Vitamin D Deficiency in Medical Students – Are you at risk? What you can do about it?
Most student’s lifestyle drastically changes upon beginning medical school curriculum. From late night library sessions to hours in the anatomy lab, sunlight isn’t exactly a high
priority when we become knee deep in lecture slides and upcoming exams. Vitamin D deficiency is rampant in America, as soon to be docs we are just as (if not more) likely to fall into this category.
A BMC Public Health Study published in June of last year, evaluated occupational risk of vitamin D deficiency. It uniquely differentiated rates of vitamin D deficiency by subsets of the healthcare field. “Rates of vitamin D deficiency among healthcare professionals were: healthcare students 72%, medical residents 65%, practicing physicians 46%, other healthcare employees 44%, and nurses 43%”(1).
As a review, low vitamin D levels are associated with increased risk of cardiovascular disease mortality (2), autoimmune diseases, osteoporosis, and multiple types of cancers (3). The level cutoff for deficiency is widely accepted as <20ng/mL or <50nmol/L. These concerning statistics were not presented to place additional stress onto your insane schedule, but to help you find easy and accessible ways for prevention.
Your Vitamin D synthesizing ability is reduced when you wear sunscreen. This is a double-edged sword because the risk of getting burned by the sun after semesters of library living is high. Just be aware that sunscreen can prevent your ability to make Vit D if you are wearing it daily during your brief sun exposure (long walk across the parking lot to get to the anatomy lab or running to the coffee shop across campus). In addition, many sunscreens on the market paradoxically contain carcinogenic ingredients, if you plan to use it check out the EWG sunscreen search engine to see if yours is up to par: https://www.ewg.org/sunscreen/#.WntyhKinFZg
Windows block UVB rays, this is a serious bummer for all those who are lucky enough to have lecture halls with windows. UVB is the ray type that increases risk of squamous and basal cell carcinoma, as well as increasing your risk for wrinkles. However, UVBs are what you need to make vitamin D from your skin. So even though the sun feels good on your arms as you drive home with the windows up after class (assuming the sun is still up), it isn’t your best option for getting in your daily sun. In fact, UVA rays can travel through glass, these rays penetrate your skins deeper layers and are linked to increased risk of melanoma. So overdoing sunlight through windows is not only not beneficial, but has the propensity to be detrimental too.
Your multivitamin most likely won’t have enough to treat deficiency or in some cases prevent it from occurring. Most multivitamins have around 400 IU’s of vitamin D. Vitamin D deficiency supplementing recommendations can range from 50,000 IU’s weekly to daily depending on the severity of deficiency(4). Some foods are great sources of vitamin D but don’t cumulatively have enough Vitamin D to prevent or treat deficiency adequately. For example, salmon is one of the foods with the highest quantity of vitamin D, to get 10,000IU’s, a commonly used dose for deficiency, you would have to eat nine six-ounce salmon fillets a day(5).
A 25-hydroxy-cholecalciferol blood test, is fast and simple, it’s covered under most health insurance plans and can help you determine what dose of vitamin D is most appropriate to supplement for you. Many walk-in and online labs are even offering it as a direct consumer product and do not require physician lab orders.
Vitamin D is cheap on Amazon, some brands are more efficacious than others, but it’s an easy and powerful fix to help preserve your health as you push through med school and residency. Some supplement companies even give discounts to medical students on their websites. It’s also available with a prescription, which may be a cheaper option depending on your insurance.
Hope this article helps you have a better understanding of the risk of Vitamin D deficiency and even puts a little sunshine in your day.