Q: I am Vitamin D deficient and should be taking 2,000 IU’s a day. Without taking vitamin supplements or drinking milk, what else can I eat or drink organically to make up for the deficit that would be equivalent to taking 2,000 IU’s a day?
A: The primary role of vitamin D is absorption and regulation of calcium. Osteopenia, osteoporosis, and osteomalacia are the chief consequences of vitamin D deficiency. Beyond bone health, there is emerging evidence that vitamin D supports the health of muscle and nerve tissue.The best way to avoid deficiency is to consume foods rich in vitamin D3, get some sunshine and take a supplement.
Vitamin D comes in two forms: vitamin D2 and vitamin D3. Vitamin D3 is preferred because it can be converted more efficiently to the form the body uses. Adequate intake from food alone is challenging because there is a limited number of foods that are rich in vitamin D3. The best sources are fatty fish such as salmon, sardines, trout, and mackerel. Below is a list of the best dietary sources of Vitamin D3.
- 3.5 oz salmon, wild caught: 600-1000 IU
- 3.5 oz. salmon, canned: 300-600 IU
- 3.5 oz. sardines, canned: 300 IU
- 3.5 oz. mackerel, canned: 250 IU
- 1 large whole egg: 41 IU
- 8 oz. fortified milk or yogurt: 100-200 IU
- 8 oz. fortified orange juice: 100 IU
During the summer, our body can make about 10,000 IU of vitamin D3 just from being outside in shorts and a t-shirt for 10-20 minutes! Unfortunately, from October through March the sun angle drops so low in the United States that we can no longer make vitamin D3 from the sun. Therefore, it is important to take a supplement to maintain an optimal blood concentration: 40-80 Nano grams per milliliter (ng/ml) 25-hydroxy vitamin D (25(OH)D).
What could increase the risk of developing vitamin D deficiency?
- Gastric bypass surgery
- Inflammatory bowel disease
- A condition that causes fat malabsorption
- Overweight or obesity
- Advanced age
If you have vitamin D deficiency — defined as less than 30 ng/ml 25(OH)D — your health care provider should review your medical history, supplements and medications to determine the dose that is right for you. Repeat blood tests should be done and your health care provider should adjust the dose as your vitamin D3 levels are restored.
A note about toxicity: Vitamin D toxicity is extremely rare and is usually due to taking extremely high doses—50,000 IU. Vitamin D toxicity—200-250 ng/ml 25(OH)D—can increase risk for calcification of the kidneys and blood vessels. These negative effects disappear once high dose are discontinued.