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Vitamin D

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What is Vitamin D?

Vitamin D is essential for bone health.  It is needed to absorb calcium and other nutrients from our diet and helps to keep bones strong. Vitamin D may also help to keep us healthy in other ways, for example by helping the immune system, but the evidence for this is not clear.

Where do we get vitamin D from?

Nearly all the vitamin D we obtain is made in our body from sunlight (around 90%), so safe sun exposure is important. Only a very small amount of vitamin D comes from the foods we eat.  However, it is still important to eat foods that contain vitamin D as part of a balanced diet, these foods include: 

  • Oily fish (salmon, mackerel, sardines)
  • Red Meat
  • Egg yolks
  • Liver
  • Fortified foods (including some margarines and breakfast cereals in the UK)Further information can be found here.

What happens when we become deficient in Vitamin D?

Adults with very low levels of vitamin D for a long time develop a condition called osteomalacia. In this condition, calcium is lost from the bones.  The bones become softened and painful and broken bones (fractures) can occur without an injury. In osteomalacia, the muscles also become weak making it hard to walk. Children who have very low vitamin D develop a similar condition called rickets which can also affect growth. 

What is the current recommendation in adults?

Public Health England advises that everyone needs vitamin D equivalent to an average daily intake of 10micrograms. This advice is based on the recommendations of the Scientific Advisory Committee on Nutrition (SACN).

Vitamin D is made in the skin by the action of sunlight and this is the main source of vitamin D for most people. SACN could not say how much vitamin D is made in the skin through exposure to sunlight, so it is therefore recommending a daily supplementary intake of 10 micrograms.

PHE advises that in spring and summer, the majority of the population get enough vitamin D through sunlight on the skin and a healthy, balanced diet. During autumn and winter, everyone will need to rely on dietary sources of vitamin D. Since it is difficult for people to meet the 10 microgram recommendation from consuming foods naturally containing or fortified with vitamin D, people should consider taking a daily supplement containing 10 micrograms of vitamin D in autumn and winter. Those at an increased risk of deficiency should consider taking a vitamin all year round.

Who is more at risk of vitamin D deficiency?

  • People whose skin has little or no exposure to the sun, like those in institutions such as care homes, or who always cover their skin when outside.
  • Ethnic minority groups with dark skin, from African, Afro-Caribbean and South Asian backgrounds

What is the current recommendation in children?

Children aged 1 to 4 years should have a daily 10 microgram vitamin D supplement. PHE recommends that babies are exclusively breastfed until around 6 months of age. As a precaution, all babies under 1 year should have a daily 8.5 to 10 microgram vitamin D supplement to ensure they get enough. Children who have more than 500ml of infant formula a day do not need any additional vitamin D as formula already contains the required amount. 

Prescribing of Vitamin D in Sheffield

In Sheffield, we are asking GPs to speak to their patients about purchasing Vitamin D themselves so that NHS resources can be used more effectively. Vitamin D is readily available over the counter, at a far lower cost than on prescription. This is also in line with national guidance from NHS England that advises that vitamins and minerals should not routinely be prescribed by GP’s.

However, it is important to note this does not affect GP prescribing of high-dose Vitamin D preparations that are not available over the counter or for those with an exception including a medically diagnosed deficiency or a condition such as osteoporosis. Your local healthcare professional will be able to advise you further. 

Where can I get vitamin D supplements from?

If you have been identified by your healthcare professional as being at risk of low vitamin D you will be advised to take a daily vitamin D supplement. You should also follow advice around safe sun exposure and try to eat foods that contain vitamin D as part of your balanced diet.

Supplements can be bought from pharmacies, most supermarkets and health food shops.

If you are pregnant, breastfeeding or have a young child under five, you may be able to get these free. Ask your midwife or health visitor for more information about Healthy Start Vitamins. Alternatively you can buy them at low cost from a local Children’s Centre.

Vitamin D information resources

To print in a leaflet format go to the printer properties - print on both sides - flip on short edge.

 

 

 

NHS Sheffield Clinical Commissioning Group

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S9 4EU