VITAMIN D DEFICIENCY

Vitamin D is a fat soluble vitamin though vitamin D3 is found naturally in small quantities such as oily fish, eggs and fortified foods. The main source of vitamin D is sunlight. Vitamin D is produced by the body in response to skin being exposed to sunlight, hence called sunshine vitamin. Vitamin D helps to make your bones strong, by utilizing calcium from diet. Vitamin d deficiency has been associated with increased risk of skeletal diseases, metabolic disorders, cancer, cardiovascular disease, autoimmune diseases, infections, and cognitive disorders. If you have vitamin D deficiency you may have following symptoms:

• Thinking problem

• Pain in bones of your body

• You may have bone fractures

• You may have unexplained muscle pain

• You may get tired easily

What Causes Vitamin D Deficiency?

A study conducted at national center for rheumatic diseases (NCRD) has shown that among 19 healthy lab workers the vitamin D level was very low (as they work in lab from 8 am to 6 pm). They do not have sufficient exposure to sunlight. From this what can we conclude is most of the people who are working in office from 10 am to 5 pm are at increased risk of vitamin D deficiency.

The cause for vitamin D deficiency in Nepal might be followings:

· Traditional and religious clothing habits and life style which prevent skin from sun exposure

· Wearing sunscreen to prevent from sun exposure

• People who do not spend enough time in sunlight

• People having darker skin absorb less sun rays in comparison to people having fair skin.

• Blockage of sunlight by air pollution in cities like Kathmandu might be reason deficient level of vitamin D in people of Kathmandu.

How Is Vitamin D Deficiency Diagnosed?

Your doctor will ask you full history to find out if you have any symptoms that are related to vitamin D deficiency. Measurement of serum concentration of 25(OH) D will tell about the level of vitamin D in blood.

Level of vitamin D:

· Less than 20 nmol/L: vitamin D deficiency

· 20-30 nmol/L : vitamin D isufficiency

· 30-100 nmol/L: vitamin D sufficiency

· Greater than 150 nmol/L: vitamin D toxicity

How is Vitamin D Deficiency treated?

Vitamin D deficiency is treated with the help of vitamin D supplements. We usually prescribe oral cholecalciferol 60000 IU (60 K Vitamin D) once a week for two months followed by once month for six months. Vitamin D can be found as softgels, capsules, tablets, and liquids.

Unfortified foods which are rich in vitamin D such as fatty fish like salmon, beef, cheese, egg yolks, fish liver oils, and mushrooms must be consumed on regular basis. Exposure to sunlight about 20 minutes per day is enough to maintain sufficient levels of vitamin D.

What you should know about vitamin D deficiency?

Patients with vitamin D deficiency may have nonspecific symptoms. Even if you have vitamin D deficiency, remember that vitamin deficiency can’t be cured overnight. Knowing that you are vitamin D deficient, taking vitamin D without the recommendation of doctor may lead to vitamin D toxicity. Vitamin D toxicity may cause side effects like like damage to the kidneys and heart. So always consult your doctor (rheumatologist) before taking vitamin D supplements.

How can I prevent vitamin D deficiency?

· Expose your body to sunlight without sunscreen for at least 20minutes. Remember that over exposure to sunlight for longer time may be harmful for your body. So if you have to go outside for longer than 20 minutes, you should better wear sunscreen.

· Take multivitamins with the recommendation of your doctor

· Consume food that are rich in vitamin D