The Ignored Vitamin

As more is learned about the importance of the 'sunshine vitamin,' doctors are finding that most of us aren't getting enough

December 08, 2008|By Stephanie Desmon | Stephanie Desmon,stephanie.desmon@baltsun.com

She didn't always order the test. For more than two decades in private practice, in fact, Dr. Patricia Czapp almost never checked the vitamin D levels of her patients.

Things have certainly changed.

"For the last two years, I've been testing virtually all of my patients," said Czapp, a family doctor at Annapolis Primary Care. "The vast majority are straight-out deficient or insufficient. It's frightening to think there's that many people walking around with that deficiency."

What doctors are beginning to understand is that vitamin D isn't just important for absorbing calcium and building bones. And new research seems to be coming out by the day suggesting vitamin D deficiency can lead not just to osteoporosis but possibly to heart disease, multiple sclerosis, diabetes, even cancer. Vitamin D is believed to impact the immune system and, one researcher suggests, perhaps even the functioning of the brain.

"When you start reading about vitamin D, how can you not offer that to your patients?" said Czapp, who was persuaded by a newly trained colleague to check for deficiencies. "What we're coming to find out is most of the cells in the body have a vitamin D receptor. Vitamin D touches hundreds of different genes in the body, regulating the immune system, fighting infection, cancer cells."

She isn't the only physician ordering more vitamin D tests. She is part of a growing trend among doctors turning the once-rare test into a routine part of the annual physical, making it one of the top five blood tests ordered nationwide, according to two leading lab companies.

Patients, reading recent headlines about vitamin D or hearing about it on the news, are also pushing the popularity of the test, asking their doctors about a vitamin they rarely thought about before. One grass-roots health organization is advocating that everyone have their vitamin D levels checked.

All this comes as the American Academy of Pediatrics doubled its recommendation last month of how much vitamin D children should take daily and as other groups are pushing for adults to get up to 10 times more than is currently recommended in their diets.

As many as half of Americans, middle-age and older, are believed to get an inadequate amount of vitamin D.

"That's quite sobering and it really says we've got to do better with vitamin D nutrition," said Dr. Anthony W. Norman, a biochemist at the University of California, Riverside who has studied vitamin D for decades.

It isn't easy to get enough vitamin D in the diet. It is found in fortified milk, juice and cereals as well as oily fish such as mackerel, sardines and wild salmon.

Vitamin D is commonly referred to as the sunshine vitamin, because our bodies make it when we are exposed to the sun. In northern climes, however, the sun isn't strong enough in the winter months. In the summer months, just 10 to 15 minutes a day would provide enough vitamin D, but fear of skin cancer means many people are wearing sunscreen when they go out, which blocks the beneficial rays.

Many people get their vitamin D from supplements.

Vitamin D levels are checked by taking a patient's blood and testing for the level of 25-hydroxy vitamin D circulating in it. More than 30 nanograms per milliliter is generally considered a healthy level of vitamin D, and any less than 20 is considered deficient.

At the North Carolina-based LabCorp, spokesman Eric Lindblom said the vitamin D test is "one of our fastest-growing tests" and that the number ordered has not only doubled this year, but each of the last four years. At New Jersey-based Quest Diagnostics, the total number of tests has grown "by approximately 80 percent compared to last year," said spokeswoman Wendy Bost.

In September, Mount Washington resident Shannon Wollman had a routine physical and, for the first time, her vitamin D level was checked.

"Everything about my blood work was perfect," she said, "except for the vitamin D deficiency."

Her doctor at Sinai Hospital in Baltimore put her on a serious regimen of vitamin D - one prescription pill of 50,000 international units a week for eight weeks to be followed by an over-the-counter vitamin D dose of about 1,000 IU every day.

Wollman, who works as a major gifts officer in Sinai's development office and as an actress and singer, said she had never thought much about vitamin D until she was given those results. Then, she said, she brought it up with one of her friends at a Rosh Hashana dinner.

"She said, 'The exact same thing happened to me and now I'm on a prescription,'" said Wollman, 40. "It's more common than you realize, and people hadn't been discussing it.

"This was never something I paid any attention to, and now I take it every day."

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