How To Get Vitamin D Without Sun

How To Get Vitamin D Without Sun

• The Institute of Medicine's current recommended dietary allowance of vitamin D is 600 to 800 IUs per day — and these numbers were designed with minimal sun exposure in mind.
• Results of the VITAL study published in November 2018 offered proof that taking a vitamin D supplement of 1000 to 2000 IUs is safe for most people.
• Dietary sources of vitamin D include dark, fatty fish, fortified dairy and cereal products, mushrooms, and fortified orange juice.
• When choosing vitamin D supplements, it's important to look for products with independent quality control testing, such as a USP seal — this ensures nutrient and contaminant testing but still does not guarantee exact nutrient content.

We know that vitamin D is an important hormone that helps our digestive systems absorb calcium and phosphorus — and that it's a necessary nutrient for human health.

But it isn't nicknamed "the sunshine vitamin" for nothing — the sun is the best source of vitamin D.

Dr. JoAnn Manson, P.H. is the chief of the division of preventive medicine at Brigham and Women's Hospital and professor of medicine and the Michael and Lee Bell professor of women's health at Harvard Medical School. She is also a study director of VITAL , the single largest ongoing research study of its kind on the effects of vitamin D and omega-3 supplements across over 25,000 participants.

The results of this study were published in the November 2018 issue of the New England Journal of Medicine. It's a significant study — Clifford J. Rosen of the Maine Medical Center Research Institute in Scarborough told Vox that "This is the largest and most definitive [vitamin D] trial with long enough follow-up and substantial representation from minorities to be an excellent cross-section of Americans."

INSIDER spoke with Dr. Manson who shared her expertise on the subject. Here's what you need to know about getting the correct amount of vitamin D from sources other than the sun.

First, it's important to understand which claims about vitamin D have been scientifically proven — and which haven't

There might be misinformation on the internet about vitamin D.

Vivek Prakash/Reuters

Numerous articles, books, and other pieces of media have been published for years that tout some version of " the miracle of vitamin D ." So far, the existing body of scientific research doesn't support most of those claims .

"There are a lot of observational studies which are not randomized clinical trials suggesting that a low vitamin D level is associated with an increased risk of many chronic diseases. We say in epidemiology that correlation does not prove causation," said Dr. Manson.

She continued, " It really requires a randomized clinical trial to prove a cause-and-effect relationship that vitamin D supplements will lower the risk of these chronic diseases. So far, the randomized clinical trials have suggested limited benefits beyond bone health."

"VITAL does suggest a promising signal for cancer death, but it's not conclusive. [VITAL results showed that] there was no reduction in cardiovascular events or total cancer incidence," she added.

The current recommended dietary allowance of vitamin D was created with people with no sun exposure in mind

Even those who don't get sunlight can get vitamin D.

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Dr. Manson told INSIDER, "There's a lot of controversy on the subject, but the Institute of Medicine has determined that the recommended dietary allowance (RDA) for vitamin D is 600 to 800 IUs a day for the general population.

"That would meet the needs of 97.5% of the general, healthy population. Of course, people who have osteoporosis or bone health problems or a malabsorption condition , or who are taking certain medications that interfere with vitamin D metabolism may need a larger amount than that.

"So clinicians have a lot of latitude in deciding the amount of vitamin D that people need. However, the 600 to 800 IUs a day was determined on the basis of minimal to no sun exposure — you know, what people would need during the winter, at high northern latitudes.

"So even people who are living in different parts of the country — these guidelines are for the US and Canada — 600 to 800 IUs a day should cover their needs."

There are dietary sources of vitamin D — but they're somewhat limited

Fish is a great source of vitamin D.

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"If you're eating a balanced diet — people who don't get any sun exposure — it should be perfectly fine to take a supplement of 1000 to 2000 IUs a day. However, many people can get the vitamin D that they need if they get the major dietary sources of vitamin D, such as dark fatty fish, fortified dairy products, fortified cereals, and some people will take a multivitamin that will give them a little extra, so that is often enough," Dr. Manson told INSIDER.

For vegans, mushrooms and fortified orange juice are some of your best food options for significant sources of vitamin D, according to Healthline.

If you find that you are not getting enough vitamin D through other means, supplements can be both useful and safe

Vitamin D supplements have found to be safe but still talk to your doctor before taking any supplement.

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Dr. Manson told INSIDER, "Certainly, taking a supplement is reasonable — we showed in the vitamin D/ omega 3 trial that taking 2000 IUs a day was safe — over 5.3 years, there was no increased risk of high blood calcium or gastrointestinal problems, so that was shown to be safe.

However, dietary sources of vitamin D are somewhat limited and some people may not get enough from diet. Especially above age 70, that's where 800 IUs a day is recommended, and that may be difficult to achieve from diet. So taking a supplement of 1000 to 2000 IUs a day is very reasonable if you have any concerns about whether you're getting enough from diet.

If you have a special requirement due to medical issues, then you may require even more than that."

Vitamins are classed as dietary supplements in the US — and regulation is minimal, but there are ways to be reasonably sure of what you're getting

Always check labels.

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Little to no regulation of the dietary supplement market can result in some scary situations — but there are ways to protect yourself when choosing a vitamin D supplement.

Dr. Manson had this advice for INSIDER readers:

"You need to be careful if you're taking over-the-counter supplements to look on the label for some evidence of quality control testing. This would include looking for the US Pharmacopeia (USP) seal, looking for something like NSF or ConsumerLab.com testing. You need to look for evidence of some independent quality control testing.

Very often, it's in the form of the USP seal. But it doesn't guarantee that the nutrient content is exactly what's stated on the label.  It is evidence that it's been tested for various things, like nutrient content and contaminations."

We need a certain amount of vitamin D for good health — but it's possible to get too much, which can present a separate set of problems

Megadosing can cause stomach pain.

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Dr. Manson told INSIDER, "At this point, we have shown that taking 2000 IUs a day is safe — there isn't a high blood calcium level that develops. It seems to be safe in terms of no real side effects or any clear risk. Certainly, if your doctor or healthcare provider has suggested that you take vitamin D, the VITAL trial would not suggest reasons to stop.

If you've been taking it at similar doses on your own, just over the counter, there's no clear reason to stop. But avoid mega-dosing. The very high doses — especially once you get to 10,000 IUs a day or higher — have been linked to risk, and there isn't evidence that those high megadoses are safe when taken long-term. So we do want to caution against megadoses."

Megadosing can result in vitamin D toxicity — with side effects including elevated blood calcium levels, nausea, vomiting, gastrointestinal distress, bone loss, and even kidney failure according to Healthline.

The VITAL study is ongoing — so there's likely more to learn from this research

Studying the effects of vitamin D might help treat conditions like depression in the future.

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Although initial results have recently been published, Dr. Manson told INSIDER that participants will keep going for several more years.

Dr. Manson told INSIDER that researchers will follow participants "at least to two years after the intervention and the treatment phase, and then we're going to try to follow them for an additional four to five years after that.

"So we hope to be able to follow them for six to seven years after stopping treatment to see if the reduction in cancer risk or cancer death becomes stronger over time.

"We'll also have additional research coming out from VITAL on cognitive function, diabetes, depression, and autoimmune diseases. These findings could help to inform decision-making."

Visit INSIDER's homepage for more.

How To Get Vitamin D Without Sun

Source: https://www.insider.com/how-to-get-vitamin-d-without-sun-2018-12#:~:text=Dietary%20sources%20of%20vitamin%20D,mushrooms%2C%20and%20fortified%20orange%20juice.

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Vitamin A&D

Vitamin A&D

Dungeons and Dragons 101: How Has D&D Endured for Almost 50 Years?

Photo Courtesy: Simon Hayter/Toronto Star/Getty Images

Dungeons and Dragons has become so popular that pretty much everyone has heard of it, even if they've never actually played it. The popular role-playing game (RPG) first made its debut almost 50 years ago, back in 1974, and has since become one of the most — if not the most — popular tabletop fantasy games in the world.

These days, you can even play D&D  online and connect with other players over popular chat platforms like Discord. If you're curious to know what the game is all about — and how it has managed to stay popular for so long — join us for a crash course, Dungeons and Dragons 101.

The Humble Origins of the World's Most Epic RPG

The revolution that would eventually become Dungeons & Dragons owes its origins to a fateful meeting between two war-game fans named Gary Gygax and Dave Arneson. It all began with an earlier game called Chainmail, which was written by Gary Gygax and a friend of his, Jeff Perren. Chainmail was a medieval-themed combat game and included a 14-page write-up that detailed how players could incorporate fantasy elements into the gameplay.

Chainmail made its way to Dave Arneson, who decided to use the fantasy rules section to develop a game of his own,Blackmoor. By combining the elements of Chainmail and several other games, Arneson developed a Lord of the Rings-style game universe where players could engage in epic battles as they explored underground dungeons and vast lore.

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In 1972, Arneson introduced Gygax to Blackmoor  — and he was immediately blown away. Ultimately, Arneson and Gygax formed a partnership and developed a new game: Dungeons & Dragons. The RPG was first distributed in 1974 by Tactical Studies Rules (TSR), a company that Gygax formed himself after struggling to find a publisher.

That year, the first 1,000 copies of the D&D box set — most of which were hand-assembled — sold for $10. Eventually, Dungeons & Dragons became more than just an innovative, fantasy-fueled idea, exploding into a bonafide phenomenon. As a result, TSR was purchased by Hasbro's Wizards of the Coast, the game's current publisher, in 1997.

What Makes D&D So Great, Anyway?

If you've never played Dungeons & Dragons yourself, you may have found yourself wondering what all the hype is about. This tends to be especially true given the notorious enthusiasm for the game that D&D tends to inspire among its fans. So, how exactly does Dungeons & Dragons work, and, in a world full of tabletop games and RPGs, why has it endured for nearly 50 years?

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One of the key reasons for  D&D 's popularity? It hinges on imagination. No matter how old you may be, the game invites you to partake in an epic exercise in make-believe, one that features heroes, monsters, battles, and plenty of adventure. Unlike the average game of make-believe, however, D&D  provides just enough framework, so that every game is not only structured, but equal parts chance and strategy.

When you start the game, you invent a character and take on their role. You can choose to become a fighter, a wizard, a cleric, or a rogue, for example. Part of the fun? Creating a whole personality, appearance, set of skills, and backstory for the character you decide to play. Using a combination of character sheets, the Player's Handbook. and your own imagination, the possibilities are nearly endless.

One player takes on the role of the Dungeon Master, the person responsible for running the game and keeping the story on track.By using an adventure book, the Dungeon Master can lead the players (and their characters) through a variety of storylines, leaving each player to decide on their reaction to the circumstances that arise. As you may know, a dice-throwing system is used to determine whether the player's strategy turns out to be a success or failure, thus emphasizing that great balance of chance and strategy.

An Endless World of Adventure

"Why did it catch on so quickly? Because it offered almost pure escapism and the ability, in the game, to do anything and everything you wanted to do!" Arneson once said in Different Worlds. "Gads! Who wouldn't get hooked on game-playing nirvana like that after years of charts, tables, painting figures, etc."

In an industry that had previously been composed of games played with miniature figurines, Dungeons & Dragons offered players the chance to use their creativity like never before. By relying heavily on the imagination and contributions of each player, the game more or less offered players the chance to write their own fantasy epic.

 Photo Courtesy: Danielle Donders/Getty Images

Take, for example,Robert Wardhaugh, a player who started a game of D&D  as a teenager in 1982. As of 2020, the game is still going, which means it has lasted a whopping 38 years. Of course, not all D&D  games last that long, but that's part of the beauty of it all — it can be what you make it.

When you sit down to start your adventure, you can conjure up a fantasy scenario that plays out for as short or as long a period as you'd like. Nowadays, there are even whole leagues and conventions where D&D fans can connect to combine their creativity and produce more exciting adventures.

D&D Goes Digital

While it's technically been possible to play Dungeons & Dragons online for some time, there was once a time when it was a bit more of a chore. Recently, however, the company has released more tools that make online gaming much easier.This became especially true during the COVID-19 pandemic, since players couldn't gather in a physical space. Thanks to these online methods of connecting, the game enjoyed a 33% sales increase during 2020, with both new and veteran players alike gathering virtually for some solid escapism and fun.

 Photo Courtesy: CasarsaGuru/Getty Images

The online option is also a great way for new players to get started. Instead of searching for players in your area, simply check out D&D Beyond, which has made online gameplay easier than ever before. There you'll find a virtual character builder, free access to game rules, and even virtual dice-rolling capabilities. Additionally, t he folks behind D&D have also created a handy beginners' guide capable of teaching you everything you need to know so that you can create your character and embark on your first quest with ease.

As you'll soon discover, a whole subculture has risen up around the world of Dungeons & Dragons over the years — and it doesn't appear to be going anywhere. So, if you're looking to meet new friends and flex your imagination, why not roll the dice?

Vitamin A&D

Source: https://www.ask.com/culture/dungeons-and-dragons-101?utm_content=params%3Ao%3D740004%26ad%3DdirN%26qo%3DserpIndex

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What Is Vitamin D Deficiency

What Is Vitamin D Deficiency

A person may not realize that they have a vitamin D deficiency, but there are some symptoms to look out for.

This article explores the signs and symptoms of a vitamin D deficiency, as well as possible complications, treatments, and when to see a doctor.

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Some sources of vitamin D include milk, white mushrooms, and cooked sockeye salmon.

Vitamin D is important for health. Some of its roles in the body include:

• helping with the absorption of calcium
• maintaining healthy bones
• regulating genes and cell growth
• preventing rickets and osteoporosis
• modulating the immune system

Vitamin D is naturally present in very few foods, and often in amounts too low to help a person meet their daily recommended intake. In response, manufacturers fortify several foods with the vitamin.

According to a 2020 review, 50% of the worldwide population has insufficient levels of vitamin D. In the United States, 35% of adults have the deficiency.

The prevalence of vitamin D deficiency is highest among older adults, people with obesity, and people in hospitals and other care facilities.

Many people with vitamin D deficiency have no symptoms. However, the deficiency can cause the following issues.

Frequent infections or illnesses

Vitamin D helps support the immune system — it plays a role in regulating immune function and inhibiting inflammatory reactions.

It can also help prevent infections in the upper respiratory tract.

Fatigue and muscle weakness

Because vitamin D is key to bone health, an insufficient amount can cause bone and muscle weakness, which can lead to fatigue.

Researchers behind a 2014 study that included 174 participants with fatigue found that taking supplementary vitamin D for 5 weeks significantly improved fatigue symptoms.

Bone and joint pain

Vitamin D can increase bone mass and prevent bone loss. If someone has bone and joint pain, it may indicate a vitamin D deficiency.

Joint pain could also result from issues such as rheumatoid arthritis. A 2012 study linked vitamin D deficiency with an increased risk of developing the condition.

Fractures

Adequate vitamin D in the body helps maintain bone strength by supporting the absorption of calcium.

According to the National Osteoporosis Foundation, this is particularly important for females after menopause, which can cause bone density to decrease and the risk of osteoporosis to increase.

If someone has a fracture, the doctor might test their vitamin D level, depending on the person's age and health history.

Depression

The authors of a 2019 review have found that lower levels of vitamin D may increase the risk of depression.

There are vitamin D receptors in the brain, and the research indicates that the vitamin has a protective anti-inflammatory effect.

As a result, the scientists conclude, a person with very low vitamin D levels and depression may benefit from taking a supplement of the vitamin.

Slow wound healing

If wounds take longer than usual to heal, it might be a sign of low vitamin D levels.

Results of an in vitro study suggest that vitamin D plays an important role in wound healing because it regulates growth factors and other compounds that form new tissue.

Another study has found that people with leg ulcers were more likely to have vitamin D deficiencies. Those who took 50,000 international units (IU) of vitamin D every week for 2 months experienced better wound healing, the researchers observed.

The deficiency can develop at an early age. In response, U.S. health authorities mandate that infant formula is fortified with 40–100 IU/100 kilocalories of vitamin D.

Symptoms of a vitamin D deficiency in children include:

• irritability
• lethargy
• bone pain or fractures
• deformities of the teeth
• developmental delays

A vitamin D deficiency can lead to further health issues.

Rickets

Rickets develops from a vitamin D deficiency, and it is rare in the U.S.

The condition tends to occur in babies and preschool-age children, though it can arise in older kids. It affects the development of the bones, wrists, knees, and joints in the ribs, and it can cause bowing of the legs.

Doctors treat rickets with vitamin D supplements and by ensuring that there is enough calcium in the diet.

Cardiovascular disease

According to 2013 research, there is a connection between vitamin D levels and the risk of cardiovascular disease. This may be because vitamin D protects the heart and combats inflammation.

An older review found that low vitamin D levels are linked to other conditions that increase the risk of developing cardiovascular disease — conditions such as hypertension and metabolic syndrome.

Autoimmune disease

Vitamin D is a natural immune modulator, and research suggests that low levels of the vitamin may be connected to autoimmune diseases, including:

• type 1 diabetes
• multiple sclerosis
• rheumatoid arthritis
• Crohn's disease

The National Institute for Health and Care Management have the following guidelines for doctors about managing vitamin D deficiencies:

• Recommend treatment if a person's vitamin D level is under 25 nanomoles per liter (nmol/l).
• Recommend treatment if the level is 25–50 nmol/l, and there are other indications of the deficiency.
• If the level is adequate (above 50 nmol/l), give advice about how to prevent the deficiency.

Adults with vitamin D deficiency

require

6,000 IU of vitamin D-3 every day for 8 weeks or 50,000 IU weekly for 8 weeks.

When a blood test shows that the person's level of vitamin D has adequately increased, the doctor may recommend a 2,000 IU daily maintenance dosage.

They may also suggest a calcium supplement and give other dietary and lifestyle advice.

Food sources

It can help to ensure that the diet includes plenty of vitamin D. Below are some foods that contain high levels of the vitamin:

Supplements

Supplements and fortified foods contain vitamins D-2 or D-3.

Manufacturers use fungi and yeasts to manufacture D-2, and this form is suitable for people on a vegan diet. They use lanolin from sheep wool to produce D-3.

Research indicates that at higher doses, vitamin D-2 is less potent than D-3.

Anyone experiencing symptoms of vitamin D deficiency should speak to a doctor.

Many people have no symptoms but can find out if they have adequate levels with a simple blood test.

Vitamin D deficiency is common, and people may not realize that they have it.

Anyone with symptoms of the deficiency should see a doctor. Also, it is important to consult a healthcare provider before taking supplements that would exceed the recommended daily intake.

What Is Vitamin D Deficiency

Source: https://www.medicalnewstoday.com/articles/vitamin-d-deficiency-symptoms

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