Vi­ta­min D de­fi­ciency com­mon in Ire­land

Bray People - - LIFESTYLE - DR MICHELLE COOPER’S

VI­TA­MIN D is a fat sol­u­ble vi­ta­min which means that it can be stored in our body for fu­ture use. The main ac­tion of vi­ta­min D is to help ab­sorp­tion of di­etary cal­cium and phos­pho­rus, which is essen­tial for bone struc­ture and strength.

Vi­ta­min D is made in our skin fol­low­ing ex­po­sure to sun­light. The re­quired sun­light must fall on bare skin for 20 to 30 min­utes, two to three times per week from April to Septem­ber in or­der to achieve healthy amounts of the vi­ta­min in our body. Foods con­tain­ing vi­ta­min D in­clude oily fish, egg yolk and for­ti­fied foods, such as cer­tain mar­garines, ce­re­als and in­fant for­mula.

Those who may suf­fer from Vi­ta­min d de­fi­ciency in­clude:

- Preg­nant or breast feed­ing women, es­pe­cially women who have had sev­eral ba­bies within a short time frame may suf­fer from vi­ta­min D de­fi­ciency. This is be­cause ex­tra vi­ta­min D is re­quired for growth.

- Breast fed ba­bies whose mothers lack vi­ta­min D or ba­bies who are fed for pro­longed pe­ri­ods of time are also at risk.

- Peo­ple who have very lit­tle sun­light ex­po­sure will also re­quire sup­ple­men­ta­tion. In par­tic­u­lar House­bound pa­tients; Peo­ple who cover up when they go out­side; Peo­ple with dark skin; Strict sun­screen users.

- El­derly peo­ple have thin­ner skin which is less ca­pa­ble of mak­ing vi­ta­min D and are a par­tic­u­larly vul­ner­a­ble group.

- Pa­tients with Crohn’s dis­ease, coeliac dis­ease and some types of liver and kid­ney dis­eases are also at risk of vi­ta­min D de­fi­ciency.

- Strict veg­e­tar­i­ans, ve­g­ans or those who do not eat fish cer­tainly re­quire sup­ple­men­ta­tion.

SYMP­TOMS OF DE­FI­CIENCY

Symp­toms are of­ten non­spe­cific or vague: - Ba­bies with se­vere vi­ta­min D de­fi­ciency can have mus­cle cramps, seizures and breath­ing dif­fi­cul­ties. They may be ir­ri­ta­ble, more prone to in­fec­tions, have de­layed teething and may be re­luc­tant to start walk­ing.

- Chil­dren with se­vere de­fi­ciency may have soft skull or leg bones and their legs may look curved.

- Adults with vi­ta­min D de­fi­ciency tend to com­plain of vague aches and pains. In se­vere cases, they may com­plain of dif­fi­culty stand­ing up or climb­ing stairs, and may walk with a wad­dling pat­tern. Bone pains may de­velop in the ribs, hips, pelvis, thighs and feet.

DI­AG­NO­SIS

A di­ag­no­sis of vi­ta­min D de­fi­ciency is based on thor­ough med­i­cal his­tory in­clud­ing pa­tient symp­toms and ex­am­i­na­tion. A sim­ple blood test will be per­formed and this will then con­firm the di­ag­no­sis.

TREAT­MENT

The treat­ment of vi­ta­min D de­fi­ciency is sup­ple­men­ta­tion with a form of vi­ta­min D called er­go­cal­cif­erol or cal­cif­erol. These prod­ucts need to be taken daily for 12 months in or­der to al­low the body to catch up on re­duced lev­els.

Af­ter the de­fi­ciency has been treated, the body’s stores of vi­ta­min D need to be main­tained with fur­ther sup­ple­men­ta­tion. Those treated for vi­ta­min D de­fi­ciency will need to be re­viewed a few weeks or months af­ter start­ing treat­ment. A fur­ther re­view af­ter one year is ad­vised.

PRE­VEN­TION

As men­tioned, var­i­ous groups of peo­ple are prone to de­vel­op­ing vi­ta­min D de­fi­ciency and are there­fore ad­vised to take vi­ta­min D sup­ple­ments. These in­clude the fol­low­ing: - Preg­nant and breast feed­ing women. - Breast fed ba­bies. - Young chil­dren up to the age of five years. - All peo­ple aged 65 years and over. - In­di­vid­u­als whose skin is not ex­posed to sun. - Those who have dark skin. - Peo­ple who suf­fer with cer­tain in­testi­nal, kid­ney or liver dis­eases.

Lack of this Vi­ta­min D is com­mon in Ire­land, as it is made in the skin by ex­po­sure to the sun – some­thing we don’t have a lot of here

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