Does Vitamin D Interfere With Thyroid Medication

Does Vitamin D Interfere With Thyroid Medication

Indian J Endocrinol Metab. 2018 Sep-Oct; 22(5): 584–588.

The Effects of Vitamin D Supplementation on Thyroid Function in Hypothyroid Patients: A Randomized, Double-blind, Placebo-controlled Trial

Afsaneh Talaei

Endocrinology and Metabolism Research Center, Department of Internal Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran

Fariba Ghorbani

Endocrinology and Metabolism Research Center, Department of Internal Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran

Zatollah Asemi

¹Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran

This article has been cited by other articles in PMC.

Abstract

Background:

Data on the effects of vitamin D supplementation on thyroid function in hypothyroid patients are scarce.

Objective:

This study was done to evaluate the effects of vitamin D supplementation on thyroid function in hypothyroid patients.

Material and Methods:

This randomized double-blind, placebo-controlled trial was conducted on 201 hypothyroid patients aged 20–60 years old. Subjects were randomly assigned into two groups to intake either 50,000 IU vitamin D supplements (n = 102) or placebo (n = 99) weekly for 12 weeks. Markers of related with thyroid function were assessed at first and 12 weeks after the intervention.

Results:

After 12 weeks of intervention, compared to the placebo, vitamin D supplementation resulted in significant increases in serum 25-hydroxyvitamin D (+26.5 ± 11.6 vs. 0.0 ± 0.0 ng/mL, P < 0.001) and calcium (+0.4 ± 0.7 vs. 0.1 ± 0.6 mg/dL, P = 0.002), and a significant decrease in serum thyroid-stimulating hormone (TSH) levels (−0.4 ± 0.6 vs. +0.1 ± 2.0 μIU/mL, P = 0.02). A trend towards a greater decrease in serum parathyroid hormone (PTH) levels was observed in vitamin D group compared to placebo group (−3.8 vs. +1.9, P = 0.07). We did not observe any significant changes in serum T3, T4, alkaline phosphatase (ALP) and albumin levels following supplementation of vitamin D compared with the placebo.

Conclusion:

Overall, the current study demonstrated that vitamin D supplementation among hypothyroid patients for 12 weeks improved serum TSH and calcium concentrations compared with the placebo, but it did not alter serum T3, T4, ALP, PTH, and albumin levels.

Keywords: Hypothyroid, thyroid function, vitamin D supplementation

BACKGROUND

The presence of vitamin D receptors in most tissues and cells in the human body leads to that vitamin D was considered as a unique hormone.[1] Several studies have demonstrated that vitamin D has an effect in decreasing the risk of chronic illnesses including autoimmune, infectious and cardiovascular diseases.[2,3,4] It has been estimated that more than one billion people worldwide have vitamin D deficiency or insufficiency.[5] The prevalence of 25(OH)D deficiency was reported as 81.3% among children in the south of Iran.[6] Elderly people as well as children and young adults are potentially at high risk for vitamin D deficiency.[7]

Several studies have reported low serum levels of vitamin D in hypothyroid patients which in turn may lead to some musculoskeletal complaints in these patients.[8,9] Other studies have demonstrated that the patients with Graves' disease also have low serum levels of vitamin D.[10,11] There are two mechanisms that may explain why serum levels of vitamin D is low in hypothyroid patients; one is that the low levels of vitamin D may be due to poor absorption of vitamin D from the intestine and the other is the body of these patients may not activate vitamin D properly.[8] In a study by Chaudhary et al.[12] was seen that administration of 60,000 IU vitamin D weekly in autoimmune thyroid disorders (AITD) had a favorable effect on autoimmunity as evidenced by significant reductions in TPO-Ab titers. In addition, vitamin D3 intake after 10 weeks in diabetic rats greatly corrected the alterations in thyroid profile and D2 (deiodinase 2) expression.[13]

Vitamin D mediates its effect through binding to vitamin D receptor (VDR) and activation of VDR-responsive genes in the target tissues.[8] VDR gene polymorphism was found to associate with AITD.[8] These mechanisms might suggest the importance of vitamin D administration in hypothyroid patients. To our knowledge, no reports are available evaluating the effects of vitamin D administration on thyroid function in hypothyroid patients. This study is aimed to determine the effects of vitamin D supplementation on thyroid function in hypothyroid patients.

PROCEDURE

Trial design

This was a 12-week randomized, double-blind, placebo-controlled clinical trial.

Participants

Participants of this study were 201 hypothyroid patients which were selected from subjects attending the endocrinology service of Arak University of Medical Sciences (AUMS) from October 2015 to December 2015. Patients aged 20–60 years old were stable for more than one year on their levothyroxine dose and thyroid-stimulating hormone (TSH) level was at 0.5–5 mIU/L without need to change the levothyroxine dose.

Ethics statements

This research was done in accordance with the Declaration of Helsinki and informed consent was received from all subjects. The research was approved by the ethics committee of AUMS and was registered in the Iranian website for registration of clinical trials (http://www.irct.ir:IRCT2016022325895N2).

Study design

At first, subjects were randomly divided into two groups by random permuted blocks to receive either 50,000 IU vitamin D supplement (n = 102) or placebo (n = 99) weekly for 12 weeks. Vitamin D capsules and its placebos (paraffin) were provided by Zahravi Pharmaceutical Company (Tabriz, Iran) and Barij Essence Pharmaceutical Company (Kashan, Iran), respectively. At the onset of the study, subjects were requested to keep their habitual diet and routine levels of physical activity throughout the study period as well as not to take any medications that might affect their reproductive physiology during treatment.

Treatment adherence

Compliance to the consumption of supplement and placebo was examined by bringing the containers of the capsules as well as by the measurement of serum 25-hydroxyvitamin D concentrations.

Assessment of anthropometric measures

Anthropometric measures including height, weight (Seca, Hamburg, Germany) and body mass index (BMI) were quantified at the onset and at the end of the study.

Assessment of outcomes

The primary outcome variables were thyroid function including serum T3, T4 and TSH in the current study. The secondary outcome variables were serum calcium, ALP, PTH and albumin.

Biochemical assessment

Twelve-hour fasting blood samples were taken by venipuncture at weeks 0 and 12 at the reference laboratory. Blood samples were taken according to a standard protocol and immediately centrifuged (Hettich D-78532, Tuttlingen, Germany). Then, the samples were stored at −80°C until analysis at the AUMS reference laboratory. Serum 25-OH-D was measured using the enzyme immunoassay method (DRG, Marburg, Germany) with inter- and intra-assay coefficient variations (CVs) of 9.7 and 4.7%, respectively. Measurement of total tetraiodothyronine (TT4) and triiodothyronine (TT3) were done using the radioimmunoassay (RIA) method, and TSH was measured by immunoenzymometric assay (IEMA) using commercial kits (Izotop, Budapest, Hungary). Intra- and inter-assay CVs were 3.3 and 6.2% for TT4, 6.7 and 7.8% for TT3 and 3.9 and 7.1% for TSH, respectively.

Randomization

Randomization assignment was conducted using computer-generated random numbers as blindness by a trained midwife at clinic.

Statistical methods

To evaluate normal distribution of variables, we performed the Kolmogrov–Smirnov test. To detect differences in the general characteristics between the two groups, we used independent samples Student's t-test and Mann–Whitney U test based on normal or abnormal distribution. Paired t-test also was applied to compare values within groups. To demonstrate the effect of vitamin D supplementation on thyroid function, one-way variance analysis ANOVA was applied. To control the effect of confounders including baseline values of biochemical parameters, age and BMI at baseline, we applied analysis of covariance (ANCOVA). A P value < 0.05 was considered statistically significant. All statistical analyses were conducted using the Statistical Package for Social Science version 18 (SPSS Inc., Chicago, Illinois, USA).

RESULTS

At the study baseline, we recruited 220 participants; however, 19 subjects were excluded from the study because of not meeting inclusion criteria. In the current study, 201 subjects [vitamin D (n = 102) and placebo (n = 99)] completed the trial [Figure 1]. On average, the rate of compliance in the present study was high, such that 100% of capsules were taken throughout the study in both groups. No side effects were reported following the consumption of vitamin D supplements in participants throughout the study. Totally, 58% of the patients were vitamin D deficient as described when vitamin D is less than 20 ng/ml.

Summary of patient flow diagram

Mean age, baseline weight and BMI, and end-of-trial weight and BMI were not significantly different between the two groups [Table 1].

Table 1

General characteristics of study participants

After 12 weeks of intervention, compared with the placebo, vitamin D supplementation resulted in significant increases in serum 25-hydroxyvitamin D (+26.5 ± 11.6 vs. 0.0 ± 0.0 ng/mL, P < 0.001) and calcium (+0.4 ± 0.7 vs. 0.1 ± 0.6 mg/dL, P = 0.002), and a significant decrease in serum TSH levels (−0.4 ± 0.6 vs. +0.1 ± 2.0 μIU/mL, P = 0.02). A trend towards a greater decrease in serum PTH levels was observed in the vitamin D group compared with the placebo group (−3.8 vs. +1.9, P = 0.07). We did not observe any significant change in serum T3, T4, ALP and albumin levels following supplementation of vitamin D compared with the placebo [Table 2].

Table 2

The effect of vitamin D supplementation on thyroid function in hypothyroid patients¹

Adjustments for baseline values of biochemical variables, age and BMI at baseline did not influence our findings, except for serum ALP (P = 0.02) and albumin levels (P = 0.04) [Table 3].

Table 3

Adjusted changes in thyroid function in hypothyroid patients¹

DISCUSSION

We found that vitamin D supplementation among hypothyroid patients for 12 weeks improved serum TSH and calcium concentrations compared with the placebo, but it did not alter serum T3, T4 levels. To our knowledge, this trial is the first evaluating the effects of vitamin D supplementation on thyroid function among subjects with hypothyroid.

Vitamin D is well known for its primary role in bone and mineral metabolism, and it has been recently shown that its deficiency is associated with many diseases such as cardiovascular disease, cancer, infection, adiposity as well as osteoporosis.[14] Also, it has been proved that low concentrations of serum vitamin D is associated with autoimmune diseases.[2] In addition, vitamin D deficiency is a global problem throughout the world.[7] It has been estimated that more than one billion people in the world have vitamin D deficiency or insufficiency.[7]

The prevalence of vitamin D deficiency in adult population has been reported to be 9–70% with a higher prevalence in Asian countries.[15,16] A study from Japan including 200 patients with Graves' disease demonstrated that 40% of women and 20% of men had vitamin D deficiency.[17] Some other studies have indicated that patients with Graves' disease also have low levels of vitamin D.[18] According to these findings, the present study showed that the prevalence of vitamin D deficiency was high in hypothyroid patients. Vitamin D supplementation significantly decreased TSH levels but had no significant effect on T4 or T3 concentrations. These results suggested that there may be a significant relationship between vitamin D deficiency and hypothyroidism. According to our results, some studies have reported the prevalence of vitamin D insufficiency in Hashimoto's disease (92%) was significantly higher than in healthy controls (63%).[19] Furthermore, Mackawy et al.[8] concluded that the patients with hypothyroidism suffered from hypovitaminosis D and there was a positive significant correlation between serum level of vitamin D with thyroid hormones and a negative significant correlation with TSH levels and suggested that the deficiency of serum levels of vitamin D was significantly associated with the degree and severity of hypothyroidism. There are two explanations for this association. First, the low levels of vitamin D may be due to poor absorption of vitamin D from the intestine.[8] Second, the body may not activate vitamin D properly.[8]

It has been known that both vitamin D and thyroid hormone bind to similar receptors called steroid hormone receptors. Some polymorphisms in VDR gene were shown to predispose people to autoimmune thyroid disease including Graves' disease and Hashimoto's thyroiditis.[20,21] Some previous studies have demonstrated that vitamin D modulates pituitary TSH secretion by binding to specific binding sites.[22] Smith et al.[23] found that vitamin D administration significantly suppressed TSH secretion in the basal state. He also showed that serum TSH levels of middle-aged and elderly women were higher than those of same-age men.[23] This result may indicate that TSH secretion is regulated by sex hormones, genetic susceptibility or environmental factors, which may also mediate the relationship between vitamin D status and serum TSH level.[24] In addition, another study found that circulating estrogen could induce serum TSH suppression in males by acting on pituitary, and vitamin D has been shown to have an important role in estrogen synthesis of both female and male gonads.[25]

CONCLUSION

Overall, the current study demonstrated that vitamin D supplementation among hypothyroid patients for 12 weeks improved serum TSH and calcium concentrations compared with the placebo, but it did not alter serum T3 and T4 levels.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

1. Lee SM, Meyer MB, Benkusky NA, O'Brien CA, Pike JW. Mechanisms of Enhancer-mediated Hormonal Control of Vitamin D Receptor Gene Expression in Target Cells. J Biol Chem. 2015;290:30573–86. [PMC free article] [PubMed] [Google Scholar]

2. Agmon-Levin N, Theodor E, Segal RM, Shoenfeld Y. Vitamin D in systemic and organ-specific autoimmune diseases. Clin Rev Allergy Immunol. 2013;45:256–66. [PubMed] [Google Scholar]

3. Mangin M, Sinha R, Fincher K. Inflammation and vitamin D: The infection connection. Inflamm Res. 2014;63:803–19. [PMC free article] [PubMed] [Google Scholar]

4. Gouni-Berthold I, Krone W, Berthold HK. Vitamin D and cardiovascular disease. Curr Vasc Pharmacol. 2009;7:414–22. [PubMed] [Google Scholar]

6. Saki F, Dabbaghmanesh MH, Omrani GR, Bakhshayeshkaram M. Vitamin D deficiency and its associated risk factors in children and adolescents in southern Iran. Public Health Nutr. 2017;20:1851–6. [PubMed] [Google Scholar]

7. Holick MF, Chen TC. Vitamin D deficiency: A worldwide problem with health consequences. Am J Clin Nutr. 2008;87:1080S–6S. [PubMed] [Google Scholar]

8. Mackawy AM, Al-Ayed BM, Al-Rashidi BM. Vitamin d deficiency and its association with thyroid disease. Int J Health Sci (Qassim) 2013;7:267–75. [PMC free article] [PubMed] [Google Scholar]

9. Aljohani NJ, Al-Daghri NM, Al-Attas OS, Alokail MS, Alkhrafy KM, Al-Othman A, et al. Differences and associations of metabolic and vitamin D status among patients with and without sub-clinical hypothyroid dysfunction. BMC Endocr Disord. 2013;13:31. [PMC free article] [PubMed] [Google Scholar]

10. Yasuda T, Okamoto Y, Hamada N, Miyashita K, Takahara M, Sakamoto F, et al. Serum vitamin D levels are decreased and associated with thyroid volume in female patients with newly onset Graves' disease. Endocrine. 2012;42:739–41. [PMC free article] [PubMed] [Google Scholar]

11. Li X, Wang G, Lu Z, Chen M, Tan J, Fang X. Serum 25-hydroxyvitamin D predict prognosis in radioiodine therapy of Graves' disease. J Endocrinol Invest. 2015;38:753–9. [PubMed] [Google Scholar]

12. Chaudhary S, Dutta D, Kumar M, Saha S, Mondal SA, Kumar A, et al. Vitamin D supplementation reduces thyroid peroxidase antibody levels in patients with autoimmune thyroid disease: An open-labeled randomized controlled trial. Indian J Endocrinol Metab. 2016;20:391–8. [PMC free article] [PubMed] [Google Scholar]

13. Alrefaie Z, Awad H. Effect of vitamin D3 on thyroid function and de-iodinase 2 expression in diabetic rats. Arch Physiol Biochem. 2015;121:206–9. [PubMed] [Google Scholar]

14. Vilarrasa N, Vendrell J, Maravall J, Elio I, Solano E, San Jose P, et al. Is plasma 25(OH) D related to adipokines, inflammatory cytokines and insulin resistance in both a healthy and morbidly obese population? Endocrine. 2010;38:235–42. [PubMed] [Google Scholar]

15. Robien K, Butler LM, Wang R, Beckman KB, Walek D, Koh WP, et al. Genetic and environmental predictors of serum 25-hydroxyvitamin D concentrations among middle-aged and elderly Chinese in Singapore. Br J Nutr. 2013;109:493–502. [PMC free article] [PubMed] [Google Scholar]

16. G R, Gupta A. Vitamin D deficiency in India: Prevalence, causalities and interventions. Nutrients. 2014;6:729–75. [PMC free article] [PubMed] [Google Scholar]

17. Yamashita H, Noguchi S, Takatsu K, Koike E, Murakami T, Watanabe S, et al. High prevalence of vitamin D deficiency in Japanese female patients with Graves' disease. Endocr J. 2001;48:63–9. [PubMed] [Google Scholar]

18. Wang J, Lv S, Chen G, Gao C, He J, Zhong H, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients. 2015;7:2485–98. [PMC free article] [PubMed] [Google Scholar]

19. Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto's thyroiditis. Thyroid. 2011;21:891–6. [PubMed] [Google Scholar]

20. Feng M, Li H, Chen SF, Li WF, Zhang FB. Polymorphisms in the vitamin D receptor gene and risk of autoimmune thyroid diseases: A meta-analysis. Endocrine. 2013;43:318–26. [PubMed] [Google Scholar]

21. Meng S, He ST, Jiang WJ, Xiao L, Li DF, Xu J, et al. Genetic susceptibility to autoimmune thyroid diseases in a Chinese Han population: Role of vitamin D receptor gene polymorphisms. Ann Endocrinol (Paris) 2015;76:684–9. [PubMed] [Google Scholar]

22. Sar M, Stumpf WE, DeLuca HF. Thyrotropes in the pituitary are target cells for 1,25 dihydroxy vitamin D3. Cell Tissue Res. 1980;209:161–6. [PubMed] [Google Scholar]

23. Smith MA, McHenry C, Oslapas R, Hofmann C, Hessel P, Paloyan E. Altered TSH levels associated with increased serum 1,25-dihydroxyvitamin D3: A possible link between thyroid and parathyroid disease. Surgery. 1989;106:987–91. [PubMed] [Google Scholar]

24. Gross HA, Appleman MD, Jr, Nicoloff JT. Effect of biologically active steroids on thyroid function in man. J Clin Endocrinol Metab. 1971;33:242–8. [PubMed] [Google Scholar]

25. Kinuta K, Tanaka H, Moriwake T, Aya K, Kato S, Seino Y. Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads. Endocrinology. 2000;141:1317–24. [PubMed] [Google Scholar]

Does Vitamin D Interfere With Thyroid Medication

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166548/

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How Many Units Of Vitamin D Per Day

How Many Units Of Vitamin D Per Day

This is a reader-friendly overview of Vitamin D. For more details, see our health professional fact sheet on Vitamin D.

For information on vitamin D and COVID-19, see Dietary Supplements in the Time of COVID-19.

What is vitamin D and what does it do?

Vitamin D is a nutrient you need for good health. It helps your body absorb calcium, one of the main building blocks for strong bones. Together with calcium, vitamin D helps protect you from developing osteoporosis, a disease that thins and weakens the bones and makes them more likely to break. Your body needs vitamin D for other functions too. Your muscles need it to move, and your nerves need it to carry messages between your brain and your body. Your immune system needs vitamin D to fight off invading bacteria and viruses.

How much vitamin D do I need?

The amount of vitamin D you need each day depends on your age. Average daily recommended amounts are listed below in micrograms (mcg) and International Units (IU):

Life Stage	Recommended Amount
Birth to 12 months	10 mcg (400 IU)
Children 1–13 years	15 mcg (600 IU)
Teens 14–18 years	15 mcg (600 IU)
Adults 19–70 years	15 mcg (600 IU)
Adults 71 years and older	20 mcg (800 IU)
Pregnant and breastfeeding teens and women	15 mcg (600 IU)

What foods provide vitamin D?

Very few foods naturally contain vitamin D. Fortified foods provide most of the vitamin D in the diets of people in the United States. Check the Nutrition Facts label for the amount of vitamin D in a food or beverage.

• Almost all of the U.S. milk supply is fortified with about 3 mcg (120 IU) vitamin D per cup. Many plant-based alternatives such as soy milk, almond milk, and oat milk are similarly fortified. But foods made from milk, like cheese and ice cream, are usually not fortified.
• Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt, margarine, and other food products.
• Fatty fish (like trout, salmon, tuna, and mackerel) and fish liver oils are among the best natural sources of vitamin D.
• Beef liver, egg yolks, and cheese have small amounts of vitamin D.
• Mushrooms provide a little vitamin D. Some mushrooms have been exposed to ultraviolet light to increase their vitamin D content.

Can I get vitamin D from the sun?

Your body makes vitamin D when your bare skin is exposed to the sun. Most people get at least some vitamin D this way. However, clouds, smog, old age, and having dark-colored skin reduce the amount of vitamin D your skin makes. Also, your skin does not make vitamin D from sunlight through a window.

Ultraviolet radiation from sunshine can cause skin cancer, so it's important to limit how much time you spend in the sun. Although sunscreen limits vitamin D production, health experts recommend using sunscreen with a sun protection factor (SPF) of 15 or more when you're out in the sun for more than a few minutes.

What kinds of vitamin D dietary supplements are available?

Vitamin D is found in multivitamin/multimineral supplements. It is also available in dietary supplements containing only vitamin D or vitamin D combined with a few other nutrients. The two forms of vitamin D in supplements are D2 (ergocalciferol) and D3 (cholecalciferol). Both forms increase vitamin D in your blood, but D3 might raise it higher and for longer than D2. Because vitamin D is fat-soluble, it is best absorbed when taken with a meal or snack that includes some fat.

Am I getting enough vitamin D?

Because you get vitamin D from food, sunshine, and dietary supplements, one way to know if you're getting enough is a blood test that measures the amount of vitamin D in your blood. In the blood, a form of vitamin D known as 25-hydroxyvitamin D is measured in either nanomoles per liter (nmol/L) or nanograms per milliliter (ng/mL). One nmol/L is the same as 0.4 ng/mL.

• Levels of 50 nmol/L (20 ng/mL) or above are adequate for most people for bone and overall health.
• Levels below 30 nmol/L (12 ng/mL) are too low and might weaken your bones and affect your health.
• Levels above 125 nmol/L (50 ng/mL) are too high and might cause health problems.

In the United States, most people have adequate blood levels of vitamin D. However, almost one out of four people have vitamin D blood levels that are too low or inadequate for bone and overall health.

Some people are more likely than others to have trouble getting enough vitamin D:

• Breastfed infants. Breast milk alone does not provide infants with an adequate amount of vitamin D. Breastfed infants should be given a supplement of 10 mcg (400 IU) of vitamin D each day.
• Older adults. As you age, your skin's ability to make vitamin D when exposed to sunlight declines.
• People who seldom expose their skin to sunshine because they do not go outside or because they keep their body and head covered. Sunscreen also limits the amount of vitamin D your skin produces.
• People with dark skin. The darker your skin, the less vitamin D you make from sunlight exposure.
• People with conditions that limit fat absorption, such as Crohn's disease, celiac disease, or ulcerative colitis. This is because the vitamin D you consume is absorbed in the gut along with fat, so if your body has trouble absorbing fat, it will also have trouble absorbing vitamin D.
• People who are obese or have undergone gastric bypass surgery. They may need more vitamin D than other people.

What happens if I don't get enough vitamin D?

In children, vitamin D deficiency causes rickets, a disease in which the bones become soft, weak, deformed, and painful. In teens and adults, vitamin D deficiency causes osteomalacia, a disorder that causes bone pain and muscle weakness.

What are some effects of vitamin D on health?

Scientists are studying vitamin D to better understand how it affects health. Here are several examples of what this research has shown:

Bone health and osteoporosis
Long-term shortages of vitamin D and calcium cause your bones to become fragile and break more easily. This condition is called osteoporosis. Millions of older women and men have osteoporosis or are at risk of developing this condition. Muscles are also important for healthy bones because they help maintain balance and prevent falls. A shortage of vitamin D may lead to weak, painful muscles.

Getting recommended amounts of vitamin D and calcium from foods (and supplements, if needed) will help maintain healthy bones and prevent osteoporosis. Taking vitamin D and calcium supplements slightly increases bone strength in older adults, but it's not clear whether they reduce the risk of falling or breaking a bone.

Cancer
Vitamin D does not seem to reduce the risk of developing cancer of the breast, colon, rectum, or lung. It is not clear whether vitamin D affects the risk of prostate cancer or chance of surviving this cancer. Very high blood levels of vitamin D may even increase the risk of pancreatic cancer.

Clinical trials suggest that while vitamin D supplements (with or without calcium) may not affect your risk of getting cancer, they might slightly reduce your risk of dying from this disease. More research is needed to better understand the role that vitamin D plays in cancer prevention and cancer-related death.

Heart disease
Vitamin D is important for a healthy heart and blood vessels and for normal blood pressure. Some studies show that vitamin D supplements might help reduce blood cholesterol levels and high blood pressure—two of the main risk factors for heart disease. Other studies show no benefits. If you are overweight or obese, taking vitamin D at doses above 20 mcg (800 IU) per day plus calcium might actually raise your blood pressure. Overall, clinical trials find that vitamin D supplements do not reduce the risk of developing heart disease or dying from it, even if you have low blood levels of the vitamin.

Depression
Vitamin D is needed for your brain to function properly. Some studies have found links between low blood levels of vitamin D and an increased risk of depression. However, clinical trials show that taking vitamin D supplements does not prevent or ease symptoms of depression.

Multiple sclerosis
People who live near the equator have more sun exposure and higher vitamin D levels. They also rarely develop multiple sclerosis (MS), a disease that affects the nerves that carry messages from the brain to the rest of the body. Many studies find a link between low blood vitamin D levels and the risk of developing MS. However, scientists have not actually studied whether vitamin D supplements can prevent MS. In people who have MS, clinical trials show that taking vitamin D supplements does not keep symptoms from getting worse or coming back.

Type 2 diabetes
Vitamin D helps your body regulate blood sugar levels. However, clinical trials in people with and without diabetes show that supplemental vitamin D does not improve blood sugar levels, insulin resistance, or hemoglobin A1c levels (the average level of blood sugar over the past 3 months). Other studies show that vitamin D supplements don't stop most people with prediabetes from developing diabetes.

Weight loss
Taking vitamin D supplements or eating foods that are rich in vitamin D does not help you lose weight.

Can vitamin D be harmful?

Yes, getting too much vitamin D can be harmful. Very high levels of vitamin D in your blood (greater than 375 nmol/L or 150 ng/mL) can cause nausea, vomiting, muscle weakness, confusion, pain, loss of appetite, dehydration, excessive urination and thirst, and kidney stones. Extremely high levels of vitamin D can cause kidney failure, irregular heartbeat, and even death. High levels of vitamin D are almost always caused by consuming excessive amounts of vitamin D from dietary supplements. You cannot get too much vitamin D from sunshine because your skin limits the amount of vitamin D it makes.

The daily upper limits for vitamin D include intakes from all sources—food, beverages, and supplements—and are listed below in micrograms (mcg) and international units (IU):

Ages	Upper Limit
Birth to 6 months	25 mcg (1,000 IU)
Infants 7–12 months	38 mcg (1,500 IU)
Children 1–3 years	63 mcg (2,500 IU)
Children 4–8 years	75 mcg (3,000 IU)
Children 9–18 years	100 mcg (4,000 IU)
Adults 19 years and older	100 mcg (4,000 IU)
Pregnant and breastfeeding teens and women	100 mcg (4,000 IU)

Does vitamin D interact with medications or other dietary supplements?

Yes, vitamin D supplements may interact with some medicines. Here are several examples:

• Orlistat (Xenical® and alli®) is a weight-loss drug. It can reduce the amount of vitamin D your body absorbs from food and supplements.
• Cholesterol-lowering statins might not work as well if you take high-dose vitamin D supplements. This includes atorvastatin (Lipitor®), lovastatin (Altoprev® and Mevacor®), and simvastatin (FloLipid™ and Zocor®)
• Steroids such as prednisone (Deltasone®, Rayos®, and Sterapred®) can lower your blood levels of vitamin D.
• Thiazide diuretics (such as Hygroton®, Lozol®, and Microzide®) could raise your blood calcium level too high if you take vitamin D supplements.

Tell your doctor, pharmacist, and other healthcare providers about any dietary supplements and prescription or over-the-counter medicines you take. They can tell you if the dietary supplements might interact with your medicines. They can also explain whether the medicines you take might interfere with how your body absorbs or uses other nutrients.

Vitamin D and healthful eating

People should get most of their nutrients from food and beverages, according to the federal government's Dietary Guidelines for Americans. Foods contain vitamins, minerals, dietary fiber, and other components that benefit health. In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy). For more information about building a healthy dietary pattern, see the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate.

Where can I find out more about vitamin D?

Disclaimer

This fact sheet by the Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

How Many Units Of Vitamin D Per Day

Source: https://ods.od.nih.gov/factsheets/VitaminD-Consumer/

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Olly Vitamin D

Olly Vitamin D

10 Healthy Foods That Are Rich in Vitamin D

Photo Courtesy: Michael Godek/Getty Images

Are you getting enough sun? In many parts of the world, that might prove difficult during the winter months — and it can impact more than your sunny disposition.When exposed to sunshine, our bodies produce vitamin D, something our bodies need to maintain healthy bones and teeth; support our immune and cardiovascular systems; and stave off certain diseases, like type 1 diabetes. Some reports suggest that roughly three-quarters of American teens and adults might not be getting enough vitamin D. So, how can you turn that number around?

How Much Vitamin D Do We Need and Where Can We Find It?

The National Institutes of Health (NIH) makes recommendations for what one's daily intake of vitamin D should be based on age, gender and other factors. The recommendations, in micrograms (mcg), can be summarized as follows:

Photo Courtesy: Sean Gladwell/Getty Images

• Infants (up to 12 months): 10 mcg daily
• Children (1 to 13 years): 15 mcg daily
• Teens (14 to 18 years): 15 mcg daily
• Adults (19 to 50 years): 15 mcg daily
• Older adults (51 to 70 years): 15 mcg daily
• Seniors (70+ years): 20 mcg daily

So, how can you supplement your vitamin D intake if all that basking in the sun isn't cutting it? Thanks to the Dietary Guidelines for Americans, we've rounded up 10 healthy foods that can help you reach those daily vitamin D goals.

Salmon

Salmon comes in quite a few different varieties — canned sockeye salmon, smoked chinook salmon, canned pink salmon, cooked sockeye salmon, cooked pink salmon and even cooked wild coho salmon — and all of them are chock-full of vitamin D. All of these options will help you hit your goals. After all, a three-ounce serving of canned sockeye salmon contains 17.9 mcg of vitamin D, while a three-ounce portion of cooked sockeye salmon contains 11.1 mcg of vitamin D.

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Smoked Whitefish

Want to change up that salmon intake? Whitefish can help with that. While whitefish are a species of fish, the term also refers to a cluster of types of fish, all of which have a mild, slightly sweet flavor. Some of the most popular "whitefish" include pollock, bass, cod, halibut, grouper and haddock. On average, a standard three-ounce serving of smoked whitefish contains an impressive 10.8 mcg of vitamin D.

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Swordfish

If you're looking for a terrific source of vitamin D, and to break up all that whitefish and salmon, try swordfish. These creatures can grow to be a whopping 1,400 pounds — and nearly 15-feet in length. While you wouldn't want to tangle with one of these in the ocean, encountering it as a nice, grilled steak is a treat. Best of all, a three-ounce portion will provide you with 14.1 mcg of vitamin D.

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Tilapia

Tilapia is a cluster of fish species that aren't found in nature. That is, tilapia is a farmed fish, which makes it pretty inexpensive. This mild species is the fourth most common type of seafood eaten by Americans, in part because of its versatility. We recommend a nice herb-and-parmesan crust, but, any way you slice it (or season it), a three-ounce portion will provide you with 3.1 mcg of vitamin D.

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Canned Tuna

Not into canned food? Well, canned fish should probably be your exception. In fact, canned tuna, in addition to being readily available and inexpensive, can make an abundance of tasty meals, from tuna salad and melts to casseroles. Best of all, a three-ounce serving of light tuna canned in oil contains about 5.7 mcg of vitamin D.

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Mushrooms

The five fish options we've listed above might not have surprised you, but this one might. Many varieties of mushrooms — including portabella, cremini, morels, chanterelles, maitake, and even your basic white button mushrooms — are excellent sources of vitamin D. In fact, half a cup of grilled portabella mushrooms delivers an impressive 7.9 mcg of vitamin D.

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Eggs

Eggs — and, in particular, egg yolks — are one of the easiest, cheapest and quickest ways to nab some vitamin D. However, they may not be the food of choice for folks with high cholesterol. If your diet allows, whip up two scrambled eggs and enjoy getting 5% of your recommended daily intake of vitamin D first thing in the morning.

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Milk

Milk is more than just a great source of calcium. In fact, vitamin D is among its significant nutritional benefits. When it comes to a 16-ounce serving of cow's milk, the vitamin D content varies based on the milk's composition. For example, whole milk contains 6.3 mcg of vitamin D, while 2%, 1% and skim milk all contain 5.9 mcg. Even soy and dehydrated (powdered) milk will help you reach your goals by providing 5.8 mcg and 3.4 mcg of vitamin D respectively.

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Yogurt

Milk is not the only dairy product capable of delivering some serious vitamin D benefits. Of course, the nutritional value of yogurt changes depending upon the variety. For example, Greek-style yogurt contains more protein and less sugar than other types of yogurt. Nonetheless, you can still expect anywhere from 2 to 3 mcg of vitamin D per eight-ounce serving, regardless of the variety of yogurt.

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Pork

So far, you've seen lots of fish and dairy options. You might be wondering, Where's the meat? Well, generally speaking, beef and chicken are not great sources of vitamin D. In fact, if you're a meat lover in search of some vitamin D, pork is your best bet. The nutritional value of pork varies depending upon the cut, method of preparation and more, but you're likely to find between 0.2 to 2.2 mcg of vitamin D in a standard three-ounce serving of pork.

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Resource Links:

• The U.S. Department of Health and Human Services and Department of Agriculture's Dietary Guidelines for Americans
• The National Institutes of Health (NIH)

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Source: https://www.symptomfind.com/health/vitamind-foods?utm_content=params%3Ao%3D740013%26ad%3DdirN%26qo%3DserpIndex

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