Now a new number is getting marquee treatment: a vitamin D level.
Do you know yours?
In the past year, a test that checks vitamin D levels in the blood has surged in popularity among doctors.
This summer the Institute of Medicine is expected to revise its recommendation for daily vitamin D intake. Experts agree the current guidelines are far too low.
If you have symptoms that include fatigue and muscle aches and pains, don't be surprised if your doctor suggests a vitamin D blood test at your next visit. Because of widespread deficiencies, some won't need any symptoms to suggest it.
Vitamin D is important to bone and muscle health for certain, but vitamin D experts worry that D deficiency is implicated in cancers, autoimmune diseases, heart disease, diabetes, high blood pressure, infections and depression, to name but a few ailments.
Carla Aamodt, an internal medicine doctor with St. Luke's Health System, said about half the patients she was testing were vitamin D deficient, with many more "borderline."
Michael Kennedy, a family physician at the University of Kansas Hospital, said a third to a half of the patients he tested in the past year were deficient.
Cardiologist James O'Keefe said general population statistics were worse. Lack of sun exposure, the natural way the body makes vitamin D, helps explain the deficiencies.
"Upwards of 70 percent of American adults are vitamin D deficient or insufficient," said O'Keefe, director of the preventive cardiology program at St. Luke's Mid-America Heart Institute. "In the last year, awareness of vitamin D deficiency has really exploded."
Doctors want to see a level of at least 30. That's nanograms per milliliter. Some prefer a minimum of 40. Levels in the low to mid-20s aren't unusual, and both Aamodt and Kennedy have had patients with levels under 5 ng/mL.
Billie Howard Barnes of Kansas City knows how that feels. The fourth-grade teacher at Pembroke Hill School had her vitamin D checked two months ago -- doctor-recommended and nothing she had considered before -- and was surprised by the call she got.
"The nurse says: 'I believe this is the lowest level we've ever had. Yours is 5.' "
Barnes is African-American, and people with darker skin, she learned, are at a higher risk of vitamin D deficiency.
"I'm 43, and getting up in the morning, my feet would hit the floor and every joint in my body was sore," she said. "I didn't realize how bad it had gotten. It just kind of crept up on me."
After several weeks of a high prescription dose of a vitamin D supplement, Barnes said she could tell a difference.
"It wasn't an instant thing, but I just feel much better. I'm not as stiff. Colleagues say there's more pep in my step," said Barnes, mother of 10-year-old twins. "And I'll tell you, my children are taking 1,000 IU (international units) a day now."
Of course, the potential wonders of other vitamins have been heralded before, only to be debunked or downplayed later.
But O'Keefe and others point out that D is unlike other vitamins and should be recognized for what it is: a hormone.
"Vitamin D is misnamed," he said.
Although there are food sources of vitamin D, its natural production takes place inside the body after the skin is exposed to sunlight. As a hormone, vitamin D helps regulate gene function throughout the body, so its implication in various body functions and disease processes makes sense. Its strong roles in bone and muscle health and in aiding calcium absorption have long been known.
The process nature intended -- ultraviolet rays on exposed skin equals vitamin D production -- would be the most likely method to remedy deficiencies except for two matters. People aren't out in the sun enough. And if they were, they would increase their risk of skin cancer.
"We're doing such a good job putting on sunscreen and being cautious because of skin cancer that we kind of left vitamin D out of the equation," Kennedy said.
That was then. Responding to an array of vitamin D research in the medical literature, Kennedy said he now regularly informed patients about the possibility of D deficiencies, and he often suggests ordering the blood test.
The test is called "25-hydroxy vitamin D," costs about $100 and may or may not be covered by insurance. O'Keefe said in the past year it had become the most popular "a la carte" blood test doctors were ordering.
If a patient is deficient, levels usually can be increased with vitamin D supplements, typically in pill form. Food sources of vitamin D, such as ocean fish and fortified milk, typically can't be consumed in enough quantities to do the trick.
For borderline and slight deficiencies, doctors often recommend an over-the-counter supplement containing 1,000 IU or more of vitamin D3 (cholecalciferol), taken daily. Many multivitamins contain 400 IU of vitamin D.
Up to 2,000 IU in a daily vitamin D supplement is considered safe for most people without worry of toxicity. Severe deficiencies may require a prescription.
Some doctors recommend both supplements and short amounts of sun exposure, with the caveat not to burn the skin. O'Keefe said a safe approach for many patients was to take a supplement plus get a maximum 15 minutes of unprotected sun exposure. But many doctors aren't comfortable suggesting sun exposure to patients.
"I'm a big advocate for sunscreen, but I'm simultaneously a big advocate for vitamin D supplements," Aamodt said.
With help from the noonday sun, the body can make a lot of vitamin D.
It's estimated that a light-skinned person in "optimal" conditions -- 60 percent skin exposure, sitting in the sun for 30 minutes between 10 a.m. and 2 p.m. in warm months -- would make 10,000 IU of vitamin D.
People with darker skin have to be in the sun longer to make the same amount and thus are more likely to be deficient.
A year and a half ago, the American Academy of Pediatrics doubled its recommendation for daily vitamin D supplements for infants through adolescents, from 200 to 400 IU.
Anecdotally, Aamodt said, patients she has treated who have vitamin D levels below 10 ng/mL said they "feel better overall, have more energy with less muscle aches and pains."
Vitamin D and calcium improve bone density and reduce falls and fractures. And although many other correlations with health and disease prevention are suspected with improved vitamin D levels, the jury is still out.
"I think the data will only get better," Aamodt said. "Stay tuned."
Vitamin D levels
--40 to 70 ng/mL: Excellent
--30 to 39: Adequate
--20 to 29: Mildly deficient
--10-19: Moderately deficient
--Under 10: Severely deficient
HealthPro Nutrient's Answer - Youth D3
Youth D3 contains natural vitamin D3 which has shown to provide a major benefit in cardiovascular health & skeletal support. D3 is normally synthesized in the body from sunlight, but due to the winter season, weather conditions, and sunscreen, the body's ability to produce optimal vitamin D3 levels are inhibited. Some believe that annual fluctuations in vitamin D3 levels explain the seasonality of the flu virus.
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Published 4/21/10 by The Kansas City Star, Mo
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