Vitamin D, the ‘sunshine’ vitamin, is a nutrient that the body needs for maintaining healthy bones, as bones can absorb calcium only when vitamin D is present. It is produced by the body when the skin is exposed to sunlight, however, more than half of the Indian population suffers from vitamin D deficiency despite being closer to the equator and receiving abundant sunlight throughout the year.
The amount of vitamin D your skin produces depends on many factors, including the time of day, season, latitude, and your skin pigmentation. It also depends on your lifestyle; for example, the use of sunscreen can also decrease vitamin D production.
It is observed that people suffer from a deficiency of vitamin D in both sunshine-deficit and sunshine-sufficient countries across the world. However, it continues to be one of the most underdiagnosed and undertreated nutritional deficiencies, according to a study. The prevalence of its deficiency, ranging from 50% to 90%, is reported in multiple community-based Indian studies done in the past decade. Dr. Edwina Raj, head of services (clinic nutrition and dietetics) at Aster CMI Hospital, says, “Vitamin D is necessary for the absorption of calcium in our body and helps to maintain our bone health. Other beneficial roles of vitamin D include reducing inflammation, immune function, and metabolism of glucose.”
Causes
Experts highlight that the Indian diet is less meat-friendly and fails to meet the vitamin D requirement for a person. Other than low dietary intake, people with liver, kidney, and skin issues also have vitamin D deficiency. The work-from-home culture has also contributed to the high incidence as fewer people are exposed to sunlight regularly. Dr Raj also adds that a person’s inability to absorb vitamin D via food, use of sunscreen, dark skin colour, covering the face and hands while travelling, and prolonged use of medicines like laxatives (for constipation) and steroids causes deficiency too. The inability to convert the vitamin into an active form is observed in those with malabsorptive disorders, cystic fibrosis, celiac disease, Crohn’s disease, post-intestinal surgeries, and obesity.
Symptoms
Vitamin D deficiency in children is called rickets and osteomalacia in adults. Dr Mohan Karisankappa Puttaswamy, consultant orthopaedics at Fortis Hospital, says rickets is a condition in infants and children with soft bones and skeletal deformities caused by the failure of bone tissue to harden. Osteomalacia is a condition in adults of weak and softened bones that is reversible with supplementation. It is different from osteoporosis, in which the bones are porous and brittle, and the condition is irreversible. “Fatigue, tiredness, bone and back pain, muscle weakness, and incorrect growth patterns among children are a few symptoms people must look out for,” Dr Puttaswamy adds.
Treatment
Doctors advise taking oral supplements or injectables, if necessary, to treat the deficiencies in the early stages, depending on the severity and their impact on one’s health. The diet can be tweaked simultaneously with a maintenance dosage of supplements if necessary. Supplements are necessary to prevent and treat the negative impact of vitamin D deficiency before it’s too late. It can be managed later with one’s daily requirements through fortified milk, cooking oil, mushrooms, sea fish, eggs, liver, etc.
Supplements with natural sources are to be introduced initially, and recommending only sunlight exposure may not help if the deficiency is severe. Doctors recommend 5-10 minutes of sunlight exposure to the face or hands between 9 am to 5 pm without sunscreen but advise people to check with dermatologists if one is sensitive towards it, as it may harm the skin. One must not supplement themselves excessively since hypervitaminosis of fat-soluble vitamins like vitamin D is equally detrimental. Excess levels of calcium accumulating in the body can lead to clogged blood vessels, kidney stones, nausea, and vomiting.