Vitamin D is vital for good bone health
VITAMIN D is acquired or produced after ultraviolet light stimulation of the skin that produces pro-vitamin D, which is subsequently converted to pre-vitamin D in the skin.
This then goes to the liver and it is further activated or converted to another type of vitamin D, which subsequently goes to the kidneys and is activated to form the active form of vitamin D.
Vitamin D is required in various functions in the body, mainly for the maintenance of a normal calcium level.
It increases the absorption of calcium through the intestines.
Apart from sunlight, sources of vitamin D include dairy products, fish and vitamin D supplements.
There is a misconception that, because we live in sunny South Africa, most people have adequate levels of vitamin D.
However, studies have shown that vitamin D deficiency is quite common.
This can negatively impact on calcium metabolism and can lead to other consequences of prolonged calcium deficiency, including bone health.
According to studies, many patients with osteoporosis are vitamin D deficient because of inadequate dietary intake, as well as inadequate exposure to sunlight.
Calcium is required for various functions of the body, including muscle contraction, and vitamin D deficiency leads to calcium deficiency.
This can lead to muscle pains and various other nonspecific symptoms.
Vitamin D deficiency may also affect cell function, proliferation of the cells and the immune system.
Those who are deficient should start taking supplements as soon as possible.
In the long term, vitamin D deficiency can also lead to muscle weakness, which in the elderly can be catastrophic because they have a higher risk of osteoporosis and weakness of the muscles.
It can lead to recurrent falls and fractures from osteoporotic bone.
Vitamin D deficiency can also increase the level of the parathyroid hormone, which further increases the risk of osteoporosis.
We are currently doing a study that is as yet unpublished, but preliminary data has shown that a number of people with various types of arthritis are vitamin D deficient.
Although this type of deficiency seems to be prevalent in many patients with autoimmune disease, including those with rheumatoid arthritis, the contribution of low serum vitamin D to the development of rheumatoid arthritis and risk is less clear.
In terms of managing vitamin D deficiency, exposure to sunlight is a double-edged sword. On the one hand, it improves vitamin D production, and on the other, it increases the risks for certain skin cancers with excessive exposure to sunlight.
If you have early morning rising sunlight, that can only help to increase vitamin D and not have any side-effects.
Hence Indian culture and tradition consists of Suryanamaskar (sun salutations) and giving Ardhya (water to rising sun with minimum clothes during or after bath).
Eating more dairy products and fish will also increase vitamin D levels, but this is problematic for strict vegetarians.
Various over-the-counter supplements are available, as well as in prescription medication.
It is advised that people be more aware of the possibility of vitamin D deficiency. Doctors should be doing vitamin D levels in most patients and supplements should be prescribed whenever necessary.
Dr Ajesh Maharaj MBBS IMS.BHU (Varanasi) H.Dip.Int.Med (SA), FCP (SA) Certified in Rheumatology (SA)