My 38-year-old patient is concerned. Osteoporosis runs in her family, i.e. bones that lose stability over time – one of the reasons: is not enough vitamin D. The saleswoman is now concerned that she too could be in short supply of this vitamin. “Is there a way to control that?” she asks.
The sunshine vitamin
We absorb most of the vitamins exclusively through our food. It’s different with vitamin D! Only a maximum of 20 percent of the daily requirement is naturally covered by nutrition, the rest can be made by the body itself. When the sun’s rays hit our top layer of skin, vitamin D is converted from cholesterol with the help of UV-B radiation.
The problem: Unfortunately, here in Germany we usually only have enough of it in the sunlight around midday in the summer. In addition, vitamin D formation decreases over the years. This is why older people in particular often develop a deficiency.
Why do we need vitamin D?
The effects of vitamin D on the organism are only partially understood. What is certain is that it is needed to deliver strengthening calcium to the bones. Vitamin D also strengthens the immune system: if the body lacks the vitamin, the T cells, the so-called killer cells of the immune system, cannot work properly.
It is also undisputed that vitamin D stimulates and controls the production of various hormones. Therefore, a connection between vitamin D deficiency and cancer, cardiovascular diseases, dementia, and depression is discussed again and again.
When is there a shortage?
Although the liver can store the vitamin D formed in summer sunlight for about half a year, the level in many people is still too low in winter. Between 35 to 60 nanograms per milliliter of blood are considered optimal.
If the level falls below 20, one speaks of a deficiency. In my patient, I even measure only 15 nanograms per milliliter. So her feelings didn’t deceive her.
I advise my patient to take 20,000 units of vitamin D per week for eight weeks – as tablets. And best of all in combination with a fatty meal, because that improves absorption.
Then we should check the vitamin D level again. The reason: Vitamin D is fat-soluble. An overdose is therefore possible – there is a risk of kidney damage, among other things! Even if you keep hearing different things…
Does the register pay for that?
Unfortunately, the control of the vitamin D level (without concrete indications) is not covered by health insurance and costs around 30 euros. The therapy is only paid for if there is an actual deficiency.
So that my patient does not slip into a deficiency again after the treatment, I recommend her a daily intake of 1,000 to 2,000 units of vitamin D. At least until summer…