Vitamin D

Vitamin D

What is vitamin D and why is it important?
  • Vitamin D is an essential nutrient that your body requires to stay healthy.
  • Vitamin D is essential for strong bones, because it helps our body to use calcium from our diet. And we know that calcium is essential for building and maintaining strong bones.
  • Other than for bone health, Vitamin D also helps to protect against many other health problems, such as some cancers, diabetes, heart disease, and high blood pressure.
What happens to bones if I do not get enough vitamin D?
  • A low level of vitamin D in the body is referred to as a "vitamin D deficiency."
  • Without Vitamin D, calcium cannot be absorbed and used effectively by our body.
  • Children who don't get enough vitamin D are at risk for rickets. Rickets is a disorder that affects the bones, causing them to soften and bend easily. Children with rickets also can have stunted growth.
  • Lack of vitamin D is not quite as obvious in adults. One might experience:
    • Fatigue.
    • Bone pain.
    • Muscle weakness, muscle aches, or muscle cramps.
    • Mood changes, like depression.
  • Long-standing Vitamin D deficient in adults can cause osteomalacia (weak bones), osteoporosis (thin bones). This can increase the risk of bone fractures and falls.
How do I get vitamin D?
  • There are 3 ways to get vitamin D
    • exposure to sunlight
    • vitamin D-fortified foods
    • dietary supplements
  • Sunlight: Vitamin D is also called the "sunshine vitamin" because your skin can make Vitamin D when exposed to sunlight. In India, where it is sunny most of the time you probably only need 15-20 minutes of sunshine 3 to 4 times a week to help your body create the vitamin D it needs.
  • Vitamin D-fortified foods: Food is not a very good source of Vitamin D. Most natural sources that have enough Vitamin D are animal in origin like fish, fish oils, egg yolks, cheese, butter. For strict vegetarians, it might be useful to look for Vitamin D fortified foods as milk, milk alternatives, some brands of orange juice, and some vitamin-fortified breakfast cereals. Read the food nutrition labels to learn if the products you choose are sources of vitamin D.
  • Dietary supplements: Vitamin D is available as supplements. If you are concerned that you are not getting enough Vitamin D, and wish to take supplements, talk to your family doctor.
How much vitamin D do I need daily?
  • Adults need at least the following amounts of vitamin D:
    • < 70 year olds = 600 international units (IU) daily
    • > 70 year olds = 800 IU daily
  • Children: Talk to your family doctor before giving children vitamin supplements.
Recommended Daily Allowance (RDA) for different age groups
Is there a test for detecting Vitamin D deficiency?
  • 25-hydroxy Vitamin D blood test will tell you whether you have sufficient Vitamin D in your body.
  • A level of 20 nanograms/milliliter to 50 ng/mL is considered adequate for healthy people. A level less than 12 ng/mL indicates vitamin D deficiency.
  • You might not need the test, as doctors will order for this test only if you are at risk for developing Vitamin D deficiency. So before doing the test, speak to your doctor.
How is deficiency treated?
  • The goals of treatment and prevention are the same—to reach, and then maintain, an adequate level of vitamin D in the body. While you might consider eating more foods that contain vitamin D and getting a little bit of sunlight, you will likely be told to take vitamin D supplements.
  • Vitamin D comes in two forms: D2 and D3. D2, also called ergocalciferol, comes from plants. D3, also called cholecalciferol, comes from animals. You need a prescription to get D2. D3, however, is available over the counter. It is more easily absorbed than D2 and lasts longer in the body dose-for-dose. Work with your doctor to find out if you need to take a vitamin supplement and how much to take if it is needed.
Can I overdose on Vitamin D?
  • ⚠️ Yes. You can get too much vitamin D if you overdo the supplements. Vitamin D toxicity is, thankfully, quite rare but can lead to increased calcium in the blood and urine which can lead to kidney stones. Rarely Vitamin D toxicity can lead to a serious neurological symptoms.
  • A common mistake is to take mega doses (6 lakh units injections of Vit D) frequently. Such high doses can lead to toxicity. High doses of Vitamin D should be taken only after consulting with your doctor.
  • Interestingly, you cannot get too much vitamin D from the sun.
Who is at risk for vitamin D deficiency?
  • People who are at risk for vitamin D deficiency include:
  • 👴🏼 Senior citizens
    👨🏿 Dark skinned individuals
    • Melanin is a brown-black pigment in the eyes, hair and skin. Melanin causes skin to tan. The darker your skin, the more sun exposure is needed in order to get sufficient vitamin D from the sun.
    ⛅️ Limited exposure to sunlight
    • People who get limited exposure to sunlight (homebound individuals)
    • People who have an indoor lifestyle
    • Cultural practices such as the burqa and purdah system
    🫓 Difficulty absorbing fat (malabsorption)
    • People who have difficulty absorbing dietary fat (because of conditions such as colitis, inflammatory bowel disease, and cystic fibrosis)
    🥛 Dietary restrictions
    • People with dietary restrictions, such as vegan, milk-allergic, and lactose-intolerance
    🩳 Obesity
    • People who are obese (body mass index [BMI] ≥30). Fat cells keep vitamin D isolated so that it is not released. Vitamin D deficiency is more likely in obese people. Obesity often makes it necessary to take larger doses of vitamin D supplements in order to reach and maintain normal D levels.
    🚶🏽‍♂️ Weight loss surgeries (Bariatric surgery)
    • Weight loss surgeries that reduce the size of the stomach and/or bypasses part of the small intestines make it very difficult to consume sufficient quantities of certain nutrients, vitamins, and minerals. These individuals need to be carefully monitored by their doctors and need to continue to take vitamin D and other supplements throughout their lives.
    🎴 Kidney Disease
    • People with kidney disease, including kidney transplant recipients
    💊 Some medications can lower Vitamin D levels.
    • Laxatives, steroids (prednisone), Cholesterol lo
    👶🏼 Infants who are only breastfed
    • Breast milk only contains a small amount of vitamin D. Often infant formulas also only include a small amount of D also. Therefore infants are at risk of not receiving enough vitamin D. This is especially true for infants who are only fed breast milk.