Too much vitamin D?

I take two 10 microgram tablets of vitamin D every day. Is this too much? I eat fish three or four times a week.

As a specialist
Pekka Järvensivu, Senior Medical Advisor, Orion

Answer According to the current official Finnish recommendations, adults of working age need 7.5 micrograms (µg) of vitamin D per day. Many studies suggest that this level prevents vitamin D deficiency but is not necessarily enough to achieve the known health effects of vitamin D.

According to the Finravinto 2007 study, the intake of vitamins and trace elements by adults in working age is at a relatively good level on average. However, the intake of vitamin D and iron is low, and women and young men are not getting enough folate (folic acid).
The use of vitamin D supplements has been shown to considerably improve vitamin D levels in the body. Women use more vitamin D supplements than men, even though nearly all adults in working age would need them.

Aging people, i.e., over 60-year-olds, need more vitamin D than the young. This is because we are spending less time in sunlight when we age, the skin no longer produces vitamin D as efficiently as before and our body cannot make use of the vitamin content of food as efficiently as the bodies of young people.
The skin of over 70-year-olds produces only 30 per cent of the vitamin D amount produced by a young person's skin. The difference is due to a decrease in the amount of provitamin D3 in the skin when we grow older.

It is recommended that over 60-year-olds receive 20 micrograms vitamin D daily throughout the year. Some scientific articles suggest even 50 µg vitamin D daily.

Vitamin D supplement necessary to a baby?

Can I stop giving vitamin D supplement to a 2-month-old, and what consequences could it have?

As a specialist
Pekka Järvensivu, Senior Medical Advisor, Orion

Answer According to recommendations, babies under 12 months should receive vitamin D supplement daily throughout the year.  If the baby is fully on breast milk or is being partially fed with breast milk, the daily dose of vitamin D is 10 micrograms. If the baby’s food consists of formula, special formula and/or vitamin-enriched baby gruel, the dose is 6 micrograms of vitamin D per day.

Continuous vitamin D intake is particularly important for the baby’s rapidly growing bones.

Cuplaton drops are used for the treatment of the so-called three month colic. Babies suffering from wind can also be treated with Cuplaton. Consult your Child Health Clinic for more advice on when and at what age to start using them.

Absorption of food

I have been wondering what happens to the absorption of food and nutrients when you grow older.

Since one’s eyesight and hearing deteriorate with age, would it be possible that the absorption of food becomes less efficient, so that we need something extra to make up for it? We are told about the nutritional quality of food and that we get everything we need from our diet if we eat right. I would like to know if this really is so. For example, does this apply to a young person with a digestive disorder, or an elderly person whose system may not be working like it used to?

ANSWER You are partially right. For example, in the elderly the absorption of vitamin D is less efficient than in younger people, which is why their recommended vitamin D intake is higher. According to the recent recommendation published by the National Nutritional Council, over 60-year-olds should receive 20 micrograms of vitamin D daily throughout the year.
Sufficient protein intake should also be ensured, because when you grow older your body no longer uses protein as efficiently as before. Daily protein intake recommended for the elderly is about 100 g.

Aging is associated with many elements that affect our nutritional needs. For example, an illness can deplete your body of its nutritional reserves, and in this case it is a good idea to use nutritional supplements. When we are aging we should also make sure that we are eating enough and following a healthy diet. 

Enough vitamin D

When do we get enough vitamin D from the sun?

As a specialist
Kirsi Saario, Product Manager, Orion

Answer If the spring and summer are reasonably sunny, we get vitamin D from the sun between May and end of August. However, sometimes most of the summer is so cloudy and rainy that it is difficult to get enough vitamin D from sun exposure alone.

Winter sun is not strong enough to trigger vitamin D production even though late winter sunlight feels warm on the skin. Our vitamin D levels are at their lowest in March and many Finns would benefit from the use of vitamin D supplements at least until May.

Vitamin D

Does vitamin D from supplements get absorbed as well as vitamin D from the diet?

As a specialist
Kirsi Saario, Product Manager, Orion

Answer Yes. Vitamin D is transformed into the active form of vitamin D in the intestine exactly the same way regardless of whether it is obtained from food or supplements. This is indicated by several studies. 

Sunlight & diet

I live in a subtropical area and get lots of sun. Do you suppose that vitamin D somehow influences prostate cancer? How? For several years I have been taking a dietary supplement that contains Saw palmetto and zinc, which supposedly gives some protection. Do such supplements work in your opinion?

As a specialist
Ulla Timonen, Senior Medical Advisor, Orion

Answer Vitamin D is synthesised by the body upon exposure to ultraviolet (UV) radiation from sunlight. It plays a critical role in calcium absorption and bone health, and deficiency in the vitamin can lead to rickets in children and osteoporosis in adults. Recent research has also suggested that vitamin D can help prevent autoimmune disorders and a variety of chronic diseases, including diabetes, heart disease and cancer. Some scientists have stated that if everyone increased the amount of time they spent in the sun, far more lives would be saved from cancers prevented than would be lost from increased skin cancer cases.

In the near future, OrionNOW will run a special feature on vitamin D. Please read more on the subject in those articles.

Saw palmetto is an alternative supplement sold in health food stores for treatment and prevention of benign prostatic hyperplasia (BPH), prostatitis and "urinary difficulty" in men. The mechanism of action mimics the pharmacologic action of finasteride (decreasing also PSA values) used for the treatment of prostate hyperplasia. Therefore, saw palmetto potentially interferes with PSA levels in men and decreases prostate cancer detection.

The supplement of zinc, especially taken in higher doses than recommended, can increase the risk of prostate cancer.

It’s very important that doctors and patients communicate with each other, which means that patients should inform their doctors about their use of any over-the-counter vitamins, minerals, or herbs.

We can't change our genes, but changes in our lifestyle, especially regarding diet and exercise, can make a difference when it comes to prostate cancer prevention. These are factors we can take control of to be proactive in preventing the disease. Remember, it is important to speak to your doctor before embarking on a diet plan that includes dramatically increasing your consumption of any one food.