Vitamin D first crossed my eye in 2003 when I noticed it was removed from many protein bars and meal-replacement protein drink mixes due to an FDA order. I thought at the time I would look into vitamin D toxicity. I cannot recall ever having a patient with hypervitaminosis D in my 18 years of practice. I was very worried that I had possibly missed or overlooked this problem. That is why I wrote "FDA's Crackdown on Vitamin D is Troubling" two years ago.

When I researched that article it was very apparent that there was a growing problem with vitamin D. However, the problem I found was not excessive vitamin D, but the opposite, a deficiency that is commonly overlooked. I have no idea what literature the FDA regulators reviewed, but from what I could tell, there is mounting evidence that vitamin D deficiency is more important than many healthcare professionals were aware of. Interns in my office who are at or near the tops of their classes academically in chiropractic college do not appear to know much more about vitamin D that I did. I have also talked to colleagues in other allied health professions and I believe that schools may not be incorporating new literature into their curriculums fast enough.

This expands on what I wrote about both in my FDA Crackdown article in 2003 and last year "Vitamin D Deficiency." You can find these articles on both my website and chiroweb.

Vitamin D – Did you Know?

• Lower serum and intake levels of vitamin D increase the rate of osteoarthritis. (OA)³
• Obesity alters endocrine function and promotes storage of vitamin D rather than utilization. Women with a body mass index over 30 have triple the rate of vitamin D deficiency compared to age matched women with a BMI of 18-25.⁴
• Running serum tests on the active form of vitamin D 1,25-dihydroxyvitamin D [1,25(OH)2D] showed no association between changes and OA. But in the same study low serum levels of its precursor 25 hydroxyvitamin D [25(OH)D] did correlate with joint space narrowing.⁵
• Vitamin D deficiency can cause chronic lower back pain.⁶
• Vitamin D deficiency is often misdiagnosed as fibromyalgia.⁷
• Animals genetically susceptible to of type 1 diabetes, rheumatoid arthritis, and multiple sclerosis did not develop these diseases when they were given Vitamin D throughout their lifetime.⁷
• Human milk contains very low levels of vitamin D.⁸
• Persons who do not get much sun exposure need at least 1000 IU of vitamin D a day to prevent deficiency. The more time we spend indoors, the greater this problem becomes, and our awareness of sunburn has further increased vitamin D deficiencies.⁷
• Sunscreen rated SFP-8, when used properly, stops 95% of vitamin D production.⁷
• Very dark-skinned people may need 6 times more sun than very fair-skinned people to produce adequate vitamin D.⁹
• Low vitamin D in adults has recently been identified as a risk factor for heart disease.¹⁰
• Vitamin D is extremely powerful in reducing the rate of cancer cell proliferation.⁷
• In the winter women were over 5 times more likely to have vitamin D deficiency than in the summer.⁴
• Cancer death rates are higher in people who have low exposure to sunlight.⁷
• Pregnant women need at least 2.5 –10 times more vitamin D (1000 – 4000 IU/d) than the current daily reference intake (DRI) of 200 - 400 IU/d.¹¹
• 100,000 IU/d of vitamin D did not harm mothers or babies during pregnancy.¹¹
• There is overwhelming evidence that healthy men use 3000 – 5000 IU/d of vitamin D.¹²
• Current research indicates 4000 IU/d of vitamin D maintains optimal levels. (The DRI states the tolerable upper limit is 2000 IU/d. Thus the outdated research implies that the current finding would cause toxicity.)¹³
• In a Finnish study of over 10,000 infants and children those who took 2000 IU/d in their first year of life reduced the incidents of developing type 1 diabetes 80% up to age 14.¹⁴

References
¹Andersen GD, FDA's Crackdown on Vitamin D is Troubling. Dynamic Chiropractic 2003; 21(20): 17.
²Andersen GD, Vitamin D Deficiency. Dynamic Chiropractic 2004; 22(13): 32
³McAlindon TE, Fedson DT, Zhang Y, et. al. Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study. Ann Intern Med. 1996;125(5):854-60
⁴Nesby-O’Dell S, Scanlon KS, Cogswell MF, et. al. Hypovitaminosis D Prevalence and determinants among African American and white women of reproductive age: third national Health and Nutrition Examination Survey. 1988-1994. Am J Clin Nutr. 2002;76:187-92.
⁵Lane NE, Gore LR, Cummings SR, et.al. Sarum vitamin D levels and incident changes of radiographic hip osteoarthritis: a longitudinal study. Study of Osteoporptic Fractures Research Group . Athritis Rhuem 1999;42(5):353-9.
⁶Al Faraj S, Al Mutairi K. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine. 2003:28(2):177-9.
⁷Holick MF, Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004; 79(3):362-71.
⁸Krieter SR, Schwartz RF, Kirkman HN, et. al. Nutritional rickets in African American breast-fed infants. J Pediatr 2000; 137:2-6.
⁹Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999;69(5):842-56.
¹⁰Zittermann A, Schleithhoff SS, Tenderich G, et. al. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol 2003:41:105-12.
¹¹Hollis BW, Wagner CL. Assessment of dietary Vitamin D requirements during pregnancy and lactation. Am J Clin Nutr. 2004;74(5):717-26
¹²Heaney RP, Davies KM, Chen TC. et. al. Human serum 25 hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr. 2003: 77(1): 204-10.
¹³Vieth R, Chan PC, MacFarlane GD. Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J clin Nutr. 2002; 79(2):288-94.
¹⁴Hypponen E, Laara E, et. al. Intake of vitamin D and risk of type 1 diabetes a birth-cohort study. Lancet 2001;358:1500-0

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