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by Mary Calvagna, MS
Vitamin D is a fat-soluble vitamin. Fat-soluble vitamins are stored in the body's liver and fatty tissues. Vitamin D acts as both a vitamin and a hormone.
Vitamin D is found in some foods, but the main sources are vitamin D-fortified milk and sunlight. The ultraviolet rays of the sun react with cholesterol present in the skin and create previtamin D3. This compound goes through a series of reactions in the kidneys and the liver, and the final product is vitamin D.
Vitamin D's functions:
In children with low vitamin D levels, supplementation can improve bone mineral density. While the evidence does not give a clear answer, it has also been suggested that vitamin D supplementation may reduce the risk of osteoporosis, high blood pressure, and some forms of cancer.
Vitamin D has also been found to improve pain symptoms in patients with low vitamin D levels.
Recommended Intake TOP
Here are the guidelines for vitamin D intake:
IU: international units
The American Academy of Pediatrics recommends supplementation for all children who do not receive at least 400 IU of vitamin D daily. Breastfed babies may require a supplement within the first few days of life. Bottle-fed babies who do not consume enough vitamin-D fortified formula may also need the supplement, as well as any child who does not get plenty of vitamin D in their diet.
As seen above, requirements for pregnant women are the same as for healthy adults, though some believe that pregnant mothers should take more vitamin D than recommended. Furthermore, some experts believe that people at highest risk for vitamin D deficiency, such as older adults or those with limited sun exposure during the winter months, should take 1,000 IU or more daily. However, since the risk of vitamin D toxicity increases with higher doses, such recommendations ought to be discussed individually with your doctor.
Vitamin D Deficiency TOP
Symptoms of overt vitamin D deficiency are rare today, but can include the following:
More mild vitamin D deficiency is thought to be relatively common, especially in higher latitudes, and may lead to increased risk of osteoporosis.
Vitamin D Toxicity TOP
Since vitamin D is stored in the body and not excreted in the urine like most water-soluble vitamins, it is possible for it to accumulate and reach toxic levels. Here are safe upper level intakes for vitamin D:
Symptoms of toxicity:
It is unlikely for sunlight and diet to cause vitamin D toxicity.
If you have problems with any symptoms related to vitamin D toxicity, take less vitamin D supplements.
Major Food Sources TOP
Fortified foods provide the most vitamin D. Examples of foods that may be fortified with vitamin D are:
There are not many foods that are natural sources of vitamin D. Of those foods that have vitamin D naturally are (most to least):
A relatively small amount of sun exposure can provide adequate vitamin D. In a study of naval personnel in submarines, 6 days of sun exposure proved capable of supplying enough vitamin D for 49 sunless days. However, the actual synthesis of vitamin D through sunlight is affected by season, latitude, time of day, cloud cover, smog, use of sunblock, and skin pigmentation.
Health Implications TOP
Populations at Risk for Vitamin D Deficiency
The following populations may be at risk for vitamin D deficiency and may require a supplement:
Eat Right—Academy of Nutrition and Dietetics
Office of Dietary Supplements
Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293(18):2257-2264.
Calcium and vitamin D for treatment and prevention of osteoporosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated December 21, 2015. Accessed May 2, 2017.
Duplessis CA, Harris EB, Watenpaugh DE, Horn WG. Vitamin D supplementation in underway submariners. Aviat Space Environ Med. 2005;76(6):569-575.
Vitamin D. Office of Dietary Supplements website. Available at: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional. Updated February 11, 2016. Accessed May 2, 2017.
Vitamin D and skin health. Oregon State University Linus Pauling Institute website. Available at:
...(Click grey area to select URL)
Updated November 2011. Accessed May 2, 2017.
Vitamin D intake and supplementation. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated April 10, 2017. Accessed May 2, 2017.
4/5/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010;91(5):1255-1260.
2/11/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Winzenberg T, Powell S, Shaw KA, Jones G. Effects of vitamin D supplementation on bone density in healthy children: systematic review and meta-analysis. BMJ. 2011;342.
3/6/2013 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Schreuder F, Bernsen RM, van der Wouden JC. Vitamin D supplementation for nonspecific musculoskeletal pain in non-Western immigrants: a randomized controlled trial. Ann Fam Med. 2012;10(6):547-555.
Last reviewed May 2017 by Michael Woods, MD, FAAP
Last Updated: 5/2/2017
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