Dr Shivani Sachdev Gour, Gynaecologist and IVF Expert, SCI Healthacare shares her views on how despite being sun abundant in India, Vitamin D deficiency is found in the country especially in women. She discusses the sources by which one can get Vitamin D, consequences and signs of deficiency and how one can measurement it. She further discusses the importance of Vitamin D for women. Vitamin D increases fertility, prevents breast cancer, make bones healthy and strong, prevents PCOD and support immune system. She suggests that one could obtain Vitamin D from three sources namely sun exposure, fortification of staple foods with Vitamin D and Vitamin D supplementation.
Inspite of India being a country of abandoned sunshine, it is estimated that more than 80% of healthy Indians especially women are Vitamin D deficient. Indian women both in urban and rural settings and of all socio economic strata are Vitamin D deficient and are not even aware of this deficiency and its consequences.
Vitamin D deficiency is associated with high prevalence of
- Type2 Diabetes – Vitamin D is required to balance sugar levels in the blood by regulating the secretion of insulin. Hence, Vitamin D deficiency increases the risk of developing Type2 Diabetes later in life.
- Cardiovascular diseases
- Osteoporosis, osteopenia (thinning of bones) – as Vitamin D helps in absorption of Calcium from the food we eat in the intestine. Therefore, Vitamin D deficiency will lead to calcium deficiency as well which will lead to weak and achy bones causing osteoporosis and increased risk of fractures.
- Flu – as Vitamin D plays an important role in activating the cells of the immune system which helps to fight infections. Therefore, if deficiency leads to risk of recurrent infections.
- Infertility – a daily morning walk of 20 minutes under the sun can help in boosting the reproductive system as Vitamin D stimulates the production of female hormone progesterone.
Sources of Vitamin D :-
- Vitamin D is photosynthesized in the skin on exposure to sunlight – UVB rays.
- Animal food sources – fatty fish (salmon, mackerel and tuna), cod liver oil, milk, egg yolk, etc.
Causes of Vitamin D deficiency:-
- Staying indoors – minimal exposure to direct sunlight specially between 10.00 AM to 3.00 PM.
- Lifestyle patterns such as clothing that limit sun exposure.
- Strict vegan diet – most Indians are vegetarian.
- Sun screen lotion.
- Lactose intolerance which has a high prevalence in India.
- Cooking practice in India – shallow and deep frying is prevalent in India during which Vitamin D is thermally degraded.
- Inadequate fortification of dairy products with Vitamin D in India.
- Pollution and smog in the cities can block the sun rays. Therefore, in Indian metro cities 50% females had Vitamin D deficiencies.
Vitamin D helps in promoting healthy bones by promoting the absorption of calcium. Vitamin D is also important during pregnancy as it helps to build the baby’s bones and teath and a deficiency during pregnancy may cause growth retardation, skeleton deformities and low birth weight. After birth the child may develop rickets and delayed physical development. Vitamin D deficiency also affects the pregnant mother as it may lead to complications such as pre term delivery, gestational diabetes, pre eclampsia and infections.
Recommended daily intake of Vitamin D for pregnant women – 4000-6000 IU per day (as advised by Vitamin D Council).
During breast feeding also Vitamin D is important for strong and healthy bones in the baby.
Signs of Vitamin D deficiency:-
- Muscle weakness – a person gets easily fatigued.
- Pain sensitivity is increased
- Stress fractures – as the bones become weak the incidences of fractures increases
- Sleepiness specially in the day times
- High blood pressure – as Vitamin D helps in regulating the blood pressure
- Increased irritability – as Vitamin D affects the levels of serotonin in the brain which impacts hormones.
How to measure Vitamin D deficiency?
- 25 – Hydroxyl Vitamin D blood test – normal range is 20 ngm/ml – 50 ngm/ml.
- Level less than 12 ngm/ml indicates Vitamin D deficiency.
Why Vitamin D is important for women?
# increased fertility
# prevents breast cancer as Vitamin D has shown to prevent breast cancer cell growth and decrease the expression of cancer causing genes. In post menopausal women improvement in calcium and Vitamin D levels reduce the risk of all cancers.
# Strong and healthy bones
# Immune support – the killer cells of the immune system which are responsible for destroying the harmful pathogens are supported by Vitamin D.
# Prevents Polycystic Ovarian Syndrome
Recommended intake of Vitamin D in females (By Vitamin D council) – 1000 Intra Units per 25pounds of body weight
Vitamin D can be obtained from 3 sources:-
- Sun exposure – spending at least 15-20 min. a day in direct sunlight, 3-5 times a week without applying sun screen lotion.
- Fortification of staple foods with Vitamin D.
- Vitamin D supplementation – Commonly available is D3 (cholecalciferol) and 1 alpha hydroxy Vitamin D3. Multi vitamin formulations are also available which contain about 400 intra units of Vitamin D3. Supplementation can be oral or by injections. If the values are very low, injection may be the best option.
Oral: Vitamin D3, 60000 IU granules in 1gram sachets. 1 sachet can be taken at an interval of 1-4 weeks as required.
Injection: Injection Arachitol 600000 units per ml, Intra muscular, every two weeks for 2 months
Taking Vitamin D supplements can cause hypervitaminosis D, which can be dangerous.