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Essentials for Healthy Living : Soak up the Sunshine Vitamin!

Submitted by on April 10, 2014 – 9:13 PM

vitamin-d-and-the-sunA 40 year old woman visited the O.P.D with complains of bone pain and muscle pain for the last 8 months and her lab reports confirmed hypovitaminosis D. She being completely unaware of her problem, asked her physician the following questions .
What is vitamin D?

Also called the sunshine vitamin, this vitamin is a group of fat soluble vitamin mostly vitamin D3 and vitamin D2. It is not an essential vitamin as our skin has the ability to synthesize it only  when exposed to sunlight. It is metabolised in liver and kidney and converted into active form, calcitriol (1,25-dihydroxycholecalciferol). This synthesis is influenced by parathyroid hormone. Hypovitaminosis D is deficiency of vitamin D. This deficiency is relatively more common in women of our region as our body is properly covered which prevents appropriate introduction of sunlight into our skin.

 

What does it do?

It is important for regulation and movement of calcium. Calcium along with phosphorus is dependent on vitamin D for its absorption from intestines.

How is it obtained?
Vitamin D can be obtained from fortified milk, cheese, whole eggs, liver, salmon and fortified margarine. Above all our skin synthesizes it when exposed to sunlight.
 How does vitamin D deficiency present itself?
Manifestation in children is in the form of rickets. These children start walking late and prefer to lie down for long periods. On physical examination these children will present with bowed legs.
In adults, the deficiency manifests itself as osteomalacia and patient will complain of chronic muscle aches and pains. On examination if sternum and tibia are firmly pressed it will reveal periosteal bone pain.
How to confirm vitamin D deficiency?
The best way to determine hypovitaminosis is by checking serum levels of 25-hydroxy vitamin D:
–       Insufficient level is 21-29 ng/dl (52.5-72.5 mmol/l)
–       Deficient <20 ng/dl ( 30 kg/m2
•       Patients with chronic kidney or liver diseases.
How can it be managed?
Treatment of children includes:
•       2000 IU/DAY  of vitamin D2 and D3 for atleast 6 weeks or
•       50,000 IU of vitamin D2 once a week for 6 weeks
Treatment for adults includes:
•       50,000 IU of Vitamin. D2 or D3 once weekly for 8 weeks or
•       6000IU/DAY for 8 weeks.

 

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