Most people miss the sun during the winter when it hides behind snow clouds.
They miss the warm rays on days when temperatures reach 17 below zero and the wind is howling.
They miss sun tans, pool parties and flip flops.
Even on days when the sun shines during the winter, people of Wyoming are missing something much greater than the warmth the sun brings and the fun activities associated with it, said Dr. James Maddy of Casper.
They're missing vitamin D.
It's impossible to absorb any vitamin D from the sun's rays between October and March in places as far north as Wyoming, Maddy said. In warmer months, people absorb a good portion of their vitamin D from the sun.
Researchers estimate between 40 and 60 percent of people in the United States are vitamin D deficient and they have linked the deficiency to a variety of ailments, including bone diseases, cancer, diabetes, hypertension and multiple sclerosis.
"There is an epidemic of vitamin D deficiency in the world, especially in the United States," Maddy said.
Current recommended daily allowances for vitamin D are between 400 and 600 International Units, which measure vitamin D. For example, a glass of vitamin D-fortified milk has about 98 IUs. However, most researchers in the field recommend at least 1,000 IUs for someone without adequate sun exposure.
Maddy said there is a group of doctors and scientists trying to raise the recommended daily allowance to 2,000 IUs
"Basically, no one in the United States is getting 1,000 IUs and we are asking for 2,000," Maddy said.
"They say, 'I eat a healthy diet. But most diets contain very little vitamin D. You would have to eat salmon every day, three to four glasses of milk, some vitamin D-fortified orange juice and you still probably wouldn't get enough."
Maddy and other Casper physicians recommend people take a vitamin D supplement or at least a multivitamin to increase their vitamin D levels.
Rita Elmore, an office manager in Maddy's Wyoming Osteoporosis Center, said she had her vitamin D level checked after hearing her boss talk about the deficiency.
"And sure enough, it was in the dumper," Elmore said. After Elmore began taking vitamin D supplements, she said some of her problems, such as tingly hands, disappeared.
She now makes her husband and son take vitamin D supplements.
Some patients of Dr. Cindy Works have seen a "huge difference" in their overall well-being after increasing their levels of vitamin D, said Works, a primary care physician who specializes in geriatric care at the Community Health Center of Central Wyoming.
Her elderly patients have seen the greatest benefit.
Doctors have always known vitamin D was connected with bone diseases, but symptoms of aging, such as muscle weakness and loss of balance, can actually be due to vitamin D deficiency, Works said.
"Studies have shown that fall rates go down in nursing homes where there is adequate vitamin D replacements," Works said.
Almost all patients who enter a nursing home are vitamin D deficient, because they either do not go outside, eat three healthy meals a day or take a supplement, she said.
"When we were made, we were outdoors people -- we weren't indoors all the time," Works said. "Vitamin D kept us healthy. It's one of those things that makes sense."
She said people who live near the equator do not experience the same problems because they receive the vitamin D they need from the sun year round. Very few people who live near the equator have multiple sclerosis, she said.
Maddy said prescription drugs for someone with osteoporosis will not work if someone is vitamin D deficient.
During the summer months, people can absorb a good amount of vitamin D from ultraviolet rays in the sun.
To have your vitamin D levels checked, Maddy recommends talking to a physician about a simple blood test.
"Physicians are astounded now that they have been checking," Maddy said. "It makes no sense not to have it checked and it makes no sense not to take a safe supplement."
Finding vitamin D
Current recommended daily allowances for vitamin D are between 400 and 600 International Units, but some doctors and scientists believe people should be getting closer to 2,000 IUs per day. Especially in the winter, that can be hard to do.
Here are some suggestions for getting enough vitamin D.
* Take a supplement. Vitamin D supplements can be purchased over-the-counter at most grocery stores and pharmacies.
Most over-the-counter supplements contain 1,000 IUs of vitamin D and are not very expensive, said Dr. James Maddy of Casper.
* Take a multivitamin. Multivitamins have about 400 to 500 IUs, Maddy said. But, do not take two multivitamins to get enough vitamin D, because you could overdose on other vitamins.
While it is difficult to overdose on vitamin D because the toxic levels are very high, levels should be monitored.
* Consume more foods and drinks fortified in vitamin D. But, be aware that vitamin D found in milk and other foods is more difficult to absorb than vitamin D received from the sun or supplements.
* Spend time outdoors in the summer months. People cannot absorb any vitamin D from the sun between October and March.
Maddy recommends people spend about 15 to 30 minutes in the sun during peak hours about twice a week without sunscreen.
Sunscreen blocks vitamin D, but people should apply sunscreen if they are going to be outside longer than 30 minutes, Maddy said. People must be safe in the sun despite its benefits to decreasing rates of vitamin D deficiency
* Use a tanning bed briefly during the winter.
Few foods contain vitamin D, but try adding some of these foods to your regular diet.
Foods with vitamin D, serving, units of vitamin D per serving
-- Cooked salmon, 3.5 ounces, 360 IUs
-- Cooked mackerel, 3.5 ounces, 345 IUs
-- Canned tuna fish, 3 ounces, 200 IUs
-- Canned sardines, 1.75 ounces, 250 IUs
-- Milk, 1 cup, 98 IUs
-- Margarine, 1 tablespoon, 60 IUs
-- Fortified cereal, 1 cup, 40 IUs
-- Egg, 1 whole, 20 IUs
-- Swiss cheese, 1 ounce, 12 IUs
Source: Casper Star-Tribune
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