Vitamin D and menopause
John W. Martin III, MD is medical director of The Women’s Center at Banner – University Medical Center Phoenix in Arizona. His office can be reached at (602) 839-4351.
Question: I read a recent report suggesting women aren’t deficient in Vitamin D as previously thought. Should I stop taking the supplements prescribed for my menopause therapy?
Answer: Admittedly this report is cause for confusion, both for readers like you and those of us prescribing Vitamin D to women going through menopause as well as those working to build bone density or having babies.
Standard practice has been to maintain a Vitamin D serum level above 30 ng/mL. However, the new Institute of Medicine (IOM) report suggests 20 ng/mL is enough. It goes further to state that, with few exceptions, women get enough Vitamin D through moderate sun exposure, diet and multivitamins Therefore, asserting that supplements and serum level evaluations are unnecessary and warning that ingesting more than 4,000 IU of Vitamin D daily can damage the kidneys and other tissues.
Despite these suggestions, many of us are reluctant to pay less attention to serum levels and are uncomfortable with the lower goal of only 20 ng/mL. Vitamin D is an essential supplement for every woman’s diet unless, of course, they have significant sun exposure without sunscreen, a practice for which I do not advocate given the risk of cancer, not to mention wrinkles and blemishes.
Vitamin D is important for normal bone strength, fracture prevention and muscle activity. Some studies suggest additional benefits, particularly among older adults, including enhanced central nervous system function (maintaining balance) and muscle contraction speed (preventing falls). Conversely, low Vitamin D levels have been linked to diabetes, coronary artery disease, hypertension and immune disorders.
Vitamin D is currently being studied with great interest. As is often the case, one report touts the benefits while another warns of the risks. It’s a lot to digest. However, I’m confident that most of us on the front lines see great value in checking serum levels and prescribing supplements to maintain the standard 30 ng/mL until further evidence convinces us otherwise.
There is much contradiction and room for legitimate disagreement about Vitamin D. Discuss your questions and concerns with your physician. Everyone’s needs vary. Don’t assume that the new findings apply to you.