that increases peoples susceptibility to flu. Research suggests that a minimum daily intake of 2200 IU of vitamin D3 is required to receive optimal benefits and maintain an adequate vitamin D blood level in adults. Vitamin D3 has been found to be 87% more effective than vitamin D2. 8

Nearly all the cells of the immune system have vitamin D receptors, and the antimicrobial proteins that fight viruses and bacteria are dependent on adequate levels of vitamin D.

9 Nearly all the cells of the immune system have vitamin D receptors, and the antimicrobial proteins that fight viruses and bacteria are dependent on adequate levels of vitamin D. Vitamin D also regulates the production of antimicrobial proteins and has an effect on T- Cells activation and attack. In this study, researchers found that supplementing with 1200 IU of vitamin D for 4 months provided a 74% reduction in the incidence of flu in children (6-15 yrs) who already had low vitamin D levels. But they even found a 40% reduction in flu incidences in those whose levels were considered adequate! In a separate large study of 19,000 people, those who had low levels of vitamin D were 40% more likely to have had a respiratory infection. However vitamin D does not work quickly it takes time to build up adequate stores in the body so consider vitamin D levels to be a long term strategy for immune health rather than a nutrient to supplement when you get a cold. 9

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11 I think we are convinced of the need to ensure our vitamin D intake is optimal particularly in the winter and spring but let s review some of the health conditions which may be affected by long term deficiency of vitamin D 11

12 Reports like this are a bit of a shock when we consider that rickets was a thing of the past and gone for good... but it seems not

13 Children are not the only people that can be affected adults are also susceptible to rickets, also known as Osteomalacia. If you went to the doctor with these symptoms, many would most likely diagnose you with either chronic fatigue syndrome or Fibromylagia

14 Conditions such as fibromyalgia, which were almost unheard of twenty years ago, have increased in recent years.....so perhaps a vitamin D test could shed some light on the cause of the symptoms. 14

As we age we generally expect to see a gradual decline in musculoskeletal function. From the age of 30 muscle mass begins to decrease and from the age of 50 this decrease speeds up further.

15 As we age we generally expect to see a gradual decline in musculoskeletal function. From the age of 30 muscle mass begins to decrease and from the age of 50 this decrease speeds up further. Vitamin D receptors are expressed in muscle tissue and research has found that this expression decreases with age. These factors, coupled with a reduced capacity to produce vitamin D from sunlight as we age, may potentially increase the risk of musculoskeletal problems. However these problems are not exclusively found in the elderly. Muscle pain, aching bones and feelings of weakness are symptoms experienced by people of all ages, particularly in Winter. 15

16 One in two people will develop osteoarthritis in at least one knee at some point in their lifetime. Osteoarthritis is characterised by the breakdown and loss of cartilage which can affect various areas of the body. Flare ups are also known to be more common and more severe in winter time and research is now showing a link between low sunlight exposure and low vitamin D levels with deterioration of joint cartilage and joint spacing. 16

Back pain is a huge problem for many people and again like vitamin D deficiency is another problem caused by our modern lifestyles and office jobs where we spend far to much time sitting at a desk in

17 Back pain is a huge problem for many people and again like vitamin D deficiency is another problem caused by our modern lifestyles and office jobs where we spend far to much time sitting at a desk in front of a computer. In addition to this lack of movement and postural issues, studies have shown that a high percentage of back pain sufferers had lower Vitamin D levels. One study showed that supplementation of vitamin D resulted in clinical improvement in 100% of patients who had been classified with abnormally low levels. 17

18 There are now 9 human studies that associate low vitamin D with low mood and depression, both of which we often associate with the winter. Here we see subjects with vitamin D levels below 40nmol/l showing higher depression scores. Perhaps this is not surprising in light of the sunshine charts we reviewed earlier and our inability to produce vitamin D during the winter months. In this study, supplementation of vitamin D at levels of 3000 and 6000IUs were tested against a placebo with both supplements groups seeing improved scores after 1 year - so improvement has come after several months of supplementing at higher levels. 18

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20 Recommended reading 20

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22 This as been the standard advice for safe sun exposure over recent years. Clearly the focus was on protecting the skin from the UV rays which may cause sunburn, photoageing and skin cancer but that advice has now changed. 22

$In this picture we see Gwyneth Paltrow, who was diagnosed with vitamin D deficiency at the very young age of 37, has osteoporosis and also experienced a fracture.$

23 Often people are concerned about exposing their skin to sunlight due to fears regarding premature ageing. And many make-ups and face creams now contain UV protection in line with this trend. In this picture we see Gwyneth Paltrow, who was diagnosed with vitamin D deficiency at the very young age of 37, has osteoporosis and also experienced a fracture. The doctors said she had some of the lowest vitamin D blood levels they had ever seen! Naturally pale it is quite likely she avoided sun exposure. She was also vegan so her diet would not have provided sufficient vitamin D either. 23

24 According to the Association of UK Dieticians, April 2016 Sunshine, not food, is where most of your vitamin D comes from. So even a healthy, well balanced diet, that provides all the other vitamins and goodness you need, is unlikely to provide enough vitamin D. So while we advocate a healthy nutrient rich diet as the base to lifestyle and supplement support, most people have a low dietary intake of vitamin D an average of 160 IU per day so the potential shortfall needs to be addressed. The major source of vitamin D in the UK is from unprotected exposure to the sun. 24

There are actually 6 skin types but to keep this simple we are just going to review 3 in the example just to demonstrate what a huge difference there is in vitamin D production depending on the type

25 There are actually 6 skin types but to keep this simple we are just going to review 3 in the example just to demonstrate what a huge difference there is in vitamin D production depending on the type of skin you have. People with pale skin are able to make vitamin D more readily but can often burn more easily and can potentially be at greater risk of skin cancer,... whereas if you have darker skin making vitamin D is going to require increased exposure but you are a lot less likely to burn. These are just rough guidelines and obviously everyone s skin responds individually to exposure to sunlight. 25

26 The key is to receive unprotected sun exposure according to your skin colour between the hours of 11am and 3pm when UVB is usually strongest. Cancer Research UK and the National Osteoporosis society are 2 of the bodies recommending the little and often approach to sun exposure for health benefits... so in between repeated exposure times... be sensible and cover up to avoid skin damage like sunburn. 26

27 How much Vitamin D you need to supplement can best be determined by knowing your starting point. A Blood serum test to determine your vitamin D levels will give you a good reading from which to start so ask your GP or look online for a hospital which will do the test for you at a small charge. This table suggests the amount of vitamin D you would need to take based on your existing vitamin D levels. So for example, if your blood serum levels were 50nmol/l and you were looking to achieve the optimal level of 100nmol/l then you would need to supplement 2600IUs of vitamin D per day and retest in 3-6mths 4000IUs daily is considered to be the safe upper limit for adults but higher dosages should be monitored with regular blood testing from the doctor. One particular study suggests that the majority of people require a daily intake of 2200 iu to maintain optimal vitamin D levels. 27

To give you an idea of what to expect, this case study was actually done by a doctor on himself and he was shocked by the low vitamin D levels at 33nmol/l he

28 To give you an idea of what to expect, this case study was actually done by a doctor on himself and he was shocked by the low vitamin D levels at 33nmol/l he started taking 3000IUs daily and retested after 3 months. They had increased to 73nmol/l a much healthier level but with some room for continued improvement. 28

The sun was once the most important source of vitamin D but modern life has changed that and supplements are now the only realistic way for specific groups of people to ensure adequate vitamin D

29 The sun was once the most important source of vitamin D but modern life has changed that and supplements are now the only realistic way for specific groups of people to ensure adequate vitamin D levels all year round. If you are interested in taking a vitamin D supplement Solgar have various different strengths such as 400 and 600 IU suitable for children and 1000, 2200 and 4000 IU for adults. There is also a liquid version which allows you some adjustment in your dosing if you prefer. There are two forms of vitamin D available. Our products are mostly vitamin D3 which is the active form of vitamin D and has been shown to be 87% more effective than vitamin D2. There are also 3 Hero products within the Solgar range for which vitamin D3 is a key nutrient. 29

Ultimate Bone Support contains all the key elements for optimal bone health with the obvious deliberate exclusion of phosphorus because the diet usually more than covers our requirements and excess

30 Ultimate Bone Support contains all the key elements for optimal bone health with the obvious deliberate exclusion of phosphorus because the diet usually more than covers our requirements and excess phosphorus levels disrupt the ratio with calcium. Minerals like calcium and magnesium are bulky contents and in this product, are required to be at higher levels so the Ultimate Bone Support is formulated as a 4 a day product The vitamin D is the more bioavailable D3 form and provides 1000IUs Some minerals are particularly difficult to absorb in non-organic form when there is low stomach acid. As we age we may find that our ability to produce stomach acid or other digestive secretions is weakened. The minerals listed here are all in highly bioavailable forms and are either already attached to proteins and therefore don t require stomach acid for chelation e.g. bisglycinates or they are in organic bonds which break easily to allow the mineral to chelate to proteins in the diet i.e. malates and citrates. The vitamin K is K2 for maximum bioavailability and extended application to the cells as it stays active in the body for over 72 hours. And 65ug is an excellent daily dose Other products to recommend with Ultimate BoneSupport include 30

31 Vitamin D3 depending on need Ester-C - helps bone matrix Whey to Go protein to assist strong muscles to prevent falling and proteins for collagen matrix of bones Solgar 7 to help protect bones by protecting cartilage and synovial fluid Collagen Hyaluronic acid Complex strengthening of connective tissue of joint plus support of collagen matrix of bones (osteoid matrix) 30

32 If a woman is a menopausal or post-menopausal then maintaining healthy bones is likely to be one of her health objectives. The 3 a day VM Prime for Women is specifically formulated with her in mind and provides a comprehensive range of nutrients with higher levels of Calcium and magnesium than many multiples, but no iron as monthly loss of iron during menstrual bleeding is reduced or ceased. We find the expected nutrients like B vitamins, selenium and zinc but also vitamin D3 and K2, both presented in highly bioavailable forms for maximum potential for calcium metabolism Other products to recommend with VM Prime for Women include UBS for bones BUT be careful due to overlap in minerals. Check the calcium, magnesium, vitamin D3 and K2 levels and adjust dosages Botanical Female complex both a formulated for women around the menopause. Lifenol hops extract has shown benefits to bone density as well as helping reduce menopausal symptoms. Wild Alaskan Salmon Oil nice range of omega 3,6,7,9 for health and wellbeing Cranflora urinary tract support, anti-bacterial Balance Rhodiola for support during stress, may help mood and cognitive function, endocrine homeostasis 31

The Beta Glucans Elderberry complex contains ingredients shown in research to support normal immune system function during periods where the body could be susceptible to developing illness such as

33 The Beta Glucans Elderberry complex contains ingredients shown in research to support normal immune system function during periods where the body could be susceptible to developing illness such as during the winter months or during stressful periods. Vitamin D has been a focus of research surrounding the immune system due to it s link with immune function. This includes a report which showed a link between vitamin D levels below 40nmol and an increased occurrence of upper respiratory tract infections. Other products to recommend with Beta Glucans Elderberry Complex include Balance Rhodiola stress affects immune system Ester-C - additional vitamin C is helpful as water soluble; connective tissue strength and stability against viruses; high levels found in white blood cells. Super Cod Liver oil provides Omega 3s for cell membrane strength and vitamin A to support mucosal membranes including throat and mouth. Zinc lozenges - commonly deficient nutrient, key for immune function, sucking lozenges helps coat throat. Multivitamin and mineral nutrient support for immune cell function 32

34 Thank you for joining us for this review of Vitamin D 33

How The Skin Tans. How The Skin Tans

How The Skin Tans. How The Skin Tans How The Skin Tans How The Skin Tans Our natural skin colour is determined by skin pigment melanin and the presence and amount of melanin in an individual is determined by hereditary factors. When our skin