Our latest tests yield some good news for the many people who take a daily vitamin D pill, or one that combines calcium and vitamin D: All of the 32 products met or exceeded their claimed levels of the vitamin, disintegrated or dissolved properly where applicable, and were well below the safe upper limit set by the Institute of Medicine. But we found levels of lead in nine of 12 supplements that combine vitamin D with calcium that would have triggered warnings for reproductive risk under California Proposition 65. However, a number of companies had reached a settlement with the California Attorney General's office that allows them latitude in how they count lead levels and in these cases the products do not have to have warnings. Still, Consumer Reports continues to believe that it is better to choose products with lower lead levels. (This information has changed from the originally published version. See below for a clarification.) Click here for a chart that shows average lead levels in supplements we tested.
We also found that costs can vary widely, as shown in the Ratings chart. So choose by price and preference of pill type, and consider whether you want a product that also contains calcium. Finally, it's not clear that everyone who takes vitamin D needs the pills. People who get enough midday sun in warmer months probably don’t need extra amounts, since the body makes from exposure to sunlight. But you might need vitamin D if you have osteoporosis or a condition such as celiac disease that impairs the body’s ability to absorb fat-soluble vitamins, including D. For details, see our article "Do You Really Need More Vitamin D?" For our tests, at least three samples of each product were analyzed for their level of vitamin D3 (the form of the vitamin most were claimed to contain) and, in the case of the combined products, their level of calcium. The supplements with calcium were also tested for the presence of arsenic, cadmium, lead, and mercury. Average vitamin D3 levels ranged from 105 percent to 141 percent of the labeled amount in the adult and children’s vitamin D-only products (1,000 international units, or IU, and 400 IU, respectively).
But even the higher levels were well below the Institute of Medicine’s maximum safe daily level of 4,000 IU. Most adults up to age 70 need no more than about 600 IU of vitamin D a day; older people, 800 IU. Avoid exceeding 4,000 IU daily unless your doctor has prescribed a higher dose to treat a deficiency. Too much vitamin D can cause kidney damage. Other symptoms of toxic amounts of D include confusion, nausea, and weakness. Few foods naturally contain vitamin D. Fatty fish and cod-liver oil have the highest levels. Smaller amounts are available in beef liver, cheese, and egg yolks. Most of the vitamin D consumed in the U.S. diet comes from fortified foods, such as milk. Calcium-Vitamin D Supplements: Average Total Lead Levels in Samples Tested* (Listed in order of lowest to highest per maximum daily dose) Label recommended maximum dose (pills/day) Total analyzed micrograms of lead per labeled maximum daily dose Nature's Bounty Calcium 1200mg Caltrate 600 + D
Citracal Petites Calcium Citrate + D3 Oscal Calcium Supplement Extra D3 CVS Calcium 600 + D Walgreens Calcium 600 + D Equate Calcium Citrate + D (Walmart) Kirkland Signature Calcium 600mg + D3 (Costco) *At least one sample from each of three batches (lots).A balanced diet, rich in a wide range of fruit and vegetables will, according to the experts, provide us with all the vitamins and minerals we need to ensure the body’s functioning. Popping supplements, they argue, is a waste of time and money. Except, we learn now, when it comes to vitamin D. Draft government guidelines regarding the ‘‘sunshine’’ vitamin - so-called because it is manufactured in the skin during exposure to UV light - are set to turn the ‘‘good diet is all you need" consensus on its head with a recommendation that we are not getting enough vitamin D, and taking a vitamin D supplement to redress the situation may be the solution. A combination of a northern latitude and bleak weather means that millions of us are deficient as dietary sources alone are not enough to keep levels in a healthy range.
Oliver Gillie, a scientist has championed the case for universal supplementation for years and says the advice comes not a moment too soon. The Government currently recommends that only pregnant women, children up to the age of five, those over 65 and people with darker skin should take regular vitamin D supplements “Everybody knows that we live a far more indoor lifestyle than even our parents did. People sit inside watching television or on computers for hours every day. “What’s more, a lot of people actively avoid the sun because dermatologists have been telling them it causes skin cancer. Obviously, you have to be careful to avoid burning but many people fail to realise that sunlight is our primary source of vitamin D and therefore crucial to health.” According to the report by Scientific Advisory Body on Nutrition (SACN) which drafted the guidelines, our bodies are suffering when it comes to vitamin D, which is needed for healthy bones and strong teeth but also plays a role in numerous biochemical processes in the body.
There is growing evidence that the vitamin - or lack of it - is linked to a number of diseases from musculoskeletal problems to heart disease, cancer, diabetes and multiple sclerosis. Professor Hilary Powers, chair of the SACN working group on Vitamin D says: “Across Europe, populations generally take on less vitamin D than country-estimates of requirements. However, there is very little in place in terms of public health strategies to address this problem.” Upping the recommended amount of vitamin D people should be consuming a day would be a ‘‘precautionary measure,’’ she added. However, it would represent a major change in policy in a nation where public health advice generallycounsels against mass supplemention (currently, folic acid supplementation before and during pregnancy is recommended, flouride is added to water in some areas to protect against tooth decay and since 1998, wheat flour has been fortified with vitamin B1 and other nutrients). The Government currently recommends that only pregnant women, children up to the age of five, those over 65 and people with darker skin as well as those who do not, for whatever reason, expose their skin to sunlight on regular basis, should take regular vitamin D supplements.
However, data gathered by Public Health England says one in five people have low levels of vitamin D, and around one in six children – that’s an estimated 10 million people across England. “Lack of vitamin D…reduces bone mineralisation.’’ according to medical nutritionist Dr Sarah Brewer. ‘‘This can lead to the deficiency diseases of rickets in children, and osteomalacia in adults. Other conditions that have been linked with a lack of vitamin D include constipation, muscle weakness, increased susceptibility to infections, poor growth, irritability and bone pain.” We obtain vitamin D primarily through the skin’s exposure to UVB rays in sunlight– but also, to a much smaller extent, through food. Dr Brewer explains: “[We can only make vitamin D] when the UV index is greater than 3 which, in the UK, is achieved on some days during spring and summer. Today [SUBS: Tuesday], for example, the UV index is only above 3 for around an hour at 2pm.” Northern latitude countries such Finland have a national policy of vitamin D supplementation and food fortification That’s a pretty small window.
Other northern latitude countries such Finland have a national policy of vitamin D supplementation and food fortification. In Denmark, Nordic Nutrition recommendations for vitamin D were recently upped from 7.5mcg (300 International Units) to 10mcg (400 IU) per day. In the UK, the recommended daily amount (RDA) is just 5mcg (200 IU) per day, although up to 25mcg (1000 units) is advised during the winter months. Oliver Gillie believes we could go further: “I’d like the government to tell us to take 2,000 IU of vitamin D a day. The vast majority of the population who live indoors needs to take a supplement - especially those who live in Scotland which is further north and gets far more cloud coverage.” Best dietary sources of vitamin D: Oily fish such as salmon, sardines and mackerel How to boost your levels: Dr Sarah Brewer says: “Usual advice is to obtain 10 to 15 minutes sun exposure to face, arms, hands or back, two or three times a week, without sunscreen. Longer exposures do not provide additional benefit, as vitamin D is rapidly degraded by excess UV radiation SPF 8 sunscreen reduces vitamin D production in the skin by 95%, while SPF15 reduces vitamin D production by 99%.”