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The D Element

December 24th, 2014

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The D Element

“Dee” in Thai means “good”. Coincidentally, vitamin D is good for the health, as it helps build and strengthen bones.

Vitamins in general cannot be generated by our body. We have to rely on food as vitamin sources. However, vitamin D is different from other vitamins, as our body can generate some of it through the skin via contact with sunlight.

Lately, many studies show that vitamin D, apart from strengthening bones, can also be beneficial in other ways. It can lower risks for some cancer, diabetes, high blood pressure and even weakened muscles in older people. Vitamin D can slow down the aging process of the muscles. These benefits are from studies done using supplementary vitamin D, which results in higher dosage of vitamin D compared to what people in general get.

The amount of vitamin D that the body generates also depends on many factors. People with darker skin can generate less vitamin D than those with light skin. Using sunscreen or covering the body with clothes can also make the skin less exposed to sunlight, and therefore the skin generates less vitamin D. In winter, for those living in colder countries, the skin generates less vitamin D because of less sunlight. Vitamin D is fat-soluble, so our body can keep it in the fat layer for later use.

Vitamin D-rich food includes fatty fish such as salmon, tuna and sardine. They are, unfortunately, not our local fish, but I suppose fatty parts of any fish would be beneficial too, such as the belly of silver pomfret or mackerel fish. Colder countries also have vitamin D-fortification in food such as milk, soy milk, orange juice and butter.

Formerly, it was stated that we should consume 200-400 IU of vitamin D per day. Nowadays, since its benefits have been more recognized, it is suggested that we should get 800-1,000 IU of vitamin D on a daily basis, especially for older people whose skin cannot generate vitamin D as effectively as before. Also, older people tend to get out less, and therefore they don’t get that much sun.

It was said that we should not receive more than 2,000 IU of vitamin D a day, but now it has been confirmed by experts that 10,000 IU a day wouldn’t be harmful to our body, especially when consumed with other vitamins and minerals. Suggested amount of vitamin D varies depending on age, sex and season. In cold countries during winter, there is not that much sunlight, so vitamin D should be consumed in higher dosage during that time. Some people have suggested measuring vitamin D in the blood for more accuracy, but the cost is quite high so it is only done in special cases, such as older people who feel weak for no reason and people with osteoporosis. If it is found that vitamin D level is too low, vitamin D should be consumed more. Increasing vitamin D intake by sunbathing might not be such a good idea as the skin can burn and it might even cause skin cancer, especially in fair-skinned people. After taking supplementary vitamin D, don’t forget to check up again to see whether it suffices.

A patient of mine is over 80 years old. His children and grandchildren took a good care of him, and by that I mean there was never any need for him to leave the house. However, he exercised in his gym at home. Every once in a while he would get some sun exposure. Later, he complained that his muscles felt weak. I first thought it was because of myocardial infarction which is common in older people. I tested his blood and found that vitamin D level was very low, so I told his children and grandchildren to give him more vitamin D. He came back a few months later, but the level didn’t improve. I asked them and found that they gave him multivitamin tablets, which had just a little amount of vitamin D.

After that, he received a special high dosage formula vitamin D supplement, until his vitamin D level came back up to a satisfactory level. He didn’t feel weak or tired anymore.

Before you take vitamin pills, don’t forget to look at the label to see whether they offer what you need, in the amount that you need!

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.

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