Vitamin D is also often called vitamin D, and is one of the trace nutrients that have received special attention in recent years. In addition, bone relieving disorders have a significant impact on the health and movement of middle-aged and elderly people, so vitamin D and calcification related to this disease are more widely discussed. Some famous TV celebrities believe that many people lack vitamin D. They quote many articles that are beneficial to diseases and health. They suggest that people should supplement vitamin D to maintain health. However, another group of people say that overeating vitamin D will increase the risk of fractures and even increase the risk of certain diseases. The two sides seem to have their own reasons, but what is the actual situation? In order to give you a complete understanding of the relevant issues of vitamin D, the team will take you to re-understand this nutrient from the most complete scientific evidence, including the basic role of vitamin D, internal recognition process, recommended volume intake, how to replenish, and the problems that may be caused by overcharging.
Vitamin D should be supplemented? Please don’t worry, read this article carefully first, and then think about whether your situation should be supplemented. Some people may be very sufficient, just light the sun, some people may just replenish food, and it is true that some people may need to take extra from nutrient supplements! Before entering the topic, please look at the following points:
It is beneficial to bone health and helps absorb charcoal●There are few natural foods rich in vitamin D. If you want to supplement food, choose fish or mushrooms that take care of ultraviolet light!
●If a mother has no sun, few sun, elderly, and darker skin, it is more likely that vitamin D is more likely to be vitamin D. If the sun is lacking, the sun can be synthesized for the body's needs, but it is useless to use it through the glass
●After the sun, women should pay attention to the supplement of vitamin D + calcification products (calcification 1,000 mg and vitamin D 400 IU )
●Baby's breastfeeding time is extended or the amount of vitamin D in the mother's body is not large during pregnancy. You can consider that low vitamin D is related to the occurrence of certain diseases, but the causal relationship has not been confirmed yet
●Baby's supplementation may cause high blood calcification, causing blood vessels and tissue calcification, and then harm the heart, blood vessels and kidneys
What is vitamin D? What kind of role do you have in human body?
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Vitamin D (also known as vitamin D) is like vitamin A, E and K. Both are fat-soluble vitamins, which are easily dissolved in fat. Therefore, it is best to use oils when ingesting, so it is easier to absorb. But in nature, only a small number of foods contain vitamin D. So what should I do? Fortunately, when human skin contacts UV light with a specific wavelength, UVB with a wavelength range of 280-320 nanometers, it can develop the synthesis of vitamin D. In other words, this is a nutrient that can be produced by itself. In theory, as long as the sun is fully exposed to the body, the body can produce useful vitamin D for use throughout the body.
But in addition to being produced by the sunlight receiving ultraviolet light, food is also another source of vitamin D. There are two types of vitamin D from food. Usually, plants come from vitamin D2 (Ergocalciferol), while animals come from vitamin D3 (Cholecalciferol).
The mechanism of synthesis of vitamin D in the body
Next, let’s explain the mechanism of synthesis of vitamin D in the human body. On the skin and skin of the human body, when ultraviolet light is exposed to 7-Dehydrocolesterol, previtamin D3 will form, and then it will be converted to vitamin D3. However, no matter whether it is vitamin D2, D3, and skin-synthesised from food, it must be converted twice in the body to become physiologically active vitamin D.
The first occurrence occurs in the liver and will produce 25(OH)D after reaction; the second time in the kidney, the product is 1,25(OH)2D with physiological activity or 24,25(OH)2D without physiological activity. If there is a problem with the health of the liver or kidney, it may also affect the activation process of vitamin D.
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Understand how vitamin D is produced in the body. Next, we will introduce what roles and functions of vitamin D have in the body.
The efficacy and physiological effects of vitamin D
From the alias of vitamin D3, it can be known that it has something to do with calcium. Activated vitamin D can promote calcium absorption in the kidney and maintain proper blood calcium and phosphorus concentration, normalize bone mineralization, and prevent muscle twitching caused by hypoxia. When the body is insufficient, the bones will become thin, brittle or deformed. Vitamin D with enough can prevent children from suffering from rickets and osteomalacia in adults. Vitamin D and suitable calcification can protect older people together and prevent bone dysfunction.
Vitamin D has other uses in addition to its related functions.. Including regulating cell growth, neuromuscular and immune function, and reducing inflammation. In addition, vitamin D also adjusts the proteins of many gene codes, as well as the proliferation, differentiation, and apoptosis of some cells. Although the brain mentioned earlier is an organ that converts 25(OH)D into 1,25(OH)2D, in fact, some cells in the body have the ability to convert, such as macrophages, but the 1,25(OH)2D produced by the brain can be sent to the whole body for use, and the cells can only use it themselves (Ref. 2).
How to know if your internal vitamin D is high or low?
If you are a ripper or an adult with osteopathy, then we can probably know that you have vitamin D deficiency, but when there is no obvious symptoms, how should we know the condition of vitamin D in our body? Modern medicine uses blood tests to test 25(OH)D to understand the concentration of body vitamin D.
Just mentioned in the above vitamin D mechanism diagram, only 1,25(OH)2D is the physiologically active vitamin D, but why is the actual detection of 25(OH)D? This is because once 1,25(OH)2D is generated, it can only circulate in the blood for about 15 hours, and it is also affected by parathyroid hormone, calcin and salt phosphate, which has a greater change, so it is not suitable for cooperation as an evaluation index. So we settle for the second best and estimate the vitamin D status in the body with a concentration of 25(OH)D.
25(OH)D can reflect skin production or dietary vitamin D supplementation, and can be kept for about 15 days, which is a more stable indicator. However, the relationship between the concentration of 25(OH)D in the blood and the health status has not yet reached a consensus in science. At present, the possible relationship between the concentration of 25(OH)D and the health status should be specifically emphasized, which is a "possible" relationship, as shown in the table:
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What is the status of vitamin D in Taiwan? According to previous surveys, it doesn't seem very good. Based on the 2005– the national nutrition and health status change survey in 2008, the serum 25(OH)D concentration of nationals over 19 years old was found to be 18.1 ng/mL in the country, and more than 66% of the nationals were deficient (33 ng/mL); in addition, the participants' blood draw date was divided into four seasons, and the summer concentration was the highest (19.7 ng/mL) and the spring lowest (16.8 ng/mL). So no matter what, the rate of people who lack vitamin D in Chinese is relatively high.
Vitamin D What are the conditions that are prone to lack? What impact does it have on health?The lack of vitamin D is actually very similar to all nutritional concepts. A certain nutritional deficiency is nothing more than a few situations such as dietary deficiency, poor absorption, increased demand or increased excretion. Long-term consumption of less than recommended amounts, too little time to sunlight, inability to convert the kidneys to 25(OH)D is activated, or poor tract absorption of the kidneys, etc., may cause vitamin D deficiency. Below are the situations where vitamin D is more likely to be lacking?
In which ethnic groups are more likely to be lacking?
Babys who drink breast milk
Just born babies are rarely taken out of the sun, and vitamin D can only rely on breast milk or formula. The former depends on the mother's own condition. If the mother has a lot of vitamin D, the content of breast milk will be high (Ref. 3); while formula milk will consider the lack of vitamin D when designed. In order to avoid the situation where the baby has a lack of vitamin D, there are two things to pay attention to. First, the mother must have sufficient vitamin D; if the mother has a low concentration or is longer during breastfeeding, then the baby can be considered to supplement the vitamin D additionally.
The efficiency of skin synthesis of vitamin D by elderly people is worse than that of young people. In addition, many older people stay at home for a long time and lack of diet are all the reasons why older people are prone to lack vitamin D. 1999– In the 2000 Taiwan National Nursing Health Conditions Change Survey, the daily actual intake of vitamin D of Taiwan's elderly person was about 240-280 IU, which was less than 400 IU recommended intake. In addition, the blood concentration of 25(OH)D in the elderly in the United States with half of the fractures was less than 12 ng/mL.
Very few people with sunlight
There are not many foods containing vitamin D. If you usually eat less fish and mushroom foods, then those who stay indoors all day and don’t go out on holidays should pay attention.
The synthetic location of vitamin D is on the basal layer and spinal layer of the epidermis of the skin, and melanin that can absorb ultraviolet light is also distributed on the epidermis. A person with black skin means that there is more melanin in the epidermis. The more energy it is absorbed by melanin, the less energy it can be used to generate vitamin D3.
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Suffering from inflammatory kidney disease (IBS) and other diseases that cause fat malabsorption
Vitamin D is a fat-soluble nutrient that must be together with oil to have good absorption. People with IBS or fat malabsorption have been blocked from digestion of oil, which also affects the absorption of fat-soluble nutrients.
People with obese or who have had gastric surgery
BMI of more than 30 people have a lower blood concentration of 25(OH)D than those with normal weight. In other words, obese people will need to supplement more vitamin D than ordinary people. Obesity does not affect the ability of skin to synthesize vitamin D, which may be due to the relationship between subcutaneous fat that prevents vitamin D from being placed in the blood circulation.. In addition, people who have undergone gastric tract surgery have less absorption process in the upper part of the kidney, which affects the absorption of vitamin D.
The relationship between vitamin D and disease and health
From some epidemic studies or the physiological mechanism of vitamin D, people will expect this nutrient may bring us more health benefits. Below is a summary of vitamin D and various health problems and its possible effects. If the research method is too complicated, you can skip it. Just look at the rough conclusion:
Muscle function
Vitamin D It can promote the introduction of calcinia in muscle cells and can regulate genes to help muscle contraction and muscle cell proliferation. Past clinical studies have also found that people with rium disease and osteosis will also have proximal muscle diseases, so it is believed that vitamin D deficiency is related to abnormal muscle function.
Studies have found that daily supplementation of vitamin D has a positive effect on muscle function, and this effect is even more significant in elderly people with vitamin deficiency. Replenishing 1,000 IU Vitad per day is enough to exert efficacy, but continuous replenishment may not be able to exert this effect. (Ref. 4).
Bone Extrapulsion
Most Vitamin supplementation studies on bone health usually also supplement the calcification, so it is difficult to separate the effects. A review study published in Lancet believes that without the risk of vitamin D, it seems that there is no need to supplement vitamin D to prevent bone dysfunction (Ref. 5).
Cancer
Vitamin D and cancer are still widely studied, among which the more expected and concerned are the roles in kidney cancer, prostate cancer and breast cancer. According to the results of epidemiological research, the higher the concentration of 25(OH)D, the lower the incidence and mortality rate of 25(OH)D in the blood; the higher concentration of 25(OH)D in the blood is related to the lower risk of breast cancer development and death. However, the results of double-blind random clinical trials so far cannot support the results of the observational study.
As for prostate cancer, there is currently no sufficient evidence to support 25(OH)D and its incidence rate, but the results of an open clinical trial support 4,000 IU per day may inhibit the development of the disease. In short, based on current research evidence, we cannot know whether vitamin D supplementation can really prevent these cancers from occurring or delaying their progress (Ref. 6).
Other health problems
Vitamin D There are also related studies on diabetes, hypertension, insulin impedance, polyproliferative sclerosis and other diseases, but the current evidence cannot provide a clear answer.
How to replenish vitamin D? What if you add too much?Sun Sun
In fact, the sun sun alone can synthesize a sufficient amount of vitamin D. This system is very efficient in generating vitamin D. As long as the arm and face are shortly connected to the sun, it can produce a corresponding amount of 200 IU from food.
But you may be curious, if you start to experience sunlight, will your body continue to produce vitamin D, or even cause excessive amounts? According to research, vitamin D overdose poisoning occurs in a single sun. Some studies have found subjects living in Hawaii and found that after 28.9 hours of sunlight, the blood concentration of 25(OH)D in the blood increased to about 60 ng/mL and no longer increased (Ref. 7).
So how long does it take for us to breathe the sun to produce enough vitamin D? Some researchers suggest that the sun is sunny between 10 a.m. and 3 p.m. every day, at least 5-30 minutes, so that the body can synthesize enough vitamin D. However, the geographical location of the recommendation should be different from Taiwan. Because Taiwan has a lower strength and strong UV intensity, it is recommended that the sun be sunny between 9 a.m. to 10 a.m. or 3 a.m. to 4 p.m. to avoid damage. As mentioned earlier, the light that promotes skin synthesis into vitamin D is ultraviolet light, and in daily life some factors affect our contact with UVB:
●Weather: If the sky is covered with clouds, it can reduce UVB's energy by 50%, and severe air pollution by 60%.●Glass: UVB cannot penetrate ordinary glass, UVA can penetrate most of it. Stay indoors with sunlight through the glass window, no matter how you feel, you will not synthesize vitamin D. Instead, it will accelerate skin aging due to UVA.
●Sunproof lotion: A sunproof product with SPF greater than 8 can block UVB from skin synthesis of vitamin D. However, in fact, people usually don’t get enough sluggishness, and skin that is not enough or sluggish can still synthesize vitamin D.
UV light is the element that causes skin photoaging. So, don’t we let UV light damage during the process of synthesis of vitamin D in the sun? Interestingly, during the process of skin synthesis, UV light will also convert trans-urocanic acid into cis-urocanic acid, which has the ability to protect UV light and avoid DNA damage (Ref. 8); in addition, melanin cells will also synthesize melanin due to ultraviolet light exposure, allowing the skin to protect it the next time it is exposed to UV light. Although the skin of the human body has a protective mechanism, it can't be stopped by contacting too much ultraviolet light at once.
Vitamin D
The food contains very few foods, either you eat fish or mushrooms! Basically, as long as you eat these two types of food this day, you can easily achieve the daily reference intake of vitamin D. However, it should be noted that whether mushrooms are exposed to ultraviolet radiation will have a great impact on the content of vitamin D..
The following picture We include the irradiated UV and unirradiated mushrooms. The irradiated UV contains 732 IU of vitamin D for every 70 grams, while the unirradiated mushrooms have only 5 IU. But the problem is coming, how do we know if the mushrooms we buy are exposed to ultraviolet light? The answer is that I don’t know, I have to ask the source to know. So if you don’t bother eating fish or are not vegetarian, eating fish to supplement vitamin D is a more safe choice.
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Vitamin D Nutrition Replenishment
If you are not able to obtain enough vitamin D by sunshine or food, you may consider vitamin D's nutritional supplements. However, in Taiwan, the addition of vitamin D is subject to regulations. The details are as follows:
1. The shape-based capsule, skeleton and marked with limited daily consumption. In the daily consumption, the total content of vitamin D shall not be higher than 800 IU (20 micrograms).2. The total content of vitamin D in other general foods and baby foods in daily consumption or every 300 grams of food (not marked with daily consumption), shall not be higher than 15μg.
Based on the legal restrictions, the highest dose of vitamin D capsule products legally purchased in Taiwan is 800 IU per day. Outside, you can see higher doses of vitamin D products due to different regulations. Remember, Vitamin D supplements that exceed 800 IU/day can be taken back to Taiwan for sale by yourself, but it will be illegal.
Most vitamin D supplements are matched with various calculus. If you read them all the way from above, I believe you have probably guessed that the activated 1,25(OH)D can promote the absorption of calculus by the calculus in the small and small cells! That's right, that's the reason, so most products will be combined with "Vitamin D3 + Celsius", and then tell you that Vitamin D3 can help Celsius absorb! (To be honest, it is the vitamin D I eaten this time that can help the calcin absorption, not the calcination in this capsule or calcination.)
There is also a very important thing. Vitamin D is a fat-soluble vitamin. It must be taken with oil to absorb it easily. It is recommended to eat it after eating or with oil-rich foods.
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What side effects may be caused by eating too much vitamin D?
The side effects of taking too much vitamin D are not certain. Eating, weight loss, urinary urethritis and heart arrhythmia are all possible symptoms. The more serious situation is to increase blood concentration, calcification of blood vessels and tissues, and then damage the heart, blood vessels and kidneys. In addition, studies have found that women who have stopped taking 1,000 mg of calcin and 400 IU of vitamin D are associated with increased risk of kidney stones (Ref. 9).
How much vitamin D should I eat before I have a problem? Most studies support the toxicity of vitamin D between 10,000-40,000 IU/day, or the blood 25(OH)D concentration of 200-240 ng/mL. Although taking less than 10,000 IU of vitamin D per day is unlikely to have toxic symptoms, the Food and Nutrition Board, Institute of Medicine, National Academy of Sciences (simplified by FNB) noted that new evidence from national surveys, observational studies and clinical trials have been found that even if vitamin D is not consumed much, 25 (OH)D will be given in the long term. Higher concentration may also have a bad impact on health. The FNB believes that the concentration of 25(OH)D in the blood should not be as high as 50-60 ng/mL, even at a lower concentration of 30-48 ng/mL is related to all causes of death, cancer risks and cardiovascular events in certain areas, and more falls and fractures in older people. Research cited by
FNB found that taking 5,000 IU per day can make the blood 25(OH)D concentration reach 50-60 ng/mL. Based on this, the upper limit of tolerance for age 9 and above is 4,000 IU/day, and the upper limit of under age 9 is 1,000-3,000 IU/day. Taiwan's upper limit for tolerance is 2,000 IU/day for age 1 or above; 1,000 IU/day for age 1 or below.
Single Vitamin D In fact, it is not easy to overdose. It is very likely that you have eaten it before overdose, but you should still pay attention when eating fish liver oil or fish liver. What is really easy to cause vitamin D. The overload of the product is the replenishment product. Before replenishing, please fully understand the dose marks on the product and just take it in a suitable amount.
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Vitamin D and the drug
Replenishing Vitamin D may interact with several drug production. Here are some examples. If a person is taking the following medicines frequently, it is best to discuss with your doctor before replenishing vitamin D.
steroid
Corticosteroid drugs, such as prednisone, are usually used to prevent inflammation. They affect internal vitamin D tropism, thereby reducing calcification, resulting in bone loss, which may develop into osteoporosis after long-term use. Discuss with your doctor how to add vitamins to additionally.
Other drugs
Editative drugs orlistat (such as Roth) and lowering steroid drugs – cholestyramine (such as Questran® LoCholest® and Prevalite®) can reduce the absorption of vitamin D and other fat-soluble vitamins. If you usually have little sunlight, you will have a higher risk of vitamin D in the long run. It is recommended to increase the number of sunlight, or to supplement vitamin D. If you want to use medicine, you should change the meal..
When you see this, have you decided to go to the sun more, or eat more mushrooms to increase your vitamin D in your body? This is the case with all the concepts of nutrition, and it is not a good thing to be too good to be too rich! To master your health, start by filling your correct knowledge, a better routine and dietary habit! If you think this article is helpful to you, don’t forget to leave a thumbs up and share it with those in need!
Reference1.NIH – Office of Dietary Supplements – Vitamin D
2.Adams, J. S., & Hewison, M. (2010). Update in vitamin D. The Journal of Clinical Endocrinology & Metabolism, 95(2), 471-478.
3.Wall, C. R., Stewart, A. W., Camargo, C. A., Scragg, R., Mitchell, E. A., Ekeroma, A., et al. (2015). Vitamin D activity of breast milk in women randomly assigned to vitamin D3 supplementation during pregnancy. The American journal of clinical nutrition, ajcn114603.
4.Binkley, N., Novotny, R., Krueger, D., Kawahara, T., Daida, Y. G., Lensmeyer, G., … & Drezner, M. K. (2007). Low vitamin D status despite abundant sun exposure. The Journal of Clinical Endocrinology & Metabolism, 92(6), 2130-2135.
5.De Fabo EC, Noonan FP. Mechanism of immunocommune suppression by ultraviolet irradiation in vivo. I. Evidence for the existence of a unique photoreceptor in skin and its role in photoimmunology. J Exp Med1983;158:84–98.
6.Jackson, R. D., LaCroix, A. Z., Gass, M., Wallace, R. B., Robbins, J., Lewis, C. E., … & Bonds, D. E. (2006). Calcium plus vitamin D supplementation and the risk of fractures. New England Journal of Medicine, 354(7), 669-683.
7. Halfon, M., Phan, O., & Teta, D. (2015). Vitamin D: a review on its effects on muscle strength, the risk of fall, and frailty. BioMed research international, 2015.
8.Reid, I. R., Bolland, M. J., & Grey, A. (2014). Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis. The Lancet, 383(9912), 146-155.
9.Jacobs, E. T., Kohler, L. N., Kunihiro, A. G., & Jurutka, P. W. (2016). Vitamin D and colorful, breast, and prostate cancers: a review of the epidemic evidence. Journal of Cancer, 7(3), 232.
10.uptodate – Overview of vitamin D
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