Distinctly Montana Magazine

Dr. Hiebert recommends taking vitamin D in food sources but also a daily dietary tablet supplement of vitamin D3. How do we know we're getting enough Vitamin D? The Institute of Medicine recommends a minimum of 600 international units (IU) of D3 daily for all children and adults through age 70 and 800 IU for adults over 71 years. The tolerable upper intake level (safe level) for healthy adults is 4,000 units daily. Should we be tested for it? It is not necessary to screen the general population (as long as they are getting the recommendations as listed above (600 to 800 IU daily ingestion). In high-risk individuals it is appropriate to measure levels, supplement to reach a target level, and remeasure in three to four months. High-risk groups are the institutionalized, over 70, dark-skinned, get limited sun exposure due to sun screen or clothing, have obesity, osteoporosis, fragility fractures, or take certain medications that interfere with vitamin D metabolism, pregnant women, patients with intestinal, liver, or kidney disease. These people should discuss their levels with their medical provider. How do we protect against skin damage but still get the sun's benefits? People are confused: should they wear sunblock ALL the time or just some of the time? It is probably best to protect the skin for the harmful effects of sun most of the time. The amount of sun necessary for vitamin D production is variable. Supplementation with Vitamin D is important to be sure adequate levels are available. Vitamin D deficiency causes osteoporosis and increased fractures, increases fall risks in the elderly, can cause muscle pains, and probably has numerous other adverse effects on health, still undergoing scientific investigation. Does having sun on your skin through a window enable you to get the effect of Vit D or cause skin cancer? Sunshine has ultraviolet radiation. UV B causes reddening or sunburn. UV A penetrates more deeply and causes more damage such as skin cancer and wrinkles. Glass filters some of the UV light but not all of it. That is why people who spend a lot of time in the car have more freckles and skin cancers on the left side of the face and arm. So it is safest to have sunscreen on with exposure to any long periods of sunlight exposure even through glass (unless the glass is very tinted or shaded). The same applies to clothes that sunlight penetrates, especially when wet. How about sun lamps? Sunlamps and tanning beds greatly increase the risk of skin cancer and wrinkles. Overall, sun exposure is a very important public health issue, especially in Montana winters, where we do not get enough sun. 70 distinctly montana • winter 2014

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