Figuring out all the factors that can affect a person's vitamin D levels is complicated.
You can get the vitamin from food (mainly because it's been added; few foods are natural sources of vitamin D) and by taking supplements (many doctors recommend taking 800 IU of vitamin D3 a day).
But vitamin D is also produced by the body in a complex process that starts when rays in the invisible ultraviolet B (UVB) part of the light spectrum are absorbed by the skin. The liver, and then the kidneys, are involved in the steps that eventually result in a bioavailable form of the vitamin that the body can use.
Here are nine factors that can influence a person's vitamin D level:
1. The latitude where you live. At higher latitudes, the amount of vitamin D–producing UVB light reaching the earth's surface goes down in the winter because of the low angle of the sun. In Boston, for example, little if any of the vitamin is produced in people's skin tissue from November through February. Short days and clothing that covers legs and arms also limit UVB exposure.
2. The air pollution where you live. Carbon particulates in the air from the burning of fossil fuels, wood, and other materials scatter and absorb UVB rays. Ozone absorbs UVB radiation, so holes in the ozone layer could be a pollution problem that winds up enhancing vitamin D levels.
3. Your use of sunscreen — in theory. Sunscreen prevents sunburn by blocking UVB light, so theoretically, sunscreen use lowers vitamin D levels. But as a practical matter, very few people put on enough sunscreen to block all UVB light, or they use sunscreen irregularly, so sunscreen's effects on our vitamin D levels might not be that important. An Australian study that's often cited showed no difference in vitamin D between adults randomly assigned to use sunscreen one summer and those assigned a placebo cream.
4. The color of your skin. Melanin is the substance in skin that makes it dark. It "competes" for UVB with the substance in the skin that kick-starts the body's vitamin D production. As a result, dark-skinned people tend to require more UVB exposure than light-skinned people to generate the same amount of vitamin D.
5. The temperature of your skin. Warm skin is a more efficient producer of vitamin D than cool skin. So, on a sunny, hot summer day, you'll make more vitamin D than on a cool one.
6. Your weight. Fat tissue sops up vitamin D, so it's been proposed that it might be a vitamin D rainy-day fund: a source of the vitamin when intake is low or production is reduced. But studies have also shown that being obese is correlated with low vitamin D levels and that being overweight may affect the bioavailability of vitamin D.
7. Your age. Compared with younger people, older people have lower levels of the substance in the skin that UVB light converts into the vitamin D precursor, and there's experimental evidence that older people are less efficient vitamin D producers than younger people. Yet the National Center for Health Statistics data on vitamin D levels fly in the face of the conventional wisdom that vitamin D inadequacy is a big problem among older people. They don't show a major drop-off in levels between middle-aged people and older folks.
8. The health of your gut. The vitamin D that is consumed in food or as a supplement is absorbed in the part of the small intestine immediately downstream from the stomach. Stomach juices, pancreatic secretions, bile from the liver, the integrity of the wall of the intestine — they all have some influence on how much of the vitamin is absorbed. Therefore, conditions that affect the gut and digestion, like celiac disease, chronic pancreatitis, Crohn's disease, and cystic fibrosis, can reduce vitamin D absorption.
9. The health of your liver and kidneys. Some types of liver disease can reduce absorption of vitamin D because the ailing liver isn't producing normal amounts of bile. With other types, steps essential to vitamin D metabolism can't occur — or occur incompletely. Levels of the bioactive form of vitamin D tend to track with the health of the kidneys, so in someone with kidney disease, bioactive vitamin D levels decrease as the disease gets worse, and in end-stage kidney disease, the level is undetectable.
Vitamins and supplements: what you need to know before taking them
After vitamin D is absorbed through the skin or acquired from food or supplements, it gets stored in the body’s fat cells, where it remains inactive until needed. Through a process called hydroxylation, the liver and kidneys turn the stored vitamin D into the active form the body needs (called calcitriol). In case you were wondering, it doesn’t matter if you’re getting D2 or D3, and the sunlight-generated kind isn’t better than the nutritional variety. “The body can use each perfectly fine- You can now get 50,000 IU tablets over the counter. There are patients with specific issues who might need a prescription for high levels of vitamin D, but for most people, that amount will raise your vitamin D level too high. One of the biggest challenges we’ve faced in dermatology and in the world of skin cancer prevention has been a lot of misinformation about vitamin D metabolism. There are claims that one needs to get a certain amount of sun exposure every day in order to produce enough vitamin D to be healthy. It’s just not true. The majority of people can get their vitamin D from nutritional supplements and from vitamin D-fortified foods.
Mutations in the vitamin D receptor (VDR) gene cause hereditary vitamin D-resistant rickets (HVDRR), a rare bone development disorder that prevents the body from absorbing calcium and phosphate properly:
Symptoms
Low levels of calcium and phosphate in the blood, resulting in soft, weak bones that are prone to fracture. Other symptoms include bowed legs, muscle weakness, and seizures. Some children with HVDRR also develop alopecia, or hair loss, on the scalp and body.
Causes
VDR gene mutations prevent the VDR protein from functioning properly. These mutations can cause the VDR protein to be abnormally short, or produce an abnormal receptor that can't bind to DNA, RXR, or calcitriol.
Treatment
Treatment for HVDRR involves administering high doses of calcium intravenously or orally to reverse hypocalcemia and secondary hyperparathyroidism. Inheritance HVDRR is often associated with consanguinity. The heritability of hypovitaminosis D has been estimated to be between 22% and 86%.
Epigenetics and vitamin D are closely related, with epigenetic modifications affecting vitamin D levels and response, and vitamin D regulating epigenetic events. Epigenetic changes are reversible and don't alter the DNA base sequence, but they can change how the body reads DNA.
Here are some ways that epigenetics and vitamin D relate:
Epigenetic modifications of vitamin D metabolism genes
These modifications can affect vitamin D levels and response. For example, DNA methylation can silence critical vitamin D tool genes.
Vitamin D receptor (VDR) gene methylation
Epigenetic modifications of the VDR gene, such as DNA methylation, may contribute to the development and progression of many human disorders, including autoimmune diseases, cancer, and infectious diseases.
Maternal vitamin D depletion
This can alter DNA methylation in offspring over multiple generations.
Vitamin D resistance
This can be overcome by administering calcitriol and DNMT or miRNA inhibitors.
Vitamin D deficiency
This is associated with an increased risk of osteoporosis, cardiovascular disease, and some cancers.
Quanlim Life
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