It is a condition that is often overlooked, even by physicians. Of course, no one expects a country that is blessed with abundant sunshine throughout the year to be severely deficient in one of the key nutrients that sunshine provides. But experts agree that vitamin D deficiencies are now becoming increasingly common and have the potential to give rise to severe complications when left undetected.
"Ninety per cent of my patients have insufficient Vitamin D levels," says Dr T. Vivek, Consultant Orthopaedic and joint replacement surgeon, St Isabel's Hospital, Chennai. "Clinical studies suggest that a majority of us don't get the Vitamin D levels we need. When the body lacks Vitamin D, it is unable to absorb calcium effectively. This can cause joint pains and general weakness; it can trigger lower back aches and lead to rapid bone loss. Many people assume that their aches and pains are a result of old age or common degenerative diseases such as spondylitis or arthritis, but the lack of Vitamin D is often the primary cause. Awareness is crucial to reverse the condition and to build stronger bones, especially before you age."
Desperate for D
Experts say that we need at least 30-50 ng/ml of Vitamin D, but for most people, the levels hover at less than 10. In an ideal scenario, the liver and kidneys activate vitamin D production after the skin has absorbed a version of it from sunshine. But today, especially since we tend to avoid the discomfort of direct sunlight and often stay indoors during the peak hours of 11 am- 3pm, absorption is severely affected. Other factors affect the production as well. "If you are alcoholic, have kidney or liver disease which is also increasingly common, a Vitamin D deficiency is likely," says Dr Vivek. "As meat products are a natural source of Vitamin D, vegetarians are at greater risk. And since women need greater amounts of Vitamin D during pregnancy and post-menopause, it can affect them more severely."
What does the lack of D do?
In adults, a lack of Vitamin D can cause the onset of diseases such as osteomalacia (the softening of bones due to the lack of calcium) and osteoporosis, (when the bones turn brittle and weak, leaving the body vulnerable to fractures, even from minor falls). In children it leads to a disease called rickets which results in deformities in the skeletal structure.
"This alarming deficiency tends to affect more than just the bones," says Dr Richa Chaturvedi, diabetic endocrinologist, Pushpawati Singhania Research Institute (PSRI), New Delhi. "The latest studies have established that it can make you more prone to diabetes (Type 1 and 2) and heart disease. It also controls hormonal responses throughout our bodies and ensures the healthy functioning of nerves and muscles."
Reversing the deficiency
If you want to increase your vitamin D levels, experts advise at least 15-20 minutes of sun exposure, preferably between 11 am-3pm, when the sun is most intense. "As early morning sunlight is weaker, you would need at least 30 minutes to an hour of exposure," says Dr Chaturvedi. "But even sitting in the sun won't ensure that you get your quota of D. Many factors can prevent absorption. For instance, if you're dark skinned, you tend to absorb less. And your body can't absorb the Vitamin through the barrier of windows (if you're indoors on most days) or if you've applied sunscreen or are wearing thick clothing."
Dietary supplementation
And that's why including Vitamin D in our diets is crucial, either through foods or supplements. In some countries, especially colder climates with weak sunshine, milk is often fortified with Vitamin D. Most dairy and meat products are good sources.
A simple blood test will help your doctor determine the Vitamin D levels in your body and whether you need supplements. Unlike other vitamin tablets, these should not be taken on a daily basis. As excessive Vitamin D can prove toxic, monitoring your needs, your physician will prescribe a weekly or monthly dose of tablets. "Regular exercise will help immensely in strengthening your bones and fighting the condition," says Dr Vivek.
