Fortunately we don’t think we have as we spend a lot of time in the garden, bushwalking etc over the winter months. Also, the amount of sun exposure needed to produce enough vitamin D is very small….just a few minutes on a smallish amount of skin.
The study relates to the adult population.
It did not identify any concerns for those in aged care, or with other mobility related restrictions.
Our observation is many in aged care are on vitamin D supplements. IE only the fittest get to sit outside in the sun or go on outings and look out the bus window. Given the choice, our mum’s carers only escort her for walks indoors. We have to make the effort to assist her outside to chat in the sun or use the walker for a short fresh air sojourn.
There are a variety of supposedly official figures re the extent of Vitamin deficiency in Australia. I don’t know when the last comprehensive study was done, as I retired from mainstream medical and Naturopathic professions 3-5 years ago, but more importantly there is a lack of data related to Medicare funding cuts ~ 5 years ago. Prior to this a Canberra based GP found across the board deficiencies by routinely testing patients. Vitamin D deficiency is associated with numerous illnesses.
Medical reporter Sophie Scott, 11 November 2014
"People having their vitamin D levels tested will face new restrictions on rebates after a massive jump in the number of tests being carried out.
In the past 10 years, there has been an almost 4,000 per cent jump in the number of patients having their vitamin D levels checked.
Under changes to the Medicare benefits schedule, only high-risk patients will get a rebate when they get vitamin D levels screened.
Eligible patients include those with deeply pigmented skin, osteoporosis or those with chronic lack of sun exposure.
A spokeswoman for the health department said the Medical Services Advisory Committee (MSAC) noted the current testing arrangements for vitamin D were not well targeted and recommended new items be created to limit testing to high risk populations.
“The new MBS items for vitamin D now include criteria about the eligible treatment population to assist health practitioners in the appropriate ordering of pathology. The previous items provided no clinical criteria,” she said.
More details on the reviews can be found on the Australian Government’s Department of Health website.
Vitamin D forms in the skin when it is exposed to UV from sunlight and can also be obtained from some foods.
It is essential for strong bones because it helps the body use calcium from the diet.
Traditionally, vitamin D deficiency has been associated with rickets; a disease in which the bone tissue does not properly mineralise, leading to soft bones and skeletal deformities.
But research has revealed the importance of vitamin D in the protection against a number of health problems.
Medical experts say 10 to 15 minutes of sunshine, three times weekly, is usually enough to produce the body’s requirement of vitamin D.
The Federal Department of Health said it is working with the National Prescribing Service to raise awareness with health practitioners of the changes to Medicare funding for the tests.
The Department said: “It is expected that practitioners will order pathology in a clinically appropriate way, consistent with the clinical guidelines issued by peak and expert bodies, including the Royal College of Pathologists of Australasia and the National Prescribing Service, and in line with the conditions listed under Medicare.”
Any doctors who flaunt the new rules could be referred to the Professional Services Review. "
Intake of supplements is one aspect that is fairly routine in aged care homes, although the dose rarely exceeds 1000iu.
My first and recent source is from NPS, others follow:
Devina Joshi, Bone and Calcium Registrar,1,2 Jacqueline R Center, Associate Professor of Medicine (Conjoint),3 Staff Endocrinologist1 and Senior Research Fellow,2 and
John A Eisman, Professor of Medicine (Conjoint),3 Staff Endocrinologist1 and Director2
I think there is something really wrong about what measurement is done for vitamin D levels. My doctor told me I was vitamin D deficient after some blood tests to measure all sorts of things.
Considering I spent one morning outdoors walking dogs, one morning outdoors gardening, and at least 12 hours a week outdoors sailing and race management, how could that possibly be?
Vitamin D deficiency can be caused by specific medical conditions, such as:
Cystic fibrosis, Crohn’s disease, and celiac disease: These diseases do not allow the intestines to absorb enough vitamin D through supplements.
Weight loss surgeries. Weight loss surgeries that reduce the size of the stomach and/or bypasses part of the small intestines make it very difficult to consume sufficient quantities of certain nutrients, vitamins, and minerals. These individuals need to be carefully monitored by their doctors and need to continue to take vitamin D and other supplements throughout their lives.
Obesity: A body mass index greater than 30 is associated with lower vitamin D levels. Fat cells keep vitamin D isolated so that it is not released. Vitamin D deficiency is more likely in obese people. Obesity often makes it necessary to take larger doses of vitamin D supplements in order to reach and maintain normal D levels.
Kidney and liver diseases: These diseases reduce the amount of an enzyme needed to change vitamin D to a form that is used in the body. Lack of this enzyme leads to an inadequate level of active vitamin D in the body.
What other factors can lead to vitamin D deficiency?
Age: The skin’s ability to make vitamin D lessens with age.
Mobility: People who are homebound or are rarely outside (for example, people in nursing homes and other facilities) are not able to use sun exposure as a source of vitamin D.
Skin color: Dark-colored skin is less able to make vitamin D than fair-colored skin.
Vitamin D is anti-inflammatory and its main purpose is as a regulator as it’s said to function more like a hormone. It’s also a fat soluble vitamin that exists in adipose tissue within the human body. The synthesis of vitamin D in your skin can be affected by where you live, skin colour, sun-screen usage, time of day, clothing, and time of year; in addition from sunlight, you can get Vitamin D from egg yolk, butter and oily fish.
Vitamin-D is far more than merely an essential nutrient needed for only bone and calcium metabolism. Many leading researchers now regard its active form in the body akin to a hormone with widespread cellular and metabolic effects. It can take up to two weeks for the conversion to the active form to take place, and in so doing to potentially overcome any deficiency. The necessary conversion is slowed in the elderly and is further delayed in those with some specific chronic diseases - the ‘co-morbidities’ we hear so much about these days. Hence taking oral Vit-D supplementation for its known beneficial immune effects needs to long precede actual exposure to infective agents, like for example SARS-CoV-2. That’s why most studies (that do not take the conversion delay into account) typically fail to show any significant beneficial effect of the precursor (oral) form of Vit-D in already infected patients - supplementation is way too late. I offer the first few sentences from the following link as a teaser for those interested in this important and highly topical topic.
Vitamin-D and COVID-19: Time for the profession to take a stand
“The role of Vitamin-D in building immunity to viruses and respiratory illnesses is widely accepted. When the COVID-19 pandemic emerged earlier this year, it was too soon to show definitively that the vitamin would have a useful impact, although experts in nutritional medicine expected it would. Nearly a year into the pandemic, however, we have dozens of research papers from quality institutions around the world – including from the US, Spain, Israel and the UK. These demonstrate that optimal blood levels of 90–130 nmol/L not only enhance immunity to COVID-19 but also reduce the severity of outcomes should infection occur.”
The paper you have cited is somewhat of a personal opinion citing the phrase ‘in our opinion’ rather than ‘data demonstrates’ eg a rigorous scientific study. The NCBI is an open library repository of papers, not all peer reviewed, maintained to provide as broad a base for researchers as possible.
Reading the paper there seems to be little if any link between cause and effect between Vitamin D and COVID-19 as the deficiency could be caused by COVID-19, not be causal, and the basis of the paper is about Vitamin D and respiratory infections in a broad sense.
I take this as potentially poor research or perhaps the ‘teaser’ suggesting more investigation noting such papers are common in research, especially for new hypotheses , but as it stands is most likely to be misinformation or premature guidance regarding COVID-19 although in a broad sense the efficacy of Vitamin D is fairly well known for many things.
Likewise another paper stating the same, that to date it is inconclusive. There are many more, virtually all concluding there is not direct evidence to date one can bet their health on re Vitamin D and COVID-19.
Assuring adequate Vitamin D is a good strategy, but linking it to COVID-19 ‘prevention’ seem premature at best and potentially misinformation.