Do you need to take vitamin D

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Do adults need to drink vitamin D

International endocrine society does not recommend adults up to 75 years old to take vitamin D and take tests for its maintenance. An exception is people with an increased risk of fractures (for example, due to osteoporosis) and diseases affecting the absorption of this substance.

Pavel Baranov, a member of the Russian and American associations of endocrinologists, explained to the “cold” that the intake of vitamin D does not improve the state of healthy people: “Studies show that this does not affect the frequency of fractures, or cardiovascular diseases, nor the risk of Covid, or on life expectancy .”

So, in The Lancet there was a meta -analysis of 81 studies with a total sample of more than 53 thousand people and found that vitamin D does not have a clinically significant effect on the mineral density of bone tissue and does not prevent fractures. And the study conducted in the United States with 25871 participants confirmed that the intake of vitamin D for more than five years does not lead to a decrease in the risk of cancer or adverse cardiovascular events.

The conclusions of the International Endocrine Society are based on studies conducted in developed countries that have no Russian analogues, endocrinologist Stanislav Khan draws attention. “This is a subtle moment, because the question of the availability of vitamin D from the sun and food should be considered separately for each country,” he believes.

Endocrinologist Marina Sviridonova notes that it is not necessary to take tests and drink vitamin not because it is “unequivocally devoid of meaning”, but because the expediency of this is not proven. “If there is no certainty that nutrition and the sun provide the body with a sufficient level of vitamin D, its preventive dose will not be superfluous,” she said.

Other interlocutors of the "cold" agree with Sviridonova. “You can take vitamin D, but not necessary, especially if you lead an active and healthy lifestyle, spend time in the fresh air, eat in a balanced and diverse. But if you are so calmer, then the preventive dosage will not hurt. In the end, vitamin D bubble is 10 times cheaper than a blood test for vitamin D, ”summarizes Pavel Baranov.

Who still needs to take vitamin D

Children under 18 years old - for the prevention of rickets and reducing the risk of respiratory tract infections.
Older people from 75 years old.
Pregnant women - to reduce the risk of premature birth, death of the baby in the womb or in the first month of life.
People with a pre -Aibet, an increased blood sugar, to reduce the risk of diabetes. At the same time, experts emphasize that it is also important for this to adhere to a healthy lifestyle.

Do I need to take tests for vitamin D

An international endocrine society recommends that the above categories take vitamin D empirically - that is, without preliminary testing.

The interlocutors of the "cold" agree that in laboratory studies really in most cases there is no need. In addition, standard tests for vitamin D measure 25-hydroxyvitamin D (25 (OH) D) in the blood, which allows us to draw only approximate conclusions about a possible deficiency, says Pavel Baranov.

“25 (OH) D is an inactive form of vitamin D, as a reserve in the pantry. Calcitriol is formed in the kidneys-an active form, and it is it that affects phosphorus-calcium metabolism, ”the doctor explains. According to him, in many private clinics, patients are directed to vitamin D screening without need, simply because the tests are a significant part of their profit.

Stanislav Khan agrees with the colleague. “A convulsive study of the content of this vitamin for everyone in a row is rather pointless and justified only in patients at risk. I wanted to assess the level 25 (OH) D - please did not want to - also okay, ”he says.

In addition, the International Endocrine Society came to the conclusion that it cannot clearly establish which indicators 25 (OH) D are considered deficit. In the last guide of 2011, the authors recognized the level of lower than 30 ng/ml insufficient. Now experts say that they do not have enough data to call this value threshold.

Among the diagnoses, in which vitamin D tests are shown, Pavel Baranov calls diseases of the near -shaped glands, bones, kidney pathology and liver failure, malabsorption syndrome - impaired nutrient absorption - as well as a number of other severe and rare diseases.

Endocrinologist Marina Sviridonova adds that vitamin D tests will not interfere when taking glucocorticoids, antiretroviral, antifungal and anti -epileptic drugs, chill and orlistate. The use of these drugs is one of the risk factors for the development of osteoporosis.

How much vitamin D you need to drink and whether it can harm its excess

The management noted that the daily intake of vitamin D in small doses is preferable than irregular - in large ones. The International Endocrine Society recommends people under 70 to accept 600 international units (IU) per day, and those older are 800 ME. The packaging usually indicates how much the drug is contained in a drop of the drug. “Dosage from 600 to 1000 IU is enough to reduce any potential risks associated with the lack of vitamin D,” comments Pavel Baranov.

“Vitamin D can be taken both on an empty stomach and during eating at any time of the day. In the absence of problems with the biliary traffic, any of its forms are perfectly absorbed - both water and oil, ”says Marina Sviridonova. She notes that a long -term intake of excessively high dosages can increase the level of calcium in the blood and urine, which threatens disorders in the work of internal organs. Formally implies dosages above 4000 me per day, but the doctor met such a complication in some patients taking from 2000 me.

Pavel Baranov also calls other probable consequences - kidney problems and excessive resorption (that is, destruction) of bone tissue. He explains that we are talking about exceeding the dosage by ten times. “Many experts extol the role of vitamin D, assure patients that this is salvation from all troubles, and prescribe horse dosages. The logic “the more, the better” does not work here. Both a disadvantage and an excess is always bad, ”says Stanislav Khan.

Why vitamin D is important

Vitamin D is primarily necessary for phosphorus-calcium metabolism: it helps to absorb both substances in the intestines and supports their necessary blood content. This is important for bone growth and bone mineralization - in simple words, it provides its density and strength. “Our bones are a living fabric that is updated every day,” explains Pavel Baranov.

In infancy, when the body grows especially quickly, a pronounced deficiency of vitamin D can lead to rickets. In this disease, the child’s bones are softened and can be deformed, which increases the risk of fractures, curvature of the legs and spine. Among other unpleasant consequences are pain in muscles and bones, later the appearance of teeth and caries.

In old age, vitamin deficiency D threats osteoporosis - a decrease in bone mass and an increase in bone fragility. This diagnosis is more often made by women due to hormonal changes after menopause. According to the International Osteoporosis Fund , fractures associated with this disease occur in every third woman and every fifth man over the age of 50. This can happen almost without reason: for example, due to falling from a small height, when tilted or lifting a heavy bag.

The relationship of vitamin D deficiency with other diseases, except for bone, has not yet been proven. This conclusion was reached by the authors of the article “Vitamin D: 100 years of discoveries, but disputes continue” , which was published in 2023 in The Lancet and summarize research over the past century. “A large number of studies are conducted in order to understand how it affects, for example, on the immune system, cancer prevention and heart function. But it’s too early to make the final conclusions on this subject, ”says Stanislav Khan.

Where do we get vitamin D

We get more than 80% of vitamin D under the influence of ultraviolet radiation. “During periods of contact with sunlight, it is synthesized in the body and accumulates in adipose tissue, and then slowly releases,” explains Pavel Baranov.

Experts cannot say exactly how much time needs to be spent in the sun in order to avoid vitamin deficiency: it depends on geography, time of day and year, air purity, age and body complexion. Even clothing affects: if she closes her legs and arms, this reduces the production of vitamin D.

For most assessments , it is enough to spend 15 minutes a day on the street from 10:00 to 15:00 three times a week. For example, the British living in a large Manchester - approximately at the latitude of Samara - have enough 13 minutes at noon three times a week in the summer. But do not forget to use sunscreen - SPF reduces the risk of skin cancer, but does not prevent the synthesis of vitamin D.

The body closes the rest of the need due to food. “It is important that the diet is diverse and on a regular basis includes products that contain vitamin D: eggs, fish, dairy and seafood,” explains Pavel Baranov. For example, 100 grams of salmon contains up to 800 international vitamin D units, in 100 grams of butter - up to 150, and almost 1700 in herring.