Vitamin-D

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What is Vitamin D?
Vitamin D is one in the group of multiple chemicals required by the body in very small quantities serving as intermediaries in various important processes in the body vital for normal functioning and development. Vitamin D is a fat-soluble vitamin. This means that it is stored in our fat cells for use when it is needed.

What are the sources of Vitamin D?
Vitamin D has two biological forms. Vitamin D2 (D2), also known as ergocalciferol, is obtained from dietary vegetable sources and oral supplements. Vitamin D3 (D3), also known as cholecalciferol, is obtained primarily from skin exposure to ultraviolet B (UVB) radiation in sunlight, various foods such as oily fish, fortified foods (milk, juices, margarines, yogurts, cereals, and soy), and oral supplements. Aside from rich sources such as oily fish, the vitamin D content of most foods is between 50 and 200 IU per serving.

What are the functions of Vitamin D?
Traditionally, Vitamin D is considered to have essential role in calcium metabolism and bone remodeling/ strengthening. However, recently many other important processes other than these have been attributed to it. Various benefits associated with adequate vitamin D levels are:
• Prevention of osteoporosis and osteopenia
• Lowering blood pressure in people with hypertension
• Lowering incidence and severity of cardiovascular disorders
• Reduced risk of Type 2 diabetes
• Decreased inflammation and Reduced risk of allergies
• Decreasing dental cavities
• Prevention and treatment of depression as well as mental diseases like Schizophrenia
• Regulating cholesterol levels in the blood
• Decreasing mortality rate from certain cancers like colon, breast, ovarian, melanoma, and prostate cancer

What are the Causes of Vitamin D Deficiency?
An estimated 1 billion people are deficient or insufficient in vitamin D. Almost 25-50% of routine patients encountered in clinical practice have Vitamin D deficiency. The causes for Vitamin D deficiency include improper exposure to Sunlight, Darker Skin, Obesity, Malabsorption diseases and Increasing Age. In addition, a wide variety of medications, including antifungal medications, anticonvulsants, glucocorticoids, and medications to treat AIDS/HIV can enhance the breakdown of vitamin D and lead to low levels. There is also a loss of vitamin D for those with chronic kidney disease, primary hyperparathyroidism, chronic granuloma-forming disorders, and some lymphomas.

How to Assess Vitamin D Deficiency?
Vitamin D deficiency is usually accompanied by normal blood levels for calcium and phosphorus, high-normal or elevated levels of PTH, normal to elevated levels of total alkaline phosphatase, a low 24-hour urine calcium excretion rate, and low levels of total 25(OH)D.
Measurement of the total 25(OH) D level is the best test to assess body stores of vitamin D. The total 25(OH) D level allows for the diagnosis and monitoring of vitamin D deficiency, whereas quantification of 25(OH) D2 and 25(OH)D3 fractions may facilitate treatment monitoring.
The guidelines for serum (blood) 25(OH) D levels are as follows:
• Deficiency: 25(OH)D level below 12 ng/mL
• Inadequate/Insufficient: 25(OH)D level between 12-20 ng/mL
• An adequate 25(OH)D level is between 20-50 ng/mL
• Excessive: 25(OH)D level over 50 ng/mL
https://youtu.be/-ynJVC9g2KU

HOW TO PREVENT AND TREAT VITAMIN D DEFICIENCY?
Many patients and physicians think that adequate vitamin D intake can be obtained via diet alone. This assumption is erroneous. With the exception of fatty fish, the vitamin D content of most foods, including fortified dairy products, is relatively low to nonexistent.
Vitamin D supplementation is safe and inexpensive, but vitamin D deficiency often remains undiagnosed or is undertreated. The amount of vitamin D that is needed to correct a deficiency will depend on the severity of the deficiency. When the blood level is below 30 ng/mL, a minimum of 1,000 IU/day of vitamin D3 will be needed for children and 1,500 to 2,000 IU/day of vitamin D3 for adults. Another rule of thumb is for every 1 ng/mL increase in your blood level you need an additional 100 IU/vitamin D per day.
Getting about 10 to 15 minutes of sun exposure a couple of times per week can also help in Vitamin D synthesis in many people.
Location: New Delhi, Delhi, India

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