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Hi SueHelen, Thanks for your question. Vitamin D, known as the Sunshine vitamin, has received a lot of attention from the media lately as new studies emphasize its importance:

Lack of Sunshine Vitamin May Cloud Survival Odds

Lack of Vitamin D Boosts Death Risk

Vitamin D May Help Prevent type 1 Diabetes

Based on your age, it looks like you should be getting about 10 mcg (400 IU) of vitamin D daily. Based on your understanding, is this how much you're getting? And you're on the right track in wanting to take more in through diet -- especially through salmon, eggs and milk -- which are some of the foods that are highest in vitamin D.

While it sounds like you're taking necessary steps to get the vitamin D you need, there may be factors as to why you're not getting enough:

Age: Americans aged 50 and older are at increased risk of developing vitamin D insufficiency. The reason is as people age, the skin cannot synthesize vitamin D as efficiently and the kidney is less able to convert vitamin D to its active hormone form;

People with fat malabsorption: As a fat-soluble vitamin, vitamin D requires some fat in the gut for absorption. People who have a reduced ability to absorb dietary fat might require vitamin D supplements;

Obesity: Obesity does not affect skin's capacity to synthesize vitamin D, but greater amounts of subcutaneous fat sequester more of the vitamin and alter its release into the circulation.

Steroids: Corticosteroid medications such as prednisone, often prescribed to reduce inflammation, can reduce calcium absorption and impair vitamin D metabolism., says the Office of Dietary Supplements.

Medications: Weight-loss drugs orlistat (brand names Xenical® and alli™) and the cholesterol-lowering drug cholestyramine (brand names Questran®, LoCholest®, and Prevalite®) can reduce the absorption of vitamin D and other fat-soluble vitamins. Both phenobarbital and phenytoin (brand name Dilantin®), used to prevent and control epileptic seizures, increase the hepatic metabolism of vitamin D to inactive compounds and reduce calcium absorption.

Would any of those scenarios apply to you? If so, I would definitely bring them to the attention of the endocrinologist.

Also, while your intake is solid, you may want to use caution as too much vitamin D can actually be considered toxic. Vitamin D toxicity can cause nonspecific symptoms such as nausea, vomiting, poor appetite, constipation, weakness, and weight loss.

August 14, 2008 - 8:22am

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