It's not impossible to drink beer and follow the keto diet. Westend61 / Getty
Drinking on the keto diet can be difficult.
Alcohol contains high carbs, typically.
But some beers have lower carbs and can be keto-friendly.
Miller Lite is generally low in carbs.
So is Corona Light.
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Treating yourself to a cold beer when observing the keto diet may seem pretty impossible. However, it's worth mentioning that this idea is actually closer to reality than you may think, as many mass beer brands offer lighter brews which go low on the calories and the carbs.
And while these beers aren't necessarily nutritious by any means, they still can function as a good occasional treat after a long workweek. However, it's always important to be careful of how much beer you actually consume when observing the keto diet, as too many carbs can throw a wrench in your hard-earned ketosis.
To put a finger on all those keto-safe beers, we spoke to an expert about the topic to help you make the best beer decisions possible. From lager to IPA, below are some options definitely worth keeping in mind.
It's important to note that there are low-carb options available.
It's not impossible to drink beer on keto. Justin Sullivan/Getty Images
"There are thousands of different beers on the market— imported and domestic, craft and microbrew," suggested Kyndra Holley, author of best-selling cookbooks Keto Happy Hour, Cravable Keto, and 30 Minute Ketogenic Cooking.
While many people following a strict low-carb, keto diet omit gluten altogether, there are many that do not and still enjoy the occasional beer, she said. The trick here is to consume low-carb beers, she explained, as they can quench your thirst and keep the calorie consumption to a minimum.
Michelob ULTRA also works on the keto diet.
Michelob ULTRA Michelob ULTRA
Boasting only 2.6 carbs, Holley said that the Michelob ULTRA line is another good beer choice, as it has only 95 calories per serving. And if you are looking for a Michelob beer with an even lower carb-count, it's worth mentioning that the Michelob ULTRA Pure Gold organic light lager, as also worth trying, as it contains just 2.5 grams of carbs and 85 calories.
Coors Light is another suitable choice.
Coors Light Coors Light
Holley noted that Coors is another brand to give a chance, as it's Coors Light American-style light lager contains a low ABV and just 5.0 carbs. And while it does have a higher calorie count (contains 102 calories), it can still be good for an occasional treat.
Heineken Light keeps the carbs low too.
Heineken Light Heineken
Holley also recommended trying Heineken Light if you're into smoother beers with hints of citrus, as it contains 99 calories and 7 grams of carbs.
You can also indulge in some keto-safe IPA.
Four Peaks Brut IPA. Four Peaks
Brands like Four Peaks are also getting in on the keto-friendly beer action, as the brand's Brut IPA contains 5 grams per bottle. And although it does contain a slightly higher calorie count, it does contain less than one gram of sugar for one 12-ounce bottle.
Don't shy away from gluten-free beer.
Omission. Omission
Holley did stress the importance of being aware that most beers available for purchase aren't gluten-free. So, if you're looking for a good gluten-free beer option, she advised checking out brands like Omission (the Omission Light beer only contains 99 calories and 5 carbs) that are crafted to remove gluten.
Almond milk has been a hit for years, especially among those who need an alternative to dairy. Whether dairy-based milks just don't agree with your stomach or you're following a vegan diet, almond milk is the way to go. In fact, its many health benefits make this beverage a real powerhouse. So, the question remains: Should you spend the time making your own almond milk — or is store-bought almond milk the superior choice?
In comparison to cow's milk, almond milk is packed with incredible health benefits. In fact, the addition of vitamins D and E gives this milk an edge when it comes to nutritional value. And, so long as you're drinking unsweetened almond milk, it won't raise your blood sugar levels.
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As it's relatively low in carbohydrates, almond milk is also a great choice for those on low-carb diets. Looking to take things to the next level? Plenty of store-bought almond milks are enriched with calcium, so you can hit those daily goals without cow's milk or other dairy products. So long as you aren't allergic to nuts, almond milk is a great — and tasty — dairy substitute.
Best-Rated Almond Milk Brands
With so many almond milk varieties available in supermarkets, it's important to know which will benefit you the most. For example, some sweetened almond milks will contain higher levels of sugar, whereas enriched varieties will give you that calcium boost we mentioned.
Photo Courtesy: Paul Aiken/Digital First Media Group/Boulder Daily Camera/Getty Images
Here's a quick breakdown on those almond milk varieties:
Unsweetened: No sugar added means this one is better for those on a low-sugar diet.
Enriched: Enriched with calcium — and, in some cases, vitamins A, D and E as well. Best for those who need a vitamin or mineral boost.
Carrageenan-free: Most almond milk brands are already carrageenan-free, but it's always good to double check. Although carrageenan is commonly used to extend a product's shelf life, it's unclear whether or not it has any bearing on a product's nutritional value.
With that in mind, let's explore some of the top-rated almond milk brands. Some popular contenders include:
Silk: Silk has a wide range of low-sugar options, as well as vanilla flavors, unsweetened vanilla flavors, and a light version with just 5g of sugar per cup. Its almonds are non-GMO — and it's free of carrageenan.
Califia Farms: The Califia Farms range includes several varieties. The original version contains just 5g of sugar per cup; however, Califia Farms also has an unsweetened almond milk. Additionally, you can find a special Barista Blend if you're a coffee person. Its almonds are GMO-free and carrageenan is not a listed ingredient.
Blue Diamond Almond Breeze: Blue Diamond Almond Breeze's almond milk has plenty of varieties, including original, vanilla, chocolate, unsweetened, and unsweetened vanilla. It's GMO-free and carrageenan-free in the U.S., but the U.K. version might still contain carrageenan.
So Delicious: So Delicious offers a vanilla variety as well as an unsweetened milk. For those looking to mix it up, there's even a special almond and cashew blend. Like the others on our list, it's GMO-free and offers an extra boost of protein, which is particularly beneficial for vegetarian and vegan folks.
How to Make Almond Milk at Home
As this recipe from Martha Stewart shows, making almond milk at home is actually quite easy. In fact, all it requires is a bit of preparation — and patience. First, you'll need to put the almonds in question in cool water and store them that way overnight. The next day, you'll drain the water and toss those soaked almonds and some water into a blender.
This is the fun part! You can mix in whatever you want — dates, vanilla, cocoa powder, berries, and anything else that might appeal to you. For best results, use a high-speed blender, and, remember, you're looking for a smooth, creamy consistency. Pour your finished product into a jar and shake well before drinking. Most homemade almond milks will last around five days if refrigerated. Pro tip: Wondering what to do with your almond pulp? Add it to your next baking project.
Store-Bought vs. Homemade: Which is Better?
In the end, it's a personal preference. For example, store-bought almond milk usually keeps a bit longer, making it the ideal option for those with busier schedules. Additionally, since almond milk isn't naturally high in calcium, the enriched, store-bought versions might also be best for those looking for a solid source of calcium.
Photo Courtesy: d3sign/Moment/Getty Images
However, homemade almond milk may hold more nutritional value — you know exactly what's in it after all, and your additives can be catered to your dietary needs. Plus, making your own almond milk allows you to experiment with those new ingredients and flavors. In the end, weigh your options carefully, so that you can milk those almonds for all they're worth.
Resource Links:
"The Health Benefits of Almond Milk" via BBC's Good Food
Lots of today's trendy diets — think Atkins, keto and sometimes paleo — are centered around low-carb foods. But cutting carbs to lose weight fast isn't a new idea. It's been around for more than 150 years. So what's driving the popularity of this eating plan?
With a low-carbohydrate diet, you keep your carbohydrates lower than what's typically found in Western diets, Jen Bruning, a registered dietitian and spokesperson for the Academy of Nutrition & Dietetics, told TODAY.
Processed foods and fast foods — common in Western diets — are often high in carbs. They can contain a lot of refined carbs that don't offer a lot of nutritional value. Low-carb diets limit these high-carb foods, as well as grains, starchy vegetables (like potatoes and peas) and fruit. They emphasize foods low in carbs and high in protein and fat instead, like meat, cheese and nuts, as well as leafy vegetables.
How does the low-carb diet work?
To start, there's no one low-carb diet. Different plans cut carbs down to different levels. The strictest diets aim to cut carbs down to zero. Others target 150 grams or less per day. As a comparison, the Dietary Guidelines for Americans recommend 225 to 325 grams per day as part of a healthy eating plan that doesn't focus on limiting carbs.
Bonnie Taub-Dix, a registered dietitian and author of "Read It Before You Eat It: Taking You from Label to Table," points out that carbs aren't all nutritionally the same. A slice of whole-grain bread, a small piece of fruit and four packets of sugar could all have about 15 carbs. "Those food all have completely different health profiles," she said. The bread has fiber, vitamins and minerals, and can help you feel full. The fruit might have fiber and antioxidants. The sugar has no nutritional value except for energy.
People want to know the best ways to lose weight and how to lose weight fast. But there's more to understand. "If you want to eat more healthfully and lose weight, you have to think about what your body needs and your health needs, not just your weight-loss needs," Taub-Dix said.
What does the research say about the low-carb diet?
What are low-carb diet benefits? Bruning said with low-carb dieting you might see improvements in blood sugar levels and weight loss. But the weight loss might not last. "Research also suggests a tendency to regain any lost weight when eating patterns return to normal," she said.
Sticking with a low-carb eating plan may help you maintain weight loss, though.
According to the Mayo Clinic, low-carb diets might help prevent or improve metabolic syndrome, diabetes, high blood pressure and heart disease.
A study published in the Journal of the American College of Nutrition found that for people with type 2 diabetes, diets that were low in carbs helped them lose weight and reduce the medication they needed to take to control of their diabetes.
Is low-carb a good choice for you?
You might want to try a low-carb diet if you're looking to lose weight in the short term or to prevent or improve metabolic syndrome, diabetes, high blood pressure or heart disease.
A low-carb diet includes a lot of other food options, so if you don't like diets with severe food restrictions you might like the variety it offers.
You may also want to look at the kinds of carbs you're eating to see where you can make changes. "If you examine your diet and feel you are lacking in non-starchy vegetables but eat lots of added sugar, you may choose to lower your refined carbohydrate intake in favor of more veggies," Bruning said.
And remember that low-carb diets are low in certain nutritious foods. "Plenty of higher-carbohydrate foods are very healthful. Think legumes, fruit and whole grains," Bruning said. "Low-carb diets also tend to be low in fiber, and fiber is known to be protective against heart disease and some cancers."
Taub-Dix is wary of any diet that eliminates an entire food group. "No one food or food group is going to be magical for you or horrible for you unless you have a food allergy or intolerance," she said. "We shouldn't demonize any one particular food or food group. That should be a red flag when choosing a diet — if a food group is eliminated, steer clear of that diet."
What do you eat on the low-carb diet?
Generally, low-carb menus will include foods that are higher in protein and fat.
On a low-carb diet, you're likely to eat foods like:
Meat
Poultry
Fish
Eggs
Some nonstarchy vegetables
You'll cut out or limit:
Grains
Legumes like lentils, beans and peas
Fruits
Breads
Sweets
Pasta
Rice
Starchy vegetables like potatoes, corn and butternut squash
Milk
Sometimes nuts and seeds
Following a low-carb diet, in a typical day you might eat low-carb meals like:
Breakfast: Omelet with cheese, mushrooms, tomatoes and spinach
Lunch: Cobb salad
Dinner: Chicken drumsticks with coleslaw
Snack: Roasted pecans
The low-carb diet is similar to:
Keto diet, which typically limits carbs to 50 grams a day or less
Keto/FLEX 12/3, which blends a low-carb diet and fasting
Low-carb, high-fat diet, which pairs a reduction in carbs with an increase in high-fat foods
Paleo diet, which tends to be low-carb in practice because it emphasizes a lot of low-carb foods
Atkins diet, which has a four phases of carb intake levels
Zero-carb diet, which aims to reduce carbs to (you guessed it) zero
Is the low-carb diet effective long-term?
Compared with low-fat dieters, low-carb dieters may see a short-term weight-loss boost. But the gain tends to disappear after a year or two, according to the Mayo Clinic. It's possible that eating more protein and fat instead of carbs can help keep you feeling full, so you eat less.
Most studies of low-carb diets have lasted less than a year. So it's not clear yet if a low-carb diet has long-term health risks.
Talk with your doctor before starting a low-carb diet or any other diet — your doctor can recommend the best healthy diet for you, based on your needs.
Stephanie Thurrott is a writer who covers mental health, personal growth, wellness, family, food and personal finance, and dabbles in just about any other topic that grabs her attention. When she's not writing, look for her out walking her dog or riding her bike in Pennsylvania's Lehigh Valley.
Vitamins are substances that your body needs to grow and develop normally. Vitamin D helps your body absorb calcium. Calcium is one of the main building blocks of bone. A lack of vitamin D can lead to bone diseases such as osteoporosis or rickets. Vitamin D also has a role in your nerve, muscle, and immune systems.
You can get vitamin D in three ways: through your skin, from your diet, and from supplements. Your body forms vitamin D naturally after exposure to sunlight. However, too much sun exposure can lead to skin aging and skin cancer. So many people try to get their vitamin D from other sources.
Vitamin D-rich foods include egg yolks, saltwater fish, and liver. Some other foods, like milk and cereal, often have added vitamin D.
You can also take vitamin D supplements. Check with your health care provider to see how much you should take. People who might need extra vitamin D include:
Older adults
Breastfed infants
People with dark skin
People with certain conditions, such as liver diseases, cystic fibrosis and Crohn's disease
People who have obesity or have had gastric bypass surgery
NIH: National Institutes of Health Office of Dietary Supplements
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Vitamin D Test (National Library of Medicine) Also in Spanish
Calcium and Vitamin D: Important at Every Age (National Institute of Arthritis and Musculoskeletal and Skin Diseases) Also in Spanish
Vitamin D Toxicity: What If You Get Too Much? (Mayo Foundation for Medical Education and Research) Also in Spanish
ClinicalTrials.gov: Vitamin D (National Institutes of Health)
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Breastfeeding: Vitamin D Supplementation (Centers for Disease Control and Prevention)
25-hydroxy vitamin D test (Medical Encyclopedia) Also in Spanish
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Many cases of leukemia across the globe may be caused by vitamin D deficiency as a result of low sunlight exposure. This is the conclusion of a new study published in PLOS One.
Share on PinterestResearchers suggest low vitamin D levels, mediated by low UVB exposure, may be responsible for many leukemia cases worldwide.
Leukemia is a cancer of the blood cells, most commonly affecting the white blood cells, or leukocytes, that help fight infection.
There were around 352,000 new cases of leukemia diagnosed worldwide in 2012, and last year, more than 54,000 cases of the cancer were diagnosed in the US alone.
While scientists are still unsure of the exact causes of leukemia, genetic and environmental factors are thought to play a role.
A number of studies have shown that vitamin D metabolites in the blood – known as 25-hydroxyvitamin D, or 25(OH)D, which is an indicator of the body's vitamin D levels – interact with acute myeloid leukemia (AML) cells. What is more, some studies have identified low vitamin D levels in patients with AML.
While vitamin D is found in some foods, including oily fish, cheese and egg yolks, it is present in small amounts. The body's best source of vitamin D is sunlight; ultraviolet B (UVB) radiation from the sun penetrates bare skin, inducing vitamin D synthesis.
In this latest study, coauthor Cedric Garland, adjunct professor in the Department of Family Medicine and Public Health at the University of California-San Diego, and colleagues set out to investigate whether low UVB exposure and low vitamin D levels are associated with leukemia risk.
Garland and colleagues analyzed data from the International Agency for Cancer Research's (IARC) Global Cancer (GLOBOCAN) 2012 database.
Fast facts about leukemia
Leukemia accounted for around 3.3% of all new cancer cases in the US last year
Around 1.5% of men and women in the US will be diagnosed with leukemia at some point in their lives
Around 58.5% of people with leukemia survive 5 years or more after diagnosis.
Learn more about leukemia
The team looked at the age-adjusted leukemia incidence rates for 172 countries, and the cloud cover-adjusted UVB irradiance for each country was assessed using data from the International Satellite Cloud Climatology Project.
The researchers found that individuals living in countries farther away from the equator, such as the US, Australia, New Zealand, Canada and Ireland, were at least twice as likely to have leukemia as people living in countries closes to the equator, such as Nigeria, Bolivia, Samoa and Madagascar.
The association remained after accounting for sex-specific life expectancy and altitude, according to the authors.
The team explains that individuals who live farther away from the equator are exposed to solar energy that has traveled farther through the Earth's atmosphere, which reduces the amount of UVB radiation that reaches the skin.
As such, the researchers say it is "plausible" that much of the leukemia burden across the globe is a result of low vitamin D levels caused by low UVB exposure.
"Skin photosynthesis accounts for a large proportion of 25(OH)D concentration. As a result, the inverse association between cloud-adjusted solar UVB exposure and incidence rates is likely to be mediated by circulating 25(OH)D, which is highly dependent on solar UVB irradiance," they explain, adding:
"Importantly, these results suggest that increased levels of UVB irradiance and vitamin D may help prevent development of leukemia."
While the team says some key strengths of their study are the inclusion of thousands of leukemia cases from hundreds of countries and the fact the findings are consistent with results from previous studies, they admit there are some limitations.
For example, they were unable to control for other factors that may fuel differences in leukemia risk between countries. "Some of these confounders may be very influential on risk for leukemia," they note.
Still, Garland and colleagues believe the association between low UVB exposure, low vitamin D levels and leukemia warrants further investigation.
While vitamin D deficiency has been linked to a number of health problems, a recent study reported by Medical News Today suggests higher monthly doses of the vitamin may increase the risk of falls among seniors.
Share on PinterestExperts are researching if vitamin D deficiency is linked to severe COVID-19 symptoms. Jasmin Merdan / Getty Images
Several studies have linked vitamin D deficiency to coronavirus infection and more severe COVID-19.
Experts are now investigating if taking vitamin D may help protect against severe COVID-19 symptoms.
Even before these studies are finished, there are good reasons to consider taking a vitamin D supplement.
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub and follow our live updates page for the most recent information on the COVID-19 pandemic.
With no coronavirus vaccines approved for full use, many people are turning to vitamins and other supplements to bolster their immune system and help them fight off COVID-19.
While plenty of posts on social media push these supplements as personal coronavirus shields, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, cautioned last month that most "so-called immune boosting supplements" actually do "nothing."
However, there is one supplement that may be of use to the immune system — vitamin D, also known as the "sunshine vitamin."
"If you are deficient in vitamin D, that does have an impact on your susceptibility to infection," Fauci said in an Instagram Live interview with actress Jennifer Garner. "So I would not mind recommending — and I do it myself — taking vitamin D supplements."
Fauci was not speaking about COVID-19 specifically, but about vitamin D's general role in supporting the immune system — in particular, about the benefits of this nutrient for people who are deficient.
Right now, the National Institutes of Health says there's not enough evidence to show that vitamin D can prevent or treat COVID-19.
But there is enough evidence that scientists are exploring the benefits of this and other supplements against the coronavirus.
Earlier research showed that vitamin D reduces the risk of respiratory tract infections other than COVID-19. The benefits varied quite a bit among these studies, but vitamin D supplementation seemed to be more helpful for people who were deficient in this nutrient.
More recent research suggests that vitamin D deficiency may increase the risk of coronavirus infection and severity of COVID-19.
For example, some studies found that COVID-19 deaths tend to be higher in countries farther away from the equator, where many people are deficient in vitamin D due to the reduced amount of sunlight, especially during winter.
"We make vitamin D by being exposed to sunlight, and in the colder months people can become deficient," said Nicole Avena, PhD, an assistant professor of neuroscience at the Icahn School of Medicine at Mount Sinai in New York.
Many factors could account for the greater number of COVID-19 cases in more northerly latitudes. But a study published last month in JAMA Network Open reinforces the importance of vitamin D for a healthy immune system.
"In our study, patients who have lower vitamin D levels were more likely to test positive for COVID-19," said study author Dr. David Meltzer, a professor of medicine at The University of Chicago Medicine.
This trend still held when they tried to control for other factors — age, obesity, other medical conditions — that might worsen COVID-19 and are linked to lower vitamin D levels.
Other studies show that patients with lower vitamin D levels who are diagnosed with COVID-19 tend to have worse outcomes.
One of these was published last month in PLoS ONE. Researchers found that people hospitalized for COVID-19 who were deficient in vitamin D were more likely to have severe symptoms or die from COVID-19.
Not all research, though, supports the link between vitamin D and COVID-19.
A UK biobank study published earlier this year in Diabetes & Metabolic Syndrome: Clinical Research & Reviews found no link between vitamin D levels and coronavirus infection.
However, Meltzer and his colleagues pointed out in their paper that the UK researchers measured vitamin D levels up to 14 years before COVID-19 testing and didn't look at whether people had been treated with vitamin D since then.
This could have weakened the observed link between vitamin D levels and coronavirus infection, they wrote.
Scientists are also eyeing other nutrients as potential treatments for COVID-19, including zinc and vitamin C, both touted for their cold-fighting benefits.
In one study, researchers from Spain reported that patients with low blood levels of zinc were more likely to die from COVID-19.
Their results were presented last week at the European Society of Clinical Microbiology and Infectious Disease (ESCMID) Conference on Coronavirus Disease. This research has not been peer-reviewed, so it should be viewed with some caution.
All of these studies are observational, meaning researchers collected data on people over time, rather than assigning people to different treatments. That makes it impossible to show a cause-and-effect relationship between vitamin D and COVID-19.
What's needed are randomized controlled trials (RCTs), the "gold standard" of clinical research. Some of these are already underway.
In one study carried out in Spain, researchers gave calcifediol, an active form of vitamin D, to 50 people hospitalized with COVID-19. Another group of 26 patients didn't receive vitamin D.
All patients were treated equally with hydroxychloroquine and azithromycin.
Only one of the patients treated with vitamin D ended up in the intensive care unit, while half of the untreated patients did.
"There are some imperfections [to the study] — it's not a very large study, there are some slight imbalances between the groups — but it's pretty impressive," said Meltzer.
While this study used vitamin D to treat people who already had COVID-19, Meltzer says the nutrient might work equally well at keeping people out of the hospital.
"One possibility is that vitamin D is not preventing COVID-19," he said, "but is causing people who are infected to have such minimal symptoms that they never get tested, never get found."
More research is needed to know if this is true.
Two randomized controlled trials starting at the University of Chicago should provide some answers. In both, people will be treated with vitamin D and then followed to see if they contract the coronavirus and how severe their symptoms are.
One trial focuses on healthcare workers. The other will recruit people from the community, with an emphasis on enrolling Black and Hispanic people, who are at high risk for both vitamin D deficiency and COVID-19.
At the Cleveland Clinic, researchers are enrolling people into a study to see if vitamin C or zinc — or a combination of the two — can reduce the duration of COVID-19 symptoms. Patients will be given the supplements after they have tested positive for COVID-19.
How soon results are available from these studies depends on how quickly researchers can enroll people into the studies. Meltzer says study volunteers are essential for the success of COVID-19 research.
"People who can enter clinical trials do a tremendous service to society," he said.
Although Meltzer is enthusiastic about the potential benefits of vitamin D, he cautions that we won't really know until the randomized controlled trials are finished.
"This doesn't mean we should let down our guard or not do any of the other things we're doing," he said. "I certainly wouldn't stop wearing a mask and go to a big party thinking everything was going to be OK because I was taking vitamin D."
Even before these studies are finished, there are good reasons to consider taking a vitamin D supplement.
"The vast majority of Americans are vitamin D deficient and could probably benefit from some modest level of vitamin D supplementation, at very little risk," said Meltzer.
In the United States, an estimated 41 percent of adults are deficient in vitamin D. People with darker skin are at greater risk — 63 percent of Hispanic people and 82 percent of Black people have low vitamin D levels.
Other factors increase the risk of vitamin D deficiency, including age, limited sun exposure, obesity, and certain medical conditions.
Avena says it is difficult to get enough vitamin D from foods. "So taking a supplement may be advised," she says, "but always check with your doctor first."
Meltzer says he takes 4,000 international units (IU) per day. The National Institutes of Health says this is the upper limit of what is safe for the vast majority of people.
"Don't consume more than 4,000 IU per day of vitamin D without your doctor's permission," said Avena. "It exceeds the safe upper limits of intake."
Larger doses can be toxic and should only be taken under medical supervision.
Avena says zinc may also be helpful once you feel symptoms of a cold coming on.
She recommends taking between 13.3 milligrams and 23 milligrams of zinc every 2 hours while you have cold symptoms, but no longer than 1 week. This is the dose found in over-the-counter gummies and lozenges.
As with vitamin D, we don't yet know if zinc will reduce symptoms of COVID-19.
While most people get enough zinc from food sources, some groups — vegetarians, people with gastrointestinal diseases, people who misuse alcohol — are at higher risk of zinc deficiency and might want to consider taking a supplement.
Vitamin D deficiency means that you do not have enough vitamin D in your body. Vitamin D is unique because your skin actually produces it by using sunlight. Fair-skinned individuals and those who are younger convert sunshine into vitamin D far better than those who are darker-skinned and over age 50.
Why is vitamin D so important?
Vitamin D is one of many vitamins our bodies need to stay healthy. This vitamin has many functions, including:
Keeping bones strong: Having healthy bones protects you from various conditions, including rickets. Rickets is a disorder that causes children to have bones that are weak and soft. It is caused by a lack of vitamin D in the body. You need vitamin D so that calcium and phosphorus can be used to build bones. In adults, having soft bones is a condition called osteomalacia.
Absorbing calcium: Vitamin D, along with calcium, helps build bones and keep bones strong and healthy. Weak bones can lead to osteoporosis, the loss of bone density, which can lead to fractures. Vitamin D, once either taken orally or from sunshine exposure is then converted to an active form of the vitamin. It is that active form that promotes optimal absorption of calcium from your diet.
Working with parathyroid glands: The parathyroid glands work minute to minute to balance the calcium in the blood by communicating with the kidneys, gut and skeleton. When there is sufficient calcium in the diet and sufficient active Vitamin D, dietary calcium is absorbed and put to good use throughout the body. If calcium intake is insufficient, or vitamin D is low, the parathyroid glands will 'borrow' calcium from the skeleton in order to keep the blood calcium in the normal range.
What are the health effects of vitamin D deficiency?
Getting enough vitamin D may also play a role in helping to keep you healthy by protecting against the following conditions and possibly helping to treat them. These conditions can include:
Heart disease and high blood pressure.
Diabetes.
Infections and immune system disorders.
Falls in older people.
Some types of cancer, such as colon, prostate and breast cancers.
Multiple sclerosis.
What are the sources of vitamin D?
You can get vitamin D in a variety of ways. These can include:
Being exposed to the sun. About 15-20 minutes three days per week is usually sufficient.
Through the foods you eat.
Through nutritional supplements.
What does sunlight have to do with getting enough vitamin D?
There are health benefits of sunlight. Vitamin D is produced when your skin is exposed to sunshine, or rather, the ultraviolet B (UV-B) radiation that the sun emits. The amount of vitamin D that your skin makes depends on such factors as:
The season: This factor depends a bit on where you live. In areas such as Cleveland, OH, the UV-B light does not reach the earth for six months out of the year due to the ozone layer and the zenith of the sun.
The time of day: The sun's rays are most powerful between 10 a.m. and 3 p.m.
The amount of cloud cover and air pollution.
Where you live: Cities near the equator have higher ultraviolet (UV) light levels. It is the UV-B light in sunlight that causes your skin to make vitamin D.
The melanin content of your skin: Melanin is a brown-black pigment in the eyes, hair and skin. Melanin causes skin to tan. The darker your skin, the more sun exposure is needed in order to get sufficient vitamin D from the sun.
What does your diet have to do with getting enough vitamin D?
Vitamin D doesn't occur naturally in many foods. That's why certain foods have added vitamin D. In fact, newer food nutrition labels show the amount of vitamin D contained in a particular food item.
It may be difficult, especially for vegans or people who are lactose-intolerant, to get enough vitamin D from their diets, which is why some people may choose to take supplements. It is always important to eat a variety of healthy foods from all food groups. The vitamin content of various foods is shown in the following table.
Vitamin D content of various foods
Food
Vitamin D content in International Units (IUs) per serving
Cod liver oil, 1 tablespoon
1360
Swordfish, cooked, 3 ounces
566
Salmon (sockeye) cooked, 3 ounces
447
Tuna, canned in water, drained, 3 ounces
154
Orange juice fortified with vitamin D, 1 cup
137
Milk, vitamin-fortified, 1 cup
115-124
Yogurt, fortified with 20% of the daily value of vitamin D, 6 ounces
80
Sardines, canned in oil, drained, 2 sardines
46
Liver, beef, cooked, 3 ounces
42
Egg yolk, 1 large
41
Cereal, fortified with 10% of the daily value of vitamin D, 1 cup
40
Cheese, Swiss, 1 ounce
6
Source: Vitamin D. Health Professionals. Dietary Supplement Fact Sheet. National Institutes of Health. Office of Dietary Supplements. August 7, 2019.
It is important to check product labels, as the amount of added vitamin D varies when it is artificially added to products such as orange juice, yogurt and margarine.
How much vitamin D do you need?
In healthy people, the amount of vitamin D needed per day varies by age. The chart below shows the often-cited recommendations of the Institute of Medicine, now the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine. It is important to know that these are general recommendations. If your doctor is checking your blood levels, he or she might recommend higher or lower doses based on your individual needs.
If you have osteoporosis, your doctor might suggest a blood test of your vitamin D levels. The amount of vitamin D supplement can be customized for each person, based on the results. For many older patients, a vitamin D supplement containing anywhere between 800 to 2000 IUs daily, which can be obtained without a prescription, can be both safe and beneficial. It is important to speak with your doctor about your individual needs.
People by age
Recommended dietary allowance (IU/day)
Upper level intake (IU/day)
Infants 0-6 months*
400
1,000
Infants 6-12 months*
400
1,500
Children 1-3 years old
600
2,500
Children 4-8 years old
600
3,000
People 9-70 years old
600
4,000
People over 70 years old
800
4,000
Females 14-50 years old, pregnant/lactating
600
4,000
*refers to adequate intake vs recommended dietary allowance of the other age groups.
Symptoms and Causes
What causes vitamin D deficiency?
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.
Human breast milk: A woman's breast milk only contains a small amount of vitamin D. Often infant formulas also only include a small amount of D also. Therefore infants are at risk of not receiving enough vitamin D. This is especially true for infants who are only fed breast milk.
Can medications cause a vitamin D deficiency?
Yes. Vitamin D levels can be lowered by certain medications. These include:
Laxatives.
Steroids (such as prednisone).
Cholesterol-lowering drugs (such as cholestyramine and colestipol).
Seizure-control drugs (such as phenobarbital and phenytoin).
A tuberculosis drug (rifampin).
A weight-loss drug (orlistat).
Always tell your doctor about the drugs you take and any vitamin D supplements or other supplements or herbs/alternative health products that you take.
What are the signs and symptoms of vitamin D deficiency?
Severe lack of vitamin D causes rickets, which shows up in children as incorrect growth patterns, weakness in muscles, pain in bones and deformities in joints. This is very rare. However, children who are deficient in vitamin D can also have muscle weakness or sore and painful muscles.
Lack of vitamin D is not quite as obvious in adults. Signs and symptoms might include:
Fatigue.
Bone pain.
Muscle weakness, muscle aches, or muscle cramps.
Mood changes, like depression.
Diagnosis and Tests
How is a vitamin D deficiency diagnosed?
Your doctor can order a blood test to measure your levels of vitamin D. There are two types of tests that might be ordered, but the most common is the 25-hydroxyvitamin D, known as 25(OH)D for short. For the blood test, a technician will use a needle to take blood from a vein. You do not need to fast or otherwise prepare for this type of test.
What do vitamin D test results mean?
There are some differing opinions about what levels of vitamin D work the best for each person. Laboratories might use different numbers for reference. Please discuss your results with your doctor.
How often do you need to get your vitamin D levels checked?
Doctors do not usually order routine checks of vitamin D levels, but they might need to check your levels if you have certain medical conditions or risk factors for vitamin D deficiency. Sometimes vitamin D levels can be checked as a cause of symptoms such as long-lasting body aches, a history of falls or bone fractures without significant trauma.
Management and Treatment
How is vitamin D deficiency treated?
The goals of treatment and prevention are the same—to reach, and then maintain, an adequate level of vitamin D in the body. While you might consider eating more foods that contain vitamin D and getting a little bit of sunlight, you will likely be told to take vitamin D supplements.
Vitamin D comes in two forms: D2 and D3. D2, also called ergocalciferol, comes from plants. D3, also called cholecalciferol, comes from animals. You need a prescription to get D2. D3, however, is available over the counter. It is more easily absorbed than D2 and lasts longer in the body dose-for-dose. Work with your doctor to find out if you need to take a vitamin supplement and how much to take if it is needed.
Can you ever have too much vitamin D?
Yes. You can get too much vitamin D if you overdo the supplements. Interestingly, you cannot get too much vitamin D from the sun. Vitamin D toxicity is, thankfully, quite rare but can lead to hypercalcemia and together the symptoms can include:
Nausea.
Increased thirst and urination.
Poor appetite.
Constipation.
Weakness.
Confusion.
Ataxia (a neurological condition that may cause slurring of words and stumbling).
Do not take higher-than-recommended doses of vitamin D without first discussing it with your doctor. However, your doctor might recommend higher doses of vitamin D if he or she is checking your blood levels and adjusting your dose accordingly. Also, be cautious about getting large doses of vitamin A along with the D in some fish oils. Vitamin A can also reach toxic levels and can cause serious problems.
Prevention
How can I help prevent vitamin D deficiency?
The goals of treating and preventing the lack of vitamin D of treatment and prevention are the same—to reach and keep an adequate level of vitamin D in the body. Your healthcare provider will let you know if you need to take or keep taking vitamin D supplements. If so, they will also let you know how much you should take. You might also want to consider:
Eating more foods that contain vitamin D: See the vitamin D food sources table included in this article. Keep in mind that foods alone usually don't meet the daily recommended levels of vitamin D.
Getting some exposure to sunshine—but not too much: Exactly how much sun exposure is needed isn't clear. 10 to 15 minutes of sun exposure two to three times a week to the face, arms, legs or back may be all that is needed to absorb a suitable amount of vitamin D. You might need more sun exposure (especially in early spring and late fall) if:
You are older.
You have a darker skin color.
You live in northern climates.
The use of sunscreen, and standing behind a window, prevents vitamin D from being produced in the skin. However, you should remember that too much sunshine increases the risk of skin cancer and ages the skin. That is why taking an appropriately dosed D supplement is far safer than intentionally getting routine sun exposure.
![[Vitamin D sources on a notepad]](https://i0.wp.com/cdn-prod.medicalnewstoday.com/content/images/articles/304/304797/vitamin-d-on-a-notepad.jpg?w=1155&h=978)
