Overview:

People across our country suffer from vitamin D deficiency. With deficiency playing a role in the incidence of conditions like rickets, osteoporosis, etc. it is essential that it be identified and treated. The blog explains this underplayed deficiency.

A deficiency in vitamin D is a concern for countries world over. Despite this, the deficiency is not given the importance it warrants. The body naturally synthesizes vitamin D on exposure to the sun’s ultraviolet B (UVB) rays, which is why this vitamin is also known as the sunshine vitamin. Yet, even in tropical countries like India, people suffer from vitamin D deficiency. Nowadays, although healthcare leaders and doctors are spreading awareness about the deficiency, many people still do not consider a vitamin deficiency to be a problem, and hence, even when blood test results show low levels of vitamin D, they end up ignoring it. However, low levels of this vitamin could cause a number of conditions, and unless addressed, it could end up overburdening the healthcare system.

Understanding Vitamin D Deficiency

Simply put, vitamin D deficiency means there is not enough vitamin D in the body. A deficiency of this vitamin is usually due to these reasons:

• Lack of sunlight exposure
• Lack of dietary vitamin D
• Presence of a health condition that affects the body’s ability to absorb this vitamin

What We Need to Know

Vitamin D plays an important role in bone health. It helps the body absorb calcium, magnesium and phosphate from the diet. Insufficient levels of this vitamin can lead to a drop in calcium. The body will then have to take the calcium it needs from the bones. Thus, it contributes to osteomalacia in adults and rickets in children. While vitamin D deficiency is also said to play a role in the body’s immune mechanism as well as insulin production, research on this is still ongoing. The amount of vitamin D a person needs is dependent on several factors like age, geographical location, current levels of vitamin D, etc. The recommended dietary allowance (RDA) given by the ICMR (Indian Council of Medical Research) is 400 IU/day for adults who do not get enough sun exposure. It is also necessary to guard against going overboard with vitamin D intake as too much of this vitamin can also cause health conditions.

Symptoms of Vitamin D Deficiency

The symptoms are more pronounced in children as they are still growing. They include:

• Soreness of muscles when there is a mild deficiency
• Deformed bones
• Joint malformation
• Bone pain

The symptoms in adults are less obvious. They may include:

• General weakness
• Bone and joint pain with the back being commonly affected
• Pain or cramps in muscles
• Mood swings

Causes of Vitamin D Deficiency

In addition to the 3 major factors mentioned earlier, a few more factors which contribute to vitamin D deficiency are also explained below:

• Lack of Dietary Vitamin D
  • People who follow a vegan diet are often at risk of vitamin D deficiency because most of the dietary vitamin D sources are animal-based - fish, fish liver oil, egg yolks, cheese, beef liver and foods which have been fortified with vitamin D like milk.
• Limited Sun Exposure
  • Our body needs 5-30 minutes of sunlight exposure to the face, arms and legs every day to synthesize vitamin D.
  • People living in places that do not get a lot of sunlight or those who just do not venture out much in the sun are at risk of vitamin D deficiency.
• Skin Colour
  • Melanin is the pigment that is responsible for skin coloration. It also absorbs ultraviolet rays and protects the skin.
  • People with dark skin tones have more of this pigment.
  • However, we know that UVB rays are necessary for vitamin D production in the body.
  • Since melanin protects the skin from the UV rays, dark-skinned people require more sunlight exposure to get enough UVB rays for vitamin D synthesis without which they might end up with a deficiency.
• Kidney and Liver Conditions
  • Vitamin D exists in two forms – active and inactive.
  • The active form is what can be used by the body.
  • The inactive form can be converted into the active form by the enzymes of the kidneys and liver.
  • But when kidney/liver conditions exist, enzymes’ production is affected.
  • This in turn affects the conversion of the inactive form of vitamin D into the active form.
  • Hence, people with kidney/liver conditions are at an increased risk of vitamin D deficiency.
• Other Health Conditions
  • Certain conditions like Crohn’s disease, cystic fibrosis, etc. affect the intestines’ ability to absorb vitamins from the diet.
  • This could result in a vitamin D deficiency.
  • Effect of Some Medications
  • Certain medications like dexamethasone, prednisone, carbamazepine, etc. make the liver break down vitamin D quicker and this could lead to a deficiency.
• Obesity
  • Vitamin D is a fat-soluble vitamin – this means that it dissolves in fat.
  • Hence, people who suffer from obesity usually have a vitamin D deficiency.
  • Typically, people with a BMI of 30 or more have reduced vitamin D levels.
• Weight-Loss Surgery
  • If the weight-loss surgery performed decreases stomach size or bypasses the small intestines, it can affect the body’s ability to absorb nutrients, vitamins, etc. from the digestive system.
  • This again affects vitamin D levels.

Diagnosis

• A blood test called 25-hydroxyvitamin D or 25(OH)D is commonly used to measure vitamin D levels in the blood.
• Doctors usually prescribe the test when the patient has risk factors or presents with symptoms of vitamin D deficiency.

Treating Vitamin D Deficiency

• There are two forms of vitamin D – ergocalciferol (D2) and cholecalciferol (D3). Out of these two, D3 is better absorbed by the body.
• Supplementation of vitamin D is the treatment for deficiencies.
• However, only a doctor can guide on how much supplementation is required.
• This is because supplementation is dependent on how deficient a person is and his/her risk factors.
• The doctor may start with a high dose and then lower it as the vitamin D levels increase.
• Recovery from the deficiency depends on the severity of the deficiency. In general, it takes around 6-8 weeks to achieve normal range.

Prevention

• It is best to get vitamin D in the natural form – from safe sun exposure and from the diet.
• Vegans can consider plant-based milk that has been fortified with vitamin D.
• Over exposure to the sun can be harmful and result in skin conditions, so short exposure periods when the sun is shining brightly will suffice.
• Supplements can be considered for winter months but only after consultation with a doctor.

Frequently Asked Questions

What causes vitamin D deficiency?

Vitamin D deficiency is mainly caused by lack of sunlight, poor diet, certain health conditions, or medications that affect absorption.

What are the symptoms of vitamin D deficiency?

Symptoms include fatigue, muscle cramps, bone pain, weakness, and mood changes. In children, it may cause bone deformities.

How is vitamin D deficiency diagnosed?

A simple blood test called 25(OH)D is used to measure vitamin D levels in the body.

Can vitamin D deficiency be treated?

Yes, it’s usually treated with vitamin D supplements and lifestyle changes as advised by a doctor.

How much sun exposure is needed for vitamin D?

About 5–30 minutes of sunlight on the face, arms, and legs a few times a week can help maintain adequate levels.

Can too much vitamin D be harmful?

Yes, excessive intake can lead to health issues. Always follow your doctor’s advice on supplements.

Become a Member to post Articles Back to Profile