[BELL RINGING] Welcome back to Coffee Break, the audio equivalent of a little sunshine on a cloudy day. Yeah. Well, we're talking about Vitamin D, also known as the sunshine vitamin. So is it the reason half of us are a bit grumpy by February? It's the nutrient that helps keep the bones strong through immune system ticking and your mood a little less. Well, soggy. And while we should get it from the sun, let's be honest, this is Britain. And if we all relied on sunlight, we'd be running on empty mind November. And we do love to moan about anything weather-related. So today, we're covering who needs it, when to top it up, and why that tiny little tablet might be doing more than you think. So whether you are a fan of the sun or you prefer the shade, or you're just here to hear our funny pounds we've got you covered. Let's step into the light and get started. [Music] I'm Dr. Jeff Hampe. And I'm Dr. Sam McGinley. And this is season one of Coffee Break. We are two general practitioners from beautiful dorms at the United Kingdom, and we are happy to have you here with us for another Coffee Break. In our show, we give you helpful and useful health and wellness information in short and easily digestible episodes. That's right, and hopefully in a fun and enjoyable way as well. In today's VAR to Sea of Health information, we hope to be your trusty island of reliable and impartial independent, unbiased information. And we may even have some guests with us to help. So sit back and enjoy a Coffee Break. [Music] Well, Vitamin D's actually really interesting, isn't it? Because we make Vitamin D ourselves. It's one of the few vitamins that we actually do make ourselves. And the reason we do this is because we've evolved to do this, because of the very poor availability of Vitamin D in our diets. So, for instance, early primates could make their own Vitamin C, but the gene that's responsible for that has been lost through evolution. So we can't make Vitamin C and we have to get it from our diets, but we're quite fortunate because it's quite abundant, easily available in our diets. Yes, interesting, isn't it? Who? So, Vitamin D, what does it help us do? In body, it does various things, including regulating calcium and phosphate levels. These particular nutrients are used to keep bones teeth and muscle-selfing. And we know this not just from the site, but also we used to see this a lot more commonly. Vitamin D deficiency in children contributed to the onset of rickets, didn't it? And also, Vitamin D deficiency causes pain in the bones. And that's due to a condition called osteomalacia. As we've said, we don't get much Vitamin D in our diets. It's not a naturally occurring Vitamin in our diets. And so we make it ourselves. So from about late March to early April to the end of September, most people in the UK should be able to make all of Vitamin D they need from sunlight exposure. Yes. And our bodies create Vitamin D from direct sunlight, acting on our skin, when we're outdoors. Absolutely. But what about between October and early March? Well, we are probably less likely to get the Vitamin D we need from sunlight, even if you live on a sunny South Coast like we are here. Yeah, that's right. Everyone thinks that on the South Coast, if we get the most sun, we get the best sun, but really it's still not intense enough as it's meant to make enough for Vitamin D. That's right. Yeah. So how can we get Vitamin D from other sources? Well, there is a small amount found in food. Sources can include oily fish, particularly salmon, sardine, trout, herring or mackerel. It's quite a lot less than, actually. This isn't really, yeah. Red meat as well. Eggs fortified food, so some fat spreads or breakfast serums have had it added intentionally. Liver, although you should avoid liver if you're pregnant. And also in the UK, cows milk is generally not a good source of Vitamin D, because it's not actually been fortified, but in some countries you will see that. Yeah, definitely. And mushrooms, actually, it's not what I listed, but mushrooms, I believe, are quite good at Vitamin D levels. Yeah. So what's the official advice, and well, the government advice is that everybody should consider taking a daily Vitamin D supplement during the autumn and winter. People who are at high risk of not getting enough Vitamin D, all children age 1 to 4 and all babies, unless they're having more than 500 miles of infant formula a day, which has Vitamin D added, should take a daily supplement throughout the year. Indeed. So shall we quantify that? So should we see how much we need? So children from the age of 1 year and adults will need 10 micrograms of Vitamin D each day. And this does include pregnant and breastfeeding women and people at risk of Vitamin D deficiency. Yeah. So babies up to the age of 1 year need 8.5 to 10 micrograms of Vitamin D a day. And it's important, because we're talking about micrograms. A microgram is different from a milligram. You'll probably see things in milligrams, but a microgram is a thousand times smaller than a milligram. The word microgram is sometimes written with the Greek symbol, which is like a U with a tail at the front, followed by the letter G. Absolutely. Yeah. And sometimes even more confusingly, companies will express the amount of Vitamin D as an international unit. And it's maybe tricky to remember, but one microgram of Vitamin D is equal to about 40 international units. So a 10 microgram dose, you're looking for about a 400 international unit or IU on the packet. And although we'll talk about Vitamin D dosing in a moment, I know that people find it increasingly hard to find supplements as our exactly 10 micrograms or exactly 400 international units. So if it's a little bit, a little bit above 10 micrograms, it's a little bit above 400 international units, that's not a huge problem. So a bit more detail, then as to who needs it. So for adults and children over four, during autumn and winter, we need to get out of Vitamin D orally, because the sun isn't strong enough for our bodies to make it. But since it's difficult, as we've said, for people to get enough vitamin D from food alone, everybody, including pregnant and breastfeeding women should consider taking that daily supplement containing 10 micrograms, trying to order them in the winter, between late March or early April to the end of September, most people make all vitamin D they need and you may choose therefore not to take a vitamin D supplement during these months. Yeah, but what about the people that risk of vitamin D deficiency? Yeah, that's a different situation, isn't it? Some people will not make enough vitamin D from sunlight. Maybe they are just in a position where they get very little or no sunlight exposure from day-to-day life now. And the Department of Health and Social Care recommends that adults and children over four take a daily supplement of vitamin D, even in the more sun-intense period of the year, if they are not often outdoors, so maybe they're frail or housebound, if they are in an institution, like a care home, if they are usually wearing clothes that cover up most of their skin. We could go with that actually, which parts of the skin are helpful to be exposed to absorb. Or if they are somebody with a darker skin complexion, perhaps they're from Africa, African Caribbean background or South Asian, and therefore those people should all consider taking a daily supplement. A general rule of thumb is if you are able to, it'd be good to expose your face and forearms to sunlight for about 15 minutes a day in order to absorb enough sunlight to create enough vitamin D. Now for infants and young children, the Department of Health and Social Care recommends that babies from birth to one year of age should have a daily supplement containing 8.5 to 10 micrograms of vitamin D throughout the year, if they are breastfed, if they are formula-fed and having less than about 500 mills, that's about a pint of infant formula a day. Now children aged 1 to 4 should be given a daily supplement containing 10 micrograms of vitamin D throughout the year, so during the summer months as well. And you can buy vitamin D supplements or vitamin drops containing vitamin D for the under fives at most pharmacies and supermarkets. And importantly, women and children can qualify for the healthy start scheme, can get free supplements, which contain vitamin D. So surely if we just take super duperdosis of vitamin D, we are basically always having a sunny holiday. That's right, isn't it? It would be nice if it was that way, but taking too many vitamin D supplements over a long period of time can cause too much calcium to build up in the body, something that we call hypercalcemia. And this actually weakens the bones and can damage the kidneys and the heart. So if you choose to take vitamin D supplements, 10 micrograms a day will be enough for most people. But absolute numbers as to what you should or shouldn't take seed. Well, if you are thinking about taking a supplement, we definitely recommend not taking more
than 100 micrograms or 4,000 international units of vitamin D a day, because that could put you into harmful levels. And this applies to adults, which includes pregnant and breastfeeding women, and the elderly and children between the ages of 11 and 17. It's important that's the cutoff for adults and children between 11 and 17. Children between 1 and 10 shouldn't have more than 50 micrograms, so 2,000 units a day, and infants under 12 months of age should definitely not have more than 25 micrograms as 1,000 units a day. Yes. Now some people may have medical conditions that mean that they may not be able to safely take as much, so you really should check where your doctor before you start taking a supplement, particularly if it's more than the basic dose we've been talking about, 10 micrograms. And there are some people as well who may not absorb the supplements as well. So again, if you've got other long-term conditions, it might be worth checking with your doctor if you're taking inappropriate dose. Yeah, and if your doctor has told you to take a different amount of vitamin D, follow their advice. Yeah. It's important to finish off by saying there isn't it that we talked about what can happen if you take too many, if you take too much vitamin D as a supplement, but actually you can't overdose on vitamin D through sunlight exposure. But you must always remember to cover up or retake your skin if you're out in the sun for long periods to reduce the risk of skin damage and skin cancer. And we will in another show be talking about sunlight, sun exposure and the issues that happen with that. Yeah, absolutely. As we said earlier, 15 minutes, face and forearms, each date is sufficient. So Sam, what's your take on point from this episode? Vitamin D is actually, it's interesting, the vitamin D is becoming increasingly talked about. I think it's important to say that vitamin D, seriously, particularly because we live in a country where sunlight exposure may be more difficult for us. So do seriously consider taking what is actually a cheap supplement during the winter months and also be aware of its role in important areas of your body, your bone health, particularly as important as we all get older. We need our bone health there for our strength in the future. Yeah, definitely. It's a relatively new thing, isn't it? So if you think back, it's quite a new recommendation that we're making with vitamin D. And 15, 20 years ago, we probably want to take a vitamin D succumbent. But it is important. It isn't a fan. It is important. This has been an episode of Coffee Break and we hope you've enjoyed it. And if you have, then I hope you'll join us for another Coffee Break soon. Remember, if you want to get in touch with us or if you have any ideas or suggestions, then please feel free to email us at the show. At
[email protected]. You can listen to us and subscribe to the show on any of the podcast platforms and via your computer, smartphone and home smart devices. We have used a variety of resources for the information in the show to try and assure that it is up to date and the most applicable. We have also put any information links we have discussed in the show. Coffee Break is a coffee break production and is edited and produced by meme.jfheim. It's created written and hosted by.jfheim and me, Dr Sam McGinley. All the content we provide in the show is for general information purposes only. The content does not constitute medical or healthcare advice. The content is valid in England at the time of recording. The content should not be relied upon as a substitute for professional medical or healthcare advice applicable to your specific circumstances. We advise that you always consult a qualified medical professional for any medical matters.
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