Commentary by Emily Frank, M.D.
Just around the time women come into motherhood, we begin witnessing our mothers and grandmothers suffering broken wrists, hips and spines.
As it happens, osteoporosis — the result of losing too much bone, producing too little of it, or both — leaves one in two women older than 50 with a broken bone, and many with loss of height. After that, a cascade of repeated fractures, pain and disability can occur.
It doesn’t have to be that way. Taking steps to prevent osteoporosis is easy and inexpensive. Today, we focus on one bone-health villain: vitamin D deficiency.
Vitamin D occurs naturally in the body in response to sun exposure. Just let the sun kiss your bare skin for a few minutes, and, voilà, you have a new stash of vitamin D. Easy enough, right? The trouble is with more of us slathering on 60 SPF sunscreen ’round the clock and leading indoor lifestyles — especially as winter approaches — we don’t get enough rays to produce vitamin D.
That deficiency can lead to porous, brittle bones, worsening the natural decline in bone strength and density we experience in our 50s, around the time menopause hits. Frequently, by the time I see patients, it’s too late. They’ve already had a fracture and bones are weak all over the body.
You may lack vitamin D if you:
• Spend little time outdoors.
• Wear sunscreen or cover your skin most of the time.
• Have dark skin.
• Underwent bariatric surgery or have health issues that hinder food absorption.
• Are pregnant or obese.
People with the deficiency may experience tiredness and general aches and pains, according to the Vitamin D Council. A severe deficiency may trigger pain in the bones or infections. Yet, in most cases, vitamin D deficiency, like osteoporosis, is symptom-free until it evolves into something more serious.
So how do you get enough vitamin D? While some foods carry the nutrient, beware: You can’t get enough through diet. Small amounts can be found in fatty fish (salmon, tuna, sardines), eggs, mushrooms, dairy and grains that are fortified with vitamin D, but not enough to maintain healthy levels.
That leaves us with two alternatives: the sun and supplements. I advise a few minutes of sun exposure without sunscreen one or two days a week. Vitamin D kicks into production in about half the time it takes your skin to turn pink and begin to burn, according to the council — that’s about 15 minutes for a fair-skinned person, or a couple of hours for a dark-skinned person. The closer to midday sun, the better, the Council advises: “A good rule of thumb is if your shadow is longer than you are tall, you’re not making much vitamin D.”
Uneasy about sun exposure? Take a supplement. It’s safe, inexpensive and widely available. I recommending 600 to 1000 IU daily for most adults. Vitamin D3 is your best bet, says the council, not the stuff mixed with calcium.
To find out your vitamin D levels, you’ll need a blood test. Winter is the best time to get one, when you have the least amount of sun exposure. If vitamin D deficiency is diagnosed, doctors may treat it with a single big dose, a higher dose once a week, or a dose every day. After levels are normalized, expect to take lower levels of vitamin D for the rest of your life. Start even before you run low on the nutrient.
Laura Frank, M.D., is a physician for St.Vincent Health.
