Are You Getting These Nutrients? - Part 13

Vitamin A is a fat-soluble vitamin that has several important functions in the body.

• It helps cells reproduce normally, a process called cellular differentiation.
• It is essential for good vision. The first sign of a vitamin A deficiency is often poor sight at night.
• It is needed for the proper development of an embryo and fetus.

Vitamin A helps keep skin and mucous membranes that line the nose, sinuses, and mouth healthy. It also plays a role in - immune system function, growth, bone formation, reproduction, and wound healing.

Vitamin A comes from two sources. One group, called retinoids, comes from animal sources and includes retinol. The other group, called carotenoids, comes from plants and includes beta-carotene. The body converts beta-carotene to vitamin A. Major carotenoids, including lycopene, lutein, and zeaxantuin, have important biological properties, including antioxidant and photoprotective activities.

It is rare in the developed world to have a serious deficiency of vitamin A. Symptoms include - dry eyes, night blindness, diarrhea, and skin problems.

While vitamin A is essential for good health, it can be toxic in high doses. Never take more than the recommended daily allowance without first talking to your doctor.

Vitamin A in the form of retinyl palmitate is found in - beef, calf, and chicken liver, eggs, fish liver oils, and dairy products, including whole milk, whole milk yogurt, whole milk cottage cheese, butter, and other cheeses.

The body can also make vitamin A from beta-carotene and other carotenoids, which are fat-soluble nutrients found in fruits and vegetables that give them their color. Most dark-green leafy vegetables and deep yellow/orange vegetables and fruits, sweet potatoes, carrots, pumpkin and other winter squashes, cantaloupe, apricots, peaches, and mangoes, contain substantial amounts of beta-carotene. By eating these beta-carotene-rich foods, you can increase levels of vitamin A in your body.

Vitamin A supplements are available as either retinol or retinyl palmitate. Tablets or capsules are available in a variety of doses. The tolerable upper limit, or safe upper limit, is 10,000 IU. For any dose close to that amount, a doctor should help you determine the amount to take. Most multivitamins contain the recommended dietary allowance (RDA) for vitamin A.

Unlike vitamin A, beta-carotene does not build up in the body. However, there is some evidence that high doses of beta-carotene can carry some risk. Talk to your doctor before taking more than the recommended amount.

Vitamin A is absorbed along with fat in the diet. Take it with food.

Studies often use high doses of vitamin A. However, such high doses can be toxic. A doctor should monitor any high-dose therapy (any dose approaching the level of 10,000 IU for an adult, or above the recommended daily allowance for a child).

Daily dietary intakes for vitamin A are:

Adult

• Men, 19 years and older: 900 mcg
• Women, 19 years and older: 700 mcg
• Pregnant women, 14 to 18 years: 750 mcg
• Pregnant women, 19 years and older: 770 mcg
• Breastfeeding women, 14 to 18 years: 1,200 mcg
• Breastfeeding women, 19 years and older: 1,300 mcg

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable doctor.

Taking too much vitamin A when you are pregnant can cause serious birth defects. Because all prenatal vitamins contain some vitamin A, you should not take a separate vitamin A supplement.

Synthetic vitamin A can cause birth defects. Women who are pregnant or trying to become pregnant shouldn't take this form of vitamin A.

Too much vitamin A is toxic and can cause liver failure, even death. Symptoms of vitamin A toxicity include – headache, fatigue, muscle and joint pain, dry skin and lips - dry or irritated, nausea or diarrhea, and hair loss.

Vitamin A from foods is considered safe. However, you can get too much from supplements. For adults, 19 and older, the tolerable upper limit for vitamin A is 10,000 IU per day. Talk to your doctor before taking any dose close to that amount.

People who have liver disease or diabetes should not take vitamin A supplements without their doctor's supervision.

Smokers and people who drink heavy amounts of alcohol should not take beta-carotene supplements.

Both vitamin A and beta-carotene may increase triglycerides, which are fats in the blood. They may even increase the risk of death from heart disease, particularly in smokers.

Vitamin A is found in many different vitamin formulas. Supplements that say "wellness formula," "immune system formula," "cold formula," "eye health formula," "healthy skin formula," or "acne formula," all tend to contain vitamin A. If you take a variety of different formulas, you could be at risk for too much vitamin A.

If you take large doses of vitamin A, you may want to avoid eating carob. It increases the amount of vitamin A available in your body.

Are You Getting These Nutrients? - Part 12

Choline

http://bobsdiabetes.blogspot.com/2012/08/nutrients-choline.html

http://bobsdiabetes.blogspot.com/2015/12/more-about-egg.html

I would urge you to read the first blog above as to write more would duplicate that blog.

With that, I will move to the next nutrient – Niacin or Vitamin B3.

http://bobsdiabetes.blogspot.com/2015/04/statins-up-risk-for-type-2-diabetes_25.html

http://bobsdiabetes.blogspot.com/2011/12/risks-of-excess-vitamins-and-other.html

Vitamin B3 is one of eight B vitamins. It is also known as niacin (nicotinic acid) and has 2 other forms, niacinamide (nicotinamide) and inositol hexanicotinate, which have different effects from niacin.

All B vitamins help the body convert food (carbohydrates) into fuel (glucose), which the body uses to produce energy. These B vitamins often referred to as B-complex vitamins, also help the body use fats and protein. B-complex vitamins are needed for a healthy liver, healthy skin, hair, and eyes, and to help the nervous system function properly.

Niacin also helps the body make various sex and stress-related hormones in the adrenal glands and other parts of the body. Niacin helps improve circulation, and it has been shown to suppress inflammation.

You can meet all of your body's needs for B3 through diet. It is rare for anyone in the developed world to have a B3 deficiency. In the U.S., alcoholism is the main cause of vitamin B3 deficiency.

Symptoms of mild B3 deficiency include – indigestion, fatigue, canker sores, vomiting, poor circulation, and depression. Severe deficiency can cause a condition known as pellagra. Pellagra is characterized by cracked, scaly skin, dementia, and diarrhea. It is generally treated with a nutritionally balanced diet and niacin supplements. Niacin deficiency also causes burning in the mouth and a swollen, bright red tongue.

The best food sources of vitamin B3 are – beets, brewer's yeast, beef liver, beef kidney, fish, salmon, swordfish, tuna, sunflower seeds, and peanuts. Bread and cereals are usually fortified with niacin. In addition, foods that contain tryptophan, an amino acid the body coverts into niacin include poultry, red meat, eggs, and dairy products.

Vitamin B3 is available in several different supplement forms:

• Niacinamide
• Niacin
• Inositol hexaniacinate.

Niacin is available as a tablet or capsule in both regular and timed-release forms. The timed-release tablets and capsules may have fewer side effects than regular niacin. However, the timed-release versions are more likely to cause liver damage. Regardless of which form of niacin you are using, doctors recommend periodic liver function tests when using high doses (above 100 mg per day) of niacin.

Generally, high doses of niacin are used to control specific diseases. Such high doses must be prescribed by a doctor who will increase the amount of niacin slowly, over the course of 4 to 6 weeks. Take niacin with meals to avoid stomach irritation.

Daily recommendations for niacin in the diet of healthy individuals are:

Adult

• Men, 19 years and older: 16 mg (RDA)
• Women, 19 years and older: 14 mg (RDA)
• Pregnant women: 18 mg (RDA)
• Breastfeeding women: 17 mg (RDA)

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable doctor. Side effects may include diarrhea, headache, stomach discomfort, and bloating.

High doses (50 mg or more) of niacin can cause side effects. The most common side effect is called "niacin flush," which is a burning, tingling sensation in the face and chest, and red or flushed skin. Take an aspirin 30 minutes before the niacin may help reduce this symptom.

At very high doses, used to lower cholesterol and treat other conditions, liver damage and stomach ulcers can occur. Your doctor will regularly check your liver function through a blood test.

People with a history of liver disease, kidney disease, or stomach ulcers should not take niacin supplements. Those with diabetes or gallbladder disease should do so only under the close supervision of their doctors.

Stop taking niacin or niacinamide at least 2 weeks before a scheduled surgery.

Niacin and niacinamide may make allergies worse by increasing histamine.

People with low blood pressure should not take niacin or niacinamide because they may cause a dangerous drop in blood pressure. DO NOT take niacin if you have a history of gout.

People with coronary artery disease or unstable angina should not take niacin without their doctor's supervision, as large doses can raise the risk of heart rhythm problems.

Taking any one of the B vitamins for a long period of time can result in an imbalance of other important B vitamins. For this reason, you may want to take a B-complex vitamin, which includes all the B vitamins.

Are You Getting These Nutrients? - Part 11

Vegetarians: Naturally, the whole picture shifts for vegetarian and vegan low-carbers, who are limiting their diets even more. In addition to the nutrients in the previous blogs, watch intake of vitamin B12, choline, niacin, vitamin A, and zinc.

For vitamin B12, I have listed several of the blogs I have written for you to examine.

Vitamin B12

http://bobsdiabetes.blogspot.com/2015/09/b12-deficiency-silent-epidemic-part-1.html

http://bobsdiabetes.blogspot.com/2015/09/b12-deficiency-silent-epidemic-part-2.html

http://bobsdiabetes.blogspot.com/2014/12/more-on-importance-of-vitamins-b12-and.html

http://bobsdiabetes.blogspot.com/2012/12/nutrients-vitamin-b12.html

http://bobsdiabetes.blogspot.com/2011/12/risks-of-excess-vitamins-and-other.html

http://bobsdiabetes.blogspot.com/2014/01/joint-january-meeting.html

http://bobsdiabetes.blogspot.com/2015/01/two-topics-for-our-january-meeting-part_12.html

Vitamin B12, also called cobalamin, is one of eight B vitamins. All B vitamins help the body convert food (carbohydrates) into fuel (glucose), which is used to produce energy. These B vitamins often referred to as B complex vitamins, also help the body use fats and protein. B complex vitamins are needed for healthy skin, hair, eyes, and liver. They also help the nervous system function properly. All B vitamins are water soluble, meaning that the body does not store them.

Vitamin B12 is an especially important vitamin for maintaining healthy nerve cells, and it helps in the production of DNA and RNA, the body's genetic material. Vitamin B12 works closely with vitamin B9, also called folate or folic acid, to help make red blood cells and to help iron work better in the body. Folate and B12 work together to produce S-adenosylmethionine (SAMe), a compound involved in immune function and mood.

Vitamins B12, B6, and B9 work together to control blood levels of the amino acid homocysteine. High levels of homocysteine are associated with heart disease. However, researchers are not sure whether homocysteine is a cause of heart disease or just a marker that indicates someone may have heart disease.

It is rare for young people to be deficient in vitamin B12, but it is not uncommon for older people to be mildly deficient. This may be because their diets are not as healthy, or because they have less stomach acid, which the body needs to absorb B12. Low levels of B12 can cause a range of symptoms including – fatigue, shortness of breath, diarrhea, nervousness, numbness, and tingling sensation in the fingers and toes.

Severe deficiency of B12 causes nerve damage.

Others at risk for B12 deficiency include:

• Vegans and vegetarians who do not eat dairy or eggs, since vitamin B12 is found only in animal products
• People with problems absorbing nutrients due to Crohn's disease, pancreatic disease, weight loss surgery, or medications
• People who are infected with Helicobacter pylori, an organism in the intestines that can cause an ulcer. H. Pylori damages stomach cells that make intrinsic factor, a substance the body needs to absorb B12
• People with an eating disorder
• People with HIV
• People with diabetes
• The elderly

Folic acid (vitamin B9), especially when taken in high doses, can mask the symptoms of a vitamin B12 deficiency. The danger is that without symptoms, someone with a vitamin B12 deficiency may not know it, and could run the risk of developing nerve damage. You should talk to your doctor first if you plan to take more than 800 mcg of folic acid, to make sure you do not have a B12 deficiency.

Other good information can be found in this blog of mine:

http://bobsdiabetes.blogspot.com/2012/12/nutrients-vitamin-b12.html

Are You Getting These Nutrients? - Part 10

The advice following is very specific and should be followed. Vitamin Pills Vs Food: “It's very tempting when reading a list like this to think, "I'll just take a vitamin pill". I don't think this is a good conclusion to leap to. Why? Because we are finding out there are many nutrients in foods that we either didn't know about before, or that work together with the vitamins we know about. For example, scientists have now discovered tens of thousands of phytonutrients in the plant foods we eat, and we don't begin to understand the complexities of how they all interact and work together. There's evidence that there could be a similar situation with animal foods, although there isn't as much science in that area.”

Deficiencies vs. Dietary Intake: “I'm aware that there is a difference between having a diagnosed condition from a nutrient deficiency (e.g. rickets) vs. having a low blood level of a nutrient vs. not getting the recommended amounts in your diet. This article is strictly talking about the latter.”

How Laura Dolson Drew up This List: “The general "inadequate intake data" is from various scientific sources, including a study which looked at the intake of certain nutrients people were consuming before and during weight-loss diets (the A-Z Diet Study). I found their "baseline data" (before the diets started) to be illuminating, as, for example, most people were not eating enough vitamin E even before embarking on a weight-loss diet. Also, I drew on my own experience in designing low-carb menus which cover all the daily nutrient needs.”

Less-Studied Nutrients: “There are micronutrients which have been getting study and attention more recently that there isn't a lot of data for, with respect to how prevalent inadequate intake is. These include vitamin K2 and choline. This doesn't mean they aren't important, just that I don't know how much of a problem they are. (Educated guess is that low-carb diets would not tend impact those two particular nutrients adversely in most people, as some of the main sources are animal foods, e.g. egg yolks for choline.) Also, we have less information about the phytonutrients.”

Tim asked to come over after reading through this information. He said that he had some learning to do and now understood why I liked my cousin for nutrition. He said that they take a look at the nutrients and food and then try to give us the suggestions for foods that will replenish what we might be missing. I said that I am tested for most of the vitamins and minerals on the list and except for vitamin B12; none of the rest is suggested for supplements. Several years prior, I had been told to take a B complex pill for four weeks and then stop. My cousin knows my history and looks over my VA lab results to suggest food changes.

Tim asked if it would be a good idea to discuss this will all the new members and review this with the long-term members. I agreed and added that we should list my blogs and the sources of information and email this to all members or have a printed list to hand out. Tim agreed and we need to discuss with the members that if they haven't been tested for some of the vitamins and minerals in the blogs, then they should consider this and have the lab results available to either Suzanne or Allison to aid them in suggesting foods they should add to their food plan.

I asked Tim if he had done this in the past and he said no, but he always had the list of foods eaten each day available for them. He added that have some tests done needs to be suggested after he discusses this with both Suzanne and Allison. I suggested that he send a list of my blogs and the sources for their consideration and possible addition to the list. Tim agreed and said he would do this because of my cataract problem. I thanked him and said we still have the list for vegetarians and vegans. He said he would make sure to add the items to the list, because he did not want to wait too much after this blog was posted.

I said that for a few of them I might have copies for him to email if he wanted. Tim added that several blogs were longer than normal, but he could understand with the information we both wanted in them. We had discussed several of them after he had copies.

Are You Getting These Nutrients? - Part 9

Our bodies use calcium in so many ways; it's hard to list them all. Of course, we know about bone health. It's also vital for the functioning of our muscles and nerves, and maintaining the correct acid/base balance.

Low-carb sources include dairy products, sardines, canned salmon, tofu, and (as in almost everything) greens.

Calcium is the most abundant mineral in your body. It is essential for the development and maintenance of strong bones and teeth, where about 99% of the body's calcium is found. Calcium also helps the heart, nerves, muscles, and other body systems work properly. It is probably best known for helping prevent osteoporosis.

Your body needs several other nutrients in order for calcium to be absorbed and used properly, including magnesium, phosphorous, and especially vitamins D and K. Many factors, including age, disease states, and medications, can affect calcium absorption. Carbohydrates may enhance calcium absorption while coffee and cigarette smoke may impede it.

The best way to get calcium is through food. Many foods are fortified with calcium. But, some people may need to take calcium supplements to get the recommended amount. It is especially important for children to get enough calcium in their diets as they are growing and forming bone, and for older people as they start to lose bone.

Postmenopausal women, people who consume large amounts of caffeine, alcohol, or soda, and those who take corticosteroid medications may need calcium supplements. Calcium deficiency can be found in people who don't absorb enough calcium, as can happen with Crohn's disease, celiac disease, and some intestinal surgeries.

The richest food sources of calcium include:

• Cheeses, such as Parmesan, Romano, gruyere, cheddar, American, mozzarella, and feta
• Low-fat dairy products, such as milk and yogurt
• Tofu
• Blackstrap molasses

Other good sources of calcium include – almonds, brewer's yeast, bok choy, Brazil nuts, broccoli, cabbage, dried figs, kelp, dark leafy greens (such as dandelion, turnip, collard, mustard, kale, and Swiss chard), hazelnuts, oysters, sardines, and canned salmon.

Foods that are fortified with calcium, such as juices, soy milk, rice milk, tofu and cereals, are also good sources of this mineral.

There are many forms of calcium available as dietary supplements. They differ in the amount of calcium they contain, how well the body absorbs them, and how much they cost. The two most popular forms are calcium citrate and calcium carbonate.

• Calcium citrate: Easily absorbed and digested by the body. It does not contain as much elemental calcium -- the amount your body actually absorbs -- as calcium carbonate. It is more expensive than calcium carbonate. Also, calcium citrate should not be used with aluminum-containing antacids.
• Calcium carbonate: Less expensive than calcium citrate and contains more elemental calcium. Requires a certain amount of stomach acid to be absorbed. So, it is usually taken with a glass of orange juice. Many antacids contain calcium carbonate.

Avoid calcium supplements that are derived from oyster shells, dolomite, and bone meal as they may contain lead, a toxic metal that can harm the brain and kidneys, cause anemia, and raise blood pressure.

Calcium supplements should be taken in small doses (no more than 500 mg at a time) during the day with 6 to 8 cups of water to avoid constipation.

The following are daily dietary recommendations from the Institute of Medicine.

Adult

• 19 to 50 years: 1,000 mg
• Women 51 years and older: 1,200 mg
• Men 51 to 70 years: 1,000 mg
• Men older than 70: 1,200 mg
• Pregnant and breastfeeding women under 19 years: 1,300 mg
• Pregnant and breastfeeding women 19 years and older: 1,000 mg

For prevention of colon cancer, some researchers recommend 1,800 mg per day. Speak with your doctor to determine the right dose for you.

Take dietary supplements only under the supervision of a knowledgeable doctor since there is a potential for side effects. Total calcium intake, from combined dietary and supplemental sources, should not exceed 2,500 mg per day.

Side effects can include constipation and stomach upset. Very high doses can cause nausea, vomiting, loss of appetite, increased urination, kidney damage, confusion, and irregular heart rhythm.

People with hyperparathyroidism, kidney failure, sarcoidosis, or cancer could be at risk for high levels of calcium and should not take calcium supplements.

People with a history of kidney stones should not take calcium supplements. However, some research suggests that calcium in foods may not increase the risk of kidney stones. If you have or have had kidney stones, talk to your doctor about whether you should limit calcium in your diet.

Some population studies suggest that getting high amounts (more than 2,000 mg per day) of calcium through the diet may increase the risk of prostate cancer. Two of these studies found that low-fat and nonfat milk, but not other dairy foods, was associated with a higher risk of advanced prostate cancer. But these studies don't prove that drinking low-fat or nonfat milk causes an increased risk of prostate cancer. And some research suggests that the amount of calcium in the diet isn't associated with prostate cancer risk. If you have prostate cancer, or are concerned about dairy products and prostate cancer risk, talk to your doctor.

Are You Getting These Nutrients? - Part 8

Up to 80% of people may not be eating the recommended intake of vitamin E. There are actually eight different forms, which is one of the reasons it's best to get vitamin E from foods, as supplements usually only contain one or two.

Low-carb sources include most nuts and seeds (sunflower seeds are especially rich in vitamin E), greens, avocado, peppers, and shrimp.

Vitamin E is a fat-soluble vitamin found in many foods, fats, and oils. It is also an antioxidant, a substance that may help prevent damage to the body's cells. Antioxidants may provide protection against serious diseases including heart disease and cancer.

Vitamin E is also important in helping your body make red blood cells, and it helps the body to use vitamin K.

People who can't absorb fat properly may develop vitamin E deficiency. Symptoms of serious vitamin E deficiency include:

• Muscle weakness
• Loss of muscle mass
• Abnormal eye movements
• Vision problems
• Unsteady walking

A deficiency that lasts a long time may also cause liver and kidney problems. Although most people in the United States aren’t seriously deficient in vitamin E, many people may have slightly low levels.

The richest source of vitamin E is wheat germ. Other foods that contain a significant amount of vitamin E include – liver, eggs, nuts - almonds, hazelnuts, and walnuts, sunflower seeds, mayonnaise, cold-pressed vegetable oils - including olive, corn, safflower, soybean, cottonseed, and canola, dark green leafy vegetables like spinach and kale, greens - beet, collard, mustard, turnip, sweet potatoes, avocado, asparagus, and yams.

There are natural and synthetic forms of vitamin E. Health care providers usually recommend natural vitamin E (d-alpha-tocopherol) or natural mixed tocopherols. Some prefer mixed tocopherols because it most closely represents whole foods. The synthetic form is called dl-alpha-tocopherol. Dosages are usually listed in international units (IU).

Most vitamin E supplements are fat-soluble. However, people who have trouble absorbing fat, such as those with pancreatic problems or cystic fibrosis, can take water-soluble E.

Vitamin E is available in softgels, tablets, capsules, and topical oils.

Doses for oral vitamin E generally range from 50 - 1,000 IU. Experts recommend getting vitamin E mostly from food rather than supplements.

The Food and Nutrition Board of the Institute of Medicine has set an upper tolerable intake level (UL) for vitamin E at 1,000 mg (1,500 IU) per day for supplemental vitamin E.

Based on clinical trials, the dose often used for disease prevention and treatment for adults is 400 - 800 IU per day. As with all supplements, you should check with a doctor before giving vitamin E to a child.

Daily intakes of dietary vitamin E are listed below. (Note: 1 mg vitamin E equals 1.5 IU.)

Adult

• Older than 18 years: 22.4 IU
• Pregnant females: 22.4 IU
• Breast-feeding females: 28.4 IU

Always check with your doctor before taking vitamin E supplements. Vitamin E may increase the risk of bleeding, especially if you are taking blood-thinners such as warfarin (Coumadin), aspirin, or clopidogrel (Plavix).

Are You Getting These Nutrients? - Part 7

Lower-than-optimal blood levels of vitamin D is becoming more common. It is thought this may be because people are spending less time outside (especially in winter and in areas far from the equator) and wearing more sunscreen. It is difficult to get enough in the diet. Very important for our bones, but is turning up as a factor in many aspects of health.

Low-carb sources include salmon, tuna, eggs, yogurt, and liver.

Vitamin D is a fat-soluble vitamin that plays a role in many important body functions. It is best known for working with calcium in your body to help build and maintain strong bones. Vitamin D is also involved in regulating the immune system and cells, where it may help prevent cancer.

Your body stores vitamin D and can make it when your skin is exposed to sunlight. Vitamin D is also found in some foods, mostly ones like milk that have been fortified with vitamin D. There are two forms of vitamin D: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Some research suggests that cholecalciferol is better at raising levels of vitamin D in the blood.

In children, a vitamin D deficiency can cause rickets, a disease that results in soft, weak bones. In adults, many people may not be getting enough vitamin D, especially those who live in northern areas (like the northern half of the U.S.) and the elderly. People with dark skin do not absorb sunlight as easily as those with light skin, so their risk of low vitamin D is even higher. One study of childbearing women in the Northern U.S. found that 54% of African-American women and 42% of white women had low levels of vitamin D.

That’s important because researchers are beginning to find that low levels of vitamin D may be linked to other diseases, including breast and colon cancer, prostate cancer, high blood pressure, depression, and obesity. The evidence doesn’t prove that too little vitamin D causes these conditions, but that people with higher levels of vitamin D are less likely to get these diseases.

Your body make vitamin D when your skin is exposed to the sun. The color of your skin affects the production of vitamin D. A fair-skinned person may need only about 45 minutes of sunlight a week to get enough vitamin D, while a person with dark skin may need up to 3 hours.

Clouds, smog, clothing, sunscreen, and window glass all reduce the amount of sunlight that actually reaches the skin. In northern areas, it is hard to get enough vitamin D from sunlight during the winter, so people living there may need to take vitamin D supplements. In the U.S., people who live above a line running from Los Angeles to South Carolina may not get enough vitamin D in winter.

Vitamin D is included in many multivitamins. It can be found alone as softgel capsules, tablets, and liquid in over-the-counter strengths from 50 - 1,000 IU. Higher doses are also available, but it is best to ask your doctor what the safest, most effective dose for you would be. For those who have trouble digesting fat, vitamin D injections are also available by prescription.

Recommended dietary allowances for vitamin D are listed below. Seniors and people who don’t get exposed to much sunlight may need to take supplements. Seniors may be at risk of developing vitamin D deficiency because, as we age, the body does not make as much vitamin D from sunlight, and it has a harder time converting vitamin D into a form it can use.

If you are concerned about your vitamin D levels, ask your doctor whether you should take a supplement, and how much.

Adult

• 19 - 50 years: 600 IU (recommended dietary allowance)
• 70 years and older: 800 IU (recommended dietary allowance)
• Pregnant and breastfeeding females: 600 IU (recommended dietary allowance)

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable doctor.

Taking too much vitamin D can cause several side effects. However, scientists don’t all agree on how much is too much.

Side effects may include - being very thirsty, metal taste in mouth, poor appetite, weight loss, bone pain, tiredness, sore eyes, itchy skin, vomiting, diarrhea, constipation, a frequent need to urinate, and muscle problems.

You cannot get too much vitamin D from sunlight, and it would be very hard to get too much from food. Generally, too much vitamin D is a result of taking supplements in too high a dose.

People with the following conditions should be careful when considering taking vitamin D supplements - high blood calcium or phosphorus levels, heart problems, kidney disease, sarcoidosis, and tuberculosis.