Vitamin D and Me: Sharing Lessons I Learned

Balance blog vitamin dThis is the first in a series of blog entries from Avera Medical Group Certified Nurse Midwives.

Recently I was told I had a vitamin D deficiency, I was in shock. I had been living in Southern Georgia, where we had an average of 214 days of sunshine a year. Although I work many hours as a midwife, I thought I was getting some sunshine. Apparently I wasn’t getting enough vitamin D.

Who is at risk

Your body makes vitamin D when it is exposed to the sun, and this is actually the easiest, most efficient way to get it. But you have to get about 20 minutes of sun a day to absorb the vitamin D you need. If you’re not getting that sunshine time, you could be deficient.

Age and skin tone also impact insufficient vitamin D as well. The older we get, the less our kidneys convert vitamin D into its active form. People with obesity, Crohn’s disease, cystic fibrosis and celiac disease also face risk because their intestines do not absorb vitamin D effectively. Vegetarians can also suffer vitamin D deficiency, and when they are pregnant, their children can be as well.

Why deficiency matters

Numerous studies show links between high vitamin D levels and reduced breast cancer risk, especially estrogen-sensitive breast cancer. Depression, schizophrenia, high blood pressure and congestive heart failure – studies have shown a lack of vitamin D can make all of these serious conditions worse. Since it helps promote calcium absorption in the stomach, vitamin D can prevent osteoporosis.

Vitamin D and pregnancy

I wish I would have had my vitamin D level checked when I was pregnant; I was constantly tired and had muscle aches, which can be symptoms of vitamin D deficiency. The American Congress of Obstetricians and Gynecologists believe there is “insufficient evidence” to test every pregnant woman. Some experts say up to 1,000-2,000 International Units (or IU) daily is safe during pregnancy for a deficiency, while others recommend 600 IUs daily. The best approach is to ask your midwife or obstetrician.

Steps if you’re deficient

Adults who are vitamin D deficient are recommended to take 50,000 IUs of vitamin D2 or D3 once a week for six weeks followed by another blood test. Some providers will recommend 2,000-4,000 IUs daily for six weeks and then re-evaluate. For women with obesity, have malabsorption syndromes or who use certain medications, a higher dose may be needed.

Preventing deficiency

Spend 20 minutes in the sun, or you consider buying a UVB light if you don’t get a lot of sunlight exposure. My sister uses one, and says it’s been the only thing to help raise her vitamin D level to normal as diet and supplements did not work.

You can try some dietary sources such as milk fortified with vitamin D, or proteins like eggs, meats, nuts, soy and seeds, as well as fatty fish like salmon, mackerel and tuna. For some people, a supplement is best, and the daily allowance for women ages 19-70 is 600 IUs daily, including during pregnancy.

My hope is that as we continue to discover the vast number of important health benefits this nutrient has on our bodies, the more we will incorporate it into our daily lives.

Courtney-Maree Heynen, BSN, MSN

By Courtney-Maree Heynen, BSN, MSN

Certified Nurse-Midwife at The Women's Center at Avera McKennan

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