Vitamin D deficiency (विटामिन डी की कमी) or hypovitaminosis D is defined as a vitamin D level that is below normal. It most commonly occurs in people when they have inadequate sunlight. The deficiency can also be caused by inadequate nutritional intake, disorders limiting its absorption, and conditions impairing vitamin D conversion into active metabolites—including certain liver, kidney, and hereditary disorders. Deficiency impairs bone mineralization, leading to bone softening diseases such as rickets in children. It can also worsen osteomalacia and osteoporosis in adults. As having numerous health effects, Siddha Spirituality of Swami Hardas Life System brings out in-depth information about vitamin D deficiency for well-being.
A nutritional condition produced by a deficiency of VITAMIN D in the diet, insufficient production in the skin, inadequate absorption from the diet, or abnormal conversion to its bioactive metabolites. It is manifested clinically as RICKETS in children and OSTEOMALACIA in adults.
Vitamin D deficiency Symptoms (विटामिन डी की कमी के लक्षण)
Vitamin D deficiency can be asymptomatic, but may also cause several problems including:
- Osteomalacia, a bone-thinning disorder that occurs exclusively in adults
- Osteoporosis, a condition characterized by reduced bone mineral density and increased bone fragility
- Increased risk of fracture
- Rickets, a childhood disease characterized by impeded growth and deformity of the long bones
- Muscle aches and weakness
- Muscle twitching is commonly seen due to reduced ionized calcium, arising from a low vitamin D
- Periodontitis, local inflammatory bone loss that can result in tooth loss
- There has been an association of vitamin D deficiency and women who develop pre-eclampsia in pregnancy
Vitamin D deficiency Risk factors (विटामिन डी की कमी के जोखिम कारक)
Certain climates, dress habits, avoidance of sun exposure, and the use of too much sunscreen protection can all limit the production of vitamin D.
Elderly people have a higher risk of having a deficiency due to a combination of several risk factors, including decreased sunlight exposure, decreased intake of vitamin D in the diet, and decreased skin thickness which leads to further decreased absorption from sunlight.
Fat percentage (वसा प्रतिशत)
Since vitamin D3 and vitamin D2 are fat-soluble, humans and other animals with a skeleton need to store some fat. Without fat, the animal will have a hard time absorbing vitamin D2 and vitamin D3, and the lower the fat percentage, the greater the risk of vitamin deficiency, which is true in some athletes who strive to get as lean as possible.
There is an increased risk of vitamin D deficiency in people who are considered overweight or obese based on their body mass index (BMI) measurement. The relationship between these conditions is not well understood. There are different factors that could contribute to this relationship, particularly diet and sunlight exposure. Alternatively, it is fat-soluble therefore excess amounts can be stored in fat tissue and used during winter when sun exposure is limited.
Sun exposure (सूर्य का संपर्क)
The use of sunscreen with a sun protection factor of 8 can theoretically inhibit more than 95% of vitamin D production in the skin. In practice, however, sunscreen is applied so as to have a negligible effect on status. The status of those in Australia and New Zealand is unlikely to have been affected by campaigns advocating sunscreen. Instead, wearing clothing is more effective at reducing the amount of skin exposed to UVB and reducing natural vitamin D synthesis. Clothing which covers a large portion of the skin, when worn on a consistent and regular basis, such as the burqa, is correlated with lower levels and an increased prevalence of hypovitaminosis D.
Regions far from the equator have a high seasonal variation of the amount and intensity of sunlight. In the UK the prevalence of low vitamin D status in children and adolescents is found to be higher in winter than in summer. Lifestyle factors such as indoor versus outdoor work and time spent in outdoor recreation play an important role.
Darker skin color (गहरे रंग की त्वचा)
The reduced pigmentation of light-skinned individuals may result in higher vitamin D levels and that because melanin acts like sun-block, dark-skinned individuals, in particular, may require extra to avoid deficiency at higher latitudes.
Rates of vitamin D deficiency are higher among people with untreated celiac disease, inflammatory bowel disease, exocrine pancreatic insufficiency from cystic fibrosis, and short bowel syndrome, which can all produce problems of malabsorption. The deficiency is also more common after surgical procedures that reduce absorption from the intestine, including weight loss procedures.
Critical illness (गंभीर बीमारी)
The deficiency is associated with increased mortality in critical illness. People who take vitamin D supplements before being admitted for intensive care are less likely to die than those who do not take vitamin D supplements. Additionally, vitamin D levels decline during stays in intensive care. Vitamin D3 or calcitriol gave orally may reduce the mortality rate without significant adverse effects.
Vitamin D deficiency Diagnosis (विटामिन डी की कमी का निदान)
Levels of 25(OH)D that are consistently above 200 nanograms per milliliter (ng/mL) (or 500 nanomoles per liter, nmol/L) are thought to be potentially toxic, although data from humans are sparse. Vitamin D toxicity usually results from taking supplements in excess. Periodic measurement of serum calcium in individuals receiving large doses is recommended.
Vitamin D deficiency Treatment (विटामिन डी की कमी का उपचार)
The Canadian Paediatric Society recommends that pregnant or breastfeeding women consider taking 2000 IU/day, that all babies who are exclusively breastfed receive a supplement of 400 IU/day, and that babies living north of 55°N get 800 IU/day from October to April.
Treating this deficiency depends on the severity of the deficit. Treatment involves an initial high-dosage treatment phase until the required serum levels are reached, followed by the maintenance of the acquired levels.
Vitamin D doses and meals (विटामिन डी की खुराक और भोजन)
The study conducted in 152 healthy men and women concluded that diets rich in monounsaturated fatty acids may improve and those rich in polyunsaturated fatty acids may reduce the effectiveness of vitamin D3 supplements.
In another study performed by Cavalier E. et al. 88 subjects received orally a single dose of 50,000 IU of vitamin D3 solubilized in an oily solution as two ampoules each containing 25,000 IU, Laboratories SMB SA, Brussels, Belgium) with or without a standardized high‐fat breakfast.
Vitamin D Foods (विटामिन डी खाद्य पदार्थ)
Salmon is a popular fatty fish and a great source. According to the United States Department of Agriculture (USDA) Food Composition Database, one 3.5-ounce (100-gram) serving of farmed Atlantic salmon contains 526 IU or 66% of the DV.
On average, wild-caught salmon packs 988 IU per 3.5-ounce (100-gram) serving or 124% of the DV. Some studies have found even higher levels in wild salmon — up to 1,300 IU per serving. However, farmed salmon contains only 25% of that amount. Still, one serving of farmed salmon provides about 250 IU or 32% of the DV.
Herring and sardines (हेरिंग और सार्डिन)
This small fish is also one of the best sources. Fresh Atlantic herring provides 216 IU per 3.5-ounce (100-gram) serving, which is 27% of the DV.
Cod liver oil (कॉड लिवर तेल)
Cod liver oil is a popular supplement. If you don’t like fish, taking cod liver oil can be key to obtaining certain nutrients that are unavailable in other sources. It’s an excellent source at about 448 IU per teaspoon (4.9 ml), it clocks in at a massive 56% of the DV.
Cod liver oil is likewise a fantastic source of vitamin A, with 150% of the DV in just one teaspoon (4.9 ml). However, vitamin A can be toxic in high amounts. Therefore, be cautious with cod liver oil, making sure to not take too much.
In addition, cod liver oil is high in omega-3 fatty acids, which many people are deficient in.
Eggs yolk (अंडे की जर्दी)
People who don’t eat fish should know that seafood is not the only source. Whole eggs are another good source, as well as a wonderfully nutritious food.
One typical egg yolk contains 37 IU of vitamin D or 5% of the DV. Levels in egg yolk depend on sun exposure and the vitamin D content of the chicken feed. When given the same feed, pasture-raised chickens that roam outside in the sunlight produce eggs with levels 3–4 times higher.
Additionally, eggs from chickens given vitamin D-enriched feed may have up to 6,000 IU per yolk.
Excluding fortified foods, mushrooms are the only good plant source of vitamin D.
Like humans, mushrooms can synthesize this vitamin when exposed to UV light. However, mushrooms produce vitamin D2, whereas animals produce vitamin D3. Though vitamin D2 helps raise blood levels, it may not be as effective as vitamin D3.
Nonetheless, wild mushrooms are excellent sources of vitamin D2. In fact, some varieties pack up to 2,300 IU per 3.5-ounce (100-gram) serving — nearly three times the DV. These mushrooms can provide 130–450 IU of vitamin D2 per 3.5 ounces (100 grams).
Fortified foods (गढ़वाले खाद्य पदार्थ)
Fortunately, some food products that don’t naturally contain vitamin D are fortified with this nutrient e.g. cow milk, and soya milk.
Vitamin D deficiency is thought to play a role in the pathogenesis of the non-alcoholic fatty liver disease. Some studies have indicated that vitamin D deficiency may play a role in immunity. Those with a deficiency may have trouble fighting off certain types of infections, and other diseases include:
Review studies have also seen associations between this deficiency and preeclampsia.