How Much Vitamin D Do You Need During Menopause | Stella
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How much vitamin D do you need during menopause?

byDr. Lucy Wilkinson

Ever wondered how much vitamin D you need or if a supplement could help your menopause symptoms? According to the National Diet and Nutrition Survey, 16% of UK adults have low levels of vitamin D. Read on to find out the benefits of vitamin D, why it is important during menopause and how to top up on this essential nutrient.

What is vitamin D?

Most of the vitamin D your body needs is made when your skin is exposed to sunlight. In countries like the UK where we don’t see much sunshine in autumn and winter, it can be difficult for your body to make enough. The same goes if you don’t get much sunshine for other reasons, such as if you’re housebound or cover up for religious or cultural reasons.

Some foods do contain vitamin D, but only in small amounts. This is why many people turn to supplements.

How much vitamin D per day is recommended?

The recommended daily amount of vitamin D is 10 micrograms – written as mcg or μg – or 400IU per day for adults aged between 18-70. 

If you want to know how much vitamin D is stored in your body, you’ll need to take a blood test. These are available from private health providers like Thriva, or from your doctor in certain cases, for example if you have low vitamin D symptoms.

Vitamin D is measured in nanomoles/litre:

  • Normal levels: 50-125nmol/L 
  • Potential deficiency: 25-50nmol/L
  • Deficiency: Under 25nmol/L

Do you need a supplement?

Many people can make enough vitamin D through sun exposure during the summer months, but all adults are currently advised to consider taking a supplement throughout autumn and winter. This should be 10 micrograms or 400IU per day.

Certain groups should definitely take the supplement, rather than just considering it. This could apply to you if you:

  • Are 65 or over
  • Have low sun exposure 
  • Have darker pigmentation in your skin. For example you have an African, African-Carribbean or South Asian background
  • Have problems with absorbing nutrients from your gut. For example you are coeliac or have Crohn’s disease
  • Have severe liver or kidney disease
  • Are pregnant or breastfeeding
  • Are obese (BMI of over 30)

Vitamin D supplements may also be recommended if you have thinning of the bones, also known as osteoporosis or osteopenia.

That said, those with normal levels of vitamin D who are otherwise healthy may not get much benefit from a vitamin D supplement. There isn’t yet any evidence that taking a supplement will help prevent fractures, cancer, cardiovascular disease, falls or type 2 diabetes for this group of people. 

Vitamin D supplements aren’t suitable for everyone, and should only be used with expert supervision in certain cases. Examples include people with some types of kidney stones, problems with the parathyroid gland, or severe liver or kidney disease.

Symptoms of vitamin D deficiency

Low levels of vitamin D can lead to symptoms including:

  • General aches and pains
  • Muscle weakness
  • Feeling generally unwell
  • Tiredness and fatigue

See your doctor and get tested if you have any of these symptoms and think you might be vitamin D deficient.

If supplements are safe for you and a blood test shows that you are vitamin D deficient, you may be advised to take a supplement.

What is the best vitamin D supplement to take?

Vitamin D is often found in two main forms: vitamin D3 and vitamin D2. Vitamin D3 is more effective at raising levels of vitamin D in the bloodstream. It is made from animal products and it is also the form your body makes from sunshine.

Vitamin D2 is made from plant products, so you may choose this type if you are vegan or vegetarian. 

Current guidelines recommend using D3 as a first choice if you are vitamin D deficient. D2 can also be prescribed by your doctor if needed for cultural, dietary or religious reasons.

You can buy supplements without a prescription or you may be eligible for free vitamins via the Healthy Start programme.

What dose vitamin D supplement is best?

Your dose depends on why you are taking it and your doctor can advise you.

Bear in mind that vitamin D supplements aren’t suitable for everyone. Speak to your doctor before taking them if you have liver problems, kidney problems, abnormal calcium levels, cancer or any other chronic medical issues.

If you are vitamin D deficient

Your doctor will prescribe a higher dose if you are vitamin D deficient. This is to refill your body’s stores of the vitamin. There are several different ways to do this. They may prescribe:

  • 1250 micrograms (50,000 IU) once a week for six weeks
  • 1000 micrograms (40,000 IU) once a week for seven weeks
  • 100 micrograms (4,000 IU) every day for 10 weeks

Talk to a doctor if you are vitamin D deficient – don’t try to treat it yourself. They can advise what products to take and at what dose. Depending on your general health and other results, they may also want to run some further tests.

If you want to prevent deficiency

Lower doses are used if you simply want to fend off vitamin D deficiency.

A 10 microgram or 400 IU supplement is currently recommended for adults, whether you take D2 or D3. This level is generally considered enough to keep vitamin D stores topped up.

Speak to your doctor if you have any symptoms that you think might be related to low vitamin D, even if you’re already taking a supplement at this dose. They may want to run some tests or give you a higher, prescribed dose of the vitamin.

Five reasons vitamin D is important during menopause

1 It can improve bone health

Oestrogen helps to maintain good bone health, including bone density. When oestrogen levels decline during menopause, your bone health can be affected. This is why you are more likely to develop thinning of the bones – osteoporosis – after menopause.
Getting both enough calcium and vitamin D supports bone health, as these nutrients play a key role in bone growth. Vitamin D helps your body to absorb calcium, which provides the strength and much of the mineral content in your bones.

2 It might support vaginal health

Interestingly, vitamin D has been linked to improvements in symptoms of genitourinary syndrome of menopause (GSM). This is a common yet sometimes distressing collection of menopause symptoms which includes vaginal dryness, itch, burning, tightness and painful sex

One small study found improvements in this condition when participants were given vitamin D supplements. However, questions remain. We still need more evidence of this effect before doctors start recommending vitamin D as a treatment.

See you doctor if you are struggling with vaginal or urinary symptoms. Highly effective treatments are available for GSM, such as low-risk vaginal oestrogen

Make an urgent doctor’s appointment urgently if you have any unusual bleeding, severe pain, recurrent UTIs or open sores on your vulva or vagina.

3 It might help with low mood

It’s common to struggle with anxiety, mood swings and feeling low during menopause. You should talk to your doctor if you’re struggling with any of these issues, as a range of treatment options are available.

You may also find vitamin D useful as part of your mental health treatment plan. We are still learning how vitamin D and mood are linked but vitamin D seems to play a role in maintaining good mental health. We don’t know how much is needed or how effective it is, but making sure that your levels are within a normal range is sensible.

While vitamin D supplements may form part of a healthy lifestyle, there is not yet enough evidence to recommend them as a stand-alone treatment for mental health conditions.

While vitamin D supplements may form part of a healthy lifestyle, there is not yet enough evidence to recommend them as a stand-alone treatment for mental health conditions.”

4 You might be confusing low vitamin D symptoms with menopause

Symptoms of low vitamin D can be similar to menopause symptoms. Feeling tired, achy, weak and generally unwell can all be signs of either condition. It may be worthwhile making sure your vitamin D levels are in the normal range before trying hormone replacement therapy (HRT).

5 You could reduce your breast cancer risk

Breast cancer affects people of all ages, but it becomes more common after menopause, so it’s important that you check your breasts regularly and have a breast screening when you are invited.There may be a link between healthy vitamin D levels and a lower risk of breast cancer. A 2013 meta-analysis found this was true for postmenopausal women, but not those who were premenopausal.

How to get more vitamin D naturally

There are two ways you can top up your vitamin D levels naturally.

1 Spend time outdoors

Your body produces the majority of its required vitamin D in response to sun exposure. It’s therefore important to get enough sunshine, but this needs to be carefully balanced with the need for sun safety to prevent sunburn and skin cancers.

Cancer Research UK currently recommends daily sun exposure of:

  • Nine minutes for pale skin
  • Up to 25 minutes for darker skin

2 Eat vitamin D-rich foods

While not as effective as sun exposure, diet is still important for maintaining healthy vitamin D levels.

What foods are highest in vitamin D?

Foods rich in vitamin D include: 

  • Oily fish like salmon, mackerel and sardines
  • Eggs
  • Red meats
  • Liver
  • Fortified foods such as breakfast cereals, plant milks and spreads

These foods are relatively good sources of Vitamin D, but it’s hard to get enough vitamin D from what you eat alone. You’ll also need to see some sunlight and/or a supplement.

Can you take vitamin D on HRT?

Yes, it’s safe to take HRT and vitamin D at the same time. As always, you should stick to recommended doses.

Just like everyone else, people on HRT should think about taking a vitamin D supplement over the winter months.

Final word

Vitamin D is an essential nutrient and is as important as ever during perimenopause and postmenopause. Recent evidence shows it might even contribute to a healthier menopause, as it can have a positive impact on mood, vaginal health and bone density, among other things.

But remember, more isn’t always better! Your GP will advise you on the best treatment for your symptoms, as well as the best dose of vitamin D for you.

For more information about other menopause topics, read more on our blog or symptoms library.