Saturday, 19, October, 2019

Vitamin D Deficiency and Its Management

 

Dr. Pratik Paudel
Consultant Physician
Kathmandu Neuro and General Hospital

Do you get exhausted easily? Do you get palpitations very often? Do your muscles feel sore and weak? Well, then there is a great likelihood that you could be a victim of Vitamin D deficiency.

Vitamin D (calciferol) belongs to a group of fat soluble secosteroids. In humans, vitamin D is unique because of its functions as a prohormone as well as its synthesis to vitamin D3 in the body when exposed to adequate sunlight.

Vitamin D regulates the concentration of calcium and phosphate in the body and promotes healthy growth and remodelling of the bone. Vitamin D prevents rickets in children and osteomalacia in adults. Along with calcium, it protects elder adults from osteoporosis.

Vitamin D also affects neuromuscular functions, causes inflammation and influences the action of many genes that regulate proliferation and apoptosis of the cells. Vitamin D is also essential for the healthy growth of hair follicle as well as for a healthy immune system. Vitamin D deficiency is the main cause of rickets in young infants because breast milk is low in vitamin D and so is the cereal based diet.

Vitamin D & Bones

Vitamin D deficiency is known to cause several bone diseases like:

  • Rickets, a childhood disease characterised by impeded growth and deformity of the long bones. The earliest sign of subclinical vitamin D deficiency is abnormal softening or thinning of the skull
  • Osteomalacia, a bone-thinning disorder that occurs exclusively in adults, and is characterised by proximal muscle weakness and bone fragility
  • Osteoporosis, a condition characterised by reduced bone mineral density and increased bone fragility

People At Risk

  • Naturally dark skinned people
  • Elderly & people who are housebound
  • People who cover their skin for religious or cultural reasons
  • Babies & infants of vitamin D deficient mothers, especially breast fed babies

Signs & Symptoms

  • Poor growth in children
  • Delayed tooth formation
  • Dental deformities
  • Tingling
  • Weakness
  • Muscle cramps
  • Bone pain
  • Spine and other bone deformities
  • Stooped posture and loss of height

Managing Vitamin D Deficiency

25 hydroxyvitamin D level of 20 ng/ml (nanogram/mililitre) in serum is desirable for bone and overall health. Vitamin D intake lower than 100 International Unit (IU)/day is associated with increased risk of hip fracture.

Oral vitamin D replacement or intramuscular injections are prescribed to treat Vitamin D deficiency.

Vitamin D Facts

  • Without sufficient vitamin D, which is crucial for calcium absorption in your intestines, your body cannot absorb calcium, thus rendering calcium supplements useless
  • Sunscreens, even the ones like SPF-8 block your body’s ability to generate vitamin D by 95%. Therefore, sunscreen products can create critical vitamin deficiency in the body
  • Natural sunlight rays responsible for generating vitamin D in your skin cannot penetrate glass. Therefore, your body can not generate vitamin D from the sunlight you receive while sitting in your car or home

Research Highlights

Research shows that dark skinned people living in the temperate climate have low Vitamin D levels as melanin in the skin hinders vitamin D synthesis.