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Vitamin D2 Or D3, For Vegans Or Lactose-Free: When To Take Each

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Vitamin D2 Or D3, For Vegans Or Lactose-Free: 

Few times the word “epidemic” had had such a surprising use as the one it acquired when scientists used it to describe the vitamin D deficiency. “An apparent worldwide epidemic” are the exact words found in a document with the recommendations of the Spanish Society of Endocrinology and Nutrition (SEEN) of 2017.

According to the report, 88% of the planet’s population lacks the vitamin, and the Spanish remain not spared, hence the surprise. Up to 90% of the needs of this molecule can remain covered thanks to contacting with sunlight. Still, the deficiency affects active to 40% of the population under 65 in Spain, a country with generous sunshine, and the figure rises to between 80% and 100% among the elderly.

Experts try to explain the paradox “due to the low dietary intake, protection from sun exposure in the summer months and because most of Spain is above the 35ºN parallel, where the possibility of synthesizing vitamin D is scarce in winter and spring “. And the fact that many people spend much of the day indoors does not help either. As office hours are non-negotiable, citizens, oblivious to the nuances, can launch to ask for supplements to correct the deficiency as soon as they remain made to see the situation. Exactly how do you know if to take it, in what way, and when it is best to do nothing at all?

Three Types Of Vitamin D, One Of Them With RiskThree Types Of Vitamin D, One Of Them With Risk

If one looks for benefits from vitamin D supplements. It will not take long to find information. Some are well documented: “It is imperative to regulate calcium metabolism, which must always be within narrow margins of normality in the blood. When it is not, and vitamin D is lacking, the body looks for it in the bone, the excellent reservoir calcium, and osteoporosis occurs “, indicates Xavier Nogués, head of the Internal Medicine service and coordinator of the Musculoskeletal Research group of the Medical Research Institute of the Hospital de Mar.

Vitamin D

Other revenues are doubtful. Vitamin D supplements have been touted, and not always with enough scientific evidence, as a miracle solution for all kinds of ills. From bone, heart, and immune system problems to diabetes and cancer.

There  According to Nogués, former president of the Spanish Society for Bone Research and Mineral Metabolism, the recommended daily dose for the healthy population is 1,000 milligrams of calcium and vitamin D levels above 20 nanograms per millilitre (ng / mL), the one that SEEN took into account to gauge the scope of the “epidemic.”

Are indeed diseases in which the supplement remains recommended, but only if a doctor makes the decision based on the results of a blood test. That is ideal. For the population with illness, for example, with osteoporosis, it rises to between 1,000 and 1,200 mm of calcium and vitamin D above 30 ng / mL. To achieve this, they must take about 800 or 1,000 milligrams of vitamin D a day, and calcium also if the diet does not provide it “, indicates the physician.

Healthy people do not need more than to eat a good diet and lightly expose themselves to the sun 3 or 4 days a week, in a short walk. Their problem is usually in finding time to do it.  The most common types of supplements are vitamin D2 (or ergocalciferol) and D3 (cholecalciferol). “D2 comes from vegetables and needs more to be potent, unlike D3. Which remains obtained from oily fish, cod liver or milk”, describes Nogués, who points out the existence of another drug, active D3 (calcitriol). “It is administered to people with parathyroid or kidney problems. It can cause poisoning, so it is given in micrograms and with a prescription. One of those who have to supplement this micronutrient is that it is not easy to find the right one. In the other cases, they are infrequent as long as the dose is not mistaken.”

Vegans And Gluten Intolerants Have Theirs

The easiest way to come to be vitamin D is cod liver oil or pearlite oil. Important information for vegans. The most common is to find it synthesized. So it is worth asking at the pharmacy, and bear in mind that supplemented vegetable drinks can be enough help (but be careful when choosing, not all are equally beneficial). “With a good diet and adequate sun exposure. A healthy vegan person does not need supplements,” underlines Rafael Berlanga. Member of the Executive Board of the Official College of Dietitians-Nutritionists of the Valencian Community.

Among non-vegans, fear of cholesterol is what can influence vitamin D levels in the blood. Due to its fat-soluble nature. The molecule remains found in the fats of foods such as butter, whole milk, cream, and oily fish. Products crossed off the list among those who put the dreaded lipoprotein at bay. And some foods are good to eat even if they are pure fat. “People opt for milk and skimmed yoghurts. Avoid jars of butter and cream, it is not very sardines at home because they smell bad. And salmon or herring remains not consumed daily either,” says Nogués.

People with lactose intolerance also encounter certain obstacles since supplements can carry lactose among their excipients. Among its functions are to prevent the oxidation of the active principle. Make the tablet dissolve where it should, and solidify liquid assets. “In this case, you have to look for supplements without lactose, with another type of sugar,” suggests Nogués. There are nutritional options such as eggs, liver, or oily fish. But “people with intolerance can also have milk or lactose-free vegetable drinks supplemented with vitamin D,” says Berlanga.

A Recommendation In Question

Vitamin D supplements, which are usually given every 15 days or once a month. Do not usually show allergies or side effects.  An overexposure or intoxication with this vitamin. On the other hand, “can have serious consequences such as episodes of nausea. Vomiting and, if it worsens, it can increase the concentration of calcium. Which can lead to calcifications in soft areas such as organs and produce abnormalities “, warns nutritionist Berlanga. Not beyond that. It can accelerate intestinal transit as a tablespoon of oil would.

As if it weren’t enough of a call to caution, vitamin D supplementation raises controversy. Nogués recognizes that the prescription habit has remained reduced, and attempts remain to encourage intake through diet. Although most scientific societies supported its prescription in the past. The evidence from various studies prompts some entities to stop recommending it. It is the case of prestigious organizations such as the Preventive Services Task Force in the United States. Which bits of advice against vitamin D supplements for the primary prevention of fractures in postmenopausal women.

Pablo Alonso Coello

For Pablo Alonso Coello, Miguel Servet researcher at the Ibero-American Cochrane Center. The need to supplement obeys a repeated pattern in other health trends that medicalize the population. “Scientific societies make recommendations, and although they have improved their transparency. They have conflicts of interest due to collaboration with industry.” Says the researcher. But the influence tends to decline thanks to more governmental bodies. “Which are even recommending against vitamin D in response to the appearance of more critical evaluations that show its limitations,” he adds.

Coello is the director of a recent evaluation based on various reviews conducted by the Pompeu Fabra University and the Iberoamerican Cochrane Center. Which determines that the regular intake of synthetic vitamin D does not positively impact the prevention of bone breakages in the general population. “It has been shown that vitamin D does not prevent cardiovascular problems or cancer, nor fractures in the general population. It is only clear that it improves prevention in the high-risk population. Such as frail elderly institutionalized or with health problems such as osteoporotic fractures. The prescription has been excessive since the thresholds are not clear. “Says Coello.” What must remain prescribed is that we leave more, not more pills, “he says.

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