Vitamin D deficiency

Vitamin D Deficiency – General information

Vitamin D is group of fat-soluble vitamins that plays a major role in the maintenance of organ systems. The two major forms of Vitamin D are Vitamin D2, also known as ergocalciferol, and Vitamin D3 or cholecalciferol. It is an important compound that does the job of regulating the levels of calcium and phosphorous in the blood. Vitamin D is also responsible for the absorption of calcium to form and maintain strong bones thus strengthening the skeletal system. It is also involved in the functioning of the immune system and hormonal system.

Vitamin D is available to the body from common food sources and is also synthesized in the skin on exposure to UV rays. Vitamin D2 or ergocalciferol is present in most fortified foods like cereals and diary products (milk) and from fungal and plant sources. Fish liver oils and fatty fish are a good source of ergocalciferol.

Vitamin D3 is primarily of animal source and is also synthesized in the skin during prolonged exposure to sunlight. For this to happen, the sun must be at an angle of 45 degree or more above the horizon with an UV index greater than 3. Such conditions are available daily in the tropics but occur only during spring and summer in the temperate region and almost never occur in the arctic region. Due to this, the farther a person lives from the equator, the more likely he or she is to develop a vitamin D deficiency.

Vitamin D helps to maintain the organ systems by keeping the levels of the calcium and phosphorus in the blood at check; strengthens the bones and immune systems among other important functions.

Vitamin D deficiency – Symptoms

Vitamin D deficiency was once notorious as the cause of rickets, which was once a major health problem. Once the cause was identified as a vitamin deficiency, a massive program of milk fortification was implemented since the 1930s. Following an increased awareness and availability of fortified foods, rickets was nearly eradicated. But the disease has made a comeback as a result of today’s changing lifestyles. Vitamin D deficiency is a cause for several bone diseases, the most common being rickets, osteomalacia and osteoporosis. When adequate amounts of Vitamin D are not available, bone formation and strengthening becomes retarded. Weakening of the skeletal system paves the way for further structural defects. Rickets is mostly a childhood disease that causes the retarded growth and deformity in the longer bones in the body.

Vitamin D deficiency is also known to be caused by the medical conditions that prevent the kidney from converting the vitamin to its active hormone form. There are illnesses like the coeliac disease and Crohn's disease that prevent the adequate absorption of the vitamin from the digestive tract. Older and obese people are more prone to this deficiency due to the slow down of the Vitamin E production. Dark-skinned people also have a higher risk as the dark skin blocks out a large percentage of the sun rays. Moreover, the usages of sun screens are not recommended as they also absorb the useful rays before they can reach the skin.

Vitamin D deficiency – Treatment

The best way to check out the Vitamin D Deficiency in Adults is by Blood tests (specially for testing osteomalacia) while in some particular cases, density of the bones can be tested. For the children, X-rays are recommended specially for the joints like wrists and knees. However, blood tests can be used for them also. Moreover, a physical examination of the bones can reveal a lot as they shall appear painful to touch. Other tests that can be done are ALP (alkaline phosphatase) isoenzyme, PTH (Parathyroid hormone), Calcium (ionized), and Urine calcium.

As per the case, the treatment can be done wherein the diet is replaced with one rich in phosphorus, calcium, or vitamin D. Deformaties can be revented or reduced by bracing or positioning. However, in some deformities cases, corrective surgery is the only way out. The general treatment recommended is exercise, diet rich with calcium, calcium supplements and Vitamin D. However, supplements should be taken under the guidance of a medical supervisor. Due to the difficulty in judging the amount of Vitamin D required by the body, the required amount is given as a measure of an Adequate Intake (AI) instead of the usual Required Daily Amount (RDA). Therefore, the unit used is International Units (IU) and 40 IU makes a microgram (mcg). Calcium and Vitamin D supplements are in various forms. The AI for Vitamin D (as ergocalciferol or cholecarciferol) for all under 50 years (whether male or female or pregnant or lactating) is 200 IU; for 51-70 years (400 IU) and 70+ years (600 IU). As one ages, you can take Vitamin D along with the calcium to reduce fractures.

Regarding the Vitamin D supplements, they are available in various forms such as Oral (ergocalciferol); intravenous (calcitriol); topical (calcipotriene or calcitriol), or intramuscular (ergocalciferol). Now, the Oral supplements of Vitamin D and calcium can be taken together. Although, oral supplements may be easily obtained, other forms require a prescription. Intake of supplements is more effective when taken with meals. People having simple deficiency can go for daily regular supplements like Adcal D3 or Calcichew D3; while others might have Vitamin D Injection (calciferol-vitamin D2) which can last for a year. The injection also relieves those suffering from osteomalacia.

Calciferol is the safe bet for those having intestinal problems. During the healing of bones, extra calcium is required. Moreover, those having severe disorders of liver or kidney and epilepsy or any other seizure disorder should be careful in taking these supplements. Moreover, using more than required quantity of mineral oil, stimulant laxatives, and long term use of corticosteroids can disrupt the Vitamin D functioning. You should know the medications you are taking before taking any Vitamin D supplements as they can effect the absorption and metabolism of the Vitamin D levels- for example barbiturates, Heparin, carbamazepine, phenobarbital, Rifampin, isoniazid, H2 blockers, colestipol, cholestyramine, Phenytoin, fosphenytoin.

Side effects includes: loss of appetite, thirstiness, odd taste, headache, diarrhea, vomiting, confusion, constipation, and weakness.