VITAMIN D

Vitamin D is a fat soluble vitamin. Unlike other water soluble vitamins such as vitamin B and vitamin C, it can not be excreted out in urine so taking large amounts of it can cause liver and kidney toxicity. Vitamin D helps the body in absorbing calcium and phosphate from  intestines thus regulating its levels. It plays a crucial role in maintaining proper bone structure.

Parathyroid hormone is essentially needed for its conversion to active form.

SOURCES

About 70% of vitamin D is formed in skin in latent form and converted to  active form (cholecalciferol or vitamin D3) in the presence of sunlight.

Last 30% is acquired through diet. Highest amount of vitamin D is found in fatty fish, eggs, fortified milk and liver oils.

LEVELS OF SERUM VITAMIN D LEVELS

CAUSES OF DEFICIENCY

The most common cause of vitamin D deficiency is dietary deficiency.

Limited or no exposure of sunlight can also cause the deficiency.

RISK FACTORS

Individuals belonging to following groups have more chances of being vitamin D3 deficient:

• Breastfed infants
• Older adults
• Post Menopausal women
• People with limited sun exposure
• People suffering from malabsorption diseases or IBD. 

COMPLICATIONS/ DEFICIENCY

Vitamin D deficiency makes it difficult for the body to maintain normal levels of calcium and phosphate in blood. When this happens, calcium and phosphate get released from your bones into circulation. When your bones lack these minerals, they become weak and fragile.

Deficiency of vitamin D in children causes Rickets and in adults, it can lead to osteomalacia.

SYMPTOMS

RICKETS

Symptoms includes:pain or tenderness in the bones of the arms, legs, pelvis, or spine

• stunted growth and short stature
• Kyphosis or lordosis
• muscle cramps
• teeth deformities: delayed tooth formation, defects in tooth
• Bossing of skull
• Legs that bows out
• Bumps in rib cage- harrison sulcus
• Delayed fontanelle closure
• pelvic deformities

OSTEOMALACIA

Deficiency of vit D and thus calcium leads to :

• Softening of bones
• Proximal muscles weakness
• Frequent bone pains
• Increased bone fragility
• Symptoms mimicking osteoporosis
• Increased risk of getting fractures(most common site: femur and pelvis)