In winter, the limited number of hours in the sun can lead to some health problems, often related to a vitamin D deficiency

Vitamin D plays an important role in several processes: it strengthens bones, keeps the heart and thyroid healthy and reduces inflammation. There are several causes of its deficiency, find out how to detect them and how to intervene.

WHAT IS VITAMIN D DEFICIENCY?                        

A vitamin D deficiency, or hypovitaminosis D, occurs when blood levels in the body are less than 30 ng/L.

Vitamin D, also known as the sunshine vitamin, is present in the human body in two forms: vitamin D2 (ergocalciferol), taken in through food, and vitamin D3 (cholecalciferol), a hormone synthesised by the body in the skin through exposure to ultraviolet B (UVB) rays.

It is best known for its action in the absorption of calcium and phosphorus, but also plays an important role in other metabolic processes.

In fact, vitamin D, in addition to strengthening bones, is also important for maintaining cardiovascular health, reducing the growth of cancer cells, helping to control infections and reducing inflammation, and the functioning of the thyroid gland.

WHAT ARE THE SYMPTOMS OF VITAMIN D DEFICIENCY?

Vitamin D deficiency is asymptomatic and only manifests itself when the deficiency is very severe.

Symptoms are:

• bone pain
• joint pain;
• muscle pain;
• muscle weakness;
• brittle bones.

In addition, it can also manifest itself with neurological symptoms, such as involuntary muscle contractions (muscle fasciculation disorders), confusional states, difficulty in thinking clearly, recurrent fatigue, anxiety and sleep disturbances.

WHAT ARE THE CONSEQUENCES OF VITAMIN D DEFICIENCY?

Given its role in maintaining bone health, the consequences of hypovitaminosis D include bone metabolism-related diseases such as rickets, osteomalacia and osteoporosis.

Vitamin D deficiency can also favour periodontitis, a dental disease also known as pyorrhoea, caused by weakening of the jaw bones.

Vitamin D deficiency also seems to be connected with many other medical conditions, including diabetes, hypertension, cancer, neurological diseases (such as multiple sclerosis) and rheumatic diseases (such as fibromyalgia).

Studies have also shown a relationship between vitamin D deficiency and skin disorders such as itching, hives and food allergies.

Finally, if a vitamin D deficiency occurs during pregnancy, the foetus will also have reduced levels of this vitamin.

HOW IS THE DIAGNOSIS MADE?

The diagnosis of vitamin D deficiency is made by testing for 25-OH-D (25-hydroxycalciferol or calcidiol), the form in which vitamin D circulates in the blood.

This test is carried out on a blood sample.

WHAT ARE THE CAUSES OF HYPOVITAMINOSIS D?

Vitamin D deficiency can be due to several causes: insufficient dietary intake or increased requirements, impaired intestinal absorption, inadequate exposure to the sun (particularly UVB rays) or excessive use of sunscreen, reduced outdoor physical activity, dark skin, living in areas far from the equator.

In addition, vitamin D deficiency may depend on factors that prevent its conversion into the active form in the body, such as kidney and liver disease or the intake of drugs such as cholesterolaemic-lowering agents, antiepileptic drugs, glucocorticoids (steroid hormones), antifungals and HIV drugs.

WHAT ARE THE RISK FACTORS?

The most common risk factors for vitamin D deficiency are: cigarette smoking, advanced age, obesity, breastfeeding (breast milk is a poor source of vitamin D), Crohn’s disease, coeliac disease, gastric bypass, kidney and liver failure.

In addition, those suffering from osteoporosis, hyperparathyroidism (a disease caused by an excess of parathyroid hormone) and lymphomas are more susceptible to vitamin D deficiency, as are patients suffering from granulomatous diseases (i.e. characterised by the appearance of granulomas, inflammatory formations, in various organs) such as sarcoidosis, tuberculosis and histoplasmosis.

NUTRITION AND VITAMIN D

Remedies for vitamin D deficiency vary depending on the cause and the severity of the deficiency.

For example, if the cause is an insufficient intake through food, an appropriate dietary regimen is prescribed.

Foods rich in vitamin D are cod liver oil and fish oils in general, milk and butter, egg yolk, fish (especially salmon, trout, herring, swordfish, eel, mackerel, tuna, carp) and porcini mushrooms.

Foods fortified with vitamin D are also commercially available, such as milk and yoghurt, margarine, soya milk and breakfast cereals.

The intake of vitamin D through specific food supplements or medication is often recommended.

It is important to follow your doctor’s instructions because taking too much vitamin D can be dangerous and has harmful side effects, especially on the kidneys and heart.

Vomiting, diarrhoea, constipation and mental confusion can be symptoms of vitamin D intoxication.

PREVENTION OF HYPOVITAMINOSIS D?

Normally, exposure to the sun’s rays without sunscreen for at least 15 minutes a day (avoiding the middle of the day to safeguard the health of the skin) ensures vitamin D production of between 80-90% of the daily requirement.

If for a prolonged period one does not receive enough ultraviolet rays, UVB in particular, and there is an insufficient supply of vitamin D through food, it may be useful to resort to specific food supplements or fortified foods.

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Source

Auxologico