Vitamin D and Parkinson’s disease
What is vitamin D?
Vitamin D is a fat soluble vitamin that serves as a hormone important for regulating calcium and immune function. Vitamin D is important for healthy bones and may reduce hypertension, psoriasis, and play a role in prevention for some cancers.
Vitamin D is sometimes called the ‘sunshine vitamin’ due to the fact that it is produced for our bodies when our skin is exposed to the sun. There are two important forms of vitamin D: D2 (ergocalciferol) and D3 (cholecalciferol).
Vitamin D levels and PD.
Research suggests the people with Parkinson’s have lower levels of vitamin D compared to those without Parkinson’s. One study showed that 55% of people with Parkinson’s are deficient compared with 36% with Alzheimer’s disease and 21% without these conditions (Evatt 2008). Exposure to sunshine is a major source of vitamin D. What this means for people with parkinson's is unclear. Additional studies suggest that vitamin D (see article)
helps more than just bones and may help cognition.
People exposed to less sunshine such as those that live in northern climates, people that spend most of their time indoors, wear sunscreen, and older persons are also at risk for vitamin D deficiency. It is interesting to note that the Parkinson's study was completed in Atlanta
, a region of the country that gets a significant amount of sunshine compared with the Northwest. If you live in the Northwest or northern climate, you may have low levels of vitamin D especially in Winter months. Persons with malabsorption syndromes such as cystic fibrosis, celiac disease, and intestinal surgeries or vegetarians or others that do not drink milk fortified with D are also at risk for deficiency.
Vitamin D and bone health?
Vitamin D aids calcium absorption and is important for healthy bones. Bone strength depends on calcium, therefore deficiency in Vitamin D and/or calcium can lead to osteoporosis or low bone density. It is important to treat or prevent osteoporosis if you have Parkinson’s since it can lead to brittle bones increasing the risk of bone fractures due to falls. Other risks factors for developing osteoporosis include inactivity, smoking, alcohol postmenopausal women and older age. Ask your doctor about a bone density scan to measure your bone density. More information on bone health and calcium is found in the General Health and Nutrition sections.
Talk to your doctor before taking a vitamin D supplement
Use vitamin D with caution and only under the supervision of your healthcare provider especially if you have liver disease, kidney disease, hypoparathyroidism, malabsorption syndrome, sarcoidosis, and possibly other granulomatous diseases, as you may have increased sensitivity to the effects of vitamin D. A simple blood test can measure levels of vitamin 25(OH)D the best measure of body stores to determine if you are deficient in vitamin D. This information is very helpful as the amount of vitamin D you may need depends on this level and will vary significantly from one person to the next.
Sources of Vitamin D
Vitamin D is present in only a few foods, added to foods such as milk and cereal or taken as a supplement with or without calcium. Our bodies can make vitamin D when exposed to ultraviolet light from sunshine. Ten minutes of sunshine a day can help increase your levels of vitamin D. Because PD increases your risk of developing the skin cancer called melanoma, it is very important to check with your doctor before exposing your skin to sun.
Supplements: The National Institute of Health (NIH) recommends 200 IU daily for adults under the age of 50 years, 400 IU 50-70 years and 600 IU over the age of 70 years. Look for supplements that provide vitamin D3 (cholecalciferol) as this form is more readily used by the body and can increase vitamin D levels better than D2 (ergocalciferol). Too much vitamin D from mega-doses can be toxic causing nausea, constipation, loss of appetite and high calcium levels. High calcium levels can cause sedation, confusion, and heart rhythm irregularities.
The FDA highly regulates prescription drugs but this is not the case for vitamins and supplements. Therefore there is no guarantee that a product you purchase is without impurities and unwanted chemicals, or that the product has the concentration or dose strength stated on the label. When purchasing vitamins or supplements it is helpful to look for products that are tested by the Unites States Pharmacopeia (USP) or consumerLab (CL). These programs list supplements that have meet standards of purity, quality and tablet consistency. Look for these abbreviations “USP” or “CL”.
Foods rich in vitamin D:
Cold water fish: Salmon, tuna, sardines
Cod liver oil
Vitamin D fortified milk and cereal
If you're concerned that you are concerned about your vitamin D level
1. Ask your doctor to measure your level with a simple blood test.
2. Increase foods high in vitamin D
3. Talk to your doctor about sun exposure and how much is best for you and your PD and skin cancer prevention.
4. Ask your doctor if a bone density scan is important for you.
Author: Monique Giroux, MD. Medical Director NWPF and Booth Gardner Parkinson's Care Center