Decode Vitamin D

A recent study by doctors in the United States revealed that several people abroad suffer from a lack of Vitamin D. The doctors abroad attributed the fact that several people in colder countries suffer from a Vitamin D deficiency owing to little or no exposure to the sun. However, despite the fact that Indians do get their fair share of exposure to the sun, the fact remains that several Indians too suffer from a Vitamin D deficiency.

The problem is extremely relevant to India. In several studies that were conducted observing toddlers, adults and the elderly in rural and urban India and across all sections of society, revealed a rampant deficiency of Vitamin D. In fact, in a study that observed around 60 healthy women in the age group of 25 to 30 years, it was found that more than 80 per cent of the women suffered from a lack of Vitamin D.
Despite the fact that most Indians are exposed to enough sunshine, Indians still suffer from a Vitamin D deficiency and listed below are reasons for the same:
Vitamin D is the most important factor that facilitates the absorption of dietary calcium. This is significant as the absorbed calcium is deposited in the bones and strengthens the same. A deficiency of Vitamin D and the subsequent lowering of serum calcium causes an increase in the secretion of the parathyroid hormone (PTH) as a compensatory mechanism and the PTH mobilises calcium from the bone into the blood making the blood levels of calcium critical to several body processes. This leads to a weakening of the bone and can cause Rickets in children or osteomalacia in adults. In addition, a Vitamin D deficiency is associated with poor muscle strength, particularly in the muscles around the hip. This combined with weaker bones translates into a higher risk of falls and fractures particularly in the elderly. Studies from India have reported a younger age of the onset of fractures of the hip compared to the west. It is important to understand that diseases like Rickets, osteomalacia, muscle weakness and fractures occur in severe cases of Vitamin D deficiency. Even a milder deficiency of Vitamin D is extremely common and can often be asymptomatic or cause minor aches and pains.
More recently, a deficiency of Vitamin D has been linked with a tendency to develop infections including tuberculosis, autoimmune diseases and cancer.

Pump that vitamin
It is important to maintain a high level of Vitamin D to ensure good health and one can easily do the same by consuming milk, egg yolk, fatty fish (sardines, mackerel), margarine, Swiss cheese, liver and codliver oil. The daily requirement of Vitamin D varies between 400-1000 IU per day, the highest requirement being in pregnant and lactating mothers and post-menopausal women.
In addition, one can also take therapeutic doses of Vitamin D as sachets or injections as per a doctor’s prescription followed by a maintenance dose of Vitamin D. It is possible to prevent a deficiency of Vitamin D by spreading awareness about the need for adequate exposure to the sun.

Dr Rohini S. Samant is a consultant rheumatologist and physician at the Hinduja National Hospital, Mumbai.

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