Vitamin D is essential for bone health, immune function and overall wellbeing. And it becomes even more crucial as we age.

New guidelines from the international Endocrine Society recommend people aged 75 and over should consider taking vitamin D supplements.

But why is vitamin D so important for older adults? And how much should they take?

Young people get most vitamin D from the sun

In Australia, it is possible for most people under 75 to get enough vitamin D from the sun throughout the year. For those who live in the top half of Australia – and for all of us during summer – we only need to have skin exposed to the sun for a few minutes on most days.

The body can only produce a certain amount of vitamin D at a time. So staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.

But it’s difficult for people aged over 75 to get enough vitamin D from a few minutes of sunshine, so the Endocrine Society recommends people get 800 IU (international units) of vitamin D a day from food or supplements.

Why you need more as you age

This is higher than the recommendation for younger adults, reflecting the increased needs and reduced ability of older bodies to produce and absorb vitamin D.

Overall, older adults also tend to have less exposure to sunlight, which is the primary source of natural vitamin D production. Older adults may spend more time indoors and wear more clothing when outdoors.

As we age, our skin also becomes less efficient at synthesising vitamin D from sunlight.

The kidneys and the liver, which help convert vitamin D into its active form, also lose some of their efficiency with age. This makes it harder for the body to maintain adequate levels of the vitamin.

All of this combined means older adults need more vitamin D.

Deficiency is common in older adults

Despite their higher needs for vitamin D, people over 75 may not get enough of it.

Studies have shown one in five older adults in Australia have vitamin D deficiency.

In higher-latitude parts of the world, such as the United Kingdom, almost half don’t reach sufficient levels.

This increased risk of deficiency is partly due to lifestyle factors, such as spending less time outdoors and insufficient dietary intakes of vitamin D.

It’s difficult to get enough vitamin D from food alone. Oily fish, eggs and some mushrooms are good sources of vitamin D, but few other foods contain much of the vitamin. While foods can be fortified with the vitamin D (margarine, some milk and cereals), these may not be readily available or be consumed in sufficient amounts to make a difference.

In some countries such as the United States, most of the dietary vitamin D comes from fortified products. However, in Australia, dietary intakes of vitamin D are typically very low because only a few foods are fortified with it.

Why vitamin D is so important as we age

Vitamin D helps the body absorb calcium, which is essential for maintaining bone density and strength. As we age, our bones become more fragile, increasing the risk of fractures and conditions like osteoporosis.

Keeping bones healthy is crucial. Studies have shown older people hospitalised with hip fractures are 3.5 times more likely to die in the next 12 months compared to people who aren’t injured.

Vitamin D may also help lower the risk of respiratory infections, which can be more serious in this age group.

There is also emerging evidence for other potential benefits, including better brain health. However, this requires more research.

According to the society’s systematic review, which summarises evidence from randomised controlled trials of vitamin D supplementation in humans, there is moderate evidence to suggest vitamin D supplementation can lower the risk of premature death.

The society estimates supplements can prevent six deaths per 1,000 people. When considering the uncertainty in the available evidence, the actual number could range from as many as 11 fewer deaths to no benefit at all.

Should we get our vitamin D levels tested?

The Endocrine Society’s guidelines suggest routine blood tests to measure vitamin D levels are not necessary for most healthy people over 75.

There is no clear evidence that regular testing provides significant benefits, unless the person has a specific medical condition that affects vitamin D metabolism, such as kidney disease or certain bone disorders.

Routine testing can also be expensive and inconvenient.

In most cases, the recommended approach to over-75s is to consider a daily supplement, without the need for testing.

You can also try to boost your vitamin D by adding fortified foods to your diet, which might lower the dose you need from supplementation.

Even if you’re getting a few minutes of sunlight a day, a daily vitamin D is still recommended.

Elina Hypponen, Professor of Nutritional and Genetic Epidemiology, University of South Australia and Joshua Sutherland, PhD Candidate – Nutrition and Genetic Epidemiology, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

People presenting at emergency with mental health concerns are experiencing the longest wait times in Australia for admission to a ward, according to a new report from the Australasian College of Emergency Medicine.

But with half of New South Wales’ public psychiatrists set to resign next week after ongoing pay disputes – and amid national shortages in the mental health workforce – Australians who rely on psychiatry support may be wondering where else to go.

If you can’t get in to see a psychiatrist and you need help, there are some other options. However in an emergency, you should call 000.

Why do people see a psychiatrist?

Psychiatrists are doctors who specialise in mental health and can prescribe medication.

People seek or require psychiatry support for many reasons. These may include:

• severe depression, including suicidal thoughts or behaviours
• severe anxiety, panic attacks or phobias
• post-traumatic stress disorder (PTSD)
• eating disorders, such as anorexia or bulimia
• attention deficit hyperactivity disorder (ADHD).

Psychiatrists complement other mental health clinicians by prescribing certain medications and making decisions about hospital admission. But when psychiatry support is not available a range of team members can contribute to a person’s mental health care.

Can my GP help?

Depending on your mental health concerns, your GP may be able to offer alternatives while you await formal psychiatry care.

GPs provide support for a range of mental health concerns, regardless of formal diagnosis. They can help address the causes and impact of issues including mental distress, changes in sleep, thinking, mood or behaviour.

The GP Psychiatry Support Line also provides doctors advice on care, prescription medication and how support can work.

It’s a good idea to book a long consult and consider taking a trusted person. Be explicit about how you’ve been feeling and what previous supports or medication you’ve accessed.

What about psychologists, counsellors or community services?

Your GP should also be aware of supports available locally and online.

For example, Head to Health is a government initiative, including information, a nationwide phone line, and in-person clinics in Victoria. It aims to improve mental health advice, assessment and access to treatment.

Medicare Mental Health Centres provide in-person care and are expanding across Australia.

There are also virtual care services in some areas. This includes advice on individualised assessment including whether to go to hospital.

Some community groups are led by peers rather than clinicians, such as Alternatives to Suicide.

How about if I’m rural or regional?

Accessing support in rural or regional areas is particularly tough.

Beyond helplines and formal supports, other options include local Suicide Prevention Networks and community initiatives such as ifarmwell and Men’s sheds.

Should I go to emergency?

As the new report shows, people who present at hospital emergency departments for mental health should expect long wait times before being admitted to a ward.

But going to a hospital emergency department will be essential for some who are experiencing a physical or mental health crisis.

Managing suicide-related distress

With the mass resignation of NSW psychiatrists looming, and amid shortages and blown-out emergency waiting times, people in suicide-related distress must receive the best available care and support.

Roughly nine Australians die by suicide each day. One in six have had thoughts of suicide at some point in their lives.

Suicidal thoughts can pass. There are evidence-based strategies people can immediately turn to when distressed and in need of ongoing care.

Safety planning is a popular suicide prevention strategy to help you stay safe.

What is a safety plan?

This is a personalised, step-by-step plan to remain safe during the onset or worsening of suicidal urges.

You can develop a safety plan collaboratively with a clinician and/or peer worker, or with loved ones. You can also make one on your own – many people like to use the Beyond Now app.

Safety plans usually include:

1. recognising personal warning signs of a crisis (for example, feeling like a burden)
2. identifying and using internal coping strategies (such as distracting yourself by listening to favourite music)
3. seeking social supports for distraction (for example, visiting your local library)
4. letting trusted family or friends know how you’re feeling – ideally, they should know they’re in your safety plan
5. knowing contact details of specific mental health services (your GP, mental health supports, local hospital)
6. making the environment safer by removing or limiting access to lethal means
7. identifying specific and personalised reasons for living.

Our research shows safety planning is linked to reduced suicidal thoughts and behaviour, as well as feelings of depression and hopelessness, among adults.

Evidence from people with lived experience shows safety planning helps people to understand their warning signs and practice coping strategies.

Are there helplines I can call?

There are people ready to listen, by phone or online chat, Australia-wide. You can try any of the following (most are available 24 hours a day, seven days a week):

Suicide helplines:

• Lifeline 13 11 14
• Suicide Call Back Service 1300 659 467

There is also specialised support:

• for men: MensLine Australia 1300 78 99 78
• children and young people: Kids’ Helpline 1800 55 1800
• Aboriginal and Torres Strait Islander people: 13YARN 13 92 76
• veterans and their families: Open Arms 1800 011 046
• LGBTQIA+ community: QLife 1300 184 527
• new and expecting parents: PANDA 1300 726 306
• people experiencing eating disorders: Butterfly Foundation 1800 33 4673.

Additionally, each state and territory will have its own list of mental health resources.

With uncertain access to services, it’s helpful to remember that there are people who care. You don’t have to go it alone.

Monika Ferguson, Senior Lecturer in Mental Health, University of South Australia and Nicholas Procter, Professor and Chair: Mental Health Nursing, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.