Vitamin D For Dummies
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If you have dietary restrictions or you have a condition that reduces your ability to absorb vitamin D, you can still get plenty of vitamin D. How, you ask? From the sun, of course. But suppose that you live at the latitude of San Francisco (37 degrees north latitude) or above, and it’s winter. You can’t get enough vitamin D from the sun at that latitude in the winter.

Getting your vitamin D if you’re a vegetarian

Other than fortified soy milk, fortified orange juice, and margarine, a vegetarian can’t eat much to get vitamin D. Be wary that although vitamin D2 has been described as “the plant vitamin D,” most plants contain almost none of it. Only certain yeasts and irradiated mushrooms have relevant amounts of vitamin D. Perhaps irradiated mushrooms are a choice, but they’re not yet being sold in stores. Vegetarians may have to take a supplement.

In addition to tablets, vitamin D also comes packaged in gel capsules because vitamin D is fat soluble. These capsules come from animal bones, however, so you won’t want to take those. Instead, choose a vegetable-based capsule, a tablet, or vitamin D in liquid form.

In addition, vitamin D2 is the form of vitamin D that comes from vegetable sources like mushrooms and yeast. You might want to make sure you’re getting that form of vitamin D and not vitamin D3, depending on how strict you are. (But the vitamin D2 in those supplements is actually chemically synthesized, and isn’t harvested from plants.)

Getting your vitamin D if you can’t absorb fats

If you have a condition that reduces your ability to absorb fat, you may suffer from vitamin D deficiency even if you eat these foods. Because vitamin D is fat soluble, if you aren’t absorbing fat, you aren’t absorbing vitamin D.

Several diseases and other medical conditions can prevent you from absorbing fats normally. Because vitamin D is a fat-soluble substance, you can become deficient in vitamin D if you get no sun. Among the conditions are the following:

  • Use of antibiotics, especially neomycin.

  • Excessive use of alcohol.

  • Crohn’s disease, a form of inflammatory bowel disease that usually affects the intestines and results in crampy abdominal pain, loss of appetite, pain with bowel movements, watery diarrhea with blood, and weight loss.

    Vitamin D may play an important role in controlling Crohn’s disease, so you want to be sure to get sufficient quantities of this vitamin.

  • Celiac disease, a digestive disease that occurs when you eat the protein gluten from bread, pasta, or other foods containing gluten. The result is a loss of ability to absorb many nutrients, with resultant vitamin deficiency. You may develop diarrhea, abdominal pain, and bloating. The disease can be controlled by avoiding anything with gluten in it.

  • Bacterial overgrowth or parasites in the intestine, which changes the environment of the intestine so the body absorbs food poorly.

  • Short bowel from intestinal resection or bariatric surgery, leaving an inadequate length of intestine to absorb nutrients.

  • Insufficient digestive agents. Pancreatic enzymes and liver enzymes are needed to digest foods. Any disease that blocks those enzymes results in malabsorption of fats. Examples are obstruction of the bile tubes that carry the enzymes, liver failure, cystic fibrosis, pancreatic cancer, pancreatitis, and removal of the pancreas.

If you have any of these conditions, obviously, you want to cure the condition to return to good health and normal uptake of nutrients. But get out in the sun for a few minutes a day. It won’t just raise your vitamin D; it will raise your spirits as well.

If you can’t get out in the sun and you can’t absorb vitamin D from food, you may have to get an injection of vitamin D, but this is a rare situation. Sometimes extremely high doses of oral vitamin D can work for conditions in which vitamin D is poorly absorbed (such as short bowel), but that approach needs to be done under the supervision of your doctor, with monitoring of the blood 25-hydroxyvitamin D levels to know that enough vitamin D is being absorbed and not too much.

Dermatologists can also administer UVB light under controlled circumstances to enable vitamin D to be formed while minimizing the risk of skin damage and cancer.

About This Article

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About the book author:

Alan L. Rubin, MD has been a physician in private practice for more than 30 years. He is the author of several bestselling health titles, including Diabetes For Dummies, High Blood Pressure For Dummies, and Thyroid For Dummies.

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