Common Vitamin D Deficiency Causes And Treatment

The most common Vitamin D Deficiency causes and recommended treatment. Are you wondering if you should be taking vitamin D supplements? The truth is most people today are deficient in this essential vitamin. The biggest reason for low levels of vitamin D is reduced exposure to the sun. According to Van Schooler (2017) people all over the world are deficient in this essential vitamin. 

How is vitamin D made in the body?

So how is vitamin D produced in the body? Ultraviolet (UV) B radiation penetrates uncovered skin and converts cutaneous 7-dehydrocholesterol to previtamin D3. Previtamin D3 is then converted to Calcidiol (i.e. 25-hydroxycholecalciferol) in the liver. Calcidiol is converted to active vitamin D, vitamin D3 (also called Calcitriol 1,25-dihydroxycholecalciferol) in the kidney. 

What does Vitamin D do? 

Vitamin D3  acts at the genetic level, in this sense it can turn specific genes on/off thus regulating the cell’s activities. It does so by binding with the Vitamin D Receptor (VDR), which is present in most cells in the body. 

By now we all know that Vitamin D3, the active form of vitamin D, is required for building and maintaining bones. It also has an impact on the intestines, immune and cardiovascular systems, pancreas, muscles, brain, and the control of cell cycles. (Nair et al.)

 An adequate amount of vitamin D is  required to aid in:

  1. Calcium and Phosphorus absorption from the gut
  2. Maintain immunity, 
  3. Stimulate insulin production, 
  4. Cognitive functions

The Sunshine Vitamin has been demonstrated in clinical studies to-

  1. Help prevent cancer and CVD
  2. Act as an Anti-hypertensive
  3. Reduce the risk of Type 2 Diabetes
  4. Alleviate depression

So, we can keep most diseases at bay by maintaining normal levels of this vitamin.

 

Vitamin D Deficiency Causes:

According to the UK Scientific Advisory Committee on Nutrition (SACN), low serum levels of vitamin D, (below 25 nmol/l (10ng/ml)) increases the risk of poor musculoskeletal health. Vitamin D deficiency is when the levels are below 20 ng/ml. 

VDD poses health risks such as loss of bone mineral density leading to fractures and osteoporosis in adults, rickets in children, the risk of developing CVD (Judd et al.). Moreover, Vitamin D deficiency (VDD) is correlated to Parkinson’s disease, Autoimmune diseases (type 1 diabetes, multiple sclerosis, Rheumatoid arthritis, and auto-immune thyroid disease).

 

Groups at risk of vitamin D deficiency (VDD):

  1. Breastfed infants and  Children, 
  2. Older adults,
  3. Pregnant and breastfeeding women, 
  4. Those suffering from fat malabsorption in the following diseases: Celiac disease, Crohn’s disease, liver cirrhosis, obstruction of the bile duct by gallstones, chronic pancreatitis, cystic fibrosis, gastric bypass (bariatric surgery), short bowel syndrome (after surgical removal of a large part of the small intestine), and small intestinal bacterial overgrowth (SIBO). 
  5. People with limited sun exposure
  6. People with dark skin -Due to a large amount of melanin which results in darker skin, this type of skin takes relatively more time as compared to a lighter skin tone to produce vitamin D. 
  7. Obese people: People with BMI ≥30 have lower serum vitamin D levels in comparison to non-obese people. Obesity may call for a higher intake of vitamin D than usually required since a higher amount of subcutaneous fat captivates more of the vitamin altering its release into the circulation. (Nair et al.)

 

Symptoms of Vitamin D deficiency:

Signs of low vitamin D are non-specific and include frequent infections, muscle weakness, tiredness, tooth decay, and backache. So, it’s wise to get your Vitamin D levels checked if you see these symptoms occurring more often. Supplemental Vitamin D: D3 (cholecalciferol) can help restore vitamin D levels to normalcy (>=20ng/ml). It is more efficacious than D2 (Ergocalciferol).

best sources of vitamin d infographic

Sources of Vitamin-D:

Sunlight: Sunlight is the best source of vitamin D you can get. If you live in a place that receives abundant sunshine, you can get all the vitamin D you need, provided you sunbathe for a few times per week. Exposure to sunlight for 5 -30 minutes sans sunscreen (face, arms, legs, etc.) between 10 am to 3 pm in Summers helps the body synthesize the required amount of vitamin D. Caution: Avoid overexposure to the sun as this may cause sunburn, skin ageing, and skin cancer. 

Vitamin D Food Sources: Make sure you include natural vitamin D rich food sources such as fatty fish (salmon, mackerel, sardines, cod liver oil) and egg (with yolk). Vitamin D-fortified foods such as milk, yoghurt and cheese are some other sources of vitamin D.

If you are a vegan, then you can go for sun-dried mushrooms and microalgae. Sundried mushrooms contain the D2 form of vitamin D. If consumed when fresh, the D2 levels will likely be above 10 μg/100 g fresh. Note: The vitamin D2 levels decrease with storage and cooking. [Cardwell et al.]

Freshwater microalgae were found to contain 80 μg of D3/100 g besides ergosterol, D2 and &-dehydrocholesterol. [Japelt et al.]

This means we can still get some vitamin D in winter, a time when the levels are generally found to be low. And when many people suffer from (SAD) Seasonal Affective Disorders.

If your vitamin D levels are below 20ng/ml, you should consider taking a supplement because the food sources of vitamin D alone are not going to be enough to maintain normal serum levels of this vitamin.

 

How much  Vitamin D should you supplement?

According to the British Nutrition Foundation 10 mcg/day of supplemental vitamin D is sufficient for most people. 

For babies, 8.5 to 10 mcg per day is recommended only if the baby is taking less than 500 ml of formula per day. 10 mcg is recommended for children aged 1-4 yrs. However, for adults higher doses of the vitamin can confer a lot more benefits. The upper safe limit is 4000 IU or 100 mcg. The required dosage depends on the level of deficiency. 

Consult your physician to find the right dose to normalize your vitamin D levels.

 

VITAMIN D Deficiency Treatment:

Even though sunlight is the best source of Vitamin D, it is not available to us throughout the year. Besides, including Vitamin D rich foods alone is not capable of restoring the serum levels of this vitamin to normalcy. Hence the need for vitamin D supplements, especially in winter. 

According to an interesting article I read, vitamin D supplementation has shown a preventive role in respiratory tract infections. Given that vitamin D has an impact on immune responses, it may act as an anti-infective agent as well. But, this is yet to be proved clinically in large populations. 

When it comes to choosing Vitamin D supplements, Biocare has variants for different conditions and age groups. Children can benefit fromflavoured-liquid and bioavailable of vitamin D3. While adults with malabsorption can go for Nutrisorb Liquid Biomulsion D– it can be taken as a sublingual vitamin D spray, under the tongue or as a drop as well They also have Vitamin D drops for babies.

Nutrisun is another company that offers a Vitamin D spray. This is a good choice for vegetarians since they source their vitamin D from lanolin which comes from sheep’s wool. 

Vegan Vitamin D: If you are a vegan, then you would be happy to know that there are vegan sources as well, such as the one that Protea Wellness offers. In their case, vitamin D (cholecalciferol) comes from Lichen (a combination of algae or cyanobacteria and fungi living together). 

Risks of overdosing:

The clinical symptoms of Vitamin D toxicity (VDT) are nausea, vomiting, abdominal pain, apathy, confusion, excessive thirst (polydipsia), excessive urination (polyuria) and dehydration.

Prevent overdosing on vitamin D as it may lead to too much absorption of calcium leading to hypercalcemia. This happens due to excessive long-term intake of the vitamin. Serum levels of Calcitriol higher than 150 ng/ml (375 nmol/ml) is an indication of vitamin D overdose. (Suchowierska et al.)

Always make sure that you buy a vitamin D supplement from a reputed manufacturer to lower the risk of overdose.

Summary: 

The Sunshine Vitamin may play a role to help prevent or reduce the risk of Type 2 diabetes, CVD, hypertension and cancer; alleviate depression apart from aiding the absorption of calcium and phosphorus. 

Vitamin D deficiency is when the serum levels of this vitamin is below 20 ng/ml. 

Limited sun exposure, old age, fat malabsorption, dark skin, and obesity are some causes of Vitamin D deficiency (VDD). 

Signs of low vitamin D levels are frequent infections, muscle weakness, tiredness, tooth decay, and backache. It is best to get your serum vitamin D levels checked if you experience these signs more often. 

VDD gives rise to health risks such as Osteoporosis (in adults), rickets (in children). Research correlates vitamin D to risk of CVD, Type 2 diabetes and other health disorders.

There are some vitamin D rich foods, such as cod liver oil, sun-dried mushrooms, microalgae, and some vitamin D-fortified foods. But these decent sources of vitamin D cannot help you reach normal vitamin D levels if you are deficient in this vitamin.    

Sunlight is THE BEST SOURCE of Vitamin D. It is enough to get all the vitamin D your body needs if bare skin is exposed to sunlight 5-30 minutes. 

If for any reason you are unable to get enough sunlight, resort to Vitamin D supplements, especially the sublingual vitamin D spray. To avoid overdosing, it is best not to take beyond 4000 IU or 100 mcg of vitamin D supplement per day. This is because long term consumption of excess vitamin D leads to toxicity.

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7 Comments

  1. Anusha Ganesan

    Happy to know that you found it useful Iniubong Peter! Sun is THE BEST Source of Vitamin D but you can go for a vitamin D supplement, some natural sources of vitamin D and some fortified sources as well.

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