Why all the hype about vitamin D?

Vitamin D deficiency does not display obvious symptoms, nor is it often diagnosed by doctors. But when left unaddressed, it can have significant health effects.

Vitamin D is a hormone that controls calcium levels in the blood, crucial for bone and muscle development, as well for the prevention of osteoporosis. Without treatment, there can be major health risks to those who have the deficiency.

Who’s at risk?

• People with naturally very dark skin

• People with little or no sun exposure such as:
– Older adults
– People who wear covering clothing for religious and cultural reasons
– People who deliberately avoid sun exposure for cosmetic or health reasons
– People hospitalised or institutionalised for long periods
– People living with a disability or chronic disease
– People in occupations with little sun exposure

• Breastfed babies who fall into the risk categories above or have mothers with low vitamin D. Breast milk contains little vitamin D and infants depend on maternal stores initially. (Formula milk is fortified with vitamin D)

• People with medical conditions or medications affecting vitamin D metabolism include obesity, end-stage liver disease, kidney disease, conditions that cause fat malabsorption (such as cystic fibrosis, coeliac disease and inflammatory bowel disease) and use of some drugs that increase the breakdown of vitamin D (such as rifampicin and some anticonvulsants).

When is supplementation needed?

Ultraviolet (UV) radiation from the sun is the best natural source of vitamin D and so a balanced UV exposure approach is often satisfactory.

Vitamin D supplements may be helpful for some people, but should be taken upon consultation with a doctor and strictly as directed.

Sun exposure recommendations

When UV levels are low (below 3), get 2–3 hours per week of midday sun exposure. In the southern parts of Australia, UV levels fall below 3 from May to August. At this time, most people need two to three hours of midday winter sun exposure to the face, arms, hands (or equivalent area of skin) spread over the week. People with naturally very dark skin, may require three to six times this amount of sun.

When UV levels are high (3 and above), get a few minutes of mid-morning or mid-afternoon sun exposure each day. UV levels are 3 or above for much of the day from September to April in the southern parts of Australia, and all year round in the north.

When UV levels reach 3 and above, sun protection is required. At this time, most people need just a few minutes of mid-morning or mid-afternoon sun exposure to the face, arms, hands (or equivalent area of skin). People with naturally very dark skin, may require three to six times this amount of sun.

People with naturally very dark skin may not need to wear sunscreen, but should still protect their eyes from the sun, with sunglasses and/or a hat.

Resources for nurses

SunSmart has a number of resources to assist nurses in confidently identifying and treating patients low or deficient in Vitamin D.

• SunSmart app – free for iPhone and android phones. The app lets you know when you do and don’t need sun protection, making it easier than ever to be smart about your sun exposure all year. Includes a Vitamin D tracker tool and sunscreen calculator
• Vitamin D tracker tool – app and web versions available. This handy, free tool takes location, skin type and sunscreen use into account to give the user advice on their sun exposure for vitamin D. Find out how your daily UV exposure compares with recommended UV exposure for vitamin D
• The Vitamin D and Sun Protection in General Practice video is a 15-minute video designed to provide health professionals in Australia with increased knowledge and confidence in advising patients about sun exposure, vitamin D and skin cancer prevention.

For more information on vitamin D, go to www.sunsmart.com.au

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