It is estimated that about 1 billion people worldwide have low blood vitamin D levels. Though vitamin D deficiency is quite common, most people are unaware of it as the symptoms are subtle and nonspecific.

Vitamin D is important for optimal skeletal health. Major function of vitamin D is to increase efficient absorption of calcium and phosphorus from the small intestine, which is important for proper mineralization of bones. Another function of vitamin D is the maturation of osteoclasts, which resorbs calcium from the bones.

Most common causes of vitamin D deficiency are:

* Inadequate exposure to sunlight and staying indoors most of the time – More common in women than men.

* Elderly age group – Vitamin D production declines with advancing age.

* Being dark skinned.

* Obesity/overweight.

* Not enough vitamin D rich food in diet (like fish, dairy etc.).

* Always wearing sunscreen when going out.

* Malabsorption of vitamin D (in people who have undergone small intestine resection or have diseases like celiac sprue and cystic fibrosis).

* Medicines like phenobarbital and rifampin are associated with vitamin D deficiency.

Vitamin D deficiency in children can cause rickets (presents as bowing of the legs). In adults it causes osteomalacia, which leads to softening and weakening of bones.

Data suggest that vitamin D deficiency may increase the risk for type I and type II diabetes mellitus and stroke and cardiovascular diseases in older adults. Vitamin D deficiency during pregnancy affects the foetus as it plays an important role in the development of foetal brain, bones and lungs.

Vitamin D deficiency is often a silent disease – either with vague symptoms or no symptoms at all. Some common signs and symptoms of vitamin d deficiency are:

* Tiredness and fatigue

* Pain in back and bone pains

* Often falling sick or getting infected

* Depression

* Delayed or impaired or wound healing

* Low bone density

* Hair loss

* Muscle pains

Most dietary sources of vitamin D do not contain sufficient amount to meet daily requirements. Major source of vitamin D is unprotected sun exposure. Exposure to sun, especially between 10 am and 3 pm, can produce vitamin D that could last twice as long in the blood when compared to ingested vitamin D. Sun exposure that results in skin turning pink in light skinned people could result in vitamin D production almost equivalent to ingesting 10,000 to 25,000 IU. Around 20 minutes of good sun exposure, with bare arms and face, 2 to 3 times a week is good enough. Do not expose for an exceedingly long time to prevent sunburn. Diet that includes fish such as swordfish, sardines and salmon, eggs and meat, cod liver oil, breakfast cereals, soy products, dairy products etc is also of prime importance. Vitamin D supplements are also to be taken. Controlling obesity and maintain a healthy body weight is also helpful.

Treating vitamin D deficiency is simple most of the time and can have huge health benefits like decreased risk of hip and nonvertebral fractures, improved bone mineral density, reduction in falls and better muscle strength in elderly etc.

So, if you do not spend adequate time in the sun or use a sunscreen always or have any concerns about your dietary intake/vitamin D deficiency symptoms, you should speak to your doctor.

Dr. Premsudha PV

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