Last few years have seen an increased awareness regarding healthy lifestyles focusing on the well being of an individual. We are surrounded by the enormous amount of information on various transforming diets, superfoods, supplements, skin and hair care products and what not. We are actually flooded with so much suggestions and opinions that we end up being confused and juggling with ‘WHAT TO DO’. But in spite of all this self-education boom, a major nutrient deficiency is still lurking around the corner and shockingly the cases are on a rise, i.e, VDD or Vitamin D deficiency aka hypovitaminosis D.
This recently caught my attention when recently I was diagnosed with Vitamin D deficiency. It was difficult for me to accept the lab reports as I regularly consume dairy products and have a fair share of sunlight as I reside on the scorching lands of Rajasthan. Being a medical student I was intrigued to know the Hows and Whys and I found it worth sharing with you all. So let’s take a look what this fuss is all about.
What is Vitamin D?
Vitamin D is a fat-soluble vitamin also known as sunlight Vitamin as it is synthesized from cholesterol by skin cells in the presence of UV-B radiation of sunlight spectrum. Then it undergoes some structural and chemical transformations in the liver then followed by the kidney to give the activated form of vitamin D or Cholecalciferol.
A normal range of vitamin D is somewhere around 20 ng/ml – 80 ng/ml. A report of Institute of Medicine published in 2011 set the sufficiency level at 20 ng/ml. Serum levels <20ng/ml fall under deficiency and those <10ng/ml are severely deficient.
And now comes my favourite part of medicine i.e, The Sherlock – where we try to connect the sign and symptoms with the theoretical information to end up on the most probable diagnosis and obviously the best possible treatment. But before that let’s have a look at the probable causes of Vit. D deficiency ( best time to summon our common senses!)
Causes of Vitamin D deficiency
- Inadequate exposure to sunlight
It’s easy to understand that exposure to sunlight is necessary for the production of precursors of Vitamin D in a body. (I always felt jealous of plants for they can perform a process as complex as photosynthesis just by basking on photons, like wow! XD now no more jealousy only good vibes. ;p )
Talking precisely, the time period of exposure and intensity of sunlight makes the difference. So naturally, required sunlight exposure and intensity are different for people living in tropics, temperate and colder regions.
- Medications, Liver and Kidney diseases
Diseases/ conditions or medicines that interfere with a transformation of vitamin D precursors in liver and kidney are also responsible for its deficiency. But this is well taken care of by well qualified medical practitioners if you happen to consult them.
- Darker skin
(I can already imagine a winning smile on Yami Gautam’s face) So, folks, this is nothing about racism, darker skin tones are due to the presence of more amount of melanin in skin cells that are meant to protect us from some harmful UV radiations. This melanin pigment in skin absorbs most of the UV radiations and thus less amount is available for synthesis of vitamin D.
- Old age
The efficiency of skin cells to synthesize vitamin D decreases over time with the normal process of ageing.
Since obese individuals have a large amount of fatty tissue, vitamin D being a fat soluble vitamin is deposited more and more in such tissues, as a result, less amount is available in a free form to do its job.
In females, menopause is a phase of major hormonal changes and is associated with various health risks if not managed carefully. Osteoporosis is one of them, where bone density decreases, bones become brittle and more prone to injuries and fractures.
Use of sunscreens every time we step outside, sedentary daily routine, preference of indoor activities, vegan diets are another set of precipitating factors.
What does the Vitamin D do in our body?
As you may recall from your middle school science textbooks, Vitamin D is essential for bone mineralization as its presence in adequate amount is necessary for absorption of Calcium from the food products, i.e; Calcium that we get from our diets cannot be used by our body until and unless vitamin D is there to assist its absorption. Thus its deficiency manifests as Rickets in children and Osteomalacia in adults where bones get deformed, brittle and more vulnerable to fractures.
Not only this, recent researchers have found the important role of vitamin D in immunity, healing processes, hair growth, even cancer protecting properties and decreased risk of cardiovascular diseases.
Symptoms of Vitamin D deficiency
- Muscle and bone pain (especially muscles and bones that experience more stress comparatively such as back and legs)
- Fatigue/ tiredness
- Minor injuries resulting in fractures
Here it is worth paying attention that initial symptoms are not taken seriously by most of us as we think of it as routine tiredness but we must rule out any nutritional deficiency in such cases.
Treatment of Vitamin D deficiency
- Dietary intake
- Dairy products, fruits and dry fruits, fish, egg cord liver oil, fortified food.
- Sunlight exposure
- A brief exposure of to sunlight twice or thrice in a week for 10-20 minutes is sufficient.
- Vitamin D supplements under the guidance of a medical professional.
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A medical student,always curious, patient listener,; anemoid, lachesist, adronitic-occhiolic-monachoptic Homo sapien. Sonder steers me towards liberosis.
Astrophe is my caffeine.