Evolving Wellness^TM

In recent years there has been a tremendous increase in the awareness and use of vitamins and minerals.

Although there have been many new discoveries on how our body metabolizes and deals with these micronutrients, we are far from knowing it all where these substances are concerned.

It is thus very important for all of us to stay as current as possible on what new discoveries are being made, where our health is concerned, as what may have been unnecessary in the past today is necessary or vice-versa.

In today’s tutorial let us cover one of the most talked about vitamins today - vitamin D.

Vitamin D is a fat soluble vitamin.  It can be found in various forms in the body such as cholecalciferol, calcidiol and calcitriol. 

Sources of Vitamin D

Due to its regulatory properties and the tissues it targets, vitamin D in its active form is regarded like a steroid hormone. It can be obtained from 3 major sources:

• Sunlight
• Supplements
• Dietary food products

Sunlight is the major source of vitamin D, since UV rays  are needed for the reaction that converts 7-dehydrocholesterol to cholecalciferol (vitamin D₃) and this prompts further conversion to the most active form calcitriol.

One need only spend an average of 10 - 15 minutes in the sun to get the recommended intake of 400IU.  This is still by far the most efficient and easiest way to obtain vitamin D.

Supplements are available of pure vitamin D or in combination with other vitamins (ie. multivitamin mixes).  Usual strength found of supplemental vitamin D alone in today’s pharmacies is 400 or 800IU.  In multivitamin packages such as Centrum the dose is also 400IU, however others contain lower amounts varying to even below 100IU. 

Although supplements are the preferred method of choice for taking in vitamin D, they are the least efficient where our body is concerned as it is not the most natural way for our body to obtain and metabolize this vitamin.

The third source of vitamin D can be obtained from food products in our daily diet.  The most abundant sources of dietary vitamin D are oily fish, like tuna, salmon, sardines, eggs, liver as well as milk and few other dairy products. Fish products contain 200-1600IU/100gm and 250ml of milk contains roughly 100IU.

Dietary vitamin D is a good choice for most and much more efficient in terms of actual absorption of the vitamin compared to supplements but its drawback is that it is not feasible for those who choose to avoid animal products for other health reasons.

Vitamin D Metabolism

So based on the above 3 sources, as we already mentioned vitamin D from sunlight is the easiest form to obtain, most efficient for our body and plentiful upon adequate exposure. 

The problem with dietary vitamin D is that it is not fully active and must be converted in the body by the liver to be used.  

Metabolism of vitamin D from sunlight begins with cholesterol being converted to 7-dehydrocholesterol which is secreted onto the skin’s surface. Upon UV exposure, 7-dehydrocholesterol absorbs specific wavelengths and is converted to vitamin D₃ in the skin.  Other byproducts are formed, but these are usually lost with skin turnover.

Vitamin D₃ then enters the blood stream, being carried by a vitamin D binding protein and is transported to the liver where it is converted to calcidiol (25-OH-Vit D₃). 

Dietary vitamin D follows somewhat a similar path except that it is packaged into special units with the help of bile salts and absorbed into the intestinal cells.  It is carried through by the lymphatic system into the blood and following to the liver where it encounters the same fate of conversion to calcidiol. 

From the liver calcidiol is transported to the kidney via the blood.  There a reaction occurs producing the active form of the vitamin - calcitriol (1,25-(OH)₂Vit D₃). 

Calcitriol is then the form of the vitamin used by bodily tissues and processes. 

Very little vitamin D is excreted, however that which is lost is through the bile. 

From this one can see that lacking exposure to the sun, such as during the winter months or absence of equal dietary amounts will have an adverse effect on all those functions that depend on its presence.

Functions of Vitamin D In Our Body

Vitamin D is an essential nutrient for bone and tooth development and maintenance. 

Vitamin D is also crucial for calcium absorption since it increases it by 30-80%.

Calcitriol mainly functions alongside the parathyroid hormone (PTH) in maintaining steady calcium concentrations in the blood.  When these decline PTH secretion increases and this signals calcitriol to take action.

As a hormone, vitamin D targets 3 main tissues: the intestine, kidney and bone. 

In the intestine, calcitriol works to increase the absorption of calcium and phosphorus.  There it interacts with genes that code for proteins involved in calcium transport. The newly synthesized proteins act in the intestine to enhance calcium absorption. 

Calcitriol also promotes this process by helping to open up voltage gated calcium channels for rapid calcium absorption. 

In the elderly, the relevance of the action of vitamin D in the intestine is that with age intestinal calcium absorption decreases and this can be linked with a diminished capacity to catalyze vitamin D from the sun. This therefore results in a decreased capacity to convert vitamin D to the required metabolites. 

In the kidney, calcitriol along with the parathyroid hormone is involved in the reabsorption of calcium and phosphorus from the distal renal tubule. 

Again with age as kidney functions decrease, these processes are less efficient. 

In bone, calcitriol works with osteocalcin. Here its main function is bone mineralization, bone modeling and remodeling.

With regard to the metabolism and function of vitamin D in humans, it is therefore very important to get an adequate intake to prevent deficiencies and possible future conditions such as osteoporosis. 

Recommended Vitamin D Dosage

Nutrient recommendations suggest 200IU for children and 400IU for adults, although reports vary as to the exact requirement. 

As stated before, this is easily obtainable from the sun (10-15 min/day). 

Elderly people require higher doses of 400-800IU and commonly most of this needs to come from a supplement since many may have restricted diets and sun exposure. 

Higher doses are required in these individuals since with age there can be increased bone loss.  In the case of post menopausal women the decline of estrogen levels causes increased bone loss as well. 

In general only individuals at risk for osteoporosis or other related conditions would require higher intakes of vitamin D.  This includes: smokers, heavy drinkers, people lacking dairy products or ones not eating a balanced diet, as well as individuals with a genetic predisposition to the disease. 

Also individuals on chronic steroids need to consume higher intakes, at least 800IU of vitamin D per day as well as have an increased calcium consumption (1500mg/day).  This is due to the fact that steroid therapy results in bone loss which is actually most rapid during the first 6 months.

Conclusion

Therefore we can see that not only is vitamin D critical for many chemical reactions in our body, but it itself has many biochemical reactions it has to undergo in order to be used appropriately.

Today vitamin D is suspected to be one of the leading vitamins deficient in the majority of the population in developed countries. It has also been linked to the prevention of cancers such as breast cancer as well as other conditions, including those tied to the immune system. Hence it is critical to make sure we all get enough of this very important vitamin.

Thus, as noted supplements may be necessary for some people. However, for the majority of the population daily sun exposure is not only sufficient but also the most efficient method for obtaining this vitamin and having the body use it. For safe sun exposure see Part 5 of our Sun Smart Series.

*Photograph courtesy of  4ever30something

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