Vitamin D
Vitamin D helps to regulate the amount of calcium and phosphate in the body. These nutrients are needed to keep bones, teeth and muscles healthy. A lack of vitamin D can lead to bone deformities such as rickets in children, and bone pain caused by osteomalacia in adults.
Between April and September most of us can get the vitamin D we need through the action of the sun on our skin. Between October and March, we need to get vitamin D from diet because the sun isn’t strong enough for the body to make vitamin D.
Maintaining Vitamin D levels from October to March – Advice for everybody
It is difficult to get all the vitamin D we need from food.
The easiest way to maintain your vitamin D levels is to take a supplement.
On the Isle of Man, over half of us will have low levels of vitamin D during the Autumn and Winter months (October to March), so we should all consider taking a Vitamin D supplement. Supplements can be bought cheaply at most pharmacies and supermarkets. There is no need to visit your doctor or have a blood test to check vitamin D levels before you start taking a supplement, unless you are concerned about symptoms or pre-existing medical conditions.
Vitamin D is also found in a small number of foods, including:
- Oily fish such as salmon, sardines, herring, mackerel and fresh tuna
- Red meat
- Liver
- Egg yolks
- Fortified foods such as fat spreads and some cereals
Manx milk is not fortified with vitamin D, as it is in some other countries.
How much vitamin D do I need?
It’s recommended that everyone should consider taking a daily supplement containing 10mcg (400 units) of vitamin D during autumn and winter months.
You should not take more than 100mcg (4000 units) of vitamin D per day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11-17 years unless higher doses are prescribed by your doctor.
Infants 0 to 1 year should have a supplement of 8.5 to10 micrograms (340 to 400 units) per day if breastfed. If formula fed, supplements should only be used if having less than 500mL formula per day (infant formula is fortified with vitamin D)
Children 1-4 years should have a supplement of 10 micrograms (400 units) per day
Some people have medical conditions such as kidney disease, liver disease and hypercalcaemia (raised calcium levels), that mean they may not be able to safely take as much. If in doubt, you should consult your doctor. If your doctor has recommended you to take a different amount of vitamin D, you should follow their advice.
For more information, see NHS Choices - Vitamin D.
Supplements for people at risk of low vitamin D throughout the year
Some people won’t get enough vitamin D even during the Spring and Summer months because they have inadequate sun exposure. This includes:
- People who stay mainly indoors – for example the frail or housebound
- People in institutions such as care homes
- People who usually wear clothes covering most of their skin when outdoors
People with dark skin from African, African-Caribbean or South Asian backgrounds may not make enough vitamin D from the levels of sunlight we get here.
Adults and children over 4 years in these groups above should consider taking a vitamin D supplement throughout the year.
Vitamin D supplementation and testing on the NHS
Vitamin D supplements are cheaply and readily available at pharmacies and supermarkets across the island. People who choose to take a supplement in line with the advice above should purchase this for themselves – supplements are not available on NHS prescription. A blood test to check vitamin D levels is not required before starting a supplement in line with the above guidance and testing will not be offered on the NHS unless a patient shows symptoms indicating osteomalacia, rickets, hypocalcaemia or has an underlying health condition which may require occasional monitoring of vitamin D levels.
Before starting a vitamin D supplement, please seek advice from your doctor if you have the following conditions:
- Chronic Kidney Disease
- Severe Liver Disease
- Hypercalcaemia (high calcium levels) or any condition that may increase the risk of high calcium levels such as certain cancers and hyperparathyroidism (overactive parathyroid gland).
The Vitamin D policy issued by DHSC Clinical Commissioning is available online.
