Are you suffering from the most common vitamin deficiency?

WORLDWIDE, vitamin D deficiency is the most common vitamin deficiency. Inadequate exposure to sunlight is the most frequent cause. Unbelievably, vitamin D deficiency is very commonplace even in sunshine- drenched countries. Vitamin D deficiency can also result from poor dietary intake. It is challenging to meet one’s vitamin D needs without adequate sunshine exposure.

Vitamin D is one of four fat-soluble vitamins. The others are A, E, and K.

The two forms of vitamin D:

• Vitamin D2 – This form is made by plants.

• Vitamin D3 – This is made in the skin when exposed to sunlight. D3 is more active than D2.

Other sources include fortified foods, fatty fish, fish liver oils, liver, and egg yolk.

D2 and D3 are metabolised by the liver and kidneys, respectively, to produce active vitamin D (calcitriol). Vitamin D is stored in the liver and fatty tissue.

Active vitamin D facilitates the absorption of calcium and phosphorous from the intestine. These minerals are then incorporated into bones, facilitating their growth, integrity, and repair.

Vitamin D deficiency most commonly occurs in individuals who:

• Do not spend enough time in the sun.

• Have a darker complexion.

• Are older.

• Cover most of their skin, e.g. for religious reasons, or who wear sunscreen when outdoors.

• Are under 6 months. Other causes:

• Reduced fat absorption. May occur with age.

• Some liver and kidney disorders.

• Certain medications – e.g. corticosteroids, verapamil, asthma meds, chemotherapeutic agents, oestrogen replacement therapy, laxatives, statins, antacids, some diabetes medications, diuretics, PPIs (e.g. omeprazole,

Alocid, Nexium, pantoprazole), Xenical.

Diagnosis One is considered vitamin D deficient if 25-hydroxy- vitamin D blood levels are < 20 nanograms/ mL and insufficient if the level is 20-29 nanograms/ mL.

Vitamin D deficiency in infants and the elderly Infants who are primarily breastfed are predisposed to vitamin D deficiency because breast milk is a poor source of vitamin D. Such infants should be given a vitamin D supplement for their first year.

The elderly are more prone to vitamin D deficiency because:

• Vitamin D requirements increase with age.

• Their skin is not efficient at making vitamin D.

• Many spend most of their day indoors.

• If bedridden/ hospitalized for extended periods.

• May be taking medications that reduce vitamin D absorption.

Symptoms and signs of vitamin D deficiency Initially, most persons with vitamin D deficiency are asymptomatic.Within months to a few years, those who are vitamin D deficient may experience:

• Frequent and more severe respiratory tract illnesses such as upper respiratory tract infections, bronchitis, pneumonia, and respiratory tract complications from COVID-19.

• Extreme tiredness, a long-established and overlooked cause of chronic tiredness.

• Poor sleep, especially in children, has been linked to vitamin D deficiency.

• Musculoskeletal pain especially in the lower back. Those with degenerative arthritis, muscle pains, and  generalized pains are more likely to have vitamin D deficiency than those without such.