CHENNAI: Have you been feeling extra tired and lethargic than usual even as you have been doing lesser physical work? Have you been experiencing new pain or discomfort in joints or muscles during the lockdown? Chances are, you might have deficiency of nutrients, particularly Vitamin-D.
Vitamin-D is produced by the human body in response to sun exposure. The ultraviolet radiation from the sun helps synthesise it. With the pandemic and the lockdown pushing people indoors for weeks, doctors say there is an increase in the number of people with Vitamin-D deficiency in cities. Vitamin-D, also known as the sunshine vitamin, is instrumental in increasing intestinal absorption of calcium, magnesium and phosphate. In addition, it modulates the response of the immune system that leads to inflammation in the body.
Who could develop deficiency?
“We often find that even one-year-old babies have Vitamin-D deficiency, so we may have to give them supplements,” said Dr Latha Ravichandran, Associate Dean of Education and Professor of Pediatrics at Sri Ramachandra Medical College. Babies with the deficiency may have soft skulls and children may develop a condition called rickets.
She added that those with kidney and liver problems absorb Vitamin-D into their body poorly. South Indians in general, and those with dark skin, in particular, already have a higher risk of developing Vitamin-D deficiency as the melanin in dark skin reduces penetration of sunlight into the body, said Dr P Keerthivasan, Consultant Orthopaedics and Spine Surgeon, Kauvery Hospitals.
Impact of deficiency
While Vitamin-D is crucial for bone development, a deficiency does not directly lead to brittle bones and fractures, said Keerthivasan. Instead, he said, there was an increase in the number of patients showing up with general tiredness, muscle or bone pains or chronic hip pain. “We initially thought this was because of lack of physical activity. We have seen patients come in with lethargy and discomfort, only to find them to be deficient in Vitamin-D,” he said, adding the problem is exacerbated by the sedentary lifestyle and poor ergonomics of the work-from-home culture.
Dr AR Kesavan, Senior Consultant and Orthopaedic Surgeon, Gleneagles Global Health City, while also agreeing that a persons with multisystem malaise turned out to be deficient in Vitamin-D, added that in more severe cases he observed a phenomenon called “pseudo fractures.” He said these patients show up with chronic pain in areas like hip. “Sometimes the bone scans show a thin black fault line in between white bones. It might look like a fracture, but it is not; instead they have a prolonged deficiency of Vitamin-D. This weakness may cause a fracture later though,” he said. He pointed that studies have also shown that a Vitamin-D deficiency also tends to worsen the impact of Covid on patients.
Solutions
The most efficient way to increase Vitamin-D in the body is by exposing your arms and face to direct sunlight between 11 am and 3 pm, said Meenakshi Bajaj, Dietician, Government Multi Super Speciality Hospital, Chennai. “Exposing at least 18 per cent of skin to direct sunlight even for 15 to 20 minutes significantly boosts Vitamin-D production,” she said. In cases where people have no access to open spaces, exposing the body near windows that allow direct sunlight may help.
She explained that women, particularly those wearing veils, have a higher risk of developing bone diseases like Osteoporosis. She added that ageing, application of sunscreen lotions and high melanin levels also diminished the skin’s capacity to synthesise the vitamin. “There are food sources of Vitamin-D, but it’s not enough to meet the requirement with food alone,” she said. Some food items like fortified orange juice, fortified oils, egg yolk, cheese, fish, cereals and dairy products have Vitamin-D.