VITAMIN & WELLNESS
Prevalence of Vitamin D Deficiency Indian endocrinologists warn of vitamin D deficiency Ganapati Mudur. BMJ. 2003 January 4; 326(7379): 12. PMCID: PMC1171971 50% of healthy people surveyed in the studies have poor vitamin D levels. An average of 70 per cent of urban Indians have a Vitamin D deficiency. Indian Society for Bone and Mineral Research Arthritis Foundation of India Vitamin D deficiency is a global problem. Even in India, home to one billion of the earth s people, where there is plenty of sun, 30 to 50% of children, 50 to 80% of adults and 90% of physicians are deficient. Confronting the Worldwide Epidemic of Vitamin D Deficiency by Marc S. Micozzi, MD, PhD, Bethesda Maryland 2008
Sources of Vitamin D 1 Through The Skin 2 From The Diet 3 From Supplements
Who is at Risk? The Elderly Dark-skinned People Overweight or Obese People Musculoskeletal Pain Sufferers People with Limited Sunlight Exposure People Working indoors during the daylight hours Breast-fed Infants and Children with Limited Sunlight Exposure 1 2 3 4 5 6 7 Source: University of California
Vitamin D Vitamin D helps the body control calcium and phosphate levels. If the blood levels of these minerals become too low, the body may produce hormones that cause calcium and phosphate to be released from the bones. This in turn leads to insufficient calcium absorption from the diet. In this situation, the body takes calcium from its stores in the skeleton, which weakens existing bone and prevents the formation of strong, new bone.
Vitamin D & Wellness The benefits of vitamin D are essential for wellness and longevity for several reasons. It Regulates : calcium and phosphorous levels bone formation the immune system inhibits secretion of parathyroid hormone insulin production blood pressure cell growth
Vitamin D deficiency plays a role in following disorders Cardiovascular diseases including stroke & hypertension Diabetes type I & II Cancer, especially prostate Depression & mood disorders Rheumatoid arthritis Low blood calcium levels Osteoporosis/osteomalaciosteomalaci Chronic bone/muscle/joint pain Rickets Inflammatory bowel diseases Periodontal disease Obesity
Obesity is associated with Vitamin-D deficiency. When the diet lacks calcium, whether from D or calcium deficiency, there is an increase in fatty acid synthase, an enzyme that converts calories into fat. Higher levels of calcium with adequate vitamin D inhibit fatty acid synthase while diets low in calcium increase fatty acid synthase by as much as five-fold. Weight normalization is therefore associated with higher levels of Vitamin D and adequate calcium. Infact, obese persons have impaired production of UV-B-stimulated D and impaired absorption of food source and supplemental D. Therefore, obesity is associated with Vitamin-D deficiency.
Signs And Symptoms Of Deficiency Of Vitamin D Vitamin D deficiency symptoms are: Depression Chronic fatigue Weight loss Muscle aches, Muscle weakness Bone pain at any age Diabetes Heart disease Stroke Osteoporosis Vitamin D deficiency in a pregnant woman causes deficiency in the fetus.tetany is caused by hypocalcemia and may accompany infantile or adult vitamin D deficiency.
Sufficiency & Insufficiency of Vitamin D Vitamin D insufficiency can result in: thin, brittle, or misshapen bones hypocalcemia (causing hyperparathyroidism) Sufficiency of Vitamin D helps in preventing: rickets in children osteomalacia osteoporosis in adults Vitamin D also modulates: neuromuscular function reduces inflammation Vitamin D also influences the action of many genes that regulate the proliferation, differentiation and apoptosis of cells. Source: Dietary Supplement Fact Sheet: Vitamin D" Office of Dietary Supplements (ODS).. National Institutes of Health (NIH). 2010-04-11.
Vitamin D Deficiency & Working Patterns Ninety per cent or more of our vitamin D comes from the sun. A major cause of deficiency is insufficient sun exposure of the skin. Vitamin D deficiency is caused, in large part, by modern society's indoor lifestyle. People live, work and play indoors under artificial light. This causes severe deficiencies in exposure to natural light (sunlight) through which vitamin D is usually generated Today, Vitamin D deficiency has become a major health problem with working people as they spend major time of the day indoors. Women working nights and longer hours may be vulnerable to deficits in vitamin D status and associated health hazards. Working patterns and vitamin D status in mid-life: a cross- sectional study Mari ward et.al. Occup Environ Med doi:10.1136/ :10.1136/oem.2010.063479 One of the reason for Vitamin D deficiency is working indoors during major part of the day when sunlight is bright. Greenbaum LA. Rickets and hypervitaminosis D. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 48.
Vitamin D & Its Associations with other Diseases Research suggests that vitamin D could play a role in the prevention and treatment of a number of different conditions, including type1 and type 2 diabetes, hypertension, glucose intolerance, and multiple sclerosis. There are also associations between low 25(OH)D levels and peripheral vascular disease, certain cancers, multiple sclerosis, rheumatoid arthritis, juvenile diabetes, Parkinson's and Alzheimer's disease. Adequate vitamin D may also be associated with healthy hair follicle growth cycles. Amor, KT; Rashid, RM; Mirmirani, P (2010). "Does D matter? The role of vitamin D in hair disorders and hair follicle cycling". Dermatology online journal 16 (2): 3. PMID 20178699 Evidence from clinical and epidemiological studies support a possible relationship between low vitamin D level and Hypertension.
A new study published in the March, 2010 issue of the Journal of Clinical Endocrinology and Metabolism found that a jaw-dropping 59 percent of the population is vitamin D deficient. In addition, nearly 25 percent of the study subjects were found to have extremely low levels of vitamin D. Recent research carried out at the University of Copenhagen has revealed that vitamin D activates the immune system by "arming" T cells to fight off infections. Low blood levels of the vitamin D have been associated with the following: Increased risk of death from cardiovascular disease Cognitive impairment in older adults Severe asthma in children Cancer Vitamin D dramatically reduces susceptibility to infectious disease such as seasonal flu and H1N1. It "activates" the immune system and allows it to function more aggressively in defending against viral invasions.
Toxicity Of Vitamin D High levels of Vitamin D are extremely rare exposure, and it is impossible to achieve toxic levels due to excessive exposure to sunlight. Over consumption of Vitamin D can lead to high levels of calcium called hypercalcemia. Symptoms of hypercalcemia that commonly identifies Vitamin D toxicity are: calcium deposits in soft tissues such as the heart and lungs damage to the kidneys kidney stones loss of appetite weight loss nausea vomiting thirst fatigue muscle weakness restlessness confusion
Prevention Know Your Vitamin D Levels Testing For Vitamin D would help your doctor in: Identifying if your health problems are due to Vitamin D deficiency. Recommending appropriate ways to safely increase sunlight exposure Recommending the right dose of vitamin D supplements. Helps in guiding you with your diet. Tracking your progress with follow-up testing Ask your doctor for preventive tips: Allow yourself limited, unprotected sun exposure- ideally sun exposure (with as much skin exposed as possible for 20 to 30 minutes a day, every day of the year, is the best way to generate adequate levels of Vitamin D. Eat a diet rich in whole foods.- Some fishes- such as salmon, tuna and mackerel, as well as fish liver oils are considered to be the best sources. Some Vitamin D is also present in beef liver, mushrooms and egg yolks. Examples of fortified foods are dairy products like cheese, butter, cream, margarine, milk, breakfast cereals, soy milk, etc. Take a top-quality multivitamin every day Take a vitamin D supplement.
Diagnosis of Vitamin D Blood Test Xray 25 25- Hydroxy Vitamin D Osteoscreen panel 1-(Calcium, Phosphorous, Vitamin D ( 25 hydroxy),pth intact Bone Densometry Test
Treatment D Rise Sachet Contains : 60,000 u Cholicalciferol Marketed by : USV Pharmaceuticals For Deficiency of Vitamin D, once a week for 2 months Followed by once a month Supplement: once a month Rs 23 per sachet To be taken only if prescribed by specialist/ doctor/ physician.
To investigate a problem related to bone metabolism or parathyroid function, possible Vitamin D deficiency or malabsorption, Testing for Vitamin D is essential for complete Wellness
References: Melamed, ML; Muntner, P; Michos, ED; Uribarri, J; Weber, C; Sharma, J; Raggi, P (2008). "Serum 25- hydroxyvitamin D levels and the prevalence of peripheral arterial disease: results from NHANES 2001 to 2004. Arteriosclerosis, thrombosis, and vascular biology 28 (6): 1179 85. doi:10.1161/atvbaha.108.165886. PMC 2705139. PMID 18417640. Evatt, ML; Delong, MR; Khazai, N; Rosen, A; Triche, S; Tangpricha, V (2008). "Prevalence of vitamin d insufficiency in patients with Parkinson disease and Alzheimer disease". Archives of neurology 65 (10): 1348 52. doi:10.1001/archneur.65.10.1348. PMC 2746037. PMID 18852350 Holick, MF (2004). "Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease". The American Journal of Clinical Nutrition 80 (6 Suppl): 1678S 88S. PMID 15585788. April 2007 by Larry E. Johnson, MD, PhDMerck Manuals online medical library Does Vitamin D Deficiency Cause Hypertension? Current Evidence from Clinical Studies and Potential Mechanisms, M. Iftekhar Ullah, Gabriel I. Uwaifo,William C. Nicholas, and Christian A. Koch Volume 2010, Article ID 579640, 11 pages Confronting the Worldwide Epidemic of Vitamin D Deficiency by Marc S. Micozzi, MD, PhD, Bethesda Maryland 2008 Dietary Supplement Fact Sheet: Vitamin D" Office of Dietary Supplements (ODS). National Institutes of Health (NIH). http://ods.od.nih.gov/factsheets/vitamind/ Retrieved 2010-04-11. Greenbaum LA. Rickets and hypervitaminosis D. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 48. Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Epidemic of Vitamin D deficiency sweeping the world. Mike Adams Marcelle Pick OB/GYN NP Is vitamin D deficiency casting a cloud over your health?