INDIA  :   Health

Vitamin D deficiency

Saturday , 30 January 2016

Women and children in the UAE suffer from a shortage of Vitamin D, despite enjoying abundant sunshine all year round. This week, TGI takes a look at treatment options for Vitamin D deficiency among Indians

Vitamin D deficiency is one of the most common health problems across the globe. This essential vitamin is created in the human body when exposed to sunlight, and is also referred to as the ‘sunshine’ vitamin. According to doctors, it plays a crucial role in working with calcium to help build and maintain strong bones, and is responsible for many cellular and immunological processes.

“Vitamin D is responsible for good health and strong bones. It plays a key role in the functioning of our muscles, brain, lungs and heart and ensures that the body fights infection. Its deficiency is the primary reason for a wide range of ailments such as diabetes, tuberculosis, osteoporosis, cardiovascular diseases and cancers,” said Dr Pradeep Bhosale, Orthopaedic & Joint Replacement Surgeon at Nanavati Super Speciality Hospital-Mumbai.

Dr Bhosale explained that this fat-soluble vitamin is required for the utilisation of calcium, “If there is a deficiency of vitamin D, all the calcium in the body gets wasted leading to low bone density. Vitamin D is therefore one of the 13 essential vitamins.”

Causes and symptoms

Doctors claim that pregnant and breastfeeding women, overweight/obese people and those above 65 years of age are prone to this deficiency. “Vitamin D deficiency is more commonly seen in women. Post menopause, the body lacks certain hormones because of which it cannot absorb the vitamin. In younger women, an unhealthy diet may lead to this deficiency,” said Dr Shreedhar Archik, Orthopaedic Surgeon at Lilavati Hospital-Mumbai.

Vitamin D deficiency is also common in people allergic to milk; those who are lactose intolerant and in ovo-vegetarians or vegetarians.

Some of common reasons that lead to vitamin D deficiency are:

  • Not consuming sufficient amount of vitamin D. This is likely if you follow a vegan diet. Fish and fish oils, cheese, egg yolks and fortified milk are rich sources of the vitamin.
  • Limited exposure to sunlight.
  • People who are dark skinned. The pigment melanin reduces the skin’s ability to make vitamin D in response to sunlight exposure.
  • People who are obese.
  • Those who are over 65 years of age.

Excessive sweating, bone pain and muscle weakness are major indicators of vitamin D deficiency. To prevent deficiency, doctors recommend 15 minutes of daily exposure to sunlight in the morning, without the application of sunscreen.

“One can include fortified food like salmon, mackerel, tuna (fatty fish) and fish oils, egg yolk, cereals and milk and yoghurt in one’s diet,” said Dr Archik. He added that the Recommended Dietary Allowance (RDA) for adults is 600 international units (IU) of vitamin D a day. While inadequate vitamin D poses health problems, doctors warn against excessive intake of vitamin D, which can lead to vitamin D toxicity.

Dr Archik added that vitamin D toxicity can occur only via intake of vitamin D rich food, and not through excessive exposure to sunlight.

Diagnosis and treatment

Doctors maintain that vitamin D deficiency remains one of the most under diagnosed medical conditions. “Since patients do not come with overt clinical signs and symptoms, it becomes difficult to diagnose the deficiency. Most of the time, it is detected when the patient has severe or prolonged deficiency,” said Dr Sachin Bhonsle, Orthopaedic Surgeon at Fortis Healthcare-Mumbai.

He added that low calcium levels in the blood are one of the markers indicating vitamin D deficiency. To diagnose vitamin D deficiency, doctors recommend a blood test to measure the amount of serum 25-hydroxy vitamin D. “If the 25-hydroxy vitamin D levels are low in the blood test, it indicates that the person is not getting enough exposure to sunlight or is not taking the required dietary vitamin D,” said Dr Bhonsle.

Treatment of vitamin D generally includes vitamin D supplements. “The dosage of vitamin D supplement depends upon the blood test and serum 25-hydroxy vitamin D levels. Only the prescribed dosages should be followed, to avoid vitamin D toxicity. Blood tests should be repeated to monitor the serum level. Also, the patient and their relatives should remain alert for possible side effects,” he explained.

India as a destination for treatment of Vitamin D deficiency

Severe or prolonged vitamin D deficiency leads to bone related problems. India has developed as a medical tourism destination for orthopaedic treatment because of its internationally qualified specialists, low costs and no waiting period. The average cost of medical treatment in India is almost 1/6th of that in developed countries. Surgeries like total knee and hip replacement, hip resurfacing and arthroscopic surgery of shoulder and knee are common orthopaedic procedures that NRIs and foreigners come to India for.

Indian corporate hospitals specialise in the latest techniques and treatments such as minimally invasive surgery, cartilage and bone transplantation, spine surgery and limb sparing surgery.

Indian orthopaedic surgeons are now performing revolutionary surgeries that can reduce recovery time. Surgery is computer-assisted and a standard X-Ray machine provides a real-time image to the surgeon. “Today, the advancement in technology is helping both surgeons and patients. It has tremendous post-operative benefits for patients, with lesser scarring, less blood loss, shorter recovery period and return to normal life in a relatively shorter period of time,” said Dr Deepak Chaudhary, Director at Sports Injury Centre (SIC)-Delhi.