Other conditions that increase the risk of D deficiency include liver disease, obesity, Crohn’s disease, ulcerative colitis, celiac disease and previous bariatric surgery. Some medications can also interfere with D levels, including certain weight-loss, cholesterol-lowering, anti-seizure and antibiotic drugs.
What’s more, vitamin D’s role extends beyond bones to the immune system and lung health.
So how can you improve your vitamin D level? Food is a great starting point. Fatty fish such as salmon, tuna, trout and mackerel are excellent sources, as is cod liver oil. Egg yolks, certain mushrooms and fortified beverages and foods such as milk, plant-based milk (including soy, almond and oat), yogurt, orange juice, margarine and breakfast cereal can also help. Most milk sold in the U.S. is fortified with vitamin D.
Sunlight also contributes, as our skin produces vitamin D when exposed to ultraviolet light, though this ability diminishes with age. Moreover, many older adults don’t spend enough time outdoors or use sun protection, or they live in northern climates where there are fewer D-producing rays, especially in winter. For those reasons, sunlight alone is oftentimes not enough to maintain a healthy level.
Supplements are the most practical solution. The National Institutes of Health recommends 800 international units (IU) daily for adults who are 71 and older. However, the appropriate dose depends on your blood level, medical history, age, diet and medicines you take. That’s why I encourage you to discuss supplementation with your health care provider.
A word of caution: More isn’t always better. Excessive supplementation can result in vitamin D toxicity, causing a dangerously high calcium level that leads to nausea, weakness, kidney stones, heart-rhythm problems and even kidney damage. My advice is simple: Know your number. If your vitamin D level is low, don’t dismiss it. Work with your health care provider to bring it to a range that is right for you.